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1.
J Contin Educ Nurs ; 52(10): 471-481, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34609252

RESUMO

BACKGROUND: Changing jobs is very stressful for new and experienced nurses alike. However, the focus is usually placed on new graduate nurses. Processes that experienced nurses who transition clinical specialties (new-to-setting nurses) undertake are absent from the literature, threatening negative outcomes. METHOD: Constructivist grounded theory guided discovery of the transition process for new-to-setting nurses, and a trustworthiness protocol was used to augment rigor. RESULTS: Experienced nurses who transitioned clinical specialties shared their experiences via 11 in-depth interviews, resulting in the middle range theory: weathering the storm of uncertainty. Nurses detached, encountered uncertainty, and established practice and place as they changed specialties. Nurses continuously handle change, but as they weather such storms, they can not only survive but also thrive. CONCLUSION: This framework provides a structure for nurse leaders (e.g., staff development professionals) as they support experienced nurses at times of change. These leaders can help nurses to successfully navigate changes to improve the safety, quality, and outcomes of health care. [J Contin Educ Nurs. 2021;52(10):471-481.].


Assuntos
Tempo (Meteorologia) , Teoria Fundamentada , Humanos , Incerteza
2.
Rev Esc Enferm USP ; 55: e20200518, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34515723

RESUMO

OBJECTIVE: To investigate how the diagnosis of cancer during pregnancy occurred and assess its repercussions on the family experience of maternity. METHOD: Qualitative research, based on Symbolic Interactionism and conducted according to the Grounded Theory method. Twelve women diagnosed with cancer during pregnancy and 19 of their family members participated in the study. Data was collected from March 2018 to March 2019, using an identification form and an in-depth interview. The analysis followed the stages of open substantive coding. RESULTS: Data were organized into two categories of analysis: Being surprised by the discovery of cancer during pregnancy, which reveals the course of experiencing pregnancy and being diagnosed with cancer, Suffering from the repercussions of cancer on pregnancy and birth, which describes the repercussions of illness in the experience of pregnancy. CONCLUSION: Cancer during pregnancy was diagnosed in young women based on signs and symptoms that were confused with those of pregnancy and postpartum. The illness brought anxiety, impotence, fear and affected the experience of maternity, as it prevented women from having their pregnancy as planned and required routines different from those of low-risk pregnancies.


Assuntos
Neoplasias , Parto , Feminino , Teoria Fundamentada , Humanos , Masculino , Neoplasias/diagnóstico , Período Pós-Parto , Gravidez , Pesquisa Qualitativa
3.
BMC Psychol ; 9(1): 143, 2021 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-34530938

RESUMO

BACKGROUND: Coping depicts how people detect, appraise, deal with, and learn from stressful encounters. Applying preferred coping strategies in various situations makes the issue a persistent agenda in hospitality workplaces, where women are unduly victims of sexual harassment. Thus, this study aimed to develop a context specific and data-driven coping strategy framework and barriers to coping strategy mechanisms for sexual harassment victimisation against women working in hospitality workplaces. METHODS: A qualitative, grounded theory approach was used. Data were collected from female employees, managers, cashiers, and customers. Semi-structured focus-group discussions and in-depth interview guides were employed. A constant comparative approach was used to describe the meanings and summarise the data. Data were coded, categorised, and networks were visualised using the ATLAS ti version 8.4.24 software package. RESULTS: In this study, six focus group discussions, ten in-depth interviews, and thirteen key informant interviews were conducted. The provided context specific coping strategic framework consists of four strictly interconnected dimensions with corresponding barriers practised by female hospitality employees. These were normalisation, engagement, help-seeking, and detachment. The normalisation dimension encompasses silence, acceptance, denial, refusal, grief, and tolerance. Confrontation, negotiation, retaliation/threatening, and discrimination of the perpetrators were included in the engagement dimension. Elements such as discussing with friends, complaining with supervisors, consulting professionals, and accusing perpetrators were in the help-seeking dimension. Lastly, job-hopping, job withdrawal, work withdrawal, and distancing were in the detachment dimension. Some barriers deterred all dimensions, some factors facilitated normalisation, and some adverse outcomes ended the engagement dimension. CONCLUSION: Our study demonstrated that the coping capacities of sexual harassment among female hospitality employees have been apparent, providing space for stakeholders to intervene. Our new coping strategy framework can serve as a valuable guide for designing context-specific interventions. These interventions could help women and stakeholders prevent sexual harassment, decrease barriers, and alleviate these effects.


Assuntos
Assédio Sexual , Adaptação Psicológica , Etiópia , Feminino , Teoria Fundamentada , Humanos , Local de Trabalho
4.
Rev Esc Enferm USP ; 55: e20210212, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34591062

RESUMO

OBJETIVE: Describing the theoretical sampling process in the development of a Grounded Theory based on the Straussian strand. The objective of the field research, used as an example, was to develop a substantive theory, based on the theoretical framework of Symbolic Interactionism, about the perceptions and experiences of patients, family members, and health professionals regarding the presence of the family during emergency care. METHOD: In the theoretical sampling, 42 participants were recruited, divided into nine sample groups, constituted based on the constant comparative method. RESULTS: The description of this example allowed to identify how theoretical sampling guided data collection, which occurred through the in-depth study of concepts and the search for answers to questions arising from the data. FINAL CONSIDERATIONS: It is expected that the readers find subsidies to understand how theoretical sampling is conducted in a Grounded Theory study, based on the Straussian strand, and thus be able to apply it.


Assuntos
Família , Projetos de Pesquisa , Teoria Fundamentada , Pessoal de Saúde , Humanos
5.
Ethiop J Health Sci ; 31(3): 589-598, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34483616

RESUMO

Background: Spiritual health is one of the important dimensions of the elderly's health, which plays an important role in other dimensions of their health. This study aimed to explain the process of spiritual health of the elderly living in nursing homes. Methods: This grounded theory study was conducted in 4 nursing homes in the city of Arak Iran between October 2019 and September 2020. The participants were 24 elderly people living in nursing homes, two health care providers, one nurse and one family member, first selected through purposive sampling and then, through theoretical sampling. The data were collected through semi-structured interviews and field notes. All the interviews were transcribed verbatim and analyzed based on Strauss and Corbin approach (2008). Results: Six main categories were identified, including helplessness, inefficient supportive environment, spiritual distress, seeking support, relative improvement of spiritual health and factors affecting spiritual health, each of which explains a part of the whole process of spiritual health of the elderly living in nursing homes. Conclusion: Supporting the elderly living in nursing homes is necessary in order to meet their spiritual needs and preserve and promote their spiritual health.


Assuntos
Casas de Saúde , Espiritualidade , Idoso , Teoria Fundamentada , Humanos , Irã (Geográfico)
6.
BMC Cancer ; 21(1): 1013, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34507545

RESUMO

BACKGROUND: When children and young people (CYP) are diagnosed with a brain tumour, Magnetic Resonance Imaging (MRI) is key to the clinical management of this condition. This can produce hundreds, and often thousands, of Magnetic Resonance Images (MRIs). METHODS: Semi-structured interviews were undertaken with 14 families (15 parents and 8 patients), and analysed using Grounded Theory. Analysis was supported by the Framework Method. RESULTS: Although the focus of the research was whether paediatric patients and their families find viewing MRIs beneficial, all patients and parents discussed difficult times during the illness and using various strategies to cope. This article explores the identified coping strategies that involved MRIs, and the role that MRIs can play in coping. Coping strategies were classified under the aim of the strategy when used: 'Normalising'; 'Maintaining hope and a sense of the future'; 'Dealing with an uncertain future'; and 'Seeking Support'. CONCLUSIONS: Coping and finding ways to cope are clearly used by patients and their families and are something that they wish to discuss, as they were raised in conversations that were not necessarily about coping. This suggests clinicians should always allow time and space (in appointments, consultations, or impromptu conversations on the ward) for patient families to discuss ways of coping. MRIs were found to be used in various ways: to maintain or adapt normal; maintain hope and a sense of the future; deal with an uncertain future; and seek support from others. Clinicians should recognise the potential for MRIs to aid coping and if appropriate, suggest that families take copies of scans (MRIs) home. Professional coaches or counsellors may also find MRIs beneficial as a way to remind families that the child is in a more stable or 'better' place than they have been previously.


Assuntos
Adaptação Psicológica/classificação , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/psicologia , Família/psicologia , Imageamento por Ressonância Magnética/psicologia , Adolescente , Criança , Conselheiros , Estudos Transversais , Feminino , Previsões , Teoria Fundamentada , Esperança , Humanos , Masculino , Pessimismo , Pesquisa Qualitativa , Apoio Social , Senso de Humor e Humor como Assunto
7.
Artigo em Inglês | MEDLINE | ID: mdl-34444399

RESUMO

In 2015, the resettlement of 25,000 Syrian refugees in Canada placed a strain on social services. Caseworkers employed in these agencies often come from similar migratory trajectories to those of the refugees. This experiential proximity requires an understanding of the subjective perspectives that caseworkers with migratory paths have of refugees in the context of their professional practice. We analyzed fifteen individual interviews with Canadian caseworkers and conducted field observations of resettlement activities in the Ottawa-Gatineau region using inductive reasoning inspired by grounded theory. Adopting a sociogenetic approach to social representation theory, this qualitative study illustrates how the social representation of refugees among foreign-born caseworkers is highly informed by their migratory past experience, as well as by the social identity and social context from which that representation was socio-generated. Our analysis reveals the mirror effect of the caseworkers as a fruitful concept for understanding the identity-otherness dynamics in the encounter between the distant other (refugee) and the self.


Assuntos
Refugiados , Canadá , Teoria Fundamentada , Humanos , Pesquisa Qualitativa , Serviço Social
8.
Artigo em Inglês | MEDLINE | ID: mdl-34360374

RESUMO

The possibility of coming to a "good death" is a challenging issue that crosses ethical and religious beliefs, cultural assumptions, as well as medical expertise. The provision of palliative care for relieving patients' pain is a practice that reshapes the path to the event of death and gives form to a particular context of awareness, recalling the notion proposed by Glaser and Strauss. This decision redesigns the relationships between patients, practitioners and caregivers and introduces a new pattern of collaboration between them. Our study focuses on the implications of the collaboration between practitioners and caregivers, starting from the assumption that the latter may provide support to their loved ones and to the practitioners, but need to be supported too. We provide a qualitative analysis of this collaboration based on an empirical research that took place in four different settings of provision of palliative care, reporting the contrast between the affective engagement of caregivers and the professional approach of practitioners. We claim that this ambivalent collaboration, while embedded in contingent and incommensurable experiences, brings to the fore the broader understanding of the path to a "good death," outlining its societal representation as a collective challenge.


Assuntos
Cuidadores , Cuidados Paliativos , Teoria Fundamentada , Humanos , Dor , Pesquisa Qualitativa
9.
BMJ Open ; 11(8): e047602, 2021 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-34408039

RESUMO

OBJECTIVES: Traditionally, evaluation is considered a measurement process that can be performed independently of the cultural context. However, more recently the importance of considering raters' sense-making, that is, the process by which raters assign meaning to their collective experiences, is being recognised. Thus far, the majority of the discussion on this topic has originated from Western perspectives. Little is known about the potential influence of an Asian culture on raters' sense-making. This study explored residents' sense-making associated with evaluating their clinical teachers within an Asian setting to better understand contextual dependency of validity. DESIGN: A qualitative study using constructivist grounded theory. SETTING: The Japanese Ministry of Health, Labour and Welfare has implemented a system to monitor the quality of clinical teaching within its 2-year postgraduate training programme. An evaluation instrument was developed specifically for the Japanese setting through which residents can evaluate their clinical teachers. PARTICIPANTS: 30 residents from 10 Japanese teaching hospitals with experience in evaluating their clinical teachers were sampled purposively and theoretically. METHODS: We conducted in-depth semistructured individual interviews. Sensitising concepts derived from Confucianism and principles of response process informed open, axial and selective coding. RESULTS: Two themes and four subthemes were constructed. Japanese residents emphasised the awareness of their relationship with their clinical teachers (1). This awareness was fuelled by their sense of hierarchy (1a) and being part of the collective society (1b). Residents described how the meaning of evaluation (2) was coloured by their perceived role as senior (2a) and their experienced responsibility for future generations (2b). CONCLUSIONS: Japanese residents' sense-making while evaluating their clinical teachers appears to be situated and affected by Japanese cultural values. These findings contribute to a better understanding of a culture's influence on residents' sense-making of evaluation instruments and the validity argument of evaluation.


Assuntos
Internato e Residência , Teoria Fundamentada , Humanos , Japão , Pesquisa Qualitativa
10.
J Adv Nurs ; 77(10): 4035-4044, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34346514

RESUMO

AIM: The aim of this article is to provide practical strategies for maintaining methodological rigour in executing a virtual qualitative study. Strategies are based on evidence from existing research about virtual qualitative methods and on the strategies used by the authors to convert a planned in-person qualitative, grounded theory study to an entirely virtual grounded theory study during the COVID-19 pandemic. The study began in-person in September 2019 and was converted to virtual in March 2020. Virtual data collection was completed in September 2020. DESIGN: This article provides a case exemplar of virtual adaptations made to a study underway when the pandemic rendered all in-person research impractical and potentially dangerous. DATA SOURCES: The strategies discussed are based on our own experiences and the supporting theoretical assumptions of qualitative research, specifically grounded theory methods. IMPLICATIONS FOR NURSING: Nursing scholars conducting qualitative inquiry may find these strategies helpful in continuing research activities during periods of limited access to the phenomena or persons of interest. Furthermore, these strategies allow nursing scholars to conduct rigorous, in-depth research without geographical limitations, providing greater possibilities for international collaborations and cross-institution research. CONCLUSION: Despite novel challenges, methodological adaptations that are carefully planned and purposeful allow qualitative and non-qualitative scholars to continue research activities in a fully virtual manner. IMPACT: This case exemplar and discussion provide practical strategies for qualitative scholars to consider while planning new studies or converting an in-person study to a virtual one. Despite the in-person nature of in-depth qualitative inquiry, a historic pandemic and a changing research environment require qualitative researchers to adapt to virtual methods while still conducting high quality, methodologically rigorous research. Qualitative scholars can use the strategies presented here to continue rigorous qualitative inquiry despite limited access to phenomena or persons.


Assuntos
COVID-19 , Pandemias , Teoria Fundamentada , Humanos , Pesquisa Qualitativa , SARS-CoV-2
11.
BMC Health Serv Res ; 21(1): 759, 2021 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-34332581

RESUMO

BACKGROUND: Adaptation and innovation are both described as instrumental for resilience in healthcare. However, the relatedness between these dimensions of resilience in healthcare has not yet been studied. This study seeks to develop a conceptual understanding of adaptation and innovation as a basis for resilience in healthcare. The overall aim of this study is therefore to explore how adaptation and innovation can be described and understood across different healthcare settings. To this end, the overall aim will be investigated by identifying what constitutes adaptation and innovation in healthcare, the mechanisms involved, and what type of responses adaptation and innovation are associated with. METHODS: The method used to develop understanding across a variety of healthcare contexts, was to first conduct a narrative inquiry of a comprehensive dataset from various empirical settings (e.g., maternity, transitional care, telecare), that were later analysed in accordance with grounded theory. Narrative inquiry provided a contextually informed synthesis of the phenomenon, while the use of grounded theory methodology allowed for cross-contextual comparison of adaptation and innovation in terms of resilience in healthcare. RESULTS: The results identified an imbalance between adaptation and innovation. If short-term adaptations are used too extensively, they may mask system deficiencies and furthermore leave the organization vulnerable, by relying too much on the efforts of a few individuals. Hence, short-term adaptations may end up a barrier for resilience in healthcare. Long-term adaptations and innovation of products, processes and practices proved to be of a lower priority, but had the potential of addressing the flaws of the system by proactively re-organizing and re-designing routines and practices. CONCLUSIONS: This study develops a new conceptual account of adaptation and innovation as a basis for resilience in healthcare. Findings emerging from this study indicate that a balance between adaptation and innovation should be sought when seeking resilience in healthcare. Adaptations can furthermore be divided into short-term and long-term adaptations, creating the need to balance between these different types of adaptations. Short-term adaptations that adopt the pattern of firefighting can risk generating complex and unintended outcomes, but where no significant changes are made to organization of the system. Long-term adaptations, on the other hand, introduce re-organization of the system based on feedback, and therefore can provide a proactive response to system deficiencies. We propose a pattern of adaptation in resilience in healthcare: from short-term adjustments, to long-term reorganizations, to innovations.


Assuntos
Atenção à Saúde , Instalações de Saúde , Retroalimentação , Feminino , Teoria Fundamentada , Humanos , Gravidez
12.
Rev Bras Enferm ; 74Suppl 6(Suppl 6): e20201295, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34406265

RESUMO

OBJECTIVES: to understand the meanings that nursing students and professors attribute to research and research teaching in the context of undergraduate studies. METHODS: this is a qualitative research, whose theoretical and methodological frameworks were Complexity Theory and Grounded Theory. Sixteen students and 14 undergraduate nursing professors from a public university in Rio de Janeiro were interviewed. Semi-structured interviews were used for data collection. RESULTS: causes, actions, and interactions related to research and teaching research in undergraduate nursing are connected with learning science for nursing praxis, which ranges from students' ability to question to their and their professors' understanding of social demands guided by science. FINAL CONSIDERATIONS: nursing professors and students signify research and teaching of this as a structure for the training of nurses for the critical professional capacity needed to meet social demands.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Brasil , Teoria Fundamentada , Humanos , Pesquisa Qualitativa , Ensino
13.
Rev Bras Enferm ; 74(suppl 4): e20200689, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34406273

RESUMO

OBJECTIVES: to identify the reasons for the prevalence of the technocratic model in obstetric care from the perspective of health professionals. METHODS: Grounded Theory. Study approved by two Research Ethics Committees and conducted by theoretical sampling, from July 2015 to June 2017. Twenty-nine interviews were conducted with health professionals from two maternity hospitals in the Southern Region of Brazil. Data collection and analysis was performed alternately; and analysis by open, axial, and selective coding/integration. RESULTS: the technocratic model still persists because the assistance is performed in a mechanized way, centered on the professionals. There is a lack of systematization of care, and under-dimensioning of the nursing staff. FINAL CONSIDERATIONS: obstetric nurses need to review their performance in obstetric centers, the internal organization, the dimensioning of nursing professionals, and become protagonists of care. Investment in academic training/updating the knowledge of midwifery professionals, based on scientific evidence and user-centered care is necessary.


Assuntos
Tocologia , Feminino , Teoria Fundamentada , Pessoal de Saúde , Maternidades , Humanos , Gravidez , Prevalência , Pesquisa Qualitativa
14.
Occup Ther Int ; 2021: 6695052, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34354554

RESUMO

Introduction: Depression in adulthood decreases social participation in the workplace, family, and community, which further results in decreased work performance and cessation and social isolation. There is a high statistic of outpatient consultation and readmission of Thais with depression, yet the mental health support for remission in community life and social participation remains limited and unclear. Further, due to the lack of mental health professional resources, particularly occupational therapists, there is much to be known regarding how such therapists work to support the development of social participation in Thai adults with depression. Objective: This research was aimed at understanding the process of how occupational therapists work to redevelop the social participation of community-dwelling Thai adults with depression. Method: The grounded theory methodology was used in this study. Data were collected through interviews and nonparticipatory observations of 14 participants who had experience providing mental health care in community services. The constant comparative analysis method was employed. Result: Three concepts illustrated a proactive community occupational therapy service for depression (PCOTS-D), namely, integrating depression care in community occupational therapy service (COTS), supporting meaningful participation, and forming collaborative networks. The PCOTS-D supported the reconnection of social participation by leading from proactive depression care service to COTS and then working to support meaningful participation toward the patient's self-management and building collaborative networks with inter- and intraprofessional teams simultaneously. Conclusion: The PCOTS-D presented a holistic view of working with community-dwelling Thai adults with depression by considering the importance of the community and researchers' network to redevelop social participation, promote health and recovery, build teams in depression care, and encourage research evidence to enhance the supportive advocacy policy for Thai people with depression.


Assuntos
Terapeutas Ocupacionais , Terapia Ocupacional , Adulto , Depressão , Teoria Fundamentada , Promoção da Saúde , Humanos , Participação Social , Tailândia
15.
Acta Biomed ; 92(S2): e2021024, 2021 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-34328133

RESUMO

BACKGROUND AND AIM: Little is known about the students' engagement in the training experience and how it is lived by the health professional students. We aim at building a theoretical model of the engagement process starting from their lived experiences with Grounded Theory approach. METHODS: In-depth qualitative interviews are conducted with 12 students from the Master Degree Courses in Nursing, Physiotherapy and Prevention Techniques in the environment and in the workplace, who had carried out and/or were doing internships in the same territory (2nd and 3rd year). Results The health professions' student engagement in the training program is developed in three main phases: initial phase, central phase and final phase, where emotions, behaviours, awareness contribute to the development of the entire engagement process with different relevance. The intertwining of these different components that develop along the stages of the experience gives life to the core category: growing through relationship, which expressed the crucial role of the relational network built during the internship experience in shaping students' engagement. CONCLUSIONS: The results of this study underline the crucial role of students' engagement in the internship experience in favouring both better learning outcomes and perspective professional success and wellbeing. (www.actabiomedica.it).


Assuntos
Internato e Residência , Estudantes de Enfermagem , Teoria Fundamentada , Humanos , Aprendizagem , Estudantes
16.
Artigo em Inglês | MEDLINE | ID: mdl-34299739

RESUMO

In a context marked by negative health indicators that make structural aspects more salient, this paper aimed at understanding and explaining the processes and determinants at work that positively and negatively interfere with the professionals' health in the French public nursing home environment. To this purpose, the qualitative approach by grounded theory was chosen. In total, 90 semi-structured interviews were recorded and 43 were transcribed; in addition, 10 observations of 46 participations in meetings and working groups were carried out in four public service and hospital establishments. Our results indicate that the role of health workers, its definition, and its execution are fundamental to the understanding of their health at work. Two protective and constructive processes are involved in the maintenance and development of the professionals' health in this work, with considerable confrontations with death and suffering: individual and collective control of emotional and cognitive commitment, and the development of resources for formation, information, and cooperation. Nonetheless, they are jeopardized when a lasting imbalance is generated between the work's demands and the available resources. This leads to a loss spiral in organizational, inter-individual, and individual resources that makes it difficult to sustain work.


Assuntos
Pessoal de Saúde , Organizações , Teoria Fundamentada , Humanos , Pesquisa Qualitativa
17.
Rev Esc Enferm USP ; 55: e03776, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34287487

RESUMO

This is a theoretical analysis of Constructivist Grounded Theory and its application in nursing research. It is organized in three topics: Characteristics of Grounded Theory; Philosophical basis of the constructivist strand; and Constructivist Grounded Theory data analysis particularities. The unique characteristics of Grounded Theory that set it apart from other approaches are simultaneous data collection and analyses, theoretical sampling, constant comparison at each stage of analysis, development of memos for reflexive and comparative analysis, and a coding system with an initial and a focused stage that is flexible and guides the analytical process of building a theory. Before embarking on a Constructivist Grounded Theory study, the literature is reviewed to hone the research question. The philosophical assumptions of symbolic interactionism and social constructivism influence the entire process. Constructivist Grounded Theory emphasizes the construction and interpretation of data recognizing social contexts, interaction, the point of view of participants, and their understandings according to the investigation time, place and situation.


Assuntos
Pesquisa em Enfermagem , Teoria Fundamentada , Humanos , Teoria de Enfermagem
18.
J Adv Nurs ; 77(10): 4170-4183, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34227135

RESUMO

AIM: To develop a theory to explain women's experiences about becoming a mother following successful in vitro fertilization treatment. DESIGN: This study is a qualitative study based on a constructivist grounded theory approach. METHODS: Data were collected using a semi-structured interview guide initially that was later to be changed to a flexible interview guide between June 2018 and 2019. Interviews were conducted with 18 women, who became pregnant and mothers following successful in vitro fertilization treatment. Data collection and analysis were performed in a cyclic manner using open, axial and selective coding. This study was reported based on consolidated criteria and was used to report qualitative research data. FINDINGS: The core category, 'non-spontaneous path to motherhood', involved the following four categories: 'the treatment process is exhausting', 'leaving the infertility world', 'pregnancy under the shadow of fear' and 'getting stuck between fertile and infertile worlds' with 10 sub-categories. CONCLUSION: This study provides valuable insight into experiences of these women about becoming a mother. Unlike the Becoming a Mother Theory, it can be said that the anticipation stage, the first stage in the Becoming a Mother Theory, begins at the moment of embryo transfer in these women. Furthermore, the personal stage, the final stage in the Becoming a Mother Theory, is not completed within the first year after birth, even women were found to conceal experiences of in vitro fertilization treatment from the social environment even after birth. IMPACT: This study will provide potential support for obstetric healthcare professionals in better understanding women's experiences about becoming a mother following successful in vitro fertilization treatment.


Assuntos
Adaptação Psicológica , Mães , Feminino , Fertilização In Vitro , Teoria Fundamentada , Humanos , Gravidez , Pesquisa Qualitativa
19.
J Midwifery Womens Health ; 66(4): 452-458, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34240539

RESUMO

INTRODUCTION: Experiences of people of color with maternity care are understudied but understanding them is important to improving quality and reducing racial disparities in birth outcomes in the United States. This qualitative study explored experiences with maternity care among people of color to describe the meaning of quality maternity care to the cohort and, ultimately, to inform the design of a freestanding birth center in Boston. METHODS: Using a grounded theory design and elements of community-based participatory research, community activists developing Boston's first freestanding birth center and academics collaborated on this study. Semistructured interviews and focus groups with purposefully sampled people of color were conducted and analyzed using a constant comparative method. Interviewees described their maternity care experiences, ideas about perfect maternity care, and how a freestanding birth center might meet their needs. Open coding, axial coding, and selective coding were used to develop a local theory of what quality care means. RESULTS: A total of 23 people of color participated in semistructured interviews and focus groups. A core phenomenon arose from the narratives: being known (ie, being seen or heard, or being treated as individuals) during maternity care was an important element of quality care. Contextual factors, including interpersonal and structural racism, power differentials between perinatal care providers and patients, and the bureaucratic nature of hospital-based maternity care, facilitated negative experiences. People of color did extra work to prevent and mitigate negative experiences, which left them feeling traumatized, regretful, or sad about maternity care. This extra work came in many forms, including cognitive work such as worrying about racism and behavioral changes such as dressing differently to get health care needs met. DISCUSSION: Being known characterizes quality maternity care among people of color in our sample. Maternity care settings can provide personalized care that helps clients feel known without requiring them to do extra work to achieve this experience.


Assuntos
Serviços de Saúde Materna , Pigmentação da Pele , Boston , Feminino , Teoria Fundamentada , Humanos , Recém-Nascido , Gravidez , Pesquisa Qualitativa , Qualidade da Assistência à Saúde
20.
BMC Fam Pract ; 22(1): 138, 2021 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-34193075

RESUMO

BACKGROUND: Considering the global refugee crisis, there is an increasing demand on primary care physicians to be able to adequately assess and address the health care needs of individual refugees, including both the somatic and psychiatric spectra. Meanwhile, intercultural consultations are often described as challenging, and studies exploring physician-patient communication focusing on emotional distress are lacking. Therefore, the aim was to explore physician-patient communication, with focus on cultural aspects of emotional distress in intercultural primary care consultations, using a grounded theory approach, considering both the physician's and the patient's perspective. METHODS: The study was set in Region Stockholm, Sweden. In total, 23 individual interviews and 3 focus groups were conducted. Resident physicians in family medicine and patients with refugee backgrounds, originating from Somalia, Syria, Afghanistan and Iraq, were included. Data was analysed using a grounded theory approach. RESULTS: Over time, primary care patients with refugee backgrounds seemed to adopt a culturally congruent model of emotional distress. Gradual acceptance of psychiatric diagnoses as explanatory models for distress and suffering was noted, which is in line with current tendencies in Sweden. This acculturation might be influenced by the physician. Three possible approaches used by residents in intercultural consultations were identified: "biomedical", "didactic" and "compensatory". They all indicated that diagnoses are culturally valid models to explain various forms of distress and may thus contribute to shifting patient perceptions of psychiatric diagnoses. CONCLUSIONS: Physicians working in Swedish primary care may influence patients' acculturation process by inadvertently shifting their perceptions of psychiatric diagnoses. Residents expressed concerns, rather than confidence, in dealing with these issues. Focusing part of their training on how to address emotional distress in an intercultural context would likely be beneficial for all parties concerned.


Assuntos
Angústia Psicológica , Refugiados , Aculturação , Teoria Fundamentada , Humanos , Atenção Primária à Saúde , Encaminhamento e Consulta
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