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"What about me?": lived experiences of siblings living with a brother or sister with a life-threatening or life-limiting condition. "我怎么办?":与患有危及生命或生命垂危疾病的兄弟姐妹共同生活的兄弟姐妹的生活经历。
IF 1.8 4区 医学 Q2 NURSING Pub Date : 2024-12-01 Epub Date: 2024-02-25 DOI: 10.1080/17482631.2024.2321645
Trine Brun Kittelsen, Charlotte Castor, Anja Lee, Lisbeth Gravdal Kvarme, Anette Winger

Background: There is a lack of knowledge regarding siblings' experiences of being a brother or sister of a child with a life-threatening or life-limiting condition. Siblings' perspectives are often expressed through their parents and not by siblings themselves.

Method: This study has a qualitative design within hermeneutic phenomenology. Thirteen siblings (ages 3-29) of children with cancer or genetic conditions participated in semi-structured interviews. Analyses followed a thematic analysis guided by van Manen's lifeexistentials.

Results: One overall theme, "What about me?", illustrates that siblings of children with LT/LL conditions are dealing with their own challenges and needs in the situation while also struggling to receive attention from their parents. The overall theme derives from three subthemes: living with heavy strains, feeling disregarded, and having needs of one's own.

Conclusion: The study revealed that siblings' own needs compete with the needs of the ill child, resulting in the risk of siblings taking a step back rather than expressing what they might actually need themselves. These findings can inform healthcare professionals on the importance of educating and supporting parents and the surrounding community close to the sibling, for example, by helping schoolteachers understand how to meet siblings' needs.

背景:人们对作为危及生命或限制生命的儿童的兄弟姐妹的经历缺乏了解。兄弟姐妹的观点通常是通过他们的父母而不是兄弟姐妹自己来表达的:本研究采用诠释现象学的定性设计。13 名癌症或遗传病患儿的兄弟姐妹(3-29 岁)参加了半结构化访谈。分析以范曼南的生命本质为指导进行主题分析:结果:一个总主题 "我怎么办?"表明,LT/LL 患儿的兄弟姐妹在应对自身挑战和需求的同时,也在努力获得父母的关注。这个总主题衍生出三个副主题:生活压力大、感觉被忽视、有自己的需求:研究显示,兄弟姐妹自身的需求与患病儿童的需求相互竞争,导致兄弟姐妹有可能退后一步,而不是表达他们自己可能真正需要的东西。这些研究结果可以让医护人员了解教育和支持父母及兄弟姐妹身边社区的重要性,例如,帮助学校教师了解如何满足兄弟姐妹的需求。
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引用次数: 0
Socio-ecological factors that influence youth vaping: perspectives from Western Australian school professionals, parents and young people. 影响青少年吸食毒品的社会生态因素:西澳大利亚州学校专业人员、家长和青少年的观点。
IF 1.8 4区 医学 Q2 NURSING Pub Date : 2024-12-01 Epub Date: 2024-02-28 DOI: 10.1080/17482631.2024.2322753
Kahlia McCausland, Sue Booth, Francene Leaversuch, Becky Freeman, Katharina Wolf, Tama Leaver, Jonine Jancey

Purpose: To understand from the perspectives of school professionals, parents and young people the socio-ecological factors that may facilitate and prevent e-cigarette use among young people in Perth, Western Australia.

Methods: Purposive sampling was used to recruit school professionals, parents and young people for one-on-one (n = 35) or joint (n = 3) interviews (in-person n = 11 or online n = 27). Data were analysed using thematic analysis and classified into four domains based on the socio-ecological model: i) individual, ii) interpersonal, iii) organizational/community and iv) societal/policy.

Results: Factors that were found to support vaping among young people included sensation-seeking and risk-taking behaviour; a low-risk perception of vapes; attractive characteristics of vapes; ease of access; perception vaping is a social activity; and lack of knowledge about vaping among parents and school professionals. Vaping prevention messages originating from the familial, educational and community spheres are lacking but wanted by adults and young people.

Conclusions: The pervasiveness of the e-cigarette trade and persistent challenges related to surveillance and enforcement need to be addressed to reduce exposure and access to e-cigarettes. A mixture of "hard" and "soft" public policy tools involving key stakeholders in a range of settings is needed to prevent e-cigarette access and uptake by young people.

目的:从学校专业人员、家长和青少年的角度了解西澳大利亚珀斯青少年使用电子烟的社会生态因素:采用有目的的抽样方法招募学校专业人员、家长和青少年进行一对一(n = 35)或联合(n = 3)访谈(面对面访谈 n = 11 或在线访谈 n = 27)。采用主题分析法对数据进行分析,并根据社会生态模型将数据分为四个领域:i) 个人领域;ii) 人际领域;iii) 组织/社区领域;iv) 社会/政策领域:结果发现,支持青少年吸食毒品的因素包括:寻求感觉和冒险行为;对吸食毒品的低风险认识;吸食毒品的诱人特征;容易获得;认为吸食毒品是一种社交活动;以及家长和学校专业人员对吸食毒品缺乏了解。缺乏来自家庭、教育和社区领域的吸食电子烟预防信息,但成年人和年轻人都希望得到这些信息:结论:电子烟贸易的普遍性以及与监督和执法有关的持续挑战需要加以解决,以减少电子烟的接触和获取。为防止青少年接触和吸食电子烟,需要在各种环境下采用 "硬 "和 "软 "相结合的公共政策工具,让主要利益相关者参与其中。
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引用次数: 0
Manifestations of and factors influencing posttraumatic growth among Chinese Crohn's disease patients: a qualitative exploration. 中国克罗恩病患者创伤后成长的表现及影响因素:一项定性研究。
IF 2.1 4区 医学 Q2 NURSING Pub Date : 2024-12-01 Epub Date: 2024-11-05 DOI: 10.1080/17482631.2024.2422137
Hong Li, Dandan Chen, Chen Zhang, Yunxian Zhou

Objective: This qualitative study aims to explore the manifestations of posttraumatic growth among Chinese patients with Crohn's disease from a cultural perspective and to identify the factors influencing it.

Methods: A descriptive qualitative research method was used. Semistructured interviews were conducted with 19 patients with Crohn's disease from several hospitals in Hangzhou, Zhejiang Province, China, and the China Crohn's and Colitis Foundation.

Results: There were five key manifestations of posttraumatic growth experienced by Chinese patients with Crohn's disease: improving interpersonal relationships, enhancing personal strengths, changing life priorities, expanding possibilities and gaining religious faith. Posttraumatic growth among patients was predominantly influenced by individual factors, the disease condition and social support.

Conclusion: The findings regarding the manifestations of and factors influencing posttraumatic growth in Chinese patients with Crohn's disease are consistent with those in previous studies in patients with chronic diseases. However, our study underscores the multifaceted impact of Chinese cultural characteristics on posttraumatic growth among Crohn's disease patients. These findings can offer valuable guidance for future complex interventions and relevant clinical studies conducted within the Chinese population.

目的:本定性研究旨在从文化角度探讨中国克罗恩病患者的创伤后成长表现,并找出影响因素:本定性研究旨在从文化角度探讨中国克罗恩病患者创伤后成长的表现形式,并找出其影响因素:采用描述性定性研究方法。方法:采用描述性定性研究方法,对来自浙江省杭州市多家医院和中国克罗恩病及结肠炎基金会的 19 名克罗恩病患者进行了半结构化访谈:结果:中国克罗恩病患者经历的创伤后成长主要有五种表现形式:改善人际关系、增强个人力量、改变生活重点、扩大可能性和获得宗教信仰。患者的创伤后成长主要受个人因素、疾病状况和社会支持的影响:关于中国克罗恩病患者创伤后成长的表现和影响因素的研究结果与以往慢性病患者的研究结果一致。然而,我们的研究强调了中国文化特征对克罗恩病患者创伤后成长的多方面影响。这些发现可为未来在中国人群中开展复杂干预和相关临床研究提供宝贵的指导。
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引用次数: 0
Awareness of cardiovascular risk among persons with type 2 diabetes: a qualitative study. 2 型糖尿病患者对心血管风险的认识:一项定性研究。
IF 1.8 4区 医学 Q2 NURSING Pub Date : 2024-12-01 Epub Date: 2023-12-19 DOI: 10.1080/17482631.2023.2294512
Lena Jutterström, Anna-Lena Stenlund, Julia Otten, Mikael Lilja, Karin Hellström Ängerud

Purpose: To describe the process of becoming aware of and acting on personal cardiovascular (CVD) risk in type 2 diabetes (T2D).

Method: A purposive sample of 14 persons living with T2D participated in semi-structured, open-ended, in-dept interviews. The interviews were analysed with grounded theory.

Result: The analysis identified the core category "Balancing emotions, integrating knowledge and understanding to achieve risk awareness and act on it." Five categories describe the movement from not being aware of the risk of cardiovascular disease (CVD) to becoming aware of this risk and taking action to reduce it. Persons with T2D need to transform their knowledge and experience of CVD risk and incorporate it in their individual situations. Emotional and existential experiences of CVD risk can lead to awareness about the severity of the condition and contribute to increased motivation for self-management. However, an overly high emotional response can be overwhelming and may result in insufficient self-management.

Conclusion: Persons with T2D seemed not to fully grasp their increased risk of CVD or recognize that self-management activities were aimed at reducing this risk. However, their awareness of CVD risk gradually increased as they came to understand the severity of T2D and became more emotionally and existentially engaged.

目的:描述 2 型糖尿病(T2D)患者意识到个人心血管疾病(CVD)风险并采取行动的过程:方法:对 14 名 T2D 患者进行有目的的抽样调查,对他们进行了半结构化、开放式的深入访谈。结果:分析确定了 "平衡 "这一核心类别:分析确定了核心类别 "平衡情绪,整合知识和理解,以实现风险意识并采取行动"。五个类别描述了从不曾意识到心血管疾病(CVD)风险到意识到这一风险并采取行动降低风险的过程。终末期糖尿病患者需要转变他们对心血管疾病风险的认识和体验,并将其融入个人情况中。对心血管疾病风险的情感和生存体验可促使人们认识到病情的严重性,并有助于提高自我管理的动力。然而,过高的情绪反应可能会让人难以承受,并可能导致自我管理不足:终末期糖尿病患者似乎并不完全了解自己患心血管疾病的风险增加,也没有认识到自我管理活动旨在降低这种风险。然而,随着他们逐渐认识到 T2D 的严重性,并在情感和生存方面更加投入,他们对心血管疾病风险的认识也逐渐提高。
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引用次数: 0
Understanding family functioning in mothers and daughters with obesity. 了解肥胖症母亲和女儿的家庭功能。
IF 1.8 4区 医学 Q2 NURSING Pub Date : 2024-12-01 Epub Date: 2024-05-11 DOI: 10.1080/17482631.2024.2348894
Becky Marquez, Florencia Lebensohn-Chialvo, Tala Al-Rousan

Purpose: This study sought to understand family functioning surrounding weight in Mexican American women with obesity.

Methods: Semi-structured in-depth interviews were conducted with mothers and adult daughters (N = 116).

Results: Thematic analysis identified five themes. 1) The communication process drives perception of supportive messages. Messages perceived as non-supportive consist of directives as interventions, confirmation of faults, and critical compliments whereas supportive consist of compliments, encouragement, empathetic listening, and disclosure. 2) Acculturation differences interfere with intergenerational alliance. Differences involve dissonance in communication, behavioural expectations, and weight-related practices. 3) Maladaptive conflict responses contribute to relational strain. These responses include avoidance, withdrawal, and defensiveness. 4) Role transformations alter the generational hierarchical relationship. Daughters serve as role models, caregivers, or collaborators. 5) Low communal coping heightens psychological distress. It does so by challenging family roles, increasing social isolation, and compromising social support.

Conclusion: Obesity interventions for Mexican American women may benefit from targeting relational skills to improve family functioning.

目的:本研究旨在了解墨西哥裔美国肥胖妇女围绕体重的家庭功能:方法:对母亲和成年女儿(N = 116)进行了半结构式深度访谈:结果:专题分析确定了五个主题。1) 沟通过程推动了对支持性信息的认知。被认为是非支持性的信息包括作为干预的指令、对缺点的确认和批评性的赞美,而支持性的信息包括赞美、鼓励、移情聆听和披露。2) 文化差异干扰代际联盟。这种差异涉及沟通、行为期望和体重相关做法方面的不协调。3) 适应不良的冲突反应导致关系紧张。这些反应包括回避、退缩和防御。4) 角色转变改变了代际等级关系。女儿成为榜样、照顾者或合作者。5) 低社区应对能力会加重心理压力。它通过挑战家庭角色、增加社会隔离和损害社会支持来达到这一目的:针对墨西哥裔美国妇女的肥胖症干预措施可能会受益于改善家庭功能的关系技能。
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引用次数: 0
Mental health service user organizations in times of crises: adaptions, challenges and opportunities experienced by local associations during COVID-19. 危机时期的心理健康服务用户组织:地方协会在 COVID-19 期间经历的适应、挑战和机遇。
IF 2.1 4区 医学 Q2 NURSING Pub Date : 2024-12-01 Epub Date: 2024-07-15 DOI: 10.1080/17482631.2024.2380360
Katarina Grim, Urban Markström

Purpose: This study examines how local user associations of mental health service-user organizations were affected by the pandemic, in order to provide guidance to user organizations and surrounding actors on future advancements. The pandemic is used as a case to explore organizational resilience and digitalization during crisis.

Methods: Data from focus group interviews and individual interviews with representatives of ten local associations were analysed using qualitative content analysis. A theoretical framework combining governance theory and organizational theory was applied.

Results: Typically, associations swiftly restructured activities to support members to meet the urgent needs that arose, not least in relation to the digital transition. Simultaneously, face-to-face interactions was valued and some members became isolated. Public sector actors often did not prioritize collaboration, and the associations had limited agency and influence in advocacy activities.

Conclusions: User organizations can play an important role in times of crisis. Surrounding social systems should provide resources to counteract resource dependencies and allow organizations to develop operating reserves. They should value collaboration and establish collaborative practices to ensure a readiness to utilize the organizations' capacities when needed. User organizations should have control over future developments, both to harness the potential of digital connectivity and to prevent a digital divide.

目的:本研究探讨了心理健康服务用户组织的地方用户协会如何受到大流行病的影响,以便为用户组织和周边参与者的未来发展提供指导。本研究以大流行病为案例,探讨危机期间的组织复原力和数字化:采用定性内容分析法,对来自焦点小组访谈和与十个地方协会代表的个人访谈的数据进行了分析。方法:采用定性内容分析法对焦点小组访谈和十个地方协会代表的个人访谈数据进行了分析,并应用了治理理论和组织理论相结合的理论框架:通常情况下,协会会迅速调整活动结构,为会员提供支持,以满足出现的迫切需求,尤其是与数字化转型相关的需求。与此同时,面对面的互动受到重视,一些成员变得孤立无援。公共部门行为者往往不优先考虑合作,协会在宣传活动中的作用和影响力有限:用户组织在危机时刻可以发挥重要作用。周围的社会系统应提供资源,以消除资源依赖性,并允许组织发展业务储备。它们应重视合作并建立合作惯例,以确保在需要时随时利用各组织的能力。用户组织应对未来的发展拥有控制权,既要利用数字连接的潜力,又要防止出现数字鸿沟。
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引用次数: 0
The search for meaning in health care inquiries: introducing qualitative meaning analysis. 在医疗保健调查中寻找意义:引入定性意义分析。
IF 2.1 4区 医学 Q2 NURSING Pub Date : 2024-12-01 Epub Date: 2024-07-25 DOI: 10.1080/17482631.2024.2382809
Helena Dahlberg, Karin Dahlberg, Christopher Holmberg

Purpose: To describe how Qualitative Meaning Analysis (QMA), based on a lifeworld theoretical approach, can be made accessible to students and researchers not well-versed in the philosophy of science or qualitative research. Additionally, to demonstrate that it is a more rigorous approach than qualitative content analysis in guiding healthcare inquiries.

Method: In recent years, qualitative approaches in nurse education and research have increasingly relied on various content analytical procedures. Liberated from clear philosophical underpinnings, they offer a seemingly pragmatic stance to nursing inquiries. However, by prioritizing 'sorting content' over the exploration of meaning, there's a risk of adopting a mechanistic approach to qualitative analysis. This is problematic because we contend that the search for meaning lies at the heart of qualitative inquiry in nursing and healthcare research, dealing with existential phenomena surrounding health, illness, and care.

Result: This paper explores the search for meaning in health care research, particularly in nursing, and introduces key epistemological aspects. It also discusses practical considerations to further familiarize and encourage the use of QMA in graduate nursing education and research.

Conclusion: Qualitative inquiry with a focus on meaning is a powerful means when the intention is to develop person-centered care, and the relationship between the professionals and patients is in focus. Such an approach has the potential to illuminate existential suffering as well as innate health capacities in patients.

目的:描述如何让不精通科学哲学或定性研究的学生和研究人员了解基于生活世界理论方法的定性意义分析(QMA)。此外,还要证明在指导医疗保健调查方面,定性意义分析是一种比定性内容分析更严谨的方法:近年来,护士教育和研究中的定性方法越来越依赖于各种内容分析程序。这些方法摆脱了明确的哲学基础,为护理调查提供了一种看似实用的立场。然而,由于将 "整理内容 "置于意义探索之上,定性分析有可能采用机械化的方法。这是有问题的,因为我们认为对意义的探索是护理和医疗保健研究中定性探究的核心,涉及到围绕健康、疾病和护理的存在现象:本文探讨了医疗保健研究,尤其是护理研究中对意义的探寻,并介绍了认识论的主要方面。本文还讨论了在护理研究生教育和研究中进一步熟悉和鼓励使用 QMA 的实际考虑因素:结论:当我们希望发展以人为本的护理,并关注专业人员与患者之间的关系时,注重意义的定性调查是一种强有力的手段。这种方法有可能揭示病人存在的痛苦以及与生俱来的健康能力。
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引用次数: 0
"Maintaining symbiosis in conflict": the quality of life of disabled elderly individuals in Chinese elderly care institutions - a grounded theory study. "在冲突中维持共生":中国养老机构中失能老人的生活质量--一项基础理论研究。
IF 2.1 4区 医学 Q2 NURSING Pub Date : 2024-12-01 Epub Date: 2024-09-05 DOI: 10.1080/17482631.2024.2397845
Ying Zuo, Guang Yang

Background and objectives: Exploring the quality of life of disabled elderly individuals in eldercare facilities holds significant importance in the improvement of service quality, the allocation of eldercare resources, and the enhancement of the well-being of the elderly. This study, grounded in the subjective perspective of disabled elderly individuals, aims to investigate their quality of life within eldercare institutions.

Research design and methods: A grounded theory approach was employed, involving semi-structured interviews with 35 participants.

Results: Data analysis revealed that the quality of life of disabled elderly individuals in Chinese elderly care institutions is characterized by "maintaining symbiosis in conflict" and encompasses four dimensions: complex adaptation process, complexities in social interactions, physical pain and the lonely soul.

Discussion and implications: Spending late years in elderly care institutions poses a trial and challenge for disabled elderly individuals, especially within a cultural environment that traditionally revolves around the "family" unit. In these institutions, disabled elderly individuals not only endure physical pain but also grapple with feelings of loneliness. They maintain the facade of family dignity by concealing true emotions, ensuring the harmonious and stable operation of the elderly care institution.Enhancing the quality of life for disabled elderly individuals requires not only an improvement in the service capabilities of elderly care institution staff but also collaborative efforts from policymakers and family members.

背景和目的:探究失能长者在养老机构中的生活质量,对于提高服务质量、优化养老资源配置、增进长者福祉具有重要意义。本研究以失能老人的主观视角为基础,旨在调查他们在养老机构中的生活质量:采用基础理论方法,对 35 名参与者进行了半结构化访谈:数据分析显示,中国失能老人在养老机构中的生活质量以 "在冲突中维持共生 "为特征,包括四个维度:复杂的适应过程、复杂的社会交往、身体的痛苦和孤独的灵魂:在养老机构中度过晚年对失能老人来说是一种考验和挑战,尤其是在一个传统上以 "家庭 "为单位的文化环境中。在养老机构中,失能老人不仅要忍受身体上的痛苦,还要面对孤独感。提高失能老人的生活质量,不仅需要提高养老机构工作人员的服务能力,还需要政策制定者和家庭成员的共同努力。
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引用次数: 0
The anatomy of crisis. 危机解剖学
IF 2.1 4区 医学 Q2 NURSING Pub Date : 2024-12-01 Epub Date: 2024-10-17 DOI: 10.1080/17482631.2024.2416580
Helena Roennfeldt, Nicole Hill, Louise Byrne, Bridget Hamilton

This phenomenological study deeply explores the individual and collective lived experience of a mental health crisis. A Lifeworld approach provided the entry point to deeper insights into the anatomy of crisis as the embodied emotional, physical, cognitive, and spiritual nature of crisis. Findings uncovered rich descriptions of mental health crises and how the crisis was encountered in a shattered sense of self and relational challenges in the context of receiving crisis care. Overall, the study revealed an embodied understanding of crisis that offers practical direction in providing crisis care that is more attuned to lived experience.

这项现象学研究深入探讨了个人和集体在心理健康危机中的生活体验。生活世界 "方法提供了一个切入点,使我们能够更深入地了解危机的解剖学,即危机所体现的情感、身体、认知和精神本质。研究结果揭示了对心理健康危机的丰富描述,以及在接受危机护理的背景下,危机是如何在自我意识崩溃和关系挑战中遭遇的。总之,研究揭示了对危机的具身理解,为提供更贴近生活经验的危机护理提供了切实可行的方向。
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引用次数: 0
Exploring mental health stigma among Indonesian healthcare students towards individuals with mental illnesses: a qualitative study. 探索印尼医学生对精神疾病患者的心理健康成见:一项定性研究。
IF 1.8 4区 医学 Q2 NURSING Pub Date : 2024-12-01 Epub Date: 2024-03-11 DOI: 10.1080/17482631.2024.2327103
Muhammad Arsyad Subu, Jacqueline Maria Dias, Richard Mottershead, Fatma Refaat Ahmed, Sari Narulita, Maryuni Maryuni, Zakiyah Zakiyah, Irma Nurbaeti, Alounoud Mohamed Al Marzouqi, Nabeel Al-Yateem

Background: The social disapproval or stigma surrounding mental illness contributes to the postponement of individuals seeking assistance and frequently undermines therapeutic alliances between mental illness sufferers and health care professionals.

Aims: This study explored perceptions and attitudes towards individuals with mental illness among college healthcare students in Indonesia.

Methods: This study used a qualitative method. Twenty five students enrolled in six healthcare programs were interviewed using a semi structured format. The data analysis adopted a thematic analysis.

Results: Our thematic analysis generated four main themes: (1) general perceptions of mental health and mental illness; (2) knowledge about mental illness; (3) mental health stigma; and (4) mental health stigma campaigns.

Conclusions: The participants exhibited positive perceptions of mentally ill people. Students understood mental health, and they exhibited positive attitudes toward mentally ill people. Some students have stigma and lack of confidence to assist those who have mental illness. Further efforts are required to acquaint students with mental health issues and facilitate their interaction with mentally ill individuals. Anti-stigma campaigns are required to combat the pervasive stigmatization of individuals with mental illness. It is recommended to conduct a more extensive study about the stigma that students encounter in relation to mentally ill individuals.

背景:目的:本研究探讨了印度尼西亚高校医学生对精神疾病患者的看法和态度:本研究采用定性方法。采用半结构化的形式对 25 名就读于六个医疗保健专业的学生进行了访谈。数据分析采用主题分析法:我们的专题分析产生了四个主要专题:(1) 对心理健康和精神疾病的一般看法;(2) 有关精神疾病的知识;(3) 心理健康污名化;(4) 心理健康污名化运动:结论:参与者表现出对精神病患者的积极看法。学生们了解心理健康,对精神病患者表现出积极的态度。部分学生对精神病患者存在偏见,缺乏帮助他们的信心。需要进一步努力让学生了解心理健康问题,并促进他们与精神病患者的互动。需要开展反污名化运动,以消除对精神病患者的普遍污名化。建议对学生遇到的与精神病患者有关的污名化问题进行更广泛的研究。
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引用次数: 0
期刊
International Journal of Qualitative Studies on Health and Well-Being
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