Physical and emotional loss from amputation and associated physical disability are associated with adverse physical and psychological experiences. However, little research, within the Ghanaian context, has focused on the impact of amputation on the well-being of amputees and their caregivers and the coping strategies they use to mitigate challenges experienced. Therefore, the present study explored the impact of amputation on the well-being of amputees and caregivers, and the coping strategies they employ to manage distress associated with amputation and caregiving.
The aim of this present study was explored using a qualitative descriptive design. Twenty (20) participants (comprising 10 amputees and 10 caregivers) responded to a semi-structured interview guide.
Findings show that whereas amputees experienced phantom limb sensation and loss of job, caregivers reported economic hardship and fear. Though stress was a common experience, the source of stress was different for amputees and caregivers. Regarding coping, whereas amputees used social distancing, social reference and social support to cope with their traumatic ordeal, caregivers simply coped by encouraging themselves. Both amputees and caregivers used religious coping.
Amputees and their caregivers experience varied stressors yet whereas the amputees get the needed support to deal with their predicament, caregivers lack adequate support.
The findings underscore the need for diverse support systems and psychoeducation on adaptive coping strategies for amputees and caregivers.
We aimed to understand what patients, caregivers and clinicians identified as the most important information from their audio-recorded clinic visits and why.
We recruited patients, caregivers and clinicians from primary and speciality care clinics at an academic medical centre in New Hampshire, U.S. Participants reviewed a recording or transcript of their visit, identifying meaningful moments and the reasons why. Two researchers performed a summative content analysis of the data.
Sixteen patients, four with caregivers, from six clinicians participated. Patients, caregivers and clinicians identified a median of 7.5 (3–20), 12.5 (6–50) and 18 (4–31) meaningful visit moments, respectively. Moments identified were similar across stakeholders, including patient education, symptoms, recommendations and medications. Four themes emerged as a rationale for finding visit information meaningful: providing and receiving information, sharing the patient experience, forming a care plan, and providing emotional support. Clinicians rarely identified patient statements as important.
There was considerable agreement between patients, clinicians and caregivers regarding visit information that is most valuable. Patient contributions may be undervalued by clinicians.
These findings can be used to improve patient-centred visit communication by focusing visit summaries and decision support on information of the most value to participants.
A lack of social support contributes to women from culturally diverse backgrounds experiencing higher rates of perinatal distress and lower rates of service engagement.
This participatory action research study aimed to understand what a culturally appropriate social intervention may look like for pregnant women from culturally diverse backgrounds. Field notes and qualitative transcripts were descriptively synthesised.
Challenges of engaging with culturally diverse communities in the context of perinatal health services were identified. Cultural factors and practices were seen to impact upon service engagement, with parents more likely to seek support outside of health settings. Community members expressed frustrations with the lack of deep cultural sensitivity in the structure and delivery of health services. Clear definitions in scope and aim of any intervention were indicated, before further community engagement.
Challenges in engaging individuals and services from diverse communities highlighted the risks of ideas embedded in oversimplified understandings based on cultural stereotypes and assumptions of homogeneity of experiences at the intersection of cultural diversity, perinatal distress and health services.
Deep cultural sensitivity requires an understanding of how members of population groups perceive and understand health and wellbeing to directly inform the development of any intervention. Attempting to design a culturally sensitive intervention for socially isolated and culturally diverse parents within mainstream health services, led to a paradoxical tension between attempting to address needs in culturally insensitive ways or not attempting to address the needs at all.
Members of the public and people who identified as having lived experience of social isolation, cultural diversity or mental distress were engaged in the community consultation phase of the study.
Medical education typically focuses on the dyadic interaction between patient and physician. However, there is another significant presence in the room that can also impact the patient's health outcomes: caregivers. This topic has been relatively underexplored until now, and there is insufficient information available regarding situations in different cultures. In this study, we aimed to separately examine the characteristics of patients that influence the frequency of being accompanied and those that affect patients' preferences regarding the presence of a companion.
This cross-sectional study was conducted in family medicine clinic of a tertiary hospital. During a period of 15 days, a total of 285 patients who visited the clinic were administered the questionnaire face-to-face. Two logistic regression models were used for dependent variables of “actual” and “desired” situations of admitting to healthcare service with companion.
Of the participants, 167 (58.6%) were female, and the mean age was 36.8 ± 16.2 The sole significant factor, influencing actual visits to be occurred with a companion, was the solution for transportation issues (odds ratio [OR]: 26.25). It was found that unmarried individuals (single/divorced/widowed) (OR: 5.47), those with higher income (OR: 1.84), and older individuals (OR: 1.04) had a higher tendency to prefer visiting the clinic with companion while female are as opposite (OR: 0.50). Anxiety, perceived social support, and health literacy weren't associated with actual situation or desire to have companion.
Patients have companions to address tangible issues. However, different factors may influence the desire to have a companion. There is a large group of individuals who, are accompanied at clinic visits against their wishes, indicating a conflict between being accompanied and the desire for one.
Our study was inspired by the unsolicited comments of patients made about their companions during clinical visits. Additionally, community provided valuable feedback during the pilot application phase, particularly in the development of the data form.
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