Qualitative research in medicine & healthcare最新文献

This study examined challenges and factors promoting resilience among 20 California family physicians (FPs) during the first six months of the COVID-19 pandemic. A subset of academic, community, and resident FPs who responded to an online survey also participated in a semi-structured interview that explored concerns, moral distress, burnout, resource needs, support systems, coping strategies, and motivation to continue caring for patients. Thematic analysis was used to identify common themes in participant interviews. Interviewees demonstrated adaptability, resilience, and grit (i.e., commitment to completing a valued goal in the face of setbacks and adversity) despite challenges disrupting patient care, fears for family and self, and frustration due to the politicization of the pandemic. Factors promoting well-being and perseverance included professional and personal support, strong coping skills, and focusing on the meaning derived from practicing medicine. A service orientation that permeates family medicine philosophy and values motivated practitioners to continue to provide patient care while dealing with overwhelming personal and structural challenges. FPs drew strength from their internal coping skills, core family medicine values, and external support, notwithstanding demoralizing effects of mixed messages and politicization of the pandemic. FPs demonstrated resilience and grit in the face of challenges created by the COVID-19 pandemic. Ensuring adequate resources to promote a physically and psychologically healthy workforce while increasing access to care for all patients is crucial to prepare for the next healthcare crisis.

For people with psychotic disorders, developing a personal narrative about one's experiences with psychosis can help promote recovery. This pilot study examined participants' reactions to and experiences of participatory video as an intervention to help facilitate recovery-oriented narrative development in early psychosis. Outpatients of an early psychosis intervention program were recruited to participate in workshops producing short documentary-style videos of their collective and individual experiences. Six male participants completed the program and took part in a focus group upon completion and in an individual semistructured interview three months later. Themes were identified from the focus group and interviews and then summarized for descriptive purposes. Prominent themes included impacts of the videos on the participants and perceived impacts on others, fulfilment from sharing experiences and expressing oneself, value of collaboration and cohesion in a group, acquiring interpersonal and technological skills, and recommendations for future implementation. Findings of this study suggest that participatory video is an engaging means of self-definition and self-expression among young people in recovery from early psychosis.

Tumor board meetings are behind-the-scenes settings where communication about health and strategizing about healthcare delivery take place. Despite their wide use in hospitals and cancer centers, there is a dearth of information about the communication practices in this context. Drawing upon six weeks of observations, this study investigated communication during tumor board meetings at a tertiary cancer center in the Southeastern United States. Findings revealed differences in communication among cancer specialties, with one tumor board consistently talking about the medical and non-medical elements of patient cases, while other specialties focused primarily on plans for treatment with little discussion about quality of life, economic, or caregiver support issues. The manuscript includes suggestions for modifying tumor conferences and opportunities for future research.

Communication within healthcare settings is often a subject of contention for patients' families at the best of times; however, contention was greatly magnified in the United Kingdom by restrictions on hospital visitations during the early stage of the COVID-19 pandemic. To support communication between families and patients, a central London hospital introduced the role of the family liaison officer (FLO). This study was designed to evaluate the rapid implementation of the FLO and to explore potential for it to become a standard role. Semi-structured interviews were conducted with five FLOs and seven colleagues who had worked alongside them between April and June, 2020. Two versions of the role emerged based on FLOs' previous background: clinical (primarily nurses) and pastoral (primarily play specialists). The FLO became a key role during the pandemic in facilitating communication between patients, clinical teams, and families. Challenges associated with the role reflect the speed in which it was implemented. It was evident to those in the role, and clinicians who the role was supporting, that it had potential to help improve hospital communication and the work of healthcare staff beyond the pandemic.

During pregnancy, women sometimes choose certain practices based upon the experience of their family and/or their vicinity to anticipate complications that may occur during childbirth. The main objective of this study is to understand the motivations and perceptions of pregnant women on lay knowledge in the prevention of complications related to childbirth among a sample of Congolese women. We conducted this study at N'djili Referral Hospital in Kinshasa, Democratic Republic of Congo, using a qualitative phenomenological survey and indepth face-to-face interviews. We interviewed seven women on the phenomenon of lay knowledge practice in the prevention of maternal difficulties and analyzed the data using thematic coding. We provided a consent form to the participants and were careful not to include identifying information. Three main themes emerged: i) discussion of complications related to pregnancy and delivery, ii) perceptions about lay knowledge in preventing complications related to childbirth, and iii) suggestions from participants about using lay knowledge in healthcare settings. Based upon data collected, we argue that lay knowledge about pregnancy can be integrated into formal antenatal training when appropriate and, in doing so, we can build trust among pregnant women toward professional medical instruction.

In the two decades since the advent of Web 2.0, scholars of cybersuicide have identified many beneficial and harmful uses of the internet. However, the discursive meanings interactionally created by suicide website users have scarcely been attended to. The present study uses the theory and method of cultural discourse analysis (CuDA) to arrive at meanings about place that radiate from online communication among users of SuicideForum.com (SF), a pro-recovery website. Analyses of 2,119 posts across 131 threads reveal two overarching discursive themes. The first speaks to problematic discourses about place, including the role of placelessness and entrapment in the genesis of suicidality and its affective states, leading to further diminution of experiential worlds. The second theme taps into participants' notions of what constitutes safe spaces, such as the presence of empathetic others who respect one's timetable for personal disclosure, and the freedom to experiment with new ways of inhabiting the world. The study has numerous implications for clinical practice, including recasting psychological disturbances in terms of self-world relations and reconsidering involuntary psychiatric hospitalization in light of forum participants' preoccupation with entrapment.

This study was designed to identify the sources of social support and the perceived psychosocial benefits people diagnosed with cancer experience at a community-based cancer wellness organization. Semi-structured, in-depth interviews were conducted with 31 people diagnosed with cancer who regularly used services at a community-based cancer wellness organization. Two themes were identified related to the sources of social support that participants experienced at the community-based cancer wellness organization: i) participants reported that individuals at the center (e.g., staff and volunteers) provided support, and ii) participants perceived the organization as a source of support. Further, four themes emerged related to participants' perceptions of the psychosocial benefits of social support experienced at the community-based cancer wellness organization including i) reduced feelings of social isolation; ii) acceptance at the center in contrast to stigmatizing experiences elsewhere; iii) validation of new identity; and iv) experiences of relaxation and stress relief. The study findings demonstrate that community-based cancer wellness organizations can be a source of connection, acceptance, validation, and stress relief to people diagnosed with cancer.