Biomedical subjects

A Madill

Publications and source records attributed to A Madill.

4 recordsLinked to original sources

PubMed2001

The relevance of lowered personal control for patients who have stoma surgery to treat cancer.

OBJECTIVES: The objective of this study was to explore the experience of patients who had stoma surgery to treat cancer in order to explicate why problems associated with stoma surgery are not decreasing despite technical improvements in stoma care. DESIGN: A longitudinal design was used in order to capture the process of preparing for surgery and dealing with its aftermath. Participants were interviewed using a semi-structured protocol on three occasions; 1-2 weeks before surgery (eight participants), 1-2 weeks after surgery (seven participants), and 3 months after surgery (four participants). METHOD: Transcripts were analysed guided by the procedures of grounded theory. This involved developing categories from the data and linking them together to form a conceptual understanding of our participants' experience. RESULTS: Lowered personal control was the most important concept to emerge from the analysis. We identified perceived causes of lowered control, its mitigating factors, the strategies used to manage this experience and the consequences of these processes. CONCLUSIONS: We make three recommendations based on the conclusion that improvements could be implemented in the psychological aspects of stoma care and, in particular, the enabling of patient perceived self-efficacy. First, improvements could be made in doctor-patient communication with doctors becoming more aware of their psychological impact on patients. Second, specialist stoma care nurses could be trained to recognize patients with dysfunctional self-efficacy beliefs and/or delayed psychological adaptation. Finally, we identify a need for more prolonged practical and emotional support for at least some stoma out-patients.

Adaptation, Psychological↗

PubMed2001

Financial services employees' experience of peer-led and clinician-led critical incident stress debriefing following armed robberies.

This study investigates financial services employees' experience of critical incident stress debriefing (CISD) and their views about peers and clinicians as facilitators. Semi-structured interview accounts of four participants who had experienced both peer-led and clinician-led CISD were analyzed using grounded theory. A core category, ambivalence, permeated each interview and divided into two poles: pathologizing and normalizing. The most frequently occurring sub-category was a dislike of professionalism. Participants preferred the peer debriefer who was perceived to have more personal involvement and with whom they felt more empowered and understood. The findings suggest that the status of the debriefer as 'peer' or 'clinician' may be a crucial variable in the effectiveness of CISD and should be considered when reviewing the outcome literature.

Adult↗

PubMed2000

Objectivity and reliability in qualitative analysis: realist, contextualist and radical constructionist epistemologies.

The effect of the individual analyst on research findings can create a credibility problem for qualitative approaches from the perspective of evaluative criteria utilized in quantitative psychology. This paper explicates the ways in which objectivity and reliability are understood in qualitative analysis conducted from within three distinct epistemological frameworks: realism, contextual constructionism, and radical constructionism. It is argued that quality criteria utilized in quantitative psychology are appropriate to the evaluation of qualitative analysis only to the extent that it is conducted within a naive or scientific realist framework. The discussion is illustrated with reference to the comparison of two independent grounded theory analyses of identical material. An implication of this illustration is to identify the potential to develop a radical constructionist strand of grounded theory.

Humans↗

PubMed1999

How do transitional objects work?: the therapist's view.

Research into the use of transitional objects (Winnicott, 1971) by adult clients in psychotherapy has given little attention to the question of how a transitional object (TO) works. This question is addressed through the use of a semi-structured interview. Data was collected on the clinical practice and theoretical understanding of TO emergence and use of three psychodynamic-interpersonal (PI) and three Gestalt psychotherapists. A grounded theory analysis suggests that a TO works by a process of embodiment which can be structured with reference to a four-level model consisting of physical, process, contextual and conceptual levels. Therapists of both orientations emphasized the TO as a focus of intersubjectivity within the therapeutic relationship. Differences between the PI and Gestalt therapists are also examined. The clinical implications of this four-level model of embodiment for the use of TOs in psychotherapy are explored, together with suggestions for further research.

Female↗