Biomedical subjects

Katherine M Boydell

Publications and source records attributed to Katherine M Boydell.

12 recordsLinked to original sources

PubMed2006

A qualitative analysis of a dyad approach to health-related quality of life measurement in children with asthma.

The measurement of health-related quality of life (HRQOL) in children often relies on parents as proxy respondents. Yet, several studies have shown poor to moderate correlations between parent and child responses, questioning the validity of the parent as proxy. This qualitative study examined a dyad approach, where parent and child were interviewed together. The objective was to observe and describe the interaction in a dyad interview, wherein both parent and child perspectives are used and where the parent may expand the child's cognitive abilities to create a more meaningful description of the child's HRQOL. Children aged 8-15 years with a clinical diagnosis of asthma and their primary caregivers were recruited from The Hospital for Sick Children, Toronto, Canada. The dyads were administered the Health Utilities Index Mark II/III, the Pediatric Asthma Quality of Life Questionnaire and the PedsQL Pediatric Quality of Life Inventory. Interviews were audio-taped and a second researcher recorded observations. Consistent with Grounded Theory methodology, observations were indexed according to categories and subcategories related to the response process. Data were analysed using open, axial and selective coding and constant comparison. Saturation was achieved at 16 dyad interviews. A cultural review and reflexive role taking were included to minimize interviewer bias and enhance rigour. Findings were grouped in the following 11 themes: recall difficulty, respondent bias, interviewer bias, frustration, coercion/parental influence, inter-relational conflict, psychic discomfort for health states, emotional sensitivity, parent as advocate, parent as enabler and comprehension. The specification of these categories facilitated the creation of an interview guide to accompany the administration of standardized HRQOL questionnaires to parent-child dyads. Such a guide would facilitate discussion between parent and child and enhance the consistency of the interview process.

Adolescent↗

PubMed2006

Ana and the Internet: a review of pro-anorexia websites.

OBJECTIVE: The purpose of this article is to describe the content of pro-anorexia websites, both qualitatively and quantitatively. METHOD: An Internet search protocol was developed to identify pro-anorexia websites. A grounded theory approach was used to generate themes from Internet-based information. Basic descriptive analysis was employed to report on key website characteristics. RESULTS: Twenty pro-anorexia websites met inclusion criteria. Saturation of themes was achieved after review of 12 websites. Key website characteristics included purpose of website (75%), information about webmaster (67%), website disclaimers (58%), and information on "tips and tricks" (67%). Religious metaphors, lifestyle descriptions, and "thinspiration" (inspirational photo galleries and quotes that aim to serve as motivators for weight loss) were frequently present. A total of 10 themes were generated. The most prevalent themes included control, success, and perfection. CONCLUSION: Health-care providers and caregivers should be aware of pro-anorexia websites and their content, as these websites contain information that promote and support anorexia nervosa.

Anorexia Nervosa↗

PubMed2006

Pediatric telepsychiatry in ontario: Caregiver and service provider perspectives.

Families in rural areas face significant geographic and economic obstacles to obtaining pediatric mental health services. Telepsychiatry promises the possibility of extending specialized expertise into areas that have no resident psychiatrists. In this study, user perspectives and experiences of a pediatric telepsychiatry program serving rural communities in Ontario, Canada, were explored. Qualitative, exploratory methods were utilized because of the complex nature of mental health services needs and provision in rural communities. Focus groups with rural mental health service providers and interviews with family caregivers of children receiving a telepsychiatry consultation were conducted. The purpose of this research was to evaluate the benefits and limitations of providing pediatric psychiatric services via video-technology to inform future program development and health policy. Whereas participants in the study indicated that their experiences with the telepsychiatry service had been positive, the need for additional local services to support treatment recommendations was emphasized.

Adolescent↗

PubMed2006

Family perspectives on pathways to mental health care for children and youth in rural communities.

CONTEXT: There is insufficient literature documenting the mental health experiences and needs of rural communities, and a lack of focus on children in particular. This is of concern given that up to 20% of children and youth suffer from a diagnosable mental health problem. PURPOSE: This study examines issues of access to mental health care for children and youth in rural communities from the family perspective. METHODS: In-depth interviews were conducted in rural Ontario, Canada, with 30 parents of children aged 3-17 who had been diagnosed with emotional and behavioral disorders. FINDINGS: Interview data indicate 3 overall thematic areas that describe the main barriers and facilitators to care. These include personal, systemic, and environmental factors. Family members are constantly negotiating ongoing tension, struggle, and contradiction vis-à-vis their attempts to access and provide mental health care. Most factors identified as barriers are also, under different circumstances, facilitators. Analysis clustered around the contrasts, contradictions, and paradoxes present throughout the interviews. CONCLUSIONS: The route to mental health care for children in rural communities is complex, dynamic, and nonlinear, with multiple roadblocks. Although faced with multiple roadblocks, there are also several factors that help minimize these barriers.

Adolescent↗

PubMed2006

Understanding help seeking delay in the prodrome to first episode psychosis: a secondary analysis of the perspectives of young people.

First episode psychosis represents a critical period for intervention to prevent future impairments and to initiate optimal interventions. Using an interpretive interactionist framework, a secondary analysis of interview transcripts was conducted based on the narratives of youth experiences of psychosis. Our goal was to better understand the factors involved in the decision to seek help (or not) from the mental health system. Findings suggest that help seeking is a social process involving a wide range of influences; two such influences are highlighted in this paper, an individual avoidant strategy of ignoring and hiding early symptoms, and the persuasive influence of significant others in the social network.

Adolescent↗

PubMed2005

Recasting research into children's experiences of parental mental illness: beyond risk and resilience.

Children who live with a mentally ill parent are viewed primarily as being 'at risk' of developing a mental illness themselves and those who remain well are considered extraordinarily resilient. This particular risk/resilience discourse is embedded within larger contemporary discourses about risk and childhood. Childhood is seen as a critical period of development during which children need protection due to their physical and psychological vulnerabilities. In this paper, the implications of this dominant casting of children are explored and it is argued that the conceptual repertoire about those living with a mentally ill parent should be expanded. A critique of the literature that established the risk/resilience discourse is followed by a discussion of research about parenting with a mental illness within which children are surprisingly absent. Recent thinking about children arising out of the 'new' social studies of childhood is summarized to illustrate its resistance to the hegemonic image of children as passive, developing, 'unfinished' persons. A recasting of children as complex young persons who have competencies as well as vulnerabilities linked to their developmental stages, would lead to different lines of inquiry about children's experiences of mental illness in a parent.

Adaptation, Psychological↗

PubMed2005

"It's overwhelming... everything seems to be too much:" A theory of crisis for individuals with severe persistent mental illness.

Crisis in individuals with severe persistent mental illness (SPMI) is a poorly understood phenomenon for which traditional crisis models do not apply. In this study we explored the crisis experience using in-depth interviews conducted with individuals with severe persistent mental illness from two community support programs. A grounded theory of the crisis experience was developed and the results illustrate that underlying vulnerability sets the stage for crisis occurrence which involves feeling overwhelmed and lacking control and manifests as agitation/anger/aggression, being low, feeling anxious, or euphoria. Immediate responses to crises involve getting help or managing alone and numerous factors contribute to crisis resolution and prevention.

Adaptation, Psychological↗

PubMed2004

Designing a framework for the evaluation of paediatric telepsychiatry: a participatory approach.

While there is a great deal of interest in evaluating participants' experiences of teleconsultation programmes, specific frameworks for such evaluations are scarce. We have conducted a multi-stage consultation to develop a framework for the study of a paediatric telepsychiatry programme. Emphasis was placed on ensuring the participation of stakeholders in the design and response stage of the evaluation. A three-part approach was taken that comprised an opinion scan, focus groups and individual interviews. This resulted in the identification of specific areas of enquiry for the evaluation. One of the key points to emerge was that attending to context is vital. In the case of telepsychiatry, it is critical to understand the nuances of the local community for whom consultations are being provided. This involves considering the 'social ecology' of each evaluation site. The evaluation should take the form of a dialogue between the evaluators and those being evaluated, in order to maximize the uptake and integration of its findings. The framework we have developed should be viewed as a guide that is general enough to be used in the design of many different types of telepsychiatry programme.

Child↗

PubMed2003

Interpreting narratives of motivation and schizophrenia: a biopsychosocial understanding.

BACKGROUND: The concept of motivation involves a complex interplay of biopsychosocial and environmental determinants. For individuals diagnosed with schizophrenia, motivation has traditionally been approached from a neuro-biological standpoint, obscuring this complexity. The findings from this study underscore the importance of broadening our understanding of motivation and schizophrenia through an exploration of individual perspectives and identification of the psychosocial factors that clarify the experience of diminished motivation.

Adult↗

PubMed2002

The dialectic of friendship for people with psychiatric disabilities.

In the psychiatric literature, the meaning and importance of friendship has remained largely unexplored, subsumed under the rubric of social support or viewed as a component of community integration. Twenty-one qualitative interviews were conducted with individuals suffering from psychiatric disabilities focusing on the meaning of friendship as they described it. Analysis revealed the contrasts, contradiction and paradox of friendship for this group of people. The ongoing struggles of people with psychiatric disabilities regarding the need to connect with others and have friends, and conversely, the need to be alone and to withdraw from others, was highlighted.

Adult↗

PubMed2002

The Knowledge Resource Base: beginning the dialogue.

The Knowledge Resource Base (KRB) is a conceptual approach to the various types of knowledge used to understand and make sense of mental illness. It is an attempt to go beyond the everyday notion that real knowledge is in the hands of clinical experts and that consumers/survivors, families, and the public have little to contribute. There are four components to the KRB, each of which represents a different perspective or type of knowledge about mental illness; medical/clinical, social scientific, experiential, and customary/traditional. The purpose of this paper is to explore the medical/clinical and experiential components of the KRB by initiating a dialogue between consumers/survivors, families, and mental health professionals regarding these components. The strengths and weaknesses of each component are identified through individual interviews and a focus group.

Attitude to Health↗

PubMedDate not supplied

A feasibility study to assess service providers' perspectives regarding the use of the child and adolescent functional assessment scale in Ontario.

This brief report describes a feasibility study conducted to assess the level of satisfaction with the Child and Adolescent Functional Assessment Scale (CAFAS) rater reliability training, the ease of achieving interrater reliability in rating CAFAS, and the clinical utility of CAFAS as an outcome measurement tool for the province of Ontario, from the perspective of service providers. This study has been instrumental in the development of a 4-year province-wide measurement initiative. The study proved useful to government policy and decision-makers, mental health administrators, clinicians, and mental health service researchers interested in the implementation of outcome measurement tools. It highlighted the fact that at least 85% of respondents were satisfied with CAFAS training and the ease of achieving interrater reliability. The majority identified the usefulness of the tool in case formulation and the value in tracking changes over time.

Activities of Daily Living↗