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Biomedical subjects

R Aroni

Publications and source records attributed to R Aroni.

3 recordsLinked to original sources

Research with bereaved parents: a question of how not why.

BACKGROUND: There is tension around the notion of research with bereaved parents. While it is recognised that the care of children with palliative care needs will only improve with better understanding of parent perspectives, the vulnerability of bereaved parents is equally recognised as a challenge to ethical research. An emerging literature suggests that research can be safely and ethically conducted with bereaved families, if performed sensitively. However, little is known about what research processes might enhance ethical research practice in this field. AIM: To explore the impact of the research process on bereaved parents, and to identify what elements enhance the experience of research participation. METHODS: This qualitative study used in-depth interview techniques with the bereaved parents of children who had died from a range of conditions. RESULTS: Interviews took place with 69 parents from 45 eligible families (70% of 64 selected eligible families) of children who had died from a range of chronic conditions. All participants considered the timing and nature of the initial approach by the researchers to be appropriate. The experience for parents was reported to be enhanced by the sensitivity of the initial approach. The use of in-depth qualitative interviews promoted parent empowerment through determining both pace and content of interviews. Although the majority of parents primarily chose to participate for altruistic reasons, many described the research process as personally beneficial. CONCLUSION: Participating in research was viewed positively by these bereaved parents. Careful attention to the research process in terms of timing, approach and the interviewer's skills were key elements that underpinned a positive experience. The skilled utilisation of in-depth interviewing techniques was perceived to enhance ethical research practice.

Adult↗

Enhancing validity: what counts as an asthma attack?

BACKGROUND: Major epidemiological studies in asthma use the question: "How many attacks of asthma have you had in the last 12 months?" We set out to study what constitutes an asthma attack from the perspective of people with asthma. We also examined concordance between qualitative responses and standard quantitative measures of this question. METHODS: Individuals aged 18 to 70 years who sought care for asthma at Emergency Departments in an Australian central city, a suburban and a regional hospital were recruited. Sixty two (43 women and 19 men) participants were interviewed in depth. All interviews were taped, transcribed and thematically analyzed. Demographic data and responses to respiratory health data were also collected. FINDINGS: Widely varying responses to the question, "How many attacks of asthma have you had in the last 12 months?" were found in the quantitative data set. Comparison of quantitative and qualitative data sets showed good agreement between these two responses (intraclass correlation 0.66). People defined asthma attacks as "major" and "minor," as determined by the degree of personal control they were able to exercise. A strongly unifying description of a severe attack was that it was "out of control." Patient's recognized that upper respiratory tract infections commonly triggered major attacks. INTERPRETATION: A commonly asked question about the number of asthma attacks in the past year needs refinement in order to enhance validity. Asthma action plans should use the words "out of control" when defining a severe attack of asthma.

Adolescent↗

Choosing to attend an asthma doctor: a qualitative study in adults attending emergency departments.

BACKGROUND: Asthma treatment guidelines currently recommend a 'therapeutic partnership' to achieve best care. It is frequently assumed that individuals presenting to emergency departments with asthma do not have a good doctor-patient relationship. We asked what is the nature of patients' relationships with their doctors in those presenting to hospital emergency departments for asthma care. METHODS: A qualitative study of all consenting individuals aged 18-70 years who presented to a hospital emergency department over 2 months was carried out. Sixty-two participants (19 male) engaged in in-depth interviews which were taped, transcribed and underwent thematic analysis. Questionnaire data were also collected and asthma severity determined. RESULTS: Nearly all patients (61/62) had a doctor whom they saw for their asthma. Patients made thoughtful choices on where they sought care according to their needs. Our findings identified that perceptions of doctors' competence, listening to patients and time constraints were important influences on doctor-patient relationships. Participants had strong expectations that their personal disease experience would be acknowledged by their doctors. CONCLUSION: This group of patients had doctors who cared for their asthma. The acceptability of medical care was determined as much by patient choice as by the quality of the doctor-patient relationship.

Adolescent↗