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Cancer narratives and the cancer support group.

We conceptualize the experience of cancer as requiring 'biographical work' and examine the nature of this work in the context of peer support groups. Interviews with participants and leaders of support groups were used to theorize the importance of support to cancer patients with varying stages and length of disease. Patient interviews led us to describe the process of joining, belonging, and identifying with, support groups as an important process within patients' ongoing biographical work and encompassing a search for a 'separate social space'. We discuss the implications for understanding the stigmatizing nature of cancer and the 'civic life' these groups support.

Adult↗

Qualitative sample extensiveness in health education research.

The use of qualitative methods is increasing in the health education literature, and there is need for more information on these methods and their use. This investigation looks at qualitative sampling practices as reported in the 93 qualitative or mixed-method studies published in Health Education & Behavior from 1980 to 2000. It focuses particularly on the extensiveness of sampling in this research (i.e., the volume and diversity of information collected about the phenomenon of interest). Among these studies, individual interviews averaged 104 +/- 134 informants (range 2 to 720) and 92 +/- 39 minutes. Focused group interviews averaged 10 groups (range 1 to 40) and 90 +/- 25 minutes. Observational studies usually occurred in multiple sites and involved approximately 16 to 24 months of fieldwork. Document analysis extensiveness varied considerably on a variety of indicators. Future qualitative research would benefit from more complete consideration and fuller reporting of sample extensiveness.

Bibliometrics↗

The experience of a good day: a phenomenological study to explain a good day as experienced by a newly qualified RN.

The main aim of this study was to provide an explanation of the newly qualified nurse's experience and description of a good day. Secondly, it sought to provide an explanation of how a good day made them feel about nursing. By identifying the main components of a good day and what positively effects the experience of a working day for a newly qualified nurse, it may be possible to move towards an increase in the occurrence of the components and emulation of a good day. While there is evidence to suggest that positive experiences within nursing increase job satisfaction and aid retention to the profession, the experience of a good day and what constitutes a good day for a newly qualified nurse has not been explored. The main components of a good day have not been identified and no work has been carried out to ascertain how these days make nurses feel about their chosen career. The aims of the study lent themselves to a phenomenological descriptive approach to research, the objective of which is identification of the essence of behaviour. Eight newly qualified nurses agreed to take part in the research. Each participant was interviewed twice, and in addition one group interview was arranged to clarify themes. The interviews, which were audio taped, were informal allowing the participants to answer in an open and unstructured manner. Once completed, all the tapes were transcribed and immersion and analysis of the data led to 5 themes naturally emerging as the components of a good day. The identified themes were, doing something well, good relationships with patients, feeling that you've achieved something, getting the work done and you need team work. In addition, although not a theme of a good day but of great importance was the description of 'that wonderful feeling at the end of a good day'. These themes contributed to feelings of job satisfaction and the pleasure of nursing. More specifically the concept of knowing the patient both from a personal level and knowing about their care and condition has been identified as a main component of a good day. This knowing the patient had a knock on effect in that when this was part of the day it was easier to prioritize and get the work done. These nurses were striving to develop a level of care and competency and, unlike expert nurses, did not have vast experience and knowledge to underpin their actions. They need to ensure that all levels of knowledge are addressed before they can carry out care. Additionally, the team dynamics and the way the team work together had a significant effect on the day.

Adaptation, Psychological↗

The experience of a good day: a phenomenological study to explain a good day as experienced by a newly qualified RN.

The main aim of this study was to provide an explanation of the newly qualified nurse's experience and description of a good day. Secondly it sought to provide an explanation of how a good day made them feel about nursing. By identifying the main components of a good day and what positively effects the experience of a working day for a newly qualified nurse, it may be possible to move towards an increase in the occurrence of the components and emulation of a good day. While there is evidence to suggest that positive experiences within nursing increase job satisfaction and aid retention to the profession, the experience of a good day and what constitutes a good day for a newly qualified nurse has not been explored. The main components of a good day have not been identified and no work has been carried out to ascertain how these days make nurses feel about their chosen career. The aims of the study lent themselves to a phenomenological descriptive approach to research, the objective of which is identification of the essence of behaviour. Eight newly qualified nurses agreed to take part in the research. Each participant was interviewed twice, and in addition one group interview was arranged to clarify themes. The interviews, which were audio taped, were informal allowing the participants to answer in an open and unstructured manner. Once completed, all the tapes were transcribed and immersion and analysis of the data led to 5 themes naturally emerging as the components of a good day. The identified themes were, doing something well, good relationships with patients, feeling that you've achieved something, getting the work done and you need team work. In addition, although not a theme of a good day but of great importance was the description of 'that wonderful feeling at the end of a good day'. These themes contributed to feelings of job satisfaction and the pleasure of nursing. More specifically the concept of knowing the patient both from a personal level and knowing about their care and condition has been identified as a main component of a good day. This knowing the patient had a knock on effect in that when this was part of the day it was easier to prioritise and get the work done. These nurses were striving to develop a level of care and competency and, unlike expert nurses, did not have vast experience and knowledge to underpin their actions. They need to ensure that all levels of knowledge are addressed before they can carry out care. Additionally the team dynamics and the way the team work together had a significant effect on the day.

Adaptation, Psychological↗

Graduate entrants into nursing - are we meeting their needs?

UNLABELLED: Changes to statutory requirements led to the need to redesign the current shortened programme for graduates (SPG) offered by the University of Dundee. A review of the literature revealed very little published material relating to this type of programme and that which did exist was predominantly American in origin. Prior to developing a new programme a study was carried out. The aim of the study was to explore the attitudes and opinions of non-nurse graduates currently undertaking the accelerated pre-registration programme of study offered by the University of Dundee. DESIGN: Purposive sampling was adopted and all students currently undertaking the programme were invited to participate. Data were collected using three focus group interviews with a minimum of five and a maximum of seven participants. All interviews were tape-recorded. The tapes were transcribed and data analysed using a content analysis approach. FINDINGS: Several important themes and sub-themes emerged from the interviews. These were consistent across all groups. The themes were: DISCUSSION: The data offered a rich insight into the attitudes and opinions of students undertaking the current SPG. The findings supported those of previous studies and have been used to inform curriculum development.

Attitude of Health Personnel↗

Student perceptions about the characteristics of an effective discussion during the reporting phase in problem-based learning.

To explore student perceptions of factors contributing to the effectiveness of discussions in the reporting phase of the problem-based learning (PBL) process, where students report and synthesise the results of self-study. Forty-eight Year 1 and 2 medical students participated in 6 focus group interviews about the characteristics of effective group discussions and possible improvements. The data were analysed qualitatively in several stages. The analysis yielded 4 main characteristics of effective discussions: asking for, giving and receiving explanations; integrating and applying knowledge; discussing differences with regard to learning content, and guiding and monitoring the content and the group process of the discussion. Integrating and applying knowledge included structuring, relating and summarising information and providing examples from practice. Discussing different opinions included discussing a variety of literature resources and disagreements. The main learning effects mentioned by the students were retention, understanding, integration and application of knowledge. Students have clear ideas about what promotes effective discussions during the reporting phase. Their PBL experience has provided them with some insights that are in line with theory and research on collaborative learning. Future research should examine differences between student and tutor perceptions of the quality of discussions. Introductions to PBL for students and tutors should include training in asking open but focused questions, supporting explanations with arguments and dealing with conflicts about learning content. Tutors should be trained in giving effective and personal feedback. Collaborative creation of external knowledge representations (i.e. concept maps) should be advocated, as should variety of literature resources.

Adolescent↗

Active roles in self-help groups for parents of children with cancer.

Quantitative and qualitative data from 43 self-help groups for parents of children with cancer were examined to identify the nature and types of parents' active roles in these groups. Group interviews with 43 self-help groups and individual questionnaires from 131 parent-members indicate that parent active roles in self-help groups often emerge at three levels--interpersonal, organizational, and institutional. Such groups can provide a unique arena for meeting parents' coping needs during a crisis.

Child↗

[Unilateral forearm agenesis and prosthesis].

PURPOSE OF THE STUDY: Antebrachial agenesis is a congenital deformity which is not invalidating for the children who have a level of independence comparable to that of other children of the same age. Although the appropriateness of a prosthesis is rarely questioned by healthcarers, it is clear that it is the healthcarers' own representation of this condition (their knowledge of the deformity and of the prosthesis proposed) that leads to the indication. The purpose of this study was to better understand the respective representations of unilateral antebrachial agenesis to help determine appropriate health care proposals. MATERIAL AND METHODS: An intensive survey using semi-directive interviews was conducted in 16 families. Group interviews with three healthcare teams were then conducted. RESULTS: Three leading topics appeared: worry about the social integration of the child, a paradoxical representation of the child perceived as independent but handicapped, and a largely negative image of the prosthesis. There was a rather important difference in the representations formulated by the parents and by the healthcarers. DISCUSSION: The discussion focused on awareness of the narcissistic content of the expectations and the plastic and functional implications of prosthesis fitting, perceived differently by parents and healthcarers. CONCLUSION: The nature of the expected result involves a change in the representation of the child more than a change in the child's body, a concept which in itself is not a true objective of healthcare. Taken the understandably difficult position of healthcarers, it might be useful to propose a different scheme for the first consultation.

Adolescent↗

[Frequent attenders in general practice. Who are they and how are they managed?].

INTRODUCTION: Frequent attenders (FAs) account for a large number of the consultations and a large part of the workload in general practice. We need knowledge about the way general practitioners (GPs) characterise this group of patients and about their proposals for clinical management. This study aims to describe the types of FAs seen in general practice and their proposed management. MATERIAL AND METHODS: Six randomly sampled CME groups in Aarhus County were offered a meeting about frequent attendance in general practice, and five groups with a total of 89 GPs accepted. FAs were defined as the top 10% patients attending during 12 months. One week before the meeting, each GP received an introduction to the meeting and the names of two FAs listed with the practice. Through exploratory focus group interviews, supplemented by a small group-based CME method, the GPs were asked to discuss FA characteristics and to make proposals for clinical management. A total of 59 (66.3%) participated in the five meetings. RESULTS: Eight FA types consistently emerged from the discussions, and the GPs suggested 12 possible ways of managing them. These aspects involved communicative, organisational (planning), and biopsychosocial skills. DISCUSSION: The variety of types shows that FAs are not solely the so-called difficult patients, but a diverse group demanding many different aspects of care. Hence, the GPs are in a key position demanding specific skills to manage these patients.

Communication↗

Patient and staff (doctors and nurses) experiences of abdominal hysterectomy in accelerated recovery programme. A qualitative study.

INTRODUCTION: The accelerated recovery programme (ARP) is becoming commonplace in surgical specialties and has also been introduced to hysterectomy patients. Diagnostic, prognostic and other clinical indicators are well described. The aim of this article is to relay knowledge about the ARP, through the experiences of the women operated and the staff involved. MATERIAL AND METHODS: The study is exploratory and descriptive, using qualitative methods. Seventeen women, with good health status, were consecutively selected from August to September 2001. The women were observed and ten were interviewed twice, at discharge and one month following their return home. The staff (n = 15) were interviewed individually and/or participated in focus group interviews before (February 2001) and following (November 2001) the introduction of the ARP. RESULTS: The women experienced little difficulty with the ARP. They defined themselves as being good girls but expressed that when the hospital's ARP had expired the attention from the staff declined. The staff continued to be concerned about whether the women received the information and psychological care they needed but claimed that the ARP proved better for the women than they had expected. CONCLUSION: The ARP did not appear to be a burden for the women involved in the study; however, it did not consider individual needs for psychological care. Future efforts should ensure a thorough introduction of the ARP to new staff as well as illustrative material for purposes of information relay and dialogue between staff and patients/family members. A nursing care ambulatory unit is recommended to support with information for women prior to and following hysterectomy in the ARP.

Adult↗

[Complementary nutrition for the young child following the devaluation of the CFA franc (African Financial Community): 2 case studies in the Congo and Senegal urban environment].

Developing countries frequently see their currency depreciated to varying degrees. The consequences of such monetary disturbances on the nutrition of young children are not well known, though children are the most vulnerable in nutritional terms. One year after the 50% devaluation of the CFA Franc (communauté financière africaine, "African Financial Community"), which took place on 12 January 1994 simultaneously in fourteen countries, nine of which are on the UNDP list of least developed countries, we wanted to find out the long-term effects of the devaluation, and the strategies that families had adopted to cope with it. In Brazzaville, Congo, in December 1994, an epidemiological survey was conducted on a representative sample of 893 children between the ages of 4 and 12 months in two districts, and indicators of child nutrition were established. A comparable survey had been conducted in December 1993, before the devaluation. In Senegal, in the absence of a previous survey which could be used in comparison, a qualitative survey using RAP methodology, was conducted in January 1995 in two towns near the capital. In three districts in each of these towns, a cluster of ten plots was chosen at random and surveyed, with a combination of semi-structured individual interviews with mothers (n = 60) and group interviews with all the women together (n = 6). The information was put together with interviews of 25 local traders selling food. In the Congo, comparison of the two surveys shows that the practice of breast-feeding had hardly changed, nor had the age at which baby food was introduced (90% of children of 4-5 months take semi-solid and solid foods); on the other hand, more children are being given the ordinary family meal earlier, at 6-9 months. The proportion of baby foods based on commercially imported flour has fallen (from 32% in 1993 to 18% in 1994), and has been replaced with local products based on maize; this change is more marked among poorer families. The low nutritional value of such preparations is in part compensated by the addition of sugar, though less milk is added (28% in 1994 as opposed to 43% in 1993). In Senegal, mothers do not seem to have changed their breast-feeding practices either, the age at which baby foods are introduced, or the number of times they are provided daily. The most important change is the drop in quality of food given to children, and the poorer family food for the older children. The partial switch from imported products to local produce was an expected consequence of devaluation; it is clearly confirmed here for nutrition of young children, with the consequent loss of nutritional quality (a reduction in energy density and in nutrients). The first thing needed is, therefore, an improvement in local manufacture of food supplements of good nutritional quality, for young children. Mothers also complain of the increased difficulty in managing a family diet so as to take account of economic needs, cultural values and nutrition. They therefore criticize a number of nutritional education messages that are clearly no longer appropriate to the new economic context. Finally the fact that young children are getting poorer quality nutrition is worrying for the future: if it lasts, the nutritional status of children will deteriorate; whenever possible, monitoring must be established so that measures can be taken when necessary to forestall any dramatic deterioration that would endanger the health of the children.

Adult↗

Nurses' perceptions of the role of liaison mental health nurse.

A focus group interview was carried out with a group of nurses to evaluate a liaison mental health nursing role. This work carried out by a liaison mental health nurse (LMHN), had been in operation for several years in a haematology unit. The views of nurses using the service were positive. The LMHN role was valued for its availability and visibility, objectivity and mental health expertise.

Attitude of Health Personnel↗

Determining problems experienced by student nurses in their work with clinical educators in Turkey.

Clinical education is considered an indispensable and vital part of nursing education. Educators have an important role in the successful completion of a student's clinical education. The clinical educator's approach, experience and knowledge have an influence on the students. Students encounter certain problems during their clinical practice under the supervision of educators. This study was conducted to determine the nature of the problems student nurses encounter during clinical training in Turkey. The focus-group interviews were used for this study. Three groups of 8, a total group of 24, composed of students completing their third year were included in the interviews. The students in this study had completed their practical training in the departments of internal medicine, surgery, pediatrics, psychiatry and public health. Among the problems mostly encountered by students, as established by the study, were inadequate assessment by the clinical educator, judgment, negative feedback, communication problems, inadequate guidance and overload. At the end of the research, recommendations were that educators should offer information in the direction of student expectations, increase their positive feedback and lighten the academic workload of these students.

Education, Nursing, Baccalaureate↗

Sample extensiveness in qualitative nutrition education research.

OBJECTIVE: Extensiveness represents the amount of information gathered in qualitative research. This study examined sample extensiveness in qualitative nutrition education research. DESIGN: Retrospective analysis was performed on articles published in the Journal of Nutrition Education (JNE) from 1969 to 1999 (Volumes 1 to 31). SUBJECTS: Content analysis was used to code articles and the studies they reported as units of analysis. OUTCOME MEASURES: Articles were coded to determine whether they included one or more studies using qualitative research and, if so, the types of qualitative studies performed, the sample extensiveness of each study, and mention of sample extensiveness limitations in the article. STATISTICAL ANALYSES: The statistics used were univariate (counts, percentages, means, medians, modes, ranges) and bivariate (chi-square, correlations). RESULTS: Of the published JNE articles, 71 (8%) used qualitative methods, and most (85%) qualitative articles were published in the 1990s. Some (19%) of these articles reported using multiple qualitative methods. The 30 studies using individual interviews interviewed an average of 45 people (range 15-155). The 38 studies using group interviews averaged 15 groups (range 1-180) and 141 people (range 9-900). Ten studies used observation/fieldwork, and eight used other types of qualitative research, with mixed [corrected] patterns of sample extensiveness in those studies. Few articles made specific statements about limitations based on sample extensiveness. IMPLICATIONS: Sample extensiveness in qualitative research in JNE varied considerably. Future qualitative research would benefit from more explicit attention to sample extensiveness.

Adult↗

Taking antenatal group B Streptococcus seriously: women's experiences of screening and perceptions of risk.

BACKGROUND: Early-onset group B streptococcal disease is a serious cause of neonatal morbidity and mortality. Although screening protocols for group B streptococcus are common, little is known of women's perceptions of this screening and the disease itself. The purpose of this study was to gain an understanding of women's experiences, knowledge, and perceptions about this bacteria and its screening. METHODS: Nine focus group interviews with 35 women explored their experiences and understanding of group B streptococcus screening. Transcribed interview data were interpreted to identify and articulate the women's experiences. RESULTS: Most women had little knowledge or understanding of group B streptococcus, obtaining their information largely from the stories or experiences of friends or family. Women struggled to understand the meaning and implications, both physical and "moral," of the disease for their baby and for themselves, clearly indicating both the subjective and statistical importance of the concept of risk for pregnant women. CONCLUSIONS: Group B streptococcus continues to be poorly understood by pregnant women who try to understand and weigh up its risks and implications so as to make the best decisions about screening. The women participated in screening ultimately, however, since it was seen to be patently "best for baby," relatively easy for them to undergo, and part of routine antenatal care.

Adult↗

The impact of abnormal fetal echocardiography on expectant parents' experience of pregnancy: a pilot study.

To examine the impact of an abnormal fetal echocardiogram (echo) on parental attitudes, emotions and coping strategies. Group interviews were performed for women and their male partners who had a fetal echo and were found to have a fetal congenital heart defect. The women and men were separated into four different focus groups. The interviews were tape recorded, transcribed and analyzed. The women expressed strong emotions of guilt, fear and sadness or hopelessness. They coped by attaching and bonding to the fetus, and were realistic about the future. The women began grieving at the time of the fetal echo. The men experienced emotions of anger and anxiety. They coped by remaining optimistic, and focused on supporting their wives. Men grieved after the birth of the baby. The fetal echo was felt to be beneficial and not harmful by the parents. The fetal echo led to significant changes in the couples' perceptions of themselves and their relationships. Clinicians performing fetal imaging must be aware of parental affective responses and coping mechanisms in order to provide the required psychological support.

Adaptation, Psychological↗

How to survive (and enjoy) doing a thesis: the experiences of a methodological working group.

'Doing a thesis', whether for Masters or PhD, can be a lonely and tortuous journey. This article offers a complementary process to the traditional apprenticeship supervision model. It describes the experiences of students who during their thesis research met monthly in a grounded theory working group. They reflected on their experiences during a focus group interview. After describing the background to how the group started in 1999 and exploring some of the ideas in the literature concerning the thesis experience, the article presents the interview. To focus the presentation, specific questions are used as category headings. Overall, the participants found attending the group was a "life-line" that gave them "hope" and was complementary to the supervision process. Through the support of peers, guidance from those ahead in the process, and consultancy with teachers and visiting methodological scholars, these students not only successfully completed their theses, but reported that they had some enjoyment along the way. This is the fifteenth in a series of articles which have been based on interviews with nursing and midwifery researchers, and were primarily designed to offer the beginning researcher a first-hand account of the experience of using particular methodologies.

Academic Dissertations as Topic↗

Cultural health practices of South African Vatsonga people on the home care of children with measles.

The purpose of this research study was to identify the cultural health practices of the Vatsonga in relation to the home care of children with measles. It was undertaken in the Giyani District of the Limpopo Province, in the Republic of South Africa. The qualitative, explorative and contextual design was used to conduct this project. Data was collected from nine key informants and nineteen general informants. Data was collected using individual interviews with key-informants and focus group interviews with general informants. Observations were also made. The findings revealed that the Vatsonga still provide home care for children with measles. Those who care for the sick children are women--either the mother of the sick child or an elderly woman with knowledge of the disease. There are different cultural practices that the Vatsonga observe when there is a child suffering from measles. These include isolation of the child, restriction of sexual intercourse, giving of a milk diet to the sick child and performance of a cultural ceremony at the resolution of the disease. Similarities and differences between hospital and home-based care were identified. Recommendations were made using Leininger's three modes of decision making as explained in the Sunrise Model, which include the following: cultural care preservation of maintenance; cultural care accommodation or negotiation; cultural care repatterning or restructuring.

Adult↗