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PubMed2005

Qualitative evaluation of a job retention pilot for people with mental health problems.

The aim of this study was to evaluate a job retention service intended to support GPs in preventing unemployment among patients with mental health problems. Interviews with job retention clients, their employers and case managers were carried out. A group interview with GPs was also conducted. Client-focused interventions were reported to be helpful by clients and GPs and employer-focused interventions were appreciated by both clients and employers. All clients attributed positive outcomes to the service. In conclusion, these preliminary results support the further development and evaluation of job retention services.

Australia↗

PubMed2004

Linking active living and nutrition counselling: dietitians' perceptions.

Healthy eating and active living have become key concepts in health promotion, and, increasingly, the two messages are being combined. Dietitians are in an ideal position to promote physical activity as an adjunct to nutrition counselling. Focus group interviews were used to identify dietitians' perceptions and needs related to incorporating active living messages into their practices. Six focus groups, involving 42 participants (40 registered dietitians and two dietetic interns), were conducted in cities throughout Alberta. Issues explored during the interviews included the dietitian's role in promoting active living, barriers to promoting physical activity, opportunities for collaboration between dietitians and exercise professionals, and dietitians' perceived needs for integrating active living messages into their practices effectively. Findings indicate strong support for incorporating active living messages into nutrition counselling. However, lack of knowledge was identified as a barrier to dietitians' proactive role, and concerns were raised about public and professional perceptions if dietitians counselled on this issue. Participants felt that they required additional knowledge and training in physical activity in order to promote it effectively. Development and implementation of programs designed to meet these needs would help dietitians integrate active living messages into their practices.

Alberta↗

PubMed2002

Voices of African American families: perspectives on residential treatment.

This article examines families' perceptions about involvement in residential treatment from the viewpoints of African American and non-African American family members. Focus group interviews found that all family members shared some common positive and negative experiences. However, unique issues remained for African American caregivers. The costs to children of being separated from their families and communities, fears regarding the use of medications, cultural dissimilarities of staff and clients, staff stereotyping, and a commitment to advocating for children other than their own were themes frequently expressed by African American family members. Implications for social services professionals serving African American families are highlighted.

Black or African American↗

PubMed2005

Interpreters' experiences of general practitioner-patient encounters.

OBJECTIVE: To study interpreters' experiences of problems in cross-cultural communication with special regard to the general practitioner (GP)-patient encounter. DESIGN: A focus-group interview with authorized interpreters was carried out. A phenomenographic method was used in the analysis. SETTING: Primary health care. RESULTS: The interpreters displayed a number of problems mainly related to the difficulty in balancing the triad relation (GP-patient-interpreter), the role of the interpreter in relation to other healthcare staff, the time aspects of the translation procedure, and the problems of diverse health beliefs and cultural inequalities. CONCLUSION: The interpreters notice a set of difficulties that need to be highlighted in order to improve consultations with cross-cultural GP-patient encounters.

Adult↗

PubMed2006

'Pressure of life': ethnicity as a mediating factor in mid-life and older peoples' experience of high blood pressure.

Hypertension is a common condition which disproportionately affects African Caribbean people in England, yet this experience is rarely reported in the literature. Whilst a body of literature exists that explores chronic illness experience, little attention is paid to hypertension, nor to ethnicity as a mediating concept in chronic illness experience. This paper explores the meaning and consequences of hypertension for African Caribbean people residing in England. The study conducted was a qualitative study, informed by the ethnographic tradition. The study methods included the conduct of two focus group interviews (10 participants), 21 in-depth interviews and five vignette interviews. Thirty-six people in total participated in the study, both men and women, aged between 37 and 82 years (median age = 59.5 years) in two English cities. The sample was generated by contacting GP surgeries, community groups and associations and included economically active and retired people. The narrative accounts provided illuminate the personal biographies of the mid-life and older participants in the study, providing evidence as to how issues such as ethnicity, migration, cultural adaptation, racism and discrimination may impact upon the chronic illness experience. Participants' understandings of their self-defined condition of high blood pressure differed greatly from medical conceptualisations of the condition of hypertension. The implications of the study are that in order to provide effective health and social care for individuals of African Caribbean origin with hypertension, care-providers require insight into how migration and cultural adaptation may create major disruption to an individual's life trajectory, to which the subsequent diagnoses of chronic illness are relative in terms of the individual's response and adaptation.

Adaptation, Psychological↗

PubMed2001

Social context of sexual relationships among rural African Americans.

BACKGROUND: Reasons for the strikingly increased rates of HIV and other sexually transmitted infections (STIs) among African Americans in the rural Southeastern United States remain unclear. Investigators have devoted little attention to the potential influence of the social and economic context on sexual behaviors. GOAL: To examine the potential influence of these contextual factors on behaviors that promote the transmission of STIs. STUDY DESIGN: Focus group interviews in which African Americans from rural North Carolina discussed life in their communities and contextual factors affecting sexual behavior. RESULTS: Respondents reported pervasive economic and racial oppression, lack of community recreation, boredom, and resultant substance abuse. Many perceived a shortage of black men because of their higher mortality and incarceration rates compared with whites, and believed this male shortage to be partly responsible for the concurrent sexual partnerships that they perceived as widespread among unmarried persons. CONCLUSION: Contextual features including racism, discrimination, limited employment opportunity, and resultant economic and social inequity may promote sexual patterns that transmit STIs.

Adolescent↗

PubMed2005

The dynamics between structure and flexibility in constant observation of psychiatric inpatients with suicidal ideation.

The aim of the study is to describe how expert nurses perform constant observation of patients with suicidal ideation. A qualitative content analysis is used to analyse individual and focus group interviews of five nurses. One main finding is identified: organizing phases and transitional phases formed during constant observation and the creation of a therapeutic relation. The findings are explained and discussed. In summary, the findings show that constant observation of inpatients with suicidal ideation seems to consist of two main aspects. One refers to its phases and consists primarily of assessing the need for control and controlling the patient from self-harm. The other aspect refers to the relationship between the nurse and the patient during a period of constant observation. There is a dynamic relation between structure and flexibility, and between control and the development of a therapeutic relationship between the patient and the nurse. The therapeutic relation is important when staff assess the need to continue round-the-clock observation.

Female↗

PubMedDate not supplied

Exploration into the recruitment of South Asian nurses.

Nursing is currently striving to ensure that its body of practitioners is reflective of the cultural diversity that exists in the population of healthcare consumers it serves. This is perceived as desirable to reflect and accommodate cultural differences within ethnic communities. The aim of this study was to investigate the rationale for the low recruitment of young South Asian people into nursing and midwifery education from an area of rich cultural diversity in the West Midlands. A triangulated approach was used involving four phases and sources of data collection. The study participants included students from secondary school (n = 70), parents of young South Asian students, career advisers and a small group of South Asian nurse practitioners. Data collection involved focus group interviews and a postal questionnaire for parents. The data revealed that very few young South Asian females and fewer young South Asian males had ever considered a career in nursing. The students' insight into the nature and scope of nursing as a profession was limited and based upon several misconceptions. Interaction with South Asian nursing role models was virtually non-existent. Their views of the physical, social and psychological demands placed on nurses made nursing an unattractive career option. Portrayals of an NHS in turmoil contributed to this view. Cultural issues also created problems for some students such as uniform policies and caring for the opposite gender. Further work needs to be undertaken to raise the profile of nursing and midwifery as a career option for young South Asian people.

Adolescent↗

PubMed2006

Is it possible for nurses and doctors to form a useful clinical overview of an EHR?

After implementation of an Electronic Health Record (EHR) at the hospital in Frederikshavn (Denmark) the doctors expressed that they had lost the overview of the information in the medical record and that it takes appreciably longer time to use the EHR. The future Electronic Health Records in Denmark will be structured according to the Fundamentals of the Danish Basic EHR Model, the "G-EPJ" Process Model. In addition, the model is interdisciplinary, problem oriented and based on clinical continuity. 16 clinicians from the hospital of Frederikshavn have joined in four focus-group interviews to clarify which information is used to form a clinical overview. The interviews have been analyzed methodically referring to Grounded Theory, and we have identified 8 factors which support the clinical overview, and besides that doctors and nurses form the clinical overview in different ways. Systematic information retrieval has been carried out to clarify how to optimize on-screen data presentation. Doctors, nurses and systems developers have worked together during 6 workshops, which has resulted in a set of screen images that support the nursing overview at the change of shift and the medical overview at ward rounds, respectively. The value of these screen images for the clinical overview has been tested in a real work situation at Roskilde Hospital, Denmark, in December 2005. And results show that the need for retrieving information from other documentation sources fell markedly when using an EHR instead of the usual paper-based record.

Denmark↗

PubMed2005

Feedback on video recorded consultations in medical teaching: why students loathe and love it - a focus-group based qualitative study.

BACKGROUND: Feedback on videotaped consultations is a useful way to enhance consultation skills among medical students. The method is becoming increasingly common, but is still not widely implemented in medical education. One obstacle might be that many students seem to consider this educational approach a stressful experience and are reluctant to participate. In order to improve the process and make it more acceptable to the participants, we wanted to identify possible problems experienced by students when making and receiving feedback on their video taped consultations. METHODS: Nineteen of 75 students at the University of Bergen, Norway, participating in a consultation course in their final term of medical school underwent focus group interviews immediately following a video-based feedback session. The material was audio-taped, transcribed, and analysed by phenomenological qualitative analysis. RESULTS: The study uncovered that some students experienced emotional distress before the start of the course. They were apprehensive and lacking in confidence, expressing fear about exposing lack of skills and competence in front of each other. The video evaluation session and feedback process were evaluated positively however, and they found that their worries had been exaggerated. The video evaluation process also seemed to help strengthen the students' self esteem and self-confidence, and they welcomed this. CONCLUSION: Our study provides insight regarding the vulnerability of students receiving feedback from videotaped consultations and their need for reassurance and support in the process, and demonstrates the importance of carefully considering the design and execution of such educational programs.

Adult↗

PubMed2005

Driving risk and rural life: everyday and reconstructed realities.

This article details the complex network of circumstances and meanings that influence rural people's driving behavior, and describes the manner in which some rural drivers' relevant social patterns support the everyday reality of driving and risk taking on rural roads. To fulfill the purpose of the study, 20 focus group interviews were conducted with 212 rural citizens in Alberta, Canada. The findings indicate that rural drivers routinely break traffic laws because: they do not perceive the harm in breaking laws, they believe that breaking laws is a natural thing to do, they negotiate the efficacy of laws according to their personal situations, and they believe in the maxim that the "ends justify the means. " It is common for rural drivers to break or "negotiate" traffic laws if it helps them in their work lives or in fulfillment of their immediate needs. They judge some traffic laws as unreasonable and question their effect on safety. Hence, they do not feel committed to universally honoring traffic laws. This information can be used to design intervention strategies for rural traffic safety that are relevant to rural drivers and thereby have optimal opportunity for success.

Accidents, Traffic↗

PubMed1996

Influence of donor insemination on sexual functions of recipients.

This paper presents the results of an investigation by personal interviews by the author, concerning different characteristics of sexual behaviour in 156 women during the period in which donor insemination was performed. The questions concerned sexual desire, orgasm, masturbation, libido alterations during the menstrual cycle, libido of wife compared to libido of husband, influence of sex films and sex books on sexual desire. The conclusion that can be drawn from this study is that donor insemination did not disturb the sexual part of marital life in the interviewed group of women.

Female↗

PubMedDate not supplied

Korean male smokers' perceptions of tobacco control policies in the United States.

The purpose of this secondary data analysis is to report Korean male smokers' perceptions of tobacco control policies in the United States. Descriptive data from four focus groups held in New York City in 2003 are presented. Focus group interviews were used to collect data, and the two investigators independently analyzed all four recorded group sessions. Korean male immigrants living in New York City area were recruited, and 22 volunteered to participate. Exclusion criteria included immigration to the United States before age 12, no smoking history, and use of chemical substance other than tobacco. Korean men differed in perceptions of the policies based on smoking status and length of U.S. residency. Among current smokers, recent immigrants had difficulty understanding smoking restrictions, whereas longtime residents complained of price increases. Both groups suggested that policies target the tobacco industry and do not target smokers. In contrast, former smokers supported more regulation of public smoking and suggested use of more aggressive antismoking campaigns. Public policymakers should take into consideration cultural attitudes and beliefs about smoking behavior in the design and implementation of tobacco control policies that affect ethnic groups whose cultural and value orientations may differ from the mainstream.

Adult↗

PubMedDate not supplied

Association between malignant tumors of the thyroid gland and exposure to environmental protective and risk factors.

Risk factors for thyroid carcinomas and adenomas were investigated using a standard questionnaire in a case-control study in Southwestern Germany, a known iodine deficiency area. A clinical registry, set up after the Chernobyl accident at the University hospital Mannheim, served as the basis for 174 incident cases of each diagnostic group. Interview data were compared within and with prevalences from a population-based matched control group of equal size from the entire area. The protective role of coffee drinking and the consumption of cruciferous vegetables, such as broccoli, were confirmed for both genders. A high consumption of tomatoes (> 200/year) was associated with an elevated risk of > 2.5 for malignant tumors but not for benign tumors in both genders. In both genders, both treatment for goiter (hyperthyroidism) and decaffeinated coffee consumption were associated with an increased risk for malignant tumors, but less so for adenomas. In women, early menarche (< 13 years) and stillbirth after first pregnancy, as well as hysterectomy, were substantial risk factors. Occupational variables and radiation, including medical indications and mammography, did not reveal particular risks. We did not address the role of regular iodine substitution, but did analyze the consumption of freshwater fish and seafood. Multivariate analyses of the most prominent risk factors confirmed the persistence of tomato consumption as a risk factor. In view of experimental evidence on the carcinogenicity of organophosphates and the neurotoxicant effect of certain agrochemicals on neuroendocrinologically regulated organs, we postulate that in Germany, importing off-season tomatoes from areas with a known history of possible inexperienced use of agrochemicals may be associated with a promoting effect for malignant neoplasias of the thyroid gland in terms of promoting already existent proliferating tissue growth.

Adenocarcinoma, Follicular↗

PubMed2000

The experiences and perceptions of nursing service managers regarding transformation of health services in selected provincial academic health complexes.

Nursing service managers are challenged with enormous transformations within the new political dispensation in South Africa. The objective of the study was to explore and describe the experiences and perceptions of the nursing service managers regarding transformation of health services in selected Provincial Academic Health Complexes. A qualitative, exploratory, descriptive and phenomenological design was employed utilising focus group interviews and narratives as methods of data collection. After content analysis was performed, results were grouped into management of health service transformation and quality of patient care in relation to the levels of the organisation. The levels in the organisation are individual level, group level, departmental level and organisational level. Positive and negative experiences and perceptions were identified.

Academic Medical Centers↗

PubMed1998

[Service expectations facing Saxony's newly established social psychiatric services. Attitudes of established neurologists, physicians in psychiatric clinics and social psychiatry service staff].

In the wake of the disintegration of the policlinical system which had prevailed in the former German Democratic Republic, far-reaching restructuring has become necessary in the "new" German laender in the field of complementary psychiatric care. Establishment throughout the state of Saxony of a uniform outreach-based ambulatory service ranks as a first component towards building regionalized community psychiatric networks. In light of some twenty years of experience in the old laender, this function is considered a task of the Social Psychiatric Services ("Sozialpsychiatrische Dienste", SPDIs). The present study had been directed at a state-wide investigation of the expectations community-practice psychiatrists (n = 165), physicians in psychiatric clinics (n = 95) and staff working in SPDIs (n = 138) in Saxony hold regarding service programmes and operating methods of these newly established service delivery structures. Given the high return rates in this anonymous postal questionnaire study, the findings presented are considered near-representative. A concurrent finding for all of the groups interviewed, expectations concerning the client population to be serviced by the SPDIs focus on the group of persons with chronic mental illness. Also, the expectations expressed concerning major care/therapeutic services to be rendered by the SPDIs concur in their emphasis on a core area of immediately client-oriented SPDI activities. Between the two medical groups, a major difference found is that community-practice psychiatrists more frequently expect high SPDI commitment regarding sociotherapeutic programmes at an institutional level, whereas clinical physicians expect them to focus on taking over medical therapies in the narrower sense. The expectations SPDI staff hold relative to the therapeutic services to be rendered by themselves go beyond the scope of what has so far been implemented in their current activity, and qualitative content analyses are presented in the article for each of the areas concerned. Along with better staffing levels, removal of in-service organizational and further education deficits are identified by SPDI staff as the two main requirements for stabilizing their operations. In order to counter undue burdening of the SPDI with service expectations and to enable a more clear-cut positioning of its programme structures within a complex psychosocial service delivery system, it is necessary--at least in the state of Saxony--that further needs-oriented establishment and/or extension of community-based psychiatric services and agencies take place.

Attitude of Health Personnel↗

PubMed1985

Interviewing 101: a preparation primer.

This article is divided into two main sections: one deals with appearance, and the other discusses behavior. The ritual of job interviews has been viewed by many as one of the most important encounters that determines the start of a successful career, while others view the interview as an adversarial game of "survival of the fittest." The interview setting is assumed to be at the site of future employment rather than a group interview setting at a college or convention.

Interviews as Topic↗

PubMed1996

[Various opinions of family physicians and rheumatologists about the management of patients with rheumatoid arthritis].

OBJECTIVE: To make an inventory of the opinions about professional duties and of the cooperation of general practitioners (GPs) and rheumatologists in the care of patients with rheumatoid arthritis (RA), after the publication of the standard 'Rheumatoid arthritis' issued by the Dutch College of General Practitioners in 1994. DESIGN: Descriptive. SETTING: Maastricht University, the Netherlands. METHOD: Information was collected by means of a written questionnaire submitted to a random sample of 500 GPs and all 148 (assistant) rheumatologists in the Netherlands, and by means of focus group interviews with GPs, rheumatologists and RA patients. This information focused on the opinion of both groups of professionals on their professional duties in diagnosis and management of RA, existing models of cooperation, the satisfaction with mutual consultations, experienced problems and possibilities to improve cooperation. RESULTS: Substantial differences existed between both groups of professionals in their views on the duties of the GP and the rheumatologist respectively, in the care of RA patients. GPs tended to an expectative policy in cases of suspected or even diagnosed RA, whereas rheumatologists preferred early referral. Hardly any cooperation model was found with agreements committed to paper on the mutual duties regarding RA patients. CONCLUSION: Inadequate mutual contacts and inadequate insight of both parties into each other's abilities appeared to be major problems impeding improvement of the mutual communication. Both groups recognized the need to improve the mutual cooperation.

Adult↗