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At least 541 records · Page 30Linked to original sources

PubMed2003

Patients' views of a pharmacist-run medication review clinic in general practice.

BACKGROUND: Reviewing elderly patients' medication is a requirement of the National Service Framework for Older People. Many general practitioners have insufficient time to review patients' medications in a consultation. Pharmacist review has been offered as an alternative and this will be a new experience for many patients. AIM: To ascertain patients' views of a pharmacist-conducted medication review clinic, run in their general practice surgery. DESIGN OF STUDY: Qualitative study using focus group interviews. SETTING: General practices in Leeds Health Authority area. METHOD: Patients aged 65 years and over, who had attended a medicine review clinic, took part in focus groups that were recorded and transcribed. Units of information representing an idea were identified and similar ideas were grouped together as themes. RESULTS: Patients had a number of prior beliefs about the clinic. Most patients knew that the clinic's purpose was to review repeat medication, to find out more about their medicines, and to ask questions about efficacy and side effects. Some patients were suspicious about the purpose of the clinic but others welcomed the opportunity to have an in-depth review and an explanation of their condition and its treatment; some patients did not accept advice or were disappointed that their expectations were not fulfilled. Most patients were happy to attend a yearly review but some expressed guilt about attending the surgery too frequently. CONCLUSION: Patients who attended the medication review clinics expressed a range of views about the service. Further research into patients' and carers' opinions about medicine review is needed to inform the development of these services.

Aged↗

PubMedDate not supplied

Where and how adolescents obtain alcoholic beverages.

Patterns of acquisition of alcoholic beverages by underage youth were studied, using focus group methods with a sample of midwestern youth. Results showed that the alcohol initially used by those in their early teens is obtained from parents' stocks or from older siblings and friends. By the midteens, parties at which alcohol (usually beer) is readily available become the major source. In the mid to late teens, young people purchase alcohol from commercial alcohol outlets, despite the fact that 21 is the legal age for purchasing alcohol. Factors reported to increase the rate of successful alcohol purchases include female buyer, male seller, young seller, and convenience store outlet. Results of focus group interviews revealed the easy accessibility of alcoholic beverages to underage youth. Further investigation into patterns of underage access to alcohol is recommended, with results from the focus group study guiding the design of probability sample studies to assess their generalizability.

Adolescent↗

PubMed2006

A focus group study of factors that promote and constrain the use of satellite-derived fire products by resource managers in southern Africa.

Semi-structured focus group interviews were employed to examine factors that affect the likelihood that resource managers in southern Africa will use information on vegetation fires provided by two satellite-derived products: an active fire product and a burned area product. The two products are updated regularly and aim to deliver the state-of-the-art in the global monitoring of fires from satellite remote-sensing. Both products are derived from data transmitted by the Moderate Resolution Imaging Spectroradiometer (MODIS) sensors carried onboard NASA's Aqua and Terra satellites. The active fire product can be accessed for free via the internet and on media by users working anywhere in the world; the burned area product will be accessible in a similar manner in 2006. The MODIS fire products provide systematic, near-global coverage and are freely available; as such, they give resource managers new opportunities to obtain or supplement information they need to manage vegetation fires effectively. However, the availability of these products does not mean that resource managers will use them, and many other factors are involved. To understand factors that affect whether southern African resource managers will use the two products, two focus groups were held with members of the Southern African Fire Network (SAFNet) in Malawi, Africa, August 2004. Analysis of the group discussions reveals a number of factors that influence whether they will use the products. The qualitative, in depth nature of the group discussions revealed 12 main factors that influence product use; not least the low international internet bandwidths for African countries outside of South Africa. Analysis of the group discussions also suggests how the uptake of MODIS fire products by resource managers in southern Africa might be enhanced by affecting specific changes to how MODIS products are packaged and delivered.

Africa, Southern↗

PubMed1999

Attitudes and beliefs of African Americans toward participation in medical research.

OBJECTIVE: To describe barriers to participation of African Americans in research. DESIGN: Focus group interviews conducted in 1997. PATIENTS: Thirty-three African-American adults presenting to an urban public hospital for outpatient medical care participated in one of five focus groups. MEASUREMENTS AND MAIN RESULTS: African-American patients' attitudes toward medical research were measured. Mistrust of doctors, scientists, and the government was reported consistently by the participants. Many participants described concerns about the ethical conduct of clinicians and investigators when poor or minority patients are involved and cited examples of exploitation as supporting evidence for their mistrust of the medical establishment. While participants were clear about the violation of human rights in the Tuskegee Syphilis Study, all were misinformed of the historical facts of the study. Few participants understood the concept of informed consent. Participants saw signing the document as relinquishing their autonomy and as a legal protection for physicians. Despite these concerns, participants gave recommendations to improve minority participation in research. CONCLUSIONS: African-American participants in this study described distrust of the medical community as a prominent barrier to participation in clinical research. Participants described real and perceived examples of exploitation to support their distrust of researchers. The goal of the consent process, to inform patients of risks and benefits so as to facilitate self-determination, was misinterpreted by these participants. Understanding the importance of interpersonal trust within the clinical relationship may prove to be a significant factor in enhancing participation in clinical trials.

Adult↗

PubMed1999

Why don't men seek help? Family physicians' perspectives on help-seeking behavior in men.

BACKGROUND: Men tend to underuse primary care health services despite their susceptibility to particular types of illness. The purpose of this study was to report the family physician's perspective on why men do not access the health care system for medical problems. METHODS: We used focus group interviews to identify major themes. The participants were family physicians in active practice randomly selected from a list of 500 full- and part-time teachers. Four focus groups were formed from 18 participants (12 men, 6 women), in practice an average of 17 years. Eleven of the physicians were in community practice. RESULTS: Three key themes were identified: (1) Support: Men appear to get most of their support for health concerns from their female partners, little from their male friends. Their pattern of seeking support tends to be indirect rather than straightforward. (2) Help Seeking: Perceived vulnerability, fear, and denial are important influences on whether men seek help. They look for help for specific problems rather than for more general health concerns. (3) Barriers: Personal barriers involved factors related to a man's traditional social role characteristics: a sense of immunity and immortality; difficulty relinquishing control; a belief that seeking help is unacceptable; and believing men are not interested in prevention. Systematic barriers had to do with time and access; having to state the reason for a visit; and the lack of a male care provider. CONCLUSIONS: Many of these findings are supported by psychological theories. Future research should apply these theories in more transferable populations and settings. However, an in-depth understanding of the patterns of men's use of primary care services is needed before we can determine if a regular source of primary care would have a positive impact on their health.

Adult↗

PubMed1997

Project 2000. Perception of the philosophy and practice of nursing: preparation for practice.

As part of a comprehensive study of perceptions of the philosophy and practice of nursing Project 2000 students and newly qualified diplomates were asked to reflect on their Project 2000 course as a preparation for professional practice. Data were collected from both students and diplomates through self-completion questionnaires and a small number of interviews with diplomates in two study centres, one in the north and the other in the south of England. Nurse managers and G grade practitioners were invited in focus group interviews to discuss the Project 2000 preparation and assess the diplomates 'fitness for purpose'. Findings suggest that the majority of students and diplomates acknowledged that the course had prepared them well. They acknowledged the importance of the inter-personal skills component of the course, together with the life sciences input. The diplomates particularly valued the theoretical aspect of the course, being well versed in research and keen to continue their learning. Perceived limitations of the course were the management preparation and course organization. Practical skill deficits were perceived as initial skills deficits only. Managers and practitioners were keen to employ the diplomates, whilst acknowledging their need for support and preceptorship. Three important issues for nursing and nurse education are discussed, including the balance of the Project 2000 course, preceptorship and support, and preparation for a role in the community.

Attitude of Health Personnel↗

PubMed2007

Caregiving time in sickle cell disease: psychological effects in maternal caregivers.

BACKGROUND: Providing home care for a child with a chronic illness can be stressful for the family. The purpose of this paper is to examine patterns of caregiving and the associated psychological impact on maternal caregivers of children with sickle cell disease (SCD). PROCEDURE: Fourteen maternal caregivers of children with SCD were interviewed as part of a larger study of maternal caregivers of children with chronic illness. Forty-four caregivers of children with HIV and 36 caregivers of healthy children were included as comparison groups. Interviews included questions regarding amount of time spent providing care for the child (technical care, non-technical care, health care management), hospitalization, emergency room visits, illness stigma, and mental health of the caregiver. RESULTS: Children with SCD had significantly lower functional status and significantly more hospitalizations in the previous 3 months than children with HIV. Caregivers of children with SCD were more likely to work full-time and had higher incomes than caregivers of children with HIV. The three caregiving groups did not differ significantly on amount of total care, although caregivers of children with SCD and caregivers of children with HIV both reported significantly more time spent in technical care than caregivers of healthy children. Despite lower functional status of the children in the SCD group, when group comparisons on caregiving time variables were adjusted for child's functional status, the differences between groups increased. This appeared to be due to the fact that caregivers in the HIV group spent more time in all caregiving categories except skin, crisis, and other care. In terms of caregiver mental health, caregivers of children with HIV and SCD had significantly higher depressive mood scores than caregivers of healthy children but the groups did not differ on caregiving burden. CONCLUSIONS: The perceived care burden of caregivers of children with SCD may be related to the unpredictable nature of the crisis care they provide. Additional attention is warranted to developing adequate resources for caregivers of children with SCD to mitigate the stress of unexpected crises.

Adaptation, Psychological↗

PubMed2003

Defining quality of life for Chinese elderly stroke survivors.

PURPOSE: This study aimed to identify the constituents and conceptual characteristics of the quality of life (QOL) of Chinese elderly stroke survivors, living in the community in Hong Kong. METHOD: A triangulated approach was used to identify the QOL components for this population. This process involved a comparison of QOL components gathered from three different methods, namely, focus group interviews, review of the literature and the contents of the generic Hong Kong Chinese version of the World Health Organization Quality of Life Scale (CWHOQOL-HK). Five health professionals were involved in the comparison process. A percentage of inter-judge agreement was used to determine the reliability of the comparisons made between the judges. RESULTS: This study identified 36 components considered to contribute to the QOL of Chinese elderly stroke survivors in Hong Kong. The conceptual characteristics of their QOL generally concurred with those identified in the literature. CONCLUSION: Both similarities and differences were found in the QOL components identified in this study when compared to those identified in studies of Western populations who are elderly and had a stroke. The contents of the CWHOQOL-HK scale were found to lack adequacy in representing the QOL of Chinese elderly stroke survivors in Hong Kong. Recommendations are given, based on the findings of this study, to overcome this limitation for its application as a QOL measure for this population.

Activities of Daily Living↗

PubMedDate not supplied

Focus group methodology for patients, parents, and siblings.

This report describes methodology that can be used as a guideline for the planning, conduct, analysis, and interpretation of data from focus groups for parents/caregivers, siblings, and children diagnosed with an illness; the methodology provides tools for the conduct of such groups in the same or similar populations. Separate focus group sessions were conducted for parents/guardians, siblings, and affected children. Methodological enhancements in planning and conducting the focus group sessions include development of a sampling frame to derive a representative group of participants, standardization of procedures through the use of a moderator's training manual tailored to each group, identification of topics to broaden content areas and stimulate discussion, and creation of a comfortable environment in which participants could express issues. Statistical considerations regarding design and conduct of the focus group session, as well as acquisition, analysis, and interpretation of data are presented with regard to validity, reliability, and generalizability of information gathered from focus group interviews. Scripts, topics, and timeframes that were initially devised by content experts were validated further and revised for direct use or adaptation by clinicians in the conduct of focus group sessions for parents/guardians, siblings, and affected children. Application of this methodology is intended to promote generalizability, reliability, and validity of information obtained, and to enable health care practitioners to provide better care to young patients and their families.

Family↗

PubMed2006

Program development of reminiscence group work for ageing people with intellectual disabilities.

BACKGROUND: The goal of this study was to adapt a narrative reminiscence program for the special needs of ageing people with mild/moderate intellectual disabilities. Research has shown that stimulating reminiscence in the elderly can be a meaningful activity, and holds promise for positive effects on well-being. METHOD: In the first stage (10 weeks), the program was developed with 1 group. Evaluation and adjustments to the program were made based on video recordings, the researcher's log, and feedback from participants and support workers. Formative evaluation was performed by means of a within-group analysis. In the second stage (3 weeks), the program was introduced to 6 other groups. Interviews with professional support workers were subjected to a cross-case analysis. RESULTS: The final program consists of 13 sessions covering different reminiscence themes. The success of reminiscence group work relies on (a) well-prepared and structured sessions, (b) adequate use of visual triggers, and (c) facilitating, coaching and moderating. CONCLUSION: The program was perceived as a valuable and meaningful activity by all participants. Although reminiscence group work is not therapeutic in nature, it may have therapeutic use for ageing people with intellectual disabilities, and in this sense is worth evaluating.

Adaptation, Psychological↗

PubMed1998

Providing care in an infectious disease clinic. Why students volunteer.

This qualitative study explores the motivations of dental students who volunteered as care providers for patients identified as carriers of infectious diseases. The study involved 12 students, seven 4th year and five 3rd year students who worked 1-2.5 days per week in an infectious disease clinic in a dental school in the northeastern United States. 4 faculty members who also volunteered their time in the clinic supervised the students. Personal interviews were conducted with each student to determine their reasons for volunteering and to explore the perceived significance of their experiences in the clinic. Internal validity was established through group interviews wherein responses during the personal interviews were discussed with the students. All 12 students were interested in Oral Medicine and all 4th year students had completed a course on HIV-AIDS for their selective requirement. Students expressed willingness to care for patients who are medically compromised in anticipation of an increase of this type of patients in their future practice. Previous exposure to a family member or friend or patients (non-dental) who were terminally ill or to patients with HIV was another common reason. All 12 students preferred to work in the infectious disease clinic more than in other school clinics. They felt that there was more faculty-student interaction and a more stimulating learning atmosphere that the faculty created. The students felt that the patients treated in the clinic were more appreciative. Students also claim they experienced more team spirit among their fellow students and staff and that the clinic atmosphere was more relaxed and less competitive. Students got the most satisfaction from helping patients who were perceived to have had problems in accessing care prior to their visit to the clinic. Results of the study show that the students volunteered to treat patients who are known to have infectious diseases such as HIV/AIDS because they find personal and academic satisfaction from working in a clinic which provides care to individuals with specific medical needs.

Attitude of Health Personnel↗

PubMed2000

Sociocultural perspectives on physical activity in the lives of older African American and American Indian women: a cross cultural activity participation study.

Illuminating the diversity and sociocultural specificity of women's experiences may be important if healthy lifestyles and quality of life are to be achieved. The incidence of cardiovascular disease linked to physical inactivity is high among African American and American Indian women. If more is understood about the experience of physical activity involvement, healthier living might be encouraged. Therefore, the purpose of this study was to explore the sociocultural meanings of physical activity for older (over the age of 40 years) African American and American Indian women who participated in the Cross Cultural Activity Participation Study (CAPS). Through qualitative in-depth interviews, we explored how sociocultural perspectives are related to perceptions about physical activity. Gender and other sociocultural factors influenced physical involvement on a continuum from negligible to significant. Both groups interviewed showed evidence that opportunities for physical activity in their free time did not always exist for them. For African American women, history and daily living issues were important factors limiting their involvement. Marginality limited American Indian women, but their cultural pride was often a source of physical activity. The juxtaposition of cultural and personal values emerged as a determinant of physical activity involvement among the women in this study. A further expansion of cultural and personal life situation perspectives is recommended to help understand the complex dimensions of physical activity as it relates to healthy living.

Adult↗

PubMed2001

Training the ideal hospital doctor: the specialist registrars' perspective.

BACKGROUND: When training for junior doctors is being planned, little discussion is focused on what outcomes hospitals are trying to achieve with regard to education/training, i.e. on what makes the ideal hospital doctor. Instead, the primary focus is on the requirements of the syllabi of the Royal Colleges (credentialing) and the requirements of service delivery (job description). Current literature has no qualitative studies of any longitude in which middle-grade doctors are asked about their vision of the ideal hospital doctor, what they feel can be done to help realize this vision, and how they feel about their own training. METHODS: This study examined data principally collected through a series of semistructured interviews conducted with eight specialist registrars (SpRs), four each from the North Trent and South Thames rotations over a period of 18 months. Additional information was taken from focus groups, interviews with programme directors, and questionnaires. FINDINGS: A model was created of the SpRs' perceptions of the key attributes of an ideal hospital doctor and of how these may be achieved in training. Eight broad areas were identified: clinical knowledge and skills; key clinically related generic/non-clinical skills; self-directed learning and medical education; implementing change management; applying strategic and organizational skills in career planning; consultation skills; research; and key personal attributes. CONCLUSIONS: SpRs are articulate in expressing their own expectations of their training and have considerable insight into the components of good training. Further improvement could be made and will require significant commitment from both trainees and trainers.

Clinical Competence↗

PubMed2004

Families in home care--a resource or a burden? District nurses' beliefs.

BACKGROUND: Caring for families in home care is a growing part of Swedish district nurses' professional work. District nurses' facilitative and constraining beliefs about families guide the extent to which families are acknowledged and engaged in the care. AIMS AND OBJECTIVES: The aim of the study was to explore district nurses' beliefs about families in home care. DESIGN: Explorative, descriptive. METHODS: Five district nurses participated in focus group interviews on three separate occasions. Each interview lasted approximately 90 minutes, was audio taped and transcribed verbatim. A thematic content analysis was used for analyses of the data. RESULTS: The result revealed two underpinning beliefs held by the district nurses towards families in home care: families are a resource and Families are a burden. Families could be a resource for the patient, for the other family members as well as for the district nurses themselves. Families could be a resource for the patient both practically and emotionally by e.g. being present and listening. Being open in communication with other family members and district nurses was also considered as a resource. The district nurses considered families as a burden when they were experienced as demanding in various ways, for example, when family members did not act in a way that pleased the district nurses or when family members showed their suffering. CONCLUSIONS: This study highlight some facilitating and constraining beliefs held by district nurses: families can be both a resource and a burden. RELEVANCE TO CLINICAL PRACTICE: It is important that district nurses are aware of what beliefs they hold as their beliefs guide their actions towards the families.

Attitude of Health Personnel↗

PubMed2004

Cultural feasibility assessment of tuberculosis prevention among persons of Haitian origin in South Florida.

A cultural feasibility study was conducted among persons of Haitian origin in South Florida to identify factors which might influence utilization of screening and treatment services for latent tuberculosis infection in this population. Five focus group interviews conducted among men and women explored cultural beliefs and practices related to TB, barriers and incentives to screening, and approaches to increasing treatment adherence. Key findings include the influence of social stigma and fears related to confidentiality of medical status as disincentives to screening. Cultural sensitivity to being labeled as a high risk group for these infections also emerged as a critical variable. Community-based approaches to health education for this population are described. Study recommendations include the planning of programs based on a service delivery model that stresses respect and personal attention to clients, improved interpersonal skills of health center staff, and coordination of services between private doctors and public health agencies.

Attitude to Health↗

PubMed2005

[Doctors' strategies to cope with the crisis in medical profession].

This article reviews the strategies of doctors to face the crisis perceived in medical practice. The results of a descriptive study are compared with current data in medical literature. In that preliminary report, where physicians in different settings of practice were interviewed, the authors found a great variety of strategies, from passive resignation and escape behaviors, to a proactive conduct of information search and analysis of the changes under way. All groups interviewed reported the importance of systematic reflection, the need of life options, of adopting healthy life styles and spirituality, as strategies to cope with professional frustrations.

Aged↗

PubMed2001

A pluralistic evaluation of nursing/practice development units.

Nursing/practice development units (N/PDU) are perceived as centres for pioneering, evaluating and disseminating innovative practice development and facilitating the professional development of practitioners. This paper reports on a pluralistic evaluation research study of the nursing/ practice development unit accreditation programme provided by the University of Leeds, UK. Individual and focus group interviews were undertaken with key stakeholders involved in six nursing/practice development units. These included: clinical leaders, team members, executive nurses, trust board members, general medical practitioners, nursing/practice development unit steering group members, and accreditation panel members. Stakeholder perceptions of what constituted a successful nursing/practice development unit were elicited and then used to judge the success of the programme. Seven criteria for judging the success of nursing/practice development units were identified. These were: achieving optimum practice; providing a patient-orientated service; disseminating innovative practice; team working; enabling practitioners to develop their full potential; adopting a strategic approach to change and autonomous functioning. The findings highlighted differences between the rhetoric of a successful nursing/practice development unit and the reality in which they function. Whereas all the units were actively involved in innovative practice development, evaluation, dissemination and networking activities, several factors influenced the success of the units, in particular, the role of the clinical leader, the motivation and commitment of nursing/practice development unit members, financial resources, and the nature of support from managers, medical staff and education institutions. Although the nursing/practice development units had made significant progress in developing both healthcare practice and practitioners, there is still a need to consider how the claim that nursing/practice development units benefit patients can be substantiated.

Accreditation↗

PubMed2004

How do drug users define their progress in harm reduction programs? Qualitative research to develop user-generated outcomes.

BACKGROUND: Harm reduction is a relatively new and controversial model for treating drug users, with little formal research on its operation and effectiveness. In order to advance the study of harm reduction programs and our understanding of how drug users define their progress, qualitative research was conducted to develop outcomes of harm reduction programming that are culturally relevant, incremental, (i.e., capable of measuring change), and hierarchical (i.e., capable of showing how clients improve over time). METHODS: The study used nominal group technique (NGT) to develop the outcomes (phase 1) and focus group interviews to help validate the findings (phase 2). Study participants were recruited from a large harm-reduction program in New York City and involved approximately 120 clients in 10 groups in phase 1 and 120 clients in 10 focus groups in phase 2. RESULTS: Outcomes of 10 life areas important to drug users were developed that included between 10 to 15 incremental measures per outcome. The outcomes included ways of 1) making money; 2) getting something good to eat; 3) being housed/homeless; 4) relating to families; 5) getting needed programs/benefits/services; 6) handling health problems; 7) handling negative emotions; 8) handling legal problems; 9) improving oneself; and 10) handling drug-use problems. Findings also provided insights into drug users' lives and values, as well as a window into understanding how this population envisions a better quality of life. Results challenged traditional ways of measuring drug users based solely on quantity used and frequency of use. They suggest that more appropriate measures are based on the extent to which drug users organize their lives around drug use and how much drug use is integrated into their lives and negatively impacts other aspects of their lives. CONCLUSIONS: Harm reduction and other programs serving active drug users and other marginalized people should not rely on institutionalized, provider-defined solutions to problems in living faced by their clients.

Journal Article↗