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PubMed2000

Integration of the primary health care approach into a community nursing science curriculum.

The purpose of this article is to explore and describe guidelines for integration of the primary health care approach into a Community Nursing Science Curriculum in a Nursing College in Gauteng. A qualitative, exploratory, descriptive and contextual research design was utilized. The focus group interviews were conducted with community nurses and nurse educators as respondents. Data were analysed by a qualitative descriptive method of analysis as described in Creswell (1994: 155). Respondents in both groups held similar perceptions regarding integration of primary health care approach into a Community Nursing Science Curriculum. Five categories, which are in line with the curriculum cycle, were identified as follows: situation analysis, selection and organisation of objectives/goals, content, teaching methods and evaluation. Guidelines and recommendations for the integration of the primary health care approach into a Community Nursing Science Curriculum were described.

Attitude of Health Personnel↗

PubMed1985

[Vaccination: barriers and motivation].

The investigation is aimed at analysing from different aspects the complex nature of the barriers against vaccination and with this the prerequisites for the development of adequate motivations among the population. The pilot study is based on the detailed interviewing of 80 persons (30 parents or mothers with infants aged up to 15 months; 30 parents or mothers with children aged from six to ten years; 20 physicians). The group interviewed was additionally broken down into persons favouring vaccination (50%) and others skeptical about or opposed to vaccination (50%). The barriers against vaccination likely to influence the attitude of the population in the Federal Republic of Germany are mentioned below: In the general consciousness of health, health education and preventive medicine the idea of vaccination does not play an important role. Vaccination is not seen as a preventive means against the central risks of life (environmental burden, stress factors, road traffic, semiluxuries). The body is not expected to suffer lasting damage from infectious diseases in childhood; the knowledge of the risks resulting from childhood diseases or infectious diseases is minimal. Childhood ailments and infectious diseases successfully overcome by the sufferer tend to weaken the motivating insight into the necessity of vaccination. The general outbreak of infectious diseases and epidemics in the Federal Republic of Germany is considered rather unlikely. The probability of being attacked by infectious diseases regarded as dangerous is deemed negligible.

Attitude to Health↗

PubMed2006

Primary health care, mental health, and the dietitian's role.

PURPOSE: Individuals with mental illness are at nutritional risk because of health, social, and economic factors. To address this problem, the Canadian Collaborative Mental Health Initiative (CCMHI) and Dietitians of Canada (DC) commissioned the development of a toolkit that outlines the role of the registered dietitian (RD) and advocates for RDs in primary health care (PHC) mental health programs. METHODS: The development of the toolkit followed a four-stage process: a comprehensive literature review, a focus group discussion with a national working group, interviews with consumers about RD services, and evaluation of the toolkit. RESULTS: The costs of mental illness in Canada are at least US dollars 6.85 billion per year. Currently, little evidence exists on how RD services can reduce these expenses. The focus group identified accessibility as the predominant issue facing individuals with mental illness. To explain consumer experiences with RD services, a three-tier theory based on in-depth interviews was developed. Consumer experiences with RDs occur in five categories: financial concerns, perception of service, status of mental illness, engagement, and self-esteem (tier 1). These are further influenced by five individual and contextual factors, e.g., social environment, the mental illness (tier 2), which are weighed as benefits and barriers instrumental in determining actions (tier 3). CONCLUSIONS: The evaluation of the final draft of the RD toolkit confirmed that it reflected the visions of PHC. The toolkit is intended to act as a blueprint for action. Dietitians are encouraged to use its contents to advocate for positions in mental health PHC settings.

Canada↗

PubMed1992

Patient perceptions of continuity of care: is there a socioeconomic factor?

This study aimed to assess perceptions of continuity of care by patients from different socioeconomic areas using focus group interviews augmented by postal replies. Patients were randomly selected from two contrasting primary medical care locations: a middle class suburb and a less affluent suburb in Adelaide, South Australia. The Ethnograph was used to analyse the content of the interviews and postal responses. Analysis used the framework described by Curtis and Rogers in the USA and Freeman in the UK. The response rate was much lower from the lower socioeconomic group (5% focus group; 20% when postal replies included). They emphasized access factors and importance of records, and alleged situations where they were taken too casually and their problems were not dealt with. Those from the middle class area (response rate 25%) emphasized interpersonal ('art of care') factors and were more likely to use their presenting problem as a criterion to decide whether they needed to postpone the problem to a time when they could see their personal doctor. Focus groups can be useful evaluation tools in general practice, but oversampling of lower socioeconomic groups is needed. Continuity of care should be considered as an aid to consistent quality of care, rather than its essence. Well controlled intervention-outcome studies in different types of practice organization in differing socioeconomic situations will increase our understanding of continuity of care.

Adult↗

PubMed1976

A comparison of four methods for determining prevalence of induced abortion, Taiwan, 1970-1971.

A methodological study of four procedures for obtaining information about induced abortion was done in Taiwan in 1970 and 1971. About 2000 women were in a repeat interview group and seen every six weeks for nine rounds; one-half of these were also asked to provide urine on each round for a pregnancy test. Another 2000 women were interviewed only once; about one-half were asked "standard" knowledge, attitude, and practice questions about their reproductive history, including abortion. The other one-half were asked the same questions except they were not queried about their practice of abortion, but rather were asked to participate in the randomized response technique (RRT). Three methods produced estimates that 13-14% of the women had had an induced abortion. The RRT gave a significantly higher estimate, 28%. All methods used were judged feasible, although there is a suggestion that, without some improvement, the RRT may be difficult to use in low literacy populations. The repeat interview did not demonstrate advantage over the single interview in obtaining prevalence of women with a history of induced abortion. Ths use of a shorter interval with probing when the pregnancy test is positive might improve identification of recent abortions.

Abortion, Induced↗

PubMed2004

Enhancing research use through online action research.

BACKGROUND: Many health professionals, including occupational therapists, have difficulty utilizing research findings in daily practice. PURPOSE: To determine if an online action research project could enhance research use among occupational therapists working in similar practice areas. METHODS: Four groups of 12-14 occupational therapists met online for approximately one year. They discussed barriers and facilitators to research utilization, defined practice questions, and attempted to search for, synthesize and apply relevant research findings. Online communications and post-group interviews were thematically analyzed. RESULTS: Only half of the participants who began the project were still online with the research project at completion. These participants believed that their involvement in the group led to increased personal awareness, motivation and confidence regarding the use of research evidence in practice and knowledge to be used in practice. Time to review, critique and synthesize research evidence continued to be a major barrier to enhanced research utilization. PRACTICE IMPLICATIONS: Online meetings designed to enhance research use among occupational therapists appear to hold some promise, but refinements are needed to ensure their ultimate success.

Biomedical Research↗

PubMed2000

Mexican Americans' perceptions of culturally competent care.

Although the literature abounds with authors' discussions of the need for nurses and other health care providers to deliver safe and optimal care to patients of diverse ethnic groups, little work has focused on defining and measuring the dimensions of culturally competent care. The purpose of this research was to identify culturally competent concepts from the perspective of Mexican Americans. Focus group interviews with Mexican American registered nurses and Mexican American lay recipients of health care were used to explore the participants' subjective perceptions regarding the indicators of culturally competent care. For this group of Mexican American registered nurses, the influence of culture remained strong despite nursing professional experience and knowledge of Western biomedical system. The predominance of themes emphasizing respect, caring, understanding, and patience in health care encounters support the critical importance of personal processes of health care with Hispanics.

Adult↗

PubMed1998

Factors affecting patient-physician communication for abused Latina and Asian immigrant women.

BACKGROUND: Domestic violence is one of today's most serious health issues. Abused Latina and Asian immigrant women face unique barriers to the discussion of abuse with health care providers. This research was undertaken to identify any provider-related factors that may affect patient-provider communication for these women. METHODS: Qualitative data were collected using semistructured focus group interviews with abused Latina and Asian immigrant women. Participants were recruited through urban community-based organizations. Twenty-eight immigrant women with histories of domestic violence participated in four focus groups: two groups of Latina women and two groups of Asian women. Iterative readings by independent researchers identified provider-related factors affecting patient-provider communication. RESULTS: The study participants identified the provider behaviors that demonstrate trust, compassion, and understanding as elements that improve patient-provider communication. In addition, participants wanted providers to initiate discussions about partner abuse. CONCLUSIONS: Improved understanding of factors that may affect abused immigrant patients' communication may assist health care providers in offering meaningful support and assistance to these patients. Providers, administrators, policy makers, and educators should consider these factors when developing policy, protocols, and educational curricula for a variety of health care settings.

Adolescent↗

PubMed2000

The community health clinics as a learning context for student nurses.

The purpose of the research study was to describe guidelines to improve the community health clinics as a learning context conductive to learning. The objectives of the study commenced by getting the perception of student nurses from a nursing college in Gauteng; community sisters from ten community health clinics in the Southern Metropolitan Local Council and college tutors from a college in Gauteng. The research design and method used, consisting of a qualitative, exploratory, descriptive and contextual approach and the design was divided into two phases. Phase one consisted of a field/empirical study and phase two of conceptualization. In all the samples follow-up focus group interviews were conducted to confirm the findings. To ensure trustworthiness, Lincoln and Guba's model (1985) was implemented and data analysis was according to Tesch's model (1990 in Creswell 1994:155) based on a qualitative approach. The conceptual framework discussed, indicating a body of knowledge, was based on the study and empirical findings from phase one to give clear meaning and understanding regarding the research study.

Attitude of Health Personnel↗

PubMedDate not supplied

[Observation, interview and discussion group: the silence of 3 research practices].

Before entering into the opposition between quantitative perspective and qualitative perspective of social research, the need is discussed of considering the social research process as a social process and the empirical observation situations per se as social situations. Therefore, in social research, the object of observation and the ways of observation are made in the same stuff. As in any social situation, social norms come into play in the observation situation. Thus, the article develops the presentation of three qualitative social research practices from their design as producing different social situations which, in turn, take on the nature of immediate contexts which favor respective articulations between the practical norms of specific social groups and the dominant social norms in society at large. The practices presented are: participant observation, in-depth interview and discussion group. A different articulation among social norms which finds silence to be privileged way of observation. Hence, the conclusion is reached that the management and analysis of silence is fundamental both for distinguishing the qualitative from the quantitative perspective, the former opening up more to silence than the latter, and to distinguish one practice from another, especially for observing the effects proper of the observation during the observation processes.

Group Processes↗

PubMed2006

Beyond clinical trials and narratives: a participatory action research with cancer patient self-help groups.

The self-help movement in Hong Kong has been gradually gaining its momentum in recent years. The primary purpose of the research was to give voice to the experiences and views of patients towards cancer care and to influence healthcare providers and policy makers to act on patients' agendas. Self-help groups and their members are mobilized through the research activities of focus groups, interviews and a patient forum to specify and act on their needs. This article describes the project and the participatory action research (PAR) strategies in the mobilization of, and collaboration with, patient groups in research design, data analysis, and dissemination of findings. The implications on healthcare practice, particularly within an era of reform and restructuring of the healthcare system, are discussed.

Community Health Services↗

PubMedDate not supplied

Qualitative study of spirituality in a weight loss program: contribution to self-efficacy and locus of control.

OBJECTIVE: The purpose of this qualitative study was to examine how spirituality affects intrapersonal characteristics associated with a weight loss program. DESIGN: A series of 5 focus group interviews was conducted with women who were past participants of the Weigh Down Workshop, a spiritually based weight loss program. SETTING: Three churches in the Minneapolis/St. Paul, Minnesota, metropolitan area. PARTICIPANTS: Focus group participants (N = 32) were white, fairly well educated, with moderate income levels. Their mean age was 50 years. PHENOMENA OF INTEREST: Behavior changes, factors affecting self-efficacy for performing the behaviors, and locus of control. ANALYSIS: Sessions were audiotaped and transcribed. Transcribed text was coded and analyzed using qualitative data analysis procedures. RESULTS: Major changes in self-reported eating behaviors included eating only when experiencing true physiological hunger and stopping when sensing a feeling of fullness. Self-efficacy for these behaviors was reported to be enhanced by observing weight loss for themselves or others. Support from other group members, the simplicity of the program, and spiritual benefits through prayer and scripture reading were also reported to enhance confidence. Women indicated that they relied on an internal locus of control based on a sense of self-discipline. CONCLUSIONS AND IMPLICATIONS: Traditional means to enhance self-efficacy were important for all women; however, for some women, spirituality was also an important aspect of adhering to program principles.

Adult↗

PubMed2004

Patients' and physicians' views on the management of acute maxillary sinusitis.

OBJECTIVES: To study the views of patients and physicians on the management of suspected acute maxillary sinusitis and on suggested changes in practice. DESIGN: Cross-sectional survey and focus group interviews of both patients and physicians. SETTING: Primary care in Finland. RESULTS: A total of 175 patients and 245 physicians replied to the survey (response rates 88% and 70%, respectively). Eight focus groups were conducted, four with patients (n = 22) and four with physicians (n = 20). Patients had less trust than physicians in the natural healing process of acute maxillary sinusitis: only 33% as opposed to 95% of physicians agreed that acute maxillary sinusitis might heal without medication. The patients emphasised the importance of careful diagnosis. Physicians experienced the diagnostic uncertainty and the demands from authorities to use fewer antibiotics as problematic. CONCLUSIONS: Most patients with suspected acute maxillary sinusitis primarily want the physician to aim at making a specific diagnosis. Physicians feel they are forced to prescribe too many antibiotics for sinusitis because of patient's expectations and lack of good diagnostic means for acute maxillary sinusitis. Better diagnostic tools, both national and local guidelines, and patient information might help to change practice towards the use of fewer antibiotics.

Acute Disease↗

PubMed1998

Focus groups, program evaluation and the mentally ill: a case study.

This article uses a case example to describe how focus group interviews were utilized in evaluating mental health services for individuals with a serious and persistent mental illness. The method, questions, and recruitment process are summarized along with a description of the focus group interaction. Modifications of logistic procedures and moderator skills are also presented along with the limitations and benefits of using this method for the purpose of evaluation.

Focus Groups↗

PubMed2005

[The Meninos do Rio Program: lifeworld, adolescence, and health risks].

This study focuses on health risks among teenagers from two towns in the Sao Francisco River Valley (Ibiai and Morada Nova) and slums in Morro das Pedras, Belo Horizonte, Minas Gerais State, Brazil. The study discusses teaching and extracurricular activities by the Federal University in Minas Gerais in these localities, aimed at promoting health in adolescence. The authors use the Habermas communicative action theory as the main theoretical and methodological approach. The research adopted a qualitative and quantitative methodology, including dynamic observation, focus groups, interviews, and questionnaires answered by high school students. Sexuality, work, and violence were the main themes and were associated with numerous health risks. Work in the 10-to-14-year-old group was associated with nearly all types of health risks. The authors analyze the relations between context and adolescent behavior using the Habermasian concept of lifeworld colonization.

Adolescent↗

PubMed2004

Communication skills, cultural challenges and individual support: challenges of international medical graduates in a Canadian healthcare environment.

Physicians require good communication skills to develop effective patient-physician relationships. Externally funded international medical graduates (IMGs) move directly from their home countries to complete residency training at the University of Ottawa, Canada. They must learn quickly how to work with patients, families and colleagues. A detailed needs assessment was designed to assess IMGs' communication skill needs through focus groups, interviews and surveys with IMGs, program directors, allied healthcare professionals and experts in communication skills. There was a high degree of consensus amongst all participants concerning specific educational needs for communication skills and training issues related to the healthcare system for externally funded IMGs. Specific recommendations include (1) English-language skills; (2) how to get things done in the hospital/healthcare system; (3) opportunities to practise specific skills, e.g. negotiating treatment, (4) adequate support system for IMGs; (5) faculty and staff education on the cultural challenges faced by IMGs.

Attitude of Health Personnel↗

PubMed2004

"Being in a funk": teens' efforts to understand their depressive experiences.

Although there is literature about adults' experiences of depression, little research has focused on teenagers' experiences. In this article, the authors describe how a sample of adolescents makes sense of depression and responds to a depression diagnosis. Twenty-two adolescents participated in in-depth individual or focus group interviews. Teens discussed their experiences with depression and getting health care for depression, and described a trajectory similar to that found among adults: a slow growth of distress, a time of being in a funk, and a time of consideration of whether they are depressed. Teens who received a diagnosis from a medical provider then sought to make sense of their depression. Teens understood a depression diagnosis as a helpful label, a chronic medical problem, or a significant part of their identity. Understanding the subjective experience of adolescents who are depressed might increase health care providers'empathy and improve their communication with teens.

Adaptation, Psychological↗

PubMedDate not supplied

Parents' and professionals' perceptions of Quality of Life in children with speech and language difficulty.

BACKGROUND: The true impact of speech and language difficulties (SaLD) on children's lives and the effectiveness of intervention is unknown. Within other fields of paediatric healthcare, clinicians and policy-makers are increasingly emphasizing the utility of Health-Related Quality of Life (HRQoL) studies and measures. SaLT has a variety of measures to assess and treat children's 'quantity' of life, but also requires measures that allow it to measure and even target their Quality of Life. AIMS: To provide novel, primary data on the HRQoL of children with speech and/or language difficulties. METHODS & PROCEDURES: The study used a qualitative methodology to begin the process of developing knowledge about HRQoL in children with SaLD. Focus group interviews were held with parents and professional carers of children with SaLD, and participants were encouraged to reflect on their experiences and beliefs around HRQoL issues for these children. The discussions within these groups were tape-recorded and analysed using the principles of grounded theory and content analysis. OUTCOMES & RESULTS: Analysis of tape-recorded data identified ten descriptive themes related to children with SaLDs HRQoL. These themes were labelled: Inclusion; Behaviour and reactions of others; Education and awareness; Friendships and family relations; Schooling; The child's needs; Dependence/independence; Quality of care; Choice and potential; and Variability. The results can be seen as lying on a spectrum, with factors outside of the child at one pole, the individual child's characteristics at the other, and the interaction between the child and significant others in the middle. A number of the themes reflected a common belief, across all groups, that the HRQoL of children with SaLD is influenced by the behaviours, attitudes and beliefs of people surrounding them. In addition, participants' beliefs that the quality of a child's social integration, relationships and care are also related to their HRQoL. CONCLUSIONS: These are encouraging results, indicating that children with SaLD experience HRQoL issues associated with their communication impairments. The results support the suggestion that speech and language therapists should ensure that their assessments and interventions account for both a child's impairment and also factors related to well-being reflected in the themes presented here. However, this was also a small-scale study and consequently further research of this type, with a larger and more varied population, is necessary so that HRQoL issues for all clinical sub-groups of children with SaLD can be explored.

Adaptation, Psychological↗