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Results for “interpretive description”

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At least 73 records · Page 4Linked to original sources

PubMed2002

Argon plasma coagulation (APC) in palliative surgery of head and neck malignancies.

OBJECTIVES: Surgical reduction of bulky disease is an important treatment option in patients with incurable head and neck malignancies. In general, conventional tumor ablation is associated with significant hemorrhage, and the resulting tumorous wound surface entails aftercare problems. Argon plasma coagulation (APC) represents a novel technique providing effective hemostasis and wound sealing. Thus, APC features requirements of particular interest in palliative surgery of the head and neck. STUDY DESIGN: Using APC, we performed 18 palliative tumor resections in a series of 8 consecutive patients with recurrent head and neck lesions. Five patients received repeated APC treatment up to five times. METHODS: APC as non-contact, high-frequency electrosurgery under inert argon plasma atmosphere allows dissection, hemostasis, and desiccation of tumor tissue in a one-step procedure. In consideration of the limited and heterogeneous group of patients, results are interpreted descriptively. RESULTS: In every case of palliative surgery, APC caused efficient hemostasis, which helped significantly to reduce both time exposure of the operation and intraoperative loss of blood. Only one APC-unrelated complication occurred (transient rhino-liquorrhea), and none of the patients developed postoperative hemorrhage. Finally, APC produced dry and clean wound surfaces facilitating surgical aftercare. The achieved esthetic and functional improvements strengthened the patient's autonomy and social acceptance. CONCLUSION: APC is highly recommended for palliative surgery of head and neck malignancies.

Adolescent↗

PubMed1997

The client-nurse relationship as experienced by public health nurses: toward better collaboration.

This article presents the findings of a study concerned with the client-nurse relationship in public health nursing settings. The purpose was to look at the ways the client and public health nurse cooperate and to see what makes for efficient collaboration. A phenomenological-hermeneutic approach was adopted. The data consisted of essays written by the public health nurses and focused interviews, which were analyzed by phenomenological method. The outcome is an interpretive description of public health nurses' experiences of collaboration with their clients. Successful collaboration requires an active and committed involvement on both sides and a joint effort to help the client cope with his/her situation. This means there has to be not only a shared understanding of the ultimate goal of nursing, but also open and sincere confidence-building interaction for the creation of a sense of confidentiality and trustworthiness. The results suggest that the contents of the client-nurse relationship are extremely important to both sides of the dyad: both the client's well-being and the public health nurse's feeling of succeeding on the job will depend to a great extent on the kind of relationship they construct. Future research should also look at how clients experience their relationship with the public health nurse.

Adaptation, Psychological↗

PubMedDate not supplied

Focal parenchymal lesions in transient ischemic attacks: correlation of computed tomography and magnetic resonance imaging.

Twenty-two patients with the clinical diagnosis of transient ischemic attacks were prospectively evaluated by computed tomography (CT) and proton magnetic resonance imaging (MRI). Nineteen patients also underwent cerebral angiography. The MRI studies were performed with a prototype super-conductive magnet using a 0.6 Tesla or a 1.5 Tesla magnetic field. Two pulse sequence techniques were used resulting in T1 and T2 weighted images. All studies were interpreted descriptively by a single neuroradiologist in a blinded fashion, with special attention to focal parenchymal abnormalities. Patients with previously documented clinical strokes or reversible ischemic neurologic deficits lasting more than 24 hours were excluded. The CT scans revealed focal areas of abnormalities in 7 of 22 patients (32%), while the MRI scans showed focal changes in 17 patients (77%). All the CT lesions were clearly visualized on MRI. The MRI changes were better seen on T2 weighted images as areas of increased signal intensity. There was a marked preponderance of deep hemispheric lesions on both CT and MRI studies. Focal parenchymal abnormalities were not limited to the symptomatic vascular territory. We conclude that MRI reveals focal parenchymal changes in the majority of patients with transient ischemic attacks and is more sensitive than late generation CT scans. However, specificity appears to be poor, and may limit clinical usefulness. While the significance of the MRI "lesions" remains speculative, they may represent markers of chronic cerebrovascular disease in these patients.

Adult↗

PubMed2006

Promoting personal safety of building service workers: issues and challenges.

This exploratory, descriptive study conducted at a large western Canadian university solicited perceptions of personal safety among building service workers who perform night shift work alone. Ten semi-structured interviews were conducted at approximately 10:00 p.m. or 7:00 a.m with a convenience sample of night building service workers in private or semi-private locations on the university campus. Transcribed interview data were subjected to inductive content analysis using descriptive, interpretive, and pattern coding (Miles & Huberman, 1994). Results suggest that building service night shift workers are exposed to personal safety hazards in their physical and psychosocial work environments. In addition, culturally and linguistically appropriate delivery of safety training and education about policies and procedures is required for culturally diverse building service workers. Promotion of personal safety in this heterogeneous worker population requires due diligence, assessment, and advocacy.

Adult↗

PubMed2002

More than a sore mouth: patients' experience of oral mucositis.

PURPOSE/OBJECTIVES: To explore patients' experience of chemotherapy-induced oral mucositis. DESIGN: Interpretive descriptive, phenomenologic. SETTING: The cancer center of a metropolitan teaching hospital in South Australia. SAMPLE: A purposive sample of six participants undergoing intensive cytotoxic therapy associated with autologous hematopoietic stem cell transplantation. METHODS: Patients were interviewed at different stages of their treatment trajectory and asked to relate their experience of oral mucositis as it developed and resolved. FINDINGS: Participants' reports indicated three distinct phases representing linear time in the course of their mucositis: the preparatory phase, the peak phase, and the persisting phase. Five themes further abstracted were the presence of nurses, therapeutic interventions, manifestations of mucositis, the distress of eating (and not eating), and whether the treatment was worthwhile. CONCLUSIONS: Oral mucositis is much more than a sore mouth. The effects of mucositis are widespread and can have a marked effect on patients' psychological well-being. IMPLICATIONS FOR NURSING: Care centers often focus on pain control through pharmacologic intervention and overlook the effects of other sequelae. Nurses' role in helping patients to cope with mucositis should encompass more than providing pharmacologic pain relief.

Adaptation, Psychological↗

PubMed2002

Partitioning and peeling for constructing prognostic groups.

We investigate methods for identifying groups of patients with different prognosis. Our focus is on procedures that yield interpretable descriptions for groups of patients and corresponding regions of the predictor space. These strategies include tree-based methods and techniques which construct a single prognostic group through 'peeling' or refining of a larger group patients. The peeling methods are relatively new and are developed in detail. Simulations and examples for describing groups of patients with poor outcomes using data from a clinical trial for patients with multiple myeloma are presented.

Algorithms↗

PubMed2004

Instrumental variables and inverse probability weighting for causal inference from longitudinal observational studies.

Inferring causal effects from longitudinal repeated measures data has high relevance to a number of areas of research, including economics, social sciences and epidemiology. In observational studies in particular, the treatment receipt mechanism is typically not under the control of the investigator; it can depend on various factors, including the outcome of interest. This results in differential selection into treatment levels, and can lead to selection bias when standard routines such as least squares regression are used to estimate causal effects. Interestingly, both the characterization of and methodology for handling selection bias can differ substantially by disciplinary tradition. In social sciences and economics, instrumental variables (IV) is the standard method for estimating linear and nonlinear models in which the error term may be correlated with an observed covariate. When such correlation is not ruled out, the covariate is called endogenous and least squares estimates of the covariate effect are typically biased. The availability of an instrumental variable can be used to reduce or eliminate the bias. In public health and clinical medicine (e.g., epidemiology and biostatistics), selection bias is typically viewed in terms of confounders, and the prevailing methods are geared toward making proper adjustments via explicit use of observed confounders (e.g., stratification, standardization). A class of methods known as inverse probability weighting (IPW) estimators, which relies on modeling selection in terms of confounders, is gaining in popularity for making such adjustments. Our objective is to review and compare IPW and IV for estimating causal treatment effects from longitudinal data, where the treatment may vary with time. We accomplish this by defining the causal estimands in terms of a linear stochastic model of potential outcomes (counterfactuals). Our comparison includes a review of terminology typically used in discussions of causal inference (e.g., confounding, endogeneity); a review of assumptions required to identify causal effects and their implications for estimation and interpretation; description of estimation via inverse weighting and instrumental variables; and a comparative analysis of data from a longitudinal cohort study of HIV-infected women. In our discussion of assumptions and estimation routines, we try to emphasize sufficient conditions needed to implement relatively standard analyses that can essentially be formulated as regression models. In that sense this review is geared toward the quantitative practitioner. The objective of the data analysis is to estimate the causal (therapeutic) effect of receiving combination antiviral therapy on longitudinal CD4 cell counts, where receipt of therapy varies with time and depends on CD4 count and other covariates. Assumptions are reviewed in context, and resulting inferences are compared. The analysis illustrates the importance of considering the existence of unmeasured confounding and of checking for 'weak instruments.' It also suggests that IV methodology may have a role in longitudinal cohort studies where potential instrumental variables are available.

Antiretroviral Therapy, Highly Active↗

PubMed2001

Qualitative studies on the patient's experience of weaning from mechanical ventilation.

In contrast to primarily deductive quantitative research, qualitative research aims to interpret data to develop theoretical insights that describe and explain phenomena such as interactions, experiences, roles, perspectives, and organizations. In this review, we summarize qualitative studies that used primarily in-depth personal interviews as a data collection method and a grounded theory analytic approach. The liberal use of illustrative excerpts and interpretive descriptions offer clinicians vicarious accounts of patient experiences of weaning from mechanical ventilation. Important experiences of patients during their weaning from mechanical ventilation included frustration, uncertainty, hopelessness, fear, and lack of mastery. The extent to which, in at least some patients, these experiences were determinants of weaning failure, consequences of weaning failure, or both, was difficult to establish. An assumption of this genre of research is that if clinicians understand the lived experiences of patients, they can better appreciate patient needs during the weaning process, and by inference, their role as clinicians during weaning from mechanical ventilation.

Data Collection↗

PubMed2005

The strength of rural nursing: implications for undergraduate nursing education.

Nursing in rural communities offers opportunities for independent nursing practice and community participation. However, recruitment of nurses to rural settings can be difficult. In response to this challenge and the rising demand within nursing education for community clinical placements, intensive, short-term, rural community clinical placements are being developed by urban universities. As yet, little research has examined the use of these placements for undergraduate nursing education. The purpose of this qualitative research study was to examine the experiences of students, registered nurse mentors, and clinical instructors in rural health clinical placements, as part of a larger study examining alternative clinical placements. Through use of the interpretive descriptive method, the perspectives of participants were elicited from focus groups and interviews. The paradox of nursing student placements in rural health is that limitations of the rural site became the impetus for nursing student learning and partnership. An implication is that service learning partnerships be pursued for mutual benefit of students, communities, and rural nurses.

Community Health Services↗

PubMed1997

Gait analysis and bivalved serial casting of an athlete with shortened gastrocnemius muscles: a single case design.

Muscle tightness may predispose an athlete to injury. Stretching may help prevent injury by increasing joint passive range of motion and perhaps by increasing ankle range of motion during gait. The purpose of this study was to determine if bivalved serial casting and a positioning program would increase the total dynamic ankle range of motion without increasing the amount of compensatory foot pronation used during gait of an athlete with shortened gastrocnemius muscles. The subject was a 21-year-old male athlete. A three-dimensional camera-based kinematic system was used to collect functional dynamic ankle range of motion data. The Musgrave Footprint system was used to determine the relative amount of foot pronation (by measuring the pronation-supination index and dynamic foot angles). Data were collected for baseline, postintervention, and withdrawal phases. Data were then graphed and descriptively interpreted using means, standard deviations, trend, and level analyses. Following the treatment, the subjects showed an increase in mean total dynamic ankle range of motion without an increase in dynamic foot pronation. Eight weeks after treatment, the increase in mean total dynamic ankle range of motion was maintained and the pronation measurement did not change.

Adult↗

PubMed2003

Holding on self-caring with osteoarthritis.

As women age, they frequently have increasing difficulties with physical functioning associated with osteoarthritis (OA). An understanding of how elderly adults care for their health is necessary to assist older women to live independently. Self-care of five community-dwelling women with OA was investigated through an interpretative descriptive study. A phenomenologic and naturalistic inquiry framework was used. Interviews were conducted using an interview guide. Deconstruction and reconstruction by constant comparison were used for analysis. Participants told stories categorized as Holding On to Present Self, Holding On to Ableness, Holding On to Being Interested and Being Interesting, Holding On By Seeking to Know, and Holding On by Purposefully Choosing and Acting. Older women with OA may have strengths of self-caring, including positive appraisal of their OA and capabilities, maintenance and development of skills, and remaining interested in the world. Health professionals can support clients by assessing strengths and difficulties and helping clients modify activities and to find resources necessary for independent living.

Adaptation, Psychological↗

PubMed2000

Thyroid cancer: patients' experiences of receiving iodine-131 therapy.

PURPOSE/OBJECTIVES: To enhance understanding of the experiences and educational needs of patients receiving iodine-131 (131I) therapy for the treatment of thyroid cancer. DESIGN: Qualitative design using interpretive description. SETTING: A 24-bed oncology/acute-care medical unit in a large tertiary hospital in western Canada. SAMPLE: 5 men and 22 women (18-80 years of age) who have received 131I therapy in the past two years. METHODS: Unstructured focus group and telephone interviews and field notes. Interviews were tape-recorded, transcribed verbatim, and subjected to thematic analysis. FINDINGS: Researchers elicited four major themes from the analysis: (a) recognizing the totality of the cancer experience, (b) being isolated, (c) recognizing the totality of the treatment experience, and (d) understanding barriers to treatment. CONCLUSIONS: Healthcare providers require a better understanding of thyroid disease and the treatment and side effects of 131I therapy. Furthermore, educational programs are required to adequately prepare nurses and patients for future care. IMPLICATIONS FOR NURSING PRACTICE: A need exists to improve the care and education provided to patients receiving 131I therapy. In particular, recognition of the totality of the cancer experience and the need for both staff and patient education were illustrated. If nurses are to provide comprehensive cancer care, both psychosocial and physical needs must be addressed and fulfilling these needs requires a collaborative approach among patients, nurses, and other healthcare professionals.

Administration, Oral↗

PubMed2002

Strength in adversity: motherhood for women who have been battered.

Research into violence against women in intimate relationships has begun to uncover women's experiences of abuse. However, there is a paucity of research addressing women's mothering experiences in the context of partner abuse. The purpose of this study was to explore the experience of motherhood from the perspective of women who have been battered. The methodology used was interpretive description, a qualitative research approach in which the women's accounts could be conceptualized as constructed narratives. Five mothers who had been battered were interviewed twice. Analysis revealed that the abuse shaped their experiences of motherhood and that they faced complex mothering challenges, but that motherhood nevertheless acted as a buffer against the abuse and as a source of strength. The findings extend our understanding of the complexities of mothering in the context of abuse and provide direction for improving health-care support for mothers who have been abused.

Adaptation, Psychological↗

PubMed2004

Spiritual caregiving at the juncture of religion, culture, and state.

In response to the increasing social diversity of health-care recipients, nurse scholars have turned their attention to developing theoretical foundations for culturally responsive and spiritually sensitive nursing practice. However, despite the potential overlap between these 2 areas, there has been little exploration of the intersections between culture and spirituality. The authors present the findings of an interpretive descriptive pilot study that examined the contexts of intercultural spiritual caregiving from the perspectives of nurses and chaplains. The findings point to the need for health-care professionals to cultivate an internal space in which to provide spiritual care and to seek spiritual points of connection amidst diverse faith and cultural traditions. The contexts of current practice environments, as well as the social setting of a pluralistic and secular state, shape the dynamics of spiritual caregiving. The findings invite postcolonial, critical analyses of contemporary conceptions of spirituality and spiritual caregiving, and call for a rethinking of the trend towards de-emphasizing creedal religions in the quest for a universal spiritual experience.

Canada↗

PubMed1992

Suicide and unemployment in Italy: description, analysis and interpretation of recent trends.

This paper assesses the relationship between suicide and unemployment in Italy during the period 1977-1987, taking into account variations by gender and region. The first objective of the study is to provide descriptive longitudinal and cross-sectional aggregate-level analyses and also trends in individual-level and population risks for suicide in relation to unemployment. Our second objective is to use the Italian data to help discriminate between rival interpretations of the unemployment-suicide link, i.e. the operation of health selection or causal (susceptibility) mechanisms. Evidence for an association between suicide and unemployment among women was not convincing. The annual rate of female unemployment was negatively correlated with the female suicide rate and unrelated to the suicide rate among the unemployed, the relative risk or population attributable risk. Individual-level analyses for each year confirmed that unemployed women were more likely to commit suicide than their employed counterparts, although the overall relative risk was low (1.5) and conference intervals for six of the eleven annual risk ratios included unity (1). Among men, the unemployment rate was positively correlated over time with the suicide rate. However, change in the suicide rate across 18 geographic regions of Italy was unrelated to change in the unemployment rate, a finding which did not appear to be invalidated by a regression to the mean effect. Unemployment was also positively related to the suicide rate among the employed and population attributable risk, but unrelated to the rate among the unemployed or the relative risk. Comparison of suicide rates among the employed and unemployed revealed an excess of suicide among the latter in each year, with an overall relative risk of 3.4. On the basis of this contradictory and inconsistent evidence, we are cautious about offering definitive interpretations concerning the nature of the unemployment-suicide link among men. We conclude by suggesting the need for further individual-level studies using retrospective case-control methods.

Adult↗

PubMed2006

The biological condition gradient: a descriptive model for interpreting change in aquatic ecosystems.

The United States Clean Water Act (CWA; 1972, and as amended, U.S. Code title 33, sections 1251-1387) provides the long-term, national objective to "restore and maintain the ... biological integrity of the Nation's waters" (section 1251). However, the Act does not define the ecological components, or attributes, that constitute biological integrity nor does it recommend scientific methods to measure the condition of aquatic biota. One way to define biological integrity was described over 25 years ago as a balanced, integrated, adaptive system. Since then a variety of different methods and indices have been designed and applied by each state to quantify the biological condition of their waters. Because states in the United States use different methods to determine biological condition, it is currently difficult to determine if conditions vary across states or to combine state assessments to develop regional or national assessments. A nationally applicable model that allows biological condition to be interpreted independently of assessment methods will greatly assist the efforts of environmental practitioners in the United States to (1) assess aquatic resources more uniformly and directly and (2) communicate more clearly to the public both the current status of aquatic resources and their potential for restoration. To address this need, we propose a descriptive model, the Biological Condition Gradient (BCG) that describes how 10 ecological attributes change in response to increasing levels of stressors. We divide this gradient of biological condition into six tiers useful to water quality scientists and managers. The model was tested by determining how consistently a regionally diverse group of biologists assigned samples of macroinvertebrates or fish to the six tiers. Thirty-three macroinvertebrate biologists concurred in 81% of their 54 assignments. Eleven fish biologists concurred in 74% of their 58 assignments. These results support our contention that the BCG represents aspects of biological condition common to existing assessment methods. We believe the model is consistent with ecological theory and will provide a means to make more consistent, ecologically relevant interpretations of the response of aquatic biota to stressors and to better communicate this information to the public.

Ecosystem↗

PubMed1993

The meaning of being homeless.

In this study, the meaning of the experience of being homeless as lived by 15 homeless women with dependent children is explored. The significance of being homeless is approached from what is known about the concept of home. Following a review of the literature, an identification of the sample, and an explanation of how data were collected, a three-level phenomenological method was utilized: description, reduction, and interpretation. The descriptive level generates seven themes: boundaries, connections, fatigue/despair, self-respect, self-determination, privacy, and mobility. The reduction level reveals three ways of being homeless: physical, social, and symbolic. The interpretation of the meaning of being homeless employs the metaphor of homelessness as a whirlpool. Implications for nursing and social policy are discussed.

Adult↗

PubMedDate not supplied

Systematic reviews of interpretive research: interpretive data synthesis of processed data.

This paper discusses the synthesis of qualitative data during the systematic review of interpretive research. Current approaches to data synthesis can be broadly classified as either descriptive or interpretive. Descriptive data synthesis is achieved through narrative and tabulation. While a number of different terms have been used, interpretive synthesis is achieved through processes similar to those used by primary interpretive researchers. However, there has been only limited professional discussion and debate of this issue and existing methods are in need of further investigation and the validity and usefulness of the product of this synthesis examined.

Data Interpretation, Statistical↗