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Comprising the largest group of health care professionals, nurses play a great role and assume many responsibilities during disaster periods, when the public needs health care services the most. The aim of this study was to reveal the experiences of nurses assigned to the disaster area during relief efforts after the February 6, 2023 earthquakes in Türkiye.
Methods
This qualitative and descriptive study used the maximum variation sampling method, one of the purposive sampling methods, and was completed with 20 nurses. Data were analyzed using inductive content analysis.
Results
Four main themes emerged from the experiences of the nurses who provided health care services in the disaster area: experiences related to pre-mission processes, experiences during the mission, post-mission experiences, and recommendations for disaster preparedness.
Conclusions
Nurses’ experiences and suggestions revealed in this study may inform future disaster preparedness and disaster management plans, and this study’s results point to the need for the development of professional nursing skills in disaster management.
Frailty in older adults with cancer is complex, evolving, and often overlooked in care. This qualitative study explored how frailty is experienced and reported using patient-reported outcome measures (PROMs) and visualized over time through journey maps. Eleven participants (65+) completed the Comprehensive Frailty Assessment Instrument (CFAI) and semi-structured interviews. Individual journey maps combined CFAI scores with personal narratives to track changes in physical, mental, and social aspects of frailty over time. While PROMs showed variability in frailty severity, narratives revealed discrepancies, such as low frailty scores despite significant treatment-related challenges. Fatigue, emotional distress, and isolation were common during treatment, with lasting impacts post-treatment. Findings suggest PROMs alone may not fully capture lived experience. Integrating narrative dialogue provides a more person-centred approach to frailty assessment and care planning.
Breastfeeding assumes critical importance in the aftermath of disasters such as earthquakes, as it provides all the essential nutrients required by infants, enhances their immune systems, and mitigates the risks associated with using contaminated water for formula preparation. This study investigates the experiences of breastfeeding mothers living in temporary shelters within the earthquake-affected region.
Methods
A qualitative approach was employed to identify the challenges faced by breastfeeding mothers. The study’s sample included 14 mothers who met the inclusion criteria. Data were collected through a semi-structured interview form and analyzed using MAXQDA qualitative data analysis software, following Colaizzi’s 7-step method.
Results
The mothers in the study ranged in age from 31-37 years, with their infants ranging from 10 days-6 months old. Based on the data gathered from the interviews, 4 main themes were identified: basic life needs (with sub-themes of housing, warmth, nutrition, hygiene/sanitation, sleep, and clothing), emotional difficulties (with sub-themes of shock, fear, crying, and stress), care difficulties (with sub-themes of challenges in accessing medication, constipation, diarrhea, reduced comfort, and decreased urine output), and breastfeeding difficulties (with sub-themes of breast rejection, breast engorgement, baby feeding issues, reduced milk production or interruption, and privacy concerns).
Conclusions
From the onset of the earthquake, mothers encountered significant challenges in breastfeeding their infants. In emergency and disaster situations, it is imperative that experienced health care personnel offer essential information and support to assist these mothers in navigating the difficulties they face.
La maltraitance organisationnelle envers les personnes aînées est présente dans différentes organisations, y compris dans le secteur de la santé et des services sociaux. Elle peut entraîner des conséquences négatives importantes sur la santé mentale et physique, ainsi que la qualité de vie, des personnes aînées qui la subissent. L’objectif de cet article est de présenter les enjeux éthiques liés à la maltraitance organisationnelle perpétrée envers les personnes aînées qui reçoivent des services de soutien à domicile. Une approche d’inspiration phénoménologique utilisée auprès d’ergothérapeutes pour identifier les enjeux éthiques de leur pratique a mené à une analyse des enjeux éthiques spécifiquement liés à des situations de maltraitance organisationnelle. Quinze ergothérapeutes (n=15) œuvrant en soutien à domicile au Québec ont été rencontrés dans le cadre d’entretiens individuels. L’analyse a été effectuée en utilisant une perspective écologique. Les résultats de l’analyse révèlent plusieurs enjeux éthiques complexes de nature micro, méso et macrosystémiques, dont l’abandon administratif des bonnes pratiques, l’accès déficitaire aux services, la chosification de l’aîné, la dépersonnalisation des services et la tolérance des violences.
The Garo tribe, one of a major indigenous communities of Meghalaya, India, relies heavily on their traditional health practices. This research investigates the healthcare-seeking behaviour of Garo women, their health concerns, their indigenous medical knowledge, and their reasons for preferring traditional over modern medicines. Conducted in East Garo Hills, Meghalaya, quantitative data (N = 96) were randomly collected from Garo women aged 15–49 through interviews to understand their health-seeking behaviour. Following a preliminary analysis, qualitative data (N = 12) were gathered through in-depth interviews to identify common illnesses, dimensions of traditional medicines, and reasons for dependency on them. Thematic analysis was performed using Atlas Ti. The result shows that almost 84% of Garo women (N = 86) seek treatment from Ojha (traditional healer) for achik (traditional) medicine, with only 6% using modern health facilities and 10% relying on herbal home remedies. Garo women rely on their age-old traditional remedies for health issues, irrespective of their educational or economic status. From the qualitative findings, this study explores the Garo tribe’s unique traditional medicine, known as ‘achik medicine’, prepared through local herbs and plants, and is disseminated by traditional healers, or ‘ojhas’, whose knowledge is generational. Moreover, every Garo household possesses medicinal plants, and all are knowledgeable about their use. Major health issues faced by Garo women are menstrual disorders, post-delivery weakness, fever with severe headache and jaundice. Reasons for using achik medicines are more effectiveness than modern medicines, cultural identity, preference for natural remedies, efficiency of Ojhas, availability, accessibility, and affordability of Ojhas. Meanwhile, the reasons for using limited use of modern healthcare facilities are poor quality of service and remote location. This study underscores the importance of preserving indigenous knowledge systems and respecting cultural heritage while ensuring the well-being of marginalised communities. Additionally, it highlights the need to improve modern healthcare quality and public transportation in the region.
Marriage with teenage girls is an important health and social challenge, which is caused by various factors. Considering that no research has been done to show the reasons for men’s desire to marry teenage girls, this research was conducted with the aim of identifying the reasons why men marry teenage girls in western Iran. This qualitative research was conducted with the conventional content analysis approach among 37 men in western Iran who married to girls under the age of 18. Targeted, theoretical, and snowball sampling methods were used to reach the participants. To collect data, semi-structured interviews were used both in-person (20 people) and online (17 people). Data analysis was done with Graneheim and Lundman approach and checking the accuracy and strength of the results with Guba and Lincoln criteria. One core category, 9 subcategories, and 88 initial codes were obtained from the data analysis. The core category, foresight along with desired upbringing, included the subcategories of getting sure of purity, to bring up the girl, seeking sexual pleasure, dominating the wife, low expectations, appropriate fertility, encouragement of social organizations and families, following models, and cultural beliefs. The reasons for men marrying teenage girls are rooted in personality traits, family encouragement, and the cultural and social context of the society. Marriage with teenage girls can be prevented by intervening at different levels and taking measures such as training and raising men’s awareness about the consequences of marrying teenage girls, changing men’s cultural and gender beliefs, raising the awareness of parents and social organizations about the adverse effects of child marriage, and establishing appropriate laws.
The European Union receives thousands of unaccompanied irregular migrant minors every year, but little is known about their life experiences during the migration process. The aim of this study is to describe their experiences as minors when they arrived in Spain in small boats, which will help to understand their psychosocial and health needs. A descriptive qualitative study was undertaken. In-depth interviews were conducted with 18 unaccompanied irregular migrants (15 men and 3 women) from different African countries with a mean age of 20.05 years (SD = 2.77). Thematic analysis was used to analyse the data. Three main themes emerged such as (1) unaccompanied irregular migrant minors: risking it all for a better life; (2) redefining your identity as a means of adaptation and (3) obtaining legal status to avoid deportation. Unaccompanied migrant minors risk their lives on the migration journey, but do not always find better conditions in the destination country. The unaccompanied irregular migrant minors are forced to rebuild their lives at a high cost; they experience rejection from the host society and their culture of origin, which has a negative impact on their physical and psychological health over time.
By 2025, over eight million UK households will be receiving Universal Credit (UC). Introduced in 2013 to simplify the benefit system and improve work incentives for working age adults, UC has been criticised for causing hardship and exacerbating inequalities. There is limited research on children and young people’s (CYP) views of UC, as well as its health and social impacts. In this pilot qualitative study, creative methods were used to understand the views of UC among CYP (n = 40) aged 12–16 years in North East England. Findings showed diverse and nuanced understanding of UC as well as contested views about conditionality, sanctions, lower UC rates for under-25s and the two-child limit alongside recognition of the stigma and shame associated with benefits. While CYP value paid employment, they stressed the importance of minimum income standards and tailored employment support for UC claimants, taking account of their personal, health and family circumstances. Findings suggest CYP are aware when parents and carers are struggling financially and may try to ease pressures on parents. Debates about principles of equality, fairness, social justice and deservingness were present in young people’s accounts. We conclude by exploring future directions for a CYP-centred approach to social policy.
Cognitive behavioural therapy (CBT) is one of the best-evidenced psychosocial interventions for psychosis and is recommended by the National Institute for Health and Care Excellence and the American Psychiatric Association. CBT was developed and derived from Western cultural values, which may not be appropriate for non-Western cultures. Trials of CBT in Western countries have indicated that participants from ethnic minority groups demonstrate low rates of engagement, retention, and recruitment. This indicates that the principles underlying CBT may conflict with individual beliefs and cultural values in non-Western countries. Therefore, we interviewed 15 people diagnosed with schizophrenia and 15 with their family members to explore the beliefs and attitudes of people diagnosed with schizophrenia and their family members concerning the proposed CBT intervention for psychosis in the Saudi context. The findings revealed that most participants accepted the proposed intervention. Important factors that influenced participants’ engagement and motivation in the CBT intervention were related to the therapist’s qualities (sex, empathy, and competence), family involvement, religion, and the number and format of CBT sessions for psychosis.
Key learning aims
(1) To explore the beliefs and attitudes of people diagnosed with schizophrenia concerning the proposed CBT intervention for psychosis and how to improve it to make it more appropriate for their needs and cultures.
(2) To explore the beliefs and attitudes of family members of people diagnosed with schizophrenia concerning the proposed CBT intervention for psychosis and how to improve it to make it more appropriate to their needs and culture.
Despite significant advancements in the development of psychotropic medications, increasing adherence rates remain a challenge in the treatment and management of psychiatric disorders. The purpose of this study is to qualitatively explore the challenges underlying medication adherence and strategies to improve it among adolescents with psychiatric disorders in Malaysia. This qualitative research design presents results from 17 semi-structured interviews with adolescent psychiatric patients, aged 11 to 19 years old, from public hospitals across Peninsular Malaysia. The data collected from interviews were transcribed and processed through thematic analysis using the NVivo 11 software. A total of three main themes concerning medication adherence were identified: (1) challenges; (2) coping strategies and (3) protective factors. In this study, thirteen subthemes emerge as challenges underlying medication adherence experienced by adolescent psychiatric patients. The coping strategies identified in this study fall under three broad subthemes which are problem-focused strategies, emotion-focused strategies and maladaptive strategies. This study also highlights social support and positive medicinal effects as protective factors for non-adherence issues in adolescent psychiatric patients. In conclusion, this study supports the notion that adherence is a multi-factorial phenomenon. This study can inform future development of interventions and targeted health promotion programmes in enhancing adherence.
Patients with progressive neurologic illness still lack access to quality palliative care services. Barriers to the comprehensive provision of neuropalliative care include gaps in palliative care education. To address this barrier, a novel international model of neuropalliative care education e-learning program was launched in 2022.
Methods
This is a qualitative study on the self-reported learning outcomes and educational gains of participants of a neuropalliative care e-learning course.
Results
Thematic analysis shows changes in the participants’ perceptions of neuropalliative care and several specific educational gains. After attending the course, participants recognized neuropalliative care as a multiprofessional and interdisciplinary effort requiring more than medical knowledge and disease-specific treatment skills. They gained understanding of the complexity of prognosis in neurological diseases, as well as ethical concepts as the basis to approach difficult decisions. Valuing the needs of patients and caregivers, as well as honest and open communication were recognized as key components of the caring process. In particular, providing emotional support and building relationships to enhance the spiritual component of care were avidly discussed as essential nonmedical treatment options.
Significance of results
E-learning courses are helping to close the gaps in healthcare professionals’ knowledge and skills about neuropalliative care.
Diagnosis of amyotrophic lateral sclerosis (ALS) takes more than 1year from detection of first symptoms. The paper seeks to understand the ALS diagnostic process and adjustment from the perspective of informal caregivers.
Methods
The data stems from an interview study with 9 current and 13 bereaved informal caregivers of people with ALS in Switzerland. The interviews were analyzed using thematic analysis.
Results
We identified 3 key themes pertaining to ALS diagnosis. In the first theme, we present the close involvement of informal caregivers in the “diagnosis journey.” Highlighted within this theme is the important role they play, which ultimately leads to diagnosis of ALS avoiding further delays. Second, we relay their perceptions on “diagnosis communication pitfalls” where they underlined empathy and planning from the part of medical professional, while communicating the terminal diagnosis of ALS. Participants’ reactions and adjustments post-ALS diagnosis are described in “the aftermath of diagnosis.” In this third theme, we highlight participants’ shock and their need to rethink overall life plans and roles in their family.
Significance of the results
Diagnosis communication that is clear, empathetic, and adjusted to the needs of the patients as well as their caregivers is critical. More work is needed to improve diagnosis communication for ALS patients. Receiving the diagnosis of ALS leads to complete changes in life of caregivers. It is therefore necessary that medical professionals provide adequate support that allows them to plan for their future.
Sexual unwellness (SU) has been linked to a lack of sexual satisfaction and to an incapacity to maintain sexual relations.
Objectives
The objective of this cross-cultural study is to shed light on older adults’ perspectives on SU across cultures.
Methods
Eighty-three older participants (65 to 98 years of age) took part in this qualitative study. Participants lived in the community and were of two different nationalities (Portuguese and Mexican). Semi-structured interviews were conducted, and content analysis was then carried out.
Results
SU emerged in the findings of the content analysis through six themes: Dissatisfying Sexual Experiences; Feelings of Isolation; Spirituality; Medication; Unattractiveness and Pain. The most common theme among older Portuguese participants was ‘Dissatisfying Sexual Experiences’ (25.5%). ‘Feelings of Isolation’ was most common among older Mexican participants (13.7%).
Conclusions
A diversity of experiences of older adults in relation to SU was highlighted in this study. Moreover, cross-cultural research on the construct of SU is essential for understanding the cultural differences in the conceptualization of the construct and how these themes may influence the quality of sexual life in old age.
The apparently contradictory co-existence of high levels of gender equality and intimate partner violence against women (IPVAW) found in Nordic countries has been termed the Nordic Paradox. The aim of this study was to examine how the Nordic Paradox is discussed and explained by Spanish professionals working in the IPVAW field. Five focus groups (n = 19) and interviews with key informants (n = 10) were conducted. Four main categories of possible explanations for the Nordic Paradox were identified: Macro-micro disconnect (i.e., discordance between individual beliefs and behaviors and macro-social norms of gender equality), IPVAW as multicausal (i.e., IPVAW defined as a multicausal phenomenon that does not necessarily have to be associated with gender equality), cultural patterns of social relationships (i.e., the role of social relationships and the way people relate to each other in the Nordic countries), and backlash effect (i.e., men’s reaction to greater equality for women). Although this study does not provide a final explanation for the Nordic paradox, its results provide us with a better understanding of the phenomenon and can help to advance research in this field.
Existential guilt is a deep and multidimensional concept that is correlated with concepts, such as in/authenticity, existential anxiety, decisiveness, and personal and social responsibility. The aim of the present study is to investigate the experience of existential guilt among cancer patients.
Methods
The present research was conducted with a qualitative method with a content analysis design. A purposeful sampling method was used to select the participants and the sampling procedure went on until we reached data saturation. Data were obtained using semi-structured interviews with the participants.
Results
From a total of 18 interviews, 94 codes related to existential guilt were obtained. After the analysis, three main concepts were extracted: (1) incompleteness, (2) passivity, and (3) feelings of harm to self and others. Each of these had a number of subcategories.
Significance of results
The participants of the present research were found to experience existential guilt in different ways. The research showed that it is necessary to find the sources of existential guilt in order that effective therapeutic attention can be given cancer patients.
Edited by
Fiona Kelly, La Trobe University, Victoria,Deborah Dempsey, Swinburne University of Technology, Victoria,Adrienne Byrt, Swinburne University of Technology, Victoria
The experience of families who resort to donor sperm conception has been rather well documented. However, how this experience unfolds in the context of insemination fraud is for the most part still unknown. The focus so far has been on the ethical principles this fraud violates and the reasons why it has not been criminally charged. This chapter presents the results of an exploratory qualitative study carried out with 13 Canadian participants who were victims of insemination fraud. With a focus on the experience of the discovery of the insemination fraud by parents and donor-conceived offspring, this chapter discusses the trajectory of this discovery, the emotions associated with it, and its disclosure to minor children. Although the experience varies according to the nature of the fraud, and the circumstances of its discovery, common patterns can be observed: shock, sideration and disbelief, feelings of being betrayed by the medical institution.
Aboriginal Elders in Australia are recognised as having an important role as community leaders and cultural knowledge holders. However, the effects of colonisation and institutional racism mean Elders also experience significant social and economic disadvantage and poor health outcomes. There has been a systemic lack of attention to the worldviews and priorities of Aboriginal people as they age. In this article, we detail the findings of a qualitative study using a localised Aboriginal Elder-informed methodology that involved interviews and focus groups with 22 Aboriginal Elders in the remote town of Walgett on what ageing well means to them. This study was undertaken as part of a long-term partnership between a unique community-controlled Elders organisation and a university. The findings illuminate the barriers and enablers to ageing well for Aboriginal people in Walgett and elsewhere, and demonstrate the value to research, policy and service delivery of listening to and learning from Elders, centring Indigenous knowledges and worldviews, and bringing a more holistic conceptualisation of wellbeing to the understanding of what it means to age well.
To examine the thematic features of dignity therapy generativity documents of advanced cancer patients receiving chemotherapy in mainland China from the perspective of meaning-making during dignity therapy.
Methods
This is a qualitative descriptive study. Content analysis was used to analyze 24 dignity therapy generativity documents derived from a quasi-experimental trial of dignity therapy for advanced cancer patients receiving chemotherapy in a daycare center at a cancer hospital in northern China.
Results
Among the 24 advanced cancer patients whose generativity documents were analyzed, 14 were male and ranged in age from 26 to 78 years (average = 50.3). Two dimensions emerged from the data: (1) the sources of meaning in life, which consisted of social relationships, things and circumstances providing meaning in life, and (2) the ultimate meaning in life, referring to finding one’s real self and realizing the purpose in life, including personal life goals, dignity and autonomy, and morality of patients.
Significance of results
The multidimensional constructs of meaning in life with distinctive traditional Chinese cultural characteristics could provide insights into dignity-conserving care for advanced cancer patients with Chinese culture and provide evidence for refining the implementation protocol of DT through intentionally addressing the ultimate meaning of patients in the therapeutic session.
This study aims to provide an in-depth understanding of the content and process of decision-making about palliative sedation for existential suffering (PS-ES) as perceived by Belgian palliative care physicians.
Methods
This Belgian nationwide qualitative study follows a grounded theory approach. We conducted semistructured interviews with 25 palliative care physicians working in 19 Belgian hospital-based palliative care units and 4 stand-alone hospices. We analyzed the data using the Qualitative Analysis Guide of Leuven, and we followed the Consolidated Criteria for Reporting Qualitative Research Guidelines (COREQ).
Results
Analysis of the data identified several criteria that physicians apply in their decision-making about PS-ES, namely, the importance of the patient’s demand, PS-ES as a last resort option after all alternatives have been applied, the condition of unbearable suffering combined with other kinds of suffering, and the condition of being in a terminal stage. Regarding the process of decision-making itself, physicians refer to the need for multidisciplinary perspectives supported by an interpretative dialogue with the patient and all other stakeholders. The decision-making process involves a specific temporality and physicians’ inner conviction about the need of PS-ES.
Significance of results
Belgian palliative care physicians are not sure about the criteria regarding decision-making in PS-ES. To deal with complex existential suffering in end-of-life situations, they stress the importance of participation by all stakeholders (patient, relatives, palliative care team, other physicians, nurses, social workers, physiotherapists, occupational therapists, chaplains, etc.) in the decision-making process to prevent inadequate decisions being made.
Underutilisation of school counselling services was prevalent prior to the COVID-19 pandemic. Using the theory of planned behaviour (TPB) as a framework, this qualitative study seeks to elicit salient beliefs towards help-seeking from a school counsellor in secondary school contexts. Through focus-group discussions and individual interviews, 29 students from 10 secondary schools were interviewed. Constructive content analysis was utilised to identify specific salient behavioural beliefs, salient normative norms and salient control belief. The salient beliefs identified include perceiving counselling as a form of professional help, nonjudgment, stigmatisation, and past counselling experience. This study identified and highlighted a systematic approach to understanding specific socio-cognitive factors that support and hinder school counselling utilisation in an Asian school context. Implications arising from the study were discussed in the light of the findings.