RESUMO
This qualitative study provides a platform for women veterans to inform our perspective of their experienced impacts following military sexual trauma (MST). We engaged 23 women veterans in semistructured interviews and used a grounded theory-informed thematic analytic approach, to interpret women's experiences. Women described negative impacts of their MST experiences across psychological, behavioral, and occupational domains. Less frequently, women discussed experiences of posttraumatic growth. These results aid our understanding of the complexities of women's posttrauma experiences and suggest that holistic intervention frameworks focused on a range of potential intervention targets are warranted in helping women veterans recover from MST.
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Vítimas de Crime, Militares, Delitos Sexuais, Transtornos de Estresse Pós-Traumáticos, Veteranos, Feminino, Humanos, Veteranos/psicologia, Trauma Sexual Militar, Delitos Sexuais/psicologia, Pesquisa Qualitativa, Militares/psicologia, Transtornos de Estresse Pós-Traumáticos/etiologia, Transtornos de Estresse Pós-Traumáticos/psicologiaRESUMO
PURPOSE: The purpose of this paper was first to gain an in-depth understanding of the barriers and facilitators to implementing the BPS model and pain neuroscience education in the current Lebanese physical therapy health care approach and explore its acceptability. METHOD: A qualitative semi-structured interview using purposive sampling was conducted with eight Lebanese physical therapists practising in different governorates. The transcribed text from the interviews was analyzed using inductive thematic analysis. RESULTS: Two topics were generated and constructed by the researchers: (1) "barriers to the implementation of pain neuroscience education, with subthemes including (a) "current health care approach," (b) "basic curriculum and continuing education," (c) "patients' barriers"; (2) "facilitators to the implementation of pain neuroscience education," with subthemes containing (a) "interest in the BPS model, (b) "therapeutic alliance," and (c) "motivation for future training on BPS approach." CONCLUSION: The analysis of the results showed that Lebanese physical therapists currently hold a strong biomedical view of chronic pain, assessment, and treatment. However, despite the presence of barriers and challenges, they are aware and open to consider the implementation and future training about the BPS model and pain neuroscience education in their approach.IMPLICATIONS FOR REHABILITATIONThe exploration of potential barriers and facilitators to the bio-psychosocial model and pain neuroscience education implementation may provide an opportunity for better development and design of a culturally sensitive pain neuroscience education material for Arab-speaking and Lebanese physical therapists.The exploration of barriers and facilitators to the implementation of pain neuroscience education will help to improve pain education and ensure better clinical pain management.The most important barriers were the dominant characteristic of the Lebanese physical therapist's health approach, which is focused on a biomechanically oriented model, and their lack of knowledge to approach chronic pain from a biopsychosocial perspective.
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Dor Crônica, Neurociências, Fisioterapeutas, Humanos, Dor Crônica/terapia, Dor Crônica/psicologia, Pesquisa Qualitativa, Atenção à SaúdeRESUMO
Efficacious strategies can now prevent the transmission of HIV from mother to child. However, transmission rates remain unacceptably high, especially in sub-Saharan Africa. Understanding women's perinatal transitions can inform interventions to support adherence to preventive strategies. Therefore, we applied Transitions Theory in a longitudinal qualitative study to explore perinatal transitions among women living with HIV in western Kenya. We conducted in-depth interviews with 30 women living with HIV at 3 key time points and, using our findings, described the theory's concepts in terms of participants' experiences. We then proposed theory-based interventions that could support smooth transition processes and positive outcomes.
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Infecções por HIV, Mães, Gravidez, Criança, Feminino, Humanos, Quênia, Transmissão Vertical de Doenças Infecciosas/prevenção & controle, Estudos Longitudinais, Infecções por HIV/prevenção & controle, Pesquisa QualitativaRESUMO
OBJECTIVE: To explore the expectations of Brazilian and German patients regarding metastatic cancer and palliative chemotherapy. METHODS: Interviews with 48 metastatic cancer patients from Brazil and Germany were conducted. The interviews were transcribed and analyzed using the thematic analysis approach to identify common themes. The sociodemographic data were collected using an instrument developed by the authors. RESULTS: A total of 48 patients participated in the study (58% were Brazilian and 42% were German). Of all participants, 35% were men and 65% were women. The participants' mean age was 41 years. The general idea captured from the interviewees' speech was that their diseases were curable or "while there is chemotherapy, there is life"; thus, the data analysis enabled the elaboration of the central theme, entitled "Mistaken expectations of metastatic cancer patients regarding palliative chemotherapy: While there is chemotherapy, there is life," with 5 subthemes, namely: (1) communication and expectations; (2) normal life; (3) the person behind the disease; (4) religiosity and spirituality; and (5) the fortitude to choose between continuing or discontinuing treatment. SIGNIFICANCE OF RESULTS: Regardless of cultural aspects, patients with metastatic cancer on palliative chemotherapy tend to believe in the healing potential of treatments. Dividing expectations only into curable or incurable is insufficient, as even patients who have acknowledged the incurability of their disease expect to live, as long as they remain under treatment as if the disease did not exist.
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Neoplasias, Cuidados Paliativos, Masculino, Humanos, Feminino, Adulto, Brasil, Motivação, Neoplasias/tratamento farmacológico, Comunicação, Pesquisa QualitativaRESUMO
Purpose: Psychological resilience is vital to the development of sport talents. Qualitative research has consistently demonstrated that sport resilience encapsulates a mixed package of resilience qualities (reflecting positive traits and characteristics) and resilience support (reflecting perceived support and related resources). Ironically, sport resilience research adopting quantitative methods has been assessing resilience as a unidimensional construct, with little attention to the multi-facet nature of resilience and its effects on performance. In the present research, we tested a novel proposition that resilience qualities predict reduced pre-competition cognitive anxiety and contribute to performance more than resilience support. Methods & Results: Across two samples of competitive table tennis players (Study 1: N = 196 competing at province level; Study 2: N = 106 competing at national level), we consistently found resilience qualities, rather than resilience support, predicted lower levels of pre-competition cognitive anxiety and superior performance at a national championship. Results also suggest that pre-competition cognitive anxiety mediated the relationship between resilience qualities and performance. Conclusion: The findings provide the first evidence supporting the divergent effects of resilience qualities and resilience support in predicting pre- competition anxiety and championship performance and call for the consideration of such a distinction when designing and delivering resilience programs.
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Resiliência Psicológica, Esportes, Tênis, Humanos, Ansiedade, Pesquisa QualitativaRESUMO
PURPOSE: The delivery of healthcare services in rural locations can be challenging. From the perspectives of rural rehabilitation practitioners and compensation claims managers, this study explored the experience of providing and coordinating rehabilitation services for rural major traumatic injury survivors. MATERIALS AND METHODS: Semi-structured interviews with 14 rural rehabilitation practitioners and 10 compensation claims managers were transcribed, and reflexive thematic analysis was conducted. RESULTS: Six themes were identified (1) Challenges finding and connecting with rural services, (2) Factors relating to insurance claims management, (3) Managing the demand for services, (4) Good working relationships, (5) Limited training and support, and (6) Client resilience and community. System-related barriers included a lack of available search resources to find rural rehabilitation services, limited service/clinician availability and funding policies lacking the flexibility to meet rehabilitation needs in a rural context. Strong peer and interdisciplinary relationships were viewed as crucial facilitators, which rural practitioners were particularly adept at developing. CONCLUSIONS: Greater consideration of unique needs within rural contexts is required when developing service delivery models. Specifically, flexible and equitable funding policies; facilitating interdisciplinary connections, support and training for rehabilitation practitioners and compensation claims managers; and harnessing clients' resilience may improve the delivery of rural services.IMPLICATIONS FOR REHABILITATIONRural survivors of major traumatic injury often have ongoing health and rehabilitation needs and struggle to access required treatment services.Rehabilitation providers and compensation claims managers highlighted areas for improvement in rural areas, including resources for locating available services, funding the additional costs of rural service delivery, and greater service choice for clients.Building rural workforce capacity for treatment of major traumatic injury is needed, including improved clinician access to specialist training and support.Developing good working relationships between clients and clinicians, including interdisciplinary collaborations, and supporting client resilience and self-management should be promoted in future service delivery models.
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Serviços de Saúde Rural, Humanos, Austrália, Acessibilidade aos Serviços de Saúde, Recursos Humanos, População Rural, Pesquisa QualitativaRESUMO
PURPOSE: The aim of this qualitative study was to explore the views of participants of a group-based, supervised, telerehabilitation programme, following discharge from hospital with Covid-19. This study was part of a single-centre, fast-track (wait-list), randomised, mixed-methods, feasibility trial of telerehabilitation (Registration: Clinicaltrials.gov reference:285205). METHODS: Semi-structured interviews were conducted over a virtual teleconference platform with 10 participants who took part in a telerehabilitation programme following Covid-19 after discharge from an acute hospital. Data were transcribed verbatim and analysed using thematic analysis. RESULTS: Five themes were important from the participant perspective: telerehabilitation programme as part of the Covid-19 journey; the telerehabilitation programme design and delivery; peer aspects; the role of the instructor; and the role of technology and online delivery. CONCLUSIONS: Overall, the telerehabilitation programme was a positive experience for participants. The instructors were central to this positive view as was the group nature of the programme. The group aspect was particularly important in supporting the broader perceived wellbeing gains, such as the sense of enjoyment and reduced social isolation. Several participants would have liked to have continued with the exercises beyond the six-week intervention indicating that the programme could be a way to help people sustain a physically active lifestyle.IMPLICATIONS FOR REHABILITATIONParticipants who were recovering from Covid-19 following hospital admission perceived the telerehabilitation to be a positive experience overall.The group aspect of the telerehabilitation programme was important in supporting the broader perceived wellbeing gains such as the sense of enjoyment and reduced social isolation.Telerehabilitation programmes for Covid-19 may need to include pathways for participants to continue to engage in exercise beyond the time-limited six-week intervention to support ongoing self-management.
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COVID-19, Telerreabilitação, Humanos, Telerreabilitação/métodos, COVID-19/epidemiologia, Terapia por Exercício, Pesquisa Qualitativa, Exercício FísicoRESUMO
CONTEXT: Paediatric Spinal Cord Injury (SCI) has an impact on a child's dynamic development, disrupting their participation in school, community, and social relationships while simultaneously causing repercussions on their caregiver's life. The rare nature of paediatric SCI calls for a detailed inspection of the literature from the perspective of children and their caregivers. OBJECTIVE: This scoping review of qualitative research determines the extent of literature from perspective of caregivers and individuals with paediatric SCI. METHODS: 9351 full-text published articles were identified from CINAHL, Ovid, PubMed, and Scopus between 2001 and 2021. After duplicate deletion, 8354 articles were left, and 103 full-text articles were assessed for their eligibility. Finally, eight articles were assessed for their relevance. Key themes that emerged from the data were summarized, compared, and synthesized. RESULTS: Six studies were from the perspectives of individuals with SCI and two from caregiver's perspective. Three major themes were identified from caregivers' opinion studies: "Obstacles to community participation"; "Unmet needs related to a child with SCI"; and "Radiating effect on caregivers' lives"; whereas five were obtained from individuals with paediatric SCI opinion studies: "Adjusting to life with SCI"; "Hardships & hardiness"; "Peers & family/emotional support"; "Perception of self & body-image post injury"; and "Transitioning into post-traumatic life". CONCLUSION: There is a need for more specialized rehabilitation centers and an accessible environment in public spaces. Also, the review sheds some light on the discriminatory attitude of society as a whole, which can be improved by providing proper knowledge and awareness of SCI.
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Cuidadores, Traumatismos da Medula Espinal, Humanos, Criança, Cuidadores/psicologia, Traumatismos da Medula Espinal/reabilitação, Pesquisa Qualitativa, Emoções, SobreviventesRESUMO
This research uses a mixed quantitative and descriptive approach to analyze the representation of LGBTQ+ people in YouTube fiction produced by Singaporean filmmakers. It observes the general characteristics of such portrayals with a particular focus on the characters' gender and identity expressions. Simultaneously, a qualitative study analyzes these observations in greater depth by means of discourse analysis on two levels. A macro level identifies the ideas conveyed by the narratives and a micro level identifies the portrayal of stereotypes, types of masculinity, visibility of sexual orientation and affective/sexual relations. The results show that Singaporean LGBTQ+ filmmakers depict homonormative characters and follow cis-heteronormative canons. They do not advocate for the normalization of LGBTQ+ realities, and instead present distorted constructions of LGBTQ+ people that do little to encourage their acceptance. This does not contribute to any improvement in sociocultural views of non-normative sexual and gender orientations and negatively impacts the LGBTQ+ identity. Moreover, LGBTQ+ people from the country's ethnic minorities are ignored. These results inform academia, audiovisual industries and regulators about the representation of LGBTQ+ people in fictional products in countries where queer populations still face stigmatization and marginalization.
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Minorias Sexuais e de Gênero, Humanos, Masculino, Feminino, Identidade de Gênero, Comportamento Sexual, Pesquisa Qualitativa, MasculinidadeRESUMO
PURPOSE: To understand the current utilisation of the clinical framework for delivery of health services to manage compensable musculoskeletal injuries from the perspectives of insurer case managers and clinical panel members. MATERIALS AND METHODS: Using a qualitative descriptive approach, 15 semi-structured interviews were conducted with members of key organisations including WorkSafe Victoria and Transport Accident Commission Victoria. All interviews were recorded and transcribed verbatim and analysed using thematic analysis. RESULTS: Four over-arching themes were identified: (i) current use of the framework and principles is suboptimal leading to several problems including lack of evidence-based treatment by clinicians; (ii) barriers to optimal use of the framework include lack of adequate training of healthcare professionals on the framework principles and financial aspects of the compensation system; (iii) utilisation of the framework could be improved with training from peak associations, insurers, and regulating bodies; and (iv) optimal use of the framework will result in better health and work outcomes. CONCLUSIONS: The current use of the framework and its principles is suboptimal but can be improved by addressing the identified barriers.IMPLICATIONS FOR REHABILITATIONRehabilitation of compensable musculoskeletal injuries is often complex.Implementing the "Clinical Framework for Delivery of Health Services" can lead to provision of time and cost effective, evidence-based rehabilitation for compensable injuries, ultimately improving patient outcomes.Clinicians can enhance the implementation of the framework principles by integrating evidence-based practice and recommendations from clinical practice guidelines in treatment of compensable musculoskeletal injuries.Implementation of the framework principles may be enhanced by reviewing the compensation funding model to allow the healthcare practitioners adequate time and remuneration to adopt the framework principles when treating persons with compensable injuries.
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Atenção à Saúde, Seguradoras, Humanos, Serviços de Saúde, Pessoal de Saúde, Pesquisa QualitativaRESUMO
PURPOSE: We sought to describe factors influencing reduced rates of obesity screening for patients with spinal cord injury (SCI) in the United States Veterans Health Administration (VA) and to foster potential solutions. MATERIALS AND METHODS: Semi-structured interviews with healthcare providers and patients with SCI who were recruited nationally from diverse VAs. We performed rapid qualitative analysis using content analysis of interview data. RESULTS: There were 36 providers and 37 patients. We identified provider, patient, and system level barriers to obesity screening for individuals with SCI. Overarching barriers involved provider and patient perceptions that obesity screening is a low priority compared to other health conditions, and body mass index is of low utility. Other obesity screening barriers were related to measuring weight (i.e., insufficient equipment, unknown wheelchair weight, staffing shortages, measurement errors, reduced access to annual screening, insufficient time, patient preference not to be weighed) and measuring height (i.e., insufficient guidance and equipment to this population, measurement errors). CONCLUSIONS: Barriers to obesity screenings exist for patients with SCI receiving care in VA. Healthcare provider and patient interviews suggest possible solutions, including standardizing height and weight measurement processes, ensuring equipment availability in clinics, clarifying guidelines, and offering support to providers and patients.IMPLICATIONS FOR REHABILITATIONIndividuals with spinal cord injury (SCI) have higher rates of obesity, but are often overlooked for annual obesity screening, even in clinic settings designed to care for individuals with SCI.Results may help tailor guidelines/education for healthcare and rehabilitation providers offering them guidance for improving obesity screening for individuals with SCI by standardizing weight and height measurement and documentation. To facilitate this, findings highlight the need for resources, such as ensuring clinics have necessary equipment, and increasing patient access to support and equipment.Improving the provision of obesity screening for individuals with SCI is necessary to improve health outcomes and patient satisfaction with care.
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Traumatismos da Medula Espinal, Saúde dos Veteranos, Humanos, Pesquisa Qualitativa, Pessoal de Saúde, Atitude do Pessoal de SaúdeRESUMO
Empathy has been highlighted as a key concept in chaplaincy care, but its meaning has hardly been explored in depth within this field. This study aims to help develop stronger conceptual clarity by investigating humanist chaplains' conceptualizations of empathy. Data were collected through semi-structured interviews with twenty humanist chaplains working in health care, military, and prisons. A qualitative design was employed to clarify which components and features constitute empathy in humanist chaplaincy care. Empathy emerges as a multidimensional concept that is "fundamentally human." Chaplains distinguish between true and pseudo empathy based on different features including authenticity and concern. This article provides a conceptual model that combines the different components and features of empathy in humanist chaplaincy care and the relationship between them in light of empathy's humanizing quality. It may be used for educational purposes and could function as a conceptual framework for future research efforts.
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Serviço Religioso no Hospital, Assistência Religiosa, Humanos, Clero, Empatia, Formação de Conceito, Pesquisa QualitativaRESUMO
OBJECTIVES: The aim of this study was to explore oral health experiences and priorities in a diverse group of adults aged over 60 in North West England, an area with high oral health inequality. METHODS: Participants were selected using purposive sample from multiple settings across the North West: community, primary dental care and residential care home. Data were collected between October 2018 and March 2019 and involved eight focus groups and three individual interviews with a total of 47 participants. The data were analysed using thematic analysis. RESULTS: Four key themes were identified. The first was issues important to people over 60, which included the appearance of one's teeth, communication, continuity of care and the treatment experience. These were informed by two further themes, past experiences of treatment, which were not always favourable, and perceived barriers, such as accessing NHS dentistry, cost, physical access and oral care in institutional settings. The fourth, connected theme focussed on how oral healthcare messages for different audiences should be disseminated. CONCLUSIONS: There are shortfalls in the provision of oral healthcare to older adults in the UK. Communication and continuity of care with a trusted oral healthcare provider are key priorities for this population. However, our participants felt that current public provision of dental services is not meeting their needs.
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Disparidades nos Níveis de Saúde, Saúde Bucal, Humanos, Pessoa de Meia-Idade, Idoso, Atenção à Saúde, Pesquisa Qualitativa, Inglaterra/epidemiologiaRESUMO
OBJECTIVES: People living with chronic obstructive pulmonary disease (COPD) in regional communities experience a higher disease burden and have poorer access to support services. This study sought to investigate the acceptability of a peer-led self-management program (SMP) in regional Tasmania, Australia. METHODS: This descriptive qualitative study, underpinned by interpretivism used semi-structured one-to-one interviews to gather data to explore COPD patients' views of peer-led SMPs. Purposeful sampling recruited a sample of 8 women and 2 men. Data was analysed using a thematic approach. RESULTS: The three final themes, 'Normality and Living with the disease', a 'Platform for sharing' and 'Communication mismatch' suggest that peer-led SMPs could offer an opportunity to share experiences. The themes also suggest that COPD often manifested as a deviation from 'normal life'. Communication was often felt to be ambiguous leading to tension between the health experts and people living with the condition. DISCUSSION: Peer-led SMP has the potential to provide the much-needed support for people living with COPD in regional communities. This will ensure that they are empowered to live with the condition with dignity and respect. Benefits of exchanging ideas and socialisation should not be ignored and may enhance sustainability of SMPs.
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Doença Pulmonar Obstrutiva Crônica, Autogestão, Masculino, Humanos, Feminino, Tasmânia, Doença Pulmonar Obstrutiva Crônica/terapia, Pesquisa Qualitativa, AustráliaRESUMO
Education is one of the most crucial instruments for refugee youth to remove the disadvantages and enhance their social and structural integration into society. However, the unequal education opportunities concerning the barriers avoid the integration of refugee students into society and make them prone to discrimination. This qualitative descriptive design study aimed at describing the experiences of the subjective perspectives of Syrian refugee students about higher education. The participants were final-year undergraduate Syrian refugee students. Data were collected by conducting in-depth semi-structured face-to-face interviews using a pilot-tested interview guide. The researchers followed a systematic data analysis procedure. The themes were finalized once the researchers had reached a consensus. The responses of the students were subsumed under the following three main themes: (1) Being 'other', (2) Hopes vs Realities, and (3) What doesn't defeat me makes me stronger. The participants reported feeling ignored and worthless due to the biases and assumptions of society, which result in stigma and discrimination. Additionally, refugee students revealed that their peers and even educators may sometimes share the same beliefs. However, the study also underlined the value of resilience in shaping the perspectives, even though they faced many challenging experiences.
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Refugiados, Adolescente, Humanos, Turquia, Síria, Universidades, Pesquisa Qualitativa, EstudantesRESUMO
OBJECTIVE: To describe how family members of critically ill patients experienced the COVID-19 visiting restrictions in Sweden. BACKGROUND: In Sweden, the response to COVID-19 was less invasive than in many other countries. However, some visiting restrictions were introduced for intensive care units, with local variations. Although there is a growing body of literature regarding healthcare professionals' and family caregivers' perspectives on visiting restriction policies, there may be inter-country differences, which remain to be elucidated. DESIGN: This study has a qualitative descriptive design. Focus group interviews with 14 family members of patients treated for severe COVID-19 infection were conducted. The interviews took place via digital meetings during the months after the patients' hospital discharge. Qualitative content analysis was used to interpret the interview transcripts. Reporting of the study followed the COREQ checklist. RESULTS: Two categories-dealing with uncertainty and being involved at a distance-described family members' experiences of coping with visiting restrictions during the COVID-19 pandemic. These restrictions were found to reduce family members' ability to cope with the situation. Communication via telephone or video calls to maintain contact was appreciated but could not replace the importance of personal contact. CONCLUSIONS: Family members perceived that the visiting restriction routines in place during the COVID-19 pandemic negatively influenced their ability to cope with the situation and to achieve realistic expectations of the patients' needs when they returned home. RELEVANCE TO CLINICAL PRACTICE: This study suggests that, during the COVID-19 pandemic, the visiting restrictions were experienced negatively by family members and specific family-centred care guidelines need to be developed for use during crises, including the possibility of regular family visits to the ICU. PATIENT AND PUBLIC CONTRIBUTION: None in the conceptualisation or design of the study.
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COVID-19, Humanos, COVID-19/epidemiologia, Pandemias, Unidades de Terapia Intensiva, Pesquisa Qualitativa, FamíliaRESUMO
PURPOSE: User participation is important in the delivery of health- and social services. Yet, our knowledge regarding how user participation is experienced from the perspective of those who use these services is limited. This study aims to develop knowledge regarding how young persons living with disabilities experience becoming independent in user participation. MATERIALS AND METHODS: This qualitative study is inspired by Constructivist Grounded Theory. Nine young persons between 16 and 25 years of age and living with a disability, participated in the interviews. RESULTS: The results revealed that user participation for young persons is a socially situated, relational, and skills-dependent process. User participation is characterized as a process, consisting of increasing skills, gradually reducing parental support, and responding to interactions with professionals. The three categories are strongly reciprocal and interrelated, forming the unifying core category of Striving towards independence in user participation. CONCLUSION: We theorize about the Interrelated process of becoming independent in user participation for young persons with disabilities. This theory highlights the need to understand the interrelatedness of user participation, allowing for a recognition of the complexity of user participation, showing it as a process involving developing skills, and gradually becoming independent and skilled in user participation.Implications for rehabilitationYoung persons with disability rely on support from parents as well as professionals to become independent in user participationProfessionals should acknowledge that user participation is a learning process and allow for time and resources to aid this processFocusing on increasing health literacy alone is not sufficient to ensure user participation for young persons with disability.
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Pessoas com Deficiência, Letramento em Saúde, Humanos, Pesquisa Qualitativa, Serviço Social, AprendizagemRESUMO
Cash transfers (CTs) have been increasingly used in low- and middle-income countries as a poverty reduction and social protection tool. Despite their potential for empowering vulnerable groups (especially women), the evidence for such outcomes remains unclear. Additionally, little is known about how this broad concept fits into and is perceived in such programmes. For example, Lesotho's Child Grants Programme (CGP) is an unconditional CT targeting poor and vulnerable households with children. The CGP has been presented as one of the Lesotho's flagship programmes in developing the country's social safety net system. Using the CGP's early phases as a case study, this research aims to capture how programme stakeholders understood and operationalized the concept of economic empowerment (especially women's) in Lesotho's CGP. The qualitative analysis relied on the triangulation of information from a review of programme documents and semi-structured key informant interviews with programme stakeholders. First, the programme documents were coded deductively, while the interview transcripts were coded inductively, and then both materials were analysed thematically. Finally, differences or disagreements within each theme were explored individually according to the programme's chronology, the stakeholders' affiliation and their role in the CGP. The complexity of economic empowerment was reflected in the diversity of definitions found in the desk review and interviews. Economic empowerment was primarily understood as improving access to economic resources and opportunities and, less so, as agency and social and economic inclusion. There were stronger disagreements on other definitions as they seemed to be a terminology primarily used by specific stakeholders. This diversity of definitions impacted how these concepts were integrated into the programme, with particular gaps between the strategic vision and operational units as well as between the role this concept was perceived to play and the effects evaluated so far.
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Empoderamento, Sexismo, Criança, Humanos, Feminino, Lesoto, Pesquisa Qualitativa, Características da FamíliaRESUMO
PURPOSE: Research highlights the differences and unique experiences of military veterans experiencing amputation compared to civilians. This review aimed to synthesise qualitative research exploring the experience of amputation and rehabilitation among existing or previous members of the military. METHODS: A systematic search of six databases (PsycINFO, AMED, MEDLINE, CINAHL, Web of Science and Scopus) was undertaken in March 2022. The results of 17 papers reporting 12 studies published between 2009 and 2022 were synthesised using a meta-ethnographic approach to generate new interpretations reflecting the experiences of members of the military who have experienced limb loss. RESULTS: Three themes were developed from the data: (1) Making the physical and psychological transition to life after amputation; (2) The role of the military culture in rehabilitation; and (3) The impact of relationships and the gaze of others during rehabilitation and beyond. CONCLUSIONS: Military veterans with limb loss experience difficulties in navigating civilian healthcare systems and gaining appropriate support away from the military. Rehabilitation professionals, with psychological training or mentoring, involved in the care of military veterans following amputation could offer psychological support during the transition to civilian life and targeted therapies to veterans experiencing high levels of pain, and facilitate peer support programmes.
Implications for rehabilitationIdentify at an early stage of rehabilitation those veterans at risk for poorer adjustment, by examining their propensity or not to adopt goal pursuit and goal adaptation strategiesOffer psychological support prior to and after the transition to civilian lifeTarget psychological therapies, such as Cognitive Behavioural Therapy and Acceptance and Commitment Therapy, to veterans who are experiencing high levels of painEncourage peer support programmes and provide support and training to peer mentors.
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Amputados, Militares, Veteranos, Humanos, Veteranos/psicologia, Militares/psicologia, Amputação Cirúrgica, Amputados/reabilitação, Pesquisa QualitativaRESUMO
PURPOSE: Advances in breast cancer care have led to a high rate of survivorship. This meta-review (systematic review of reviews) assesses and synthesises the voluminous qualitative survivorship evidence-base, providing a comprehensive overview of the main themes regarding breast cancer survivorship experiences, and areas requiring further investigation. METHODS: Sixteen breast cancer reviews identified by a previous mixed cancer survivorship meta-review were included, with additional reviews published between 1998 and 2020, and primary papers published after the last comprehensive systematic review between 2018 and 2020, identified via database searches (MEDLINE, Embase, CINAHL, PsycINFO). Quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and the CASP (Critical Appraisal Skills Programme Qualitative) checklist for primary studies. A meta-ethnographic approach was used to synthesise data. RESULTS: Of 1673 review titles retrieved, 9 additional reviews were eligible (25 reviews included in total). Additionally, 76 individual papers were eligible from 2273 unique papers. Reviews and studies commonly focused on specific survivorship groups (including those from ethnic minorities, younger/older, or with metastatic/advanced disease), and topics (including return to work). Eight themes emerged: (1) Ongoing impact and search for normalcy, (2) Uncertainty, (3) Identity: Loss and change, (4) Isolation and being misunderstood, (5) Posttraumatic growth, (6) Return to work, (7) Quality of care, and (8) Support needs and coping strategies. CONCLUSIONS: Breast cancer survivors continue to face challenges and require interventions to address these. IMPLICATIONS FOR CANCER SURVIVORS: Breast cancer survivors may need to prepare for ongoing psychosocial challenges in survivorship and proactively seek support to overcome these.
