Distrust and patients in intercultural healthcare: A qualitative interview study

2016 ◽  
Vol 25 (3) ◽  
pp. 313-323 ◽  
Author(s):  
Lise-Merete Alpers
Keyword(s):  
Cultural Competence ◽  
Ethnic Minority ◽  
Belief Systems ◽  
Healthcare Personnel ◽  
Ethical Considerations ◽  
Informed Consent Form ◽  
Qualitative Interview Study ◽  
Nurses And Physicians ◽  
Depth Interviews ◽  
Minority Ethnic

Background: The importance of trust between patients and healthcare personnel is emphasised in nurses’ and physicians’ ethical codes. Trust is crucial for an effective healthcare personnel–patient relationship and thus for treatment and treatment outcomes. Cultural and linguistic differences may make building a trusting and positive relationship with ethnic minority patients particularly challenging. Although there is a great deal of research on cultural competence, there is a conspicuous lack of focus on the concepts of trust and distrust concerning ethnic minority patients, particularly in relation to the concept of ‘othering’. Aim: To study which factors help build trust or create distrust in encounters between healthcare professionals and hospitalised ethnic minority patients, as well as study the dynamic complexities inherent within the process of ‘othering’. Research design: Qualitative design, in-depth interviews and hermeneutic analysis. Participants and research context: The interviewees were 10 immigrant patients (six women and four men – eight Asians, two Africans – ages 32–85 years) recruited from a south-eastern Norwegian hospital. Ethical considerations: Study approval was obtained from the hospital’s Privacy Ombudsman for Research and the hospital’s leadership. Participation was voluntary and participants signed an informed consent form. Conclusion: Distrust and othering may be caused by differences in belief systems, values, perceptions, expectations, and style of expression and behaviour. Othering is a reciprocal phenomenon in minority ethnic patient–healthcare personnel encounters, and it influences trust building negatively. Besides demonstrating general professional skill and competence, healthcare personnel require cultural competence to create trust.

Experiences that inspire hope: Perspectives of suicidal patients

2016 ◽  
Vol 25 (4) ◽  
pp. 444-457 ◽  
Author(s):  
May Vatne ◽  
Dagfinn Nåden
Keyword(s):  
Suicide Attempts ◽  
Research Question ◽  
Qualitative Interviews ◽  
Healthcare Personnel ◽  
Ethical Considerations ◽  
Drugs And Alcohol ◽  
Written Information ◽  
Informed Consent Form ◽  
Suicidal Patients ◽  
Suicidal Crisis

Background: Suffering in a suicidal crisis includes feelings such as despair, loneliness, anxiety, fear, shame, guilt and hopelessness. This study highlights the experiences of patients in the aftermath of suicide attempts. The research question was, what do suicidal patients see as meaningful help in care and treatment situations? Methodology: The methodology is inspired by Gadamer’s hermeneutics, where the parts are understood in light of the whole, and the whole is understood in light of the parts. Qualitative interviews were employed. Participants and research context: A total of 10 persons, 4 women and 6 men 21–52 years old, were informed and asked to participate by specialists in psychology at two emergency psychiatric wards and by one crisis resolution team. Nine of the participants had experienced one or more suicide attempts using drugs and alcohol. Forced hospitalization prevented one of the 10 participants from attempting suicide. Ethical considerations: Before the participants signed an informed consent form, the interviewer met all participants to provide the written information, talking about the interview. A meeting to terminate contact was arranged after the participants had read their own interviews. Findings: Three themes were generated by the methodology we applied: (1) experiencing hope through encounters, (2) experiencing hope through the atmosphere of wisdom and (3) experiencing a ray of hope from taking back responsibility. Discussion: The findings are discussed in the light of Eriksson’s suffering theory and Lindström’s theory about psychiatric care, as well as earlier research and theories about suicidality. Conclusion: The study reinforces possibilities that hope in suicidal patients can be inspired in encounters with healthcare personnel and within caring cultures. Through dialogue and cooperation, patients’ safety and ability to cope with suffering is created and thereby the hope and will to struggle for life.

Dual loyalties: Everyday ethical problems of registered nurses and physicians in combat zones

2017 ◽  
Vol 26 (2) ◽  
pp. 480-495 ◽  
Author(s):  
Kristina Lundberg ◽  
Sofia Kjellström ◽  
Lars Sandman
Keyword(s):  
Registered Nurses ◽  
Healthcare Personnel ◽  
Humanitarian Law ◽  
Military Operations ◽  
Ethical Considerations ◽  
Common View ◽  
Ethical Problems ◽  
Ethical Codes ◽  
Individual Interviews ◽  
Nurses And Physicians

Background: When healthcare personnel take part in military operations in combat zones, they experience ethical problems related to dual loyalties, that is, when they find themselves torn between expectations of doing caring and military tasks, respectively. Aim: This article aims to describe how Swedish healthcare personnel reason concerning everyday ethical problems related to dual loyalties between care and military tasks when undertaking healthcare in combat zones. Design: Abductive qualitative design. Participants and research context: Individual interviews with 15 registered nurses and physicians assigned for a military operation in Mali. Ethical considerations: The participants signed up voluntarily, and requirements for informed consent and confidentiality were met. The research was approved by the Regional Ethics Review Board in Gothenburg (D no. 816-14; 24 November 2014). Findings: Three main categories emerged: reasons for not undertaking combat duties, reasons for undertaking combat duties and restricted loyalty to military duties, and 14 subcategories. Reasons for not undertaking combat duties were that it was not in their role, not according to ethical codes or humanitarian law or a breach towards patients. Reasons for undertaking combat duties were that humanitarian law does not apply or has to be treated pragmatically or that it is a case of force protection. Shortage of resources and competence were reasons for both doing and not doing military tasks. Under some circumstances, they could imagine undertaking military tasks: when under threat, if unseen or if not needed for healthcare duties. Discussion/conclusion: These discrepant views suggest a lack of a common view on what is ethically acceptable or not, and therefore we suggest further normative discussion on how these everyday ethical problems should be interpreted in the light of humanitarian law and ethical codes of healthcare personnel and following this, further training in ethical reflection before going on military operations.

scholarly journals US Physicians’ and Nurses’ Motivations, Barriers, and Recommendations for Correcting Health Misinformation on Social Media: Qualitative Interview Study

10.2196/27715 ◽  
2021 ◽  
Vol 7 (9) ◽  
pp. e27715
Author(s):  
John Robert Bautista ◽  
Yan Zhang ◽  
Jacek Gwizdka
Keyword(s):  
Health Care ◽  
Social Media ◽  
Health Care Professionals ◽  
Health Concern ◽  
Positive Outcomes ◽  
Personal Choice ◽  
Health Authorities ◽  
Qualitative Interview Study ◽  
Nurses And Physicians ◽  
Depth Interviews

Background Health misinformation is a public health concern. Various stakeholders have called on health care professionals, such as nurses and physicians, to be more proactive in correcting health misinformation on social media. Objective This study aims to identify US physicians’ and nurses’ motivations for correcting health misinformation on social media, the barriers they face in doing so, and their recommendations for overcoming such barriers. Methods In-depth interviews were conducted with 30 participants, which comprised 15 (50%) registered nurses and 15 (50%) physicians. Qualitative data were analyzed by using thematic analysis. Results Participants were personally (eg, personal choice) and professionally (eg, to fulfill the responsibility of a health care professional) motivated to correct health misinformation on social media. However, they also faced intrapersonal (eg, a lack of positive outcomes and time), interpersonal (eg, harassment and bullying), and institutional (eg, a lack of institutional support and social media training) barriers to correcting health misinformation on social media. To overcome these barriers, participants recommended that health care professionals should receive misinformation and social media training, including building their social media presence. Conclusions US physicians and nurses are willing to correct health misinformation on social media despite several barriers. Nonetheless, this study provides recommendations that can be used to overcome such barriers. Overall, the findings can be used by health authorities and organizations to guide policies and activities aimed at encouraging more health care professionals to be present on social media to counteract health misinformation.

scholarly journals US Physicians’ and Nurses’ Motivations, Barriers, and Recommendations for Correcting Health Misinformation on Social Media: Qualitative Interview Study (Preprint)

2021 ◽  
Author(s):  
John Robert Bautista ◽  
Yan Zhang ◽  
Jacek Gwizdka
Keyword(s):  
Health Care ◽  
Social Media ◽  
Health Care Professionals ◽  
Health Concern ◽  
Positive Outcomes ◽  
Personal Choice ◽  
Health Authorities ◽  
Qualitative Interview Study ◽  
Nurses And Physicians ◽  
Depth Interviews

BACKGROUND Health misinformation is a public health concern. Various stakeholders have called on health care professionals, such as nurses and physicians, to be more proactive in correcting health misinformation on social media. OBJECTIVE This study aims to identify US physicians’ and nurses’ motivations for correcting health misinformation on social media, the barriers they face in doing so, and their recommendations for overcoming such barriers. METHODS In-depth interviews were conducted with 30 participants, which comprised 15 (50%) registered nurses and 15 (50%) physicians. Qualitative data were analyzed by using thematic analysis. RESULTS Participants were personally (eg, personal choice) and professionally (eg, to fulfill the responsibility of a health care professional) motivated to correct health misinformation on social media. However, they also faced intrapersonal (eg, a lack of positive outcomes and time), interpersonal (eg, harassment and bullying), and institutional (eg, a lack of institutional support and social media training) barriers to correcting health misinformation on social media. To overcome these barriers, participants recommended that health care professionals should receive misinformation and social media training, including building their social media presence. CONCLUSIONS US physicians and nurses are willing to correct health misinformation on social media despite several barriers. Nonetheless, this study provides recommendations that can be used to overcome such barriers. Overall, the findings can be used by health authorities and organizations to guide policies and activities aimed at encouraging more health care professionals to be present on social media to counteract health misinformation. CLINICALTRIAL

Experiences of Hearing Parents Following the Diagnosis of Their Child's Hearing Loss

2018 ◽  
Vol 30 (2) ◽  
Author(s):  
Ronel Sanet Davids ◽  
Mariana De Jager
Keyword(s):  
South Africa ◽  
Hearing Loss ◽  
Thematic Analysis ◽  
Qualitative Methodology ◽  
Cape Town ◽  
Best Interest ◽  
Ethical Considerations ◽  
Hearing Parents ◽  
Phenomenological Design ◽  
Depth Interviews

An estimated 90 per cent of children with a hearing loss are born to hearing parents. Most parents are unprepared for the diagnosis, leaving them shocked, confused, sad and bewildered. This article reports on a study aimed at exploring and describing the experiences of hearing parents regarding their child’s hearing loss. The study was conducted in Cape Town, South Africa. The study applied a qualitative methodology with a phenomenological design. Purposive sampling was implemented and data were collected by means of unstructured in-depth interviews. Data were analysed using thematic analysis. Ethical considerations were adhered to. The main findings of the study indicated that hearing parents experience a myriad of emotions when their child is diagnosed with a hearing loss. This study advocates for various stakeholders in the helping profession to collaborate in the best interest of hearing parents and a child with hearing loss. Furthermore, these findings serve as guidelines for professionals working with these families.

Preventative health screening community events, a mechanism to target minority ethnic populations in improving primary care utilisation to improve health outcomes

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711005
Author(s):  
Raza Naqvi ◽  
Octavia Gale
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Outcomes ◽  
Ethnic Minority ◽  
Access To Health Care ◽  
Health Screening ◽  
Service Utilisation ◽  
Community Based ◽  
Access To Health ◽  
Minority Ethnic

BackgroundPreventative medicine has become a central focus in primary care provision, with greater emphasis on education and access to health care screening. The Department of Health reports existing health inequalities and inequalities in access within ethnic minority groups. Studies assessing the value of community engagement in primary care have reported variable outcomes in term of subsequent service utilisation.AimTo consider the benefit of community-based health screening checks to improve access and health outcomes in minority ethnic groups.MethodAn open community health screening event (n = 43), to allow targeted screening within an ethnic minority population. Screening included BP, BMI, BM and cholesterol. Results were interpreted by a healthcare professional and counselling was provided regarding relevant risk factors. Post-event feedback was gathered to collate participant opinion and views.ResultsSeventy-nine per cent of participants were from ethnic minority backgrounds: 64% were overweight or obese and 53% of participants were referred to primary care for urgent review following abnormal findings. All those referred would not have accessed healthcare without the event referral. All (100%) participants believed it improved health education and access to health care.ConclusionThis study clearly demonstrates the value of targeted community-led screening and education events in public health promotion. There was a significant benefit in providing community-based screening. There is a need for a longitudinal analysis to determine the impact on health outcomes and long-term access to healthcare provision.

scholarly journals Contested or complementary healing paradigms? Women’s narratives of COVID-19 remedies in Mwanza, Tanzania

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Gerry Mshana ◽  
Zaina Mchome ◽  
Diana Aloyce ◽  
Esther Peter ◽  
Saidi Kapiga ◽  
...  
Keyword(s):  
Belief Systems ◽  
Emerging Infections ◽  
Community Members ◽  
Women's Narratives ◽  
Traditional Remedies ◽  
Traditional Therapies ◽  
Audio Files ◽  
Smart Mobile ◽  
Depth Interviews ◽  
African Setting

Abstract Background COVID-19 has caused worldwide fear and uncertainty. Historically, the biomedical disease paradigm established its dominance in tackling emerging infectious illnesses mainly due to innovation in medication and advances in technology. Traditional and religious remedies have emerged as plausible options for prevention and treatment of COVID-19, especially in Africa and Asia. The appeal of religious and traditional therapies against COVID-19 in the African setting must be understood within the historical, social, and political context. This study explored how women and community members dealt with suspected symptoms of COVID-19 in Mwanza, Tanzania. Methods This study was conducted in Nyamagana and Ilemela districts of Mwanza, Tanzania, between July and August 2020. We conducted 18 mobile phone in-depth interviews with a purposively selected sample of women aged 27–57 years participating in an existing longitudinal study. For safety reasons, smart mobile phones were used to collect the data. Each interview was audio recorded after obtaining verbal consent from the participants. The audio files were transferred to computers for analysis. Four researchers conducted a multistage, inductive analysis of the data. Results Participants reported wide use and perceived high efficacy of traditional remedies and prayer to prevent and treat suspected symptoms of COVID-19. Use was either alone or combined with public health recommendations such as hand washing and crowd avoidance. Despite acknowledging that a pathogen causes COVID-19, participants attested to the relevance and power of traditional herbal medication and prayer to curb COVID-19. Four main factors underline the symbolic efficacy of the traditional and religious treatment paradigms: personal, communal, and official reinforcement of their efficacy; connection to local knowledge and belief systems; the failure of biomedicine to offer a quick and effective solution; and availability. Conclusions In the context of emerging contagious illnesses, communities turn to resilient and trusted treatment paradigms to quell fear and embrace hope. To tackle emerging infections effectively, it is essential to engage the broader sociopolitical landscape, including communal considerations of therapeutic efficacy.

Enhancing the professional dignity of midwives: A phenomenological study

2017 ◽  
Vol 26 (4) ◽  
pp. 1062-1074 ◽  
Author(s):  
Christelle Froneman ◽  
Neltjie C van Wyk ◽  
Ramadimetja S Mogale
Keyword(s):  
Research Design ◽  
Phenomenological Study ◽  
Tertiary Hospital ◽  
Ethical Considerations ◽  
Optimal Care ◽  
Team Members ◽  
University Of Pretoria ◽  
Phenomenological Research Design ◽  
The University ◽  
Depth Interviews

Background: When midwives are not treated with respect and their professional competencies are not recognised, their professional dignity is violated. Objective: This study explored and described how the professional dignity of midwives in the selected hospital can be enhanced based on their experiences. Research design: A descriptive phenomenological research design was used with in-depth interviews conducted with 15 purposely selected midwives. Ethical considerations: The Faculty of Health Sciences Research Ethics Committee of the University of Pretoria approved the study. The research was conducted in an academic tertiary hospital with voluntary participants. Findings: To dignify midwives it is essential to enhance the following: ‘to acknowledge the capabilities of midwives’, ‘to appreciate interventions of midwives’, ‘to perceive midwives as equal health team members’, ‘to invest in midwives’, ‘to enhance collegiality’, ‘to be cared for by management’ and ‘to create conducive environments’. Conclusion: The professional dignity of midwives is determined by their own perspectives of the contribution that they make to the optimal care of patients, the respect that they get from others and the support that hospital management gives them. With support and care, midwives’ professional dignity is enhanced. Midwives will strive to render excellent services as well as increasing their commitment.

Ethical challenges when using coercion in mental healthcare: A systematic literature review

2016 ◽  
Vol 25 (1) ◽  
pp. 92-110 ◽  
Author(s):  
Marit Helene Hem ◽  
Elisabeth Gjerberg ◽  
Tonje Lossius Husum ◽  
Reidar Pedersen
Keyword(s):  
Patient Autonomy ◽  
Moral Distress ◽  
Mental Healthcare ◽  
Healthcare Personnel ◽  
Ethical Challenge ◽  
Ethical Challenges ◽  
Best Interest ◽  
Ethical Considerations ◽  
Search Terms ◽  
Healthcare It

Background: To better understand the kinds of ethical challenges that emerge when using coercion in mental healthcare, and the importance of these ethical challenges, this article presents a systematic review of scientific literature. Methods: A systematic search in the databases MEDLINE, PsychInfo, Cinahl, Sociological Abstracts and Web of Knowledge was carried out. The search terms derived from the population, intervention, comparison/setting and outcome. A total of 22 studies were included. Ethical considerations: The review is conducted according to the Vancouver Protocol. Results: There are few studies that study ethical challenges when using coercion in an explicit way. However, promoting the patient’s best interest is the most important justification for coercion. Patient autonomy is a fundamental challenge facing any use of coercion, and some kind of autonomy infringement is a key aspect of the concept of coercion. The concepts of coercion and autonomy and the relations between them are very complex. When coercion is used, a primary ethical challenge is to assess the balance between promoting good (beneficence) and inflicting harm (maleficence). In the included studies, findings explicitly related to justice are few. Some studies focus on moral distress experienced by the healthcare professionals using coercion. Conclusion: There is a lack of literature explicitly addressing ethical challenges related to the use of coercion in mental healthcare. It is essential for healthcare personnel to develop a strong awareness of which ethical challenges they face in connection with the use of coercion, as well as challenges related to justice. How to address ethical challenges in ways that prevent illegitimate paternalism and strengthen beneficent treatment and care and trust in connection with the use of coercion is a ‘clinical must’. By developing a more refined and rich language describing ethical challenges, clinicians may be better equipped to prevent coercion and the accompanying moral distress.

Ethical listening to employees during a pandemic: new approaches, barriers and lessons

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marlene S. Neill ◽  
Shannon A. Bowen
Keyword(s):  
Mobile Applications ◽  
Feedback Loop ◽  
Ethical Considerations ◽  
Communication Management ◽  
Content Type ◽  
Building Relationships ◽  
Global Pandemic ◽  
Management Professionals ◽  
Depth Interviews ◽  
Practical Implications

PurposeThe purpose of this study was to identify new challenges to organizational listening posed by a global pandemic and how organizations are overcoming those barriers.Design/methodology/approachThe researchers conducted 30 in-depth interviews with US communication management professionals.FindingsCommunication management professionals value listening, but do not always make it the priority that it merits. They listed lack of desire of senior management, time, and trust of employees as barriers to effective organizational listening. The global COVID pandemic has made it more challenging to connect to employees working remotely and to observe nonverbal cues that are essential in communication. Organizations are adapting by using more frequent pulse surveys, video conferencing technology and mobile applications. Most importantly, this pandemic has enhanced moral sensitivity and empathy leading organizations to make decisions based on ethical considerations.Research limitations/implicationsThe researchers examined organizational listening applying employee-organization relationships (EOR) theory and found that trust is essential. Trust can be enhanced through building relationships with employees, ethical listening and closing the feedback loop by communicating how employers are using the feedback received by employees to make a positive change.Practical implicationsCommunication managers need to place a higher priority on listening to employees. Their listening efforts need to be authentic, morally autonomous or open-minded, and empathetic to respect the genuine concerns of employees and how organizational decisions will affect them. Listening is essential to serving as an ethical and effective strategic counselor.Originality/valueThe study examines organizational listening in the context of a global pandemic.

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