scholarly journals Talking about dying and death: a focus group study to explore a local community perspective

2011 ◽  
Vol 1 (1) ◽  
pp. 8 ◽  
Author(s):  
Marilyn N. Y. Kirshbaum ◽  
Ian Carey ◽  
Brigid Purcell ◽  
Seamus Nash
Keyword(s):  
Focus Group ◽  
Qualitative Methodology ◽  
Local Community ◽  
National Policy ◽  
Healthcare Services ◽  
Framework Analysis ◽  
Focus Group Study ◽  
Care Services ◽  
Wide Range ◽  
Palliative Care Services

There is a general perception held by health care practitioners based in hospices, palliative care services and general healthcare services that society is reluctant to talk about dying and death. This avoidance behaviour is observed, noted and expressed in national policy briefings as being detrimental to patient involvement in decision making, effective coping and preparation for death, organ donation, writing a will, and the process of bereavement. The aim of the pilot study was to explore the perceptions of a local community on the broad subject of <em>Talking about Dying and Death</em>. An interactive qualitative methodology using a constructivist approach enabled exploration of a wide range of views from a self-selected group resident within the local community (n=8). Data were collected from a focus group session facilitated by the researcher and an associate researcher. Systematic and analytical coding of transcripts was undertaken using Framework Analysis (Richie and Spencer 1994). Four overriding themes were identified: i) <em>emotions, beliefs and behaviours</em>; ii) <em>coping with adversity</em>; iii) <em>difficulties, barriers and tensions</em>, and iv) <em>fostering a participative future</em>. There were some notions of superstition amongst the participants, but little mention of formal religious beliefs. Within the themes, <em>Coping with Adversity</em> and <em>Difficulties, Barriers and Tensions</em> is the core of the community&rsquo;s views and needs. The link to the local hospice service is significant for it is the place where practical help, spiritual care, and an appreciation for sensitivity, openness and honesty can be put into action. The importance of communication and language are critical above all else. Dying and death was articulated as an upsetting topic, and remains a taboo in this community in the United Kingdom, with a belief that talking will bring harm. Promotion of talking about dying and death was discussed in relation to the role of the local hospice and several suggestions were put forward.

scholarly journals Access and participation: What factors influence the provision and utilisation of health care services by children with learning disabilities?

2017 ◽  
Vol 41 (S1) ◽  
pp. S452-S452
Author(s):  
A. Rebowska
Keyword(s):  
Health Care ◽  
Learning Disabilities ◽  
Young People ◽  
Intellectual Disabilities ◽  
Health Care Services ◽  
Healthcare Services ◽  
Children And Young People ◽  
Care Services ◽  
Healthcare Needs ◽  
Wide Range

AimsThe aim of this literature review is to explore the range of factors that influence the degree of access to health care services by children and young people with learning disabilities.BackgroundChildren with learning disabilities are at increased risk of a wide range of health conditions comparing with their peers. However, recent reports by UK government as well as independent charities working with children and young people with learning disabilities demonstrated that they are at risk of poor health outcomes as a result of barriers preventing them from accessing most appropriate services.MethodsComprehensive searches were conducted in six databases. Articles were also obtained through review of references, a search of the grey literature, and contacting experts in the field. The inclusion criteria were for studies evaluating access to healthcare services, identification and communication of health needs, organisational aspects impacting on access and utilisation, staff attitudes where they impacted on access, barriers, discrimination in patients with intellectual disabilities age 0–18. The literature search identified a sample of 36 papers. The marked heterogeneity of studies excluded conducting a meta-analysis.ResultsBarriers to access included problems with identification of healthcare needs by carers and healthcare professionals, communication difficulties, the inadequacy of facilities, geographical and physical barriers, organisational factors such as inflexible appointment times, attitudes and poor knowledge base of healthcare staff.ConclusionThe factors identified can serve as a guide for managers and clinicians aiming to improve access to their healthcare services for children and young people with intellectual disabilities.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Physicians’ views on the usefulness and feasibility of identifying and disclosing patients’ last phase of life: a focus group study

2021 ◽  
pp. bmjspcare-2020-002764
Author(s):  
Catherine Owusuaa ◽  
Irene van Beelen ◽  
Agnes van der Heide ◽  
Carin C D van der Rijt
Keyword(s):  
Palliative Care ◽  
Organ Failure ◽  
Care Quality ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Focus Group Study ◽  
Timely Initiation ◽  
Care Services ◽  
Palliative Care Services ◽  
Physician Patient

ObjectivesAccurate assessment that a patient is in the last phase of life is a prerequisite for timely initiation of palliative care in patients with a life-limiting disease, such as advanced cancer or advanced organ failure. Several palliative care quality standards recommend the surprise question (SQ) to identify those patients. Little is known about physicians’ views on identifying and disclosing the last phase of life of patients with different illness trajectories.MethodsData from two focus groups were analysed using thematic analysis with a phenomenological approach.ResultsFifteen medical specialists and general practitioners participated. Participants thought prediction of patients’ last phase of life, i.e. expected death within 1 year, is important. They seemed to find that prediction is more difficult in patients with advanced organ failure compared with cancer. The SQ was considered a useful prognostic tool; its use is facilitated by its simplicity but hampered by its subjective character. The medical specialist was considered mainly responsible for prognosticating and gradually disclosing the last phase. Participants’ reluctance to such disclosure was related to uncertainty around prognostication, concerns about depriving patients of hope, affecting the physician–patient relationship, or a lack of time or availability of palliative care services.ConclusionsPhysicians consider the assessment of patients’ last phase of life important and support use of the SQ in patients with different illness trajectories. However, barriers in disclosing expected death are prognostic uncertainty, possible deprivation of hope, physician–patient relationship, and lack of time or palliative care services. Future studies should examine patients’ preferences for those discussions.

scholarly journals A focus group study of older Chinese people with CVD patients in the North West of the UK

2021 ◽  
Vol 22 ◽  
Author(s):  
Shaun Speed ◽  
Zeyuan Sun ◽  
Zhenmi Liu
Keyword(s):  
Cardiovascular Disease ◽  
Primary Care ◽  
Focus Group ◽  
Cultural Values ◽  
Help Seeking ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Chinese Patients ◽  
Focus Group Study ◽  
North West

Abstract Background: Cardiovascular disease (CVD) is the leading cause of death for Chinese migrants around the world. Chinese CVD patients rely heavily on their native Chinese language, cultural values and beliefs, which adds challenges for the healthcare providers to offer primary healthcare services with standard protocol. The inappropriate treatment could lead to life loss, mistrust in doctor-patient relationship and heavy burden for healthcare funding. Methods: 28 participants were included for focus group study with the grounded theory methodology. Results: There is considerable misunderstanding among the Chinese community about the role of primary care doctors in the treatment of cardiovascular disease resulting in the variable use of primary care services. Conclusion: Chinese CVD patients or identified risk factors for CVD arguably need closer management, culturally sensitive advice, support and robust follow-up compared to the general population. Doctors and nurses should enhance their practice and give them confidence in their interaction with Chinese patients on the basis of how they think and behave in relation to help seeking.

scholarly journals The quality of maternal-fetal and newborn care services in Jordan: a qualitative focus group study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mohammad S. Alyahya ◽  
Yousef S. Khader ◽  
Anwar Batieha ◽  
Majed Asad
Keyword(s):  
Focus Group ◽  
Newborn Care ◽  
Focus Group Study ◽  
Care Services

scholarly journals Aesthetically Designing Video-Call Technology With Care Home Residents: A Focus Group Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Sonam Zamir ◽  
Felicity Allman ◽  
Catherine Hagan Hennessy ◽  
Adrian Haffner Taylor ◽  
Ray Brian Jones
Keyword(s):  
Focus Group ◽  
Older People ◽  
Focus Groups ◽  
New Technologies ◽  
Low Cost ◽  
Care Home ◽  
Framework Analysis ◽  
Focus Group Study ◽  
People With Dementia ◽  
Technological Intervention

BackgroundVideo-calls have proven to be useful for older care home residents in improving socialization and reducing loneliness. Nonetheless, to facilitate the acceptability and usability of a new technological intervention, especially among people with dementia, there is a need for user-led design improvements. The current study conducted focus groups with an embedded activity with older people to allow for a person-centered design of a video-call intervention.MethodsTwenty-eight residents across four care homes in the South West of England participated in focus groups to aesthetically personalize and ‘dress-up’ the equipment used in a video-call intervention. Each care home was provided with a ‘Skype on Wheels’ (SoW) device, a wheelable ‘chassis’ comprising an iPad or tablet for access to Skype, and a telephone handset. During the focus group, residents were encouraged to participate in an activity using colorful materials to ‘dress-up’ SoW. Comments before, during and after the ‘dress up’ activity were audio recorded. Framework analysis was used to analyze the focus group data.ResultsOlder people, including seven with dementia were able to interact with and implement design changes to SoW through aesthetic personalization. Themes arising from the data included estrangement, anthropomorphism, reminiscence, personalization, need for socialization versus fear of socialization and attitudes toward technology. After this brief exposure to SoW, residents expressed the likelihood of using video-calls for socialization in the future.ConclusionCare home residents enjoy engaging with new technologies when given the opportunity to interact with it, to personalize it and to understand its purpose. Low cost aesthetic personalization of technologies can improve their acceptability, usability, and implementation within complex care environments.

scholarly journals Assessing the Appeal of Instagram Electronic Cigarette Refill Liquid Promotions and Warnings Among Young Adults: Mixed Methods Focus Group Study

10.2196/15441 ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. e15441 ◽  
Author(s):  
Linnea I Laestadius ◽  
Kendall E Penndorf ◽  
Melissa Seidl ◽  
Young I Cho
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Focus Group ◽  
Smoking Status ◽  
Nicotine Addiction ◽  
Electronic Cigarette ◽  
Framework Analysis ◽  
Focus Group Study ◽  
User Perceptions ◽  
Regulatory Strategies

Background While marketing for electronic cigarette refill liquids (e-liquids) is widespread on Instagram, little is known about the post elements that create appeal among young adult Instagram users. Further information is needed to help shape regulatory strategies appropriate for social media. Objective This study examined young adult Instagram user perceptions of actual e-liquid marketing posts and US Food and Drug Administration (FDA)–mandated nicotine addiction warning statements on Instagram. Methods A series of 12 focus groups (n=69) were held with non–tobacco users, vapers, smokers, and dual users in Wisconsin between September and December 2018. Participants discussed the elements of posts that they found appealing or unappealing, in addition to completing a survey about each post and e-liquid. Focus group transcripts were analyzed by smoking status using a framework analysis approach. Results Although willingness to try e-liquids was highest among nicotine users, focus group discussions indicated that Instagram posts promoting e-liquids held appeal for individuals across smoking statuses. The primary elements that created appeal were the perceived trustworthiness of the Instagram account, attractive design and flavor visuals, and promotion of flavors and nicotine levels that met personal preferences. Post appeal was reduced by references to vaping subcultures, indicators that the post creator did not take nicotine addiction seriously, and FDA-mandated nicotine warning statements. Non–tobacco users were particularly drawn to posts featuring nicotine-free e-liquids with attractive visual designs and flavors known from foods. Conclusions Young adults consider a broad range of elements in assessing the appeal of e-liquid marketing on Instagram, with minor but notable distinctions by smoking status. Non–tobacco users are uniquely drawn to nicotine-free e-liquids and are more deterred by the FDA’s mandated nicotine addiction warning statements than those from other smoking statuses. This suggests that it may be possible to tailor policy interventions in a manner that helps to reduce novel uptake of vaping without significantly diminishing its potential harm-reduction benefits.

scholarly journals A qualitative focus group study concerning perceptions and experiences of Nigerian mothers on stillbirths

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
R. Milton ◽  
F. I. Alkali ◽  
F. Modibbo ◽  
J. Sanders ◽  
A. S. Mukaddas ◽  
...  
Keyword(s):  
Focus Group ◽  
Social Dynamics ◽  
Healthcare Facility ◽  
Healthcare Services ◽  
Northern Nigeria ◽  
Health Seeking ◽  
Focus Group Study ◽  
Major Barrier ◽  
Societal Factors ◽  
Tertiary Healthcare

Abstract Objective To explore the experiences and perceptions of stillbirth among mothers from a tertiary medical centre in Kano, Northern Nigeria. Design Qualitative, interpretative. Setting Tertiary healthcare facility, Murtala Muhammad Specialist Hospital (MMSH), Kano, Northern Nigeria. Sample Mothers who had given birth to a liveborn baby at the MMSH in the prior 6 months (n = 31). In order to capture the experiences and perception of stillbirth within this cohort we approached mothers who had in a previous pregnancy experienced a stillbirth. Of the 31 who attended 16 had a previous stillbirth. Methods Semi-structured Focus Group Discussions, consisting of open-ended questions about stillbirth, beliefs, experiences and influences were held in MMSH, conducted over 1 day. Results Our findings highlight that this is a resource-poor tertiary facility serving an ever-growing population, increasing strain on the hospital and healthcare workers. Many of the participants highlighted needing permission from certain family members before accessing healthcare or medical treatment. We identified that mothers generally have knowledge on self-care during pregnancy, yet certain societal factors prevented that from being their priority. Judgement and blame was a common theme, yet a complex area entwined with traditions, superstitions and the pressure to procreate with many mothers described being made to feel useless and worthless if they did not birth a live baby. Conclusions As access to healthcare becomes easier, there are certain traditions, family and social dynamics and beliefs which conflict with scientific knowledge and act as a major barrier to uptake of healthcare services. The findings highlight the need for investment in maternity care, appropriate health education and public enlightenment; they will help inform appropriate interventions aimed at reducing stigma around stillbirth and aide in educating mothers about the importance of appropriate health seeking behaviour. Stillbirths are occurring in this area of the world unnecessarily, globally there has been extensive research conducted on stillbirth prevention. This research has highlighted some of the areas which can be tackled by modifying existing successful interventions to work towards reducing preventable stillbirths.

Palliative care model in Thailand

2021 ◽  
Vol 27 (3) ◽  
pp. 132-146
Author(s):  
Suchira Chaiviboontham ◽  
Piyawan Pokpalagon
Keyword(s):  
Palliative Care ◽  
Healthcare Services ◽  
Limited Range ◽  
Outcome Evaluation ◽  
Care Services ◽  
Care Processes ◽  
Care Models ◽  
Palliative Care Services ◽  
Referral Systems ◽  
Care Outcome

Background: Thailand has few hospices and a limited range of palliative care services. Aims: To explore palliative care models in Thailand. Methods: A convergent mixed-methods study design using purposive sampling to select three levels of healthcare services and one religious organisation. Findings: The quantitative data revealed that the structures of palliative care accessibility, referral systems, and continuity of care were in place at all levels of healthcare services. The qualitative data revealed the themes of the structure of palliative care, processes and outcomes. Conclusion: The variety of palliative care structures identified in Thailand are suitable for the context in which palliative care is provided. The problems that need solving are referral systems, patient access to opioids, inequitites in care distribution and medicine dispensing and palliative care outcome evaluation.

scholarly journals (A194) “Displaced Voices”: Are those Displaced by War Satisfied with the Provision and Quality of Health Care they Received?

2011 ◽  
Vol 26 (S1) ◽  
pp. s54-s55
Author(s):  
K. Wickramage ◽  
R. Surentrikumaran
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Services ◽  
Qualitative Methodology ◽  
Healthcare Services ◽  
Internally Displaced ◽  
Community Health Volunteers ◽  
Care Services ◽  
Humanitarian Response ◽  
Displaced Children

Research into how war-displaced communities value or prioritize aid response is limited. A clearer conceptualization of what affected populations seek from the international humanitarian response to their needs would be valuable in planning for emergencies.AimExploring internally displaced person's (IDP) experiences and perceptions of the humanitarian response, with a focus on health risks, resources, and health services received during their displacement.MethodA mixed-method approach using both quantitative and qualitative methods was used. This study assessed the perceptions of IDPs on provision of health and other services using an interviewer-administered-questionnaire (survey) using a sample frame that included the entire displaced population of 150,000 IDPs living in 97 camps. Findings from the survey were synthesized with the key themes that emerged through the qualitative methodology. In-depth interviews were conducted with health cluster actors. An innovative child-to-child (CTC) based research methodology was used to ascertain the insights and perceptions of displaced children and adolescents.ResultsThe survey revealed community satisfaction with health care services immediately after displacement (within IDP camps) improved considerably from 63% to 80% (6 months after the acute phase). Significant gains also were registered for shelter (54.2% to 81.4%), and sanitation (47.4% to 62%). Satisfaction of services rendered by primary healthcare workers also were high; 81.7% for public health midwife (who provided maternal and child health care), and 76.8% for public health inspectors (who provided environmental health and disease control). However, CTC workshops revealed inequalities in access to food based on ‘caste’ and occupation. Protection issues relating to violence from community and militant groups were reported.ConclusionsDespite IDP satisfaction with healthcare services, there were gaps in food security and violence/protection activities. Recognizing of the role/impact community health volunteers play in health care is an important factor in enhancing primary health care services in IDP camps.

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