The Association between Health and Culture: The Perspective of Older Adult Hospital In-Patients in Israel

People from different cultures are often hospitalized while the staff treating them do not have sufficient knowledge about the attitudes and feelings of the patients regarding culture and health. To fill this gap, the aim of this study was to examine the perspective of Israeli older adult hospital in-patients regarding the association between health and culture and to understand the meaning of the participants’ experiences with regards to the medical staff’s attitude towards them. This study was carried out using qualitative methodology that followed the interpretive interactionism approach. The research participants were 493 (mean age 70.81, S.D.: 15.88) in-patients at internal care departments at a hospital in Israel who answered an open-ended question included in the questionnaire as part of a wide study held during 2017 to 2018. Two main themes were found: (1) a humane attitude of respect and the right to privacy and (2) beliefs, values, and traditional medicine that are passed down through generations. The findings highlighted the issue of the patients’ cultural heritage and ageist attitudes they ascribed to the professional staff. This study provided recommendations for training the in-patient hospital workforce on the topic of cultural competence, beginning from the stage of diagnosis through treatment and to discharge from the hospital, in order to improve the service.

Creative and Expressive Arts in a Young Adult Problem-Solving Court and Its Influence on Participant Experience and Outcomes

This research explores the integration of creative and expressive arts in a young adult problem-solving court and the perceived benefits of participation. The Young Adult Diversion Court (YADC) was created to help young adults 17 to 20 years of age complete probation requirements. This qualitative study is informed by interpretive interactionism to examine the lived experience of participants. Ethnographic observations were conducted over 20 months, and interpretive interviews were held with 32 young adult participants and 8 program coordinators. Participants described an engaging programmatic design, and felt cared for and supported by staff in the YADC. The use of the creative and expressive arts and spoken-word practices allowed participants to overcome vulnerabilities through self-expression, regulate emotions and process trauma, and consider possible future selves. This research suggests the potential of alternative approaches in the criminal justice system that intervene in the lives of young adults to promote positive change.

The meaning of nursing 200 years after Nightingale - perceptions of professional practice in the intensivist context

ABSTRACT Objectives: to know the meaning of contemporary nursing from the experience of intensive care nurses. Methods: qualitative research based on the theoretical framework of Symbolic Interactionism and the methodological framework of Interpretive Interactionism. The setting was a general hospital in Bahia, being carried out with 12 nurses working in intensive care for at least one year, through semi-structured interviews and drawing-text-theme technique, whose data were organized according to Miles and Huberman and analyzed upon the referential. Results: the sense of being a nurse was evidenced; a being for care, resulting from the experience in intensive care, capable of promoting the development of professional self-image, by causing, in nurses, other skills - besides the scientific ones, such as empathy, creativity, spirituality and compassion. Final Considerations: the sense of being a nurse, currently, expresses developments inherited from the Nightingalean proposal, but transcends the technical-managerial emphasis of this to a humanistic care perspective converging with our contemporary professional identity: a being for care.

Vivenciando a parada cardiorrespiratória e óbito por familiares: estudo descritivo

Aim: understand the experience of relatives of people who suffered cardiac arrest and died. Method: this is a descriptive, qualitative study that used, respectively, symbolic interactionism and interpretive interactionism as a theoretical and methodological reference. Data were collected through a semi-structured interview at the household of 11 relatives, from November 2015 to June 2016. Results: the analysis of the narratives evidenced several feelings such as anger, anxiety and hope. Two epiphanies were identified. The first epiphany, discovering that the relative died, had as categories: experiencing the moment of the CRA and receiving the news. In the second epiphany, coexisting with the immediate changes, the following categories were evidenced: remembering and feeling the pain of loss and changes after the death of the relative. Conclusion: the interactionist perspective made it possible to better understand the experience of relatives in waiting for the attendance of cardiorespiratory arrest and the subsequent reception of the news of death of their loved one.

Phenomenon of moral distress through the aspect of interpretive interactionism

Background: Most previous studies on moral distress focused on the factors that cause moral distress, paying inadequate attention to the moral conflict of nurses’ values, the physician–nurse power hierarchy, and the influence of the culture. Research objective: To analyze the main causes for moral distress with interpretive interactionism. Research design: A qualitative study was adopted. Participants: Through purposeful sampling, 32 nurses from 12 different departments were chosen as the samples. Ethical considerations: Approval from the Institutional Review Board of the Kaohsiung Medical University Hospital. Findings: Moral distress is likely to occur in the following clinical situations: patients have no idea about their diseases; the medical decisions fail to meet the optimum benefit of patients; and patients with terminal cancers are not given a proper death. The reason why nurses become trapped in moral distress is that they fail to achieve moral goodness. Inadequate confidence, the physician–nurse power hierarchy, and the Oriental culture affect nurses’ goodness-based intention for patients, which deteriorates moral distress. Discussion: The main cause for moral distress is the moral goodness of nurses. If nurses’ goodness-based intention for patients is inconsistent with the moral objective of achieving optimum benefit for patients, it leads to moral distress. Culture is an essential background factor of care for patients. In the Oriental culture, family members influence patients’ right to know about their diseases, the choice of treatment, and patients’ autonomy of not receiving cardio-pulmonary resuscitation. This results in moral distress in medical care. Conclusion: The occurrence of moral distress demonstrates that nurses have moral characteristics such as goodness and caring. It is suggested that appropriate educational strategies can be adopted to weaken the power hierarchy between physicians and nurses and enhance nurses’ confidence and cultural sensitivity, so as to reduce the moral distress of nurses.

Beyond “Witnessing”: Children’s Experiences of Coercive Control in Domestic Violence and Abuse

Children’s experiences and voices are underrepresented in academic literature and professional practice around domestic violence and abuse. The project “Understanding Agency and Resistance Strategies” (UNARS) addresses this absence, through direct engagement with children. We present an analysis from interviews with 21 children in the United Kingdom (12 girls and 9 boys, aged 8-18 years), about their experiences of domestic violence and abuse, and their responses to this violence. These interviews were analyzed using interpretive interactionism. Three themes from this analysis are presented: (a) “Children’s experiences of abusive control,” which explores children’s awareness of controlling behavior by the adult perpetrator, their experience of that control, and its impact on them; (b) “Constraint,” which explores how children experience the constraint associated with coercive control in situations of domestic violence; and (c) “Children as agents,” which explores children’s strategies for managing controlling behavior in their home and in family relationships. The article argues that, in situations where violence and abuse occur between adult intimate partners, children are significantly affected, and can be reasonably described as victims of abusive control. Recognizing children as direct victims of domestic violence and abuse would produce significant changes in the way professionals respond to them, by (a) recognizing children’s experience of the impact of domestic violence and abuse; (b) recognizing children’s agency, undermining the perception of them as passive “witnesses” or “collateral damage” in adult abusive encounters; and (c) strengthening professional responses to them as direct victims, not as passive witnesses to violence.

Trust in nurse–patient relationships

The aim of this study was to report the results of a literature review of empirical studies on trust within the nurse–patient relationship. A search of electronic databases yielded 34 articles published between 1980 and 2011. Twenty-two studies used a qualitative design, and 12 studies used quantitative research methods. The context of most quantitative studies was nurse caring behaviours, whereas most qualitative studies focused on trust in the nurse–patient relationship. Most of the quantitative studies used a descriptive design, while qualitative methods included the phenomenological approach, grounded theory, ethnography and interpretive interactionism. Data collection was mainly by questionnaires or interviews. Evidence from this review suggests that the development of trust is a relational phenomenon, and a process, during which trust could be broken and re-established. Nurses’ professional competencies and interpersonal caring attributes were important in developing trust; however, various factors may hinder the trusting relationship.