A good death in the child with life shortening illness: A qualitative multiple-case study

Background: Understanding what makes a ‘good death’ in the child with life shortening illness is important, as it informs appropriate and effective end-of-life care. Above play, peer contact and opportunities for assent, prior literature review found meeting needs and managing control were critical. The influence of disease types, location of death and palliative care support remains unclear. Aim: Explore how a good death for children can occur in the real-world context and identify factors influencing it. Design: A qualitative multiple-case study. The case was defined as family and professional caregivers of children who died, stratified across disease categories (cancer or non-cancer) and palliative care contact. Data collection included (1) interviews, (2) artefacts, (3) clinical notes. Framework Analysis facilitated in-depth within and cross-case analysis. Setting/participants: Singapore health-care context. Respondents included bereaved parents, health and social care providers from hospital, and a community palliative care service. Results: Five cases were constituted, with eight parents and 14 professionals as respondents. Eight common themes were identified, sub-categorised under three domains and interpreted theoretically: (1) Antecedents: Letting go, Acknowledging the child, Closure (2) Determinants: Suffering, Control, Systems and processes (3) Attributes: Comfort, Dying not prolonged. These factors were consistent across all cases, regardless of individual diagnoses, place of care and palliative care access. Conclusions: Elements that universally influence a good death are revealed within an ecologically sound and holistic conceptual framework. The impact of attitudes among healthcare professionals, and service delivery at systems level highlighted in this study have immediate applications in practice and policy.

Perceptions and Experiences of Health-care Personnel Regarding Violence Against Health Care: a Qualitative Multiple Case Study

BackgroundHealth-care workers are at high risk of facing violence all over the world. The sanctity, respect and protection of health care is threatened by violence in health-care settings. The study aims to explore the perception of health-care personnel about violence in health-care settings in district Peshawar.MethodsThis qualitative multiple case study uses a participatory approach to develop an understanding of the processes and themes that explain the health-care personnel`s experience of violence. Ten focus group discussions and three individual in-depth interviews were conducted with eighty-three participants recruited through purposive sampling.ResultsThree distinct recurrent themes emerged from the responses of the different stakeholders and consensus was reached on seven broad categories. The themes were: (a) Not all the wounds are visible: the theme describes the nature, frequency, and characteristics of violence and explores that violence is not merely any physical action taken against men or women to cause visible physical wounds, but also includes verbal or emotional abuse that attempts to hurt the feelings or affects the health of an individual. (b) But violence is never the answer: different categories including the perpetrators of violence, causes, and contributing factors, and the consequences and effects of violence on individuals and institutions were explored and summarized that there could be many causes to provoke violence but still violence cannot be justified. (c) Vaccine for violence: described the various strategies for the prevention of violence and suggests various measures at the public and institutional levels to be incorporated for a future without violence. ConclusionThe study concluded that violence against health care is a frequently occurring phenomenon in health-care settings. Most of the incidents are not highlighted as they are verbal/emotional but have far more impact on the health-care personnel. A holistic approach was suggested for ending violence in the health-care settings and the need to involve all relevant stakeholders was emphasized. The recommended measures include policy formulation, promoting awareness and education, capacity building of health-care personnel on communication strategies/consultation skills, improved security of the health-care settings, and positive role of media in promoting the respect of health-care personnel. Further research should then focus on evaluating the effectiveness of these measures.

THE ROLE OF LEADERSHIP IN TACIT KNOWLEDGE TRANSFER IN THE NIGERIAN OIL AND GAS INDUSTRY.

The oil and gas industries are knowledge driven industry. The technology deployed in deep water exploration and production involve knowledge-intensive process by highly technical personnel. The problem was that the leadership of the oil and gas industries have not necessitated early recovery of tacit knowledge transfer from experts to employees managing the plant operations. The purpose of this qualitative multiple case study was to gain an understanding of how oil and gas industry leaders in Nigeria facilitate the transfer of tacit knowledge from experts to employees managing the plant after exploration activities. The conceptual framework was the socialization, externalization, combination, and internalization model developed by Nonaka and Takeuchi and Burns’ transformational leadership theory. A qualitative multiple case study design was used by adopting multiple sources of information including semi-structured interviews, field notes, and review of organizational documents. The unit of analysis was leaders in an oil and gas services organization. The data analysis processes involved coding of the data, categorizing the coded data, and subsequently generating themes in line with the research question using NVivo Version 12 software. Findings indicated that leaders facilitated the transfer of tacit knowledge through the creation of a safe working environment and demonstration of care for the employees. The opportunity to facilitate the transfer of tacit knowledge from expert to employees managing operations after exploration enhance the organization’s stability and promotes healthy communities. Keywords– Knowledge-Transfer, Leadership Style, Oil and Gas Industry

The Usefulness of Offering 24/7 Online Support Within a Wider Mix of Professional Services for People With Intellectual and Developmental Disabilities Living Independently: A Qualitative, Multiple Case Study

Service organizations for people with intellectual and developmental disabilities (IDD) increasingly use telecare applications to improve their services. This study explored the usefulness of offering the 24/7 online support service DigiContact within a broader mix of professional services for people with IDD living independently. We employed a qualitative multiple case study, in which the cases of nine online support users were reconstructed through semistructured interviews with both support users and their case workers. Thematic analysis showed that online support was used as an addition to regular onsite support to enable a more tailor-made delivery of professional supports. Online support can be valuable for its users by increasing the accessibility of professional support and creating opportunities for more self-direction in support.

Successful approaches for implementing additive manufacturing

PurposeThe purpose of this qualitative, multiple-case study was to explore the successful strategies that managers of light and high-tech small and medium-sized manufacturing companies in the Netherlands, use to adopt additive manufacturing (AM) technology into their business models.Design/methodology/approachA qualitative, multiple-case study approach was used. The participants for this study consisted of executive-level managers of light and high-tech manufacturing companies in the Netherlands. Company documents were studied, and individual interviews were undertaken with participants to gain an understanding of the strategies they used to adopt AM technology into their business models.FindingsThree significant themes emerged from the data analysis: identify business opportunities for AM technology, experiment with AM technology and embed AM technology.Research limitations/implicationsThe findings of this study could be of advantage to industry leaders and manufacturing managers who are contemplating to adopt AM in their business models.Originality/valueThis study may contribute to the further proliferation of AM technology. Industry leaders may also gain a clearer understanding of the effects of 3DP on local employment. The results of the study may also work as a catalyst for increased awareness for manufacturing firm leaders who have not yet considered the opportunities and threats AM technology presents to their organizations.