“You’re changing the pattern”: cognitive analytic team formulation with learning disabilities care staff

Purpose This study aims to explore how care staff working with people with learning disabilities experienced psychologist-facilitated team formulation sessions in a cognitive analytic style (contextual reformulation). Design/methodology/approach Eleven participants attended at least one contextual reformulation session regarding a client their team referred because of challenging behaviour. Post-intervention semi-structured interviews were analysed using qualitative inductive thematic analysis. Findings Five themes were developed: multiple roles and functions of sessions and clinicians; challenging behaviour in relationship; making links – understanding can be enlightening, containing and practical; the process of developing a shared understanding and approach; and caught between two perspectives. Findings suggested contextual reformulation helped staff see challenging behaviour as relational, provided them with the space to reflect on their emotions and relate compassionately to themselves and others, and ultimately helped them to focus their interventions on understanding and relationally managing rather than acting to reduce behaviour. Research limitations/implications Qualitative methodology allows no causal inferences to be made. Ten of 11 participants were female. Originality/value This qualitative study adds to the limited research base on team formulation in learning disabilities settings and specifically that using a cognitive analytic approach.

Who Gets to Be in The Guild?

While media studies have frequently assessed the importance of representation, research in this area has often been siloed by institutional and methodological norms that define academics as “gender”, “race”, or “class” scholars, rather than inclusive scholars of all these and more. This paper thus responds to recent calls for more intersectional work by simultaneously addressing the overlapping representations of race, gender, and gamer identity, and their relation to Lorde’s concept of the mythical norm, in the popular webseries, The Guild (YouTube, 2007-2013). Via a detailed, inductive thematic analysis of the show’s two characters of color, Zaboo and Tinkerballa, we find a doubly problematic intersection between standard “gamer identity” tropes and gendered Asian/American stereotypes. The show forecloses on its potential to be truly diverse and reinforces the oppressive, marginalizing practices it tries to mock, suggesting that gaming culture will not change until we address its intersecting axes of power and exclusion. This research also demonstrates how the constructed identity of media audiences-- in this case, stereotypical “gamer” identity-- can exacerbate and reaffirm existing power disparities in representation. We suggest that media scholars remain attentive to the intersecting articulations of media consumer and individual identities in considering how representation can influence systems of inclusion and exclusion, as well as viewers’ lived outcomes.

Experience, impact and needs of informal parental caregivers around the communication of a diagnosis of schizophrenia

Aims: To qualitatively characterize the experience, impact and needs of informal family caregivers around the communication of a diagnosis of schizophrenia. Methods: In all, 13 informal family caregivers were recruited. All were parents. Semi-structured interviews were used to explore their experience of the diagnosis of schizophrenia, the impacts of the diagnosis and the needs related to the diagnosis around its communication. Interviews were recorded, transcribed, codes generated and mixed deductive–inductive thematic analysis undertaken. Results: Participants described receiving the diagnosis of schizophrenia for their relative as a devastating experience, although some nuanced the experience with a sense of relief of finally naming the disorder and getting access to care. Caregivers’ experience and representations prior to hearing the diagnosis played an important role in the way the ‘news’ was internalized. The communication of the diagnosis constituted a starting point for acceptance of the reality of the illness in participants. Numerous unmet needs around the communication of the diagnosis were reported by participants, including personnalized support, specific explanations about the disorder and guidance on their role as caregiver. Conclusion: A specific attention must be given to the communication of the diagnosis of schizophrenia to the informal family caregivers. Information giving must be early, comprehensive, personalized and embedded into tailored education and support programmes for caregivers to facilitate illness acceptance and adaptation.

A qualitative study of military officers’ perceptions of the adaptions couples make to meet the military organisation’s implicit expectations

Purpose The purpose of this study was to investigate military officers’ perception of the implicit expectations the organisation has for the officer’s private life and what implications it may have for gender norms at the organisation, family and individual levels. Design/methodology/approach A qualitative approach, using an inductive thematic analysis, was performed. The data was based on 20 interviews with military officers, including 18 men and 2 women. Findings Two main themes, with three subsequent subthemes, were identified. These themes were interpreted as being necessary for the military officer to be able to manage organisational demands. The first included the implicit expectations the organisation had for the family. The three subthemes included the officer’s acceptance of frequent travel demands, adapting private life in accordance to organisational demands and picking a partner that matches the goals of the organisation. The second identified main theme included the military officer’s descriptions of implicit expectations the organisation held for the officer’s partner. Three subthemes were identified, including the partner’s need to be independent and psychologically strong, to take the main responsibility for managing family life and to engage in emotion work with the extended family. Originality/value The findings identify important perceptions that military officers have regarding the military’s expectations for their private life and the adaptive behaviors regularly performed. These adaptive behaviors allow the military officer to be able to engage in work that sustains the organisation.

Italian Adolescent Young Caregivers of Grandparents: Difficulties Experienced and Support Needed in Intergenerational Care-Giving: Qualitative Findings from a European Union Funded Project

The article aims to describe the experiences of 87 Italian adolescent young caregivers (AYCs) of grandparents (GrPs), with reference to the caregiving stress appraisal model (CSA) that provides a theoretical lens to explore the difficulties encountered and support needed in their caring role. Qualitative data were drawn from an online survey conducted within an EU Horizon 2020 funded project. An inductive thematic analysis was carried out, and the findings were critically interpreted within the conceptual framework of the CSA model. The analysis highlighted three categories of difficulties: material, communication and emotional/psychological. The most common material difficulty was the physical strain associated with moving “uncooperative” disabled older adults. The types of support needed concerned both emotional and material support. The study provides a deeper understanding of the under-studied experiences of AYCs of GrPs. Based on these findings, policies and support measures targeted at AYCs of GrPs should include early needs detection, emotional support and training on intergenerational caring in order to mitigate the stress drivers. Moreover, the study advances the conceptualisation of the CSA model by considering the above-mentioned aspects related to intergenerational caregiving.

Co-Designing a New Yoga-Based Mindfulness Intervention for Survivors of Stroke: A Formative Evaluation

Movement-based mindfulness interventions (MBI) are complex, multi-component interventions for which the design process is rarely reported. For people with stroke, emerging evidence suggests benefits, but mainstream programs are generally unsuitable. We aimed to describe the processes involved and to conduct a formative evaluation of the development of a novel yoga-based MBI designed for survivors of stroke. We used the Medical Research Council complex interventions framework and principles of co-design. We purposefully approached health professionals and consumers to establish an advisory committee for developing the intervention. Members collaborated and iteratively reviewed the design and content of the program, formatted into a training manual. Four external yoga teachers independently reviewed the program. Formative evaluation included review of multiple data sources and documentation (e.g., formal meeting minutes, focus group discussions, researcher observations). The data were synthesized using inductive thematic analysis. Three broad themes emerged: (a) MBI content and terminology; (b) manual design and readability; and (c) barriers and enablers to deliver the intervention. Various perspectives and feedback on essential components guided finalizing the program. The design phase of a novel yoga-based MBI was strengthened by interdisciplinary, consumer contributions and peer review. The 12-week intervention is ready for testing among survivors of stroke.

“We will make you feel safe”: Female medical staff's experiences of meeting with raped women in Sweden

The focus of this study was on female emergency medical personnel's experiences of treating women who have been raped and on their own experiences of being women themselves working in this situation. We interviewed 12 female medical personnel in four focus groups of two to five participants each. The material was analysed using inductive thematic analysis. Participants’ experiences were structured under two main themes: Prerequisites for care and Effects on oneself. As women, the participants emphasized their understanding of other women and stressed the importance of offering flexible care and taking time with each patient. They described how their work affected them personally, making them increasingly aware of men's violence against women and their need for support from their colleagues. They also discussed structural barriers to both patient care and self-care. If unaddressed, such shortcomings risk negatively affecting raped women seeking medical care and may also be detrimental to the health and well-being of the professional offering care.

Exploring how veterinary professionals perceive and use grief support resources to support companion animal caregivers in Ontario, Canada

Objective: The aim of this study was to qualitatively explore veterinary professionals’ use and perceptions of grief resources and services to support companion animal caregivers following companion animal euthanasia. Background: The loss of a companion animal can be a source of great sorrow and grief. Like human loss, many companion animal caregivers may seek out and benefit from grief resources, of which veterinary professionals are often important providers. Yet, little is known about how, when or for what reasons veterinary professionals provide these resources. Methods: A qualitative study consisting of group and individual interviews involving 38 veterinary professionals and staff from 10 veterinary hospitals in Ontario, Canada was conducted. Verbatim transcripts were evaluated using inductive thematic analysis to identify themes and subthemes. Results: Results indicated that typically resources were only provided if a caregiver requested information, or when veterinary professionals recognised that the caregiver may benefit from these resources. To assess a caregiver’s need, participants reported considering their age, the strength of the human-animal bond, their previous and ongoing life circumstances, and their emotional state. Several barriers limiting veterinary professionals’ use of grief resources were also described including perceptions that few adequate resources existed and a lack of knowledge of existing or new resources. Conclusion: Overall, findings suggest that there are substantial opportunities to improve and embed a provision of grief resources within the veterinary profession. There is a need to develop adequate resources to meet caregivers’ supportive needs and implement these resources within the greater veterinary profession.

Factors Influencing Men’s Experiences and Engagement with the Rugby Fans in Training—New Zealand Pilot Trial: A Healthy Lifestyle Intervention for Men

Health promotion programs designed specifically to support men to improve their lifestyle behaviours are required to improve men’s health. This study explored factors that influenced men’s experiences of, and engagement with, the Rugby Fans in Training—New Zealand pilot trial, a professional sport-based healthy lifestyle intervention for overweight men. Thirty-five men (mean age = 45, SD = 10 years) who completed the 12-week intervention participated in one of eight semi-structured focus groups. Using inductive thematic analysis, five themes represented the meanings in the data. First, a group of like-minded men all in the same boat recognised the importance of being in similar life situations and having similar reasons for joining the programme. Second, the men described the importance of the support and motivation provided by the team atmosphere created through the programme. Third, the motivational coach recognised the characteristics, skills and knowledge of the coach delivering the programme which created engagement with it. Fourth, the education sessions were valued for the knowledge gained and underpinning philosophies that guided them. Finally, the involvement of the rugby franchise influenced commitment to the programme and created initial interest. These results provide evidence for the key components that should be incorporated into the future development of and improvement to healthy lifestyle interventions for men.

The role of organizational culture in normalizing paramedic exposure to violence

Purpose Violence against paramedics is a complex – but underreported – problem. Extant research suggests organizational culture may play a role in sustaining cultural norms that downplay the significance and limit reporting. The purpose of this paper is to qualitatively explore paramedics’ experience with violence, with particular emphasis on understanding how organizational culture contributes to under-reporting. Design/methodology/approach The authors surveyed paramedics from a single, large, urban service in Ontario, Canada, asking participants to describe their experiences with violence, including whether – and why or why not – the incidents were reported. Within a constructivist epistemology, we used inductive thematic analysis with successive rounds of coding to identify and then define features of organizational culture that limit reporting. Findings A total of 196 (33% of eligible) paramedics completed the survey. Fully 98% of participants disclosed having experienced some form of violence; however, only a minority (40%) reported the incidents to management, or the police (21%). The authors defined a framework within which a lack of support from management, and consequences for offenders, implicitly positions the ability of paramedics to “brush off” violent encounters as an expected professional competency. Disclosing emotional or psychological distress in response to violent encounters invited questions as to whether the individual is personally suited to paramedic work. Originality/value While the extant research has indicated that underreporting is a problem, the findings shed light on why – a critical first step in addressing what has been described as a serious public health problem.