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Objective:To investigate the feasibility of contracted nursing services for disabled persons.Methods:A qualitative study on the feasibility of contracted nursing services for disabled persons was conducted from August 2020 to October 2020 with the phenomenological method. Community nurses were selected with the purpose of sampling method from Yuetan and Baizhifang Community Health Service Centers in Beijing Xicheng District for semi-constructed interviews, and 12 community nurses were finally interviewed according to the principle of information saturation. The research team took field notes, audio recordings and transcriptions of the interviews, coded to refine the themes, and fed back with the respondents to confirm the accuracy of the themes.Results:All the interviewed nurses thought that the contents of basic medical and public health required by the Guidance manual of contracted services of family doctors for disabled persons (the manual) including basic documentation, appointments, pre-diagnosis and post-diagnosis services, home care, rehabilitation nursing guidance, referral services and extended nursing services for the disabled and their families could be completed. All interviewees said that the manual had a guiding role in contracted services for disabled persons. Eight interviewed nurses believed that the manual involved referral services and rehabilitation care, but the technical guidance content did not meet the actual work needs and it should be supplemented and improved; 9 interviewees pointed out that there was a lack of communication with various types of disabled people in service practice, especially for those with vision, hearing, mental disabilities and disabled children; 7 interviewees said that it the free home care for the disabled was not sustainable. Conclusion:The contracted nursing services for disabled persons are feasible and the manual has a guiding role for the practice,and some contents need to be added in the manual to further improve service capacity for disabled people.
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En las últimas décadas, han aumentado los estudios sobre las competencias para el ejercicio de profesiones de la salud. En psicología y en particular, en la psicoterapia, se han elaborado diferentes escritos que detallan las competencias que deben adquirir los y las psicoterapeutas durante su formación. Sin embargo, no se encuentran estudios sistemáticos que detallen las actividades y experiencias asociadas a su desarrollo, denominadas en este trabajo como indicadores asociados. Con el objetivo de conocer cuáles son las actividades y experiencias asociadas al desarrollo de competencias clínicas, se realizaron 20 entrevistas semi-dirigidas que fueron sometidas a un análisis temático en el que complementariamente participaron expertos, quienes actuaron como jueces en diferentes etapas del proceso. Como resultado, se identificaron cinco indicadores asociados: i. Formación de base y actualización, ii. Desarrollo personal y trabajo sobre sí mismo, iii. Pertenencia a instituciones y red de profesionales, iv. Supervisión y v. Experiencia personal y profesional.
In recent decades, studies on the competencies for the exercise of health professions have increased. In psychology, particularly for psychotherapy, various writings have been produced detailing the competencies that psychotherapists must acquire during their training. However, no systematic studies are detailing the activities and experiences associated with their development, in this work called Associated Indicators. In order to know the activities and experiences associated with the development of clinical competencies, 20 semi-structured interviews were carried out subjected to a thematic analysis in which experts participated as judges in different stages of the process. As a result, five associated indicators were identified: Basic training and refresher training, personal development and work on oneself, membership of institutions and networks of professionals, supervision and personal and professional experience.
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Humans , Male , Female , Adult , Psychiatry/education , Clinical Competence , Surveys and Questionnaires , Competency-Based EducationABSTRACT
To understand the survival stress of community-dwelling people with mental disorder. Fifteen cases were selected by purposive sampling and received semi-structured individualized interviews.The data were analyzed by Colaizzi framework and themes were extracted. Four themes were extracted:physiological stress due to psychiatric symptoms and side effects of drugs;psychological stress due to the outcome of mental illness and to conflict of roles in daily life;social and environmental stress such as social discrimination,lack of job opportunities,and difficulty in obtaining social welfare resources;and interpersonal stress caused by discrimination and deteriorating family relations. Community-dwelling people with mental illness have a higher level survival stress after returning to their families and society,with the stressors including symptoms of illness,social discrimination,and interpersonal relationship.Eliminating self-discrimination of the patients,improving social support and social welfare system,and increasing individualized community mental rehabilitation activities may reduce the survival stress of these patients and promote their rehabilitation.
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Humans , Independent Living , Mental Disorders , Qualitative Research , Social SupportABSTRACT
Objective To explore the influencing factors of career planning for nurses aged 30 to 40 years old. Methods Based on descriptive qualitative study, purposive sampling and the maximum variation strategy were used, nurses aged 30 to 40 years old who work at hospitals in Zhejiang province were selected as participants. Face-to-face semi-structured interviews were conducted focusing on influencing factors of career planning and field notes were written. Traditional content analysis was used for analyzing the data, and themes were extracted. The sample size was based on the criteria of saturation. Results A total of 12 participants were included. After analysis, the main influencing factors of career planning were identified: self- perception (such as their own personality, interests and expertise, professional ability, physical condition), knowledge of nursing work (including the cognition of nursing specialty and the nature of nurses' work), career development space (such as career development platform, career development path, career development bottleneck, learning and promotion opportunities), family factors (including family support and family outlook), hospital culture(including interpersonal relationships, leadership support, management style), career planning knowledge(including knowledge of career planning and guidance on career planning in work). Conclusions There are many factors influence career planning. Relevant departments and nursing managers should assist these nurses in making reasonable career planning according to their situation.
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Objective To investigate the attitude of PhD nursing students towards clinical work. Methods A qualitative research was made to ten full-time PhD students in nursing from six universities in a semi-structured interview,with the data so acquired analyzed using Colaizzi phenomenological methedology. Results Four themes were extracted from the analysis.They are their evaluation on nursing career and clinical work;their role in clinical work;their concerns for engaging in clinical work;and their expectations for clinical work.Conclusions Some of the nursing PhD students intend to engage in clinical nursing work after graduation, yet not without concerns, namely decent positions and career development.In this consideration,nursing administrators should take into full account of the students′career expectations and value their important role in this field.In addition, a scientific hierarchical management system should be established,suitable positions should be set up, and new fields of clinical nursing practice explored, in order to fully leverage their talents and promote disciplinary progress to the field of nursing.
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Objective: To investigate the ethical decision-making process of breaking confidentiality when counselors dealing with self-inflicted injury and suicide issues in college situation. Methods: A semi-structural interview was addressed to 10 counselors from 7 college counseling centers in Beijing, among whom with (10 ± 8) years of experience on average in this field. Content analysis method was used to transcription of the interviewing data. Results: Totally 8 counselors had received ethical training more or less, and attached great importance to ethical codes. There were still some conflicts between school regulations and confidentiality rules in 7 university counseling centers. Different counselors varied greatly in decision-making on breaking confidentiality when facing college students' self-inflicted injury and suicide. Faced with conflicts between college demands and confidentiality principles, counselors could take the professional standpoint and consider more of the interests of students. Conclusion: The decision-making process on self-inflicted injury and suicide confidentiality breakthrough needs to be standardized. College's attention and support to the counseling work should be strengthen and enhance ethical awareness.
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Objective To explore the connotation of patient safety competency of nurses, and to provide references for the safety of education and patients' safety competency. Methods The connotation of patient safety competence of nurses was discussed through semi-structured interview and expert meeting method. Results Patient safety competency of nurses contained 7 aspects, including patient-centered care,team cooperation, safety risk management,information evidence-based application, patient safety culture, clinical safety and continuous quality improvement. Conclusions Patient safety competency of nurses is based on the knowledge, attitude and skill, and includes comprehensive abilities in all other aspects.
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Objective:To investigate the use of psychological testing in hospital and its potential existent ethical issues.Methods:Eleven psychometricians from 6 specialized and 5 general hospitals accepted a semi-structural interview.With (10.8 ± 8.8) years of experiences on average in this field,they tested 2 to 30 patients each day.Content analysis was used to investigate the psychometricians' qualification,usage of tests,informed consent,scoring,explanation and preservation.Results:Normally,the number of psychometricians in one hospital varied from 1 to 4.Out of 11 interviewees,2 were unqualified.Three of the interviewees pointed out there were non-standard circumstances when some doctors choosing the tests.Six of them thought that the frequently used tests' norms were obsolete.Eight interviewees considered that comparatively low psychometric fee influenced their devotion of explaining the results.Conclusion:In hospital,it's necessary to strength the ethical awareness of decision-makers and executors in psychological testing.
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Objective To constructthe nurse job satisfaction index evaluation system by analytic hierarchy process (AHP) so as to provide theoretical basis for nursing managers. Methods Semi-structured interviews and literature review were used in establishing the preliminary nurse job satisfaction evaluation index system.The Delphi method was applied in expert consultation and a three-level index system was established, the weight, the largest eigenvalue and the weight vector were all calculated. Index consistency was inspected. Results 4 first-level indicators, 13 second-level indicators and 39 third-level indicators were established.The weight was 1.630 0-3.280 0 for the first-level indicators, 0.4494-1.4723 for the second-level indicators and 0.0913-0.783 9 for the third-level indicators.The weight vector was 0.038-0.616 for the first-level indicators,0.045-0.750 for the second-level indicators and 0.041-0.875 for the third-level indicators.The max-eigenvalue was 4.231 for the first-level indicators,6.226 for the second-level indicators and 4.176 for the third-level indicators. The consistency test value of judgment matrix ranged from 0.000 to 0.077, and the consistency ratio was less than 0.1. Conclusions With distinct gradation,clear structure, reasonable weight and rich content, the index system provides a theoretical basis for the nurse job satisfaction evaluation.
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O artigo analisa a qualidade e a consistência de um roteiro de entrevista compreensiva, adaptado para o estudo da tentativa de suicídio e sua ideação entre pessoas idosas e apresenta o método utilizado na aplicação desse instrumento. O objetivo é demonstrar como o uso da entrevista semiestruturada e sua forma de organização e análise de dados foram testados e aperfeiçoados por uma rede de pesquisadores de doze universidades ou centros de pesquisa do Brasil, Uruguai e Colômbia. O método envolveu a aplicação do instrumento em que se socializou um manual de instruções sobre a coleta, sistematização e análise de dados. A metodologia foi aplicada em 67 entrevistas com idosos na faixa de 60 anos ou mais e em 34 entrevistas com profissionais da saúde em treze municípios brasileiros, em Montevidéu e Bogotá, permitindo a verificação da consistência do instrumento usado e a aplicabilidade do método, durante o processo e ao final. O roteiro aperfeiçoado e as instruções para replicá-lo e analisá-lo são aqui apresentados. Os resultados apontam a adequação e a credibilidade dessa abordagem metodológica testada e qualificada de modo interdisciplinar e interinstitucional.
The article analyses the quality and consistency of a comprehensive interview guide, adapted to study attempted suicide and its ideation among the elderly, and imparts the method followed in applying this tool. The objective is to show how the use of a semi-structured interview and the organization and data analysis set-up were tested and perfected by a network of researchers from twelve universities or research centers in Brazil, Uruguay and Colombia. The method involved application and evaluation of the tool and joint production of an instruction manual on data collection, systematization and analysis. The methodology was followed in 67 interviews with elderly people of 60 or older and in 34 interviews with health professionals in thirteen Brazilian municipalities and in Montevideo and Bogotá, allowing the consistency of the tool and the applicability of the method to be checked, during the process and at the end. The enhanced guide and the instructions for reproducing it are presented herein. The results indicate the suitability and credibility of this methodological approach, tested and certified in interdisciplinary and interinstitutional terms.
Subject(s)
Humans , Male , Female , Aged , Suicide, Attempted , Suicidal Ideation , Suicide, Attempted/statistics & numerical data , Uruguay , Brazil , Records , Interviews as Topic , Colombia , Qualitative ResearchABSTRACT
Introduction: This study explored the significance of the treatment of severely disabled stroke patients hospitalized in a convalescent rehabilitation ward, as documented through the narratives of these patients' families. <br>Methods: The wives of two inpatients who needed assistance in almost all activities of daily living and who were in a convalescent rehabilitation ward, participated in this study. Semi-structured interviews were carried out with two wives about how they viewed their experience during hospitalization and discharge. Interviews were recorded with their permission and transcribed verbatim. Significant expressions in these two transcripts were selected, coded, compared constantly and generate relevant categories. <br>Results: Narratives fell into three categories: recognition of patient disabilities, hope for recovery, and goal-setting and decision of destination at discharge. These categories are characterized by changing towards discharge influenced by description of the condition from doctors or information gathered from media or acquaintances. <br>Conclusion: Families of severely disabled patients seek meaning of their experiences through narratives which unfolded deeply and intensively. Assisting these processes is an essential role of convalescent rehabilitation wards. If these assistances are achieved successfully, convalescent rehabilitation wards can contribute to meaning of life of patients and families after discharge.
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Objective: To study the diagnostic validity, inter-rater reliability, and test-retest reliability of the Th-DIGS. Methods: The DIGS was translated into Thai. The accuracy and understandability was assured by back translation, consensus review and a pilot interview. The studied subjects were recruited from three major referral mental health centers in central Thailand. We recruited a total of 170 subjects with clinical psychiatric diagnoses and 33 controls. The referral psychiatric diagnoses were schizophrenia (n=33), major depressive disorder (n=31), bipolar I disorder (n=32), alcohol dependence (n=39), amphetamine dependence (n=35). To study validity and inter-rater reliability, we interviewed the subjects with the Th-DIGS by a trained interviewer in the presence of a co-rater who simultaneously completed the Th-DIGS. Approximately four weeks later, we re-interviewed the subjects using the Th-DIGS by a third independent interviewer to study the test-retest reliability. We then calculated the diagnosis concurrent validity, inter-rater and test-retest reliability of the Th-DIGS. Results: The overall kappa of concurrent validity was 0.82 with 93.6% sensitivity and 95.0% specificity. The overall kappa coefficients of inter-rater reliability and the test-retest reliability were 0.89 and 0.78, respectively. The excellent validity and reliability are robust to most diagnoses. The concurrent validity of alcohol dependence and the test-retest reliability of controls, major depressive disorder and alcohol dependence were in fair-to-good range. Moreover, the Th-DIGS also reliably discriminated normal controls from subjects with psychiatric disorders. Conclusion: The Th-DIGS has been developed. The study in Thai subjects demonstrated a good-toexcellent validity, inter-rater and test-retest reliability. This indicates that the Th-DIGS is a highly valid and reliable instrument for use in psychiatric studies, and studies of a variety of psychiatric disorders including alcohol dependence and amphetamine dependence.
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Objective: To study the diagnostic validity, inter-rater reliability, and test-retest reliability of the Th-DIGS. Methods: The DIGS was translated into Thai. The accuracy and understandability was assured by back translation, consensus review and a pilot interview. The studied subjects were recruited from three major referral mental health centers in central Thailand. We recruited a total of 170 subjects with clinical psychiatric diagnoses and 33 controls. The referral psychiatric diagnoses were schizophrenia (n=33), major depressive disorder (n=31), bipolar I disorder (n=32), alcohol dependence (n=39), amphetamine dependence (n=35). To study validity and inter-rater reliability, we interviewed the subjects with the Th-DIGS by a trained interviewer in the presence of a co-rater who simultaneously completed the Th-DIGS. Approximately four weeks later, we re-interviewed the subjects using the Th-DIGS by a third independent interviewer to study the test-retest reliability. We then calculated the diagnosis concurrent validity, inter-rater and test-retest reliability of the Th-DIGS. Results: The overall kappa of concurrent validity was 0.82 with 93.6% sensitivity and 95.0% specificity. The overall kappa coefficients of inter-rater reliability and the test-retest reliability were 0.89 and 0.78, respectively. The excellent validity and reliability are robust to most diagnoses. The concurrent validity of alcohol dependence and the test-retest reliability of controls, major depressive disorder and alcohol dependence were in fair-to-good range. Moreover, the Th-DIGS also reliably discriminated normal controls from subjects with psychiatric disorders. Conclusion: The Th-DIGS has been developed. The study in Thai subjects demonstrated a good-toexcellent validity, inter-rater and test-retest reliability. This indicates that the Th-DIGS is a highly valid and reliable instrument for use in psychiatric studies, and studies of a variety of psychiatric disorders including alcohol dependence and amphetamine dependence.