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1.
BMC Pediatr ; 22(1): 195, 2022 Apr 11.
Article in English | MEDLINE | ID: covidwho-1785147

ABSTRACT

BACKGROUND: Literature on factors influencing medication adherence within paediatric clinical trials is sparse. The Paracetamol and Ibuprofen in the Primary Prevention of Asthma in Tamariki (PIPPA Tamariki) trial is an open-label, randomised controlled trial aiming to determine whether paracetamol treatment, compared with ibuprofen treatment, as required for fever and pain in the first year of life, increases the risk of asthma at age six years. To inform strategies for reducing trial medication crossovers, understanding factors influencing the observed ibuprofen-to-paracetamol crossovers (non-protocol adherence) is vital. The aim of this study was to investigate the factors influencing the decision-making process when administering or prescribing ibuprofen to infants that may contribute to the crossover events in the PIPPA Tamariki trial. METHODS: Constructivist grounded theory methods were employed. We conducted semi-structured interviews of caregivers of enrolled PIPPA Tamariki infants and healthcare professionals in various healthcare settings. Increasing theoretical sensitivity of the interviewers led to theoretical sampling of participants who could expand on the teams' early constructed codes. Transcribed interviews were coded and analysed using the constant comparative method of concurrent data collection and analysis. RESULTS: Between September and December 2020, 20 participants (12 caregivers; 8 healthcare professionals) were interviewed. We constructed a grounded theory of prioritising infant welfare that represents a basic social process when caregivers and healthcare professionals medicate feverish infants. This process comprises three categories: historical, trusting relationships and being discerning; and is modified by one condition: being conflicted. Participants bring with them historical ideas. Trusting relationships with researchers, treating clinicians and family play a central role in enabling participants to challenge historical ideas and be discerning. Trial medication crossovers occur when participants become conflicted, and they revert to historical practices that feel familiar and safer. CONCLUSIONS: We identified factors and a basic social process influencing ibuprofen use in infants and trial medication crossover events, which can inform strategies for promoting adherence in the PIPPA Tamariki trial. Future studies should explore the role of trusting relationships between researchers and treating clinicians when conducting research.


Subject(s)
Asthma , Ibuprofen , Acetaminophen/therapeutic use , Asthma/drug therapy , Child , Fever/drug therapy , Grounded Theory , Humans , Ibuprofen/therapeutic use , Infant , Infant Welfare
2.
Inquiry ; 59: 469580221090405, 2022.
Article in English | MEDLINE | ID: covidwho-1784980

ABSTRACT

This study was conducted to develop a substantive theory on school nurses' experiences responding to infectious diseases by applying the grounded theory method to explore their experiences and derive related concepts. Study participants were 20 school nurses with experiences coping with infectious diseases while working in schools. The research question of this study was "What kind of experience did the school nurses have in response to infectious diseases?" The analysis included open, axis, and selective coding. We derived 164 concepts, 45 subcategories, and 17 categories. Further, paradigm, situation, and school infectious disease response control tower models were derived. The results of this study can serve as bottom-up policy data to understand the current situation surrounding school infectious disease management through the experiences of school nurses.


Subject(s)
School Nursing , Adaptation, Psychological , Grounded Theory , Humans , Pandemics , Qualitative Research
3.
Reprod Health ; 18(1): 213, 2021 Oct 26.
Article in English | MEDLINE | ID: covidwho-1779654

ABSTRACT

BACKGROUND: Human papillomavirus is the most common cause of sexually transmitted diseases. Various studies report that positive human papillomavirus diagnosis results in psychosexual issues for the infected and reduces their quality of life. However, the adaptation of the infected has not been addressed yet. The present study aims to identify the process by which individuals infected with human papillomavirus adapt to their disease. METHOD: This is a qualitative work of research with a grounded theory design. The setting of the study was the skin clinic of Shahid Faghihi Hospital in Shiraz. The participants consisted of 27 individuals: 18 patients, 3 doctors, 2 counselors, and 4 spouses of patients. The subjects were selected via purposeful and theoretical sampling method until data saturation was reached. Data were collected through face-to-face, in-depth, semi-structured interviews from April 2019 to December 2020. The collected data were analyzed using Corbin and Strauss's method (2015) and MAXQDA 2018. RESULTS: The theory which emerged from the data was "trying to maintain resilience in the absence of psychological security." Analysis of data showed the main concern of participants in adapting to their diagnosis with human papillomavirus was "life stress". "Stigma and ignorance" was found to be a contextual condition and "paradox in support" was an intervening condition in the patients' adaptation. The patients' action/interaction responses to their main concern in the context in question were "emotional confrontation" and "maintaining resilience." The outcome was "oscillation between tension and tranquility." CONCLUSION: The present study explains the process by which patients with human papillomavirus adapt to their condition. Identification of the concerns of patients with human papillomavirus and the factors which affect their adaptation can help healthcare policy-makers and providers develop effective support plans in order to increase patients' quality of life. Early interventions, e.g. counseling care providers to modify their behaviors toward alleviating the psychosexual tension of the infected, can facilitate the adaptation of the infected and decrease the consequences of the infection for them.


Human papillomavirus (HPV) is the most common cause of sexually transmitted diseases. Almost all men and women get the infection at least once throughout their lives. The high-risk types of HPV account for about 5% of cancer cases globally. HPV can cause anogenital cancers and warts in both genders. In this grounded theory study, we conducted 27 in-depth interviews with Iranian patients, their spouses, and health care providers from April 2019 to December 2020. The collected data were analyzed using Corbin and Strauss's method (2015) and MAXQDA 2018. The participants were concerned about tension in family relationships, being stigmatized, getting cancer, recurrence of warts, transferring their disease to others, and changes in the appearance of their genitalia. They stated that HPV is regarded as a shameful disease in society. Most of the participants said they had never heard anything about HPV. The patients' action/interaction responses to their concerns were "emotional confrontation" and "maintaining resilience." These strategies helped the patients recover some of their tranquility. However, some of patients' concerns were persistent and kept them oscillating between tension and tranquility. An understanding of the patients' perception of their disease is essential to development of effective educational interventions to change patients' perspective on their situation and improve their recovery. Furthermore, because of the low level of public awareness about HPV and sexual health and the flow of misinformation to the infected, it is recommended that educational interventions focus on the patients' concerns.


Subject(s)
Alphapapillomavirus , Papillomavirus Infections , Grounded Theory , Humans , Papillomaviridae , Papillomavirus Infections/diagnosis , Quality of Life , Social Stigma
4.
Front Public Health ; 10: 852612, 2022.
Article in English | MEDLINE | ID: covidwho-1776073

ABSTRACT

The risk factors affecting workers' unsafe acts were comprehensively identified by Human Factors Analysis and Classification System (HFACS) and grounded theory based on interview data and accident reports from deep coal mines. Firstly, we collected accident case and field interview data from deep coal mines issued by authoritative institutions. Then, the data were coded according to grounded theory to obtain relevant concepts and types. The HFACS model was used to classify the concepts and categories. Finally, the relationship between core and secondary categories was sorted out by applying a story plot. The results show that risk factors of unsafe acts of deep coal mine workers include environmental factors, organizational influence, unsafe supervision and unsafe state of miners, and the main manifestations of unsafe acts are errors and violations. Among them, the unsafe state of miners is the intermediate variable, and other factors indirectly affect risky actions of coal miners through unsafe sates. Resource management, organizational processes and failure to correct problems are the top three risk factors that occur more frequently in unsafe acts. The three most common types of unsafe act are unreasonable labor organization, failure to enforce rules, and inadequate technical specifications. By combining grounded theory and the HFACS framework to analyze data, risk factors for deep coal miners can be quickly identified, and more precise and comprehensive conceptual models of risk factors in unsafe acts of deep coal miners can be obtained.


Subject(s)
Accidents, Occupational , Coal Mining , Miners , Factor Analysis, Statistical , Grounded Theory , Humans , Risk Factors
5.
Inquiry ; 59: 469580211056194, 2022.
Article in English | MEDLINE | ID: covidwho-1765266

ABSTRACT

Communication is central to nursing care. Yet, the nonverbal aspect of communication tends to be neglected or underestimated in nursing studies. Research has shown that older patients interpret nurses' communication messages during the clinical encounter. This article conceptualizes older adults' interpretation of and need for nonverbal communication (NVC) to enhance patient-centered communication advocated by the World Health Organization. The Corbin and Strauss (2015) inductive Grounded Theory approach was used to collect data from 3 hospital units in Cameroon using in-depth interviews with eight older adults, thirteen nurses, and four student nurses between July 2018 and January 2020. Open coding, axial coding, and selective coding were used for analysis, which reveals that interpretations of NVC can be positive or negative. It means that older adults view nurses either as angels or as difficult persons, depending on the nurses' positive or negative NVC and behaviors. These interpretations lead to consequences ranging from a preference for some nurses to noncompliance with care. The results further show that older adults need active listening, humor, and affection from nurses. Information regarding older adults' interpretation of and need for NVC can be used to improve curriculum content and to develop skills in and awareness of NVC with older adults. It is recommended that further research expand on effective nonverbal techniques during COVID-19 times where the meaning of facial expressions and voice inflection can be disrupted.


Subject(s)
COVID-19 , Nurses , Aged , Cameroon , Grounded Theory , Humans , Nonverbal Communication
6.
Front Public Health ; 10: 833909, 2022.
Article in English | MEDLINE | ID: covidwho-1742279

ABSTRACT

Pandemic the COVID-19 is a global threat to rural entrepreneurial businesses with an uncertain ending. Therefore, it is necessary to provide a paradigm model to reduce the negative effects of this crisis, increase the resilience of rural entrepreneurial businesses or even turn this threat into an opportunity for the development of rural entrepreneurial businesses in the long run. This study, using a qualitative approach, investigated the resilience of rural entrepreneurial businesses in dealing with the COVID-19 crisis in Kermanshah province using a paradigm model. Using purposeful and theoretical sampling, 26 cases were selected. The tools used for data collection were open questionnaires (unstructured), individual depth interviews, and taking notes. The results provide a relatively comprehensive model that consists of six basic parts: causal conditions (included economic management, health factors, human resources management, and adaptation factors), the phenomenon (included low resilience of rural entrepreneurial businesses in the face of the COVID-19 crisis), contextual conditions (including social factors; cultural factors and psychological factors), interventing conditions (included business management and legal supports), action strategies (included Planned resilient actions and Unplanned resilient actions), finally, the consequences (included adapting to crisis conditions and increasing resilience in the long run, and also lack of adaptation to crisis conditions and lack of continuity of business survival in the long run). In general, rural entrepreneurial businesses in the face of crisis must, through planned resilience measures, both increase their business resilience in the short term, as well as develop the business and gain a competitive advantage in the long run. Finally, based on the findings and in order to developing resilience in rural entrepreneurial businesses during the COVID-19 crisis, some recommendations were presented.


Subject(s)
COVID-19 , COVID-19/epidemiology , Commerce , Grounded Theory , Humans , Iran/epidemiology , Rural Population
7.
BMC Public Health ; 22(1): 469, 2022 03 09.
Article in English | MEDLINE | ID: covidwho-1736402

ABSTRACT

BACKGROUND: Combating viral outbreaks extends beyond biomedical and clinical approaches; thus, public health prevention measures are equally important. Public engagement in preventive efforts can be viewed as the social responsibility of individuals in controlling an infectious disease and are subjected to change due to human behaviour. Understanding individuals' perception of social responsibility is crucial and is not yet explored extensively in the academic literature. We adopted the grounded theory method to develop an explanatory substantive theory to illustrate the process of how individual responded to the outbreak from a social responsibility perspective. METHODS: In-depth interviews were conducted among 23 Malaysians either through telephone or face-to-face depending on the participant's preference. Both purposive and theoretical sampling were used. Participants were invited to share their understanding, perceptions and activities during the COVID-19 pandemic. They were further probed about their perceptions on complying with the public health interventions imposed by the authorities. The interviews were audio-recorded and transcribed verbatim. Data was analysed via open coding, focus coding and theoretical coding, facilitated by memoing, sketching and modelling. RESULTS: Study findings showed that, social responsibility is perceived within its role, the perceived societal role responsibility. In a particular context, an individual assumed only one of the many expected social roles with their perceived circle of responsibility. Individuals negotiated their actions from this perspective, after considering the perceived risk during the outbreak. The four types of behaviour depicted in the matrix diagram facilitate the understanding of the abstract concept of negotiation in the human decision-making process, and provide the spectrum of different behaviour in relation to public response to the COVID-19 pandemic. CONCLUSIONS: Our study adopted the grounded theory approach to develop a theoretical model that illustrates how individual response to COVID-19 preventive measures is determined by the negotiation between perceived societal role responsibility and perceived infection risk. This substantive theoretical model is abstract, thus has relevance for adoption within similar context of an outbreak.


Subject(s)
COVID-19 , Grounded Theory , Humans , Pandemics/prevention & control , SARS-CoV-2 , Social Responsibility
8.
J Korean Acad Nurs ; 51(6): 689-702, 2021 Dec.
Article in Korean | MEDLINE | ID: covidwho-1614086

ABSTRACT

PURPOSE: This study aimed to develop a situation-specific theory to explain nurses' experiences of the COVID-19 crisis. METHODS: The participants were 16 hospital nurses who experienced the COVID-19 crisis. Data were collected through in-depth individual interviews from September 2, 2020 to January 20, 2021. Transcribed interview contents were analyzed using Corbin and Strauss's grounded theory method. RESULTS: A total of 38 concepts and 13 categories were identified through an open coding process. The core category found was becoming a pioneering nurse who turns crises into opportunities. The causal conditions were the chaos of being exposed defenselessly to an unexpected pandemic, fear caused by a nursing care field reminiscent of a battlefield, and moral distress from failing to protect patients' human dignity. The contextual conditions were feeling like the scapegoat of the hospital organization, increasing uncertainty due to the unpredictable state of COVID-19, and relative deprivation due to inappropriate treatment. The central phenomenon was suffering alone while experiencing the dedication of the COVID-19 hero image. The action/interactional strategy were efforts to find a breakthrough and getting the nurse's mind right, and the intervening conditions were gratitude for those who care for broken hearts and getting used to myself with repetitive work. The Consequences were becoming an independent nurse and frustration with the unchanging reality. CONCLUSION: This study provides the foundation for the nurse's situation-specific theory of the COVID-19 crisis by defining the crisis perceived by nurses who cared for COVID-19 patients and suggesting types of coping with the crisis.


Subject(s)
COVID-19 , Nurses , Grounded Theory , Humans , Pandemics , Qualitative Research , SARS-CoV-2
9.
Int J Environ Res Public Health ; 18(24)2021 12 19.
Article in English | MEDLINE | ID: covidwho-1580721

ABSTRACT

The COVID-19 pandemic has confronted emergency and critical care physicians with unprecedented ethically challenging situations. The aim of this paper was to explore physicians' experience of moral distress during the pandemic. A qualitative multicenter study was conducted using grounded theory. We recruited 15 emergency and critical care physicians who worked in six hospitals from the Lombardy region of Italy. Semi-structured interviews about their professional experience of moral distress were conducted from November 2020-February 2021 (1 year after the pandemic outbreak). The transcripts were qualitatively analyzed following open, axial, and selective coding. A model of moral distress was generated around the core category of Being a Good Doctor. Several Pandemic Stressors threatened the sense of Being a Good Doctor, causing moral distress. Pandemic Stressors included limited healthcare resources, intensified patient triage, changeable selection criteria, limited therapeutic/clinical knowledge, and patient isolation. Emotions of Moral Distress included powerlessness, frustration/anger, and sadness. Physicians presented different Individual Responses to cope with moral distress, such as avoidance, acquiescence, reinterpretation, and resistance. These Individual Responses generated different Moral Outcomes, such as moral residue, disengagement, or moral integrity. The Working Environment, especially the team and organizational culture, was instrumental in restoring or disrupting moral integrity. In order for physicians to manage moral distress successfully, it was important to use reinterpretation, that is, to find new ways of enacting their own values by reframing morally distressing situations, and to perceive a cooperative and supportive Working Environment.


Subject(s)
COVID-19 , Physicians , Grounded Theory , Humans , Morals , Pandemics , SARS-CoV-2
10.
Front Public Health ; 9: 795481, 2021.
Article in English | MEDLINE | ID: covidwho-1572346

ABSTRACT

The outbreak of a sudden infectious epidemic often causes serious casualties and property losses to the whole society. The COVID-19 epidemic that broke out in China at the end of December 2019, spread rapidly, resulting in large groups of confirmed diagnoses, and causing severe damage to China's society. This epidemic even now encompasses the globe. This paper takes the COVID-19 epidemic that has occurred in China as an example, the original data of this paper is derived from 20 Chinese media reports on COVID-19, and the grounded theory is used to analyze the original data to find the risk transmission rules of a sudden infectious epidemic. The results show that in the risk transmission of a sudden infectious epidemic, there are six basic elements: the risk source, the risk early warning, the risk transmission path, the risk transmission victims, the risk transmission inflection point, and the end of risk transmission. After a sudden infectious epidemic breaks out, there are three risk transmission paths, namely, a medical system risk transmission path, a social system risk transmission path, and a psychological risk transmission path, and these three paths present a coupling structure. These findings in this paper suggest that people should strengthen the emergency management of a sudden infectious epidemic by controlling of the risk source, establishing an efficient and scientific risk early warning mechanism and blocking of the risk transmission paths. The results of this study can provide corresponding policy implications for the emergency management of sudden public health events.


Subject(s)
COVID-19 , China/epidemiology , Grounded Theory , Humans , Policy , SARS-CoV-2
11.
BMJ Open ; 11(12): e051928, 2021 12 08.
Article in English | MEDLINE | ID: covidwho-1562103

ABSTRACT

INTRODUCTION: Since early 2020, the COVID-19 pandemic has challenged societies and revealed the built-in fragility and dependencies in complex adaptive systems, such as healthcare. The pandemic has placed healthcare providers and systems under unprecedented amounts of strain with potential consequences that have not yet been fully elucidated. This multilevel project aims to explore resilient performance with the purpose of improving the understanding of how healthcare has adapted during the pandemic's rampage, the processes involved and the consequences on working conditions, ethics and patient safety. METHODS: An emerging explorative multilevel design based on grounded theory methodology is applied. Open and theoretical sampling is performed. Empirical data are gathered over time from written narratives and qualitative interviews with staff with different positions in healthcare organisations in two Swedish regions. The participants' first-person stories are complemented with data from the healthcare organisations' internal documents and national and international official documents. ANALYSIS: Experiences and expressions of resilient performance at different system levels and times, existing influencing risk and success factors at the microlevels, mesolevels and macrolevels and inter-relationships and consequences in different healthcare contexts, are explored using constant comparative analysis. Finally, the data are complemented with the current literature to develop a substantive theory of resilient performance during the pandemic. ETHICS AND DISSEMINATION: This project is ethically approved and recognises the ongoing strain on the healthcare system when gathering data. The ongoing pandemic provides unique possibilities to study system-wide adaptive capacity across different system levels and times, which can create an important basis for designing interventions focusing on preparedness to manage current and future challenges in healthcare. Feedback is provided to the settings to enable pressing improvements. The findings will also be disseminated through scientific journals and conferences.


Subject(s)
COVID-19 , Pandemics , Delivery of Health Care , Grounded Theory , Humans , Patient Safety , SARS-CoV-2
12.
Games Health J ; 10(6): 408-419, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1550518

ABSTRACT

Objectives: An empirical study is carried out based on Plague, Inc. to explore whether the game has raised awareness of public health and urged players to make a better choice about health. Materials and Methods: Twenty-six college students from 24 cities in 11 provinces of China were investigated for a week-long survey. According to grounded theory principles, we coded original records from 69 diary reports using qualitative analysis tools. Results: We constructed nine core categories from participants' journals and drew the mechanism chart of the game as a means of health communication. The results showed that participants had experienced (1) an iterative learning process based on the authenticity and multiperspective features of the game and obtained specific learning outcomes; (2) deep thinking through the association between the game and the real world. And we extracted variables that are highly predictive of behavior change, including cognition of seriousness, cognition of susceptibility, action clue, and self-efficacy. Furthermore, noncore categories (including emotions and gameplay) directly and indirectly impacted players' learning and behavior change. Conclusion: The study shows Plague, Inc. has played a positive role in health communication (mainly reflected in the improvement of players' cognitive level, the establishment of health belief, and behavior changes). Moreover, it is concluded that reflection plays an important role in health communication interventions. However, careful consideration should be given to the use of this game as a means of health intervention due to its limitations and certain deficiencies.


Subject(s)
COVID-19 , Health Communication , Plague , Video Games , Grounded Theory , Humans , SARS-CoV-2
13.
Int J Environ Res Public Health ; 18(22)2021 11 19.
Article in English | MEDLINE | ID: covidwho-1544055

ABSTRACT

The work of public safety personnel (PSP) is inherently moral; however, the ability of PSP to do what is good and right can be impeded and frustrated, leading to moral suffering. Left unresolved, moral suffering may develop into moral injury (MI) and potential psychological harm. The current study was designed to examine if MI is relevant to frontline public safety communicators, firefighters, and paramedics. Semi-structured interviews (n = 3) and focus groups (n = 3) were conducted with 19 participants (public safety communicators (n = 2); paramedics (n = 7); and firefighters (n = 10)). Interviews and focus groups were audio-recorded, transcribed, coded, and constantly compared in accordance with the grounded theory method. A conceptual theory of "frustrating moral expectations" emerged, with participants identifying three interrelated properties as being potentially morally injurious: chronic societal problems, impaired systems, and organizational quagmires. Participants navigated their moral frustrations through both integrative and disintegrative pathways, resulting in either needing to escape their moral suffering or transforming ontologically. The current study results support MI as a relevant concept for frontline PSP. Given the seriousness of PSP leaving their profession or committing suicide to escape moral suffering, the importance of the impact of MI on PSP and public safety organizations cannot be ignored or underestimated. Understanding the similarities and differences of morally injurious exposures of frontline PSP may be critical for determining mental health and resilience strategies that effectively protect PSP.


Subject(s)
Firefighters , Stress Disorders, Post-Traumatic , Allied Health Personnel , Canada , Grounded Theory , Humans , Meat
14.
J Adv Nurs ; 78(5): 1402-1412, 2022 May.
Article in English | MEDLINE | ID: covidwho-1537829

ABSTRACT

AIM: During the COVID-19 pandemic in the UK, clinical research nurses had to work in new ways and under significant pressure to generate evidence for the developing health crisis. Research nurse support needs, personal and professional challenges have not been explored. This study addresses that gap, generating learning for continued support and development of the research nurse specialty and its ability to respond to public health priorities. DESIGN: We employed a qualitative exploratory approach through online open-ended interviews to explore research nurses' experiences of delivering research during the pandemic using principles of Grounded Theory. METHODS: Fifteen research nurses in the local research taskforce were identified through purposive sampling. Qualitative interviews were conducted online between November 2020 and January 2021 and analysed using the principles of constructivist grounded theory. RESULTS: Three themes of adapting to uncertainty, inclusive leadership and finding validity in the stretch zone were generated in the analysis. CONCLUSION: A model of inclusive leadership and support can facilitate high-functioning performance in a research team, supporting a rapid, confident and efficient response to research needs. IMPACT: Research nurses, a previously invisible workforce, have proved critical to the pandemic response. This study explores the experiences of a team of redeployed research nurses and develops a theory of their experience as they were undertaking the rapid delivery of urgent public health studies during COVID-19. What was found was a process of adaptation and resilience through collaborative teamwork, a strong sense of purpose and role validation enabled by an inclusive leadership style. This work will drive future development of a model of research nursing with a focus on collaboration between research and clinical colleagues.


Subject(s)
COVID-19 , COVID-19/epidemiology , Grounded Theory , Humans , Leadership , Pandemics , Qualitative Research , United Kingdom
15.
Prim Health Care Res Dev ; 22: e67, 2021 11 10.
Article in English | MEDLINE | ID: covidwho-1510538

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic and the resulting measures can impact daily life and healthcare management amongst patients with beta thalassemia major. METHODS: The Corbin and Strauss method of grounded theory was used to explore the impact of the COVID-19 pandemic on health-related quality of life (HRQoL) amongst Iranian patients with beta thalassemia major. Semi-structured interviews with 16 patients with thalassemia major in the eastern of Iran were performed. Data collection was conducted from 19 September through 18 November 2020. Collected data were recorded, transcribed, and coded to develop themes and subthemes. Paradigm components were sought to find out what happened to these patients and explore the process and events. RESULTS: Insights from these interviews led to five major themes: 'changing physical health', 'emotional and psychological reactions', 'changing the nature of relationships and the scope of social support', 'metamorphosis of ongoing healthcare, and 'functionality and adaptation to new realities.' The emerging core concept was labelled: 'maintaining well-being balance.' The COVID-19 pandemic disturbed the balance of life and health of the patients. Multiple strategies to maintain balance and reduce the negative effects of the COVID-19 pandemic on HRQoL were used by the patients, the healthcare team, and support systems. CONCLUSIONS: Due to the fear of COVID-19, the patients with beta thalassemia were less likely to contact healthcare professionals. They considered postponing blood transfusion and abandoned evaluating disease complications. Reduced access to the healthcare system and shifting resources from existing programmes to COVID-19 by the healthcare system were incompatible policies. These policies and strategies had strong and negative effects on the physical domain of HRQoL. The patients experienced a deterioration of emotional functioning. They reported a strong reduction in social functioning and felt lonely. Online interventions supporting mental health and social interactions and telemedicine can help during the times of social distancing and lockdowns.


Subject(s)
COVID-19 , beta-Thalassemia , Communicable Disease Control , Grounded Theory , Humans , Iran , Pandemics , Quality of Life , SARS-CoV-2 , beta-Thalassemia/therapy
16.
Intensive Crit Care Nurs ; 68: 103137, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1482624

ABSTRACT

OBJECTIVES: This study aimed to produce a theoretical model to understand factors which affect the resilience of neonatal nurses. Nurses experience high levels of burnout due to the occupational stress they are exposed to. Burnout negatively affects both staff and patient outcomes, and in this population would likely affect the establishment of crucial early caregiver-infant relationships in the neonatal unit. Research suggests that increasing nurses' resilience can protect them against burnout, thus understanding factors that affect resilience in this population is critical. RESEARCH METHODOLOGY: The study adopted a constructivist grounded theory design. SETTING AND PARTICIPANTS: All participants were qualified registered nurses employed on a permanent basis in a Level 3 neonatal unit. Thirteen registered nurses attended one individual semi-structured interview. A constructivist grounded theory approach was used to analyse the subsequent verbatim transcripts. FINDINGS: The resulting model identified that individuals working as nurses in the neonatal unit function within different systemic contexts: the nursing team; the family unit; the broader neonatal team; the National Health Service and their world outside the unit. Each context presents different practical, emotional and ethical challenges. These challenges are navigated through a combination of contextual, interpersonal and intrapersonal strategies. CONCLUSIONS: The model is contextually embedded and extends existing literature pertaining to resilience of healthcare staff in other contexts. Suggestions are made in terms of adaptations to the organisational, social and individual contexts to benefit nursing resilience. Implications of the findings are also considered within the context of the ongoing Covid-19 pandemic.


Subject(s)
Burnout, Professional , COVID-19 , Grounded Theory , Humans , Infant, Newborn , Pandemics , SARS-CoV-2 , State Medicine
17.
Int J Environ Res Public Health ; 18(19)2021 09 27.
Article in English | MEDLINE | ID: covidwho-1438621

ABSTRACT

As the novel coronavirus (COVID-19) pandemic continues, frontline nurses caring for COVID-19 patients are experiencing severe fatigue and mental stress. This study explored nurses' adaptation process in caring for COVID-19 patients and examined how nurses interact with the phenomenon using a grounded theory approach. The study aimed to develop a substantive theory and provide basic data with which to develop intervention programs that can support nurses caring for COVID-19 patients. Data were collected between 7 August and 31 October 2020, via face-to-face in-depth interviews with 23 nurses who had been caring for COVID-19 patients for six months or more at a nationally designated COVID-19 hospital. Sampling was started purposively and continued theoretically. Data analysis, performed using the method proposed by Strauss and Corbin, resulted in 13 main categories, the core one being "growing as a proficient nurse alongside comrades on the COVID-19 frontline". The study's results identify the nurses' adaptation process in caring for COVID-19 patients and their reactions to the circumstances around it. Ensuring that nurses can systematically cope with emerging infectious diseases requires regularly providing them with basic education on caring for patients with such diseases and strengthening professional education in order to develop nurses specializing in them. This study also recommends that a support system for work and childrearing be developed.


Subject(s)
COVID-19 , Nurses , Adaptation, Physiological , Grounded Theory , Humans , SARS-CoV-2
18.
J Adv Nurs ; 77(10): 4035-4044, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1341267

ABSTRACT

AIM: The aim of this article is to provide practical strategies for maintaining methodological rigour in executing a virtual qualitative study. Strategies are based on evidence from existing research about virtual qualitative methods and on the strategies used by the authors to convert a planned in-person qualitative, grounded theory study to an entirely virtual grounded theory study during the COVID-19 pandemic. The study began in-person in September 2019 and was converted to virtual in March 2020. Virtual data collection was completed in September 2020. DESIGN: This article provides a case exemplar of virtual adaptations made to a study underway when the pandemic rendered all in-person research impractical and potentially dangerous. DATA SOURCES: The strategies discussed are based on our own experiences and the supporting theoretical assumptions of qualitative research, specifically grounded theory methods. IMPLICATIONS FOR NURSING: Nursing scholars conducting qualitative inquiry may find these strategies helpful in continuing research activities during periods of limited access to the phenomena or persons of interest. Furthermore, these strategies allow nursing scholars to conduct rigorous, in-depth research without geographical limitations, providing greater possibilities for international collaborations and cross-institution research. CONCLUSION: Despite novel challenges, methodological adaptations that are carefully planned and purposeful allow qualitative and non-qualitative scholars to continue research activities in a fully virtual manner. IMPACT: This case exemplar and discussion provide practical strategies for qualitative scholars to consider while planning new studies or converting an in-person study to a virtual one. Despite the in-person nature of in-depth qualitative inquiry, a historic pandemic and a changing research environment require qualitative researchers to adapt to virtual methods while still conducting high quality, methodologically rigorous research. Qualitative scholars can use the strategies presented here to continue rigorous qualitative inquiry despite limited access to phenomena or persons.


Subject(s)
COVID-19 , Pandemics , Grounded Theory , Humans , Qualitative Research , SARS-CoV-2
19.
BMC Health Serv Res ; 21(1): 732, 2021 Jul 23.
Article in English | MEDLINE | ID: covidwho-1322937

ABSTRACT

BACKGROUND: Pandemics such as COVID-19 are a serious public health risk for Australian Aboriginal and Torres Strait Islander communities, yet primary healthcare systems are not well resourced to respond to such urgent events. At the start of the COVID-19 pandemic, a federal government advisory group recommended a rapid, tailored Indigenous response to prevent predicted high morbidity and mortality rates. This paper examines the efforts of one ACCHO, which in the absence of dedicated funding, pivoted its operations in response to COVID-19. Gurriny Yealamucka Health Service (Gurriny) is the only primary healthcare service in the discrete Indigenous community of Yarrabah, Far North Queensland. METHODS: The research was conducted at the request of the Chief Executive Officer of Gurriny. Using grounded theory methods, thirteen Gurriny staff and five Yarrabah and government leaders and community members were interviewed, transcripts of these interviews and 59 documents were imported into NVIVO-12 and coded, and key concepts were compared, organised into higher order constructs, then structured into a theoretical framework. RESULTS: Gurriny responded to COVID-19 by leading with local solutions to keep Yarrabah safe. Four key strategies were implemented: managing the health service operations, realigning services, educating and supporting community, and working across agencies. These strategies were enabled or hindered by five conditions: the governance and leadership capacity of Gurriny, relying on the health taskforce, locking the door, "copping it", and (not) having resources. A year after the first case was experienced in Australia and on the eve of vaccine rollout to Indigenous communities, there have been no COVID-19 cases in Yarrabah. DISCUSSION: The success of the locally led, holistic, comprehensive and culturally safe response of Gurriny suggests that such tailored place-based approaches to pandemics (and other health issues) are appropriate, but require dedicated resourcing. Key challenges were the fragmented and rapidly changing government processes, poorly coordinated communication and resource allocation channels, and bottlenecks in hierarchical funding approval processes. CONCLUSIONS: The COVID-19 response in Yarrabah demonstrates the need for governance reform towards greater resourcing and support for local decision making by Aboriginal community-controlled health organisations.


Subject(s)
COVID-19 , Health Services, Indigenous , Australia , Grounded Theory , Humans , Pandemics , Public Health , Queensland , SARS-CoV-2
20.
BMJ Open ; 11(6): e048677, 2021 06 17.
Article in English | MEDLINE | ID: covidwho-1276963

ABSTRACT

OBJECTIVE: To explore paramedic experiences of providing care during the 2020 COVID-19 pandemic and develop theory in order to inform future policy and practice. DESIGN: Qualitative study using constructivist evolved grounded theory (EGT) methodology. One-to-one semistructured interviews were conducted using a general interview guide. Voice over Internet Protocol was used through Skype. SETTING: Conducted between March 2020 and November 2020 in the Welsh Ambulance Services National Health Services Trust UK which serves a population of three million. PARTICIPANTS: Paramedics were recruited through a poster circulated by email and social media. Following purposive sampling, 20 Paramedics were enrolled and interviewed. RESULTS: Emergent categories included: Protect me to protect you, Rapid disruption and adaptation, Trust in communication and information and United in hardship. The Basic Social Process was recognised to involve Tragic Choices, conceptualised through an EGT including Tragic personal and professional choices including concerns over personnel protective equipment (PPE), protecting themselves and their families, impact on mental health and difficult clinical decisions, Tragic organisational choices including decision making support, communication, mental health and well-being and Tragic societal choices involving public shows of support, utilisation and resourcing of health services. CONCLUSIONS: Rich insights were revealed into paramedic care during the COVID-19 pandemic consistent with other research. This care was provided in the context of competing and conflicting decisions and resources, where Tragic Choices have to be made which may challenge life's pricelessness. Well-being support, clinical decision making, appropriate PPE and healthcare resourcing are all influenced by choices made before and during the pandemic, and will continue as we recover and plan for future pandemics. The impact of COVID-19 may persist, especially if we fail to learn, if not we risk losing more lives in this and future pandemics and threatening the overwhelming collective effort which united society in hardship when responding to the COVID-19 Pandemic. TRIAL REGISTRATION NUMBER: IRAS ID: 282 623.


Subject(s)
COVID-19 , Pandemics , Allied Health Personnel , Grounded Theory , Humans , Pandemics/prevention & control , Qualitative Research , SARS-CoV-2 , United Kingdom , Wales/epidemiology
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