ABSTRACT
OBJECTIVE: To provide an in-depth understanding of the perspectives of health professionals caring for parents who have lost a baby from a twin pregnancy, either during pregnancy or in the neonatal period. STUDY DESIGN: A qualitative study involving semi-structured interviews. Twenty-six health professionals were interviewed from maternity and neonatal departments in one hospital. Data were analyzed using a generative thematic approach. RESULTS: Three main themes were identified from the data: health professionals' lack of confidence in their interactions with bereaved parents; their desire to learn more about bereavement; and a consideration of sensitive health-care practices for bereaved parents. CONCLUSIONS: Health professionals acknowledged that parents who experience the loss of a twin have specific needs, some of which can be addressed by relatively small changes to clinical practices and behaviors. They felt, however, that they needed education about bereavement in order to react more effectively to bereaved parents' needs.
Subject(s)
Bereavement , Health Personnel/psychology , Pregnancy, Twin/psychology , Professional-Patient Relations , Communication , England , Female , Humans , Needs Assessment , Pregnancy , Qualitative Research , Tertiary Care CentersABSTRACT
OBJECTIVE: To provide an in-depth account of the role feticide has relative to experiences of late termination of pregnancy (TOP). METHOD: Exploratory qualitative interview study. Participants were recruited from three National Health Service (NHS) units that provide secondary and tertiary level fetal medicine services. Data were collected from 36 in-depth interviews, with 12 parents (representing eight cases) who had experienced late TOP for fetal anomaly and 23 health professionals with experience of feticide provision. The qualitative analysis utilised a generative thematic approach, facilitated by Atlas.ti qualitative software package. RESULTS: Two key themes from the study provide data on how perceptions of feticide were described by those involved in late TOP: (1) feticide is recognised and described as a legitimate clinical procedure and (2) the practice of feticide is conceptualised as difficult but necessary. CONCLUSION: For health professionals who provide and facilitate feticide, and for parents making decisions about late TOP and feticide, the procedure is understood as a necessary rather than chosen activity. Parents' perceptions of feticide may differ, and good clinical care must be designed to cope with this variation. For health professionals, feticide seems more readily distinguished from other types of TOP activities and may evoke simultaneous positive and negative perceptions.
Subject(s)
Abortifacient Agents/therapeutic use , Abortion, Eugenic/psychology , Attitude of Health Personnel , Health Knowledge, Attitudes, Practice , Parents , Abortion, Eugenic/methods , Female , Humans , Interviews as Topic , Male , Parents/psychology , Pregnancy , Pregnancy Trimester, Second , Pregnancy Trimester, ThirdABSTRACT
OBJECTIVE: To understand participants' experiences and understandings of the interventions in the trial of a computerised decision support tool in patients with atrial fibrillation being considered for anti-coagulation treatment. DESIGN: Qualitative process evaluation carried out alongside the trial: non-participant observation and semistructured interviews. PARTICIPANTS: 30 participants aged >60 years taking part in the trial of a computerised decision support tool. RESULTS: Qualitative evidence provided the rationale to undertake a decision to discontinue one arm of the trial on the basis that the intervention in that arm, a standard gamble values elicitation exercise was causing confusion and was unlikely to produce valid data on participant values. CONCLUSIONS: Qualitative methods used alongside a trial allow an understanding of the process and progress of a trial, and provide evidence to intervene in the trial if necessary, including evidence for the rationale to discontinue an intervention arm of the trial.
Subject(s)
Anticoagulants/therapeutic use , Atrial Fibrillation/drug therapy , Decision Making, Computer-Assisted , Patient Participation/methods , Physician-Patient Relations , Qualitative Research , Risk Assessment/methods , Aged , Anticoagulants/adverse effects , Clinical Trials Data Monitoring Committees , Comprehension , Decision Making , Decision Support Systems, Clinical , Female , Gambling , Humans , Interviews as Topic , Male , Middle Aged , Patient Participation/psychology , Video RecordingABSTRACT
The purpose of the present investigation was to examine the impact of coaching certification upon coaching attitudes toward important social psychological correlates of involvement in sport. Specifically, 249 coaches with 0, 1, 2, 3, 4 and 5 levels of certification in the National Coaching Certification Program for Hockey were compared on attitudes toward important social psychological correlates of athletic involvement. As a consequence of anomalies in the sample, the six levels of certification were collapsed to form a factorial design comprising 2 levels of certification (coaches with 0.1 and 2 levels versus coaches with 3, 4, and 5 levels) and 2 levels of competition (house league versus competitive league coaches). The results revealed that coaches with greater certification were older and more experienced. Also, coaches in competitive leagues were more experienced, attached more importance to setting realistic objectives and playing well, but less importance to providing a recreational experience for players than house league coaches. Also, with increasing certification, coaches in competitive leagues attached increased importance to beating an opponent and having a winning team while house league coaches showed a decrease. Finally, the emphasis planed upon providing equal ice time for all players remained low over the two levels of certification in the competitive league coaches; it showed a decrease with greater certification in the house league coaches.
