ABSTRACT
We conducted a prospective study in the ICU of life-sustaining treatment and comfort care decisions over time in patients with end-stage liver disease (ESLD) from the perspectives of patients, family members, and healthcare professionals. Six patients with ESLD, 19 family members, and 122 professionals participated. The overarching theme describing the decision-making process was "on the train." Four sub-themes positioned patients and family members as passengers with limited control, unable to fully understand the decision-making process. Findings suggest that including patients and family members in non-immediate life-saving decisions and verifying early on their understanding may help to improve the decision-making process.
Subject(s)
End Stage Liver Disease/therapy , Terminal Care/methods , Adult , End Stage Liver Disease/psychology , Family/psychology , Female , Humans , Intensive Care Units , Interviews as Topic , Male , Palliative Care/methods , Palliative Care/psychology , Prospective Studies , Terminal Care/psychologyABSTRACT
Chinese immigrants in the United States experience a higher incidence of cancers of the oral cavity, pharynx, stomach, and liver and higher rates of tuberculosis and hepatitis B virus than other U.S. immigrant groups. Because of language and cultural barriers, many do not seek the health information they need, resulting in delayed diagnosis and inability to effectively manage health problems. The purpose of this study was to identify the cultural beliefs and meanings influencing the utilization behaviors and perceptions of how this group finds and uses the health information they need. Using an explorative qualitative descriptive design, 24 Chinese immigrants in two urban centers in the northwestern part of the United States were interviewed about their beliefs and perceptions of health information. Results revealed many challenges that served as barriers to health promotion, indicating that health care providers need to respond to the needs of this population with increased thoughtfulness and culturally relevant practices.
Subject(s)
Health Education , Hepatitis B/epidemiology , Neoplasms/epidemiology , Tuberculosis/epidemiology , Adult , Aged , China/ethnology , Female , Focus Groups , Hepatitis B/classification , Humans , Incidence , Male , Middle Aged , Neoplasms/classification , Northwestern United States/epidemiology , Tuberculosis/classificationABSTRACT
The purpose of this qualitative study is to describe rural women's barriers and motivators for participation in a walking program. Twenty rural women, ages 22 to 65, participated in a 12-week walking program. Data from field notes and focus groups were analyzed using qualitative content analysis. Data were inductively coded, codes were categorized into themes, and themes were classified as barriers or motivators to adopting a walking program. Three main barriers are identified: balancing family and self, chronic illness gets in the way of routine, and illness or injury breaks routine. Seven motivators are identified: being part of a group, group camaraderie, learning, pacesetter, seeing progress, energizing, and I am a walker. Women report that family responsibilities are a powerful and pervasive barrier. Motivators center on the importance of group interaction. This qualitative study increases our understanding of rural women's barriers and motivators to embarking on and sustaining a regular walking routine.
