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PubMed2001

Management of dementia in primary health care: the experiences of collaboration between the GP and the district nurse.

OBJECTIVE: The objective of this study was to explore the context and experiences of collaboration between the GP and the district nurse (DN) in diagnosing dementia, in order to identify possible procedures to improve care. METHODS: Two group interviews were conducted with four DNs and five GPs, respectively, working in the municipality of Copenhagen. RESULTS: The group interviews revealed that the suboptimized collaboration could be due to different inter-professional diagnostic strategies and a lack of understanding of the importance of early, shared, decision making. This could create conflicts between the groups. CONCLUSIONS: This study indicates a possibility for improved collaboration between the two professional groups in diagnosing dementia. Possible approaches for improved care should focus on an inter-professional understanding of the importance of early, shared, decision making, emphasizing early identification and care of diagnosed demented patients. Establishing a shared collaboration model including out-patient memory clinics, GPs and DNs could be a first step. This model should also take into account an evaluation of possible consequences for the diagnosed demented patients in terms of treatment and care and consider the indication for referrals to a comprehensive diagnostic evaluation. We are at present planning a study to address these aspects.

Adult↗
PubMed2006

[Ethical dilemmas in caring for patients with SARS].

This paper explored experiences caring for patients with severe acute respiratory syndrome (SARS), with a focus on the suffering between the "private" and "professional" selves, in order to describe the psychological impact and ethical practice of SARS events as related to nursing professionals. Eight small group interviews were conducted with a total of twenty-one nurses with experience caring for SARS patients. Group interviews were audio-taped and transcribed for analysis. Data, analyzed using the constant comparative method, revealed the following three ethical dilemmas: suffering in care giving, response to the calling, and distresses involved in decision making. In this study, the authors further addressed relationships between suffering and ethical practice, the calling and a nurse's professional responsibilities, and transcendence in intersubjectivity. The authors hope that the results of this study will lead to a new understanding of ethical practices nursing and help nurses develop reflected care that promotes personal and professional growth.

Adult↗
PubMed1994

Hispanic cultural health beliefs and folk remedies.

Cultural awareness of health care practices and beliefs is increasing, but knowledge regarding Hispanic folk remedies and health care practices and beliefs is limited. This study used a focus group interview format for an open discussion of folk remedies and the health and illness practices of the participants. Eleven Hispanic women participated in a group interview that addressed the question, How do Hispanic health beliefs affect health care practices? Specifically, what actions are taken to treat symptoms of illness or injury? Qualitative data analysis of the 75 symptom and treatment statements was completed, and data were grouped according to symptom and complexity of treatments. This resulted in a rich compilation of remedies that Hispanics use in home treatments, with the emergence of a pattern comparable to the nursing process. This information adds to the current knowledge base of cultural health practices and provides a basis for continued research.

Attitude to Health↗
PubMed2004

Nurses' personal statements about factors that influence their decisions about the time they spend with residents with long-term mental illness living in psychiatric group dwellings.

One seldom-discussed issue is the factors that influence nurses' decisions about the time they spend with residents in psychiatric care. This study uses a qualitative naturalistic approach and consists of an analysis of focus-group interviews with nurses, which aimed to identify factors affecting nurses' decisions about being with or being nonattendant in their relationship with their residents. Two series of focus-group interviews were conducted, interpreted and analysed through content analysis. The study included all the staff (n=32) at two municipal psychiatric group dwellings housing residents mainly with a diagnosis of long-term schizophrenia. This study revealed that the main factor that determined nurses' nurse/resident time together or nonattendance time was whether they liked or disliked the individual resident. One possible explanation is the carers' change from a perspective in which the nursing care was given on the basis of each resident's needs and rights, based on the individual nurse's professional judgement, to a consumer perspective, which leads to a change in responsibility from themselves to the individual residents.

Adult↗
PubMed1991

Pediatric asthma, a qualitative and quantitative approach to needs assessment.

This article describes an approach to needs assessment in a specific location using both focus group interviews and a written questionnaire. In this case study, the target population consists of parents of asthmatic children (0-4 years of age). Six focus group interviews were conducted with the purpose of discussing parents' experiences with health care for asthma, their beliefs and knowledge of general aspects of asthma, medication and preventive actions. As a supplement, parents completed a written questionnaire providing additional quantitative information on parental knowledge and misconceptions. Results indicated that parental knowledge of asthma in general was not adequate, especially with respect to medication, preceding signs and preventive activities. Important misconceptions, which might contribute to noncompliance with self-management behaviors, were revealed during discussions with the parents. Several differences were found between results of the interviews and the questionnaire, for instance regarding parental knowledge about preventive measures, medication and perceived parental satisfaction with health care for asthma. These differences indicate the value of using both a survey and a focus group.

Adult↗
PubMedDate not supplied

Focus groups: a useful tool for curriculum evaluation.

BACKGROUND AND OBJECTIVES: Focus group interviews have been used extensively in health services program planning, health education, and curriculum planning. However, with the exception of a few reports describing the use of focus groups for a basic science course evaluation and a clerkship's impact on medical students, the potential of focus groups as a tool for curriculum evaluation has not been explored. Focus groups are a valid stand-alone evaluation process, but they are most often used in combination with other quantitative and qualitative methods. Focus groups rely heavily on group interaction, combining elements of individual interviews and participant observation. This article compares the focus group interview with both quantitative and qualitative methods; discusses when to use focus group interviews; outlines a protocol for conducting focus groups, including a comparison of various styles of qualitative data analysis; and offers a case study, in which focus groups evaluated the effectiveness of a pilot preclinical curriculum.

Curriculum↗
PubMed1989

Use of focus groups to explore consumers' preferences for content and graphic design of nutrition publications.

The purpose of this research was to determine consumers' preferences for the content and design of nutrition print materials through the use of focus group interviews. Thirty-seven non-pregnant, non-nursing female consumers 20 to 50 years of age attended one of six focus group interviews. Existing nutrition print materials were used to stimulate discussion on content and graphic design features of the materials. Content features discussed included glossaries, quizzes, diet evaluation checklists, diet monitoring forms, and "factual" vs. "how to " information. Graphic design features discussed included color, format, size, organization, and general appearance. Participants were asked to discuss the personal impressions and practical considerations that formed the basis of their opinions regarding each feature and to elaborate on how the existing materials might be improved to meet their particular needs. Features that drew the most positive reactions were bright food colors, organizational cues, clear information and explanations, features that help personalize the issue being addressed, and "how to" information.

Adult↗
PubMed2003

The meanings of organ donation: Muslims of Pakistani origin and white English nationals living in North England.

This study explores the meanings of organ donation, with emphasis on donating eyes and hearts, comparing people across gender and across two ethnic groups. Four focus group interviews were conducted with people living in the North of England: (1) five Muslim women of Pakistani origin, (2) five Muslim men of Pakistani origin, (3) nine white English women, and (4) eight white English men. The focus group interviews were analysed using grounded theory and a conceptual micro-model created for each group. The main finding was that the act of organ donation can be perceived as involving a personal cost. The Muslims of Pakistani origin related costs with their religious beliefs. In contrast, the white English associated costs with their distrust of the medical system. Women were concerned about the transmission of disease or of personality, whereas the white English men highlighted their personal rights. We conclude that the meaning of organ donation is more than about being and having a body. It is bound up in metaphors of embodiment, religious considerations, and moral judgement of scientific and medical conduct.

Adult↗
PubMedDate not supplied

Gender differences in teen parents' perceptions of parental responsibilities.

Accurate information concerning teen parents' knowledge of their children's development and their expectations for paternal involvement becomes increasingly important as efforts increase to promote involvement of unmarried fathers with their children. The purpose of this descriptive study was to assess differences in the knowledge and perceptions of normal child development, and expectations for paternal responsibilities between unmarried, low-income African American and Mexican American adolescent mothers and their males partners. Seven unmarried adolescent mothers participated in a focus group interview held at a family service agency in the Midwest. Afterward, their male partners and reported fathers of their babies, participated in a separate focus group interview The mean age of the adolescent mother participants was 16.7 years, the mean age of their partners was 19.3 years. Data were analyzed using a tape-based analysis method. A number of differences were identified between the perceptions of the adolescent mothers and young fathers including their level of child development knowledge, context for selecting physical methods of discipline, expectations for paternal role behaviors, and feelings about child support payments and establishing legal paternity. The study findings may help health care providers develop more effective prenatal and parenting educational experiences for adolescent parents.

Adolescent↗
PubMed2001

Recall of diet during a past pregnancy.

The authors conducted a study of women's ability to recall diet during a past pregnancy. For a prospective study, women completed self-administered food frequency questionnaires (FFQs) before and during pregnancy (1989-1992). These women, mostly White and well-educated, were contacted 3-7 years later (1996-1997) for a retrospective dietary assessment performed by either telephone interview (n = 154) or self-administered FFQ (n = 115). Energy-adjusted Pearson correlations ranged from 0.10 to 0.49 for the telephone interview group and from 0.02 to 0.67 for the self-administered questionnaire group. When participants' intakes were ranked, quintile agreement (within one quintile) between original diet and recalled diet ranged from 60% to 69% in the telephone interview group and from 69% to 79% in the self-administered questionnaire group. Correlations and percentages of agreement were higher among women who used the same questionnaire for both dietary assessments than among those who used different questionnaires. These results suggest that diet during pregnancy is recalled with similar accuracy as or perhaps slightly lower accuracy than adult diet generally. This may reflect, in part, the influence of current (nonpregnancy) diet on recall of past (pregnancy) diet. While the results of this study may not be generalizable to those obtained from other populations, to the authors' knowledge it is the first study of recall of diet during pregnancy.

Adult↗
PubMed2006

Aggressive behaviour in the high-secure forensic setting: the perceptions of patients.

Twenty-seven patients undergoing treatment in a high-secure forensic facility participated in focus group interviews to elicit their perceptions of (1) the factors leading to aggressive behaviour; and (2) strategies to reduce the risk of such behaviour. The focus group interviews were audiotaped, transcribed and analysed using content analysis. The participants identified that a combination of patient, staff and environmental factors contributed to violence in the study wards. The cause of aggressive behaviour centred around five major themes: the environment; empty days; staff interactions; medication issues; and patient-centred factors. Potential strategies identified by patients to reduce aggressive behaviour included: early intervention; the provision of meaningful activities to reduce boredom; separation of acutely disturbed patients; improved staff attitudes; implementation of effective justice procedures; and a patient advocate to mediate during times of conflict. Findings suggested that social and organizational factors need to be addressed to change the punitive subculture inherent in forensic psychiatric facilities, and to ensure a balance between security and effective therapy.

Aggression↗
PubMed2004

Vision, permission and action: a bottom up perspective on the management of public health nursing.

AIM: To explore the opportunities and obstacles that impinge on attempts to advance public health nursing, paying particular attention to the role of, and implications for, nursing management. BACKGROUND: Nurses are to have a central role in the government's drive to re-invigorate the United Kingdom public health agenda. This paper explores the perceptions and support needs of the primary and community nurses, health visitors and midwives charged with meeting that goal. METHOD: Focus group interviews were conducted separately with health visitors, school nurses, district nurses, community midwives and practice nurses from the a single health authority area in Yorkshire. Eight group interviews were conducted involving 31 practitioners in total. All interviews were audio recorded and transcribed in full. Data were analysed using the framework approach. FINDINGS: Workload, resource and time pressures limit the ability of community and primary care nurses to deliver public health work. Furthermore, nurses feel that the leadership required to guide service delivery and optimize deployment of under utilized public health skills at local level is missing, and that public health activity lacks legitimacy. CONCLUSION: If the new public health agenda is to be delivered, nursing managers will have to be clear about what is meant by public health work and decide whether it is to remain a peripheral concern or core activity. Having made that decision they must communicate it to practitioners on the ground through word and deed--that is, by identifying capacity, restructuring workloads and re-prioritizing activity.

Attitude of Health Personnel↗
PubMedDate not supplied

Perceptions of children, parents, and teachers regarding whole-grain foods, and implications for a school-based intervention.

OBJECTIVE: To identify perceptions of whole-grain foods and factors influencing intake by children, parents, and teachers as the basis for increasing intake by children within a school-based intervention. DESIGN: Focus group interviews with questions based on Social Cognitive Theory. SETTING: After-school care programs in 4 elementary schools in a large metropolitan district in St. Paul, Minn. PARTICIPANTS: Seven, three and two focus group interviews with children (n = 40; grades K-6), parents (n = 18), and teachers (n = 11), respectively. PHENOMENON OF INTEREST: Child and adult factors influencing intake of whole-grain foods, with a tasting activity to stimulate discussion. ANALYSIS: Qualitative data analysis procedures to generate common themes from encoded transcripts. RESULTS: Adults and children were positive about sensory characteristics of whole-grain products. Knowledge of ways to identify these foods was limited. Taste preferences strongly influenced selection of bread and cereals. Children suggested that new school foods should look and taste good, be familiar, and be promoted through sampling, peer influence, and incentives. Adults suggested a gradual increase in whole-grain content of school meals. IMPLICATIONS FOR RESEARCH AND PRACTICE: Focus groups were useful in understanding perceptions regarding whole-grain foods and yielded valuable insight toward design of a school-based intervention.

Adult↗
PubMed2000

Critical thinking by nurses on ethical issues like the termination of pregnancies.

This research forms part of a larger interdisciplinary research project on the termination of pregnancies. The focus of this part of the project is on the ethical issues related to termination of pregnancies. The practice of the professional nurse is confronted with ethical dilemmas and disputes. Whether the nurse chooses to participate in the termination of pregnancies or not, the core function of the nurse is that of counseling and ethical decision-making. Effective counseling requires empathy, respect for human rights and unconditional acceptance of a person. Making ethical decisions implies making critical decisions. It is self-evident, therefore, that such decisions should be based on sound arguments and logical reasoning. It is of vital importance that ethical decisions can be justified on rational ground. Decision-making is a critical thinking approach process for choosing the best action to meet a desired goal. The research question that is relevant for this paper is: Are nurses thinking critically about ethical issues like the termination of pregnancies? To answer the research question a qualitative, exploratory, descriptive design was used (Mouton, 1996:103-169). Registered nurses were selected purposively (Creswell, 1994:15). 1200 registered nurses completed the open-ended questionnaires. Focus group interviews were conducted with 22 registered nurses from a public hospital for women and child health services. Data analysis, using secondary data from open-ended questionnaires and transcribed focus group interviews, were based on the approach of Morse and Field (1994:25-34) and Strauss and Corbin (1990). The themes and categories from open coding were compared, conceptualized and linked with theories on critical thinking (Paul, 1994; Watson & Glaser, 1991 and the American Philosophical Association, 1990). The measures of Lincoln and Guba (1985) and Morse (1994) related to secondary data analysis were employed to ensure trustworthiness. Based on these findings the researcher concluded that nurses are not thinking critically when making ethical decisions concerning the termination of pregnancies. Recommendations are made as a possible solution for this problem.

Abortion, Legal↗
PubMed2001

Strengths and weaknesses of traditional Chinese medicine and Western medicine in the eyes of some Hong Kong Chinese.

OBJECTIVE: To explore the attitudes of Hong Kong Chinese towards the strengths and weaknesses of traditional Chinese medicine (TCM) and Western medicine. DESIGN: Qualitative study of subjects' opinions using semi-structured focus group interviews. SETTING: Southern district of Hong Kong Island where many of the residents have a fisherman background. PARTICIPANTS: Twenty nine participants took part in eight focus group interviews. MEASUREMENTS AND MAIN RESULTS: Participants' attitudes towards TCM and Western medicine were explored in the interviews. Both TCM and Western medicine are used concurrently by many people in Hong Kong. Patients make decisions on which type of doctors they want to see for the specific illnesses that they are suffering from. They consider both types of medicines to have strengths and weaknesses: TCM being better in curing the root of the problem but quite slow in action while Western medicine is more powerful but sometimes too powerful with significant side effects. CONCLUSIONS: It is important for medical practitioners to be aware of the health attitudes of their patients from different ethnic backgrounds. It will lead to a better patient-doctor relationship and better compliance of treatment.

Adult↗
PubMed1997

Using focus groups to develop a nutrition education video for high school students.

Focus group interviews were used to develop a nutrition education video and a teacher's guide for use in Florida high schools. Authors conducted a pilot and four focus group interviews with ninth grade students in five geographically distinct regions of Florida. Most students agreed that a video with scenarios or success stories would work well. Teens expressed interest in 10 topics: eating disorders; consequences of unhealthy eating; preparing quick, healthy meals; what constitutes a balanced diet; nutrition and fitness; weight control; food and the environment; the food guide pyramid; nutrition facts and fallacies; and food labels. Students suggested no more than three or four topics should be covered in the video, and the video cast should consist mainly of teen-agers with different body sizes, who were average, attractive, and from different ethnic backgrounds. Music was recommended only for transitions between scenes, as background, or during the credits.

Adolescent↗
PubMed1991

Reproductive health: knowledge, attitudes and needs of adolescents.

OBJECTIVE: To determine the knowledge and attitudes of adolescents with respect to reproductive health, with particular emphasis on their knowledge of the symptoms and transmission of sexually transmitted diseases (STDs), preventive strategies and sources of information. DESIGN: Questionnaire survey of a stratified random sample of Year 10 students followed by group interviews with volunteers from the sample. SETTING: The study was carried out in 33 Victorian secondary schools. PARTICIPANTS: The questionnaire was administered to a stratified random sample of 1351 Year 10 students. Group interviews were conducted with 533 volunteers from the sample. MEASUREMENTS AND MAIN RESULTS: Considerable gaps were identified in knowledge of STDs and their short-term and long-term effects on reproductive health. An STD Knowledge Score was constructed based on responses to 46 items. The mean score for the full sample was 22.7 (49.3% correct) with a standard deviation of 6.4. As a group, country students scored better than city students (mean, 23.8 v. 22.2, t = 3.97, P less than 0.001) and females better than males (mean, 23.5 v. 21.9, t = 4.21, P less than 0.001). Medical practitioners were rarely identified as a source of preventive advice. CONCLUSION: The deficiencies identified in knowledge about reproductive health suggest that young people need better access to health information. Schools and the medical profession need to work together both to provide information and to help young people develop the confidence to use available information sources.

Adolescent↗
PubMed1955

Mental health and group tensions.

The author points out that, with the development of technology in industry and the resultant more-technical roles demanded of workers, communication between them and between all persons in an industrial organization becomes of primary importance. This is particularly so because of the constant demands for change within an industrial organization. Any change, however minor, will inevitably involve a wide area of the organization, and special attention will therefore have to be paid to communication between persons.The author goes on to describe some of the investigations which have been made by the Institute of Preventive Medicine, Leyden, and indicates the extreme difficulty of obtaining accurate information. He shows also how the different attitudes of persons within a factory can lead to completely different perceptions of the field and of the attitudes of others within the same organization. He concludes that the main task of the mental health workers in industry lies in the prevention of tensions within it.One of the means of preventing tensions is to aim at a concept of "productive collaboration" within a factory. This task is seen as a special kind of therapy which must concern all levels of the factory. The author describes a procedure of investigation-diagnostic and therapeutic-within a factory, commencing with a phase of introduction, a pilot study, extensive individual interviewing, group interviewing, and a more specifically therapeutic phase, in which groups or specific individuals are enabled to talk their problems out. Finally, the investigating team must take steps to prevent situations of tension recurring, and, before leaving, must be certain that the plant is capable of maintaining a healthy equilibrium by itself.

Communication↗