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PubMed1983

Topical corn oil in the management of essential fatty acid deficiency.

Conflicting anecdotal reports about the efficacy of topical linoleate in managing essential fatty acid deficiency prompted this prospective study of 10 critically ill surgical patients receiving continuous total parenteral nutrition (TPN). Ten ml of corn oil (4800 mg of linoleate) were massaged into the skin daily commencing after 7.7 +/- 3.8 (mean +/- SD) days of fat-free intake. Plasma samples were obtained weekly. Total lipids were extracted and methylated, and fatty acids were quantitated by gas-liquid chromatography. The triene:tetraene ratio (20:3 omega 9/20:4 omega 6) increased progressively in patients despite corn oil therapy. In 89% of patients the ratio exceeded 0.2, which is diagnostic of essential fatty acid deficiency (EFAD). Topical application of corn oil does not prevent or treat EFAD in patients on TPN.

Administration, Topical↗
PubMed2001

Networking, coping, and communicating about a medical crisis: a phenomenological inquiry of transplant recipient communication.

Through a phenomenological framework, the authors attempt to shed light on the communication processes of organ transplant recipients when discussing transplantation and related topics. Eight essential themes (awareness, support, commitment, pride, education, mentoring, comparison, and community) emerged from 37 participants as central to the communicative experiences of transplant recipients and their families. Additional insight was generated through a 2nd tier of focus group discussions resulting in a proposed model of transplant recipient communication. An interpretation of the model, implications for future research, and implications for praxis are presented.

Adaptation, Psychological↗
PubMed2005

Compassion stress and the qualitative researcher.

Human subjects are carefully protected in the research process. However, the same consideration is not currently being given to the qualitative researcher, even those investigating topics that are likely to elicit powerful emotions. The role of researcher's emotional responses and the self-care strategies that, in some circumstances, are appropriate for the researcher and other research support personnel have not received the attention they deserve in qualitative research literature. Based on experience in conducting research on the topic of self-directed learning and breast cancer, and on the limited literature available, the author makes the case for the use of strategies such as counseling, peer debriefing, and journal writing as means of dealing with the potential for "compassion stress" as experienced by the researcher and other research support personnel. She also suggests that the preparation of social science researchers should include information on appropriate self-care strategies.

Adaptation, Psychological↗
PubMed1991

In vitro toxicity testing for antibacterials against human keratinocytes.

The use of cultured human keratinocytes in an in vitro comparison of topical antibacterial toxicity for epithelial cells was examined. The complement of three assessments allows testing of epithelial migration, growth, and survival. The three assessments included (1) flow cytometry for determination of cell survival, (2) a comparison of confluent cell culture growth after antibacterial exposures, and (3) an evaluation of cell migration using a technique of dermal explants to study radial migration. A comparative ranking of the toxicities of the various topical antibacterials was determined with the three assessments. This has confirmed anecdotal reports that many of the topical antibacterials are cell-toxic and may inhibit wound healing. This information can be directly extrapolated to the clinical setting, unlike many of the animal data for wound healing that currently exist.

Anti-Bacterial Agents↗
PubMed2001

Engaging with phenomenology: is it more of a challenge than it needs to be?

When seeking to understand the human condition, with all the problems this enterprise poses for traditional scientific research approaches, qualitative research is held to be in some ways superior to rigidly quantitative research. As a result, many beginning health researchers plan to employ a qualitative approach to explore topics that were previously inaccessible via traditional scientific means. However, implementing a qualitative approach is not an easy process and, in many cases, researchers must look long and hard to find material to assist them in developing their research plans. This may be particularly so in phenomenological research. This article examines some of the problems and pitfalls faced by phenomenological researchers new to the approach. Through accounts of personal experience, it highlights some of the areas where phenomenological researchers could be helpful by being less reticent about the process of implementing a phenomenological study.

Anecdotes as Topic↗
PubMed2005

The effects of teaching medical professionalism by means of vignettes: an exploratory study.

The purpose of this study is (1) to evaluate whether an educational program for preclinical students has an effect on the knowledge of professional behaviour for clerks and (2) to study how preclinical students compare with advanced clinical students concerning this knowledge. The authors used an observer-rated test consisting of vignettes describing a dilemma concerning professional behaviour. Students' description of proposed behaviour was scored in one of three categories: unacceptable, acceptable or excellent. Preclinical students were compared with clinical students and the effect of an educational session on student scores on this test was assessed. The educational programme had a positive effect on student scores. However, the knowledge of professional behaviour did not generalize to situations that had not been the explicit topic of the session. A difference was found between preclinical and clinical students in two of the four vignettes: in one vignette clinical students had better scores, in another vignette they had worse scores. It is concluded that the educational programme had a positive effect on student knowledge of professional behaviour but there was no generalization. For more generic rules to sink in, probably many cases need to be discussed, with explicit attention paid to the rationales of these rules. Students who were advanced in their clerkships held different views on professional behaviour compared with preclinical students, possibly due to a socialization process.

Anecdotes as Topic↗
PubMed2001

The midwife's ultimate paradox: a UK-based study of the death of a mother.

OBJECTIVE: to identify the meaning of the death of a mother to the midwife providing care for her. DESIGN: a qualitative study in which the fieldwork comprised mainly semistructured telephone interviews. Data were also collected by letters and e-mail correspondence. SETTING: the midwife informants are based in the UK. PARTICIPANTS: because of the sensitive nature of the topic, a volunteer sample of midwives who had 'experienced' the death of a mother was appropriate. Further 'non-experienced' midwives were recruited using a snowball technique. FINDINGS: the midwife's experience of the death of a mother is comparable with that of emergency personnel attending large-scale disasters. It features images intruding, identifying with those involved, encountering death and being unprepared. KEY CONCLUSIONS: the midwife faces a number of psychological challenges following the death of a mother, which justify this event being considered as a disaster. The findings of implications for practice: this study suggests that there may be a need for cultural change among midwives. It is possible that changes in midwifery education and in the midwife's continuing education may facilitate this.

Adaptation, Psychological↗
PubMed2000

Coming to terms with perceived danger. A researcher's narrative.

Little attention has been given to the topic of perceived or imagined dangers in fieldwork, even though such dangers may significantly affect both collection and interpretation of data in qualitative research. Furthermore, methodological arguments persist in regard to interpreting qualitative research that gives voice simultaneously to the research participant and the researcher. In this article reflexivity and narrative methods were used to examine the concept of perceived danger(s) in a field setting using naturalistic inquiry. First, reflexivity and narrative methods were used to retrospectively construct a personal narrative that describes the impact of the field experience on the researcher. Then, narrative analysis was used to interpret this personal narrative and to further examine why the researcher "perceived" certain dangers, and how she came to know that these risks and dangers were presumed but unwarranted. This narrative is an example of how qualitative researchers can give voice to their field experiences.

Anecdotes as Topic↗
PubMed2001

Giving bad news: a GPs' narrative perspective.

The purpose of this study was to explore GPs' perspectives on giving bad news during consultations. To this end, 168 GPs were asked to recall, and record on the first page of a questionnaire, an occasion when they had given medically related bad news to a patient. The stories were analysed with a qualitative and interpretative approach. Two axes, each with a semantic polarity, were identified: a relational axis (semantic polarity: escape vs accompanying) and an ethical axis (semantic polarity: the doctor's choice vs the patient's choice). Furthermore, two main topics appeared to be common to almost all the narratives: the need to reassure the patient and the account of the doctor's emotions. Two different relational patterns appear to be described by doctors. A substantial number of GPs implicitly describe a disease- or doctor-centred consultation: in these cases the physicians refer to signs and symptoms, diagnosis and treatments; they decide for themselves whether to tell the truth or not. On the other hand, a smaller number describe consultations that could be defined as patient centred: these doctors consider that their duty of care for the individual ill person is paramount and try to respect the patient's right to decide. In both these relational patterns, GPs feel it is a fundamental professional duty to reassure the patient; furthermore, they feel the most difficult aspect is managing their own emotional responses.

Adult↗
PubMed2006

Effects of writing about emotions versus goals on psychological and physical health among third-year medical students.

A randomized, controlled trial compared writing about emotional topics (EMO) to writing about goals as the "best possible self" (BPS; after King, 2001) and evaluated emotional approach coping, i.e., efforts to cope through processing and expressing emotion, as a moderator of writing effects on psychological and physical health in 64 third-year medical students. In participants with higher baseline hostility, the EMO condition was associated with less hostility at 3 months compared to the BPS and control conditions. Emotional processing (EP) and emotional expression (EE) moderated the effect of experimental condition on depressive symptoms at 3 months; high EP/EE participants reported fewer depressive symptoms in the EMO condition, whereas low EP/EE individuals reported fewer depressive symptoms in the BPS condition compared to the EMO and control conditions. A moderating effect of EP on physical health was also identified, such that low EP individuals who wrote about goals (BPS) had fewer health care visits at 3 months compared to low EP participants in the EMO and control conditions.

Adaptation, Psychological↗