Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “thematic analysis methods”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources
PubMed2006

Multidisciplinary perceptions of the role of nurses and healthcare assistants in rehabilitation of older adults in acute health care.

AIM: This paper describes the perceptions of nurses, healthcare assistants, doctors and therapists of rehabilitation and the role of nurses and healthcare assistants on an acute older adults ward in a London teaching hospital. BACKGROUND: The role perception, education and training and attitudes towards the older adults have been identified as barriers that have an impact upon the nurses' role within rehabilitation. However, little is known about the role of nurses and healthcare assistants in rehabilitation of older adults in acute health care. DESIGN: Action research study. METHOD: Twenty-four semi-structured interviews were conducted and audio recorded about healthcare professionals' understanding of rehabilitation, the type of skills needed and their perceptions of the role of nurses and healthcare assistants in rehabilitation. The interview transcripts were analysed using the thematic content analysis. RESULTS: The findings suggest that the therapists relied on nurses and healthcare assistants for therapy carry-over. Healthcare assistants were perceived as the professional group who could deliver therapy carry-over. There was an evidence of role hierarchy as healthcare assistants perceived that they were not actively involved in decision-making or discharge planning. CONCLUSION: This paper suggests that healthcare assistants and nurses are viewed as the professional group best placed to deliver therapy carry-over. However, whilst there is an acknowledgement of their role, there remains a reluctance to acknowledge healthcare assistants as a professional group and to involve them within decision-making and discharge planning. RELEVANCE TO CLINICAL PRACTICE: Employers must be seen to advocate, support and implement education and training programs for healthcare assistants. However, whilst nurses and healthcare assistants have an integral role in rehabilitation, there needs to be more research into the how they are supported by therapy professionals.

Aged↗
PubMed2001

Unpacking the 'value added' impact of continuing professional education: a multi-method case study approach.

The tangible benefits of continued professional education (CPE) continues to be widely debated within nursing. Whilst there is a plethora of literature relating to CPE, there is an absence of empirical evidence confirming the value of educational activities. Using a case study approach, this study sought to examine the relationship between undertaking a named course (Children's Neuroscience Course) and the perceived benefits to practitioners. Nursing students who had successfully undertaken the course (n = 14) were invited to participate. Self-report evaluations (completed at induction, mid point and exit), academic performance, and data collected from a questionnaire were analyzed using non-parametric measures. In addition, semi-structured interviews (n = 9) were undertaken and analyzed using a thematic content approach. Second level analysis involved triangulating the various data sets using coding frames and three themes were identified: improved knowledge, improved care delivery and professional development, which were judged as benefits to the practitioners who had undertaken the course. Further, there was a significant relationship between undertaking the course and participant's perception of their increased abilities in delivering care to the child with a neurological problem and their families. This paper will illustrate the benefits of a multi-method case study approach for evaluating the 'value added' impact of educational provision.

Adult↗
PubMed2007

The process of health visiting and its contribution to parental support in the Starting Well demonstration project.

Significant resources are being directed at interventions designed to attenuate the effects of deprivation on children's health and development. The Starting Well demonstration project, established in two deprived areas within a Scottish city, aimed to show that a programme of planned activities to support families could improve child health. The project was subject to a main quantitative evaluation and several additional qualitative and mixed-method evaluations. The present paper draws on findings from one of the qualitative studies that sought to gain insight into how interventions provided by health visitors were operationalised and how they were perceived by parents. The particular focus of this paper is how the process of health visiting resulted in parents' perceptions of being supported. A longitudinal design captured variation in work undertaken by health visitors and temporal changes in maternal experiences of child rearing. Semi-structured interviews were conducted with 20 mothers and their health visitors at two time points, i.e. when infants were 3-4 and 9-10 months old. Sampling was 'purposive', and included first-time and experienced mothers. The findings reported here are based on 59 interviews carried out during 2002 and 2003. The analysis involved a thematic approach focused on programme implementation, and participant perceptions about process and benefit. Parental perceptions of being supported were exemplified by increased confidence in infant care, reduced anxiety regarding infant care needs, increases in knowledge and sense of personal competence in parenting practices, reduced isolation, and advocacy for those experiencing problems. A selection of the interactional processes that resulted in these forms of perceived support are reported, including methods of providing information, cautious and tactful questioning of maternal decision-making, and encouragement of successful parenting practice. The implications for practice, service delivery and targeting at the individual level are noted.

Female↗
PubMed2026

Making patient-oriented decisions with collegial support as an anchor: Oncologists' experiences of late-line treatment selection in metastatic breast cancer.

BACKGROUND: Treatment guidelines support oncologists in treatment decision-making for patients with metastatic breast cancer (MBC). However, treatment decision-making is complicated by the rapid pace of therapeutic advances, the complexity of incorporating patient preferences, and the underrepresentation of diverse populations in clinical trials. This study explored oncologists' experiences of treatment selection in late-line MBC when evidence and guidelines provide limited guidance. MATERIALS AND METHODS: This qualitative study was conducted using a constructivist approach and involved individual interviews with twelve oncologists in Sweden. Participants had between five and forty years of experience in breast cancer care and worked within publicly funded healthcare across academic and regional hospitals. An inductive reflexive thematic analysis was used to identify themes, with attention to both manifest and latent meanings in the data. RESULTS: The overarching theme interpreted was: Making patient-oriented treatment decisions with collegial support as an anchor, reflecting how oncologists adapt their treatment decision-making to patient needs while relying on colleagues for professional stability. Four themes were elucidated: Offering to use professional knowledge and experience to decide; Inviting the patient to a dialogue to decide; Supporting the patient in making the final decision; and Turning to colleagues for advice and support. CONCLUSION: This study challenges the positivist evidence-based assumption that oncologists act as neutral facilitators who simply present treatment options for patients to choose. Instead, it positions oncologists as active decision-makers who clearly state their professional stance, retain responsibility for treatment decisions, and respect patient autonomy, moving beyond the traditional, dichotomized shared decision-making model. IMPLICATIONS TO PRACTICE: We argue that oncologists are active stakeholders in a value-led decision-making process and encourage them to clearly articulate the values underlying their recommendations. This approach enables patients to be addressed with full autonomy, while the ultimate responsibility for treatment decisions remains with the oncologist.

Humans↗
PubMedDate not supplied

Watching & worrying: early pregnancy after loss experiences.

PURPOSE: To describe women's early pregnancy after loss experiences (up to 25 weeks gestation), to document the timing and frequency of their common discomforts and events, and to explore changes in these over time. STUDY DESIGN: Longitudinal, qualitative descriptive, and triangulated (data, methods, analyses). METHODS: Qualitative data were collected from 82 women pregnant after a past perinatal loss, who were followed through their 25th week gestation. Field notes were taken on all women; 75 women recorded events of their pregnancy through text and stickers on an investigator-supplied calendar. Thematic analysis was done from field notes and hand-written calendar entries; content analysis was conducted on sticker-entered events and symptoms. RESULTS: Themes identified in the data were Growing Confident, Fluctuating Worry, Interpreting Signs, Managing Pregnancy, and Having Dreams. The first four themes comprise the see-saw nature of these pregnancies. Managing Pregnancy includes the subthemes of Being Hypervigilant, Seeking Reassurance, and Relying on Internal Beliefs. The theme of Having Dreams was a serendipitous finding, in the sense that women reported their dreams without prompting, but the data did not reach saturation. Future research in this area is suggested. Calendar stickers indicate that fatigue and headaches are the most commonly reported discomforts. Fetal movement, felt by all the women by 25 weeks gestation, was very reassuring. CLINICAL IMPLICATIONS: Nurses should understand that women who have experienced a previous pregnancy loss have omnipresent worry and anxiety during a subsequent pregnancy, and seek reassurance that their pregnancy and baby are okay. Therefore, the frequent calls and visits to healthcare providers from these women represent their most common and comforting way of coping with their worry.

Abortion, Spontaneous↗
PubMed2005

Misunderstandings about illness and treatment among patients with type 2 diabetes.

AIMS: This paper reports a study whose aim was to describe the misunderstandings that Swedish patients with type 2 diabetes have about their illness and treatment. BACKGROUND: It is well known that patients with type 2 diabetes need extensive support and education to learn to manage and live with their illness. However, a Swedish survey has shown that only 34% of these patients had good metabolic control. Despite intensive education and support, misunderstandings about both the illness and treatment seem to be common. Furthermore, patients are currently complaining that health care services sometimes obstruct rather than support self-care and learning. METHODS: We videotaped 18 authentic encounters between a patient with diabetes and a physician, or a diabetes nurse. Patients then viewed the video and reflected on what took place during the consultation. Video-recordings and transcribed reflections were analysed thematically. RESULTS: Five themes emerged from the analysis: (a) Type 2 diabetes is not 'real diabetes'; (b) Complications - horror visions or suppression; (c) Self-monitoring of blood glucose and medication is a routine, not a learning tool; (d) Diet - the important thing is to reduce fat and (e) 'Physical exercise is good, they tell us'. Four of the 18 patients showed no misunderstandings. Misunderstandings of diabetes and its treatment were thus common and numerous, despite regular checkups and good access to care. The patients adhered to prescribed regimens but did not know why they performed many routines or how they could benefit from them. CONCLUSION: The results show that misunderstandings of illness and treatment were common. We suggest that diabetes educators should base their education on this variation of understanding, using a phenomenological approach to learning. Reflecting on this kind of varied experiences can be a powerful tool to help people to move from 'novice to expert' and apply basic routines to new situations.

Adult↗
PubMed1994

Emotional responses of family members during a critical care hospitalization.

BACKGROUND: The needs and satisfaction levels of family members of critically ill patients have received much attention in the literature. The feelings of family members, however, have not been thoroughly investigated. To develop appropriate nursing interventions to assist family members in coping with a critical care hospitalization, accurate information about their emotional response to the situation is needed. OBJECTIVE: To examine emotional responses of family members and their descriptions of supportive behaviors of others during a critical care hospitalization. METHODS: An exploratory design was used to study 52 subjects with critically ill family members in the pediatric, neonatal, medical, surgical and cardiovascular intensive care units in a large tertiary care hospital. The subjects kept daily logs of their feelings and the supportive behaviors of others. Thematic analysis was used to identify major themes. RESULTS: Analysis revealed a broad range of powerful emotions throughout the intensive care unit stay. Negative and positive emotions such as despair and joy were sometimes identified by subjects within a 24-hour period. Although fear, worry, anger and exhaustion were dominant themes during the first 24 hours and when the family received bad news about the patient, there was no pattern of emotional response evident as the stay progressed. Some differences between subjects drawn from the medical and neonatal intensive care units were evident. CONCLUSIONS: The findings suggest that family members of critically ill patients experience deep emotional turmoil throughout the intensive care unit stay. Specific nursing interventions to promote adaptive coping are needed throughout the experience.

Adolescent↗
PubMed1977

[Innovative approach of teaching-learning of histology and embriology].

The paper presents an innovative approach to the teaching-learning of histology and embryology. The traditional teaching of the subject in the Faculty of Medical Sciences of Rosario National University, Santa Fe, Rosario, Argentina, up to 1974 is subjected to critical analysis, and on this basis the need for the innovation is propounded and the method for applying it proposed. A detailed account is given of the theoretical framework of the experiment reported, of the general and specific objectives of the teaching-learning technique, and of the thematic units into which the curriculum was divided. In the teaching-learning plan followed--described in the article--the conventional professorial lecture and its accompanying practical demonstrations are replaced by round tables and theoretical-practical tasks requiring active involvement and integrating theory and practice, in which teams tackle problems under teacher coordination. It also provides for evaluation of the students, teachers and course and eliminates the conventional examination.

Argentina↗
PubMed1998

Participation of French general practitioners in public health surveillance: a multidisciplinary approach.

STUDY OBJECTIVES: To evaluate the feasibility of a novel approach to measure compliance of sentinel general practitioners (SGPs) in sentinel public health surveillance and to determine the characteristics in the SGP's profile that can be objectively associated with their perseverance in public health surveillance. DESIGN: Prospective study of the compliance of the SGPs (compliance being defined as the length of time during which an SGP complies with a given theoretical surveillance protocol) and qualitative study of the determinants of their initial motivations (using group and face to face interviews). SETTING: The 1970 SGPs who have participated in the Sentinel system since 1984. PARTICIPANTS: Among them, the 502 SGPs recruited since 1 July 1992 have been questioned by mailed questionnaire and 20 SGPs have been questioned during face to face semistructured interviews. MAIN RESULTS: According to the maximum number of silences allowed by the given theoretical protocol, median compliances varied between 1.9 months (95% CI = (1.8, 2.0)) and 14.3 months (95% CI = (13.8, 15.2)). In multivariate analysis, long compliances for SGPs with a < or = 5 or > or = 20 years seniority was seen and an interest in using multimedia home servers. On the other hand, interest in local epidemiological surveys and previous experience with other surveillance networks or clinical trials were associated with short compliances. No statistical association was found between compliance and computing experience, having a medical secretary, a particular feeling of being a "public health actor", or the desire to belong to a GPs' network. A thematic analysis of interview records showed that the main motivation of the SGPs was their need to share their experiences and to self evaluate by comparison with colleagues by the means of a surveillance system that would be used as a health information system. CONCLUSIONS: The longitudinal method used in this study was shown to be an efficient tool to monitor non-compliant SGPs with respect to given surveillance protocols. Furthermore, this approach allows the selection out of the SGPs' profile the characteristics that are associated with a longer compliance. The additional variables to be taken into account in this profile could be identified among the topics, attitudes, and experiences collected during the semistructured interviews. This work considers the question of understanding what determines the motivation of GPs to participate in public health surveillance and what are their expectations of feed back. This question is essential if information systems in general practice are to be implemented.

Cooperative Behavior↗
PubMed2006

Family conflict in dementia: prodigal sons and black sheep.

OBJECTIVE: To describe family conflict in cases of dementia referred to the Guardianship Tribunal of New South Wales, Australia. METHOD: The file notes of 50 cases of family and systems conflict in cases of dementia presented to the Guardianship Tribunal were examined. Demographics, MMSE score, and type and severity of dementia were recorded. The documents and evidence presented to the Tribunal were coded and subjected to thematic analysis to identify the themes of the conflict, the protagonists and the position of the person with dementia with respect to the conflict. RESULTS: Family conflict was most commonly seen in mild to moderate dementia. Conflict occurred most frequently between siblings (with a group of siblings allied against a 'black sheep' member) and involved other systems such as service providers in 25% of cases. The person with dementia was usually involved in the conflict or in alliance with one or other of the family members in conflict, especially when paranoid ideation was fuelled by family members. Common themes included accusations of neglect, exploitation, lack of communication or sequestration of the person with dementia. No family had received family therapy prior to the application; conciliation during the hearing was successful in 30% of cases. Legal transactions such as Powers of Attorney were frequently made and frequently revoked by persons with dementia involved in family conflict. CONCLUSION: Dementia may be a great family divider, particularly when there are cracks in family solidarity. The understanding of family conflict in dementia has ramifications for both clinical and medico-legal practice. These findings may encourage family-centered interventions which address family dynamics and interpersonal conflict. They may also assist in capacity assessments of persons with dementia who change legal documents because of family conflict.

Aged↗
PubMed2006

Therapists' experiences and perceptions of teamwork in neurological rehabilitation: reasoning behind the team approach, structure and composition of the team and teamworking processes.

BACKGROUND AND PURPOSE: Teamwork and the interdisciplinary team approach have been strongly advocated for use in the provision of neurological rehabilitation services. However, whether teamwork has been adopted, and in what form, has yet to be established. The present study investigated therapists' experiences and perceptions of the reasoning behind the team approach in neurological rehabilitation, the structure and composition of the team within which they worked and the team working process. METHOD: This article reports part of an exploratory qualitative study. Five occupational therapists and five physiotherapists from three teams: a rehabilitation centre; a community team; and a stroke unit based within the UK. Semi-structured interviews were undertaken with each participant and then transcribed. Content and thematic analysis of the qualitative interview data was carried out, with respondents validating both the transcription and analysis stages. RESULTS: Perceived composition and structure of the neurological rehabilitation team was variable across teams and between individual team members. There was disparity as to whether patients were included within the neurological team; the interdisciplinary team approach had not been consistently adopted and there were sub-teams and other team memberships in existence. Reasoning behind the team approach supported the perceived benefits of teamwork from a number of perspectives, and the activities reported as part of the team process were diverse. CONCLUSIONS: Different teams may choose to use different strategies depending on the aims and context of the team effort. In some instances interdisciplinary teamwork and patient-centred approaches were not adopted consistently and the process of teamwork itself is both complex and diverse.

Communication↗
PubMed1999

The early stages of low back pain: a pilot study of patient diaries as a source of data.

BACKGROUND: Low back pain accounts for a significant proportion of a GP's workload, but care of the condition is widely regarded as unsatisfactory. Recent recommendations to improve primary care management include more appropriate explanatory models and early access to physical therapy. OBJECTIVES: This study explored the feasibility and utility of patient diaries as a source of qualitative data on patients' experience of low back pain presenting in primary care. METHOD: Within a larger study of physiotherapist-led management of low back pain presenting in general practice, a random sample of patients was invited to keep a record of their illness experience over 7 days using a diary. Patients' written accounts were then subject to qualitative thematic analysis. RESULTS: Diary respondents did not differ from the wider group of patients presenting with back pain. Patients recounted diverse experience of disability, pain and emotional reactions. The specific themes which emerged from our analysis support the relevance to patients of a biopsychosocial paradigm in the management of low back pain. CONCLUSIONS: Diaries are a feasible and valid source of qualitative data in patients with new episodes of low back pain. In addition, they may provide the clinician with useful information and their completion may offer direct benefits to patients.

Activities of Daily Living↗
PubMed2002

Difficult decisions: social and ethical implications of changing medical technology.

OBJECTIVES: A primary objective of this paper is to present data on subjective perceptions of health and quality of life in individuals living with early- or late-onset genetic conditions (cystic fibrosis, CF, and Huntington's disease, HD, respectively). The paper will also discuss the social and ethical dilemmas raised by advances in reproductive and testing technology, consider the different emphases in definitions in quality of life, and speculate on criteria used to make reproductive decisions following prenatal testing. METHODS: Adults suffering from CF and HD attending two regional centres in the UK took part in semi-structured interviews between late 1999 and summer 2001. Self-report data on how a specific body image is constructed were also collected. Interviews were analysed using thematic qualitative analysis, and the body data were analysed using SPSS. RESULTS: Qualitative analysis uncovered themes relating to the question of how we value life, and exposed broad ethical dilemmas arising from advances in testing and treatment technology. These data are supported by findings from a body chart analysis that highlight a discrepancy between the quality of life experienced by this group of respondents and the way they believe the wider public perceives them, particularly in reference to pain. CONCLUSIONS: Although some of the data support previous findings, such as the disability paradox, other voices contradict this view. Due to their unique experiences, the accounts of individuals currently living with genetic conditions should be considered in the wider bio-ethical debates.

Abortion, Eugenic↗
PubMed1998

Analysis of Canadian population with potential geographic access to intravenous thrombolysis for acute ischemic stroke.

BACKGROUND AND PURPOSE: We sought to identify the Canadian population with potential access to intravenous tissue plasminogen activator within 3 hours of onset of acute ischemic stroke. METHODS: Assuming that 60 minutes is needed for stroke recognition, emergency room evaluation, and administration of tissue plasminogen activator, 120 minutes remain for transport, using a 3-hour treatment window. Ambulance databases were analyzed for transport times of 60, 90, and 120 minutes and were found to correspond to transport distances of 32, 64, and 105 kilometers (20, 40, and 65 miles), respectively. Using Geographical Information System (GIS) software, these radii were overlaid on thematic maps of Canadian hospitals identified as having a third- or fourth-generation CT and with a neurologist and an emergency physician on staff. Analysis was then performed on complete Canadian census data from 1991 and the interim 1996 census count. RESULTS: 67.3%, 78.2%, and 85.3% of the total Canadian population were within 32, 64, and 105 kilometers, respectively, of an identified hospital. For individuals >/=65 years of age, 64.4%, 77.0%, and 85.7% were within the respective radii. Complete analysis by age, ethnic origin, and gender are detailed. CONCLUSIONS: In the model described, a substantial percentage of the Canadian population has geographic access to a hospital potentially capable of delivering intravenous thrombolysis for acute ischemic stroke. GIS analysis can identify both population groups and rural areas with limited access to thrombolytic stroke treatment. A coordinated emergency medical service response for stroke is advocated to maximize coverage, as a 60-minute delay in emergency room arrival eliminated 5.1 million people from potential treatment.

Acute Disease↗
PubMed2007

Review of advanced nursing practice: the international literature and developing the generic features.

AIM: The aim of this article is to review the nursing literature on the notion of advanced nursing practice (ANP) and consequently provide clarifications on the concept of advanced nurse practitioner by developing its' generic features. BACKGROUND: This paper commences by critically reviewing the concept of advanced nursing practice as it is portrayed within the literature. From this review, a series of contradictions emerged in terms of definitions and roles. On further analysis of the literature the core aims and goals of the ANP are revealed. METHODS: An informative and narrative systematic literature review was undertaken, using specific inclusion and exclusion criteria. The mass of retrieved material was carefully screened and methods of data saturation were used. Consequently, the material was read, re-read and indexed as to develop seven thematic units that formed the generic features of the ANP. FINDINGS: The generic features that emerged are: (i) the use of knowledge in practice, (ii) critical thinking and analytical skills, (iii) clinical judgement and decision-making skills, (iv) professional leadership and clinical inquiry, (v) coaching and mentoring skills, (vi) research skills and (vii) changing practice. CONCLUSION: Reviewing the literature on the concept of ANP, a great variety of definitions, conceptualizations and roles emerged. Nonetheless, on a closer reading, a common goal was identified, which was the attainment of practice and professional autonomy via ANP roles for enhanced practice provision. Eventually, from the reviewed literature, seven generic features of the ANP were developed, thus providing clarification to the role and the characteristics of the ANP. RELEVANCE TO CLINICAL PRACTICE: Clarifying the confusion surrounding advanced nursing practice and gaining an in-depth understanding of its' generic features would facilitate practitioners, practice educators and clinical managers to develop those skills that would allow them or their staff or students to practise at an advanced level.

Humans↗
PubMed2006

Fully automatic external defibrillators in acute care: Clinicians' experiences and perceptions.

BACKGROUND: Fully automatic external defibrillators (FAEDs) reduce the time to defibrillation [Martinez-Rubio A, Kanaan N, Borggrefe M, Block M, Makijarvi M, Fedele F, et al. Advances in treating in-hospital cardiac arrest: safety and effectiveness of a new automatic external cardioverter-defibrillator. J Am Coll Cardiol 2003;41(4):627-32; Mattioni T, Kanaan N, Riggio D, Bahu M, Lin D, Welch S, et al. Performance of an automatic external-cardioverter-defibrillator algorithm in the discrimination of supraventricular from ventricular tachycardia. Am J Cardiol 2003;91:1323-6] and improve outcomes [Martinez-Rubio A, Kanaan N, Borggrefe M, Block M, Makijarvi M, Fedele F, et al. Advances in treating in-hospital cardiac arrest: safety and effectiveness of a new automatic external cardioverter-defibrillator. J Am Coll Cardiol 2003;41(4):627-32]. There is, however, no guidance or standard about their use in the UK. This paper presents the results of a study, which explored clinicians' experiences and perceptions of using FAEDs in acute care in the UK. AIMS: This study sought to understand clinicians' experiences and perceptions of the use of FAEDs in acute care and their impact on decision making. METHODS: Using a qualitative approach, 43 nurses and four physicians were included in a trial of FAEDs in a Coronary Care Unit (CCU) and cardiology ward during 2004. Semi-structured interviews were conducted with nurses and physicians prior to and following the trial. Data were analysed using thematic analysis [Attride-Stirling J, Thematic networks: an analytic to research. Qual Res 2001;1(3):385-405]. RESULTS: Decision control, safety, a lack of confidence in the technology, previous experience and concerns about the psychological affect on patients affected clinicians' decision making and limited the use of the FAED. CONCLUSION: Despite reported benefits of the FAED [Martinez-Rubio A, Kanaan N, Borggrefe M, Block M, Makijarvi M, Fedele F, et al. Advances in treating in-hospital cardiac arrest: safety and effectiveness of a new automatic external cardioverter-defibrillator. J Am Coll Cardiol 2003;41(4):627-32; Mattioni T, Kanaan N, Riggio D, Bahu M, Lin D, Welch S, et al. Performance of an automatic external-cardioverter-defibrillator algorithm in the discrimination of supraventricular from ventricular tachycardia. Am J Cardiol 2003;91:1323-26], personal and contextual issues affected the clinicians' decision making. More and better understanding about how FAEDs and their context of use may challenge established practice is required in order that it is utilised in the most effective way.

Attitude of Health Personnel↗
PubMed2004

Content and processes of postpartum counseling after a distressing birth experience: a review.

BACKGROUND: A distressing birth experience can produce debilitating symptoms of psychological trauma; however, little is known about the content and processes of counseling interventions to relieve trauma symptoms. This review identifies and examines common content and processes of postpartum counseling interventions to address trauma symptoms following childbirth. METHOD: A search of major databases (Cinahl 1982-2003; Cochrane 2003; Embase; Proquest; Psychlit; Pubmed/Medline 1966-2003; Sociofile) was conducted, using combinations of the key words of "childbirth,""postpartum,""posttraumatic stress disorder,""anxiety,""trauma,""stress,""debriefing," and "counselling" or "counseling." Identified content and processes were clustered through a thematic analysis. RESULTS: Nineteen publications were retrieved. Counseling strategies provided women with opportunities to talk about their birth experience, express feelings about what happened, have questions answered, address gaps in knowledge or understanding of events, connect the event with emotions and behavior, talk about future pregnancies, and explore existential issues. CONCLUSIONS: Descriptions of postpartum counseling and debriefing are generalized and nonspecific; they provide minimal direction for postpartum counseling models, lack necessary detail for replication, may require psychotherapeutic training and therefore be unsuitable for use by caregivers, and are often based on opinion with little empirical evaluation. Few studies have tested specific counseling interventions on a range of maternal outcomes. Further research is needed to develop counseling models for use by health professionals with women who report a distressing birth experience.

Counseling↗
PubMed2004

Identifying the palliative care role of the nurse working in community hospitals: an exploratory study.

AIM: to ascertain registered nurses' and GPs' perceptions of and influences on the nurse's role in providing palliative care in community hospitals. DESIGN: qualitative exploratory/descriptive study. SETTING: two community hospital sites within Perth and Kinross, Scotland. METHOD: taped semi-structured interviews with four registered nurses and two GPs. Participants' perceptions were sought on the roles of nursing and medical professionals and of factors facilitating and hindering the provision of palliative care within the community hospital setting. FINDINGS: six key themes were identified through thematic analysis of the information: communication, teamwork and relationships, holistic care, resources, culture, professional role. CONCLUSION: the themes were inter-related and gave valuable insight into the multidimensional nature and significance of the nurse's role in palliative care in the community hospital setting.

Attitude of Health Personnel↗