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Experiences of Infertility in British and Pakistani Women: A Cross-Cultural Qualitative Analysis

HEALTH CARE FOR WOMEN INTERNATIONAL 2016年第2期37卷 180-196页

作者： Batool, Syeda Shahida de Visser, Richard Oliver GC Univ Lahore Dept Psychol Lahore Pakistan Univ Sussex Sch Psychol Falmer BN1 9QH E Sussex England

The psychosocial impact of infertility is affected by cultural factors. In this cross-cultural qualitative study we explored the experience of infertility among six women living in Pakistan and eight living in the UK. Although infertile women in the UK and Pakistan had many shared experiences related to their own desires for motherhood and the hopes of others, they also faced unique psychosocial challenges shaped by cultural context. Based on our findings, we suggest a need for further resources and networks to support women, particularly women living in cultures that allow women few fulfilling social roles other than motherhood.

关键词： Infertility treatment Adjustment (Psychology) Culture Experience Fertilization in vitro Infertility Interviewing Phenomenology Research -- Methodology Motherhood Research -- Finance Sampling (Statistics) Stigma (Social psychology) Ethnology -- Research Qualitative research Social support Educational attainment Thematic analysis medical coding

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Cue-Responding Behaviors During Pharmacy Counseling Sessions With Patients With Asthma About Inhaled Corticosteroids: Potential Relations With Medication Beliefs and Self-Reported Adherence

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HEALTH COMMUNICATION 2016年第10期31卷 1266-1275页

作者： Driesenaar, Jeanine A. De Smet, Peter A. G. M. van Hulten, Rolf Noordman, Janneke van Dulmen, Sandra Netherlands Inst Hlth Serv Res NIVEL POB 1568 NL-3500 BN Utrecht Netherlands Radboud Univ Nijmegen Dept Clin Pharm Med Ctr Nijmegen Netherlands Radboud Univ Nijmegen IQ Healthcare Med Ctr Nijmegen Netherlands Univ Utrecht Div Pharmacoepidemiol & Clin Pharmacol NL-3508 TC Utrecht Netherlands Univ Groningen Dept Pharmacotherapy & Pharmaceut Care NL-9700 AB Groningen Netherlands Radboud Univ Nijmegen Dept Primary & Community Care Med Ctr Nijmegen Netherlands Buskerud & Vestfold Univ Coll Fac Hlth Sci Drammen Kongsberg Norway

The aim of this study was to examine cue-responding behavior at the pharmacy while counseling about inhaled corticosteroids (ICS) in relation to medication adherence and medication beliefs. Patients with asthma aged 18years using ICS were recruited from 12 pharmacies. Counseling sessions were video-recorded. Patients' emotional and informational cues and pharmacists' and pharmacy technicians' cue-responding behaviors were coded using an expanded version of the medical Interview Aural Rating Scale. The Beliefs about Medicines Questionnaire assessed patients' ICS concern and necessity beliefs. Self-reported ICS adherence was measured by four questions. During the 86 sessions, patients expressed on average 2.3, mostly informational, cues (70.8%). In 26.7% of the sessions, no cues were expressed. Pharmacists' and technicians' responses to emotional cues (59.3%) were mostly inadequate, and to informational cues mostly appropriate (63.6%). Providing inappropriate information (20.3%) was related to higher concerns post session (p<.05), and cue exploration to higher self-reported adherence at 3months (p<.05). Apparently, providers' responses to patients' cues might have therapeutic value. In addition, patients might need to be encouraged to ask questions and express their concerns.

关键词： STEROID drugs DRUG therapy for asthma DRUGS PATIENT compliance PATIENT education PHARMACISTS PHARMACY technicians QUESTIONNAIRES VIDEO recording DATA analysis software medical coding

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The transformative meanings of viewing or not viewing the body after sudden death

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DEATH STUDIES 2016年第1期40卷 46-53页

作者： Mowll, J. Lobb, E. A. Wearing, M. Univ Notre Dame Sch Med Darlinghurst NSW Australia NSW Forens & Analyt Sci Serv Dept Forens Med Sydney NSW Australia Calvary Hlth Care Kogarah NSW Australia Cunningham Ctr Palliat Care Darlinghurst NSW Australia Univ New S Wales Sch Social Sci Fac Arts & Social Sci Kensington NSW 2033 Australia

This study investigates the experience of viewing or not viewing the body for 64 relatives bereaved after a sudden and unexpected death.(1) Thematic analyses of in-depth interviews reveal the importance of viewing and the challenges in providing choice. Some participants experienced difficulties including regret and intrusive images. These are discussed alongside the transformative meanings of seeing or not seeing the body for bereaved relatives.

关键词： INTERVIEWING RESEARCH methodology SUDDEN death ATTITUDES toward death THEMATIC analysis CROSS-sectional method RETROSPECTIVE studies medical coding

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Discharge Communication in Patients Presenting to the Emergency Department With Chest Pain: Defining the Ideal Content

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HEALTH COMMUNICATION 2016年第5期31卷 557-565页

作者： Ackermann, Selina Heierle, Anette Bingisser, Martina-Barbara Hertwig, Ralph Padiyath, Rakesh Nickel, Christian Hans Langewitz, Wolf Bingisser, Roland Univ Basel Dept Psychol Basel Switzerland Univ Basel Hosp Dept Emergency Med CH-4031 Basel Switzerland Univ Basel Hosp Dept Psychosomat Med CH-4031 Basel Switzerland Max Planck Inst Human Dev Ctr Adapt Rational Berlin Germany

In an emergency department (ED), discharge communication represents a crucial step in medical care. In theory, it fosters patient satisfaction and adherence to medication, reduces anxiety, and ultimately promotes better outcomes. In practice, little is known about the extent to which patients receiving discharge information understand their medical condition and are able to memorize and retrieve instructions. Even less is known about the ideal content of these instructions. Focusing on patients with chest pain, we systematically assessed physicians' and patients' informational preferences and created a memory aid to support both the provision of information (physicians) and its retrieval (patients). In an iterative process, physicians of different specialties (N=47) first chose which of 81 items to include in an ED discharge communication for patients with acute chest pain. A condensed list of 34 items was then presented to 51 such patients to gauge patients' preferences. Patients' and physicians' ratings of importance converged in 32 of the 34 items. Finally, three experts grouped the 34 items into five categories: (1) information on diagnosis;(2) follow-up suggestions;(3) advice on self-care;(4) red flags;and (5) complete treatment, from which we generated the mnemonic acronym InFARcT. Defining and structuring the content of discharge information seems especially important for ED physicians and patients, as stress and time constraints jeopardize effective communication in this *** pain accounts for up to 10% of all patient presentations in emergency departments (EDs) (Konkelberg & Esterman, 2003). The majority of these patients will usually be discharged within hours, after exclusion of serious conditions such as myocardial infarction (Goodacre et al., 2011). A comprehensive workup of low- to intermediate-risk patients is not feasible in the ED (Reichlin et al., 2009). Yet many of these patients go on to suffer from repeated episodes of chest pain, assoc

关键词： ANXIETY PREVENTION ACADEMIC medical centers CHEST pain COMMUNICATION CORRELATION (Statistics) DRUGS HOSPITAL emergency services INTERVIEWING RESEARCH methodology PATIENT compliance PATIENT satisfaction FINANCING of research STATISTICS UNCERTAINTY QUANTITATIVE research DISCHARGE planning INTER-observer reliability CROSS-sectional method SEVERITY of illness index DATA analysis software PATIENTS' attitudes PHYSICIANS -- Attitudes medical coding DESCRIPTIVE statistics MANN Whitney U Test

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Utah's 72-Hour Waiting Period for Abortion: Experiences Among a Clinic-Based Sample of Women

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PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2016年第4期48卷 179-187页

作者： Roberts, Sarah C. M. Turok, David K. Belusa, Elise Combellick, Sarah Upadhyay, Ushma D. Univ Calif San Francisco ANSIRH Oakland CA 94607 USA Univ Utah Dept Obstet & Gynecol Salt Lake City UT USA

CONTEXT: In 2012, Utah became the first state to enact a 72-hour waiting period for abortion. Despite debate about the law's potential effects, research has not examined women's experiences with it. METHODS: A cohort of 500 women recruited at four family planning facilities in Utah in 2013-2014 completed baseline surveys at the time of an abortion information visit and follow-up telephone interviews three weeks later. Logistic regression and coding of open-ended responses were used to examine which women had abortions and, for those who did not, their reasons. RESULTS: Among the 309 women completing follow-up, 86% had had an abortion, 8% were no longer seeking abortion, 3% had miscarried or discovered they had not been pregnant, and 2% were still seeking abortion;one woman was still deciding, and the waiting period had pushed one woman beyond her facility's gestational limit for abortion. At the information visit, women reported little conflict about the abortion decision (mean score on a scale of 0-100 was 13.9 for those who eventually had an abortion and 28.5 for others). Low decisional conflict, but not socioeconomic status, was associated with having an abortion (odds ratio, 1.1). On average, eight days elapsed between the information visit and the abortion. CONCLUSION: As most women in this cohort were not conflicted about their decision when they sought care, the 72-hour waiting requirement seems to have been unnecessary. Individualized patient counseling for the small minority who were conflicted when they presented for care may have been more appropriate.

关键词： ABORTION laws ABORTION -- Economic aspects ANXIETY BLACKS CONFIDENCE intervals DECISION making MENTAL depression HISPANIC Americans INTERVIEWING STATISTICS SUBSTANCE abuse SURVEYS WHITES MULTIPLE regression analysis SOCIOECONOMIC factors INTIMATE partner violence medical coding

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Negotiating the equivocality of palliative care: a grounded theory of team communicative processes in inpatient medicine

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HEALTH COMMUNICATION 2016年第5期31卷 536-543页

作者： Ledford, Christy J. W. Canzona, Mollie Rose Cafferty, Lauren A. Kalish, Virginia B. Uniformed Serv Univ Hlth Sci Dept Family Med Bethesda MD 20814 USA Wake Forest Univ Dept Commun Winston Salem NC 27109 USA Texas State Univ Dept Commun Studies San Marcos TX 78666 USA Ft Belvoir Community Hosp Dept Family Med Ft Belvoir VA 22060 USA

In the majority of U.S. hospitals, inpatient medicine teams make palliative care decisions in the absence of a formalized palliative system. Using a grounded theory approach, interviews with inpatient team members were systematically analyzed to uncover how participants conceptualize palliative care and how they regard the communicative structures that underlie its delivery. During analysis, Weick's model of organizing emerged as a framework that fit the data. The 39 participant inpatient team members discussed palliative care as primarily a communicative process. Themes describing the meaning of palliative care emerged around the concepts of receiver of care, timeline of care, and location of care. The emerging model included four stages in the communicative processes of inpatient palliative care: (a) interpret the need, (b) initiate the conversation, (c) integrate the processes, and (d) identify what works. In contrast to stable, focused palliative care teams or hospice care teams, which have prescribed patient populations and processes, the inpatient medicine team faces the equivocality of providing palliative care within a broader practice. This research offers a four-phase model to show how these inpatient teams communicate within this context. Implications for the provision of palliative care are discussed.

关键词： COMMUNICATION FOCUS groups GROUNDED theory HEALTH care teams HOSPITAL patients INTERPROFESSIONAL relations INTERVIEWING RESEARCH methodology medical care PSYCHOLOGY -- Mathematical models JUDGMENT sampling THEMATIC analysis medical coding

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Pharmaceutical Role Expansion and Developments in Pharmacist-Physician Communication

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HEALTH COMMUNICATION 2016年第2期31卷 161-170页

作者： Bergman, Alicia A. Jaynes, Heather A. Gonzalvo, Jasmine D. Hudmon, Karen Suchanek Frankel, Richard M. Kobylinski, Amanda L. Zillich, Alan J. Richard L Roudebush VA Med Ctr Indianapolis IN USA Purdue Univ Coll Pharm W Lafayette IN 47907 USA

Expanded clinical pharmacist professional roles in the team-based patient-centered medical home (PCMH) primary care environment require cooperative and collaborative relationships among pharmacists and primary care physicians (PCPs), but many PCPs have not previously worked in such a direct fashion with pharmacists. Additional roles, including formulary control, add further elements of complexity to the clinical pharmacist-PCP relationship that are not well described. Our objective was to characterize the nature of clinical pharmacist-PCP interprofessional collaboration across seven federally funded hospitals and associated primary care clinics, following pharmacist placement in primary care clinics and incorporation of expanded pharmacist roles. In-depth and semistructured interviews were conducted with 25 practicing clinical pharmacists and 17 PCPs. Qualitative thematic analysis revealed three major themes: (1) the complexities of electronic communication (particularly electronic nonformulary requests) as contributing to interprofessional tensions or misunderstandings for both groups, (2) the navigation of new roles and traditional hierarchy, with pharmacists using indirect communication to prevent PCP defensiveness to recommendations, and (3) a preference for onsite colocation for enhanced communication and professional relationships. Clinical pharmacists' indirect communication practices may hold important implications for patient safety in the context of medication use, and it is important to foster effective communication skills and an environment where all team members across hierarchies can feel comfortable speaking up to reduce error when problems are suspected. Also, the lack of institutional communication about managing drug formulary issues and related electronic nonformulary request processes was apparent in this study and merits further attention for both researchers and practitioners.

关键词： COMMUNICATION in medicine -- Research OCCUPATIONAL roles PHARMACISTS PHYSICIANS (General practice) HOSPITAL pharmacies INTERPROFESSIONAL relations INTERVIEWING RESEARCH methodology PRIMARY health care FINANCING of research SAMPLING (Statistics) QUALITATIVE research DATA analysis THEMATIC analysis PATIENT-centered care medical coding DESCRIPTIVE statistics COMMUNICATION

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The Great Whoosh: Connecting an Online Personal Health Narrative and Communication Privacy Management

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HEALTH COMMUNICATION 2016年第1期31卷 12-21页

作者： Smith, Stephanie A. Brunner, Steven R. Univ Arizona Dept Commun Tucson AZ 85721 USA

This research study examined Bud Goodall's online health narrative as a case study through the use of a thematic analysis to investigate the presence of communication privacy management (CPM) theory. Emergent themes of humor as a privacy management strategy, legitimization of co-owners, shifting privacy rules at end of life, and metaphors as privacy protection were used to recount Goodall's cancer experience on his personal blog, connecting to the components of CPM. The themes the authors analyzed represent the push-pull dialectical tension experienced to reveal and conceal information, conceptualization of private information, shared boundaries, and boundary linkages.

关键词： COMMUNICATION privacy management theory NARRATIVES INTERNET & privacy medical informatics BLOGS -- Social aspects PANCREATIC tumors CANCER patient medical care CANCER patient psychology COMMUNICATION EXPERIENCE INFORMATION resources management CASE study (Research) medical ethics medical personnel & patient METAPHOR PERSONAL space PRIVACY SELF-disclosure TERMINAL care ETHNOLOGY research ACCESS to information THEMATIC analysis medical coding CASE studies PSYCHOLOGICAL aspects

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Waking Up the Mind: Qualitative Study Findings About the Process Through Which Programs Combining Income Generation and Health Education Can Empower Indigenous Guatemalan Women

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HEALTH CARE FOR WOMEN INTERNATIONAL 2016年第3期37卷 323-340页

作者： Gurman, Tilly A. Ballard, Anne Kerr, Samantha Walsh, Janee Petrocy, Amy George Washington Univ Dept Global Hlth Milken Inst Sch Publ Hlth 2175 K St NW Washington DC 20037 USA Univ Arizona Mel & Enid Zuckerman Coll Publ Hlth Tucson AZ USA Friendship Bridge Panajachel Solola Guatemala

We explored the process through which two income-generation programs that include health education empower indigenous Guatemalan women artisans. Both artisans (n = 44) and program staff (n = 11) participated in semistructured interviews. Respondents expressed that women gained support about personal issues and experienced an awakening of the mind (despertar la mente). Through active participation, women's fear of strangers and speaking in public decreased. Women also gained mobility, awareness of their rights as women, and self-confidence from earning and managing their own income. Given our findings, we suggest that programs combining income generation and health education have the potential to empower women.

关键词： INDIGENOUS peoples CONFIDENCE FEAR HANDICRAFT HEALTH education INCOME INTERVIEWING RESEARCH methodology PARTICIPANT observation SELF-efficacy QUALITATIVE research SOCIAL support THEMATIC analysis medical coding

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Military suicide coverage: AP news wire & suicide guidelines

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DEATH STUDIES 2016年第9期40卷 570-577页

作者： Schuman, Donna Praetorius, Regina T. Barnes, Donelle M. Arana, Allyson A. Univ Texas Arlington Sch Social Work 211 Cooper StBox 19129 Arlington TX 76019 USA Univ Texas Arlington Coll Nursing & Hlth Innovat 211 Cooper StBox 19129 Arlington TX 76019 USA Univ Texas Arlington Dept Psychol 211 Cooper StBox 19129 Arlington TX 76019 USA

The authors evaluated how well Associated Press News Wire stories adhered to the Recommendations for Reporting on Suicide T during 2012, a peak year of military suicide. They included individual suicide stories (N = 167) from randomly selected days. They also evaluated differences in the military versus civilian coverage. Military and civilian stories typically had about five negative practices, and less than one positive practice, with military stories significantly more likely to miss valuable opportunities to promote help-seeking. The findings, combined with previous evidence, suggest the need for the development of specific military suicide reporting guidelines.

关键词： CHI-squared test CONFIDENCE intervals CONTENT analysis (Communication) FISHER exact test VETERANS medical protocols REPORT writing MILITARY personnel STATISTICAL hypothesis testing SUICIDE DATA analysis software medical coding DESCRIPTIVE statistics

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