Common Negative Experiences Research Articles

Significant Experiences Caring for Vascular Anomalies: A Survey of Caregivers and Adult Patients

Objectives: The goal of the current study was to gain a deeper understanding of the significant experiences that characterize care for vascular anomalies (VAs). Materials and methods: A total of 166 adult patients and 88 caregivers (N = 254) completed an anonymous online cross-sectional survey about their experiences seeking care for their (or their child’s) vascular anomaly. We used thematic analysis to analyze participants’ responses to 3 open-ended questions asking about the biggest challenges, most memorable positive experiences, and any other significant experiences. Results: Participants reported significant healthcare experiences representing 5 primary areas: diagnosis and treatment, healthcare system and logistics, psychosocial consequences, physical consequences, and clinical relationships. The availability of clinical knowledge and information was identified as an overarching theme affecting all 5 categories. The most common negative experiences related to healthcare system and logistics (n = 100). Clinical relationships were commonly identified in both positive (n = 100) and negative (n = 86) experiences. Conclusion: Their responses highlighted the value of a well-organized system of care that promotes productive interactions with expert clinicians and connects patients with support organizations. Unfortunately, VA patients and caregivers often experience long diagnostic journeys, fragmented care, and nonproductive interactions with clinicians due to the pervasive lack of information about VAs. The results indicate the need for systemic changes to address these barriers to care for patients with rare diseases.

Understanding Patients' Negative Experiences with Telehealth: A Content Analysis of Survey Data.

Understanding differences in how demographic groups experience telehealth may be relevant in addressing potential disparities in telehealth usage. We seek to identify and examine themes most pertinent to patients' negative telehealth experiences by age and race in order to inform interventions to improve patients' future telehealth experiences. We performed a content analysis of Press Ganey patient experience surveys from adult patients at 17 primary care sites of a large, public healthcare system with visits from April 30, 2020 to August 27, 2021. We used sentiment analysis to identify negative comments. We coded for content themes and analyzed their frequency, stratifying by age and race. We analyzed 745 negative comments. Most frequent themes differed by demographic categories, but overall, the most commonly applied codes were "Contacting the Clinic" (n = 97), "Connectivity" (n = 84), and "Webside Manner" (n = 79). The top three codes accounted for >40% of the negative codes in each race category and >35% of the negative codes in each age category. While there were common negative experiences among groups, patients of different demographics highlighted different aspects of their telehealth experiences for potential improvement.

The Emotional Impact and Coping Mechanisms Following Adverse Patient Events Among Canadian Vascular Surgeons and Trainees.

This study's objective is to evaluate the emotional experiences, coping mechanisms, and support resources for Canadian vascular surgeons and trainees following an adverse patient event or near miss. This is a cross-sectional survey study of all Canadian Society for Vascular Surgery (CSVS) members from October to November 2021. We collected data on participant experiences with adverse events, their emotional responses, the coping mechanisms used, and their perceptions on available support resources. The survey was sent to 233 CSVS members yielding 66 responses. The majority (77%) of respondents had experiences with adverse event causing serious patient harm. The most common negative experience following an adverse event included feelings of negativity towards oneself, general distress, and anxiety about potential for future errors. The most common coping mechanism was seeking advice from a mentor or close colleague. Peers (82%) and senior colleagues (59%) were the most preferred sources of support. Most of the respondents would reach out to a mentor if they had 1, but 30% reported no mentor or close colleague for support. Adverse patient events and near misses have serious negative impact on the lives of Canadian vascular surgeons and trainees. Peers and senior colleagues are the most desired source for support, but this is not universally available. Organized efforts are needed to bring awareness in our vascular surgery community on the ubiquitous nature and detrimental effects of adverse events.

ADVERSE CHILDHOOD EXPERIENCES IN PSYCHOACTIVE SUBSTANCE USE DISORDERS: A STRUCTURED LITERATURE REVIEW

Adverse childhood experiences include psychological, physical, and sexual forms of abuse, as well as dysfunction in the home, including substance abuse among family members, and mental health problems in the family. These experiences are among the most intense and frequent sources of stress that children can experience early in life, and they also increase their risk of various behavioural disorders and substance abuse. Aim: The study aimed to investigate the prevalence and potential impact of childhood adverse experiences in connection to alcohol and other psychoactive substance abuse and addiction. Methods: A structured literature review was conducted, and an electronic search of the PubMed database was performed. The review process initially identified 653 articles, of which 11 were included in the review. Results: Smokers and alcohol users are more likely to report an adverse childhood experience compared to people who do not report harmful habits. Parental divorce was one of the most common negative experiences that affected 17-59.5% of the respondents. The results of the Adverse Childhood Experiences Survey are a potentially significant predictor of risky behaviour.

Associations Between Child Maltreatment, Inflammation, and Comorbid Metabolic Syndrome to Depressed Mood in a Multiethnic Urban Population: The HELIUS Study.

BackgroundChild maltreatment is a common negative experience and has potential long-lasting adverse consequences for mental and physical health, including increased risk for major depressive disorder (MDD) and metabolic syndrome. In addition, child maltreatment may increase the risk for comorbid physical health conditions to psychiatric conditions, with inflammation as an important mediator linking child maltreatment to poor adult health. However, it remains unresolved whether experiencing child maltreatment increases the risk for the development of comorbid metabolic syndrome to MDD. Therefore, we investigated whether child maltreatment increased the risk for comorbid metabolic syndrome to depressed mood. Subsequently, we examined whether C-reactive protein (CRP), as an inflammatory marker, mediated this association. In addition, we investigated whether effects differed between men and women.MethodsAssociations were examined within cross-sectional data from the multiethnic HELIUS study (N = 21,617). Adult residents of Amsterdam, Netherlands, self-reported on child maltreatment (distinct and total number of types experienced before the age of 16 years) as well as current depressed mood (PHQ-9 score ≥ 10), and underwent physical examination to assess metabolic syndrome. The CRP levels were assessed in N = 5,998 participants. Logistic and linear regressions were applied for binary and continuous outcomes, respectively. All analyses were adjusted for relevant demographic, socioeconomic, and lifestyle characteristics, including ethnicity.ResultsA higher number of maltreatment types as well as distinct types of emotional neglect, emotional abuse, and sexual abuse were significantly associated with a higher risk for current depressed mood. Child maltreatment was not significantly associated with the risk for metabolic syndrome in the whole cohort, nor within individuals with depressed mood. As child maltreatment was not significantly associated with the CRP levels, subsequent mediation analyses were not performed. No significant moderating effects by sex were observed.ConclusionIn this multiethnic urban cohort, child maltreatment was associated with a higher risk for depressed mood. Contrary to our expectations, child maltreatment was not significantly associated with an increased risk for metabolic syndrome, neither in the whole cohort nor as a comorbid condition in individuals with depressed mood. As the data were cross-sectional and came from a non-clinical adult population, longitudinal perspectives in relation to various stages of the investigated conditions were needed with more comprehensive assessments of inflammatory markers.

Supportive interactions with primary care doctors are associated with better mental health among transgender people: results of a nationwide survey in Aotearoa/New Zealand.

BackgroundPast research has established that transgender people experience significant disparities in mental health outcomes and healthcare dissatisfaction compared with cisgender people, but more research is needed on how supportive healthcare interactions relate to the mental health of transgender people.ObjectivesThe 2 main aims of our analyses were: (i) to establish the most common negative experiences in healthcare and the most common supportive experiences specifically with primary care doctors for transgender people; and (ii) to examine the association of supportive experiences with mental health variables after controlling for demographic factors.MethodsData from the 2018 Counting Ourselves nationwide survey of transgender people were analysed using regression modelling. The 948 participants with a primary care doctor or general practitioner were included in analyses. Participants were aged 14–83 years old (mean 30.20).ResultsThe most common supportive experiences involved primary care doctors treating transgender people equitably, with competence, and with respect. Participants with more negative healthcare experiences had higher psychological distress as well as higher likelihood of reporting nonsuicidal self-injury and suicidality. Conversely, participants with more experiences of supportive primary care doctors had lower psychological distress and were less likely to have attempted suicide in the past 12 months.ConclusionWhen transgender people receive supportive care from their primary care providers they experience better mental health, despite ongoing negative healthcare experiences. Future research is needed to confirm ways of supporting positive trajectories of mental health for transgender people but these findings demonstrate the importance of positive aspects of care.

The mediating role of willingness to seek help on the relationship between peer victimization and mental health outcomes

Peer victimization is a common negative experience in childhood that can result in a number of harmful consequences, including a range of mental health challenges. Consequently, adult intervention, especially for elementary school-aged children, has been identified as a key ingredient in the prevention of and intervention with acts of aggression and peer victimization. However, children are not always willing to seek help from adults at school in response to peer victimization exposure, suggesting variability in children’s responses to being targeted by peers. A potential mediating pathway may exist where victimization exposure impacts children’s willingness to seek help from adults at school, which in turn may have an impact on their adjustment, including mental health outcomes. However, little is known about the role of children’s willingness to seek help in the link between exposure and negative mental health outcomes. In the present study, we examine 1) if willingness to seek help from teachers mediates the relationship between peer victimization exposure and mental health outcomes (depressive symptoms, anxiety symptoms, and self-esteem); and 2) the mediation effects for boys and girls. Based on a sample of 960 3rd-5th grade students from seven elementary schools, results suggest that, while increased peer victimization was associated with lower willingness to seek help and worse mental health outcomes, meditational effects were only found for self-esteem for both boys and girls. Implications for practice in schools are discussed in terms of potential prevention and intervention practices in schools.

Understanding “Zoom fatigue”: Theorizing spatial dynamics as third skins in computer-mediated communication

“Zoom fatigue”—theorized here as part of a larger experience with computer-mediated communication (CMC) exhaustion—has emerged as a common negative experience through prolonged use of CMC platforms. Despite CMC exhaustion’s ubiquity, the relatively novel phenomenon has caused much speculation for its root causes with little information pinpointing why it occurs. Utilizing research, observations, and personal accounts, this article explores synchronous online consultations (SOCs) within writing centers as matching sites to ponder the basis for CMC exhaustion. In doing so, third skins are proposed to account for how nuanced differences in space between SOCs and face-to-face exchanges mean participants are not engaged as human actors but “flattened” into a totality of third skin comprising person, background, and technology. The resulting transformation and our bodies exerting substantial cognitive efforts to interact with this transformation are theorized to produce CMC exhaustion. The implications for this are twofold: 1) for readers interested in the underlying causes of CMC exhaustion, this work presents a framework to test the ideas proposed and develop mitigating strategies, and 2) for readers who study SOCs, third skins might explain previously observed limitations in the effectiveness of visuality in CMC.

Establishing a taxonomy of potential hazards associated with communicating medical science in the age of disinformation

ObjectivesDisinformation on medical matters has become an increasing public health concern. Public engagement by scientists, clinicians and patient advocates can contribute towards public understanding of medicine. However, depth of feeling...

Residency Interview Experiences in Oral and Maxillofacial Surgery Differ by Gender and Affect Residency Ranking

Resident interview experiences are crucial for applicants when ranking programs. The purpose of the present study was to evaluate the interview experience among current oral and maxillofacial surgery (OMS) residents to determine the factors that influenced their selection and ranking of training programs and whether these experiences differed between women and men. We conducted a cross-sectional survey of OMS residents in 2018. The 12-question survey included demographics, reasons for selecting an interview and ranking programs, and positive and negative experiences during the interviews. Logistic regression models were constructed to evaluate the predictors of unprofessional or negative experiences. A total of 1134 surveys were emailed, with 165 completed questionnaires (14.6%) returned by 35 women (21.2%) and 130 men (78.8%). Their average age was 30.8years (range, 25 to 42). The racial/ethnic distribution was as follows: white, 75.8%; Asian, 15.8%; and other, 8.4%. Of the 165 respondents, 52% were in MD and 48% in non-MD programs. The top factors in selecting an institution at which to interview were clinical scope and volume, and the reason for ranking a program high was resident friendliness, which was similar among the female and male respondents. Unprofessional behavior or negative experiences were reported by 62 respondents (38%) and occurred by both faculty and residents and during both interviews and social events. Demeaning behavior toward the applicant, residents, and colleagues was the most common negative experience overall, with the women experiencing more gender-specific inappropriate behavior. Female respondents and those who were in dual-degree programs were 2.4 and 2.1 times more likely to experience unprofessional conduct than their peers, respectively (P=.03). Female and male residents were influenced by the same factors when selecting interviews and ranking residency programs. Unprofessional and inappropriate conduct was reported by 38% of the respondents. Women and dual-degree respondents were 2.4 and 2.1 times more likely to experience unprofessionalism during interviews, respectively. This might have contributed to the low number of current female OMS residents.

Histories of Social Functioning and Mental Healthcare in Severely Dysfunctional Dual-Diagnosis Psychiatric Patients

Abstract Disengagement from mental health services is a major obstacle to the treatment of homeless dual-diagnosis patients (i.e., those with severe mental illness and substance-use disorder). A subgroup of these patients is considered to be treatment resistant and we aim to explore whether patients’ reasons for disengagement may stem from negative experiences in their lives and treatment histories. This retrospective, explorative study examined the medical files of 183 severely dysfunctional dual-diagnosis patients who had been admitted involuntarily to a new specialized clinic for long-term treatment. Most patients shared common negative experiences with respect to childhood adversities, low school achievement, high levels of unemployment, discontinuity of care, and problems with the judicial system. The lifetime histories of treatment-resistant, severely dysfunctional dual-diagnosis patients showed a common pattern of difficulties that may have contributed to treatment resistance and disengagement from services. If these adversities are targeted, disengagement may be prevented and outcome improved.

Rural posting experience, requests for transfer, and perspectives about critical factors for staff retention among primary health care workers in urban Kano, Nigeria.

Inadequate skilled manpower at rural posts is a serious impediment toward equitable and universal access to healthcare in Nigeria. To examine the experiences of primary health care (PHC) workers on rural assignments, requests for transfer, and perspectives about critical factors for retention of healthcare workers at rural posts. Using descriptive cross-sectional design, 262 PHC workers in Kano were studied. Data were collected using semi-structured questionnaires and analyzed on Statistical Package for Social Sciences version 22. Pearson's Chi-square and Fisher's exact tests were used to test for significant association between categorical variables. P ≤ 0.05 was considered significant. The mean age of the workers was 36.0 ± 9 years. Majority were females (55.4%) and married (64.2%) with mean working experience of 13.0 ± 8.0 years. Only 29 (11.2%) had rural posting experience. Mean duration of posting was 4.0 ± 2.0 years; 19 (65.5%) sought re-deployment for lack of social amenities and good schools for children 19 (100.0%) and poor work environment 17 (89.5%). Common positive rural experiences mentioned were less work pressure 26 (89.7%), cordial relationship with colleagues and community members 24 (82.8%), and willingness of the community to partake in health activities 24 (82.8%). Common negative experiences reported include lack of social amenities 27 (93.1), lack of equipment and supplies in facilities 26 (89.7%), and stagnation 22 (75.9%). The workers' perspectives about critical factors for retention at rural posts include good facility infrastructure and functional equipment 240 (92.3%), good housing 237 (91.2%), potable water and electricity supply 238 (91.5%), good schools for staff's children 38 (91.5%), and good access of road to town 239 (91.9%). While steering gear at upgrading basic infrastructures in rural areas, government should in the interim, ensure attractive working and living conditions at rural posts.

Moving from chance and ``chemistry'' to skills: Improving online student learning outcomes in small group collaboration

While instructors know the importance of successful small group collaboration, and the value of the skills required to execute them, students continue to prefer to work independently. The promise and development of recent online tools, however, and streams of recent research on small group collaboration, continue to produce less-than-satisfying or sufficiently generalizable pedagogical interventions. This study examines a more systematic attempt to direct students through specific tasks designed to improve their experience and produce higher quality student learning outcomes. Two groups of graduate students across four required online classes were surveyed about their attitudes and the steps they take when engaging assigned small group projects. The first group was offered a pre-recorded lecture as a resource while the second group was offered the same lecture plus additional specific ground rules to help avoid common negative experiences. Both groups were asked to complete surveys about their experiences. While many students continue to exhibit less-than-productive behaviors and practices, even after engaging the guidelines, some improvements did emerge. The study points out that more attention to pedagogical intervention is indicated if instructors hope to improve learning outcomes in valuable small group collaborations.

“It Belongs to the Internet”: Animal Images, Attribution Norms and the Politics of Amateur Media Production

“It Belongs to the Internet”: Animal Images, Attribution Norms and the Politics of Amateur Media Production

Exploring Workplace Bullying in Nursing

Bullying in the nursing workplace has been identified as a factor that affects patient outcomes and increases occupational stress and staff turnover. The purpose of this project was to assess registered nurses' perceived exposure to workplace bullying. A convenience sample of a Pacific Northwest state professional nurses' association membership was solicited for this descriptive study using the Negative Acts Questionnaire-Revised (NAQ-R). Forty-eight percent of respondents admitted to being bullied in the workplace during the previous 6 months, with respondents choosing "being ignored or excluded" as the most common negative experience in the workplace. The results of this study suggest that workplace bullying remains a problem for which reduction strategies must be devised as a means of retaining nurses and preventing adverse outcomes. One strategy shown to be effective in curbing bullying is assertiveness and aggression training for nurses.

Coping Behaviors among Sexual Minority Female Youth

This article summarizes data from a qualitative study investigating the ways in which female youth perceive and respond to challenges related to the interplay of late adolescence and a minority sexual orientation. Fifteen sexual minority females in late adolescence were interviewed individually and in focus groups. The interviews focused on participants’ perceptions of challenges, the impact those stressors have in their lives, and methods they utilize to cope with them. The most common negative experiences reported were isolation, lack of acceptance, harassment, and violence. Sub-themes include: hearing negative messages about gender and sexual orientation, pressures to conform to a variety of cultural norms including gender norms, fears of future violence, and pressure to identify sexual orientation. Collectively, the participants described these negative consequences of experiences of heterosexism, sexism, and racism as their most difficult experiences. The most common responses to these stressors reported by participants were finding support in relationships, engaging in coping responses, pursuing education and activism, rebellion and resistance, and avoidance and deferment.

A female perspective on living with HIV disease.

The study discussed in this article explored women's views of the positive and negative aspects of life with HIV. Even in the face of a stigmatizing physical illness and with elevated levels of depression and anxiety, the 55 women interviewed for the study were able to identify a large number of positive events; for many, HIV served as a motivating force for positive change. Common negative experiences included physical symptoms, a limited life span, alienation, and stigma. Results suggest that whereas women demonstrate a remarkable capacity to adapt, there are a number of specific areas where social services and community interventions can be targeted.

Physicians' Perceptions of Communication with and Responsibilities of Pharmacists

ObjectiveTo understand physicians' perceptions of (1) their communication with pharmacists, (2) pharmacists' professional duties, and (3) the degree of responsibility with which pharmacists perform these tasks. DesignStructured interviews with convenience sample of physicians in phase 1; written survey mailed to convenience sample of physicians in phase 2. ParticipantsSix physicians in Wyoming in phase 1, and 313 primary care physicians who were members of the Wyoming Medical Society in phase 2. Main Outcome MeasuresPhysicians' attitudes and experiences related to their interactions with pharmacists and their perceptions about pharmacists' responsibilities. ResultsUsable surveys were returned by 176 physicians (response rate = 59.1%). Age ranged from 27 to 86 years (mean ± SD = 43.5 ± 10.4 years), 79.5% were men, and 50.6% were in family practice. Almost 25% had personal contact with pharmacists regarding patients' medications four or more times daily, but 20.6% rarely had this type of contact. Pharmacists contacted physicians' offices regarding prescription refills frequently, with 28.7% reporting 10 or more contacts daily. For 79.2% of respondents, an office nurse had the most contact with pharmacists. Respondents were most comfortable with pharmacists' responsibilities of catching prescription errors (88.0%), providing patient education (65.1%), suggesting nonprescription medications (63.4%), and suggesting prescription medications to physicians (52.0%). Respondent's age was negatively correlated with three functions related to pharmacotherapeutic regimens: designing regimens, monitoring effects of failed regimens, and monitoring outcomes. The most common negative experiences with pharmacists involved pharmacists' scaring the patient, dispensing unauthorized refills, and making inappropriate comments in the presence of patients. ConclusionFuture research with a larger, more representative sample of physicians will help explain this dynamic relationship. These preliminary results should be useful in training future physicians and pharmacists.

Perceived Risk and Sources of Information Regarding Cocaine

A study was made of the perceptions of risk and of the sources of information about risk regarding cocaine. Subjects were adult (N = 90) and juvenile (N = 20) cocaine abusers in seven Baltimore area treatment programs. Using structured interview, it was found that 87.8% of adults and 80.0% of youth had experienced at least one negative consequence of their cocaine use, other than addiction, prior to entry into treatment. The most common negative experience reported by both groups was the loss of reality testing. Moreover, 86.6% of adults and 65.0% of youth reported becoming addicted to cocaine before entering treatment. While juveniles sampled had entered treatment within a year of first cocaine use, adults entered treatment 7.9 years after first use and reported an average of 6.6 years of cocaine use before experiencing the first negative consequences. Television received consistently high ratings as an accessible and credible source of information about cocaine. Adolescents rated schools relatively high on the amount and accuracy of cocaine-related information provided.