Consensual Approach Research Articles

An exploratory study of the impact of COVID-19 on foster parenting.

As the COVID‐19 virus began to spread in the United States of America, states' child welfare administrators and policymakers responded differently. Some states implemented more restrictive policies, some less or did not require many restrictions (i.e., stay at home orders or masking in public spaces). Video‐based online focus groups with foster parents in four states utilized a consensual qualitative approach to identify themes relating to foster parenting during COVID‐19 and understand how policies related to COVID‐19 restrictions affected their caregiving decisions. Themes that emerged included pathways to foster parenting pre‐pandemic, the impact of COVID‐19 on both foster parents, children in care, and foster parents' ability to understand the broader importance of their caregiving. While participants in all of the states reported similar experiences relating to the need for resources and support and the challenge of managing both work and remote education for their children, those in states with restrictive policies were more likely to report pandemic‐specific concerns including a lack of agency communication or case progress, the mental health toll on foster children in their care and their concerns about accepting new placements. Implications for policy and practice are discussed.

The Impact of COVID-19 on Black College Students' Mental Health

COVID-19 has had a deleterious impact on both the Black community and college students. Studies on this topic have taken a general approach and thus do not consider how the effects of the pandemic are distinct and potentially exacerbated among subgroups of students. The current study addressed this gap in the literature by examining the psychological impact of COVID-19 on Black college students. A sample of Black college students (Mage = 20.09) was interviewed and asked to describe their emotional reactions to COVID-19 and their coping processes in response to the pandemic. Interview data were analyzed using a consensual qualitative research approach (Hill et al., 1997, 2005). Findings showed that a majority of students had a negative emotional reaction to the pandemic (e.g., low mood and stress), and a small subset of students had a positive emotional reaction (e.g., emotional growth). In addition, students tended to cope with the pandemic most commonly via engagement (e.g., positive reframing) and social support coping strategies. We discuss the implications of our findings and offer recommendations for how institutions may better support Black college students' mental health in the midst of the ongoing pandemic.

All opinions are not equal: Toward a consensual approach to the development of drug policy

AbstractDrug policy has been subjected to much scrutiny from different stakeholder groups who present sometimes very different opinions on solutions to address a problem. Reconciling such differences, that are underpinned by both anecdotal and empirical evidence, is a priority yet to be fully achieved. In this study, we examine: (i) whether differences exist among actor groups regarding their perceived importance in policymaking; (ii) whether those who dominate the decision process value the input of laypeople or minority actors; and (iii) whether differences exist, with regard to i and ii, between study sites (i.e. Australia and Hong Kong) that have markedly different drug strategies. Overall, differential preference weightings between dominant groups reveal a strong influence of political orientation. Results suggest that decisions made by health professionals were regarded as the most important, while most of the respondent groups gave a low preference toward policy decisions made by law enforcers. Dominant groups also tend to discount the inputs of laypeople and other minority groups. Our study highlights the importance for policy actor groups to consider such a differential weighting of inputs when synthesising knowledge and gathering opinions for the development of drug policy.

Clients' Perspectives on Patient-Centeredness: a Qualitative Study with Low-Income Minority Women Receiving HIV Care in South Florida.

Low-income, minority women living with HIV often experience multiple barriers in care that contribute to suboptimal care outcomes. Medical case managers (MCM) and medical providers are key players involved in care coordination and aid women along the HIV care continuum. The objective of this study was to identify current and potential patient-centered practices that facilitate adherence to medication and retention in care, from the perspective of racially and ethnically diverse women living with HIV. We implemented a qualitative study using semi-structured interviews with 75 African American, Hispanic/Latina, and Haitian women who were enrolled in the Ryan White HIV/AIDS Program in South Florida in 2019. We organized domains of exploration using a patient-centered care framework to identify practices in which providers acknowledged, respected, and responded to clients' preferences, needs, and values. Interviews were analyzed using consensual thematic analysis approach. Findings reflect women valued MCMs who were proactive and directive in care, provided motivation, and aided with navigation of shame, fear, and stigma. Women valued medical providers who upheld simple educational communication. Moreover, women reported that providers who reviewed medical results with clients, incorporated questions about families, and inquired about multiple physical and clinical needs beyond HIV created opportunities for women to feel respected, valued, and in turn, enhanced their involvement in their care. Findings identify specific interpersonal practices that can enhance the ability to better meet the needs of diverse groups of women, specifically those from racial/ethnic minority groups who face multiple sociocultural barriers while in care.

Implementing enhanced recovery after surgery programmes in a healthcare facility: issues and economic impacts

For many specialties and operating techniques, enhanced recovery after surgery provides greater economic benefit if it is deployed across a whole healthcare institution rather than in just one or two departments. As with all innovations in the world of hospital care, the adoption of new procedures is a slow process because it is based on a consensual approach. To promote the dissemination and uptake of new practices at the local, national or institutional level, incentives must be developed and examples must be given. Successful deployment within a healthcare institution requires strategic adaptations in three areas: (i) the management of human resources dedicated to the patient pathway, (ii) a care unit architecture that facilitates working practices and patient management, and (iii) the use of digital tools and smart objects. Hospital decision-makers need to have a clear understanding of what is at stake, so that they can implement coordinated actions and encourage adoption. The investment required is hard to define because it results from a combination of skills and knowledge. At the institutional level, the return on investment is greater when the strategy is applied to all surgical specialties at once, since the structure can provide more care with fewer beds and fewer care units while maintaining the quality of patient management.

Creative Arts Therapy in the "Remote Therapeutic Response" Format in the Education System.

Many creative arts therapists work in the education system on a regular basis. As a result of the pandemic, all have had to treat students in a “remote therapeutic response” format. The aim of the present study was to map creative arts therapists’ perceptions of the “remote therapeutic response” in the education system. Semi-structured interviews were conducted with 15 creative arts therapists who participated in the study. The consensual qualitative research approach yielded seven domains: (1) the emotional experiences of transitioning to a remote therapeutic response; (2) the implementation of the remote therapeutic response; (3) benefits of remote creative arts therapy; (4) challenges in remote creative arts therapy; (5) remote contact with parents; (6) working in the educational system; (7) insights and recommendations. Although the findings show that creative arts therapists believe that remote creative arts therapy will never be a fully satisfactory replacement for most clients, remote work, despite its many difficulties and challenges, has also opened the door to new possibilities in the world of creative arts therapy in the education system.

Youth participation: a new approach based on the intersections between models, views and European policies

INTRODUCTION. Education policies have indicated the importance of youth participation in schools, which is one of the European Goals within the EU Youth Strategy framed by the EU youth policy cooperation for 2019-2027. The subject of youth participation refers to multiple definitions and diverse theoretical frameworks, which show the difficulty of finding a consensual definition or approach. The main objective of the current paper is to characterize youth participation models and to identify how those models convey different views, establishing possible connections with political discourses. METHOD. The study is based on an interpretive perspective. Data was collected by documentary analysis of 28 models of youth participation, which were analysed in the light of four pre-established categories: orthodox, multidimensional participation, qualitative and non-conformist. RESULTS. The majority of the 28 models of youth participation were specifically designed for children and young people; they fit a bottom-up perspective and were focused on non-formal education contexts. In addition, these models underline a multidimensional view of participation. DISCUSSION. The results evidence a trend towards considering an ideological relationship between youth participation and democracy, as advocated in European youth policies.

Using qualitative, community-based input to steer post–coronavirus disease 2019 pharmacy practice in substance use

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has had a disproportionately negative impact on individuals with a substance use disorder (SUD). A rapidly changing public health and treatment environment has resulted in increased needs for pharmacist engagement in SUD-focused patient care. ObjectivesThis study used semistructured interviews of SUD professionals to evaluate where they believe pharmacy practice could better support people at risk of or having SUD in light of challenges posed by the COVID-19 pandemic. MethodsProfessionals dedicated to the care of individuals with SUD were recruited from a large community substance use coalition to participate in a qualitative study examining how pharmacists could take a more active role in SUD prevention, intervention, recovery, and harm reduction (HR). A consensual qualitative research approach was used in data analysis. ResultsDomains identified in analysis included pharmacists as educators of patients and communities, pharmacists as educators of health care providers, pharmacists as advocates for individuals with SUD, the need for increased pharmacist engagement owing to COVID-19 challenges for individuals with SUD, the need for expanded pharmacy practice interventions, and the need for pharmacist self-development. ConclusionIncreased medication counseling, HR practices, addressing stigma, and community-level education focused on SUD were among the most commonly reported areas for pharmacy practice development. In addition, the urgent need to adjust pharmacy practice in response to the COVID-19 pandemic was also identified by interviewees.

Speech-language pathologists’ perspectives of interprofessional collaboration

ABSTRACT This study aims to provide insight into speech-language pathologists’ experiences of and preparation for interprofessional collaborative practice across various settings and geographical locations in the United States. We disseminated an online survey via Qualtrics© to reach a representative sample of speech-language pathologists. We questioned respondents about the extend to which they engage in interprofessional collaborative practice, professionals with whom they engage in interprofessional collaborative practice, preparation for interprofessional collaborative practice, and barriers to engaging in interprofessional collaborative practice. Responses from 296 participants were analyzed to describe details regarding speech-language pathologists’ experiences in interprofessional collaboration. Quantitative data included means, ranges, standard deviations, and frequency counts. Open-ended responses underwent analysis through a consensual qualitative approach. Most speech-language pathologists in this study (59%) reported feeling prepared for interprofessional collaboration. Participants reported that they engage in interprofessional collaborative practice with other professionals from disciplines such as nursing, occupational therapy, teaching, physical therapy, and school psychology. To best prepare students for future speech-language pathology practice, participants recommended that students engage in interprofessional education to learn about collaborating with these disciplines. These results could have implications for future design and implementation of interprofessional education activities for students and practicing clinicians.

W poszukiwaniu wzorców partycypacji w deliberacji publicznej. Badanie uczestników i uczestniczek I Wrocławskiego Panelu Obywatelskiego

The purpose of this article is to present and analyze individual interviews conducted with the participants of the Citizens’ Assembly in Wrocław in order to identify the main motivations behind their will to participate, as well as what participatory strategies they are likely to adapt. The article is situated between empirical and political analysis, theory of participation, and political psychology. This way we are able to identify seven attitudes presented by participants in three areas: understanding of interests, democracy, and political process. These attitudes differ, the consensual approach being the one we identify as the most desirable for public deliberation, and particular ones — the so-called free-riders — the main challenge that needs to be addressed.

Is It Easy to Use and Useful? Mental Health Professionals’ Perspectives Inform Development of a Novel Treatment Engagement System for Youth Mental Health Services☆☆☆

User experiences are essential to the adoption of an intervention and can be integral to intervention design. We applied two concepts from the technology acceptance model (i.e., perceived ease of use, perceived utility) to understand how mental health professionals experienced a novel system of resources (i.e., engagement system) designed to improve problem identification, coordination, and treatment planning decisions related to addressing problems of low treatment engagement in school mental health services. We conducted a 1-hour focus group with 10 mental health professionals (provider n = 8, supervisor n = 2) using prompts to elicit their perspectives about the effort involved in using the engagement system and about the usefulness of the system in their work. The focus group was transcribed and segmented into 70 excerpts by trained coders. We analyzed the transcript using a consensual qualitative research approach. Ease of use was coded in 15 (39%) excerpts and utility was coded in 24 (61%) excerpts. The valences of excerpts were neutral (n = 18; 46%), positive (n = 10; 26%), and negative (n = 11; 28%). Thirty-nine (56%) excerpts discussed the engagement system. Excerpts pertained to problem identification (n = 18; 46%), coordination (n = 18; 46%), and treatment planning (n = 3; 8%). Findings revealed that resources and procedures were rated differently on their perceived ease of use and utility. Participants reported that the coordination resource had high utility and positively impacted their clinical practice and supervision, while the problem identification resources had low ease of use and were burdensome or difficult to use. Some lessons learned include the value of designing resources that provide structure to clinical decision processes yet allow for some flexibility, the need for simpler and automated procedures to reduce provider burden, and the importance of clear guidelines on how resources should and should not be used. We used this feedback to inform changes to the engagement system prior to testing in a randomized trial. This brief report highlights how applying the technology acceptance model to evaluate interventions can aid in the successful implementation of novel clinical interventions.

Critical Synthesis Toward Transformative Collaboration: A Dialectical Analysis of Functionalist and Critical Paradigms

Social workers are required to become effective boundary spanners to address complex social problems with community-based and cross-system collaboration. However, substantial tensions exist in the literature about how to build successful collaboration, stemming from the massive use of the two competing paradigms: functionalist and critical paradigms. Using a dialectical analysis, this article attempted to uncover and synthesize paradoxical understandings of the major elements of successful collaboration. Significant contradictions between the two contrasting paradigms are identified at the multidimensional levels, including (1) member capacity for developing objective/consensus knowledge vs. subjective/dissensus knowledge, (2) unity vs. diversity in membership, (3) centralized vs. decentralized network governance, and (4) stable/standardized vs. flexible/responsive coordination. The results suggest that there is no consensual approach to developing transformative collaboration that promotes members’ critical capacity, equal relations, democratic governance, and empowering coordination. Social workers should identify and utilize inherent contradictions as a catalyst for developing and maintaining transformative collaboration by considering its dynamic process, context, and interconnection with other systems.

The Sword of King Solomon

Conjoined twin pregnancies are one of the greatest dilemmas we face in healthcare practice. Thanks to scientific knowledge and evolution, technology and the higher level of wealth in our society, conjoined twins have a chance to survive, albeit with the risk of major consequences on their lifespan and quality of life. Particularly, in the case of newborns with extreme prematurity or congenital malformations, special care must be taken in the use of treatments that offer little to no benefit. This is especially the case with procedures and techniques of unproven efficacy that could create unfounded expectations and hopes in parents and health professionals. It is within this conceptual framework that the author presents a case submitted to a bioethics committee at a pediatric hospital in a Latin American metropolis and analyzes the ethical challenges posed to the treating team and the consensual approach determined by the team.

“It’ll Never Be Safe, But You Can Limit the Harms”. Exploring Adolescents’ Strategies to Reduce Harms Associated with Psychoactive Substance Use

Introduction: Harm reduction strategies are behaviors that may be applied in order to reduce adverse consequences associated with psychoactive substance use. Adolescents who use substances make up a large population that may benefit from applying such strategies. However, previous research in this area has focused on adults. Therefore, the purpose of this qualitative study was to describe and examine harm reduction strategies among adolescents who use psychoactive substances. Methods: Semi-structured individual interviews were conducted with 72 adolescents of equal sex distribution (aged 17–18 years) who had used various substances at least three times in the past 12 months and had no history of substance use disorders (SUD) treatment. Data were transcribed and then analyzed thematically based on the Consensual Qualitative Research approach. Findings: Adolescents who use substances described the harm reduction strategies they use. According to the meaning youth attributed to these strategies, five themes were developed, that included approaches to risk, substance use safety conditions, preparation for use, manner of use, and controlled use. Most of the identified strategies correspond to those found in studies on adults. The main source of adolescents’ knowledge about these strategies was the Internet. Peers appeared to play an important role in reducing substance-related risks. Conclusions: Despite risk-taking, adolescents in our study showed active engagement in reducing their substance-related risks and harms. Practical implications are provided, including supporting harm reduction strategies, enhancing the active role of peers and the Internet as communication channels in preventing SUDs as well as other substance-related problems among adolescents.

Risk and Protective Factors for the Mental Wellbeing of Deployed Healthcare Workers During the COVID-19 Pandemic in China: A Qualitative Study.

Background: Though many literatures documented burnout and occupational hazard among healthcare workers and frontliners during pandemic, not many adopted a systemic approach to look at the resilience among this population. Another under-studied population was the large numbers of global healthcare workers who have been deployed to tackle the crisis of COVID-19 pandemic in the less resourceful regions. We investigated both the mental wellbeing risk and protective factors of a deployed healthcare workers (DHWs) team in Wuhan, the epicenter of the virus outbreak during 2020.Method: A consensual qualitative research approach was adopted with 25 DHWs from H province through semi-structured interviews after 3 months of deployment period.Results: Inductive-Deductive thematic coding with self-reflexivity revealed multi-layered risk and protective factors for DHWs at the COVID-19 frontline. Intensive working schedule and high-risk environment, compounded by unfamiliar work setting and colleagues; local culture adaptation; isolation from usual social circle, strained the DHWs. Meanwhile, reciprocal relationships and “familial relatedness” with patients and colleagues; organizational support to the DHWs and their immediate families back home, formed crucial wellbeing resources in sustaining the DHWs. The dynamic and dialectical relationships between risk and protective factors embedded in multiple layers of relational contexts could be mapped into a socio-ecological framework.Conclusion: Our multidisciplinary study highlights the unique social connectedness between patient-DHWs; within DHWs team; between deploying hospital and DHWs; and between DHWs and the local partners. We recommend five organizational strategies as mental health promotion and capacity building for DHWs to build a resilient network and prevent burnout at the disaster frontline.

RETRACTED: Contemporary dance and the problem of evaluation: A consensual approach in the Chinese case

• Contemporary dance is a dance style, using the body for conceptual ideas expression. • Modern contemporary dancers have heightened figural and verbal creative abilities. • The dancer's creative experience positively affects the creativity evaluation. • Contemporary dance is understood more profoundly by the dance experienced people. Creativity is an essential element of modern dance and is often cited as a key goal of dance training. From the experts' side, creativity is often seen as part of a score for choreography or approach to improvisation. The audience evaluates the creative component of a contemporary dance subconsciously, by perceiving a dance - for a mass audience, contemporary dance is often abstract and does not have clear criteria and thus its meaning is not considered properly. There is no single approach to the means by which it is possible to understand and subsequently evaluate the creative abilities shown in dance, which prompts researchers to search and improve approaches to assessing creativity in contemporary dance. The study attempts to test a simple method of consensus assessment of contemporary dance, which allows a viewer to subconsciously assess the manifestation of creativity in contemporary dance. Due to the pandemic, the author had to form groups of participants in the experiment through Chinese social networks: WeChat, Weibo, Qzone, Youku. The sample is represented by: choreographers - 12 people ( n = 4 men and n = 8 women); dancers - 46 participants ( n = 32 women, n = 14 men); spectators - 123 people ( n = 83 women and n = 40 men). The main analysis was carried out using the capabilities of the LAVAAN package; to determine the influence of the main studied categories (experience and knowledge), the correlation was checked using Cohen's kappa (value 0.82, high level of reliability). Analysis of variance was used to determine the difference in average ratings of videos with dance performances. The results show that a real-life dance experience is critical. The fact that raters have had some dance lessons or that they regularly watch dance videos does not affect the final score in assessing the creative component of the shown contemporary dance. Raters with dance choreography experience rated creativity higher. The practical significance and prospects for further research lies in the possibility of using the developed methodology to study the problem of creativity not only in modern dance, but also in other varieties. The prospects are also that it is possible to study the peculiarities of the formation of creativity in modern dance, not only in China but also in other countries.

Retraction: Evaluating creativity in contemporary dance: a consensual approach towards research on the practice in China

This article refers to:RETRACTED ARTICLE: Evaluating creativity in contemporary dance: a consensual approach towards research on the practice in China

Implementation of ultrasound after central venous catheter insertion: A qualitative study in early adopters.

The adoption rate of point of care ultrasound (POCUS) for the confirmation of central venous catheter (CVC) positioning and exclusion of post procedure pneumothorax is low despite advantages in workflow compared to traditional chest X-ray (CXR). To explore why, we convened focus groups to address barriers and facilitators of implementation for POCUS guided CVC confirmation and de-implementation of post-procedure CXR. We conducted focus groups with emergency medicine and critical care providers to discuss current practices in POCUS for CVC confirmation. The semi-structured focus group interview guide was informed by the Consolidated Framework for Implementation Research (CFIR). We performed qualitative content analysis of the resulting transcripts using a consensual qualitative research approach (NVivo software), aiming to identify priority categories that describe the barriers and facilitators of POCUS guided CVC confirmation. The coding dictionary of barriers and facilitators consisted of 21 codes from the focus group discussions. Our qualitative analysis revealed that 12 codes emerged spontaneously (inductively) within the focus group discussions and aligned directly to CFIR constructs. Common barriers included provider influences (e.g. knowledge and beliefs about POCUS for CVC confirmation), external network (e.g. societal guidelines, ancillary staff, and consultants), and inertia (habit or reflexive processes). Common facilitators included ultrasound protocol advantage and champions. Time and provider outcomes (cognitive offload, ownership, and independence) emerged as early barriers but late facilitators. Our qualitative analysis demonstrates real and perceived barriers against implementation of POCUS for CVC position confirmation and pneumothorax exclusion. Our findings discovered organizational and personal constructs that will inform development of multifaceted strategies toward implementation of POCUS after CVC insertion.

Athletic Training Educators' ConferenceApril 29–May 1, 2021

Athletic Training Educators' ConferenceApril 29–May 1, 2021

Contributor Factors for Psychological Well-Being: A Qualitative Study of Teachers' Perspective in Malaysia

Universally, the educational systems are undergoing restructuring and transformations. The role of teachers has increased following this reformation and experiencing growing pressure to perform. Given that the nature of the teaching profession is both challenging and rewarding, it is vital to understand teachers' psychological well-being to support the mental health of this population. This study aimed to understand better the subjective perspectives regarding the contributor factors to psychological well-being among teachers. A consensual qualitative research approach was adopted in this study by collecting data through in-depth, semi-structured interviews. Interviews are used to understand the participants' narrative descriptions in-depth and uncover the meaning of their experiences, beliefs, and values. Seven Malaysian teachers were recruited from local school settings through purposive sampling. Data analysis involved an open-coding process in deriving themes from the participants' responses. Findings revealed five themes that indicate contributor factors for psychological well-being: positive attitudes, spiritual convictions, family and friends' support, personal growth, and personal responsibility. The practical implications of teachers' psychological well-being, mental health and psychotherapy practice, and future research were also discussed in this work.