Descriptive Exploratory Study Research Articles

An investigation into the acceptability, adoption, appropriateness, feasibility, and fidelity of implementation strategies for birth companionship in Tehran: a qualitative inquiry on mitigating mistreatment of women during childbirth

BackgroundA birth companion is a powerful mechanism for preventing mistreatment during childbirth and is a key component of respectful maternity care (RMC). Despite a growing body of evidence supporting the benefits of birth companions in enhancing the quality of care and birth experience, the successful implementation of this practice continues to be a challenge, particularly in developing countries. Our aim was to investigate the acceptability, adoption, appropriateness, feasibility, and fidelity of implementation strategies for birth companions to mitigate the mistreatment of women during childbirth in Tehran.MethodsThis exploratory descriptive qualitative study was conducted between April and August 2023 at Valiasr Hospital in Tehran, Iran. Fifty-two face-to-face in-depth interviews were conducted with a purposive sample of women, birth companions, and maternity healthcare providers. Interviews were audio-recorded, transcribed verbatim, and analyzed using content analysis, with a deductive approach based on the Implementation Outcomes Framework in the MAXQDA 18.ResultsParticipants found the implemented program to be acceptable and beneficial, however the implementation team noticed that some healthcare providers were initially reluctant to support it and perceived it as an additional burden. However, its adoption has increased over time. Healthcare providers felt that the program was appropriate and feasible, and it improved satisfaction with care and the birth experience. Participants, however, highlighted several issues that need to be addressed. These include the need for training birth companions prior to entering the maternity hospital, informing women about the role of birth companions, assigning a dedicated midwife to provide training, and addressing any physical infrastructure concerns.ConclusionDespite some issues raised by the participants, the acceptability, adoption, appropriateness, feasibility, and fidelity of the implementation strategies for birth companions to mitigate the mistreatment of women during childbirth were well received. Future research should explore the sustainability of this program. The findings of this study can be used to support the implementation of birth companions in countries with comparable circumstances.

Evaluating the new family medicine internship programmes in the Western Cape, South Africa

Background: In 2021, South Africa introduced a new 6-month internship in family medicine and primary care. This study aimed to assess the new rotation at district health facilities in the Western Cape.Methods: A descriptive survey of interns and supervisors, as phase-two of an exploratory sequential mixed methods study. Questionnaires were developed from a descriptive exploratory qualitative study. Data were analysed with the Statistical Package for Social Sciences.Results: Questionnaires were completed by 72 interns (response rate 21%) and 36 supervisors (response rate 90%), across 10 training programmes. Interns felt more independent (97.2%), confident (90.3%) and resilient (91.6%). They learnt to manage undifferentiated and chronic conditions (91.6%), to refer patients (94.3%) and conduct procedures (77.8%). Most interns were not exposed to community-based services (68.0%) and continuity of care (54.1%). Supervision was mostly adequate during the day (79.1%) and afterhours (80.6%). Many interns reported no structured teaching programme (41.7% – 55.6%). Most supervision was from medical officers and registrars. Supervisors saw interns as valuable members of the clinical team (100.0%), who required extra support and administration (42.5%). The majority of interns (75.0%) and supervisors (72.7%) thought the rotation was the right length and the best preparation for community service (67.6%).Conclusion: The rotation met most expectations of the Health Professions Council of South Africa. Programmes need to improve exposure to community-orientated primary care, public health medicine, palliative and ongoing care. Supervision and orientation of interns needs improvement.Contribution: This is the first evaluation of the new family medicine internship programme in South Africa.

Socio-technical transitions towards sustainable development: A proposal for learning assessment in livestock SMEs in the semi-arid Pampas of Argentina

The urgency to achieve the Sustainable Development Goals in the face of climate change has increased interest in studies on innovation niches in food systems. Strategic Niche Management in the framework of the Multi-Level Perspective considers that deep learning must be achieved in experimenting with innovations and demands greater understanding of instrumental aspects to guide the evolution of a niche. This study proposes to assess the progress of innovative performance towards sustainability of small and medium livestock enterprises in the Southwest of Buenos Aires, a fragile region of the Pampas biome of Argentina, as a result of learning generated in rural extension activities of the National Institute of Agricultural Technology (INTA) in order to identify leverage points in the process of technological change towards more sustainable systems. An exploratory-descriptive study was carried out using qualitative-quantitative methods. Ten producers were interviewed and the MESMIS method was proposed for the construction of indicators and assessment of learning goals towards sustainability. A rapprochement of producers from modal practices to more innovative ones was observed, reflecting conditions for the progress and consolidation of the niche. However, they need for greater professionalization and institutional articulation. The study generated a measurement instrument for the self-assessment of the niche enterprises and the planning of INTA's intervention strategies. It sought to broaden empirical research in Latin America, which is still scarce in approaches to socio-technical transitions, and to advance in the evaluation of experiments in transformative innovations on the agenda for the literature.

Practices developed by midwives from territory da Bocaina to assist women in the puerperal pregnancy period

The objective of this study is to describe the cultural practices used by midwives from Traditional Communities in the territory of Bocaina to assist women in the puerperal pregnancy period. It is a descriptive exploratory study with a qualitative approach. Data were collected from April to November 2022, based on semi-structured interviews with midwives in these communities. Data analysis was performed using the Bardin content analysis method. It was observed that the midwives in this territory have different knowledge, but all of them pass through empirical and traditional knowledge. Despite the advancement of science, knowledge, traditions and culture are still practices that they exercise and that are intertwined with mythical-religious affair, especially when it comes to the assistance provided to women in the puerperal pregnancy period. Its cultural practices are the main methods for assisting women in the puerperal pregnancy period, highlighting the use of medicinal plants, sympathies and blessings. It is concluded that midwives, in fulfilling their role, play an important role in health care in their community, especially in women's health.

Application of artificial intelligence in hypertension.

Hypertension is an important modifiable risk factor for morbidity and mortality associated with cardiovascular disease. The incidence of hypertension is increasing not only in Korea but also in many Western countries due to the aging of the population and the increase in unhealthy lifestyles. However, hypertension control rates remain low due to poor adherence to antihypertensive medications, low awareness of hypertension, and numerous factors that contribute to hypertension, including diet, environment, lifestyle, obesity, and genetics. Because artificial intelligence (AI) involves data-driven algorithms, AI is an asset to understanding chronic diseases that are influenced by multiple factors, such as hypertension. Although several hypertension studies using AI have been published recently, most are exploratory descriptive studies that are often difficult for clinicians to understand and have little clinical relevance. This review aims to provide a clinician-centered perspective on AI by showing recent studies on the relevance of AI for patients with hypertension. The review is organized into sections on blood pressure measurement and hypertension diagnosis, prognosis, and management.

Understanding Metaphors: A Study with Portuguese 4-6 Year-old Children

We present the first metaphor comprehension data from 36 Portuguese children aged 4, 5 and 6, using the TCM Júnior, a metaphor comprehension test for young children, in its European Portuguese version. This is an exploratory descriptive study, with a view to collecting data, contributing to the measurement and standardization of the resource used. TCM Júnior is an adaptation of its corresponding Italian acronym, which is in the process of being validated for the Portuguese population in this age group (4 to 6 years old). We describe the resource used, the TCM Junior, Metaphor Comprehension Test for 4-6 years old and the results obtained with a sample. The instrument used is in the process of gauging, or external validation that is, meeting normative data, although it is already subject to adaptation procedures, as it is an original test in Italian. In this study, 36 participants of both sexes participated. Although still incipient, because there are still few data, with groups by age and sex that are not equitable and significant, the results are promising. We will report on the data obtained and analyzed. Although still preliminary and exploratory, with a sample that is still not very representative and significant, the results appear to be not very distant from the averages obtained by their Italian counterparts. Keywords: metalinguistic awareness, understanding, figurative language, metaphors, TCM junior

Identifikasi Ektoparasit pada Kelelawar di Gua Kenculit Desa Mekar Sari Kabupaten Lombok Tengah

Kenculit cave is one of the caves in the southern region of Lombok Island which is known as a habitat for several types of small mammals, one of which is bats (order Chiroptera). The problem is that bats are one of the mammals that act as hosts for ectoparasites. The aim of the research was to determine the types of ectoparasites in bats in the kenculit cave in Mekar Sari Village, West Praya District, Central Lombok Regency. This type of research is an exploratory descriptive study designed using direct observation. The bat sampling technique uses the trapping method. Meanwhile, ectoparasite samples were taken by combing the bat's hair and then observing using a stereo microscope. Based on the research results, it shows that there are 3 types of ectoparasites from 2 different bat species, namely Taphozous melanopagon with 1 type of ectoparasite (Amblyomma sp.), and the Miniopterus pusillus bat species found with 2 types of ectoparasite (Cyclopodia sp. and Ancystropus sp.).

Critical care nurses’ experiences of communication- vulnerable patients in the intensive care unit and the influence on rendering compassionate care

Background. Interventions administered to critically ill patients, including mechanical ventilation, sedation or other treatments may hinder communication between patients and nurses. These communication challenges may affect critical care nurses’ ability to provide compassionate, person-centred care. Objective. To identify nurses’ experiences with patients who are communication-vulnerable in the intensive care unit and how they affect nurses’ ability to offer compassionate care. Method. This qualitative explorative descriptive study involved nurses who worked in intensive care units from four private hospitals in Gauteng, South Africa. Focus groups were conducted with 30 critical care nurses in groups of two to six participants each. Thematic analysis was used to identify themes. Results. Five main themes were identified based on nurses’ reports of their experiences with critically ill patients who experience communication difficulties and their impact on rendering compassionate care. Themes were deductively identified based on the social purposes of communication categories. Participants indicated that communication-vulnerable patients influence their ability to provide compassionate care. Generally, the physical, emotional, social and communication difficulties of assisting communication-vulnerable patients caused nurses to feel frustrated and negative towards their work environment, which added to their work stress and sometimes resulted in compassion fatigue. Conclusion. The study shows that various factors could impact the nurses’ ability to provide compassionate care and that they require support to provide person-centred care. These factors can include the physical environment, the patient’s alertness and awareness and institutional barriers. To support nurses in providing compassionate care, communication partner training may be warranted.

Data-Driven Decision Support Tool Co-Development with a Primary Health Care Practice Based Learning Network

Background The Alliance for Healthier Communities is a learning health system that supports Community Health Centres (CHCs) across Ontario, Canada to provide team-based primary health care to people who otherwise experience barriers to care. This case study describes the ongoing process and lessons learned from the first Alliance for Healthier Communities’ Practice Based Learning Network (PBLN) data-driven decision support tool co-development project. Methods We employ an iterative approach to problem identification and methods development for the decision support tool, moving between discussion sessions and case studies with CHC electronic health record (EHR) data. We summarize our work to date in terms of six stages: population-level descriptive-exploratory study, PBLN team engagement, decision support tool problem selection, sandbox case study 1: individual-level risk predictions, sandbox case study 2: population-level planning predictions, project recap and next steps decision. Results The population-level study provided an initial point of engagement to consider how clients are (not) represented in EHR data and to inform problem selection and methodological decisions thereafter. We identified three initial meaningful types of decision support, with target application areas: risk prediction/screening, triaging specialized program referrals, and identifying care access needs. Based on feasibility and expected impact, we started with the goal to support earlier identification of mental health decline after diabetes diagnosis. As discussions deepened around clinical use cases associated with example prediction task set ups, the target problem evolved towards supporting the upstream task of organizational planning and advocacy for adequate mental health care service capacity to meet incoming needs. Conclusions This case study contributes towards a tool to support diabetes and mental health care, as well as lays groundwork for future CHC EHR-based decision support tool initiatives. We share lessons learned and reflections from our process that other primary health care organizations may use to inform their own co-development initiatives.

Perceptions and Experiences of Inequity for Women of Refugee Background Having a Baby during the COVID-19 Pandemic in Melbourne, Australia.

Listening to What Matters is an exploratory descriptive qualitative study that aimed to (1) understand how women of refugee background in Melbourne, Australia experienced access to health information and maternity and/or early parenting care during the COVID-19 pandemic and (2) whether pandemic health directives had an impact on structural inequities for women of refugee background who received maternity and/or early parenting care during the COVID-19 pandemic. Semi-structured interviews were conducted with 41 participants including 17 women of refugee background, who identified as belonging to the Karen, Assyrian Chaldean, Iraqi, Syrian, Afghan, Sudanese, or South Sudanese communities and 24 health and social care professionals who identified as providing pregnancy or early parenting care during the pandemic in the north western suburbs of Melbourne. Interviews with women were conducted in preferred languages by community researchers. Interviews with professionals were conducted in English by researchers. Reflexive thematic data analysis included constructivist positionality and a trauma and violence informed approach. The results reported in this paper include three themes, with four accompanying subthemes, as follows: theme (1), 'Structural inequities and the toll of the pandemic'; theme (2), 'Supportive infrastructure'; and theme (3), 'Cultural safety during the pandemic'. The results demonstrate that cumulative negative impacts such as unequal access to health information, family separation and isolation, inadequate household income, and mental and social health concerns had the potential to amplify pre-existing structural inequities for women of refugee background. Community engagement facilitated by bicultural workers, interpreters, and trusted care providers facilitated fast-paced, two-way communication that built capacity and health literacy for women who were unable to speak English and unfamiliar with the health care system and, improved experiences of care. More research is needed to understand how the intersectional cumulative impacts of structural inequities have affected maternal and neonatal health outcomes for women of refugee background during the pandemic, as well as any differences in maternal and neonatal health outcomes between Australian-born and refugee background women and babies.

Community perceptions, beliefs and factors determining family planning uptake among men and women in Ekiti State, Nigeria: finding from a descriptive exploratory study

ObjectivesTo examine family planning through the community’s perception, belief system and cultural impact; in addition to identifying the determining factors for family planning uptake.DesignA descriptive exploratory study.SettingThree communities were selected...

Registrars' experience with research in family medicine training programmes in South Africa.

Completion of a research assignment is a requirement for specialist training in South Africa. Difficulty with completion delays graduation and the supply of family physicians. The aim of this study was to explore the experience of registrars with their research in postgraduate family medicine training programmes. An explorative descriptive qualitative study. Extreme case purposive sampling selected registrars who had and had not completed their research on time, from all nine training programmes. Saturation was achieved after 12 semi-structured interviews. The framework method was used for data analysis, assisted by ATLAS.ti software. The assumption of prior learning by teachers and supervisors contributed to a sense of being overwhelmed and stressed. Teaching modules should be more standardised and focussed on the practical tasks and skills, rather than didactic theory. Lengthy provincial and ethics processes, and lack of institutional support, such as scholarly services and financial support, caused delays. The expertise of the supervisor was important, and the registrar-supervisor relationship should be constructive, collaborative and responsive. The individual research experience was dependent on choosing a feasible project and having dedicated time. The balancing of personal, professional and academic responsibilities was challenging. Training programmes should revise the teaching of research and improve institutional processes. Supervisors need to become more responsive, with adequate expertise. Provincial support is needed for streamlined approval and dedicated research time.Contribution:The study highlights ways in which teaching, and completion of research can be improved, to increase the supply of family physicians to the country.

Exploring experiences of HIV care to optimize patient-centred care in Conakry, Guinea: a qualitative study.

Studies on the organisation of care and the power dynamic between providers and patients with HIV in sub-Saharan Africa are rare. This study aims to describe the patient-provider relationship and explore the challenges to optimal and patient-centred care for HIV patients. This was a qualitative exploratory descriptive study using in-depth individual interviews and focus group discussions. In total, 17 individual interviews and 5 focus group discussions were conducted. This was conducted in four urban health facilities in Conakry, the capital of Guinea. Three group of participants were included in this study namely patients with HIV; health providers including facilities and services managers; and psychosocial counsellors. Psychosocial counsellors provide emotional and psychosocial support to HIV patients. Their role in the organization care in Guinea is new and they contribute to strengthening adherence of patients with HIV to ARV treatment. Patients with HIV, health providers, and psychosocial counsellors have a positive perception of the patient-provider relationship. This relationship was characterized essentially by maintaining confidentiality of HIV status disclosure, caring attitudes towards patients (being available, adjusting locations for accessing ART, based on patients' preferences), and participating in HIV patient's social life. However, scolding and miscommunication about the interpretation of viral load tests were reported. The shortage of human resources, low salaries of health staff, poor infrastructure, and the financial burden borne by patients with HIV impede the implementation of optimal patient-centred care. Integrating psychosocial counsellors in HIV care organization, improving access to ARV, infrastructure, increasing human resources, and removing the financial burden for HIV patients are needed to optimal patient-centred care in Guinea.

Parental experiences in navigating health services for paediatric residual obstructive sleep apnoea: An exploratory qualitative descriptive study.

To explore parents' experiences and perceptions regarding engagement in health services for managing residual paediatric obstructive sleep apnoea (OSA) across levels of care. Qualitative description guided study design. Data were collected through semi-structured interviews with parents of children diagnosed with residual OSA at a university-based sleep clinic. The relevant literature informed the interview guide and was piloted before data collection. Inductive, manifest content analysis was used to describe parents' perceptions and experiences using data-driven categories and sub-categories. Several strategies were employed to ensure rigour in this study. Eight interviews were conducted. Parents' views were organized into five categories: awareness of the sleep issue, interaction with non-sleep specialists, interaction with sleep specialists, interaction with dental professionals, and further actions and support. Parents reported several engagement issues due to their interactions with different care providers. These issues included having to personally identify and raise the sleep problem, feeling that care providers did not take this problem seriously, waiting for an extended period to be referred for sleep services, and receiving conflicting or insufficient treatment recommendations. Overall, parents perceived that their actions and the services received across levels of care were not effective enough to address paediatric OSA. Based on this exploratory qualitative descriptive research, along with developing evidence-based clinical guidelines for paediatric OSA screening and management tailored to different levels of care, strategies intended to improve the engagement of patients and care providers in addressing paediatric OSA should be developed and empirically tested.

Singapore nurses’ perception of professional identity

Introduction: Nurses’ professional identity is important for their career orientation and clinical practice. This study explored Singaporean nurses’ perceptions of professional identity. The results provide an understanding of how guided learning and reflection could help nurses in their professional identity formation and development. Methods: Using an exploratory descriptive qualitative research study and purposive sampling by researchers teaching in the programme, 64 Registered Nurses with a diploma qualification pursuing a Bachelor of Science degree with Honours in Nursing programme in Singapore were invited to participate. They responded to open ended survey questions online, which were analysed using a thematic analysis. Ethical approval was obtained. Results: All 64 first year students were invited to participate at the start of the module and upon the completion. The response rates were 94% and 81% respectively. Two overarching themes – “nurses as professionals with knowledge and moral character” and “the construction of professional identity” - emerged from the data. Conclusion: The nurses perceived their professional nursing identity as a construct comprised of knowledge and moral characteristics, which is consistent with international literature. A professional nursing identity, relationships with other healthcare professionals, patients and confidence in practice were all interrelated. Guided reflection and discussion on clinical experiences and social interactions helped students become aware of their professional identity and responsibilities. Such purposive educational effort needs to be started early and supported through the students’ educational journey into clinical practice. Keywords: Professional Identity of Nursing, Singapore Nurses, Image of Nursing, Social Perception of Nursing in Singapore, Nurse Education

Audiobooks cabins project )Masmooa( in the Kingdom of Saudi Arabia: An exploratory descriptive study

Audiobooks cabins project )Masmooa( in the Kingdom of Saudi Arabia: An exploratory descriptive study

An assessment of information seeking behavior of agricultural agents to retrieve need-based information in Sidama regional state of Ethiopia

The objective of the current study was to assess the levels of access of agricultural agents in the Sidama Region to agriculture-specific information from researchers and the media and its effect on their confidence in communicating with farmers. The capacity of trained professionals through educational institutions is crucial to empowering rural communities. As a result, up-to-date knowledge is crucial to leverage the agricultural sector since there could be changes in innovations, science, and technologies. To understand such status quo, In the study circumstances, an exploratory sequential mixed design descriptive study was employed. Cluster random sampling was used, and two samples of districts from the region were identified. In-depth interviews, focus groups, and questionnaires were used to gather the data. Based on reoccurring themes, the transcribed qualitative material was documented, classified, and subjected to a thematic analysis. Besides, data obtained from the questionnaire were analyzed using SPSS. The finding indicates that the agents had poor information-seeking behavior. In addition, the agricultural agents had less access to various sources of information including low access to researchers, media and the Internet. Moreover, the agents were dissatisfied with the nature and regularity of the training provided. With the possible influence of lack of access to information and low interaction with researchers, agents' confidence in communicating farm topics to farmers was also found to be less than expected. A significant positive correlation was also found between agent confidence, research linkage, media access, and information-seeking behavior. Above all, development agents were not driven to speak with researchers, explore media sources for information on agriculture, or converse with colleagues about agricultural matters; this showed that most agents merely had basic college-level knowledge. Agents' confidence in speaking with farmers could be strengthened with improved research linkage, media access, and encouragement to seek information.

Interventions for Type 2 Diabetes reduction among older people living with HIV in Harare.

Interventions for Type 2 Diabetes reduction among older people aged more than 50 years living with HIV (PLWH) are pertinent as they face excess risks amid a growing population of ageing PLWH. To describe interventions for Type 2 Diabetes reduction among older people living with HIV in Harare Urban DistrictSetting: The study was conducted in a low socio-economic setting from five primary health care clinics in Harare urban District. A qualitative multi-method approach was applied using an exploratory descriptive design and an integrative review literature. The exploratory descriptive study collected data from two purposively selected samples; (1) older PLWH and (2) nurses. Whittemore and Knafl's framework was used for the integrative literature review with articles from 2013 to 2023 selected. Data source triangulation was applied using Braun and Clark's content analysis framework. Ethical approval was obtained (14056739_CREC_CHS_2022). 23 older PLWH with mean age, 62 years, 9 nurses with an average of 6 years' experience and 12 articles comprised the three data sources. Key themes that emerged were that, screening should include; assessment from a younger age; assessment of HIV and ART-specific risks; diagnostic testing of Type 2 diabetes tests at ART initiation and routinely. Health education should provide information on adequate physical activity parameters and increased consumption of fruits and vegetables. Metformin may be considered as a pharmacological intervention where lifestyle interventions fail. The proposed interventions suggest measures to reduce Type 2 Diabetes and mitigate excess risks faced by older PLWH.Contribution: Improved screening, health education and pharmacological interventions for older PLWH in primary health care settings enable Type 2 Diabetes reduction.

Quantifying emergency department nursing workload at the task level using NASA-TLX: An exploratory descriptive study

BackgroundEmergency departments (ED) nurses experience high mental workloads because of unpredictable work environments; however, research evaluating ED nursing workload using a tool incorporating nurses’ perception is lacking. Quantify ED nursing subjective workload and explore the impact of work experience on perceived workload. MethodsThirty-two ED nurses at a tertiary academic hospital in the Republic of Korea were surveyed to assess their subjective workload for ED procedures using the National Aeronautics and Space Administration Task Load Index (NASA-TLX). Nonparametric statistical analysis was performed to describe the data, and linear regression analysis was conducted to estimate the impact of work experience on perceived workload. ResultsCardiopulmonary resuscitation (CPR) had the highest median workload, followed by interruption from a patient and their family members. Although inexperienced nurses perceived the ‘special care’ procedures (CPR and defibrillation) as more challenging compared with other categories, analysis revealed that nurses with more than 107 months of experience reported a significantly higher workload than those with less than 36 months of experience. ConclusionAddressing interruptions and customizing training can alleviate ED nursing workload. Quantified perceived workload is useful for identifying acceptable thresholds to maintain optimal workload, which ultimately contributes to predicting nursing staffing needs and ED crowding.

Evaluation of educational activity in a district reference unit: perception of pregnant women

Introduction: Health education during prenatal care is crucial for the knowledge and empowerment of families, but studies show gaps in this service. Courses and groups for pregnant women have been useful in disseminating information about childbirth practices. Objective: To identify the perception of pregnant women about the Pregnancy and Companion Courses offered by Obstetric Nursing residents in a District Reference Unit (URD) ​​in the Federal District. Methodology: Exploratory descriptive study with a qualitative approach. Results: Of the eleven interviewees, the majority are between 30 and 40 years old and married. Most of them are not linked to the study's URD and receive assistance from private health services. They are all first-time mothers and this is the first Pregnancy Course they have attended. The most highlighted information in the course were the phases of labor and the changes in the parturient woman's body during this process. Final considerations: Obstetric Nursing residents train pregnant women and companions, promoting the humanization of childbirth and transforming the families' experience. This helps to demystify outdated beliefs and prepare them for eventualities.