Descriptive Exploratory Study Research Articles

Educators' perception of oral health in children's schools in Brazil

This study aimed to explore educators' perceptions regarding oral health promotion and the application of Atraumatic Restorative Treatment in the school environment. It is an exploratory descriptive observational study with a qualitative approach. The sample consisted of 18 educators from an Early Childhood Education Center. For data collection, a form was used with open and closed questions about oral health care for children: recreational and educational activities, supervised brushing and Atraumatic Restorative Treatment. Data were analyzed by descriptive analysis and by the Discourse of the Collective Subject. About 60% of educators considered caries a disease, 50% having observed toothache in children in the school environment. The educators considered the educational/preventive activities and the use of Atraumatic Restorative Treatment beneficial to the children. They reported relevance in oral health prevention and promotion actions carried out in the school environment, observing the generation of autonomy and empowerment in children. They also cited a favorable opinion on the use of Atraumatic Restorative Treatment.

Online Learning Method in COVID-19 Pandemic: The Perspectives, Opportunities, and Challenges of Nursing Students in Aceh, Indonesia: An Exploratory Descriptive Study

The Covid-19 virus pandemic caused a significant impact on communities’ life and their activities throughout the world. The Covid-19 pandemic also had a significant effect on the education system in Indonesia and requires all teaching and learning activities for students to be carried out by virtual or online learning method. Aim: This study was to explore online learning methods' perceptions, opportunities, and challenges in the COVID-19 pandemic among nursing students. Method: A descriptive explorative study was implemented with a cross-sectional design. The study was conducted on 276 nursing students in Aceh, Indonesia. The data were collected using a 5-point Likert scale and the standardized Online Learning Perception Scale (OLPS) and Opportunities and Challenges Online Learning (OCOL) questionnaires. The reliability test of the questionnaires were indicated by Cronbach alphas of 0.89 and 0.90, respectively. Result: The study results showed that 50.4% of the nursing students have positive perceptions about the online learning method, 51.4% of the students believe that online learning offers high opportunities, and 50.4% of students think that the online learning method is highly challenging. It showed more than 50% of the students have significant on the positive perceptions, high opportunities, and challenges in learning method. Conclusion: The positive perception, high opportunities, and challenges towards online learning methods among nursing students is the result of a study that proved the benefits of online learning methods which can be used as an alternative for students to achieve learning goals, especially during the COVID-19 pandemic. Positive perceptions from students towards online learning methods can be encouragement and strength for one of the online-based learning methods and could also be proven by the high opportunities and challenges students in this online learning method.

Daugiaperspektyvinė interpretacinė ir fenomenologinė slaugytojų streso ir minčių kontrolės analizė Jungtinėje Karalystėje, Jungtinėse Amerikos Valstijose ir Šveicarijoje

Background. Nurses constitute a worldwide community of human resources committed to critical care. They are exposed to stress and intruding thoughts so they are at the risk of poor performance. The study aimed to ask experts about how can nurses manage stress effectively in Asian developing countries.
 The aim. To explore stress management skills for nurses to be applied in developing Asian countries through the personal lived experience of experts from developed countries. Multiperspectival Interpretive Phenomenological Analyses (MIPA) are performed case by case and across the participants to establish convergence and divergence.
 Methods. This experiential exploratory descriptive qualitative study was carried out by conducting semi-structured interviews with experts residing, educated, and professionally practising in the United States of America, United Kingdom, and Switzerland, with a purposing sample of 11 stress experts who were subjected to interpretative phenomenological analysis (IPA). The current study uses HyperResearch software v.4.5.4 and also uses qualitative criteria (Lincoln & Guba, 1985) to increase data rigour and the Graneheim and Lundman method to analyse content (Graneheim & Lundman, 2004).
 Results. The research data showed 102 codes, 4 experiential statements, and 15 personal experiential themes/subcategories. Strategies for stress management and thought control include the practiceof mindfulness and meditation through mindfulness-based stress reduction courses, mindfulnessbased cognitive therapy courses; and the conduction of mindfulness-based organisational education on a larger scale. Nurses can beneft from thought labelling, and cognitive defusion to challenge automatic thoughts. Systematically, nursing management can improve through intervision, on-the-job support, and balance of power gradient. Nurses must adopt stress relief strategies such as practicing self-compassion, yoga, the method of active noticing, rational emotive behaviour skills, afrmations, and acceptance.
 Conclusion. Nurses face stress in daily life. Continuous and practical methods of stress management are important and contribute to stress reduction for them. It is essential for nurses to practice mindfulness, meditation, thought control, and stress relief processes to work optimally.
 Keywords: stress management, thought control, nursing, psychology, qualitative.

Interventions to improve young men’s utilisation of HIV-testing services in KwaZulu-Natal, South Africa: perspectives of young men and health care providers

Introduction: HIV-testing services (HTS) are an important point of entry to prevention and treatment of HIV in South Africa. Despite the availability of HTS across the region and in SA, the uptake among men remains low, especially young men residing in rural and peri-urban communities. This study aimed to explore interventions that could improve the uptake of HTS among young men in KwaZulu-Natal. Methods: A descriptive exploratory qualitative study was conducted in which 17 young men and two health care providers in Ladysmith were purposively and conveniently sampled. Data were collected through semi-structured interviews using WhatsApp and landline audio calls between September and December 2021 and thematically analysed. Results: An improvement in the health care provider attitudes and service delivery, establishment of adherence clubs for young people living with HIV, ensuring a diverse and balanced health care provider staff composition at primary health care facilities, and increased demand creation in spaces frequented by men are vital for enhancing access and utilisation of HTS among young men. Additionally, health care providers believe that the presence of male health care providers, investment in health education, prioritising men in the morning at the primary health care facilities, and the establishment of male clinics within communities as key factors in improving the uptake of HTS among young men. Conclusion: To attract and retain young men in HTS and in HIV treatment and care, several improvements at primary health care facilities need to be implemented. These should focus on addressing the specific needs and preferences of young men, ensuring their comfort and engagement in health care.

Evaluating a sexual and reproductive health education program in Mozambique: A mixed method study

Background: Early and inappropriate messages regarding sexuality and marriage taught during adolescent initiation rituals teachings in Mozambique are considered a determinant of high rates of early marriage, adolescent pregnancy, and maternal mortality. The Alert Community for a Prepared Hospital implementation research project in Natikiri, Nampula, Mozambique (2016-2020) identified adolescent initiation rituals counsellors and traditional authorities as pertinent agents to provide sexual and reproductive health education to adolescents during the initiation rituals. Objective: Develop, apply, evaluate, and disseminate a modern, transformative education tool, about sexual and reproductive health and rights, for counselors to use with adolescents during initiation rituals in Northern Mozambique. Methods: This is an exploratory descriptive and intervention study, using mixed method approaches. Findings: Results suggest, the education tool was well accepted by rituals counsellors, community leaders and the adolescents who attended the initiation rituals. It was shown to improve adolescent’s knowledge and lead to a positive behaviour change in sexual and reproductive health and rights. Conclusions: This intervention may be replicated at a national level with a low cost and significantly contribute to reducing adolescent pregnancy and early marriages and improving maternal and child health.

Evaluation of Leadership Training and Resilience Development Outcomes during the COVID-19 Pandemic

ABSTRACT Human service organizations can support leaders through training to become resilient, adaptive, and innovative during rapid complex changes. This qualitative descriptive exploratory research study reports findings on a leadership resilience training program using online evaluation surveys of 56 directors and managers in a large Canadian not-for-profit mental health/substance abuse agency. Thematic data analysis and descriptive statistics revealed positive training outcomes on four levels: satisfaction; knowledge/skills; work/team performance; and organizational resilience/sustainability. Leaders identified adaptive, resilient, and authentic leadership styles, clan/adhocracy organizational cultures, psychological safety and innovation, and organizational preparedness as important to successfully manage the pandemic and future extraordinary organizational challenges.

Exploring perceptions of frailty, resilience, and self-efficacy in older adults and caregivers in acute care context.

This study aimed to explore the experience and perceptions of frailty in hospitalized older adults and caregivers caring for older adults, in relation to resilience and self-efficacy. A qualitative explorative descriptive study design was utilized. Face to face interviews were conducted from September 2020 to July 2021 with 24 older adults who were 65 years and above and hospitalized in the acute care hospital. Ten informal family caregivers were also recruited. Data were analysed using an inductive content analysis approach. Frailty encompassed physical elements as well as manifestations of psychological traits, fear of the unknown, and being in control. Resilience was determined by individual psychological traits and mindset, and the possession of a coping mechanism. Self-efficacy could influence both frailty and resilience through inner motivation and assistance received. Older adults and family caregivers reported that considerable decline in physical health with age and level of perseverance can determine the level of frailty. Resilience and self-efficacy play a pivotal role in the context of frailty. Understanding resilience in this context will assist nurses to facilitate the use of individual and sociocultural resources to improve the way resilience is experienced by older adults. Various coping strategies can enhance self-efficacy and build greater resilience in older adults, including maintaining their active involvement in health management and social life.

Midwives’ experiences of providing pre-eclampsia care in a low- and middle-income country – A qualitative study

ProblemLike other low- and middle-income countries, Ghana has high maternal mortality stemming from pre-eclampsia. Ghanaian midwives are frontline service providers of emergency care in obstetric complications and have the greatest potential to maximise pre-eclampsia outcomes. Little is known about the potential barriers and challenges to midwives' capacity to provide quality care in pre-eclampsia in Ghana. Therefore, we aimed to explore and gain insights into midwives’ experiences of pre-eclampsia care including their knowledge, skills, and psychological aspects such as midwives' resilience. BackgroundThere is a rising global incidence of pre-eclampsia. Quality midwifery care in inter-professional collaborative practice is crucial to reducing pre-eclampsia-related morbidity and mortality. MethodsA qualitative descriptive exploratory study. In-depth semi-structured interviews (n = 35) were performed in 2021 and analysed by thematic analysis. FindingsThere were three main themes. 1) Competence and Confidence in care; midwives provided timely and appropriate care based on sound knowledge and skills; they explained how pre-eclampsia care was organised within a multidisciplinary context and described collaborative working amongst midwives for mutual learning and support. 2) Emotional concerns and empathy; midwives’ described fulfillment in achieving positive pre-eclampsia outcomes. In contrast, maternal loss was distressing and traumatic. 3) Call for improved care resources for pre-eclampsia; midwives recommended expansion of continuing professional development opportunities, appropriate infrastructure, resources, tailored public education, and a review of pre-service education to support their participation in pre-eclampsia care. ConclusionTo improve the quality of care in pre-eclampsia, midwives should be capacitated, systems should promptly address barriers, and prioritise midwives’ emotional well-being.

"What will the doctor give me, the same painkiller?": a qualitative study exploring health-care seeking and symptoms self-management among patients for the treatment of long-term chikungunya disease, in Curaçao.

Long-term chikungunya disease, characterized by persistent disabling rheumatic symptoms, including poly-arthralgia/arthritis of severe pain intensity, can persist for years after infection with the re-emerging mosquito-borne chikungunya virus. Although persistent symptoms and pain severity are important determinants of health-care seeking and self-management of symptoms, research on these in relation to long-term chikungunya disease is scarce. This study aimed to explore the perceived benefits and perceived barriers concerning health-care seeking, based on the Health Belief Model, and the symptoms self-management strategies used for health outcome improvement among individuals affected by long-term chikungunya disease. An exploratory qualitative descriptive study was conducted with 20 purposively selected adults (17 females and 3 males) with persistent rheumatic symptoms, recruited from an ongoing longitudinal chikungunya cohort, in Curaçao. Semi-structured interviews were carried out, audio-recorded, and transcribed. An iterative coding process was used for themes identification through inductive thematic analyses. No perceived benefits in health-care seeking were reported. Identified themes in relation to perceived barriers were: (1) health-care seeking at disease onset; (2) general practitioners(GPs) perceptions and awareness of persistent symptoms; (3) challenges for medical referrals and support; (4) no validation of symptoms and challenges accessing therapy; (5) health system restrictions; and (6) social stigmatization of psychological help. These perceived barriers have led participants to self-manage persistent symptoms. Over-the-counter pharmacological and/or non-pharmacological treatments were used without consulting GPs. Identified themes were: (1) self-medication of symptoms; and (2) self-management true non-pharmacological treatments. To promote the benefits of long-term health-care seeking and subsequently reduce the possible harmful use of analgesics, a collaborative physician-patient therapeutic relationship need to be encouraged. To facilitate this, important shifts may be needed in chikungunya sequalae education of both patients and health-care professionals, and policy makers need to revise health systems for the long-term provision of multidisciplinary care to achieve beneficial health outcomes in long-term chikungunya disease.

Healthcare Support Personnel’s Understanding of Radiation Safety Measures in Radiology Departments: An Exploratory Descriptive Study

Healthcare Support Personnel’s Understanding of Radiation Safety Measures in Radiology Departments: An Exploratory Descriptive Study

Identification of a specific biomarker panel for early chronic pancreatitis diagnosis: An exploratory prospective descriptive and observational study

Identification of a specific biomarker panel for early chronic pancreatitis diagnosis: An exploratory prospective descriptive and observational study

Describing Anisocoria in Neurocritically Ill Patients.

Anisocoria (unequal pupil size) has been defined using cut points ranging from greater than 0.3 mm to greater than 2.0 mm for absolute difference in pupil size. This study explored different pupil diameter cut points for assessing anisocoria as measured by quantitative pupillometry before and after light stimulus. An exploratory descriptive study of international registry data was performed. The first observations in patients with paired left and right quantitative pupillometry measurements were included. Measurements of pupil size before and after stimulus with a fixed light source were used to calculate anisocoria. The sample included 5769 patients (mean [SD] age, 57.5 [17.6] years; female sex, 2558 patients [51.5%]; White race, 3669 patients [75.5%]). Anisocoria defined as pupil size difference of greater than 0.5 mm was present in 1624 patients (28.2%) before light stimulus; 645 of these patients (39.7%) also had anisocoria after light stimulus (P < .001). Anisocoria defined as pupil size difference of greater than 2.0 mm was present in 79 patients (1.4%) before light stimulus; 42 of these patients (53.2%) also had anisocoria after light stimulus (P < .001). The finding of anisocoria significantly differed before and after light stimulus and according to the cut point used. At most cut points, fewer than half of the patients who had anisocoria before light stimulus also had anisocoria after light stimulus. The profound difference in the number of patients adjudicated as having anisocoria using different cut points reinforces the need to develop a universal definition for anisocoria.

Impact of the COVID-19 pandemic on emergency department team dynamics and workforce sustainability in Australia. A qualitative study

IntroductionThe COVID-19 pandemic has challenged health care professionals and changed our approach to care delivery. The aim in this study was to explore nurses’ experiences providing care in the ED during the COVID-19 pandemic in Australia and the impact of this on ED team functioning. MethodsA qualitative explorative descriptive study was conducted using thematic analysis strategies. Participants comprised: Registered Nurses (n = 18) working in clinical roles in the Emergency Department and Leadership Registered Nurses (n = 6) within the organisation. One on one interviews (n = 21) and one focus group interview were conducted utilising semi-structured, conversational style, in-depth interviews between January 2022 and April 2022. ResultsTwo major themes were identified that described the impact on ED team dynamics and longer-term impacts on the ED nursing workforce. The first major theme was: ‘Changed Emergency Department team identity and dynamics’ and included four sub-themes: i) PPE is a barrier to team camaraderie; ii) outsiders versus insiders – ambivalence to PPE spotter role; iii) personal safety comes first in a pandemic; and iv) using PPE depersonalises the whole patient experience. The second major theme was: ‘This pandemic caught everyone off guard’ and had three sub-themes. The associated sub-themes were: i) People outside ED have no understanding of what it has been like; ii) COVID-19 is here to stay - Permanent changes to care delivery and nursing practice; and iii) tenacity of a true profession. ConclusionsStudy findings illuminated the dynamics and functionality of ED nursing, encompassing the unique qualities of camaraderie, autonomy, resilience and tenacity.

Identification of Coastal Mangroves in the Legend Ecotourism Pademawu District Pamekasan Regency: an Explorative Descriptive Study

Identification of Coastal Mangroves in the Legend Ecotourism Pademawu District Pamekasan Regency: an Explorative Descriptive Study

Patient safety in primary care: application validation Doris - patient safety

Objective: to validate a smartphone application that helps provide guidance on safe care processes when caring for patients in Primary Care. Method: exploratory descriptive study, carried out with eight Primary Care users, who handled the application and carried out its evaluation based on a questionnaire on functionality and usability characteristics. In analyzing the results, the Content Validity Index (CVI) was used. Results: females predominated (seven); age ranged from 21 to 52 years old, with a mean of 34 (SD 9.6 – standard deviation). The majority of people had completed high school education, with 5 being users. As for professional activity, seven carried it out. Most users, seven, were unaware of the subject of Patient Safety and the actions presented by the application. The evaluation of items related to functionality reached CVI 0.97 and items related to usability obtained CVI 1.0. The general assessment reached a satisfactory level with CVI 0.98. Conclusion: the application presented satisfactory results in the user validation process, demonstrating quality in all characteristics evaluated in a real environment.

The neuropathology of intimate partner violence

Lifelong brain health consequences of traumatic brain injury (TBI) include the risk of neurodegenerative disease. Up to one-third of women experience intimate partner violence (IPV) in their lifetime, often with TBI, yet remarkably little is known about the range of autopsy neuropathologies encountered in IPV. We report a prospectively accrued case series from a single institution, the New York City Office of Chief Medical Examiner, evaluated in partnership with the Brain Injury Research Center of Mount Sinai, using a multimodal protocol comprising clinical history review, ex vivo imaging in a small subset, and comprehensive neuropathological assessment by established consensus protocols. Fourteen brains were obtained over 2 years from women with documented IPV (aged 3rd–8th decade; median, 4th) and complex histories including prior TBI in 6, nonfatal strangulation in 4, cerebrovascular, neurological, and/or psychiatric conditions in 13, and epilepsy in 7. At autopsy, all had TBI stigmata (old and/or recent). In addition, white matter regions vulnerable to diffuse axonal injury showed perivascular and parenchymal iron deposition and microgliosis in some subjects. Six cases had evidence of cerebrovascular disease (lacunes and/or chronic infarcts). Regarding neurodegenerative disease pathologies, Alzheimer disease neuropathologic change was present in a single case (8th decade), with no chronic traumatic encephalopathy neuropathologic change (CTE-NC) identified in any. Findings from this initial series then prompted similar exploration in an expanded case series of 70 archival IPV cases (aged 2nd–9th decade; median, 4th) accrued from multiple international institutions. In this secondary case series, we again found evidence of vascular and white matter pathologies. However, only limited neurodegenerative proteinopathies were encountered in the oldest subjects, none meeting consensus criteria for CTE-NC. These observations from this descriptive exploratory study reinforce a need to consider broad co-morbid and neuropathological substrates contributing to brain health outcomes in the context of IPV, some of which may be potentially modifiable.

Users' perception of hesitancy and delay in vaccination in Primary Health Care

Introduction: Vaccination is an extremely important and necessary act from the beginning of a human being's life. Aim: Unveil users' perception of the reasons for hesitancy and delay in vaccination. Outlining: This is an exploratory-descriptive study with a qualitative approach, through the application of a semi-structured interview with users (51) of the Basic Health Units (UBS) in the city of Tianguá – CE, data collection was carried out between November and December 2021, the interviews were transcribed, Bardin's content analysis technique (2016) was used to organize data and the results were presented with the help of the Iramuteq™ software. Results: four thematic categories were identified: 1 – Fear and dread of the adverse effects is a factor in the vaccine refusal, 2 – Challenges in ensuring user accessibility to vaccines, 3 – Users' distrust about the benefits of vaccines and 4 – Lack of information and understanding about the effects of non-adherence to vaccination. It was then found that hesitancy and/or refusal to get vaccinated is motivated by multifactorial aspects, which can influence users' decisions individually or jointly. Implications: Health professionals play a key role in promoting vaccination, being a preferred source of information indicated by users.

Radiology Service Tariff Calculation Model Using the Activity Based Costing (ABC) Method at Naibonat Regional Hospital, Kupang Regency

Determination of health service tariffs also determines optimal health service outcomes. Determination of radiology examination rates at Naibonat Hospital until 2023 still refers to Regional Regulation No. 5 of 2012 concerning public service fees, where the determination of fees still uses the conventional calculation system, and there are changes in image processing modalities, tools, and materials used, this demands a rate adjustment. Calculation of rates using the Activity Based Costing (ABC) method, can be a solution to determine more accurate rates, supported by Pramawati's research (2021) which shows the results of determining rates are more accurate using the ABC method. The purpose of this study was to calculate the tariff pattern for radiological examinations at Naibonat Hospital using the ABC method and obtain an accurate tariff calculation model for radiological examinations. This research is a descriptive explorative study, with a quantitative approach using numerical data which aims to calculate a unit cost-based examination rate model by implementing an Activity Based Costing system on ultrasound examination of the abdomen, chest x-rays, abdomen, skull, and extremities. The data obtained was then subjected to qualitative analysis to obtain the steps for calculating tariffs using the ABC method. The results of this study indicate that the calculation model for radiological examination rates using the ABC method is valid. To find rates, first, determine the basic rate with the formula unit cost = direct cost + overhead, the results obtained are then calculated. Examination rates = cos unit + hospital services, so the examination rates at the Radiology unit of Naibonat Hospital, namely abdominal USG Rp 242.036, photo thorax Rp. 116,995, photo abdomen Rp. 150,321, photoskull Rp. 153,262, and a photo extremity Rp. 121,409.

Physical, Sensorial, and Physicochemical Characteristics of Arabica Coffee Dried under Two Solar Brightness Conditions

The solar drying process is a critical postharvest stage for preserving coffee quality and is widely used in coffee-producing countries. A descriptive exploratory study was carried out in zones with different annual solar brightness to determine the climate variability influence on solar drying. Variables related to the evolution of drying, physical and sensory quality, and the physicochemical characteristics of the Castillo® coffee variety were analyzed. Coffee quality was assessed by means of SCA protocol. An automatic system was designed to record variables inside the dryers and mass loss. The drying rates were different by climatic zone above and below 0.52%∙h−1. Drying time was significantly longer in less solar brightness zones (Wilcoxon test). An inverse linear relationship between rewetting percentage and bean moisture was observed. Regarding coffee quality, the average scores were 81.37 and 80.93 SCA points for the climatic zones with the lowest and highest solar brightness, respectively. The bean color, water activity, acidity, and fat content did not vary between climatic zones. The coffee quality was not affected by solar drying in contrasting climatic conditions, despite the differences in drying time. Solar drying behaviors were identified that allow for the development of strategies for improving the process efficiency and management of coffee.

Metodologias de ensino-aprendizagem para o desenvolvimento de competências de inovação na graduação em enfermagem

Innovation is defined as the act of innovating, a new concept or idea, which aims to improve quality. Innovation skills can be developed during the undergraduate course, through different teaching-learning methodologies. With the aim of listing the methodologies used and correlating them with innovation skills, a quantitative, exploratory-descriptive study was developed with 13 Nursing undergraduate professors. Data collection took place between February and March 2023, with descriptive statistical analysis. As results, from a teaching perspective, there was a correlation of methodologies with potential for the development of innovation skills, with emphasis on simulation, identified as correlated to the nineteen skills listed. It is concluded that in teaching practice, the correlation between the methodologies used and the innovation skills that can be developed in their application was perceived, which constitutes an important contribution to teaching innovation and the teaching of innovation.