Descriptive Exploratory Study Research Articles

Patients' Perspectives on Commencing Oral Anticoagulants in Atrial Fibrillation: An Exploratory Qualitative Descriptive Study.

Oral anticoagulants (OACs) are prescribed to patients with atrial fibrillation (AF) in order to lower stroke risk. However, patient refusal to commence OACs hinders effective anticoagulation. This study aimed to explore barriers and facilitators to patient agreement to commence OACs from the perspectives of patients with AF attending Australian general practices. A qualitative descriptive study utilising semi-structured individual interviews was conducted from March to July 2022. Ten patients (60% male, median age = 78.5 years) completed interviews. Patients' passive roles in decision-making were identified as a facilitator. Other prominent facilitators included doctors explaining adequately and aligning their recommendations with patients' overall health goals, including the prevention of stroke and associated disabilities, and a clear understanding of the pros and cons of taking OACs. Reportedly insufficient explanation from doctors and the inconvenience associated with taking warfarin were identified as potential barriers. Addressing factors that influence patient agreement to commence OACs should be an essential aspect of quality improvement interventions. Subsequent studies should also delve into the perspectives of eligible patients with AF who choose not to commence OACs as well as the perspectives of both patients and doctors regarding the decision to continue OAC treatment.

Exploring Mistreatment of Medical Students by Patients: A Qualitative Study.

Mistreatment of medical students by patients has not been qualitatively explored in the literature. The authors sought to develop a rich understanding of the impact and consequences of medical students' experiences of mistreatment by patients. This exploratory descriptive qualitative study was conducted at a large Canadian medical school from April-November 2020. Fourteen medical students were recruited for semistructured interviews. Students were asked about their experiences of mistreatment by patients and how they responded to these experiences. Transcripts were thematically analyzed using an inductive approach, and the authors interwove critical theory into their conceptual interpretation of the data. Fourteen medical students (median age = 25.5; 10, 71.4% self-reported male; 12, 85.7% self-identified visible minority) participated in this study. Twelve (85.7%) participants had personally experienced patient mistreatment and 2 (14.3%) had witnessed mistreatment of another learner. Medical students described being mistreated by patients based on their gender and race/ethnicity. Although all participants were aware of the institution's official mechanism for reporting mistreatment, none filed an official report. Some participants described turning to their formal (faculty members and residents) and informal (family and friends) social supports to cope with mistreatment by patients. Participants described resenting and avoiding patients who mistreated them and struggling to maintain empathy for, openness to, and overall ethical engagement with discriminatory patients. Students often described a need to be stoic toward their experiences of mistreatment by patients, often seeing it as their "professional duty" to overcome and thus suppress the negative emotions associated with mistreatment. Medical schools must proactively develop multifaceted mechanisms to support medical students who experience mistreatment by patients. Future research can further uncover this neglected dimension of the hidden curriculum to better develop responses to incidents of mistreatment that commit to antiracism, antisexism, patient care, and learner care.

CONSULTING MARKET IN ARGENTINA: conception and development

This research aims to describe the geographical and demographic profile of the consultant in Argentina. This is an exploratory-descriptive study of a quantitative-qualitative nature. At first, the profile of the consultant and the quantitative results are addressed. The qualitative results of the categories 'The start of the consulting market in Argentina' and 'Development of the consulting market' are presented below. In that sense, the study, in addition to covering the gap on the topic, serves as a basis for decision-making and encourages discussions and academic research on the consulting market in Argentina.

Loneliness and time alone in everyday life: A descriptive-exploratory study of subjective and objective social isolation

Loneliness—the subjective experience of social isolation—is a common experience that can become an enduring feature of everyday life. How does feeling lonely relate to spending time alone? In this descriptive-exploratory study, we used the Electronically Activated Recorder (EAR), a naturalistic observation tool that samples sounds from participants’ daily lives, to assess time spent alone as an index of social isolation. We combined data from three samples (N = 426) to examine the association between subjective and objectively-assessed isolation, and whether the association varies as a function of gender, marital status, and age. The constructs are weakly but significantly correlated, and spending more than 75% of time alone was associated with much higher loneliness scores, especially among older adults.

Australian emergency nurses' experiences of working with personal protective equipment during the COVID-19 pandemic. A qualitative study

IntroductionThe COVID-19 pandemic has exposed a need to understand the challenges associated with wearing Personal protective Equipment (PPE). The aim in this study was to explore emergency nurses’ experiences early in the COVID-19 pandemic in Australia and the impact of PPE use on their practice. MethodsAn explorative descriptive qualitative study was conducted between January 2022 and April 2022. Eighteen emergency nurses and six leaders participated. Semi-structured interviews (n = 21) and one focus group were conducted. Interview transcripts were analysed using Braun and Clarke’s framework. ResultsTwo major themes were identified. The first theme was: (1) The shifting ground of the COVID-19 pandemic response. Associated sub-themes were: i) What’s the go with PPE today? ii) In the beginning we were scrambling for masks; iii) Emergency is the true frontline. The second theme was: (2) Physical and emotional impacts of emergency nursing work. Sub-themes were: (i) Facing the fear of exposure; (ii) By the end of the shift I am just absolutely spent; iii) Discomfort of wearing PPE impacts on compliance. ConclusionsHealthcare leaders need to secure PPE supply chains and evaluate the effectiveness and side-effects of different PPE designs to minimise occupational harms associated with prolonged PPE use.

Evaluating patient safety research performance in Arab world countries: Changing trends and reflections.

Patient safety is a major concern in health care. Research is an important tool to minimize preventable errors. Research performance and trends evaluation need to be identified for future guidance. Our objective was to evaluate the research performance in Arab World countries related to patient safety so that real picture is available to all stake holders for future application. This was a descriptive exploratory study carried at King Abdulaziz University Jeddah, using Bibliometric analyses on Web of Science extracted data, exploring the research publications related to Patient Safety from the Arab World in last two decades (2001-2020). Digital resources were used. Data collected was further explored to see the trends. Only 2% of total worldwide publications on Patient Safety were from Arab World. A positive trend, however, has emerged since 2015. Out of 5940 documents identified, only 383 had single authorship. Egypt and Saudi Arab were the major contributors. Other countries had less or even zero publications. Researchers are coordinating with others in Western countries to enhance the research productivity. Cairo University with 734 publications had most affiliations. Publications on safety culture and medication safety were frequent. Hospital Acquired Infections and error reporting had limited research. Researches on patient safety in the Arab World are not sufficient. Countries other than Egypt and Saudi Arabia also need to contribute more frequently. Critical problems, like Hospital Acquired Infections, should have regular research from all countries to assist those treating patients and those making health related policies.

Sleep Quality and Its Relationship to Anxiety and Hardiness in a Cohort of Frontline Italian Nurses during the First Wave of the COVID-19 Pandemic.

The COVID-19 pandemic has had a considerable impact on the psychological and psychopathological status of the population and health care workers in terms of insomnia, anxiety, depression, and post-traumatic stress disorder. The primary aim of this study was to describe and evaluate the impact of the pandemic on insomnia levels of a cohort of Italian nurses, particularly those involved in the care of COVID-19 patients. The secondary aim was to identify the interaction between insomnia and hardiness, anxiety, and sleep disturbances. A descriptive-exploratory study was conducted using an online survey during the first wave of the COVID-19 pandemic (March to July 2020). The questionnaire consisted of multiple-choice, open-ended, closed, and semi-closed questions. The psychometric tools administered were the Dispositional Resilience Scale (DRS-15), the State-Trait Anxiety Inventory (STAI-Y), and the Insomnia Severity Index (ISI). a cohort of 1167 nurses fully completed the questionnaire (86.2% of total respondents). The insomnia scale survey showed an increase in post-pandemic scores compared to those before the pandemic, implying that insomnia levels increased after the first pandemic wave. Insomnia scores were directly correlated with anxiety levels (r = 0.571; p ≤ 0.05) and inversely correlated with hardiness levels (r = -0.324; p < 0.001). Multivariate analysis revealed the following protective factors: not having worked in COVID-19 wards, high levels of hardiness (commitment), and the presence of high pre-pandemic insomnia disorder. The main risk factor for insomnia reported in the analysis was a high anxiety score. Anxiety represented the main risk factor for insomnia severity in our sample, while hardiness was confirmed as a protective factor. Thus, it is necessary to design further studies to identify additional risk factors for poor sleep quality and to develop educational courses and strategies aimed at enhancing rest and sleep quality, especially for frontline nurses.

“Nursing students' social representation of tutorial classes in learning process: Qualitative study”

Tutorial guidance, allows nursing students to develop soft skills. The aim is to understand the social representation of nursing bachelor's degree students on tutorial guidance classes. Qualitative, descriptive-exploratory study, guided by the theory of social representations. Data collection was performed through a free word association test delivered to undergraduate nursing students. The social representation of fits into the framework of an active learning methodology. Students should be prepared for assuming an active role.

Knowledge Management and Interorganizational Networks of the Wine Industry

Interorganizational networks have stood out in the agribusiness sector as arrangements in which people collaborate and cooperate to obtain external knowledge resources, and to drive innovation and sustainability. Therefore, knowledge management (KM), through its practices and processes, assists in the creation and sharing of knowledge collaboratively among network participants. The present study aims to analyze the knowledge processes adopted in interorganizational networks of the Portuguese wine supply chain. The research is applied in nature and adopts a qualitative approach through a descriptive exploratory study. The multiple case study method was used, carried out in three wine networks in the wine regions of Tagus and Alentejo in Portugal. Field data were collected using the interview technique, supported by a semi-structured script. The results indicate that the companies participating in the networks have common goals: to access external knowledge resources, reach international markets, develop product innovations, and create sustainable brands. However, the findings also allow us to consider that access to knowledge resources depends on the capacity of each company in the network. Thus, the mere formation of networks does not guarantee that the dissemination of knowledge will occur.

An Exploratory Study of Physical Therapists From High-Income Countries Practising Outside of Their Scope in Low and Middle-Income Countries.

To quantify how often physical therapists from high-income countries (HIC) travelling to low- and middle-income countries (LMIC) practise outside their scope of practice, in what circumstances, and their likelihood of doing the same in the future. An exploratory descriptive study using a survey. One hundred and twenty-six licensed physical therapists from around the world participated. Physical therapists typically spent less than a month (73.8 per cent) in LMIC; 67.5 per cent believed that physical therapists practise outside of their scope, and 31.7 per cent reported doing so. Reasons were believing that something is better than nothing (47.5 per cent ), a mismatch between the physical therapist's and host's expectations (40.0 per cent ), and preserving their relationship with the host (25.0 per cent ). It was deemed appropriate by 64.5 per cent to practise outside of their scope in some situations and 53.8% considered repeating the activity in the future. Half of the respondent's first experience in LMIC occurred as a student or in their first decade of practice. Working in LMIC requires a keen understanding of the risks and challenges associated with such experiences. To ensure best practice, a skill set that consists of critical self-reflection, systems thinking, and structural competency combined with clinical competency and accountability is imperative.

Digital transformation of antenatal education: A descriptive exploratory study of women’s experiences of online antenatal education

ProblemResearch on how women experience online antenatal education is currently limited. A more nuanced understanding may assist organisations to tailor future digitalisation that best meets the needs of users. BackgroundCOVID-19 emergency measures forced a rapid implementation of online antenatal education. Women are known to enjoy some aspects of online antenatal education, but still desire social interaction. A marked digital divide is evident for more vulnerable populations. AimTo explore how pregnant women experience an online antenatal education program. MethodsA descriptive exploratory study was undertaken through collection of two concurrent data-sets. Quantitative data was collected from the online Parent Education Feedback Form (n = 38) Based on the six-stage process of Braun & Clarke, reflexive thematic analysis was used to analyse data sourced from semi-structured interviews with women (n = 5) who had undertaken online antenatal education. FindingsFour themes, and eight associated sub-themes, were identified to better understand how women experience online antenatal education. The four primary themes identified were: Experiential Digital Learning; Desired Journey; Contemporary Representation; and Human Connection in the Digital Age. DiscussionWell-designed digital platforms provide opportunities for interaction, content personalisation and self-tailored approaches in online antenatal education. Women require caregivers who hold specialist digital capabilities. Further research is warranted to better understand how digitalisation of antenatal education impacts women disadvantaged by digital exclusion. ConclusionThe digital transformation of antenatal education impacts a vast array of factors in women’s experiences during pregnancy. A specialist skill-set from midwives is needed to champion quality antenatal education in the digital age.

Collaborative learning as constructivist practice: An exploratory qualitative descriptive study of faculty approaches to student group work

Collaborative learning is a common teaching technique, posited to align with a constructivist approach to teaching and learning. This qualitative descriptive study explores how, if at all, faculty implementation and discussion of collaborative learning shows evidence of it as a constructivist practice. Nineteen faculty at a large public mid-Atlantic university in the United States, representing a variety of academic disciplines, were interviewed about the ways in which they use collaborative learning in their courses. Driscoll’s five constructivist conditions for learning guided qualitative analysis: complex and relevant learning environments, social negotiation, multiple perspectives and modes of learning, ownership in learning, and self-awareness of knowledge construction. Faculty descriptions of collaborative learning provided a rich picture of its use and revealed ample alignment with these conditions. Faculty most often highlighted the ways in which collaborative learning supported the creation of complex and relevant learning environments and allowed for students’ ownership in learning. They least often discussed the ways in which collaborative learning supported self-awareness of knowledge construction and occasionally expressed challenges with social negotiation.

Profiles of COVID-19 Impact on Informal Caregivers of Older Mexican Americans.

Objectives: This manuscript is a descriptive exploratory study of the impact of the COVID-19 pandemic for caregivers of very old Mexican Americans. Methods: Using data from Wave 10 of the Hispanic Established Population for the Epidemiological Study of Elderly (2021), we examined the characteristics of caregivers of very old Mexican Americans by their perceived level of impact from the pandemic. We examined sociodemographic characteristics, COVID-19 testing and vaccination, stress and depression, and health of caregivers and care recipients. Results: Caregivers who reported the most impact were more likely to report financial and emotional stress. They reported more depressive symptoms and high levels of distress related to neuropsychological behavior symptoms of their care recipient. Discussion: High levels of depressive symptoms, financial stress, and neuropsychological behavior symptoms illustrate that the concerns of caregivers before the pandemic were heightened during the pandemic.

"I'm Afraid If This Goes Wrong… What Will Become of Me?": The Psychological Experience of Grandparents in Pediatric Palliative Care.

Portugal has been identified as the European country with the most rapid evolution of Pediatric Palliative Care provision, where approximately 7800 children have life-limiting conditions. This is a highly complex experience not only for the children and their parental caregivers, but also for their healthy siblings and grandparents. The present descriptive-exploratory study seeks to contribute to the understanding of the psychological experience of life-limiting conditions in grandparents. A total of 19 families, consisting of 15 grandmothers and 4 grandfathers, completed a sociodemographic and clinical data sheet and a semi-structured interview was conducted in which they shared their testimony. The results of the thematic analysis highlighted an integrated view on 10 important dimensions in the grandparental experience and promoted creative responses by means of their own perspective. However, it has some limitations, such as the small sample size and the data collection procedure via telephone. The results contribute to the design of specific intervention methodologies in an ecosystemic approach and suggest further research to explore more protective factors and communication with health professionals. For psychological intervention, it is suggested considering the identification of individual and family resources that contribute to the activation of key processes in resilience and posttraumatic growth.

Profil peresepan dan analisis risiko racikan antidepresan di sebuah apotek di Yogyakarta

In Yogyakarta, the number of patients suffering from depression reached 5.5%. To enhance the therapeutic benefit, psychiatrists frequently prescribe a combination of antidepressants to their patients. To identify the risk for incompatibility, the prescription profile of antidepressant medicines that are compounded together must be examined. The purpose of this study is to examine the prescribing patterns of compounded medications designated as antidepressants in a Yogyakarta pharmacy. The prescription is the research subject in this descriptive exploratory study. Prescriptions that satisfied the inclusion criteria were gathered, and the frequency of prescriptions was calculated. Two medications with the greatest prescribing frequency were then examined for potential interactions and incompatibility. Folic acid is the most commonly prescribed medicine when combined with another. It was formerly used with sertraline HCl, maprotiline HCl, trifluoperazine HCl, and diazepam. The psychiatrist was used to mixing three to four active drugs administered in capsules. The drug combination has various interactions that must be properly monitored. These findings can be used by the doctor to choose the best medicine combination.

Experiences of persons with lower limb amputation after prosthetic rehabilitation in Ghana: A qualitative inquiry.

Lower limb amputations (LLAs) have long been associated with physical, social, and psychological consequences. Individuals with LLAs have challenges with mobility and often become isolated from their social networks. Disability rehabilitation technologies such as prosthetic devices are used to improve the mobility capabilities of lower limb amputees. To improve clinical outcomes, feedback from the prosthetic users is a key element to consider. The study sort to explore the experiences of lower-limb prosthetic users after prosthetic rehabilitation in a prosthetic and orthotic rehabilitation center in the Eastern Region of Ghana. This study adopted an exploratory descriptive qualitative study design. A purposive sampling technique and semistructured interview guide was used to interview 17 participants by the first author. The social model of disability underpinned the study. Lower-limb prosthetic users (≥18 years) with unilateral LLA attending outpatient follow-up at a prosthetic and orthotic rehabilitation center were recruited. The interviews were audio recoded, transcribed verbatim, and analyzed using the procedure for thematic content analysis by Braun and Clarke (2013). Participants reported injuries and tingling in their residual limb. Internal stigma resulting from negative comments and labeling from the public were reported. Prosthetic users experienced empathy and being treated as weaklings by their family/peers. Participants avoided relationships because of recurrent rejection, embarrassment, fear of sexual abuse, and exploitation. As a coping method, some participants chose to isolate themselves to avoid humiliation and public disgrace. Other coping mechanisms included watching television, listening to music, conversing with others, ignoring criticism, and having faith in God. Participants' narrative in this study gave insight into the varied lived experiences on the individual level, family/peer level, and the coping mechanisms used. Challenges relating to discomfort from the prosthesis, internal stigma, relationship avoidance, and altered sexual life should be given much attention and used in implementing initiatives to improve clinical outcomes.

Barriers and enablers for safe medication administration in adult and neonatal intensive care units mapped to the behaviour change wheel.

Intensive care settings have high rates of medication administration errors. Medications are often administered by nurses and midwives using a specified process (the '5 rights'). Understanding where medication errors occur, the contributing factors and how best practice is delivered may assist in developing interventions to improve medication safety. To identify medication administration errors and context specific barriers and enablers for best practice in an adult and a neonatal intensive care unit. Secondary aims were to identify intervention functions (through the Behaviour Change Wheel). A dual methods exploratory descriptive study was conducted (May to June 2021) in a mixed 56-bedded adult intensive care unit and a 6-bedded neonatal intensive care unit in Sydney, Australia. Incident monitoring data were examined. Direct semi-covert observational medication administration audits using the 5 rights (n = 39) were conducted. Brief interviews with patients, parents and nurses were conducted. Data were mapped to the Behaviour Change Wheel. No medication administration incidents were recorded. Audits (n = 3) for the neonatal intensive care unit revealed no areas for improvement. Adult intensive care unit nurses (n = 36) performed checks for the right medication 35 times (97%) and patient identity 25 times (69%). Sixteen administrations (44%) were interrupted. Four themes were synthesized from the interview data: Trust in the nursing profession; Availability of policies and procedures; Adherence to the '5 rights' and departmental culture; and Adequate staffing. The interventional functions most likely to bring about behaviour change were environmental restructuring, enablement, restrictions, education, persuasion and modelling. This study reveals insights about the medication administration practices of nurses in intensive care. Although there were areas for improvement there was widespread awareness among nurses regarding their responsibilities to safely administer medications. Interview data indicated high levels of trust among patients and parents in the nurses. This novel study indicated that nurses in intensive care are aware of their responsibilities to safely administer medications. Mapping of contextual data to the Behaviour Change Wheel resulted in the identification of Intervention functions most likely to change medication administration practices in the adult intensive care setting that is environmental restructuring, enablement, restrictions, education, persuasion and modelling.

"Embracing the Inner Strength and Staying Strong": Exploring Self-Care Preparedness among Nurses for Enhancing Their Psychological Well-Being against the Long-Term Effect of COVID-19 Pandemic in Brunei Darussalam.

During three years of the unprecedented, massive COVID-19 pandemic that affected the world, nurse front liners faced substantial challenges and experienced long-term adverse mental health. This study explored psychological self-care practices undertaken by nurses to strengthen their mental health and develop resilience in their professional care role while addressing the challenges of the COVID-19 era. A qualitative descriptive exploratory study was conducted on 40 nurses who worked in providing COVID-19 care across Brunei using focus groups aided by semi-structured open-ended questions. Data were thematically analyzed using constructivist grounded theory. Four themes emerged: (1) 'Care of the mind, heart and soul'; (2) 'Physical care for the psychological well-being'; (3) 'Venting out and distraction'; (4) 'Have faith, think and stay positive'. The challenges of dealing with a worldwide pandemic unintentionally placed nurses' mental well-being at risk while the government strategized and prioritized containing and preventing the spread of and death from COVID-19. Health administrators, as well as nursing educators, need to promote and develop resources to strengthen nurses' psychological self-care practices. This will not only benefit individual nurses but will help promote the well-being of patients and employees, improve the health of all, and counteract any unintended stressful situations, even beyond the COVID-19 pandemic.

Dynamics of Student Internship System in Faculty of Art of KNUST, Kumasi, Ghana: Exploring Perceptions, Values, Access and Development Outcomes

An internship programme is a great way to connect what is learnt in class with actual work experience. Existing research has underscored the positive contribution of internship to the educational process and career outcomes among students. The internship programme for students of Faculty of Art, KNUST is a requirement or considered as a compulsory 15 credit hour course for the award of undergraduate degree. As such it is a vital component of the curriculum. Nonetheless, empirical literature on the dynamics of the internship programme at the university is sparse. Without insight into these dynamics however, there will be lack of information that could inform policy and continuous improvement of the programme. To bridge this gap, this paper seeks to analyze the internship experiences of students to determine what factors seem to create the greatest perceived value. The study employed the descriptive exploratory study design approach. Data was obtained from a total of 376 students of the Faculty of Art through the use of questionnaire designed in open and close ended patterns and focus discussions. The statistical package for the social sciences (SPSS) computer package was used for data analysis, while descriptive statistical tools such as frequency and percentage were used to analyze the facts sought from the questionnaire. The students described a variety of skills learned during the internship including mastering the use of some equipment, software, and report writing. About 80% of the participants indicated that the internship programme was important and linked the classroom work to real work environment. All the students regardless of their experiences indicated they had value for the internship which they believe will play a role in their future career objectives. On the other hand, some of the students had some unfavourable experiences including inadequate work space, provision of inadequate PPEs, boring and difficult tasks. Others were engaged in other duties that were not related to their field of studies, all of which could potentially influence the perception of students.

Importance of palliative care in oncology: a qualitative study

The objective is to know the perception of nursing professionals about the importance of palliative care in the hospital oncology sector. This is a descriptive-exploratory study of a qualitative nature, with nursing professionals from an oncology sector. Data collection was carried out through a questionnaire prepared on the Google Forms platform with previously structured questions. For data analysis, Braun and Clarke's thematic analysis was used. Eleven nursing professionals participated in the study, most of whom were female nursing technicians. From the data analysis, three themes emerged, namely: Concept of palliative care; Importance of palliative care in the hospital environment; Importance of approaching palliative care during academic training and continuing education. Research participants perceive the importance of introducing palliative care during their training and within the hospital environment. Reporting that the hospital environment is where most patients with life-threatening diseases are found, requiring a palliative care approach in this environment.