Empowerment In Decision Research Articles

Patients and Spine Surgeons' Perspectives regarding Decision-Making and Outcomes in Lumbar Surgery: An Exploratory, Qualitative Study.

Decision-making in lumbar surgery for degenerative conditions is influenced by various factors, including patient expectations and empowerment. The role of patient-reported outcomes (PROs) in guiding these decisions is underexplored. This study aims to understand the perspectives of patients and spine surgeons in decision-making for lumbar surgery and explore their perspectives on the relevance and influence of pre- and post-surgery PROs. An exploratory qualitative study was conducted between February 2022 and November 2023. A total of 15 patients with degenerative lumbar conditions and 9 spine surgeons from 5 tertiary public hospitals in Singapore were recruited. Data were analyzed using a framework analysis approach, ensuring validity through member checking, reflexive journals, and data source triangulation. Three overarching categories emerged: "expectations and outcomes," "decision empowerment," and "surgical experiences." There is a shift toward shared decision-making, highlighting the importance of patient-centric approaches. Surgical decisions are primarily influenced by PROs, particularly health-related quality of life (HRQoL) and pain relief. Patients prioritize pain relief and improvements in daily functioning, while surgeons also emphasize avoiding postoperative complications. Decision support tools, including PRO data, are essential but need better accessibility and integration within clinical settings. Positive surgical experiences are driven by clear communication, trust with surgeons, swift recovery, and no regrets post-surgery. Our study emphasizes the importance of patient-centered approaches in lumbar surgery decision-making, particularly regarding pre- and post-surgery PROs. Implementing these approaches may enhance patient satisfaction and surgical outcomes, urging the surgical community to prioritize informed, empathetic decision-making to improve healthcare quality.

Investigating Pathways Linking of Women's Education Status and Empowerment to Intimate Partner Violence Among Married Women in Sri Lanka: A Structural Equation Modeling Approach.

In Sri Lanka, intimate partner violence (IPV) remains a major concern, particularly for married women. Women's education and empowerment are significant contributors to IPV. Despite this, there have been no recent studies exploring the complex relationship between education and multidimensions of empowerment in relation to IPV in Sri Lanka. Therefore, this research addresses this gap by exploring the complex pathways connecting married women's education and multidimensional empowerment to IPV. Using data from the 2019 Sri Lankan Women's Wellbeing Survey, this study included 1,165 married women. A path analysis based on structural equation modeling (SEM) was used to examine the complex interplay between distinct empowerment domains and IPV. The SEM results revealed both direct and indirect effects of women's education and empowerment on IPV experiences. Education is positively linked to age at marriage, employment status, and husbands' educational level, while inversely associated with accepting attitudes toward violence. Age at marriage plays a major role as a mediator, mediating the relationship between women's education and their involvement in decision-making, and the relationship between husbands' education and women's IPV experience. Moreover, the relationship between women's age at marriage and their IPV experiences was fully mediated by their decision-making ability, highlighting the importance of empowerment in decision-making. These findings underscore the need for targeted interventions that address the interconnected factors affecting IPV risk among married women in Sri Lanka, particularly focusing on education, empowerment, and marriage timing.

Toward participatory participation: A community perspective on effective engagement in post-disaster recovery and reconstruction

ABSTRACT Engaging citizens is crucial in disaster recovery efforts, yet its actualization remains elusive. Communities often find themselves relegated to passive recipients, leading to suboptimal reconstruction projects. The primary objective of this study was to explore the community’s perspective regarding optimal processes and outcomes requisite for their meaningful participation, aligning these insights with community development principles. Utilizing qualitative research methodologies such as face-to-face interviews, observations, focus group discussions, and questionnaire surveys the study identified key processes, including equitable stakeholder representation, empowerment in decision-making, integration of indigenous knowledge, early community engagement, and capacity enhancement. These processses are pivital for achieving sustainable development outcomes such as project ownership and successful attainment of project objectives. This research provides critical insights into engaging residents in post-disaster recovery and reconstruction efforts emphasizing the integral role of community development in facilitating inclusive and effective recovery and ensuring projects meet community needs and expectations.

Developing partnership with patients and carers: A need of the time for mental health service delivery.

Contemporary practice of psychiatry is witnessing a radicle shift in the care of mentally ill. As compared to the 20th century, we are now moving towards community psychiatry and large mental hospitals and asylums are closing with a shift to manage these patients closer to their homes. Following these changes in mental health care, current literature provides growing evidence for developing partnership with patients, carers and family members in the delivery of mental health services. While this approach is appreciated for improving the quality of life of patients, there has also been some concerns about increasing burden of carers and families when they have limited resources and support to face the challenges in dealing with the management of their patients.1 Treatment and management of mental health problems are complex and needs a wider recognition for having patients and care-givers involvement in the treatment processes. Patients with mental health problems unfortunately suffer from a wide range of psychosocial adversities and require engagement leading to more empowerment in decision making processes. Furthermore, quality of health services can be measured by the experiences of patients and their families. Their viewpoints can reflect their happiness as well as the effectiveness of the services that could be based on their knowledge and understanding of their role in the treatment processes. However, in many societies, the nature and role of families are either undermined or not fully understood.2 Families may be considered as a cause for the onset of mental health issues and can be blamed for causing or triggering the illnesses. Similarly, the clinicians are given the full authority to decide about the treatment choices and preferred possibilities. Their role may be acknowledged as “the ultimate expert” who can decide in a final way and patients or families may have limited opinions in such decisions. Professionals may also consider confidentiality issues as a primary reason for not sharing information and taking relatives or family members on board, so they are frequently excluded from the decision-making processes. Apart from confidentiality reasons, clinicians may not have sufficient training and skills to deal with families and patients in terms of supporting and dealing with their concerns.3 Continued...

Determinants of women's empowerment in Nepal.

Nepal is characterized by low empowerment of women which may have negative effects on their health status as well as sexual and reproductive rights. We seek to identify key determinants of women empowerment in Nepal using a rich set of socio-demographic and socio-economic characteristics as well as behavioral factors and regional indicators. This study utilizes 4,211 women aged between 15 and 49 years from the 2022 Demographic and Health Survey (DHS) for Nepal. Following the previous study for Mozambique, we use Principal Component Analysis (PCA) to identify components of women's empowerment along three domains: beliefs about violence, decision-making and control over sexuality and safe sex. We use logistic regressions to identify significant predictors of empowerment in each domain and provide crude and adjusted odds ratios along with their 95% confidence intervals. We found that older age is generally associated with higher empowerment across all these domains. Interestingly, while partner controlling behavior tended to decrease empowerment in beliefs about violence and control over sexuality, it was linked to increased decision-making empowerment. Notable regional differences emerged, with higher levels of empowerment observed in the Madhesh and Sudurpashchim regions. Further, education level and wealth were correlated with increased empowerment in control over sexuality and safe sex, though not in the other two domains. Access to media showed mixed effects, reducing empowerment in decision-making but enhancing it in control over sexuality and safe sex. Our results have many similarities but also notable differences with previous literature which emphasizes the importance of regular and region-specific studies of women's empowerment, acknowledging the potential for its change over time and also the prevailing differences across regions.

Figure of Socio-Economic Status, Participation and Empowerment of Women in Decision Making Process: Context Sirajganj Municipal Area of Bangladesh

Bangladesh gained independence on 16 December 1971. Since independence till date, the government has taken various steps to empower women. Despite all these efforts, the economic structure of women’s decision-making process has not yielded the desired results. The main reason is that women’s decisions are not valued in any family, social, political, or economic field. In the present study, we have analyzed the socio-economic status of women and their empowerment in decision-making. In doing so, we look at women’s age, religion, education, occupation, marital status, family status, maintenance, household expenses, adoption, children’s education, property rights, property buying and selling, house building, housework, and health and nutrition.

Amplifying adolescent and emerging adult voices: Development of a pediatric-to-adult transition research advisory council

BackgroundAdolescents and emerging adults (AEA) with chronic health conditions may face numerous challenges when undergoing the transition from pediatric to adult health care. Despite the need for engagement with AEA in health research, little is known about how researchers operationalize this engagement. In an effort to enhance transparency in the practices of patient engagement, this commentary details the process of developing a pediatric-adult transition-specific youth advisory council in Alberta: the Transition Research Advisory Council (TRAC). ObjectivesWe provide an overview of AEA engagement in health research and detail TRAC’s recruitment and onboarding strategies. Moreover, TRAC members provided reflections on their motivations and experiences during the onboarding process. Key recommendationsThis commentary provides key recommendations for AEA council development, emphasizing equity, diversity, and inclusion principles, optimizing compensation plans, adopting an iterative engagement approach, fostering capacity-building and mentorship, and promoting empowerment in decision-making.

The challenges of personnel management for public service organizations in the era of technological disruption in Indonesia

This thesis examines the challenges of personnel management for public service organizations in the era of technological disruption in Indonesia. The advent of new technologies has significantly impacted various aspects of personnel management, including the adoption of technology-enabled HR systems, the redesigning of job roles and responsibilities, and the need for upskilling and reskilling initiatives. The thesis begins with an introduction that highlights the context and significance of the topic, followed by a thorough review of the relevant literature and theoretical frameworks. The methodology section outlines the research approach and data collection methods utilized in the study. The findings of the study reveal that the adoption of technology-enabled HR systems brings both opportunities and challenges. While these systems enhance efficiency and streamline processes, they also require careful consideration of factors such as employee training, data security, and resistance to change. Furthermore, the era of technological disruption necessitates the reevaluation and redesigning of job roles and responsibilities to align with emerging technologies. This requires organizations to proactively identify the impact of technology and develop strategies to equip employees with the skills needed for the digital age. The thesis explores the significance of enhancing employee engagement and motivation in the face of technological disruption. Clear communication, employee recognition, career development opportunities, work-life balance initiatives, empowerment in decision-making, and employee development programs are identified as crucial factors in fostering employee engagement and motivation.

The nexus of women’s empowerment and sustainable agricultural practices in developing countries: a case of Pakistani women farmers

The adoption of sustainable agricultural practices at the farm level is essential for lowering greenhouse gas emissions and creating sustainable food systems. This study explored the nexus of women’s empowerment in agriculture and the adoption of sustainable agricultural practices in Pakistan. A face-to-face survey using multistage simple random and purposive sampling techniques was used to collect the data from 384 Pakistani women farmers. A partial least-squares structural equation model was used to analyze the data. The findings indicated that empowering women in agricultural asset control (β = 0.38, p < 0.01) positively influences the adoption of sustainable agricultural practices on farms. Similarly, women’s empowerment in decision-making (β = 0.41, p < 0.01) also significantly affects the adoption of sustainable agricultural practices. Moreover, women’s empowerment in legal rights (β = 0.14, p < 0.01), productivity and skills (β = 0.15, p < 0.01), and information and communication technology (β = 0.19, p = 0.02) significantly increases farm-level adoption of sustainable agricultural practices.

Interventions for the empowerment of older people and informal caregivers in transitional care decision-making: short report of a systematic review

BackgroundCare transitions across different settings necessitate careful decision-making for all parties involved, yet research indicates that older people and informal caregivers do not have a strong voice in such decisions.ObjectiveTo provide a systematic overview of the literature about interventions designed to empower older people and informal caregivers in transitional care decision-making.DesignA systematic review (Prospero Protocol CRD42020167961; funded by the EU’s Horizon 2020 program).Data sourcesFive databases were searched: PubMed, EMBASE, Web of Science, PsycINFO, and CINAHL.Review methodsThe review included evaluations of empowerment in decision-making interventions for older people and informal caregivers facing care transitions, that were published from the inception of the databases up until April 2022. Data extractions were performed by two independent researchers and the quality of studies was assessed with the relevant JBI-critical appraisal tools. A narrative descriptive analysis of the results was performed.FindingsTen studies, reporting on nine interventions, and including a total of 4642 participants, were included. Interventions included transition preparation tools, support from transition coaches, shared decision-making interventions, and advance care planning. Designs and outcomes assessed were highly diverse and showed a mix of positive and lacking effects.ConclusionsThere is a lack of research on how to empower older people and their informal caregivers in transitional care decision-making. Empowerment in decision-making is usually not central in transitional care interventions, and effects on actual empowerment are mostly not assessed. Conclusions on how to empower older people and informal caregivers in transitional care decision-making cannot be drawn.

A cross-sectional study on factors associated with health care seeking for acute respiratory infection and fever in children under-five in Zambia.

mortality in under-five children remains a significant challenge in developing countries, including Zambia, where pneumonia and malaria account for twenty percent of under-five deaths. Poor health care seeking is one of the contributors to the high mortality rates. This study examined the predictors of health care seeking for acute respiratory infection (ARI) and fever among under-five children in Zambia. the study used a population based cross-sectional survey program evaluation dataset with sample size of 12,507 households from 28 districts. Binary logistic regression was used to examine the determinants of appropriate care seeking for ARI or fever, ARI, and fever. the prevalence of fever or ARI in children under five was 22.9%, ARI 12.9%, and fever 13.4%. Educational status and non-participation in positive deviance hearth (PDH) were significant predictors in those with fever or ARI. Children whose household head had secondary education or higher were 4.5 times more likely to seek care than those whose household head did not have any education. Among those with ARI, educational status, women empowerment in decision-making and growth monitoring and promotion (GMP) were significant predictors while for fever only GMP was a significant predictor. over two thirds of caregivers sought care appropriately for fever or ARI. Only educational status and GMP were associated with more than one appropriate care seeking outcome. Through GMP services, policymakers can improve healthcare seeking behavior in children under five.

Participatory communication in South African municipal government

The South African Municipal Systems Act (2000) directs South Africa’s municipalities to ensurethat it uses IDP processes as a form of public participation in its affairs. This qualitative study wasconducted in Jouberton Township in the Matlosana local municipality, North West Province, toassess the extent to which participatory communication takes place in municipal IDP processes.Using participant observation, semi-structured interviews and focus group discussions, thestudy found that community members were passive participators in municipal IDP processes inwhich their involvement was limited to being informed about what would happen or had alreadyhappened. Dialogue was facilitated through a top-down modernisation-based approach, andno evidence emerged of community empowerment in decision making regarding developmentprojects. The findings suggest a need for the application of bottom-up participatory communicationand “empowered” participation during municipal IDP processes. They also suggest a need forfurther research on how “participation as an end” can be theorised in line with participatorycommunication in a complex municipal system that already requires “participation as a means”to achieve certain goals.

Association of maternal characteristics with child feeding indicators and nutritional status of children under-two years in Rural Ghana

BackgroundOptimal nutrition during the first two years of a child’s life is critical for the reduction of morbidity and mortality. In Ghana, majority of children miss out on optimal nutrition and only few (13%) of children receive a Minimum Acceptable Diet (MAD). Several studies have investigated the influence of community-level factors on infants and young children feeding (IYCF) practices. However, little is known about the influence of maternal factors on IYCF practices in rural settings. Therefore, this study assessed the influence of maternal factors on the feeding indicators and nutritional status of children aged 6–23 months in two administrative districts in Ghana.MethodsData were collected among 935 mothers who had children aged 6–23 months and accessed 21 Child Welfare Clinics within the study area. The study involved a face- to-face interview using structured questionnaires to capture maternal characteristics, dietary intake and anthropometric measurements of children. Multivariate logistic regression was used to study the association between maternal factors and child nutrition outcomes (MAD, dietary diversity score (DDS) and anthropometric indicators) using Stata 16.0 software.ResultsBeing employed (AOR = 3.07, 95% CI: 1.71—5.49, p < 0.001) and attaining secondary or higher education (AOR = 2.86, 95% CI: 1.42—5.78, p = 0.003) were significant predictors of children receiving MAD. Similarly, having an average decision-making autonomy increased the child’s odds of receiving MAD (AOR = 1.68, 95% CI: 1.02—2.76, p = 0.040). Children of mothers who attained secondary or a higher level of education (AOR = 0.59, 95% CI: 0.36 -0.97, p = 0.040) and those whose mothers were employed (AOR = 0.71, 95% CI: 0.47—1.07, p = 0.043) were associated with a reduced risk of underweight and stunting respectively. Children of mothers with average financial independence status were more likely to receive diversified meals (AOR = 1.55, 95% CI: 1.01–2.38, p = 0.045).ConclusionsHigh educational level and being employed have positive influence on MAD, stunting and underweight of children. High decision-making power and average financial independence of mothers are good predictors of children receiving MAD. Family planning, women empowerment in decision-making, providing employment opportunities for mothers and promoting girl-child education are recommended.

Psychosocial Challenges of Rohingya Women in Refugee Camps during Covid 19 Lockdown

This paper described how Forcedly Displaced Myanmar Nationals (FDMN) Rohingya women and girls coped with difficulties during the pandemic in Cox's Bazar refugee camps. The purpose of this study is to assess the ongoing issues, coping mechanisms, and psychosocial conditions during the pandemic. This research used Focus Group Discussions (FGD) and in-depth interview, the researcher's own observation, as well as secondary data sources. The findings suggested that FDMN women faced tremendous difficulties due to a lack of food/non-food item (NFI) and unusable facilities. Despite humanitarian organizations providing extensive psychosocial support to FDMN women and girls through friendly spaces for women and girls and they volunteered in the absence of employees due to lockdown, the women faced issues related to the expectation based on their traditional role. This paper concluded that activities that can improve the psychosocial health as well as intervention for the community and increased women and girls’ engagement for empowerment in decision making about their role as a woman in order to reduce their vulnerabilities to domestic violence is important. Also, FDMN men and boys should be exposed to awareness program to prevent gender-based violence.

IMPACT OF EDUCATION AND EMPLOYMENT ON WOMEN EMPOWERMENT

This study is an endeavour to examine the status of women and most importantly the impact of education and employment on women empowerment. In most countries, women in particular are still kept deprived of the facilities such as education and work/ employment, to be economically and educationally strong. Cross section, descriptive, and empirical study was done using survey technique method to gather information from the educated and employed. The result indicates that education and employment have high significant positive relationship with women empowerment in decision making, control over the resources and voice. Education helps women get employment and employment makes them financially independent and economically strong which then leads to their empowerment. When women are empowered, they reach out and empower other women. Research findings will definitely help the future researchers to understand influence of education and employment on women residing in developing countries to improve their ability to make strategic life choice to attain the capability desired for them and her family members, moreover the finding also provides a view on the status of women.

The Impact of Income Increment Program toward Socioeconomic Changes of Orang Asli in Perak, Malaysia

The Income Increment Program (IIP) is one of the programs introduced to the Orang Asli in 2014 to reduce hardcore poverty rates among indigenous community in Malaysia. This study aims to identify the participation of Orang Asli in the IIP and examine the impact of IIP toward socioeconomic changes. This study involved 110 Orang Asli who participated in the IIP in the state of Perak, Malaysia. The study showed that majority of the respondents involved in agriculture and farming as their main income, while collecting forest produce and rubber tapping as part-time jobs. Among the IIP projects undertaken in the state of Perak are vegetables, calamansi and banana plantations, as well as cattle farming, tilapia farming and stingless bee farming. The findings showed that there was an increment of the income among respondents although majority of them earned less than RM1000 per month. Findings also revealed that the highest impact of IIP is the empowerment in decision making, followed by changes in lifestyle, economic aspects and ownership. Overall, the level of impact is high in empowerment and changes in lifestyle, while moderate in other aspects discussed. Suggested recommendations were discussed for future improvement of IIP.

Policies of Women Empowerment in Decision Making Positions: The Case of Egypt 2014- 2020

This study seeks to assess the policies of empowering Egyptian women in decision-making positions as well as identifying the challenges that limit the chances of women in taking over leadership positions. Additionally, a number of secondary goals were investigated such as; defining the concept of empowerment and leadership with a focus on their types and dimensions, identifying the characteristics and skills of women leaders, understanding the aspects of women empowerment in decision-making positions as well as monitoring and evaluating the existing stance of women in leading positions. The study showed that the leadership empowerment of women is progressing at a fast and advanced pace, which indicates that the empowerment of women is amongst the key goals of the 2030 vision and recommends additional procedures to ensure consistency of such policies to support sustainable societal development. Keywords: Women – Empowerment – Decision Making – Leadership positions - development DOI: 10.7176/JLPG/112-12 Publication date: August 31 st 2021

An analysis of characteristics and content of highly used books for the general population in the cancer space on Amazon.com.

e24034 Background: Cancer patients and supporters frequently turn to written resources for assistance and empowerment in decision-making. Previous work has analyzed misinformation available on search and social media platforms; however, little attention has been paid to amazon.com (AMZ) despite 37% of cancer patients seeking information from books. Previous work also suggests there is a preponderance of vaccine-hesitant books on AMZ. Here, we report the first analysis of the characteristics and content of books, excluding medical textbooks, in the cancer space. Methods: On 11/25/20, the top 100 books were pulled from the “Best Sellers in Cancer” (BS) page on AMZ. Queries were also performed using keywords “cancer treatment” (CT), and “natural cancer treatment” (NCT), filtering for books. Non-sponsored results from the first 5 pages per search were pulled. 2 coders were trained to manually collect variables on genre, advice, terminology (TN) in the description, author, and publisher; disagreement was settled by a third coder. Books were excluded if they were not in English, duplicates within the same query, did not focus on human cancer, or were medical textbooks. Chi square testing was used to compare results of CT v. NCT. Analysis was performed using R software. Results: 56, 60, and 70 books were included for BS, CT, and NCT, respectively. For BS, 15 (26.8%) were memoirs, 12 (21.4%) dietary guides, 11 (19.6%) treatment guides, 6 (10.7%) self-help, and 4 (7.1%) cookbooks. 16 (28.6%) focused on one tumor subtype; breast was the most common (9, 56.3%). Many appeared to offer non data-driven advice (Table). Many BS books employed “war” TN (ex: fight, battle), “hype” TN (ex: game-changing), spiritual TN (ex: faith, God, prayer), and CAM TN (ex: supplement, herb) (Table). Many also insinuated offering a cure, or a novel therapy (Table). Compared with CT books, NCT books were more likely to offer non-data driven advice and be published independently, and less likely to have an MD/DO author (Table). Conclusions: Nonscientific advice is present in many non-medical text cancer books available on AMZ, including BS books. Patients seeking information on AMZ about NCT are likely to find books offering non-data driven advice or that insinuate a cure or new/novel information. Future work should investigate opportunities to regulate such content or to direct patients towards high-quality resources on platforms like AMZ.[Table: see text]

Management of human resources and quality of service in the National Superintendency of Migration, Headquarters of Lima, 2019

The objective of this article is to determine how human resources management influences the quality of service to the users of the Superintendencia Nacional de Migraciones, Headquarters of Lima – Peru, 2019. The study is descriptive and non-experimental cross-sectional design which was directed to a sample of 168 collaborators and 381 users. Among the obtained results, it has been determined that 34% of the employees surveyed almost never feel motivated by the work done and the 60% of the surveyed users consider that the treatment of the server is only sometimes adequate. It put forwards as value proposal an outline on personnel management processes and the bases for empowerment in decision making. There is a very significant relationship between the organizational climate, recognition of personnel, the commitment of collaborators; and the quality of service to the user for having found a p-value of 0.000 <α = 0.05 through the Rho Spearman correlation.

Person-oriented ethics for autism research: Creating best practices through engagement with autism and autistic communities.

Research ethics means issues that concern the welfare and wellbeing of people who take part in research. It is important in all scientific studies. Ethics helps people who do research treat people who take part in research fairly and with respect. This article is about day-to-day ethics when autistic people take part in research. We present tips for researchers who want to do this type of study.We used two methods to create these tips. First, we wanted to know what other people said about this topic. We used a literature review to find out. Second, we wanted to know what autistic people, parents, and professionals thought, and had a working group meet to discuss it. The working group provided advice that researchers could consider around day-to-day ethics in research. This article talks about these methods and advice. The advice fits into five big groups:Tailor the research process for the unique needs of each person.Think about the world in which people who take part in research live.Make it easier for people to make their own choices.Value what people who take part in research have to share and consider their needs and strengths.Think about how researchers and people who take part in research work together.This project shows why it is useful for researchers and communities to talk about research ethics together.