Community Experience Research Articles

WP2.8 - Patient experience of surgeon-patient communication in general surgery in Northern Ireland: a qualitative analysis

Abstract Aims This project explores the patient experience and perception of surgeon-patient communication in general surgery in Northern Ireland. Through qualitative analysis of patient feedback, this project aims to identify pertinent aspects of communication that significantly impact the patient experience within the context of inpatient surgical care, and compare this to existing literary consensus. Methods Patient feedback data was collected from Care Opinion, accessed at https://www.careopinion.org.uk. Search parameters included stories about general surgery and communication, spanning a period of twelve months, submitted from the five health and social care trusts in Northern Ireland. 121 of 178 search returns met the inclusion criteria for analysis. Braun and Clarke’s Thematic Analysis framework was selected for coding data and identifying themes and understand participant experiences within the data set. Results Three themes emerged from analysis of patient feedback. These themes were the aspects of patient-doctor communication that were valued most by patients during admission. They include the pitch at which information is delivered, the frequency of updates patients were given regarding their care, and provision of question and answer opportunity with their surgeon. Conclusions The important discovery from this analysis is that contemporary literary knowledge does not fully represent the patient experience of doctor-patient communication in Northern Ireland. Instead, analysis of patient feedback has identified new aspects of communication that most impact patient experience, and has yielded new means of understanding and achieving patient-centred practice.

Gynecologic cancer survivor preferences for provider communication regarding sexual health after treatment: a qualitative study.

Survivorship from gynecologic cancers is becoming increasingly prevalent. There are significant sexual side effects that influence quality of life that would be reduced with proper intervention; however, existing literature highlights the lack of understanding of the sexual health needs within this population. Furthermore, multiple studies show that one contributing factor to sexual well-being in survivorship is provider-patient communication. The aim of this study is to explore experiences of sexual distress and survivor experiences of sexual health communication. Adult participants who had been out of active treatment for 3months were recruited to participate in focus groups. Six focus groups (n = 32) were conducted with survivors of gynecologic cancers via Zoom. Research team members analyzed content using thematic analysis. Two broad themes were identified: Experiences of provider communication and Preferences for provider communication, with subthemes nested under both. Subthemes from the Experiences theme included absent/lacking communication, negative experiences, emotional reaction to lack of communication, and feeling like sexuality was not valued. Subthemes from the Preferences theme included more conversation and open communication about sexuality, more resources/referrals, and more provider training on sexuality. Survivor experiences of subjective sexual health are often dependent on the type and quality of information they receive from their healthcare team during treatment. Unfortunately, the majority of participants endorsed negative or absent communication related to their sexual health needs, leading to additional distress.

The role of women during the Spanish Civil War

This study explores the multifaceted roles of women during the Spanish Civil War, examining the diverse perspectives delineated in academic literature. Leveraging scholarly articles sourced from Web of Science and Scopus spanning from 2013 to 2022, we analyse temporal trends, author demographics, scholarly impact, journal prominence, and thematic content. Our investigation culminates in the classification of contributions into six overarching themes: humanitarian aid and healthcare, biographical narratives, communication dynamics, experiences of exile and refugee communities, women’s mobilisation and ideological engagement, and the harrowing realities of repression and violence inflicted upon women. Furthermore, our findings reveal that research predominantly originates from Spain and is disseminated through Spanish-language journals. However, there exists a notable interconnection with the United States, evidenced by the participation of prominent North American authors and publication in non-Spanish journals. This research offers insights into the multifaceted roles of women during the Spanish Civil War and their academic representation.

Enhancing cross-cultural communication for Chinese tourists in non-native English-speaking destinations: a study of sociolinguistic competence and politeness challenges

Abstract The current study explores the sociolinguistic challenges experienced by Chinese tourists. The purposive sampling approach was applied for data collection to comprehend the respondents’ communication hurdles. Online and offline questionnaires were also distributed to accommodate senior travellers. A total of 964 valid responses were gathered, which reflected the increasing trend of outbound tourism among Chinese nationals. The present study employed sociolinguistic competence as a mediating variable (specifically, its interplay with intercultural communication anxiety and politeness) within the Communicative Competence Model (CCM) framework. Several strategies that consider the nuanced aspects of language and culture are also proposed. The findings can potentially enhance service standards in the tourism sector by improving Chinese visitors’ intercultural communication experiences in various international destinations.

Can we talk? A correspondence study to examine responsiveness of physical educators to requests for a phone call from parents of children with disabilities

ABSTRACT The Individuals with Disabilities Education Improvement Act (2004) mandates that parental input be considered when making educational decisions for children with disabilities, including in physical education. However, parents of children with disabilities often report suboptimal communication experiences with physical educators. The purpose of the current study was to examine if the initiation of a parent–physical educator relationship is influenced by whether students have a disability or not. An online message correspondence study methodology was used to detect potential disparities in the responsiveness of a sample of 320 physical educators to electronic message requests for a phone call to discuss physical education service from hypothetical parents of a child with a visual impairment (VI), autism spectrum disorder (ASD), Down syndrome (DS), or no disability. Parents of children with ASD had reduced odds of receiving a positive response as compared to parents of children without disabilities (15.8% vs 26.9% RR = .57). Similarly, parents of children with DS had reduced odds of receiving a positive response as compared to parents of children without disabilities (15.2% vs 26.9%, RR = .59). Strategies to promote parent–physical educator relationships are urgently needed, especially for parents of children with ASD and DS.

A Multicultural Islamic Religious Education Curriculum Development

Curriculum development is often based on inappropriate strategies, due to a lack of comprehensive understanding of objectives, starting points, methods and functions. This study examines the development of multicultural Islamic Religious Education (PAI) curriculum in Da’wa Management Study Program (Prodi MD), Faculty of Da’wah and communication of Sunan Kalijaga State Islamic University Yogyakarta. Type of qualitative research, with the method of Case Studies (case study). The approach used is Curriculum Development. The theory used as a framework for analysis is The Theory of Grass-Roots Initiative. Research findings show that the Da’wa Management Program the faculty of Da’wa Management and communication UIN (State Islamic University) Sunan Kalijaga developed a multicultural PAI curriculum in response to the development and needs of the community. Therefore, curriculum development is centered on the field experience of the academic community, both educators and learners. The paradigm used during the development process is naturalist-inclusive, where the material, learning process, and output are directed towards one goal, namely students who are tolerant, moderate, and able to bridge social gaps, both in the classroom and in society and industry. This article contributes to providing guidance for integrating multicultural values ​​into the Islamic Religious Education curriculum, in order to create inclusive and responsive learning towards diversity.

Experiences of Care, Racism, and Communication of Postpartum Black Women Readmitted After Delivery

OBJECTIVE: To explore the contribution of psychosocial factors, perceived barriers to care, structural racism, and experiences of care to disparities in postpartum outcomes for Black patients, as measured by emergency department (ED) visits and postpartum readmissions. METHODS: We conducted semi-structured interviews with women of color who were readmitted or had an ED visit related to perinatal outcomes within 30 days of delivery hospitalization. We created an interview guide based on patient, community, and health system factors, asking questions about care and lived experience through delivery, discharge, coming home, and ED visits or readmission during the postpartum period. Patients were identified through the electronic medical record system. Interviews ranged from 30 to 60 minutes and were transcribed, and medical charts were reviewed for delivery and postpartum outcomes. We coded interviews through deductive engagement with the interview guide, which was validated through double-comparative coding between researchers, and used content analysis to delineate themes surrounding barriers to and lack of quality postpartum care for birthing people of color. RESULTS: Principal themes that emerged from the interviews with participants were: perceived lack of communication about the complications they experienced; structural racism described through examples of not being listened to or believed; a perceived lack of respect for Black women's bodies by doctors and nurses, which became embedded in inappropriate verbal and nonverbal communication practices by clinicians and staff; and mismatches in care for participants were noted from the care provided and chart documentation compared with what patients understood to be happening with their health. CONCLUSION: To counter the increasing rates of morbidity and mortality among postpartum Black patients, stronger efforts are required to address the needs of Black patients during the postpartum period through documenting and acknowledging patients' lived experiences, addressing communication needs, and understanding the consequences of structural racism.

Exploring Patient Preferences Related to Shared Decision-Making in Chronic Disease Management.

Background and objective Shared decision-making (SDM) in healthcare has transitioned from a paternalistic model to a collaborative approach, particularly significant in chronic disease management. This shift focuses on aligning healthcare decisions with patient preferences and values, thereby enhancing patient engagement and treatment adherence. However, patient preferences regarding involvement in SDM vary widely, influenced by demographic, disease-specific, psychological, cultural, and social factors. This study aimed to explore patient preferences related to SDM in chronic disease management in Saudi Arabia, by assessing attitudes towardSDM, the impact of decision aids, and the role of clinician communication in influencing these preferences. Methods A cross-sectional survey design was employed, involving 409 adult outpatients with chronic diseases attending four public hospitals in Saudi Arabia. Participants were selected using purposive and convenience sampling. The survey, translated into Arabic, collected demographic data and information on preferences and experiences in decision-making, communication, and information sharing. The data were analyzed using SPSS Statistics (IBM Corp., Armonk, NY) to identify patterns and correlations. Results Key findings indicated a strong preference among the participants for involvement in treatment decisions (n=303, 74.2%) and clear communication using layman's terms (n=338, 82.6%). Major barriers to active participation in SDM included lack of time during appointments (n=275, 67.2%), difficulty understanding medical terminology (n=220, 53.9%), and feeling intimidated to ask questions (297, 72.6%).Comfort in SDM was highest intheage group of 41-50 years[mean=4.16, standard deviation (SD)=28.44; F=2.3287, p=0.0739]. Patient satisfaction was significantly higher in the age group of 18-30 years(mean=3.42, SD=1.09; F=3.0503, p=0.0284). Conclusions Our findings highlightthe need for incorporating patient preferences into chronic disease management strategies to enhance engagement and satisfaction.

Ageing in place in a rural town in Aotearoa New Zealand: A Deweyan transactional perspective

Rural communities are ageing more rapidly than urban centres due to changing demographics and preference for ageing in familiar communities. Concurrently, ageing in place policies have progressively reinforced community living as the best option for most people. For ageing in place to be successful, understanding the relationship between the community environment and the functional ability of older adults is crucial. Yet, little is known about the relationship between older adults and their environment during their everyday experiences in diverse rural communities. This article reports on the findings from walking interviews with 15 older adults as they negotiated their physical environment in a rural community in New Zealand. Dewey's transactional perspective and theory of inquiry were utilised to view the everyday transactions these older adults were undertaking while being out and about doing what they value. A Deweyan perspective enabled a deep understanding of how participants negotiated and renegotiated their environment as they encountered indeterminate situations. The three main categories identified from the data: negotiating changing capabilities in a changing environment; negotiating the environment safely; and negotiating access within the environment, captured the holistic nature of the participants' everyday transactions and their continually changing relationship with their environment. The observations and discussions during the walks uncovered problem-solving and active citizenship as these older adults undertook their own ‘commonsense’ investigations of their environment. The findings highlight the valuable contribution rurally living older adults are making as active citizens during their everyday transactions. Understanding the resourcefulness these experienced older stakeholders bring to their rural communities is the first step in active collaboration at the local level. Mobile research methods are a useful means of capturing real-time experiential data in an inclusive and creative way.

Postdigital Literacies in Everyday Life and Pedagogic Practices

In this article, we contribute to literacy and education studies by proposing three overarching features (elements) of postdigital literacy events, informed by an ecological, relational, and sociomaterial framing of literacy. These features are: (1) entanglement, (2) digital materiality, and (3) spatiotemporality. Entanglement is about how learning entangles with our social, cultural, and material contexts through communicative acts, which include an understanding of media entanglements through interface seams(/seaminess) and transmediality. Digital materiality reminds us that digital media are also material, including notions of digital matter, instantiation, representation, and significance. The feature of spatiotemporality accounts for spatiotemporal flow and presence across online/offline environments, concerned with postdigital reconfigurations of time, space, and place. All three elements incorporate challenges around equity, power, and values. We also advance theory-in-practice by providing examples of how postdigital literacy features/elements manifest in pedagogy and everyday life, based on our experiences as academics working in diverse contexts. This work can support international research, teaching, and knowledge around how media practices interrelate through postdigital communication and literacy experiences, what that means, and with what effects, within a vision of education for mutually enriching planetary futures.

The development of a model for monitoring the quality of online psychological and educational services by using automated analysis of user reviews

Introduction. Digitalization of education and healthcare is an inevitable response to the demands of society. However, it is associated with the emergence of many risks, and the need for regulation and evaluation of new online practices is becoming increasingly important. Questions about the quality of online services are becoming more and more significant, as well as the search for new methods to monitor large amounts of publicly available data about online interactions with helping professionals. The purpose of this study is to develop a model for monitoring psychological and educational online services through automated analysis of user reviews and feedback. Materials and methods. The sample for the study consisted of a variety of reviews about online psychological and educational services. A total of 24,351 reviews of psychologists' work and 6,812 reviews of tutors' work were uploaded. These reviews were ranked in order to identify levels of user satisfaction. We used the following methods to collect and analyze the data: 1) Automated data parsing to extract relevant feedback using the GraphQL API; 2) The TF-IDF (term frequency-inverse document frequency) method to identify the most important linguistic markers in the reviews; 3) The LDA (latent Dirichlet allocation) method for thematic modeling of the reviews. The results of the study. An empirical study of online reviews of psychological and educational services in accordance with this model revealed their thematic structure in four main areas: assessment of interaction (19.8%), assessment of results (26%), organization of professional interaction (20.4%), and assessment of professional skills relevant to clients (29.1%).The main characteristics that users perceive in psychological online services are: the importance of comfortable communication (21.9%), inclusiveness (13.9%), and specialist experience (5.9%). Additionally, the ability to structure a request is also significant (19.8%). The result of evaluating the psychologist's work can be seen in user reviews. Some of the most common responses include: understanding the problem (18.5%), seeing the issue from a different perspective (6.7%), and feeling better (11.3%). Assessments of the quality of online education services include accessibility and clarity of presentation (29.5%), as well as confidence and flexibility in communication (6.1%). Additionally, finding a common language with students is also important (6.2%). Conclusion. The analysis of user feedback on educational and psychological online services can help to understand the directions for the development of work by helping specialists, create a system for monitoring non-specialized assistance, describe criteria for the training and retraining of specialists, and create educational programs for developing digital competence among psychologists and educators.

The Impact of Pastoral Care on Students’ Religious and Psychological Well-Being in a Christian Tradition-Based Residential Hall in Hong Kong

This study investigates the impact of pastoral care on the religious and psychological well-being of students residing in St. John’s College, a Christian tradition-based residential hall in Hong Kong. The research employs a mixed-methods approach and comprises two complementary studies: a quantitative analysis (Study 1) involving 98 participants and a qualitative investigation (Study 2) with 26 participants. Study 1 utilised the Religious Commitment Inventory-10 (RCI-10) and the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) to measure religious commitment and psychological well-being, respectively. Initial findings revealed significant correlations suggesting that higher levels of religious commitment engender improved psychological well-being. Study 2 explored these relationships further through semi-structured interviews, providing deeper insights into how pastoral care influences students’ religious practices and mental health. The qualitative data underscored the nuanced role of pastoral activities in fostering a supportive community atmosphere, enhancing both personal and communal religious experiences.

Monitoring climate change vulnerability in the Himalayas.

Longitudinal assessment of climate vulnerability is essential for understanding the complex factors affecting how people experience and respond to climate change. We report on the first longitudinal assessment of climate vulnerability in the Himalayan region, exploring the evolving landscape, perceptions, and experiences of communities of climate change impacts, vulnerability, and adaptation in Kashmir over an 8-year period from 2017 to 2024. We provide the Himalayan Re-study Framework (HRF) to monitor, characterise, and conceptualise climate change in the Himalayas. Utilising mixed methods, we showcase how climate change is affecting social, economic, political, and environmental dimensions, examining how the impacts of climate change and vulnerability evolve over time, shaping and reshaping how climate risks are experienced and responded to by communities. Our analysis reveals a nuanced understanding of vulnerability, highlighting the impact on communities' livelihoods and water security, differential impacts on marginalised communities, and the gendered nature of climate change. We examine how certain sections of the population face marginalisation, discrimination, and racism, and how climate change exacerbates these challenges. Kashmir's vulnerability to climate change extends beyond environmental factors, intertwining with culture, livelihoods, social dynamics, and politics. Climate change continues to compete for attention with immediate political and socio-economic challenges, highlighting the need for integrated approaches to address both environmental and societal issues in Kashmir.

Creating “Liminal Community”: Communal Liminal Experience and Identity Transformation Among Black Women Tech Founders in Detroit

Creating “Liminal Community”: Communal Liminal Experience and Identity Transformation Among Black Women Tech Founders in Detroit

Josiah Royce, William James, and the Social Renewal of the “Sick Soul”: Exploring the Communal Dimension of Religious Experience

In The Sources of Religious Insight, Josiah Royce assesses William James’ pragmatic evaluation of exalted, private religious experience, advanced in The Varieties of Religious Experience as inadequate to encompass the full range of religious experience. Among other contributions, Royce adds social and communal experience to James’ individualistic appraisal. Rather than tacking on to the familiar contemporary critical conversation about the Jamesian restriction to private experience, I argue that James and Royce are helpfully brought together through an understanding of religious conversion: James’ foundational predicament of the “sick soul” returned to health through religious conversion gains depth and coherence through the attention Royce gives to overcoming alienation through communal participation. In our time of dislocation and self-preoccupation, drawing together these two seminal models of religious experience provides an instructive account of the individual’s transformation by way of communal renewal.

"Because I Am a Female": Stigma and Safety Perspectives from Racially/Ethnically Diverse Women with Serious Mental Illnesses.

Individuals with serious mental illnesses (SMIs) face safety risks related to their mental health conditions that are often compounded by experiences of trauma, victimization, residence in impoverished neighborhoods, and histories of homelessness. Stigma and safety challenges significantly impact community integration for individuals with SMIs, particularly women, who often bear a disproportionate burden of vulnerability, gender-based stigma, violence, and other inequalities. This study investigates how women with SMIs engage in the meaning-making of their safety and stigma experiences that, in turn, influence their community integration. From a large multi-site study exploring community experiences of racially/ethnically diverse participants with SMIs, a subsample of 28 cis and trans-gender women, who reported experiencing gendered stigma and a lack of safety, were chosen for the current study. The interviews were analyzed using modified principles of Interpretive Phenomenological Analysis (IPA) to understand how women with SMIs made meaning of their safety and stigma encounters in their families, communities, and neighborhoods. IPA analysis resulted in the emergence of themes within a broad category of safety that represented participants' meaning-making about their physical safety and stigma experiences. Specifically, we used the broad themes from an existing framework of safety called 'Navigating Safety' model as sensitizing concepts for our analysis. Physical and psychological aspects of safety for this study were experienced in tandem whereby the women made sense of how their experiences of a lack of physical safety in multiple contexts shaped their sense of self, internalized stigma, and their social relationships. Within the broad theme of physical safety, participants described unsafe neighborhoods, exposure to domestic and intimate partner violence, and vulnerability to sexual violence. Additionally, under psychological safety, we identified how gender-based norms, race and ethnicity, sources of stigma (internalized, familial, and societal), and social isolation contributed to their mental health and social relationships (particularly with family). These findings highlight how the compounding influence of the intersection of multiple stigmatized identities exerts safety challenges on the lives and community experiences of women with SMIs. Focusing on access and affordability of appropriate gender-responsive resources for women, including trauma-informed care, could reduce hospitalizations, mental health symptoms, and stigma so they can safely integrate into their communities.

Moving from Second Sight to Critical Consciousness Building: Using Social Justice Youth Development and Youth Participatory Action Research to Promote Praxis in Out-of-School Time

Abstract Youth development programs offer flexible environments for healing and positive identity development for youth facing discrimination and oppression. Programs often occur in out-of-school time (OST), a context that is clearly positioned in tandem with the education system to create complex relationships that lead to challenges in OST spaces. Youth development programs occurring in OST settings have the potential for resisting or replicating oppressive practices toward youth occurring in the education system. This article highlights a youth participatory action research (YPAR) project within an OST program using photovoice, field trips, and arts-based strategies. Eleven youth participated in the project over the course of nine months. Thematic content analysis of weekly photovoice and critical consciousness resulted in a primary theme of peeling back the layers. This theme encompassed the evolution of youth understanding the interconnectedness between their individual-level experiences of racism and broader community and systems-level inputs. This article describes critical consciousness development of OST youth participants through intentional engagement in critical dialogue, experiential field trips, and reflective art making.

Karihwaientáhkwen: Conceptualizing Morality in Indigenous Consciousness

Many public institutions, including universities and colleges, have committed to Indigenous engagement – the institutional effort to engage with experiences, histories, and perspectives of First Nations, Inuit, and Métis peoples in meaningful ways. In many areas of institutional endeavour, these commitments have frequently included a focus upon spiritual orientations of Indigenous peoples as a central aspect of their knowledge and worldviews. In this study, we sought to acquire knowledge on moral understandings that were resident in the consciousness of Indigenous Elders and Knowledge Keepers situated at universities across Canada. Findings revealed that personal and communal experiences informed a developed sense of responsibility that may be situated in the unique manifestations of their respective knowledge systems, heritages, and consciousnesses. Although non-Indigenous orientations such as those of Christianity informed the narratives of some, a prevailing sense of traditional identity emerged from participants.

Utilizing Large Language Models in Ophthalmology: The Current Landscape and Challenges.

A large language model (LLM) is an artificial intelligence (AI) model that uses natural language processing (NLP) to understand, interpret, and generate human-like language responses from unstructured text input. Its real-time response capabilities and eloquent dialogue enhance the interactive user experience in human-AI communication like never before. By gathering several sources on the internet, LLM chatbots can interact and respond to a wide range of queries, including problem solving, text summarization, and creating informative notes. Since ophthalmology is one of the medical fields integrating image analysis, telemedicine, AI, and other technologies, LLMs are likely to play an important role in eye care in the near future. This review summarizes the performance and potential applicability of LLMs in ophthalmology according to currently available publications.

A Qualitative Exploration into How Teachers Understand and Practice Forgiveness

Forgiveness, though hard for many to simply define in concrete terms, is not necessarily a foreign concept or practice for the average individual. In an attempt to further understanding of forgiveness, the present study gathered the thoughts, opinions, and experiences of a specific community of individuals, public school teachers. Using a series of six focus group interviews, analysis of data produced insights and conclusions related to how teachers understand forgiveness in theory and practice, how they practice forgiveness within their jobs, and their thoughts on forgiveness or virtue education within schools. Thematic analysis is presented with quotational support and a discussion of application to both forgiveness theory and future forgiveness education pursuits is offered in summation. Due to the many mental, emotional, and physical health benefits associated with forgiveness, the value of exploring forgiveness and forgiveness education is readily evident. This study provides a glimpse into the experiences of a community of individuals who practice forgiveness regularly within the context of their jobs as public school educators.