Qualitative Focus Group Study Research Articles

Cross-Generational Understandings of Ageism and Its Perceived Impacts on Personal-Public Health

ABSTRACT In 2016, the World Health Organization (WHO) launched a global campaign to combat ageism, emphasizing its potential harm to personal and public health. This qualitative focus group study explored generational differences in understanding the WHO’s definition and impact of ageism among baby boomers (ages 60–72; n = 17) and silent generation members (ages 78–85; n = 10). Verbatim transcripts were analyzed via a grounded theory approach, and representative themes and quotations were extracted by consensus. Members of both age groups initially downplayed personal impacts of ageism in favor of a broader discussion of age-related discrimination on a societal level. As each discussion progressed, however, participants acknowledged economic, social, and health impacts linked with ageism, but primarily for others. Both groups noted ageist actors in places of employment, healthcare settings, restaurants, retirement communities, and within family networks. Interestingly, each group rated risk of harm by ageism as greater for the other group. Our findings highlight challenges associated with the translation of a broad public health campaign to engage specific stakeholder subgroups. We discuss future research, education, and training initiatives across all ages to address the detrimental impacts of ageism.

Exploring Risk Perception and Behaviours at the Intersection of Flood Events and Private Groundwater Supplies: A Qualitative Focus Group Study

Flooding events can inflict major disruption on society and cause significant infrastructural and environmental damage. However, the adverse health impacts of flooding, particularly as they pertain to private groundwater resources used for consumption, are frequently overlooked. Whilst the literature has previously found a lack of well stewardship among private well owners under ‘normal’ conditions, our understanding of private well owners’ perceptions of and preparedness for the risks posed by flooding to their domestic well-water supply is limited. This study advances the qualitative literature on this subject. It is amongst the first qualitative studies employing focus groups to examine private well owners, and the first in an Irish context. Six focus groups were conducted in four counties in Ireland, with the themes emerging from the focus groups refined, organised, and interpreted in the context of the Health Belief Model. Most focus group participants expressed awareness of the potential severity of well contamination following flooding, but many did not consider their local area “at risk” of it, notwithstanding the occurrence of previous local flooding events. All focus group participants shared the view that owners were primarily responsible for their own wells. However, their capacity to undertake appropriate actions was reduced by reliance on visual and olfactory evidence to assess water quality, and concerns regarding the financial cost and accessibility of water testing facilities. The phenomenon of misperception was also evident among participants. In light of the increasing frequency and severity of extreme weather events including flooding, these findings provide direction for future socio-hydrogeological interventions. Targeted communication strategies highlighting the risks posed by flooding, mitigation measures that promote well stewardship, and protective behaviours are required. The provision of access to free well water testing would also promote protective actions.

A qualitative focus group study concerning perceptions and experiences of Nigerian mothers on stillbirths

ObjectiveTo explore the experiences and perceptions of stillbirth among mothers from a tertiary medical centre in Kano, Northern Nigeria.DesignQualitative, interpretative.SettingTertiary healthcare facility, Murtala Muhammad Specialist Hospital (MMSH), Kano, Northern Nigeria.SampleMothers who had given birth to a liveborn baby at the MMSH in the prior 6 months (n = 31). In order to capture the experiences and perception of stillbirth within this cohort we approached mothers who had in a previous pregnancy experienced a stillbirth. Of the 31 who attended 16 had a previous stillbirth.MethodsSemi-structured Focus Group Discussions, consisting of open-ended questions about stillbirth, beliefs, experiences and influences were held in MMSH, conducted over 1 day.ResultsOur findings highlight that this is a resource-poor tertiary facility serving an ever-growing population, increasing strain on the hospital and healthcare workers. Many of the participants highlighted needing permission from certain family members before accessing healthcare or medical treatment. We identified that mothers generally have knowledge on self-care during pregnancy, yet certain societal factors prevented that from being their priority. Judgement and blame was a common theme, yet a complex area entwined with traditions, superstitions and the pressure to procreate with many mothers described being made to feel useless and worthless if they did not birth a live baby.ConclusionsAs access to healthcare becomes easier, there are certain traditions, family and social dynamics and beliefs which conflict with scientific knowledge and act as a major barrier to uptake of healthcare services. The findings highlight the need for investment in maternity care, appropriate health education and public enlightenment; they will help inform appropriate interventions aimed at reducing stigma around stillbirth and aide in educating mothers about the importance of appropriate health seeking behaviour. Stillbirths are occurring in this area of the world unnecessarily, globally there has been extensive research conducted on stillbirth prevention. This research has highlighted some of the areas which can be tackled by modifying existing successful interventions to work towards reducing preventable stillbirths.

What do geriatric rehabilitation patients and experts consider relevant? Requirements for a digitalised e-coach for sustainable improvement of nutrition and physical activity in older adults \u2013 a qualitative focus group study

BackgroundDuring geriatric rehabilitation, attempts are made to increase the patients’ health and functional capacity. In order to maintain these improvements in the medium- and long-term, behavioural changes regarding mobility and nutrition are also targeted, but these are often not sustainable. International studies show positive effects on the sustainability of the improvement of physical activity behaviour in healthy seniors through the use of electronic devices and software applications. Comparable approaches that include nutrition topics or combine them and were additionally developed for geriatric rehabilitation patients (≥70 years) to date are not known. The aim of this study was to identify what geriatric rehabilitation patients require from an electronic coaching system (e-coach) to support them in improving their nutritional and physical activity behaviour, and what content and features physiotherapists and dieticians consider relevant.MethodFocus group interviews (09–11/2019) were conducted in a geriatric rehabilitation centre in Germany with patients aged 70 years and older, relatives and experts (physiotherapists and nutritionists). The focus groups were recorded, transcribed verbatim and analysed using content analysis.ResultsThree focus groups with patients and relatives (n = 17, 65% female, 16 (94%) in age category 70–99 years) and one focus group with experts (2 dieticians and 1 physiotherapist) were conducted. Relevant contents and feedback elements for nutrition and physical activity in old age were identified. The patients’ comments show that an e-coach must offer obvious benefits for the older persons and promote motivation in order to be used. The willingness to change nutrition and physical activity behaviour and the previous experiences in these areas are very heterogeneous, therefore content should be adaptable to different requirements.ConclusionExperts and patients identified quite similar contents, barriers and facilitators for a nutrition and physical activity e-coach. The e-coach needs to be able to address different points of behaviour change, enable adaptations to the individual patient and convince the older person that using it will help them to improve their nutrition and physical activity. It is also important that the e-coach is easy to use and can be easily integrated into the patient’s everyday life after rehabilitation.

Opiniones de Familiares de Personas con Enfermedad Mental Sobre su Participación en la Toma de Decisiones Clínicas. Un Estudio de Grupo Focal

Background and objectivesMental illnesses can affect an individual's decision-making capacity, forcing family members to make decisions about treatment. Cultural variations in preferences and degree of participation in care have been reported. The objective was to identify and characterise opinions, preferences concerning participation and decision-making methods regarding treatment among relatives of patients with mental illnesses treated in mental health institutions in Bogotá, Colombia. MethodsA qualitative focus-group study with 37 adult relatives of patients with mental illness seen in two psychiatric clinics and discourse analysis on decision-making based on constructivist grounded theory. ResultsFour initial categories consistent with the literature, as well as a new culturally relevant category that emerged, called “companionship”, are presented. The initial deductive categories described are: companionship, tools, method, symptoms and treatment. Specific and exclusive themes were derived that resulted in 31 final emerging subcategories. Family members were seen to want to actively participate in the decision-making process along with the psychiatrist and the patient, but to face some specific difficulties in relation to mental illness making it difficult for them to act as efficient caregivers. A systemic scheme on the interaction of the categories in decision-making is proposed. ConclusionsFamily members of individuals with mental illness seek to participate in clinical decision-making with affection, responsibility and intuition, in a collaborative relationship with the psychiatrist and the institution in charge of their treatment.

Participatory Development and Pilot Testing of an Adolescent Health Promotion Chatbot.

Background: The use of chatbots may increase engagement with digital behavior change interventions in youth by providing human-like interaction. Following a Person-Based Approach (PBA), integrating user preferences in digital tool development is crucial for engagement, whereas information on youth preferences for health chatbots is currently limited.Objective: The aim of this study was to gain an in-depth understanding of adolescents' expectations and preferences for health chatbots and describe the systematic development of a health promotion chatbot.Methods: Three studies in three different stages of PBA were conducted: (1) a qualitative focus group study (n = 36), (2) log data analysis during pretesting (n = 6), and (3) a mixed-method pilot testing (n = 73).Results: Confidentiality, connection to youth culture, and preferences when referring to other sources were important aspects for youth in chatbots. Youth also wanted a chatbot to provide small talk and broader support (e.g., technical support with the tool) rather than specifically in relation to health behaviors. Despite the meticulous approach of PBA, user engagement with the developed chatbot was modest.Conclusion: This study highlights that conducting formative research at different stages is an added value and that adolescents have different chatbot preferences than adults. Further improvement to build an engaging chatbot for youth may stem from using living databases.

Engaging clinicians early during the development of a graphical user display of an intelligent alerting system at the bedside

BackgroundArtificial Intelligence (AI) is increasingly used to support bedside clinical decisions, but information must be presented in usable ways within workflow. Graphical User Interfaces (GUI) are front-facing presentations for communicating AI outputs, but clinicians are not routinely invited to participate in their design, hindering AI solution potential. PurposeTo inform early user-engaged design of a GUI prototype aimed at predicting future Cardiorespiratory Insufficiency (CRI) by exploring clinician methods for identifying at-risk patients, previous experience with implementing new technologies into clinical workflow, and user perspectives on GUI screen changes. MethodsWe conducted a qualitative focus group study to elicit iterative design feedback from clinical end-users on an early GUI prototype display. Five online focus group sessions were held, each moderated by an expert focus group methodologist. Iterative design changes were made sequentially, and the updated GUI display was presented to the next group of participants. Results23 clinicians were recruited (14 nurses, 4 nurse practitioners, 5 physicians; median participant age ∼35 years; 60% female; median clinical experience 8 years). Five themes emerged from thematic content analysis: trend evolution, context (risk evolution relative to vital signs and interventions), evaluation/interpretation/explanation (sub theme: continuity of evaluation), clinician intuition, and clinical operations. Based on these themes, GUI display changes were made. For example, color and scale adjustments, integration of clinical information, and threshold personalization. ConclusionsEarly user-engaged design was useful in adjusting GUI presentation of AI output. Next steps involve clinical testing and further design modification of the AI output to optimally facilitate clinician surveillance and decisions. Clinicians should be involved early and often in clinical decision support design to optimize efficacy of AI tools.

"Friction by Definition": Conflict at Patient Handover Between Emergency and Internal Medicine Physicians at an Academic Medical Center.

IntroductionPatient handoffs from emergency physicians (EP) to internal medicine (IM) physicians may be complicated by conflict with the potential for adverse outcomes. The objective of this study was to identify the specific types of, and contributors to, conflict between EPs and IM physicians in this context.MethodsWe performed a qualitative focus group study using a constructivist grounded theory approach involving emergency medicine (EM) and IM residents and faculty at a large academic medical center. Focus groups assessed perspectives and experiences of EP/IM physician interactions related to patient handoffs. We interpreted data with the matrix analytic method.ResultsFrom May to December 2019, 24 residents (IM = 11, EM = 13) and 11 faculty (IM = 6, EM = 5) from the two departments participated in eight focus groups and two interviews. Two key themes emerged: 1) disagreements about disposition (ie, whether a patient needed to be admitted, should go to an intensive care unit, or required additional testing before transfer to the floor); and 2) contextual factors (ie, the request to discuss an admission being a primer for conflict; lack of knowledge of the other person and their workflow; high clinical workload and volume; and different interdepartmental perspectives on the benefits of a rapid emergency department workflow).ConclusionsCauses of conflict at patient handover between EPs and IM physicians are related primarily to disposition concerns and contextual factors. Using theoretical models of task, process, and relationship conflict, we suggest recommendations to improve the EM/IM interaction to potentially reduce conflict and advance patient care.

No One Size Fits All: A Qualitative Study of Clerkship Medical Students' Perceptions of Ideal Supervisor Responses to Microaggressions.

This study explores medical students' perspectives on the key features of ideal supervisor responses to microaggressions targeting clerkship medical students. This single-institution, qualitative focus group study, based in an interpretivist paradigm, explored clerkship medical students' perceptions in the United States, 2020. During semistructured focus groups, participants discussed 4 microaggression scenarios. The authors employed the framework method of thematic analysis to identify considerations and characteristics of ideal supervisor responses and explored differences in ideal response across microaggression types. Thirty-nine students participated in 7 focus groups, lasting 80 to 92 minutes per group. Overall, students felt that supervisors' responsibility began before a microaggression occurred, through anticipatory discussions ("pre-brief") with all students to identify preferences. Students felt that effective bystander responses should acknowledge student preferences, patient context, interpersonal dynamics in the room, and the microaggression itself. Microassaults necessitated an immediate response. After a microaggression, students preferred a brief one-on-one check-in with the supervisor to discuss the most supportive next steps including whether further group discussion would be helpful. Students described that an ideal supervisor bystander response incorporates both student preferences and the microaggression context, which are best revealed through advanced discussion. The authors created the Bystander Microaggression Intervention Guide as a visual representation of the preferred bystander microaggression response based on students' discussions. Effective interventions promote educational safety and shift power dynamics to empower the student target.

Perception and Experience of Biologic Therapy in Atopic Dermatitis: A Qualitative Focus Group Study of Physicians and Patients in Europe and Canada.

IntroductionThe Biologics in Atopic Dermatitis: Experiences & Learnings (BADEL) project aims to improve real-life understanding of how, where, and when biologics can play a role in the treatment of atopic dermatitis (AD) from the perspective of healthcare professionals (HCPs) and patients.MethodsIndividual experiences of 24 patients with moderate-to-severe AD and who had been treated with biologic therapy (dupilumab) for ≥ 3–6 months, and 20 HCPs with a sub-specialty interest in AD were collected by means of focus groups held in Canada, Germany, France, Italy and the United Kingdom. Dupilumab was the only biologic therapy available at the time of the study.ResultsMost patients had suffered from AD for many years, particularly from itch and psychosocial issues, with AD negatively impacting all aspects of their life. They had experienced a long treatment journey and seen many dermatologists, enduring treatment delays and failures. They had been prescribed various therapies without long-term success. Biologics provided symptom improvement, offering many patients a near-normal quality of life. Side effects, especially conjunctivitis, were the greatest drawback, and there were a few issues with incomplete or unreliable efficacy. HCPs agreed that biologic therapy for AD in the majority of patients demonstrated rapid onset, good efficacy and tolerability, and are a viable option in patients who had exhausted all other treatment options. However, those patients who failed to sufficiently respond or developed intolerable adverse effects, particularly ocular symptoms, require alternative therapeutic options.ConclusionBiologics can provide a near-normal quality of life for many patients with AD. Patients with AD who have failed conventional therapies should be offered all such novel therapies. Education and good patient–HCP communication will enable patients to manage their disease and treatment expectations. Patients and HCPs alike eagerly await alternative targeted therapies, which will offer greater choice and flexibility.

Dental Visits for Autistic Children: A Qualitative Focus Group Study of Parental Perceptions.

Patient groups who pose behavioral challenges during dental attendance may be offered more restricted dental treatment options. Unsuccessful participation with dental visit tasks and demands has been commonly reported for autistic children. This study aimed to examine parental perceptions of difficulties associated with dental attendance and oral care for autistic children and young adults, to highlight reported challenges and potential adaptations, and to identify interventions that will encourage positive experiences of dental attendance. Qualitative data were gathered through 2 focus groups with parents of primary school and secondary school pupils with autism, interviewed in separate groups. Questions about parents' perceptions of dental attendance and oral care were asked. The groups were audio-recorded and transcribed verbatim. The transcripts were analyzed and initial codes generated. Development of subthemes and themes followed a process of thematic analysis. Parental perceptions, which confirmed data from other studies, included the need for understanding and training, awareness of sensory issues, recognition of the individuality of autistic traits, time and clarity for communication, and factors affecting the confidence of parents to advocate in the clinical environment. Focus group participants identified the critical value of empathizing with an autistic perspective and highlighted the importance of positive oral health messages. They also noted the lack of understanding regarding the complexity of altering self-imposed, ritualistic dietary regimes and attempting to enact good dental preventive habits for their children. Analysis of data from parent focus groups provided a greater understanding of the needs and responsivity required for successful dental visits for autistic children and young adults. A range of potential interventions was identified and incorporated within a model of needs. Interventions based on Partnership Working, System Change, and Training of Dental Staff could be effective in reducing challenges posed by dental attendance for many children with autism. Sensory sensitivities, communication difficulties, comorbid intellectual disability, and dental anxiety are barriers to successful participation during dental attendance for autistic children. This research proposes that interventions supporting Partnership Working, System Change, and Training of Dental Staff can reduce challenges posed by dental attendance. The model of interventions developed as part of this project can be used by oral care teams to help reduce barriers and improve the success of dental visits for autistic children.

Managers’ experience-based understanding of capacity to work in workers with common mental disorders

Abstract Background The capacity to work among workers with common mental disorders (CMD) is important to understand but scarcely explored from a manager perspective, even though their views could add essential knowledge. The aim of this study was to explore and describe managers' experience-based understanding of capacity to work in individuals with CMD. Methods This qualitative focus group study used inductive manifest content analysis as analytic technique. First-line managers with experiences of employees with CMDs were recruited via organizations and networks. Eight focus group interviews with altogether 31 participants were performed. Results The analysis resulted in five categories of managers' experience-based understanding of occupational functioning in workers with CMDs: (1) The capacity to mentally focus on work tasks decreases or disappears, with negative consequences for work output. (2) The capacity to commit to continuous and coherent tasks changes, making tasks that span over longer periods of time difficult. (3) The capacity to independently adapt to the needs of the situation decreases, causing the worker to need more guidance and instructions than usual. (4) The capacity to keep up professional appearances is reduced, meaning that the worker struggle with the professional role. Finally, (5) the ability to interact socially and professionally decreases, which potentially causes conflicts at the workplace. Conclusions This study shows managers' experience-based understanding of CMDs in workers as severe changes and reductions of employees' capacities needed for occupational functioning. These findings add to the understanding of the construction of the capacity at the workplace. A deeper understanding of reduced work capacity is also needed to adapt workplaces and our findings can facilitate work accommodations for employees with CMDs. Key messages This study adds a manager perspective to the increasing knowledge about how capacity to work is influenced by CMD. This study shows that managers experience that CMD in workers severely change and reduce employees’ capacities needed for occupational functioning.

Inpatients experiences about the impact of traumatic stress on eating behaviors: an exploratory focus group study

BackgroundUnhealthy changes in eating behavior among people experiencing trauma have been observed. There is, however, a lack of in-depth knowledge regarding the impact of the after effects of traumatic life experiences on eating behavior. Because eating behavior represents important components for promotion and maintenance of good health throughout life, this study aimed to explore inpatients’ lived experiences of the impact of traumatic stress on eating behavior.MethodThirteen female and two male inpatients (age range 28–62 years), recruited from a psychiatric clinic in Norway, participated in this qualitative explorative focus group study. The data analysis was performed using systematic text condensation.ResultsThe results in the present study describe the participants’ experiences about the impact of traumatic stress on their eating behavior. Their discussions and descriptions disclosed problems that could be summarized into four main themes: “experiencing eating behaviors as coping strategies”; “experiencing being addicted to food and sweets”; “experiencing eating behaviors controlled by stress and emotions”; and “experiencing lack of appetite and reduced capacity to plan and prepare meals”.ConclusionTraumatic stress can impact eating behavior in several complex ways that over time may cause adverse health consequences. The results add to an important understanding of changes in eating behavior that might appear in people struggling to cope with the after effects of traumatic life experiences to the existing literature. To better understand the complexity of how traumatic experiences may impact eating behavior, this knowledge is important and useful for health professionals offering support to those who experience struggling with eating behavior after traumatic experiences.

Educational strategies to enhance EBM teaching and learning in the workplace: a focus group study

ObjectivesThis study aimed to gather and synthesise educational strategies that can improve teaching and learning of evidence-based medicine (EBM) in the workplace, and make them concrete by listing ideas for...

Adaptability of Human Geography Study Program Alumni Competencies in the Job Market

research alumni preparedness for the job market. The aim of the study was to analyze alumni competences of the Master`s study program in Human Geography and compare them to job market demands. The analysis of theoretical performance appraisal by competencies indicated the importance of employee competencies. Graduates must be competent in professional erudition, functional flexibility, innovation and knowledge management, human resource mobilization, international orientation etc. The Master study program of Human Geography at KU has been successfully operating since 1998, and the Ministry of Education, Science and Sport included it in the list of the unique study programs in the Republic of Lithuania. In order to ensure that the competencies of the students could correspond to the labor market, the developers and renewers of the study program must regularly listen to the feedback of the graduates, who completed this program. A qualitative focus group study was conducted in order to reveal a reflection of graduates and their appraisal for better matching of the program to labor market needs. Empirical data were collected during the alumni round table discussion. The study involved 10 alumni and qualitative content analysis was performed to analyze the empirical data. After analyzing the data of the interview-discussion research, the following 7 categories were distinguished: Project preparation competence – one of the most important competencies of the master’s study program; GIS program management competence formation and application in work activities; International orientation, foreign language skills open more opportunities; Information, literature search and competences of literature analysis; Tendencies of adaptability of students competencies in practical and work activities; Unawareness of the profession of human geography in society; Suggestions for better compliance of alumni competencies with the labor market. The interview-discussion statements of the research participants were concentrated in the following main subcategories: Academic worldview formation (s); Strong alumni foreign language competence; Application of competencies shows wide multifunctionality of the study program; Importance of application of competencies is unquestionable; Project preparation competence is successfully applied or has a strong potential for application in work activities in the short and long term; Literature analysis; Information, literature search, etc. The content of all categories and subcategories is localized at a positive level of matching labor market to graduates’ competencies. Keywords: alumni, job market, human geography, master’s study program, content analysis.

Clinicians\u2019 perceptions of a potential wearable device for capturing upper limb activity post-stroke: a qualitative focus group study

BackgroundThere is growing interest in the use of wearable devices that track upper limb activity after stroke to help determine and motivate the optimal dose of upper limb practice. The purpose of this study was to explore clinicians’ perceptions of a prospective wearable device that captures upper limb activity to assist in the design of devices for use in rehabilitation practice.MethodsFour focus groups with 18 clinicians (occupational and physical therapists with stroke practice experience from a hospital or private practice setting) were conducted. Data were analyzed thematically.ResultsOur analysis revealed three themes: (1) “Quantity and quality is ideal” emphasized how an ideal device would capture both quantity and quality of movement; (2) “Most useful outside therapy sessions” described how therapists foresaw using the device outside of therapy sessions to monitor homework adherence, provide self-monitoring of use, motivate greater use and provide biofeedback on movement quality; (3) “User-friendly please” advocated for the creation of a device that was easy to use and customizable, which reflected the client-centered nature of their treatment.ConclusionsFindings from this study suggest that clinicians support the development of wearable devices that capture upper limb activity outside of therapy for individuals with some reach to grasp ability. Devices that are easy to use and capture both quality and quantity may result in greater uptake in the clinical setting. Future studies examining acceptability of wearable devices for tracking upper limb activity from the perspective of individuals with stroke are needed.

Investigating Mental Health Service User Opinions on Clinical Data Sharing: Qualitative Focus Group Study.

BackgroundSharing patient data can help drive scientific advances and improve patient care, but service users are concerned about how their data are used. When the National Health Service proposes to scrape general practitioner records, it is very important that we understand these concerns in some depth.ObjectiveThis study aims to investigate views of mental health service users on acceptable data sharing to provide clear recommendations for future data sharing systems.MethodsA total of 4 focus groups with 4 member-checking groups were conducted via the internet between October 2020 and March 2021, with a total of 22 service users in the United Kingdom. Thematic analysis was used to identify the themes.ResultsSix main themes, with several subthemes were identified, such as the purpose of data sharing—for profit, public good, and continuation of care; discrimination through the misattribution of physical symptoms to mental health conditions (ie, diagnostic overshadowing) alongside the discrimination of individuals or groups within society (ie, institutional discrimination); safeguarding data by preserving anonymity and confidentiality, strengthening security measures, and holding organizations accountable; data accuracy and informed consent—increasing transparency about data use and choice; and incorporating service user involvement in system governance to provide insight and increase security.ConclusionsThis study extends the limited research on the views and concerns of mental health service users regarding acceptable data sharing. If adopted, the recommendations should improve the confidence of service users in sharing their data. The five recommendations include screening to ensure that data sharing benefits the public, providing service users with information about how their data are shared and what for, highlighting the existing safeguarding procedures, incorporating service user involvement, and developing tailored training for health care professionals to address issues of diagnostic overshadowing and inaccurate health records. Adopting such systems would aid in data sharing for legitimate interests that will benefit patients and the National Health Service.

Nurses' Perceptions of Patient Participation in the Postanesthesia Care Unit—A Qualitative Focus Group Study

PurposeTo explore postanesthesia care unit (PACU) nurses' experiences and perception of patient participation during PACU care. DesignQualitative focus group study based on a phenomenological hermeneutic approach. MethodsWe conducted three focus group interviews with 18 nurses from three different PACUs. Themes were created based on interpretive theory inspired by Ricoeur. FindingsFour themes and 11 subthemes were found. Patients’ clinical condition and situation, time management, ethical aspects, and the patient-nurse relationship all had a high impact on postanesthesia nursing practice and conditions for involving patients. ConclusionsPACU nurses want patients to participate in their own treatment and care in the PACU; however, nurses perceive patient participation differently. Nurses experience challenges including patients’ impaired autonomy, absence of a holistic approach, and lack of time and resources. Nurses highlight that these barriers should not become an excuse for noninvolvement.

Early Social Workers’ Experiences during the COVID-19 Pandemic: A Qualitative Study

ABSTRACT This study reports the findings of a qualitative focus group study of 16 recently graduated MSW social workers in the New York City area regarding their experiences working during the devastating initial wave of the COVID-19 pandemic from March to June 2020. Each respondent participated in one of two 90-minute focus groups in October of that year. Themes delineated were: Varying levels of agency responsiveness and support; Rapid changes in job functions; Great decrease in availability of client services and resources; Social workers’ difficult emotional reactions; Balancing family circumstances with work responsibilities; Fear of contracting COVID-19; and Professional pride and growth. The findings indicate the need for more holistic supervisory support for beginning social workers, more effective and transparent communication in agency settings, and better preparedness for crisis situations. The results are also a tribute to the dedication of new social workers who worked tenaciously during a global crisis despite their own difficult emotional reactions and family situations.

\u201cSo, when a woman becomes ill, the total structure of the family is affected, they can\u2019t do anything\u2026\u201d Voices from the community on women with breast cancer in India: a qualitative focus group study

BackgroundPsychological symptoms are common in women with breast cancer and profoundly affect their role in the family and wider community, varying across cultural backgrounds. Breast cancer is becoming the most common cancer among women in India. We aimed to understand the cultural context within which Indian women with breast cancer living in India, experience psychological concerns from the perspectives of healthcare professionals, volunteers and church members.MethodsFive focus groups were conducted in South India (clinicians (2 groups)) lay public (3 groups). A topic guide was explored: understanding of breast cancer, experiences of patients with regard to diagnosis and treatment and psychological impact. Groups were audio-recorded and verbatim transcribed. Lay groups were conducted in Malayalam with translation and back-translation. Transcripts were subjected to thematic analysis using “cultural task analysis” as a lens for analysis.ResultsForty-five (oncologists (5), nurses (10), church members (16) and community volunteers working in a palliative care unit (14) participated. Three major themes psychosocial issues related to diagnosis, psychosocial impact of cancer treatment and coping with diagnosis and treatment and nine subthemes emerged from the two groups. All described psychological impact on women with breast cancer including body image, change of family role and their need for support. Family and faith were recognised as the major framework providing key support but also significant stress. Clinicians were also concerned about financial implications and issues around early cancer detection. Laypeople and nurses also commented that poor communication and lack of empathy from doctors aggravated distress.ConclusionClinical and lay communities were aware of the widespread psychological impact affecting women with breast cancer which are amplified by the patriarchal context within which they live, which extends into clinical practice. Family and faith provide a strong support structure and are a cause of distress, as core roles and expectations are challenged by this disease of womanhood.