Family, state, class and solidarity: re-conceptualising intergenerational solidarity through the grounded theory approach.
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ABSTRACT:
SUBMITTER: Timonen V
PROVIDER: S-EPMC5549129 | biostudies-other | 2013 Sep
REPOSITORIES: biostudies-other
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Project description:There was a paucity of research describing the perspectives and experiences of clinical genetics providers in telehealth prior to the SARS-CoV-2 pandemic. The available literature focused primarily on provider satisfaction and offered limited insight into genetics providers' work in telehealth. The purpose of this study, conducted just prior to the widespread knowledge of SARS-CoV-2 in the United States and mass transition to telehealth, was to understand the telehealth process from the vantage of genetics providers working in telehealth practice settings. This research employed grounded theory using the constant comparative method in coding and analysis of data to generate theory. Ten genetics providers were interviewed over the phone about their experiences, specifically the efficacy of telehealth work, providers' perspectives of patient outcomes, and personal fulfillment derived from telehealth patient care. Six themes emerged in the study: Making Professional Choices, Increasing Patient Access, Providing Effective Services, Understanding Telehealth Limits, Feelings about Telehealth Consultations, and Deepening Personal Fulfillment. These major themes guided the creation of the Theoretical Model of Telehealth Providers in Genetics, which depicts the connections between providers' personal fulfillment in telehealth, commitment to patient services, and the provision of telehealth to the public. This model may help others who are working on telehealth initiatives or developing telehealth programs. Findings from this study can support the current use and the growth of telehealth in genetics as a result of the SARS-CoV-2 pandemic. Future research is needed to describe the telehealth process and develop valid instruments for assessing and measuring the constructs of the Theoretical Model of Telehealth Providers in Genetics.
| S-EPMC9790448 | biostudies-literature
Project description:Video game companies are increasingly diversifying their profit models. Rather than relying exclusively on the sale of video game titles or the subscription model, video game companies are maximising the revenues and extending the lifecycle of their games by means of a strategy based on the sale of in-game goods. This study contributes to the theory on in-game goods purchases by explaining why and how video game players purchase different types of in-game goods. We used an inductive approach involving qualitative data analysis based on grounded theory. Six types of in-game goods are grouped into three categories: functional-based goods, probability-based goods, and ornamental-based goods. After acknowledging the heterogeneity of the categories, a conceptual framework is developed by conducting 21 in-depth interviews, from which it emerges that players purchase functional-based goods, probability-based goods, and ornamental-based goods for different motives and through the different behavioural processes. First, the purchase of functional-based goods is a strategy for entering the flow experience. Second, the purchase of probability-based goods is a compromise for purchase restrictions. Third, the purchase of ornamental goods is driven by the synergism of intrinsic motivations and exposure in the virtual world. Therefore, video game researchers should not treat in-game goods as a homogeneous concept. The findings also suggest that it is critically important for video game developers to strike a balance between the challenges of the gameplay and the skills of players because excessively raising (or lowering) the level of difficulty could pose a threat to the company's sustainable profit.
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Project description:BackgroundPharmaceutical care has been implemented and regulated differently across Europe with no consensus among countries in relation with professional competencies and especially on nurse prescribing. Demophac Project funded by the European Commission aims to develop a Pan-European Pharmaceutical Care Model with collaboration of 14 partner teams across Europe including Spain where nurse prescribing is starting its implementation at regional level. The aim of the study was to increase understanding of the role of nurses in Pharmaceutical care in Spain after the Nurse Prescribing Regulation approved in 2018 throughout exploring the views and expectations of health professionals involved in the representative settings.Methods and findingsIn depth interviews were conducted in a structure previously agreed by the European Demophac partnership around four topics associated with the Nursing ideal role in pharmaceutical care and the ideal interaction with other healthcare professionals. A grounded-theory approach based on Corbin & Strauss was conducted to interpret collected data from the Spanish most representative settings (primary care, specialized care and residential care for older population). Participants were health professionals involved in pharmaceutical care that accepted to participate (nurses (n = 7), physicians (n = 8) and pharmacists (n = 9)). A pharmaceutical care comprehensive model for the Spanish context considering the recently approved Nurse Prescribing role and the interprofessional collaboration and communication was developed towards facilitating the understanding in such context and the contribution to the unified European Demophac Framework.ConclusionsNurses are primarily responsible for population's Pharmaceutical Care while other professionals pivot on them to provide quality healthcare on a multidisciplinary level. Nurse prescribing may contribute efficiently to the Spanish Health System though more consensus in terms of nurses' training nationwide and enhancement in communication among different professionals within healthcare organizations is required to achieve adequate integrated care into practice.
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Project description:The article addresses the strength and character of intergenerational family solidarity under different family cultures and welfare state regimes in order to answer the following two questions: (1) Is intergenerational solidarity stronger under the more collectivist southern family tradition than under the more individualist northern tradition? (2) Is more generous access to social care services a risk or a resource for family care? These questions are explored with data from the OASIS project, a comparative study among the urban populations aged 25+ (n=6,106) in Norway, England, Germany, Spain, and Israel. The findings indicate that the welfare state has not crowded out the family in elder care, but has rather helped the generations establish more independent relationships. Intergenerational solidarity is substantial in both the northern and southern welfare state regimes, and seems to vary in character more than in strength.
| S-EPMC5546341 | biostudies-other
Project description:BACKGROUND:Adult children of parents with mental illness experience a myriad of complex emotions as they attempt to make meaning of the lived experiences of their parents. A crucial time for adult children is emerging adulthood, a time when they move away from their family of origin and establish their own identity and independence. Despite existing research that provides a static description of adult children's lived experiences, the literature lacks an explanatory theory about the dynamic, relational processes that occur as adult children progress from one life stage to the next. METHODS:The current study aimed to develop an explanatory theory of the relational trajectory that adult children might experience as they course through adulthood and parenthood over time. Semistructured interviews using grounded theory analysis were conducted with 10 adult children aged between 27 and 51 years old. RESULTS:Three key phases within the Relational Trajectory Model (RTM) were identified: (i) confusion, (ii) contemplation, and (iii) reconciliation. By reflecting on their own parenting role, adult children were able to reach an evolved parental identity, with the majority of participants also making relationship reparations with their parents with mental illness. Parallels are drawn to theories of identity and intergenerational family systems to further explain and substantiate the processes encompassed within the RTM. CONCLUSION:Generating an explanatory theory serves as a potential guide for mental health professionals working with families with parental mental illness, by drawing attention to the intricacies of familial relationships and interpersonal ties.
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Project description:Family meals are recognized as an opportunity to promote the health of families. Popular discourse posits that changes to contemporary family life have made family meals harder to achieve and promotion of the 'traditional' family meal may be adding pressures to contemporary families. While research has been conducted on family meals over the last three decades, there is no explicit investigation of the experiences and practices of family meals over this time. Understanding the evolution of family meal practices across time is important for developing achievable expectations in relation to this ritual. Qualitative interviews were conducted with a diverse population of South Australian parents in the 1990s (n = 32) and with a separate population of parents in 2020 (n = 22) to gather their experiences of family meal practices. A comparative analysis, informed by grounded theory, was undertaken to identify similarities and differences in experiences across these two time periods. The results indicated stability in many family meal experiences across time, particularly in their value and significance in family life. Negotiations balancing time, cost, food preferences and responsibility persisted. The stability of family meal values and practices is important to consider when making recommendations, designing interventions and creating services targeting the family meal.
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Project description:To rationalize the selection of a research methodology, one must understand its philosophical origins and unique characteristics. This process can be challenging in the landscape of evolving qualitative methodologies. Grounded theory is a research methodology with a distinct history that has resulted in numerous approaches. Although the approaches have key similarities, they also have differing philosophical assumptions that influence the ways in which their methods are understood and implemented. The purpose of this discussion paper is to compare and contrast three widely used grounded theory approaches with key distinguishing characteristics, enabling a more thoughtful selection of approach. This work contributes to the existing literature through contrasting classic Glaserian grounded theory, Straussian grounded theory, and constructivist grounded theory in a systematic manner with prominent distinguishing characteristics developed from a review of the literature. These characteristics included historical development, philosophical perspective, role of the researcher, data analysis procedures, perspective of the grounded theory, and strengths/critique. Based on this analysis, three considerations are proposed to direct the methodological choice for a study: purpose, philosophy, and pragmatics. Understanding the similarities and differences in the grounded theory approaches can facilitate methodological transparency and determine the best fit for one's study and worldview as a researcher.
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Project description:The trigeminocardiac reflex (TCR) is defined as sudden onset of parasympathetic dysrhythmias including hemodynamic irregularities, apnea, and gastric hypermotility during stimulation of sensory branches of the trigeminal nerve. Since the first description of the TCR in 1999, there is an ongoing discussion about a more emergent clinical definition. In this work, the author worked out an approach to such an improved definition.In this study, a grounded theory approach was used. Literature about TCR was systematically identified through PubMed (MEDLINE), EMBASE (Ovid SP), and ISI Web of Sciences databases from 1/2005 until 8/2015. TCR was defined as a drop of heart rate (HR) below 60 bpm or 20% to the baseline. A grounded theory approach was used to analyze and interpret the data through a synthesis by the researcher's perspectives, values, and positions.Out of the included studies, the authors formed available data to an update of the understanding of changes in hemodynamic parameters (HR and blood pressure) in a TCR. According to this update, an HR deceleration should be a constant observation to identify a TCR episode while a drop in blood pressure should probably not being fixed to a certain percentage of decrease.The here presented working definition improves our understanding of the TCR. It leads the way to a new understanding of the TCR for a proper clinical definition.
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Project description:Informal caregivers, mainly family members and friends, provide supportive and palliative care for people with amyotrophic lateral sclerosis (ALS) during their terminal disease course. Informal caregiving for people with ALS continues towards palliative care and end-of-life care with the progression of the disease. In this study, we provide a theoretical understanding of informal caregiving in ALS utilising 23 semi-structured interviews conducted with informal caregivers of people with ALS (pwALS) in Switzerland. Due to the expected death of the care recipient, our grounded theory approach outlines informal caregivers' caregiving work as an effort to secure a balance amongst different caregiving activities, which feed into the final stage of providing palliative care. Overall, our theoretical understanding of ALS informal caregiving work encompasses the core category 'holding the balance' and four secondary categories: 'Organising support', 'being present', 'managing everyday life' and 'keeping up with ALS'. The core category of holding the balance underlines the significance of ensuring care and normalcy even as disease progresses and until the end of life. For the informal caregivers, this balancing act is the key element of care provision to pwALS and therefore guides decisions surrounding caregiving. On this understanding, those caregivers that succeed in holding the balance can provide care at home until death. The balance is heavily influenced by contextual factors of caregiving, for example relating to personal characteristics of the caregiver, or activities of caregiving where the goal is to ensure the quality of life of the pwALS. As there is a heterogeneity of speed and subtype of progression of ALS, our work accounts for multiple caregiving trajectories.
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Project description:BackgroundSubstance misuse teaching within the undergraduate medical curriculum has been underrepresented compared to more traditional medical topics. In response several national curriculum reviews such as the most recent UK department of health initiative (DOH) have identified deficiencies in substance misuse education and have suggested curriculum interventions for local faculties to implement. The student perspective however has largely been muted during this process and this study aims to explore this using a constructivist grounded theory approach.MethodsEleven final year and intercalating medical students across three separate focus groups participated in this study over a three-month period commencing from March 2018. Time between the audio recorded focus groups allowed for a parallel process of data collection and analysis into more focussed codes and categories to occur, consistent with the grounded theory approach. The qualitative study took place in a single medical school in the UK.ResultsMedical students had a common consensus that substance misuse education was an underperforming subject in their curriculum, from limited teaching hours to curriculum design and organisational problems. Students identified an alternative curriculum is required to not only prepare students for their future clinical duties but also their own personal lives. Students highlighted this proximity to a 'dangerous world' where exposure to substance misuse risks were faced daily. This exposure also provided a source of informal learning experiences which students deemed as being potentially unbalanced and even dangerous. Students also identified unique barriers to curriculum change with reference to a lack of openness due to the impacts of disclosure in substance misuse.ConclusionLarge scale curriculum initiatives appear to correspond to the student voice obtained in this study, providing backing for the implementation of a co-ordinated substance misuse curriculum within medical schools. The student voice however provides an alternative lens by outlining how substance misuse pervades into students' lives and how informal learning is a largely underestimated hidden source of learning with more dangers than benefits. This together with the identification of further barriers to curriculum change, provide space for medical faculties to incorporate and work with students to facilitate local level curriculum changes relating to substance misuse education.
| S-EPMC10068233 | biostudies-literature