As being Professional and Self-sufficient Lady, I Will Not Marry”- An Exploratory Study

INTRODUCTION: The prevention of recurrent suicidal behaviours in adolescents should consider their perceptions, needs and expectations. To identify the protective factors of recurrent suicidal behaviours in adolescents; To describe the family and the expectations for future involvement; To know the most important aspects of hospitalization and discuss expectations of nursing care follow-up after hospital discharge. A descriptive, qualitative and exploratory study was carried out in a sample of 33 adolescents with suicidal behaviours. Data were collected through semi-structured interviews, and the data processing used the content analysis technique. Findings arising from data allowed identifying the protective factors: family, friends and other trusted persons. During the hospitalization, the adolescents reinforce the knowledge about themselves and the newly learnt coping strategies. Psychological support and health professionals are what they value most about hospitalization and emphasize the need to maintain contact with the nurses after discharge. Knowing the needs and expectations of adolescents with suicidal behaviour will make nursing psychotherapeutic interventions more effective and congruent in this vulnerable group. Ensuring psychoeducational intervention to the families of adolescents with suicidal behaviour and continuity of care after discharge, and reinforcing the training in suicidology for all health professionals.

BackgroundIn the Thai Universal Coverage health insurance scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group-based retrospective payment, for which quality of the diagnosis and procedure codes is crucial. However, there has been limited understandings on which health care professions are involved and how the diagnosis and procedure coding is actually done within hospital settings. The objective of this study is to detail hospital coding structure and process, and to describe the roles of key hospital staff, and other related internal dynamics in Thai hospitals that affect quality of data submitted for inpatient care reimbursement.MethodsResearch involved qualitative semi-structured interview with 43 participants at 10 hospitals chosen to represent a range of hospital sizes (small/medium/large), location (urban/rural), and type (public/private).ResultsHospital Coding Practice has structural and process components. While the structural component includes human resources, hospital committee, and information technology infrastructure, the process component comprises all activities from patient discharge to submission of the diagnosis and procedure codes. At least eight health care professional disciplines are involved in the coding process which comprises seven major steps, each of which involves different hospital staff: 1) Discharge Summarization, 2) Completeness Checking, 3) Diagnosis and Procedure Coding, 4) Code Checking, 5) Relative Weight Challenging, 6) Coding Report, and 7) Internal Audit. The hospital coding practice can be affected by at least five main factors: 1) Internal Dynamics, 2) Management Context, 3) Financial Dependency, 4) Resource and Capacity, and 5) External Factors.ConclusionsHospital coding practice comprises both structural and process components, involves many health care professional disciplines, and is greatly varied across hospitals as a result of five main factors.

Who is sensitising whom? A participatory interview guide development as an awareness tool within a health care research project

Childhood overweight and obesity have been increasing over recent years and, more than ever, we are being called to act, whether as clinicians, parents or educators. The aim of this empirical research is to assess children’s cognitive and emotionally internalized mental representation of a Preferred and Healthy Meal , using drawing as methodological instrument. This is a cross-sectional, exploratory and descriptive study using a qualitative methodology – content analysis. In the present research, conducted in two moments, with 1013 children (aged 4-10 years), from Lisbon metropolitan area, we’ve asked children to draw a Preferred Meal and a Healthy Meal, trying to evaluate the child’s implicit knowledge and habits of drink intake and food cooking methods. 2026 drawings were collected: 1013 representing a Preferred Meal and 1013 a Healthy one. Drawings were evaluated using a content analysis instrument specifically developed for this study, using ATLAS.ti 6. For purposes of obtaining a descriptive analysis, data were treated using the Statistical Package for the Social Sciences (SPSS) 19.0 for Windows. The obtained results on Cooking Methods (sub-categories Meat , Fish and Potatoes ) reveal that children, regarding the Preferred Meal, selected both healthier and unhealthier cooking methods like Fried ( Meat and Potatoes ), Stewed and Grilled ( Meat ). Representations of healthy cooking methods, on the other hand, show conspicuous disparities by age-group as children aged 4 and 5 years take frying as a healthy meat cooking method, whereas children aged 6 years are virtually unanimous in choosing grilling as the best representation of healthy meat cooking method. As to Potato and Fish healthy cooking methods, most children elect boiling . Regarding the beverages that children included in their Preferred Meals, we found some discrepancies with selection of fresh juices in the age-groups 4YG and 5YG with clear contrast with the dominance of soft drinks (carbonated beverages sweetened with sugar) in the older groups. Regarding healthy drink choices, soft drinks decrease drastically, being consensually replaced by Water in all age groups or by Natural / Fresh Juices in the younger age groups, despite an undeniable presence of soft drinks, disguised of “natural”. The results obtained in the study points out that preferred cooking methods and drinks are internalized during childhood and are connected to early experiences with food and to pathogenic (family and society) nutritional patterns. They also testify to the children’s ability to learn to select healthy cooking methods, despite being an abstract cognitive construct, at a very early age. Despite that knowledge, when it comes to drinks, this study evidences that children’s reveal some erroneous representations influenced by exposure to media, namely related to advertising soft drinks bearing a ‘healthy food’ label. These are the stronger arguments to support the need for developing health education ludic-pedagogic instruments for children. Keywords: Drinking behaviours; Cooking Methods; Childhood Overweight; Child Obesity; Health Education

An exploratory study is developed based on the analysis of the Nonguen case, located in the metropolis of Concepcion, Chile. This study aims to answer which are the issues that territorial governance processes of recent metropolizated peri-urban spaces should address, and which are the actors involved in such spatial governance. A qualitative methodology is used. Qualitative data is taken from 9 reports, prepared with information extracted from focus groups with neighborhood leaders. Content analysis was applied, using Atlas.ti software. The results show that the incorporation to the metropolis generates loss of community life and the lifestyle associated with rurality. The emerging challenge is how to maintain the value of rural life while advancing in urbanization. In order to define the future of the living space regulating the real estate development, neighborhood empowerment should be increased.

BackgroundHow the informal providers deliver health services are not well understood in Bangladesh. However, their practices are often considered inappropriate and unsafe. This study attempted to fill-in this knowledge gap by exploring their perceptions about diagnosis and appropriate treatment, as well as identifying existing barriers to provide appropriate treatment.MethodsThis exploratory study was conducted in two peri-urban areas of metropolitan Dhaka. Study participants were selected purposively, and an interview guideline was used to collect in-depth data from thirteen providers. Content analysis was applied through data immersion and themes identification, including coding and sub-coding, as well as data display matrix creation to draw conclusion.ResultsThe providers relied mainly on the history and presenting symptoms for diagnosis. Information and guidelines provided by the pharmaceutical representatives were important aids in their diagnosis and treatment decision making. Lack of training, diagnostic tools and medicine, along with consumer demands for certain medicine i.e. antibiotics, were cited as barriers to deliver appropriate care. Effective and supportive supervision, training, patient education, and availability of diagnostics and guidelines in Bangla were considered necessary in overcoming these barriers.ConclusionInformal providers lack the knowledge and skills for delivering appropriate treatment and care. As they provide health services for substantial proportion of the population, it’s crucial that policy makers become cognizant of the fact and take measures to remedy them. This is even more urgent if government’s goal to reach universal health coverage by 2030 is to be achieved.

BackgroundFalls are a major threat to older people’s health and wellbeing. Approximately half of falls occur in outdoor environments but little is known about the circumstances in which they occur. We conducted a qualitative study to explore older people’s experiences of outdoor falls to develop understanding of how they may be prevented.MethodsWe conducted nine focus groups across the UK (England, Wales, and Scotland). Our sample was from urban and rural settings and different environmental landscapes. Participants were aged 65+ and had at least one outdoor fall in the past year. We analysed the data using framework and content analyses.ResultsForty-four adults aged 65 – 92 took part and reported their experience of 88 outdoor falls. Outdoor falls occurred in a variety of contexts, though reports suggested the following scenarios may have been more frequent: when crossing a road, in a familiar area, when bystanders were around, and with an unreported or unknown attribution. Most frequently, falls resulted in either minor or moderate injury, feeling embarrassed at the time of the fall, and anxiety about falling again. Ten falls resulted in fracture, but no strong pattern emerged in regard to the contexts of these falls. Anxiety about falling again appeared more prevalent among those that fell in urban settings and who made more visits into their neighbourhood in a typical week.ConclusionsThis exploratory study has highlighted several aspects of the outdoor environment that may represent risk factors for outdoor falls and associated fear of falling. Health professionals are recommended to consider outdoor environments as well as the home setting when working to prevent falls and increase mobility among older people.

Characterization of adopted suicidal behavior and its main influencing factors: A qualitative study with adolescents

Background. Community pharmacists play a central role in the management of minor ailments and their clinicalknowledge is vital in improving treatment outcomes of these ailments. The provision of minor ailment servicein developed countries has been successful yet the practice in the Philippines has not been documented.
 Objectives. The aim of this study was to document the involvement of community pharmacists in the managementof minor ailments, the practices, and the perceived challenges in the provision of pharmacy service.
 Methods. This was an exploratory descriptive study. Using qualitative research technique, a guided interviewquestionnaire was employed for data gathering. The practices employed and perceived challenges encounteredby pharmacists were interpreted using conventional content analysis.
 Results. Colds, cough, skin allergy, diarrhea were the four most common ailments managed by communitypharmacists. Pharmacists had underdeveloped roles in consultation. Community pharmacists were knowledgeableon the causes of the minor ailments and the medications dispensed were compliant with approved productindications. The absence of institutional guidelines (66%), lack of ailment-specific training (100%), insufficientclinical skills (76.7%), and a dominant patient self-selection behavior for OTC medicines (73.3%) were perceived aschallenges in the provision of minor ailment services.
 Conclusion. Community pharmacists managed common ailments with non-prescription medicines howeverconsultation roles were found to be underdeveloped.

BackgroundBased on practices in commercial organizations and public services, healthcare organizations are using service charters to inform patients about the quality of service they can expect and to increase patient-centeredness. In the Netherlands, an integrated regional stroke service involving five organizations has developed and implemented a single service charter. The purpose of this study is to determine the organizational enablers for the effective development and implementation of this service charter.MethodsWe have conducted an exploratory qualitative study using Grounded Theory to determine the organizational enablers of charter development and implementation. Individual semi-structured interviews were held with all members of the steering committee and the taskforce responsible for the service charter. In these twelve interviews, participants were retrospectively asked for their opinions of the enablers. Interview transcripts have been analysed using Glaser’s approach of substantive coding consisting of open and selective coding in order to develop a framework of these enablers. A tabula rasa approach was used without any preconceived frameworks used in the coding process.ResultsWe have determined seven categories of enablers formed of a total of 27 properties. The categories address a broad spectrum of enablers dealing with the basic foundations for cooperation, the way to manage the project’s organization and the way to implement the service charter. In addition to the enablers within each individual organization, enablers that reflect the whole chain seem to be important for the effective development and implementation of this service charter. Strategic alignment of goals within the chain, trust between organizations, willingness to cooperate and the extent of process integration are all important properties.ConclusionsThis first exploratory study into the enablers of the effective development and implementation was based on a single case study in the Netherlands. This is the only integrated care chain using a single service charter that we could find. Nevertheless, the results of our explorative study provide an initial framework for the development and implementation of service charters in integrated care settings. This research contributes to the literature on service charters, on patient-centeredness in integrated care and on the implementation of innovations.

An exploratory qualitative study of caregivers' knowledge, perceptions and practices related to hospital hygiene in rural Niger

ObjectiveDespite considerable spending on mental health in the Netherlands, access to mental health remains suboptimal, particularly for migrants and ethnic minorities. Addressing the growing mental health service needs requires an understanding of the experiences of all stakeholders, specifically minority populations. In this exploratory study, we sought to understand the perspectives and experience of mental health services by migrants and their provider. An exploratory qualitative study was conducted with 10 participants, five of whom were mental health service providers and the other five were clients who had utilized or currently utilized MHS in the Netherlands.ResultsWe identified three themes that explained the experiences of clients and providers of MHS in the Netherlands (i) Perceptions of mental health service utilization (ii) Mismatch between providers (iii) Availability of services. The most significant factor that influenced participants experience was a service provider of a different cultural background. Minority populations accessing mental health services have multiple needs, including an expressed need for cultural understanding. Their experiences of mental health services could be improved for minority populations by addressing the diversity of health providers.

Este estudo objetivou conhecer as percepções de familiares de crianças que convivem com doenças crônicas sobre os componentes das situações de vulnerabilidade relacionando-os com a Teoria Sócio-Ecológica. Trata-se de uma pesquisa qualitativa, exploratório-descritiva, realizada com nove familiares de crianças que convivem com doenças crônicas e hospitalizadas em um hospital-escola do município de Porto Alegre, Rio Grande do Sul, utilizando-se dinâmicas de criatividade e sensibilidade e o referencial de análise de conteúdo. Emergiram três categorias, sendo aqui explorada a segunda, vulnerabilidade Programática e sua inserção no mesossistema das Instituições de Saúde. O componente institucional ou programático da vulnerabilidade conecta os componentes individual e social, envolvendo o monitoramento de programas de prevenção e cuidado. Observou-se uma ligação entre os sistemas do ambiente ecológico e os componentes das situações de vulnerabilidade, que ao ser identificada, possibilita o incremento das ações de saúde voltadas a criança e sua família.

PurposeHotel industry is witnessing a radical change as a result of technology interaction such as artificial intelligence (AI) in service tasks. As a result of this transformation, the pattern of service delivery based on human interaction has been changed to digital interaction. This brought opportunities to the hotels industry and consolidate its competitive advantage. However, the understanding gap still existed in both practical implementation and literature, especially in developing countries. Therefore, this paper aims to explore how hotels use AI to carry out services tasks.Design/methodology/approachThe authors adopted the qualitative research method through Semi interviews. The sample was purposively selected from five 5-star hotels in the UAE, meanwhile, the managers were the targeted respondents.FindingsThrough content analysis, the authors find that the UAE hotels use AI in managing trip planning, reception service and room services. The authors also find that there are four key drivers that improve the performance of AI, which include AI infrastructure flexibility, strategic alignment, management and skills. Finally, the authors found four indicators of the impact of AI on hotels, which are quality, cost and market share and customers satisfaction.Originality/valueThis study is one of few studies that explored the use of AI in the hotels industry and discussed how AI influence several aspects of hotels performance and helped them to attain their competitive advantage. This study is also one of few studies and the first study in UAE to explore the key drivers of AI performance in UAE hotels.

Social determinants (SD) such as age, gender, ethnicity, postal code, or socioeconomic status, as well as health beliefs strongly impact health outcomes. This study aims to analyze the influence of SD on adherence to healthy lifestyle recommendations among individuals with prediabetes. This sequential explanatory mixed-methods study will include an initial cross-sectional analysis of quantitative data, followed by a qualitative ethnomethodological study using critical discourse analysis. The quantitative analysis will use data from 103 participants with prediabetes included in the intervention arm of the PREDIPHONE trial. The relationship between adherence to the lifestyle modification intervention (diet and physical activity) and sociodemographic characteristics will be explored by multivariable linear regression. The qualitative study will explore how gender, social class, and other factors (such as social and family support, knowledge about one's health condition, health beliefs, and patient-professional relationship) can influence adherence to lifestyle changes in a selected subgroup of individuals. Data generation techniques will include semi-structured interviews, discussion groups, support network mapping, and the researcher's field diary. The rigor strategies that will be applied include triangulation, data saturation, and reflexivity. Prediabetes exhibits an uneven distribution, disproportionately affecting individuals from underprivileged social classes, directly impacting on adherence behaviors. Our study can guide the development of health interventions tailored to individuals with prediabetes, focusing on addressing social disparities in lifestyle modification. Participants will contribute through semi-structured interviews and discussion groups, providing insights into their experiences on adherence to lifestyle changes. ClinicalTrials.gov, identifier NCT06488677.