Search

Background: For almost 60 years, Indian psychiatry literature has called for all medical students to learn psychiatry so that millions of mentally unwell people across India might receive appropriate treatment. Yet for almost 60 years, medical students have disengaged from psychiatry education, resulting in limited learning. The literature has repeatedly cited the solution as one that involves longer exposure on posting and more exam questions, with little impact. This research sought to understand why medical students disengage from psychiatry education so that meaningful change might occur. Methods: The research utilized constructivist grounded theory, initially in one medical college in Mumbai, followed by a quantitative survey to test the findings with a wider group of interns across 10 states of India. An iterative process of data gathering and analysis was undertaken using the constant comparison method and theoretical integration. Results: Findings identified that 98% of interns believe all MBBS (doctors) should "know" psychiatry, with "know" meaning practical skills—how to assess and treat people with mental illness. The majority of students attend psychiatry to learn those skills, but on finding faculty too overworked to teach, they disengage, saying : "there's nothing in it for me." The findings indicate that more exam questions would not increase engagement. Conclusion: Medical students want to learn skills to help those in mental distress. Faculty do not have time and, arguably, the training to teach them. To address the nation's mental health needs, the government needs to prioritize teaching of psychiatry skills by releasing and enabling psychiatry faculty, alongside the certification of psychiatry skills. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to demonstrate how presuppositional interviews can develop reflexive transparency in grounded theory methodologies. Grounded Theory aims to generate understanding of a given socio-psychological process using a systematic methodology for gathering, analysing and interpreting data. As the researcher is intrinsic to this process, reflexivity is an essential tool to explore and challenge the researcher unknown presuppositions that influence the research process and findings. Reflexivity in practice is challenging as it aims at identifying unknown influences which are by nature, hidden. In this paper, we demonstrate how presuppositional interviews can be applied to Classic and Constructivist grounded theory, and to qualitative research in general. We illustrate this process with two practical case studies, demonstrating how the presuppositional interview can be utilised to enhance transparent reflexive practice. We suggest the presuppositional interview enables higher levels of reflexivity and subsequent positive impact on praxis and the research process. [ABSTRACT FROM AUTHOR]

The presuppositional interview in qualitative research requires the researcher to be interviewed about their thoughts, assumptions, and presumptions about their research. Its purpose is to recognise the impact of our thoughts, feelings, and actions in the ways in which we, as the researcher, exist in the research process. In earlier papers, we have discussed the purpose of the presuppositional interview, however, there is little attention in the literature about the person who interviews the researcher about their research, the presuppositional interviewer. The purpose of this paper is to discuss this unique role because the function and conversational structure differs from other types of interviewing. We propose the role of the presuppositional interviewer role is a reflexive advocate, as their engagement is intentionally directed toward supporting the researcher to develop insights about themselves, in the context of their research. The interviewer has no part in the interpretation. Instead, they are engaging in an activity which promotes the need to support and celebrate curiosity, but that remains in the domain of the researcher. To achieve this, we discuss the role and purpose of the presuppositional interviewer and offer practical guidance as to how to interview with presuppositional purpose. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to explain and describe the use of presuppositional interviews as means of the researcher being able to expose their own, often unknown, assumptions about the phenomena of interest. Within this, we provide a philosophical and practical account for the development and use of a presuppositional interview from an insider perspective to expose insights which influence researcher reflexivity and directly impact on the research process. Author A's hermeneutic phenomenological study seeks to gain insights into the lived experience of children learning mathematics in outdoor environments, such as forests and woodland. The paper describes how the reflexive method of presuppositional interviewing helped him to understand more about his research position and find a clearing in his 'Being in the Wood.' A template for a presupposition interview schedule is presented. [ABSTRACT FROM AUTHOR]

Background: Registered nurses are 'critical' to population health, international responses to emergencies, epidemics and disasters. Retention of registered nurses (RNs) is an international nursing priority. In England, RNs are encouraged to be involved in improving healthcare services. This benefits quality of care, operational and financial performance. However, RN involvement in improvement may reduce RN retention. It is important to understand this relationship when developing effective RN retention strategies. Aim: The purpose of this research is to describe possible relationships between RN involvement in improving healthcare services and RN retention, using published 2018 data for National Health Service (NHS) Trusts in England. Methods: The relationship between RN involvement in improving healthcare services and RN retention was explored using a correlational design, involving secondary data from the annual NHS Staff Survey and Model Hospital. Results: In mental health NHS Trusts in England, a statistically significant, positive correlation of 0.24 was found between RN 'ab(ility) to make suggestions for improvement' and RN retention. In mental health NHS Trusts, a statistically significant correlation of 0.278 was found between RNs 'making improvements happen' and RN retention. In acute NHS Trusts in England, a statistically significant, negative correlation of −0.15 was identified between RNs 'mak(ing) improvements happen' and RN retention. Conclusions: The findings suggest that RN retention factors in mental health and acute NHS Trusts differ from community and specialist NHS Trusts in England. This is an important consideration for national RN retention programmes as a single approach to RN retention may not be effective across all healthcare settings. [ABSTRACT FROM AUTHOR]

Individuals with acquired limb loss are faced with various challenges. Family networks become important in facilitating coping and recovery, but the limited research into their own experiences has so far only examined spousal and parental carers. This research aimed to: understand the experiences of acquired limb loss from the perspective of the family network; and to develop a theoretical model to explain how they experience limb loss of the other. The use of 'network' was adopted to include kin self-identified as family. Participants (n = 14) were recruited nationally. Interviews were conducted in a process moving from unstructured, semi-structured and structured interviews, using Grounded Theory method. A theoretical model was developed around the interaction of five core categories. Families witness the difficulties faced by the person with limb loss, leading to a responsibility to provide support. Families subsequently experience various challenges of limb loss; together with numerous emotional reactions. Various forms of coping are used in order to resolve these experiences. Families are involved in the processes and challenges of an amputation in another family member, regardless of aetiology, gender or relationship structure. The theoretical model can be understood through the integration of existing research. The issues identified indicate potential considerations for services supporting such families. The challenges and emotions experienced by family members have potential consequences for the support offered to the person with limb loss. This could ultimately influence the physical and psychological rehabilitation of the person with limb loss. Services should support families in witnessing difficulties in the person with limb loss, adjusting to relational changes and managing health care systems. [ABSTRACT FROM AUTHOR]

This discussion paper considers some of the practical and ethical aspects of doing qualitative interviews using synchronous online visual technologies within a shifting research context. It is argued that the immediate access to potential participants and subsequent data collection necessitate adjustment to the ways in which qualitative researchers understand and apply ethics, accountability, and responsibility in their data collection processes. We examine the parallels between interviewing face-to-face and interviewing using technology from a practical and integral perspective. In the online environment researchers require a heightened sensitivity and awareness of their attitudes, knowledge, and skills before, during and after the interview to ensure that the process is safe, rigorous and meaningful for collecting comprehensive qualitative data. To do this, we consider how to plan, conduct and end online interviews using voice over internet protocol. [ABSTRACT FROM AUTHOR]

This paper provides a practical analysis of being reflexive when doing Interpretive Phenomenological Analysis (IPA) research. We argue that although reflexivity is widely discussed in relation to qualitative research, there are few practical examples demonstrating how to be reflexive. To address this, reflexivity will be presented through the experiences learnt from doctoral research using IPA. Reflexivity is understood in qualitative research as an attentiveness to the influence of the researcher on the research process.. However, experiencing reflexivity as an IPA researcher is tricky, time-consuming and often uncomfortable; it does not 'happen' and the researcher had to learn to 'live' with data. Drawing on the work of Heidegger, the experience and expression of reflexivity is conceptualised as the 'house of being', a shared analytic space that researchers and participants inhabit. This paper adds to the existing discussion of reflexivity by extending the dialogue of 'what is it like' to be reflexive and how to integrate reflexivity into research. The insights in this paper are intended to generate insight as to how reflexivity can be overt in the doing and writing of IPA research and to assist IPA and qualitaive researchers in their awareness and implementation of reflexivity in research. [ABSTRACT FROM AUTHOR]

In this article, we propose reflexivity can be revealed through a deliberate adjunct to the interpretative phenomenological analysis (IPA) process. This adjunct, which we refer to as "echoes," is a mixture of the participant's and researcher's words and experiences resonating with each other during the research process. We argue that explicitly recognising echoes gives a heightened sensitivity to both the researcher's own place and being in the research, and to the other in relation to the researcher. Exploring the echoes enables the researcher to work with, rather than dismiss, his or her own presuppositions and exposes greater phenomenological sensibility toward the research subject and is-ness of that phenomenon. The purpose of this article is to outline how attending to echoes is a strategy for IPA researchers to promote and overtly journal reflexivity as central within their research practices. To exemplify how echoes can be used, practical examples from a doctoral research project are given to demonstrate how resonance can explicate reflexivity in the IPA process. [ABSTRACT FROM AUTHOR]

A large number of multidisciplinary, qualitative and quantitative research suggests that providing care for family members with mental health illnesses can have both positive and negative effects on the carers' wellbeing. However, to date a comprehensive overview and synthesis of literature that compares and contrasts positive and negative effects of family-caregiving on the carer is missing. To address this gap, this scoping review examines the effects of family-caregiving on carers' wellbeing. A Boolean search generated a total of 92 relevant articles that were included in the analysis. The results suggest that, to understand the effects of family-caregiving on the carer's mental and physical wellbeing, it is necessary to take a combination of situational and sociodemographic characteristics into consideration. Elderly, female, spousal-carers and primary-carers may be a group that is at risk of suffering from a lack of positive mental and physical wellbeing as a result of caring. However, the negative effects of caregiving can be balanced by extraversion, social support and religious or spiritual beliefs. Therefore, future interventions that aim to promote family caregivers' wellbeing may need to take personality, particular circumstances as well as cultural and personal beliefs into consideration. [ABSTRACT FROM AUTHOR]

An ethically problematic clinical case is used to illustrate the potential importance of understanding clinical ethics in an interdisciplinary context. Whilst much has been written on ethics education for multidisciplinary and interdisciplinary teams, we argue that it is important that both healthcare professions and healthcare teams are able to look outside their own disciplinary ethos and sometimes outside their formal teams when considering the ramifications of an ethical issue. A complex (fictional but based on the authors’ pooled experiences) case involving the delivery of a new-born from a mother with HIV is used to illustrate this, because multiple clinical teams will be involved at different times and in parallel with one another. [ABSTRACT FROM PUBLISHER]

We report key themes arising from a postgraduate workshop organized by the King's Interdisciplinary Discussion Society (KIDS) held in April 2011. KIDS believe that health is a phenomenon that transcends disciplinary boundaries, and therefore issues relating to health care and medical ethics are best addressed with an interdisciplinary approach. The workshop, entitled 'Everyday Ethics and Primary Healthcare', included poster presentations and oral presentations from participants from a range of disciplines and occupational backgrounds which highlighted the challenges faced by primary health-care workers. Three common themes emerged: the impersonal and cumbersome work environment that can result from the encroachment of rationalizing tools; the tension between 'ethical practice as an ongoing sensibility' and 'ethical practice as \"box-ticking\"'; and the contested nature of what constitutes 'health'. Participants felt that the interdisciplinary perspective was helpful in elucidating the various ethical issues arising in primary health care. [ABSTRACT FROM AUTHOR]