Perceptions and experiences of the implementation, management, use and optimisation of electronic prescribing systems in hospital settings:protocol for a systematic review of qualitative studies

Introduction: There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support. Methods and analysis: Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest and SCOPUS. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature: Healthcare Management Information Consortium, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by 2 reviewers. Qualitative studies, either standalone or in the context of mixed-methods designs, reporting the perspectives of any actors involved in the implementation, management and use of ePrescribing/CPOE systems in hospital-based care settings will be included. Data extraction will be conducted by 2 reviewers using a piloted form. Quality appraisal will be based on criteria from the Critical Appraisal Skills Programme checklist and Standards for Reporting Qualitative Research. Studies will not be excluded based on quality assessment. A postsynthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method. Ethics and dissemination: The study does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.

Social media data in research : provenance challenges?

Postprint

The ecocultural context and child behavior problems: A qualitative analysis in rural Nepal.

Commonly used paradigms for studying child psychopathology emphasize individual-level factors and often neglect the role of context in shaping risk and protective factors among children, families, and communities. To address this gap, we evaluated influences of ecocultural contextual factors on definitions, development of, and responses to child behavior problems and examined how contextual knowledge can inform culturally responsive interventions. We drew on Super and Harkness' "developmental niche" framework to evaluate the influences of physical and social settings, childcare customs and practices, and parental ethnotheories on the definitions, development of, and responses to child behavior problems in a community in rural Nepal. Data were collected between February and October 2014 through in-depth interviews with a purposive sampling strategy targeting parents (N = 10), teachers (N = 6), and community leaders (N = 8) familiar with child-rearing. Results were supplemented by focus group discussions with children (N = 9) and teachers (N = 8), pile-sort interviews with mothers (N = 8) of school-aged children, and direct observations in homes, schools, and community spaces. Behavior problems were largely defined in light of parents' socialization goals and role expectations for children. Certain physical settings and times were seen to carry greater risk for problematic behavior when children were unsupervised. Parents and other adults attempted to mitigate behavior problems by supervising them and their social interactions, providing for their physical needs, educating them, and through a shared verbal reminding strategy (samjhaune). The findings of our study illustrate the transactional nature of behavior problem development that involves context-specific goals, roles, and concerns that are likely to affect adults' interpretations and responses to children's behavior. Ultimately, employing a developmental niche framework will elucidate setting-specific risk and protective factors for culturally compelling intervention strategies.

A Qualitative Study of Contextual Factors’ Impact on the Adaptation of a Caregiver-mediated Early Autism Intervention in South Africa

Background: Autism Spectrum Disorder (ASD) is a major global health challenge as the majority of individuals with ASD live in low- and middle-income countries (LMICs) and receive little to no services or support from health or social care systems. Despite this global crisis, the development and validation of ASD interventions has almost exclusively occurred in high-income countries, leaving many unanswered questions regarding what contextual factors would need to be considered to ensure the effectiveness of interventions in LMICs. This study sought to conduct explorative research on the contextual adaptation of a caregiver-mediated early ASD intervention for use in a low-resource setting in South Africa.

Methods: Participants included 22 caregivers of children with autism, including mothers (n=16), fathers (n=4), and grandmothers (n=2). Four focus groups discussions were conducted in Cape Town, South Africa with caregivers and lasted between 1.5-3.5 hours in length. Data was recorded, translated, and transcribed by research personnel. Data was then coded for emerging themes and analyzed using the NVivo qualitative data analysis software package.

Results: Nine contextual factors were reported to be important for the adaptation process including culture, language, location of treatment, cost of treatment, type of service provider, familial needs, length of treatment, support, and parenting practices. One contextual factor, evidence-based treatment, was reported to be both important and not important for adaptation by caregivers. The contextual factor of stigma was identified as an emerging theme and a specifically relevant challenge when developing an ASD intervention for use in a South African context.

Conclusions: Eleven contextual factors were discussed in detail by caregivers and examples were given regarding the challenges, sources, and preferences related to the contextual adaptation of a parent-mediated early ASD intervention in South Africa. Caregivers reported a preference for an affordable, in-home, individualized early ASD intervention, where they have an active voice in shaping treatment goals. Distrust of community-based nurses and health workers to deliver an early ASD intervention and challenges associated with ASD-based stigma were two unanticipated findings from this data set. Implications for practice and further research are discussed.

The knowledge, attitudes and beliefs of patients and their healthcare professionals around oral dosage form modification: a systematic review of the qualitative literature

Objectives: The objective of this systematic review was to synthesize the available qualitative evidence on the knowledge, attitudes and beliefs of adult patients, healthcare professionals and carers about oral dosage form modification. Design: A systematic review and synthesis of qualitative studies was undertaken, utilising the thematic synthesis approach. Data sources: The following databases were searched from inception to September 2015: PubMed, Medline (EBSCO), EMBASE, CINAHL, PsycINFO, Web of Science, ProQuest Databases, Scopus, Turning Research Into Practice (TRIP), Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews (CDSR). Citation tracking and searching the references lists of included studies was also undertaken. Grey literature was searched using the OpenGrey database, internet searching and personal knowledge. An updated search was undertaken in June 2016. Review methods: Studies meeting the following criteria were eligible for inclusion; (i) used qualitative data collection and analysis methods; (ii) full-text was available in English; (iii) included adult patients who require oral dosage forms to be modified to meet their needs or; (iv) carers or healthcare professionals of patients who require oral dosage forms to be modified. Two reviewers independently appraised the quality of the included studies using the Critical Appraisal Skills Programme Checklist. A thematic synthesis was conducted and analytical themes were generated. Results: Of 5455 records screened, seven studies were eligible for inclusion; three involved healthcare professionals and the remaining four studies involved patients. Four analytical themes emerged from the thematic synthesis: (i) patient-centred individuality and variability; (ii) communication; (iii) knowledge and uncertainty and; (iv) complexity. The variability of individual patient’s requirements, poor communication practices and lack of knowledge about oral dosage form modification, when combined with the complex and multi-faceted healthcare environment complicate decision making regarding oral dosage form modification and administration. Conclusions: This systematic review has highlighted the key factors influencing the knowledge, attitudes and beliefs of patients and healthcare professionals about oral dosage form modifications. The findings suggest that in order to optimise oral medicine modification practices the needs of individual patients should be routinely and systematically assessed and decision-making should be supported by evidence based recommendations with multidisciplinary input. Further research is needed to optimise oral dosage form modification practices and the factors identified in this review should be considered in the development of future interventions.

Making meaningful connections: Using insights from social pedagogy in statutory child and family social work practice

Reports into incidents of child death and serious injury have highlighted consistently concern about the capacity of social workers to communicate skilfully with children. Drawing on data collected as part of an Economic and Social Research Council funded UK-wide research project exploring social workers’ communicative practices with children, this paper explores how approaches informed by social pedagogy can assist social workers in connecting and communicating children. The qualitative research included data generated from 82 observations of social workers’ everyday encounters with children. Social pedagogical concepts of ‘haltung’ (attitude), ‘head, heart and hands’ and ‘the common third’ are outlined as potentially helpful approaches for facilitating the intimacies of inter-personal connections and enhancing social workers’ capacity to establish and sustain meaningful communication and relationships with children in the face of austere social, political and organisational contexts.

Power relations and good governance: a social network analysis of the evolution of the integrity in public office act in the Commonwealth of Dominica

La Banque mondiale propose la bonne gouvernance comme la stratégie visant à corriger les maux de la mauvaise gouvernance et de faciliter le développement dans les pays en développement (Carayannis, Pirzadeh, Popescu & 2012; & Hilyard Wilks 1998; Leftwich 1993; Banque mondiale, 1989). Dans cette perspective, la réforme institutionnelle et une arène de la politique publique plus inclusive sont deux stratégies critiques qui visent à établir la bonne gouvernance, selon la Banque et d’autres institutions de Bretton Woods. Le problème, c’est que beaucoup de ces pays en voie de développement ne possèdent pas l’architecture institutionnelle préalable à ces nouvelles mesures. Cette thèse étudie et explique comment un état en voie de développement, le Commonwealth de la Dominique, s’est lancé dans un projet de loi visant l’intégrité dans la fonction publique. Cette loi, la Loi sur l’intégrité dans la fonction publique (IPO) a été adoptée en 2003 et mis en œuvre en 2008. Cette thèse analyse les relations de pouvoir entre les acteurs dominants autour de évolution de la loi et donc, elle emploie une combinaison de technique de l’analyse des réseaux sociaux et de la recherche qualitative pour répondre à la question principale: Pourquoi l’État a-t-il développé et mis en œuvre la conception actuelle de la IPO (2003)? Cette question est d’autant plus significative quand nous considérons que contrairement à la recherche existante sur le sujet, l’IPO dominiquaise diverge considérablement dans la structure du l’IPO type idéal. Nous affirmons que les acteurs "rationnels," conscients de leur position structurelle dans un réseau d’acteurs, ont utilisé leurs ressources de pouvoir pour façonner l’institution afin qu’elle serve leurs intérêts et ceux et leurs alliés. De plus, nous émettons l’hypothèse que: d’abord, le choix d’une agence spécialisée contre la corruption et la conception ultérieure de cette institution reflètent les préférences des acteurs dominants qui ont participé à la création de ladite institution et la seconde, notre hypothèse rivale, les caractéristiques des modèles alternatifs d’institutions de l’intégrité publique sont celles des acteurs non dominants. Nos résultats sont mitigés. Le jeu de pouvoir a été limité à un petit groupe d’acteurs dominants qui ont cherché à utiliser la création de la loi pour assurer leur légitimité et la survie politique. Sans surprise, aucun acteur n’a avancé un modèle alternatif. Nous avons conclu donc que la loi est la conséquence d’un jeu de pouvoir partisan. Cette recherche répond à la pénurie de recherche sur la conception des institutions de l’intégrité publique, qui semblent privilégier en grande partie un biais organisationnel et structurel. De plus, en étudiant le sujet du point de vue des relations de pouvoir (le pouvoir, lui-même, vu sous l’angle actanciel et structurel), la thèse apporte de la rigueur conceptuelle, méthodologique, et analytique au discours sur la création de ces institutions par l’étude de leur genèse des perspectives tant actancielles que structurelles. En outre, les résultats renforcent notre capacité de prédire quand et avec quelle intensité un acteur déploierait ses ressources de pouvoir.

Intervenção social com crianças refugiadas: estratégias profissionais do Serviço Social com crianças refugiadas em Portugal

O objetivo principal é analisar a Intervenção social com crianças refugiadas em Portugal e as estratégias profissionais do Serviço Social como resposta às necessidades dessas crianças. Assim, pretendemos conhecer de que forma o assistente social, enquanto agente ativo na sociedade e capacitado de uma ação meditativa, produz respostas a esta problemática e conhecer também a realidade do nosso país relativamente à chegada de crianças refugiadas. A metodologia de investigação usada foi qualitativa tendo sido, realizado um questionário com oito perguntas fechadas e abertas, sendo divulgado on-line pelas redes sociais em grupos de serviço social. Foram recolhidas oito respostas, no entanto dois inquéritos não se enquadravam nos critérios de inclusão definidos pelo que foram excluídos. A partir dos dados obtidos foi possível perceber que existe uma estrutura preparada em Portugal para proceder ao acolhimento de crianças refugiadas sozinhas, que considera nos seus procedimentos o superior interesse da criança mas que padece ainda de algumas lacunas, nomeadamente ao nível da formação dos agentes de intervenção no terreno e do ensino da língua portuguesa. / The present study aimed to analyze the social intervention with refugee children in Portugal and the professional strategies of social workers in order to insure the needs of these children. Our main objective was to understand how the social worker, as an active agent in society and capable of a meditative action, produces answers to this problem and also know the reality of our country in respect to the arrival of refugee children. By the use of qualitative research methodology and the application of a questionnaire, composed with eight open and closed questions, published online in social networks of social service groups, we came up with eight responses. However two surveys did not fit the inclusion criteria defined and, therefore, were excluded. From the data obtained it was revealed that there is a structure prepared in Portugal to carry out the reception of refugee unattended children. It is a structure that considers the procedures regarding the best interests of the child, but it still suffers from some shortcomings, particularly in terms of training of intervention agents on the ground and in the tutorship of Portuguese language.

Grounded Theory methods in child psychotherapy research

This article considers the place of qualitative research in psychoanalysis and child psychotherapy. It discusses why research methodology for many years occupied so small a place in these fields, and examines the cultural and social developments since the 1960s which have changed this situation, giving formal methods of research much greater significance. It reflects on the different pressures to develop formal research methods which arise both from outside the psychoanalytic field, as a condition of its continued professional survival, and from within it, where its main aim is the development of fundamental psychoanalytic knowledge, It suggests that the conduct of mainly quantitative research into treatment outcomes is largely a response to these external pressures, whilst the main benefits to be gained from the development of qualitative research methods, such as Grounded Theory, are in facilitating the knowledge-generating capacities and achievements of child psychotherapists themselves. The paper describes Grounded Theory methods, and explains how they can be valuable in the recognition of hitherto unrecognised meanings and patterns as these are made visible in clinical practice. Finally, it briefly describes five different examples of completed doctoral studies, all of which have added significantly to the knowledge-base of child psychotherapy, and which demonstrate how much can be accomplished using this method of research.

The International <IR> Framework’s impact on the social and relationship disclosures in the healthcare industry

Abstract Background and Problem: The altering business world and the growing requests from stakeholders have resulted in the establishment of new reports. These are among others Sustainability reports and Integrated Reporting. On the contrary, traditional financial reports do not consider the significance of intangible assets in modern entities. The social and relationship capital has further shown to be important for firms, especially healthcare companies and pharmaceuticals, but is not as developed as other capitals within the <IR> framework and therefore not always included in annual reports. However too few disclosures within this area could lead to high liabilities. The IIRC launched the <IR> framework year 2013 as a solution, as it gives a more comprehensive view of the reporting entity. Within this framework there are six capitals: manufactured, human, financial, natural, intellectual and social and relationship.   Purpose: The purpose of this thesis is to find out how the International <IR> Framework has influenced the reporting of the social and relationship disclosures within the healthcare industry, to compare the reporting of the six medical firms chosen and to examine how the social concerns have been developed over time. Delimitations: This study is conducted over a period of three years, from year 2012 to year 2014. It only examines healthcare companies which use the International <IR> framework and it has solely focus on the social and relationship capital. All other capitals within the <IR> framework are excluded from the study. Method: This study has a qualitative research strategy and is based on information collected from published documents in form of annual reports. The annual reports from year 2010, 2011 and 2012 are used to find social and relationship disclosures and a disclosure scoreboard is used to find similarities, differences and patterns. Empirical Results and Conclusion: It has been found that the aggregated social and relationship disclosures have been reduced over time. The year followed by the release of the <IR> framework was seen to have the least disclosures and therefore conclusion was drawn that the <IR> framework had a negative influence on the social and relationship disclosures. There were also differences among the companies studied both in extent and content. The former could be linked to factors such as size and nationality and the latter could be linked to reputation preservation and legitimacy interests.

Experiences of African American male engineering students: a qualitative analysis

Prior to the 1970s, African Americans were essentially invisible in the science and engineering academic and professional communities (Babco, 2001a). The few who did earn degrees in these fields, obtained them primarily from historically Black colleges and universities (HBCUs), and these institutions also served as the primary employer for these graduates in science and engineering (Hines, 1997; Babco, 2001a, 2001b). Since the 1970s, African Americans have made considerable progress, but still are not on a level playing field with White males in terms of opportunities for preparation of science and engineering careers or for employment and advancement in those careers. The purpose of this study was to explore second and third-year African American male engineering students’ perceptions and examine what experiences have contributed to their access to and persistence in engineering. A qualitative research design was employed to gather data necessary to answer the research questions. Eight second and third-year African American male engineering students from Research University (pseudonym) participated in interviews with the researcher. The data from the interviews was used to consider the themes that emerged from the participants. The findings from this study suggest that African American male engineering students at Research University have specific experiences that influence their persistence and academic achievement. Themes identified from the interview data include: (1) pre-college experiences; (2) participation in academic and social networks; (3) institutional programming and organizational support; (4) personal accountability and motivation; and (5) goals outside of engineering. As a result of this research, several future implications are highlighted. These include acknowledging the value of diversity, continued support through organizations, and increased knowledge of best practices.

Searching for knowledge in the belly of the beast: diversity, social equity and the African graduate student mother's experience in US higher education

Diversity has become a buzz word in public discourse and in educational circles. Higher education institutions in the US have increasingly used this word as a cornerstone of their mission statements and have made increasing efforts to attract students from different backgrounds. As part of the increase in diversity efforts among US colleges, is a significant rise in the number of international students. Attracting international students has become a priority for U.S. universities regardless of size or location. This study examines the intersection between the structure of American educational environment and the blended identities of African Graduate Student Mothers. Within the context of contemporary diversity efforts in US educational institutions, this study examines both the structural environments and the socio-cultural constructs that affect the experiences of African graduate student mothers. Based on a qualitative research interview design, a total of nineteen African graduate student mothers at a Mid-Western University in the US were interviewed individually and in groups over a six weeks period. Results from this study show that apart from the difficult and often dehumanizing treatment African student mothers endure from immigration and consular officials in their various countries and ports of entry, they often find themselves at the margins of their various programs and departments with very little support if any. This is because most of them enroll into graduate programs after arriving as dependants of their spouses; a process that does not allow them to negotiate for departmental commitments and support prior to their arrival. Not only do these women face racial discrimination from white professors, staff and fellow students, but they also experience discrimination and hostilities from African Americans and other minority groups who see them as threats to the limited resources that are often set aside for minority groups in such institutions.

Social representations of nursing students about hospital assistance and primary health care

Objective: To analyze how social representations of hospital and community care are structured in two groups of nursing students – 1st and 4th years. Method: Qualitative research oriented by the Theory of Social Representations. We used a questionnaire with Free Association of Words. Data were analyzed in the Software IRaMuTeQ 0.6 alpha 3. Results: We applied the method of Descending Hierarchical Classifi cation and obtained four classes. Class 4 has the largest social representation (30.41%) within the corpus. The two organizational axes are nurse and disease/patient in the central core. On the periphery are the care and help related to the nurse and the treatment and prevention associated with the disease. Conclusion: Social representations focus on disease/patient and on the role of nurses in the treatment, prevention, and care. Health promotion and the social determinants of health are absent from the social representations of students.

Weathering crises on social media – Theory and practices from social media active organizations operating in Finland

Thesis compiles findings from previous research to produce guidelines on addressing crises on social media. These guidelines extracted from previous research are compared qualitatively with empirical evidence from 12 organizations by examining whether organizations apply practices recommended in previous research. Much of guidelines gain support from practitioners with few exceptions. Findings stemming from theory and practice combine to shed light on how controversies are born on social media, how crises can be prevented on social media and how organizations may manage crisis situations on social media. The majority of the resulting guidelines focus on how to address negative information and communicate during a crisis but other means of crisis management are also presented. Previous research had voiced that the field of public relations was very fractured, crisis management was lacking qualitative research and provided very little information on what organizations should do before a crisis. Thesis collects a comprehensive amount of previous research from various fields of PR in an effort to unite findings and guidelines, gathers and analyzes empirical data in a qualitative manner and includes a pre-crisis paradigm. One of the challenges in the field of crisis management still remains the absence of universally agreed definition of a crisis and the lack of means to quantify and compare the magnitude of crises.

Charging The Net: Social Activism in Women's Professional Tennis

This dissertation is an analysis of social activism within women’s professional tennis. In the 46 years since the women known as the Original 9 began protesting against the pay inequality between men’s and women’s tennis, subsequent cohorts of women have brought different issues and concerns to women’s tennis, expanding its scope and efforts.  Using qualitative research, including interviews with former players and press conference participation at tournaments to access current players, this study shows the lineage of social activism within women’s tennis and the issues, expressions, risks and effects of each cohort. Intersectionality theoretically frames this study, and analyses of performativity appears regularly. Each generational cohort is a chapter of this study. The Original 9 of the Movement Cohort fought for equal prize money. The Bridge Cohort, the era of Evert and Navratilova, continued the Movement Cohort’s push for equal prize money; however, they also ushered in identity politics (including gender, sexuality, and nationality, but with the notable exception of race). The Professional Cohort, the current era, followed the Bridge Cohort and is characterized by its focus on corporatization and mass-marketing. As such, there is a focus among the players on individualism which can seem like a lack of social activism is occurring. However, race, neglected during the Bridge Cohort, emerged during the Professional Cohort. The individualism of this cohort made space for Blackness to show unapologetically, though, within certain constraints. Finally, a few players are working on social justice issues in society at large, as well as trying to institute change within women’s tennis. These players make up the Post-Professional Cohort (or, as Pam Shriver from the Bridge Cohort calls them, “Bridge Throwbacks”).  This study shows the evolution of social activism within women’s tennis, as it reflects larger social change. Though bound together as one unified body, the social activism engaged in by each generation focused on different issues, making each generational cohort distinct from the whole of women’s professional tennis.