Ethnography

人种学
  • 文章类型: Journal Article
    背景:在关于妊娠期疟疾(MiP)的科学文献中,尚未对基于批判理论的生活方式进行研究。这项研究的目的是分析哥伦比亚西北部MiP的生活方式或社会健康决定的单一过程。
    方法:混合QUAN-QUAL收敛三角剖分研究。在定量成分中,我们对400名孕妇进行了心理测量评估和横断面设计,并对她们进行了Pender-Walker生活方式量表和MiP预防调查.在定性研究中,对46名孕妇进行了一项重要的人种学研究,其中描述了她们关于家庭和医疗保健生活方式的叙述和实践。
    结果:MiP的频率为9%,在那些没有控制死水的人中,这种疾病的发生率更高(29%),没有使用杀虫剂处理过的蚊帐(16%),并且在发烧时去了医院(14%)或显微镜检查(20%)。这与不健康生活方式的存在不谋而合,对疟疾知之甚少,对生病风险的认识很低,以及关于MiP的含义和经验,产妇,怀孕表现出很高的临床症状,文化,以及所研究妇女的社会经济负担。
    结论:这种流行病学概况和生活方式的方法基于健康证据中的批判理论假设,即暴露于疟疾的孕妇遭受严重的社会影响,文化和健康不公正,不可能影响目前哥伦比亚疟疾控制的健康模式,生物医学,实证主义和功利主义理论。
    BACKGROUND: In the scientific literature on Malaria in Pregnancy (MiP), no studies have been conducted on lifestyles based on critical theory. The objective of this study was to analyse the lifestyles or singular processes of social determination of health in MiP in northwestern Colombia.
    METHODS: Mixed QUAN-QUAL convergent triangulation study. In the quantitative component, a psychometric evaluation and a cross-sectional design were conducted in 400 pregnant women to whom the Pender-Walker lifestyle scale and a survey on MiP prevention were applied. In the qualitative study, a critical ethnography was conducted with 46 pregnant women in whom their narratives and practices regarding lifestyles at home and healthcare were described.
    RESULTS: The frequency of MiP was 9%, and a higher occurrence of the disease was identified in those who did not control stagnant water (29%), did not use insecticide-treated net (16%) and went to the hospital (14%) or the microscopist (20%) when they had fever. This coincides with the presence of unhealthy lifestyles, little knowledge about malaria, and a low perception of the risk of getting sick, as well as meanings and experiences about MiP, maternity, and pregnancy that show a high clinical, cultural, and socioeconomic burden for the women studied.
    CONCLUSIONS: This epidemiological profile and the approach to lifestyles based on the postulates of critical theory in health evidence that pregnant women exposed to malaria suffer serious social, cultural and health injustices that are not possible to impact with the current health model of malaria control in Colombia guided by aetiopathogenic, biomedical, positivist and utilitarian theories.
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  • 文章类型: Journal Article
    童工是剥夺儿童许多基本权利的重要社会问题之一,让他们面临许多问题和后果,包括健康问题。因此,这项研究的目的是检查德黑兰劳动儿童的健康状况。这是一项使用Carspecken方法进行的人种学研究,并于2022年完成。这项研究的主要参与者包括居住在德黑兰的10-18岁的工作儿童。为了收集信息,研究人员出现在工作场所,学校,和工作儿童居住超过两年的地方,观察他们的生活和活动。还对童工和知情人士进行了正式和非正式的采访。总的来说,在这项研究中,对数百名工作儿童进行了评估和观察。研究人员和50多个孩子进行了友好的交谈,并对六名在职儿童进行了官方采访。此外,对知情人士和在职儿童的父母进行了10多次正式采访。除了观察和访谈,还检查和解释了诸如医疗记录和工作儿童图纸之类的文件。从观察中获得的信息,采访,文件被输入到MAXQDA软件中,并提取其原始代码。高级代码以及子类别和主要类别是由低级代码的聚合形成的。健康受损是由折磨身体的三个亚类(工作和环境创伤,性虐待,营养不良,疲劳,睡眠障碍和卫生条件不足),不安的头脑(焦虑的孩子,抑郁和孤立,自尊心降低和注意力不集中)和社交能力中断(消极的社会角色建模,侵略和暴力,固执和报复,骚扰和滋扰,应受谴责的社会行为,忽视他人的所有权,扰乱的关系和群体外的自我审查)。本研究的结果表明,工作儿童的健康受到各种身体损害,心理,和社交方式。因此,应该在国家和国际层面采取一些措施来改善他们的健康,例如修订有关儿童的现行法律,并告知儿童其权利。
    Child labor is one of the important social issues that deprive children of many fundamental rights, and make them face many problems and consequences, including health problems. Thus, this study was conducted with the aim of examining the health of working children in Tehran. This is an ethnographic study that was conducted using Carspecken\'s approach and was completed in 2022. The main participants of this study included working children aged 10-18 years living in Tehran. In order to collect information, the researcher was present at the workplace, school, and living places of working children for more than two years, observing their lives and activities. Formal and informal interviews were also conducted with the working children and informed people. In total, hundreds of working children were assessed and observed in this research. A friendly conversation was formed between the researcher and more than 50 children, and official interviews were conducted with six of the working children. Also, more than 10 official interviews were conducted with informed people and parents of working children. In addition to observations and interviews, documents such as medical records and drawings of working children were also examined and interpreted. The information obtained from observations, interviews, and documents was entered into MAXQDA software, and its raw codes were extracted. The high-level codes as well as sub and main categories were formed from the aggregation of low-level codes. Impaired health was formed from three subcategories of tormented body (work and environmental trauma, sexual abuse, malnutrition, fatigue, sleep disorder and inadequate hygiene), disquieted mind (anxious children, depression and isolation, reduced self-esteem and unfocused mind) and disrupted sociability (negative social role modeling, aggression and violence, stubbornness and vindictiveness, harassment and nuisance, reprehensible social behaviors, neglecting others\' ownership, disturbed relationships and out-group self-censorship). The results of the present study showed that the health of working children is compromised in various physical, psychological, and social ways. Therefore, some measures should be taken at the national and international levels to improve their health, such as revising the existing laws regarding children and informing children of their rights.
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  • 文章类型: Journal Article
    社会处方涉及将个人与社区团体和活动联系起来,经常支持他们的心理健康和幸福。近年来,它在NHS中获得了越来越多的支持。不同类型的社区活动的好处有很强的证据基础,包括运动组,艺术团体和自然干预,关于心理健康结果,然而,人们对这些群体如何影响心理健康和福祉知之甚少。这项研究通过哪些个人层面的机制(“如何”)探索这些群体支持心理社会福祉。
    进行了为期12个月的人种学研究,以探索关键共享,跨4个社会处方社区团体的个人层面机制:足球,唱歌,园艺和阅读。这项研究主要集中在那些患有严重精神疾病的人身上,而以前大多数社会处方研究都集中在轻度至中度的心理健康问题上。为了构建调查结果,使用了休闲活动作用机制的多层次理论框架。
    主要的共同心理机制是:增强自信和自尊,增加的目的/意义,成就感增强,体验愉悦;社会机制包括:增加社会支持,友谊的形成和孤独的减少,增强社区意识和归属感;行为机制是:增加独立性和对经验的开放性,减少成瘾行为和建立更健康的习惯,寻求工作的行为增加,并提供结构和例程。
    希望这项研究的结果可以帮助专业人员增加他们对这些团体如何支持个人的心理健康的理解,从而加强转介实践。
    这项研究使用人种学方法,其中首席研究员花了一年多的时间参与4个不同的社区团体,通过采访,对话和观察,探讨这些群体对个人生活的心理健康影响。参与者有中度到重度的心理健康状况,小组由阅读组成,园艺,唱歌和足球组。这项研究探索了这些群体的心理健康益处的潜在机制。关键的共同心理机制是:增强的自信和自尊,增加的目的/意义,成就感增强,体验愉悦;社会机制包括:增加社会支持,友谊的形成和孤独的减少,增强社区意识和归属感;行为机制是:增加独立性和对经验的开放性,减少成瘾行为和建立更健康的习惯,寻求工作的行为增加,并提供结构和例程。希望这项研究的结果可以帮助转介专业人员(例如全科医生,社会工作者,链接工人)增加他们对这些团体如何支持个人心理健康的理解,从而提高参考技能。
    UNASSIGNED: Social prescribing involves connecting individuals to community groups and activities, often to support their mental health and well-being. It has received increasing support in recent years across the NHS. There is a strong evidence base for the benefits of different types of community activities, including exercise groups, arts groups and nature interventions, on mental health outcomes, however, less is known about how these groups impact mental health and well-being. This study explores through what individual-level mechanisms (the \'how\') these groups support psychosocial well-being.
    UNASSIGNED: An ethnographic study was conducted over 12-months to explore key shared, individual-level mechanisms across 4 social prescribing community groups: football, singing, gardening and reading. This study focused mostly on those with severe mental illness, whereas previously most social prescribing studies have focused on mild to moderate mental health problems. To frame the findings, a \'multi-level theoretical framework of mechanisms of action\' of leisure activities was used.
    UNASSIGNED: Key shared psychological mechanisms were: increased self-confidence and self-esteem, increased purpose/meaning, increased sense of achievement, experience of pleasure; social mechanisms included: increased social support, formation of friendships and reduced loneliness, enhanced sense of community and belonging; behavioural mechanisms were: increased independence and openness to experience, reduction in addictive behaviours and building healthier habits, increased work-seeking behaviour, and provision of structure & routine.
    UNASSIGNED: It is hoped that the findings of this study can help referring professionals increase their understanding of exactly how such groups support individuals\' mental health, thus enhancing referring practices.
    This study uses ethnographic methods, wherein the lead researcher spent over a year participating in 4 different community groups, using interviews, conversations and observation to explore the mental health impact of such groups on individuals\' lives. The participants had moderate to severe mental health conditions, and the groups consisted of a reading, gardening, singing and football group. The study explored \'mechanisms\' underlying the mental health benefits of these groups. Key shared psychological mechanisms were: increased self-confidence and self-esteem, increased purpose/meaning, increased sense of achievement, experience of pleasure; social mechanisms included: increased social support, formation of friendships and reduced loneliness, enhanced sense of community and belonging; behavioural mechanisms were: increased independence and openness to experience, reduction in addictive behaviours and building healthier habits, increased work-seeking behaviour, and provision of structure & routine. It is hoped that the findings of this study can help referring professionals (e.g. GPs, social workers, link workers) increase their understanding of exactly how such groups support individuals’ mental health, thus improving referring skills.
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  • 文章类型: Journal Article
    背景:数字辅助医疗服务和技术越来越受欢迎。他们帮助病人管理他们的病情,从而减轻医护人员的负担。数字医疗保健使个人能够获得更适合其需求和偏好的护理。如果实施得当,它可以通过在医疗保健需求的背景下考虑每个人的机会和局限性来促进公平,preferences,值,和能力。
    目的:本研究旨在了解需求,值,以及获得24/7数字医疗服务的慢性阻塞性肺疾病(COPD)患者的偏好。此外,我们的目标是了解他们所属社区的动态,以及这些社区如何相交。这将为我们提供必要的知识,以建立提供教育的新方法,包括为卫生专业人员开展教育活动,火车,并赋予COPD患者权力。
    方法:该研究包括7名被诊断为COPD的线人,他们接受了来自新西兰地区一个区域项目的24/7数字医疗服务支持,丹麦。在两个月的时间里,线人被访问了4次,包括“你好”访问,半结构化面试的一天,和2天的实地观察。线人参加了半结构化的采访,遵循参与者观察和人种学方法。使用归纳方法对访谈内容进行了分析,以对经验数据进行分类。
    结果:使用归纳法,我们确定了与线人需求相关的3个主要类别,值,和偏好:(1)健康,(2)价值创造,(3)资源。这三个主要类别基于9个子类别:(1)健康和障碍,(2)自我监控,(3)药物治疗,(4)行为,(5)动机,(6)爱好,(7)社交网络,(8)卫生专业人员,(9)技术。这些发现表明,线人重视在COPD发作之前保持日常活动和保持认同感。此外,他们表达了不被COPD定义的愿望,因为关于COPD的讨论经常偏离话题。
    结论:数字健康解决方案和为其提供服务的医疗保健专业人员应优先考虑他们所服务的个人,考虑到他们的需要,值,和偏好,而不是仅仅关注医疗状况。这种方法确保了生活在长期健康状况下的人的最高水平的日常生活和赋权。围绕个人的社区必须进行持续的互动和协作。他们应该共同努力,融入人们的需求,值,以及对未来数字医疗服务的偏好,从而促进赋权和自我管理。旨在发展注册护士数字医疗服务能力的新教育计划应促进两个社区之间的合作。这种合作对于支持长期健康状况患者的日常活动至关重要。
    BACKGROUND: Digitally assisted health care services and technologies are gaining popularity. They assist patients in managing their conditions, thereby reducing the burden on health care staff. Digital health care enables individuals to receive care that is more tailored to their needs and preferences. When implemented properly, it can promote equity by considering each person\'s opportunities and limitations in the context of health care needs, preferences, values, and capabilities.
    OBJECTIVE: This study aims to understand the needs, values, and preferences of individuals with chronic obstructive pulmonary disease (COPD) who are provided with a 24/7 digital health care service. Furthermore, we aim to understand the dynamics of the communities to which they belong and how these communities intersect. This will provide us with the essential knowledge to establish new methods of providing education, including the development of educational activities for health professionals to engage, train, and empower people living with COPD.
    METHODS: The study included 7 informants diagnosed with COPD who received 24/7 digital health care service support from a regional project in Region Zealand, Denmark. The informants were visited 4 times during 2 months, including a \"Hello\" visit, a day with a semistructured interview, and 2 days with field observations. The informants participated in a semistructured interview, following participant observation and an ethnographic approach. The interview content was analyzed using an inductive methodology to categorize the empirical data.
    RESULTS: Using the inductive approach, we identified 3 main categories related to the informants\' needs, values, and preferences: (1) Health, (2) Value Creation, and (3) Resources. These 3 main categories were based on 9 subcategories: (1) health and barriers, (2) self-monitoring, (3) medication, (4) behavior, (5) motivation, (6) hobbies, (7) social networks, (8) health professionals, and (9) technology. These findings revealed that the informants placed value on maintaining their daily activities and preserving their sense of identity before the onset of COPD. Furthermore, they expressed a desire not to be defined by their COPD, as conversations about COPD often shifted away from the topic.
    CONCLUSIONS: Digital health solutions and the health care professionals who offer them should prioritize the individuals they serve, considering their needs, values, and preferences rather than solely focusing on the medical condition. This approach ensures the highest level of daily living and empowerment for those living with long-term health conditions. The communities surrounding individuals must engage in constant interaction and collaboration. They should work together to incorporate people\'s needs, values, and preferences into future digital health services, thereby promoting empowerment and self-management. New educational programs aimed at developing the digital health service competencies of registered nurses should facilitate collaboration between the 2 communities. This collaboration is essential for supporting patients with long-term health conditions in their daily activities.
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  • 文章类型: Journal Article
    背景:重症监护环境中大量不必要的警报导致工作人员的警报疲劳,并威胁患者的安全。为重症监护病房(ICU)的警报管理开发和实施有效和可持续的解决方案,了解员工与患者监测系统和警报管理实践的互动至关重要。
    目的:本研究调查了护士和医生与患者监护系统的相互作用,他们对报警管理的看法,和智能报警管理解决方案。
    方法:这项探索性的定性研究与人种学,在德国大学医院的ICU中进行了多方法方法。在数据收集中使用三角测量,102小时的实地观察,与ICU工作人员进行12次半结构化访谈,并对参与式任务的结果进行了分析。数据分析遵循归纳,扎根理论方法。
    结果:护士和医生报告在大部分工作时间和任务中与连续生命体征监测系统进行交互。没有既定的警报管理标准;相反,护士和医生表示,警报是通过临时反应解决的,他们认为有问题的做法。工作人员对智能报警管理的看法各不相同,但是他们强调了可理解和可追溯的建议对增加信任和认知的重要性。
    结论:工作人员与无所不在的患者监测系统及其警报的互动是ICU工作流程和临床决策的重要组成部分。警报管理标准和工作流程已被证明是不足的。我们的观察,以及员工的反馈,建议更改是有必要的。警报管理解决方案应与用户一起设计和实施,工作流,和现实世界数据的核心。
    BACKGROUND: The high number of unnecessary alarms in intensive care settings leads to alarm fatigue among staff and threatens patient safety. To develop and implement effective and sustainable solutions for alarm management in intensive care units (ICUs), an understanding of staff interactions with the patient monitoring system and alarm management practices is essential.
    OBJECTIVE: This study investigated the interaction of nurses and physicians with the patient monitoring system, their perceptions of alarm management, and smart alarm management solutions.
    METHODS: This explorative qualitative study with an ethnographic, multimethods approach was conducted in an ICU of a German university hospital. Using triangulation in data collection, 102 hours of field observations, 12 semistructured interviews with ICU staff members, and the results of a participatory task were analyzed. The data analysis followed an inductive, grounded theory approach.
    RESULTS: Nurses and physicians reported interacting with the continuous vital sign monitoring system for most of their work time and tasks. There were no established standards for alarm management; instead, nurses and physicians stated that alarms were addressed through ad hoc reactions, a practice they viewed as problematic. Staff members\' perceptions of intelligent alarm management varied, but they highlighted the importance of understandable and traceable suggestions to increase trust and cognitive ease.
    CONCLUSIONS: Staff members\' interactions with the omnipresent patient monitoring system and its alarms are essential parts of ICU workflows and clinical decision-making. Alarm management standards and workflows have been shown to be deficient. Our observations, as well as staff feedback, suggest that changes are warranted. Solutions for alarm management should be designed and implemented with users, workflows, and real-world data at the core.
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  • 文章类型: Journal Article
    护理的背景通过其结构和指导原则确定和组织实践。它有时是一个产生紧张和多种选择的空间,提供不同护理的变量和持续时间的不确定性。我们可以认为,舒适过程的构建不仅取决于其参与者的意愿和情况本身,但也受专业人士的制约,文化,以及插入它的社会背景。本文是姑息治疗单位舒适领域的博士研究的一部分,这些是出现的部分结果。
    使用人种学方法进行定性研究。
    我们对18位临终患者及其匹配的重要家庭成员(18位)和21位卫生专业人员进行了半结构化访谈。我们还对护理情况进行了参与者观察。
    行动的上下文,在那里学习意义和实践,与某种与实际相关的身份联系在一起,上下文知识,与集体和归属感联系在一起。影响姑息治疗单位护理环境的各种因素之间的关系,构成本主题的三个领域,特别是:一体化和包容的环境,护理的概念,以及组织文化的包容性因素。
    特定背景是该姑息治疗单元中舒适度的支撑轴。护理的背景,其中对象和规定支持将舒适过程构建为整合文化的实体,既定的护理概念,允许知识的深化。
    UNASSIGNED: The context of care determines and organizes practices through its structures and guiding principles. It is sometimes a space that generates tension and multiple choices, variable in the provision of different care and uncertain in its duration. We can consider that the construction of the comfort process does not only depend on the will of its actors and the situation itself, but is also conditioned by the professional, cultural, and social context in which it is inserted. This article is part of a doctoral study in the field of comfort in a palliative care unit, and these are some of the partial results that emerged.
    UNASSIGNED: Qualitative study using ethnographic approach.
    UNASSIGNED: We conducted semistructured interviews with 18 patients at the end of life and their matched significant family members (18) and 21 health professionals. We also conducted a participant observation of care situations.
    UNASSIGNED: The context of action, where meanings and practices are learned, is linked to a certain identity that is related to practical, contextual knowledge, linked to a collective and to a feeling of belonging. The relationship between the various factors that shape the Care Context in the palliative care unit studied, constitute the three domains of this topic, specifically: the integrative and inclusive environment, the conceptions of care, and the inclusive factors of organizational culture.
    UNASSIGNED: The specific context was determinant as a supporting axis for comfort in this palliative care unit. The context of care, where objects and provisions support the construction of the comfort process as an entity that integrates culture, established conceptions of care, allowing the deepening of knowledge.
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  • 文章类型: Journal Article
    借鉴人种学实地调查和跨专业焦点小组讨论的数据,这项研究调查了老年病房工作人员的日常生活,以探索和了解在住院老年护理中从事叙事关系的条件。避免对叙事实践的个人主义理解,我们应用了一种基于对叙事的关系理解的行动叙事方法,个人叙事没有与社会和文化特征分开。这帮助我们探索了对日常实践条件的个人解释如何与更广泛的社会或文化理解结合在一起,以获得有关这些在老年护理的日常情况下如何相互联系和改革的见解。这些发现提供了基于老年病房医护人员如何解释其实践条件的叙事关系的机会的见解。以及他们如何根据这样的解释行事。虽然一些解释与鼓励叙事关系的态度和活动有关,其他人同时通过制定任务导向来挫败叙事关系,司,或专注于可测量的生物医学或功能相关的结果。此外,研究结果表明,并讨论了在日常医疗保健情况下制定解释时产生的紧张关系的后果,因此质疑关于条件的假设是静态的和线性的。
    Drawing on data from ethnographic fieldwork and interprofessional focus group discussions, this study enquires into staff\'s everyday life on a geriatric ward to explore and understand conditions for engaging in narrative relations in in-patient geriatric care. Avoiding individualistic understandings of narrative practices, we applied a narrative-in-action methodology built on a relational understanding of narrativity, where individual narratives are not separated from social and cultural features. This helped us explore how individual interpretations of the conditions for everyday practices come together with broader social or cultural understandings to gain situated insights about how these are continuously related and reformed by one another in everyday situations of geriatric care. The findings offer insights into the opportunities to engage in narrative relations based on how healthcare staff on a geriatric ward interpret conditions for their practices, and how they act based on such interpretations. While some interpretations were associated with attitudes and activities encouraging narrative relations, others simultaneously thwarted narrative relations by enacting task-orientation, division, or a focus on measurable biomedical or function-related outcomes. Moreover, the findings suggest and discuss consequences of the tensions created as interpretations are enacted in everyday healthcare situations, thus questioning assumptions about conditions as something static and linear.
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  • 文章类型: Journal Article
    背景:关于早期帕金森病的现有定性研究借鉴了患者报告的疾病经验,旨在捕捉与疾病患者最相关的症状和影响。作为这项研究的补充,本研究从整体上调查了早期帕金森病患者的经历,人种学观点。我们探索了态度,信仰,以及塑造人们如何理解和适应早期帕金森病生活的社会结构。
    方法:研究人员采访了30名早期帕金森病患者,10亲戚,以及美国和德国的10名神经学家和运动障碍专家。许多采访都是亲自进行的,让研究人员花时间在参与者的家中,见证他们的日常生活。一个多学科的社会科学家团队,临床研究人员,和患者组织代表领导的混合方法研究设计和分析。深入的人种学访谈产生了定性的见解,随后进行了定量调查,以评估其在150名患者中的患病率。
    结果:除了发展早期帕金森病患者的生活体验途径外,我们确定了五个关键的主题发现,这些发现提供了关于该疾病的临床特征如何在患者日常生活中变得有意义的见解。家庭关系,和主观幸福感:(1)患有早期帕金森病的人在接受医学诊断之前就开始接受他们的疾病;(2)接受不是最终的成就,而是一个周期性的过程;(3)患有早期帕金森氏病的人“活在当下”,以使未来更易于管理;(4)减缓疾病进展是推动早期帕金森氏症患者行动的重要目标;(5)患有早期帕金森氏症的人重视基于生活经验并与他们的疾病进展阶段相关的信息。
    结论:这种整体,对患者生活经验的人种学方法提供了五个关键的主题发现,这些发现补充了早期帕金森病的定性和定量数据集的见解。加强对早期帕金森病症状如何影响患者的健康相关生活质量和更广泛的社交生活的了解,可以帮助我们更好地了解患者如何对医疗服务和治疗的使用做出决定。
    这项研究旨在了解早期帕金森病患者的生活经历。除了观察症状如何影响人们的日常生活,这项研究调查了人们对早期帕金森病的看法和意义.第一步是对早期帕金森氏症患者进行采访,他们的亲戚,和医生。这些访谈涵盖了诸如早期帕金森氏症患者最终如何被诊断等主题,他们去哪里获取信息,以及他们如何接近未来。在第二步中,详细分析了访谈的记录和笔录。从分析中产生的想法和主题被用来描绘人们如何体验早期帕金森病作为他们更广泛生活的一部分。研究人员确定了五个关键见解:(1)人们通常在被诊断之前就开始接受帕金森氏症;(2)接受帕金森氏症是一个持续的过程;(3)具有早期帕金森氏症价值的人生活在当下;(4)患有早期帕金森氏症的人将减缓疾病的恶化视为重要目标;(5)从他人的第一手经验中学习比科学信息更有价值。最终,这项研究表明,了解早期帕金森病如何融入人们的日常生活可以帮助研究人员,医生,患者组织提供更有效的支持和护理。
    BACKGROUND: Existing qualitative research on early-stage Parkinson\'s disease draws on patients\' reported disease experience, aiming to capture the symptoms and impacts most relevant to patients living with the disease. As a complement to this research, the present study investigated the patient experience of early-stage Parkinson\'s disease from a holistic, ethnographic perspective. We explored the attitudes, beliefs, and social structures that shape how people understand and adapt to life with early-stage Parkinson\'s disease.
    METHODS: Researchers interviewed 30 people with early-stage Parkinson\'s disease, 10 relatives, and 10 neurologists and movement disorder specialists in the USA and Germany. Many of these interviews took place in-person, allowing researchers to spend time in participants\' homes and witness their daily lives. A multidisciplinary team of social scientists, clinical researchers, and patient organization representatives led the mixed-methods study design and analysis. In-depth ethnographic interviews yielded qualitative insights, with a quantitative survey following to assess their prevalence in a larger sample of 150 patients.
    RESULTS: In addition to developing a patient life experience pathway of early-stage Parkinson\'s disease, we identified five key thematic findings that provide insight into how the clinical features of the disease become meaningful to patients on the context of their daily lives, family relations, and subjective well-being: (1) People with early-stage Parkinson\'s disease start coming to terms with their disease before receiving a medical diagnosis; (2) Acceptance is not a finalized achievement, but a cyclical process; (3) People with early-stage Parkinson\'s disease \"live in the moment\" to make the future more manageable; (4) Slowing disease progression is an important goal driving the actions of people with early-stage Parkinson\'s; and (5) People with early-stage Parkinson\'s disease value information that is grounded in lived experience and relevant to their stage of disease progression.
    CONCLUSIONS: This holistic, ethnographic approach to patient life experience provided five key thematic findings that complement insights from qualitative and quantitative datasets on early-stage Parkinson\'s disease. An enhanced understanding of how early-stage Parkinson\'s symptoms impact patients\' health-related quality of life and their broader social lives can help us better understand how patients make decisions about their usage of healthcare services and therapies.
    This study aimed to understand the experience of people living with early-stage Parkinson’s. In addition to looking at how symptoms impact people’s daily lives, this research examined how people think about and give meaning to early-stage Parkinson’s. The first step was to conduct interviews with people with early-stage Parkinson’s, their relatives, and doctors. These interviews covered topics such as how people with early-stage Parkinson’s are eventually diagnosed, where they go for information, and how they approach the future. In the second step recordings and transcripts of the interviews were analyzed in detail. The ideas and themes that emerged from analysis were used to create a picture of how people experience early-stage Parkinson’s as part of their broader lives. Researchers identified five key insights: (1) people often begin to come to terms with Parkinson’s before being diagnosed; (2) accepting Parkinson’s is an ongoing process; (3) people with early-stage Parkinson’s value living in the moment; (4) people with early-stage Parkinson’s see slowing the worsening of the disease as an important goal; and (5) learning from the first-hand experience of others can be more valuable than scientific information. Ultimately, this research shows that understanding how early-stage Parkinson’s fits into people’s everyday lives can help researchers, doctors, and patient organizations provide more effective support and care.
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  • 文章类型: Journal Article
    有利于年龄的环境旨在通过促进社会,心理,身体参与。这可能会延迟慢性复杂疾病的发作,使人们能够在家里独立生活,防止孤独。这项研究调查了挪威一个名为Helgetun的社区生活环境,旨在探索它如何促进积极老龄化。
    我们选择了一种由观察组成的人种学方法,非正式对话,并对15名居民(11名女性,4男,年龄62-84岁)。我们使用反身性主题分析来分析数据。
    我们开发了三个主题,在这个生活环境中促进积极老龄化:保持自我认同,经历成长和发展,感觉到一种归属感。这些主题与身体活动水平有关,社会参与,以及对居住环境的总体满意度。保持自我认同与在生活中扮演新角色以及获得有意义的活动有关。经历成长和发展,涉及接触新的活动,学习新技能,体验掌握。最后,感觉到一种归属感意味着感觉到安全和团体的一部分,以及获得社会支持和帮助。这种社会关系和安全感反映在他们应对新冠肺炎疫情的经历中,其中大多数感觉相对不受影响,这表明这种生活方式可能会增加这个年龄组的依赖。
    具有灵活的结构,适应居民的核心需求和个人资源,可以促进社区生活环境中的积极老龄化。我们的发现有助于越来越多的证据表明,这些环境增加了社会和身体的参与,同时减少社会孤立和孤独。这些发现在挪威的背景下可能特别相关,在挪威,老年人对家庭的依赖程度较低,并且是政策制定者思考未来老年人生活设计的基点。
    Age-friendly environments intend to promote active ageing by facilitating social, mental, and physical participation. This could potentially delay the onset of chronic complex conditions, enabling people to live longer independently at home, and prevent loneliness. This study investigates a community-based living environment in Norway called Helgetun and aims to explore how it can facilitate active ageing.
    We chose an ethnographic approach consisting of observation, informal conversations, and in-depth semi-structured interviews with 15 residents (11 female, 4 male, ages 62-84). We analysed the data using reflexive thematic analysis.
    We developed three themes on facilitating active ageing in this living environment: maintaining self-identity, experiencing growth and development, and feeling a sense of belonging. These themes were related to physical activity levels, social engagement, and overall satisfaction with the living environment. Maintaining self-identity concerned getting a new role in life as well as access to meaningful activities. Experiencing growth and development involved being exposed to new activities, learning new skills, and experiencing mastery. Lastly, feeling a sense of belonging meant feeling safe and part of a group, as well as receiving social support and help. This feeling of social connectedness and safety was reflected in their experience with the COVID-19 pandemic, in which most felt relatively unaffected, suggesting that this way of living could increase reliance among this age group.
    Having a flexible structure, adapting to the core needs and individual resources of the residents, can facilitate active ageing in community-based living environments. Our findings contribute to the growing evidence that these environments increase social and physical engagement, whilst reducing social isolation and loneliness. These findings may be particularly relevant in a Norwegian context-where older adults are less dependent on family for care-and are meant as grounding points for policymakers to reflect upon designing future senior living.
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  • 文章类型: Journal Article
    住院患者可以从护理新技术的出现中受益。有许多技术产品可用,但是这些很少找到实践的方法。需要进一步了解接受和使用护理技术的情况。在研究项目“实施护理创新中心”中,德国一家创伤外科住院病房实施了技术创新。实施后,它被调查:哪些实施的技术被接受/拒绝,以及哪些因素影响护士对技术的接受/拒绝?
    使用了重点民族志,包含两种方法:第一,进行参与者观察以检查护士和患者与技术的互动。观察结果固定在实地研究日记中,并使用评估性定性内容分析进行分析。第二,护士使用问卷提供有关使用频率和技术适用性的信息.使用UTAUT模型对研究结果进行了合并和分析。
    七项研究技术可以总结为四个结果类别:(1)动员床垫,护士和病人接受和使用特殊的投影仪和声音枕头,因为它们提供了一种无需额外努力就能提供高质量护理的方法。(2)跌倒预防系统始终用于患者护理作为工作义务,但是由于护士认为系统容易出错,接受度很低。(3)接受交互式治疗球,但由于工作量大,护士不能使用它。(4)不使用或不接受用于护患通信的App和工作设备跟踪系统,因为护士在系统中没有看到实际的益处。
    接受或拒绝产品并不一定等同于使用或不使用该技术。在实施之前,用户对技术的接受是一种偏见——当用户有时间尝试技术时,意向使用可以稳定为持续使用。接受和使用的技术可以掩盖问题(例如人员短缺)并鼓励有问题的发展,例如减少床边的接触时间。因此,技术接受应该有资格询问接受的技术有什么贡献。
    UNASSIGNED: Hospitalised patients could benefit from the emergence of novel technologies for nursing care. There are numerous technical products available, but these rarely find their way into practice. Further knowledge is required about the circumstances under which technology in nursing is accepted and used. In the research project \"Centre for Implementing Nursing Care Innovations\", technical innovations are implemented on a trauma surgery inpatient ward in Germany. After implementation, it was investigated: Which implemented technologies are accepted/rejected, and which factors influence the acceptance/rejection of technology for nurses?
    UNASSIGNED: A focused ethnography was used, containing two approaches: First, participant observation was conducted to examine nurses\' and patients\' interaction with technologies. Observations were fixed in a field research diary and analysed using evaluative qualitative content analysis. Second, a questionnaire was used by nurses to provide information about the use frequency and technology suitability. The results of the study were consolidated and analysed using the UTAUT model.
    UNASSIGNED: Seven studied technologies can be summarised in four result categories: (1) A Mobilising mattress, a Special projector and a Sound pillow are accepted and used by nurses and patients, because they offer a way to provide high quality care with little additional effort. (2) A Fall prevention system is consistently used in patient care as a work obligation, but since nurses consider the system error-prone, acceptance is low. (3) An Interactive therapy ball is accepted but nurses cannot use it due to the high workload. (4) An App for nurse-patient communication and a work-equipment tracking system are not used or accepted because nurses do not see a practical benefit in the systems.
    UNASSIGNED: Acceptance or rejection of a product does not necessarily equate to use or non-use of the technology. Before implementation, technology acceptance among users occurs as prejudice-when users are given time to experiment with technology, intention-to-use can stabilize into sustained use. Accepted and used technologies can serve to mask problems (such as staff shortages) and encourage problematic developments, such as the reduction of contact time at the bedside. Therefore, technology acceptance should be qualified in asking to what accepted technology contributes.
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