Facilitating parent-child interactions is a key component of evidence-based early childhood home visiting programs. Several observational measures have been created to effectively capture home visiting activities from an operationalized perspective. While the field has a reasonable understanding of what home visitors can do to facilitate developmentally supportive interactions, and why, the how remains elusive for many home visitors. This qualitative study used a modified grounded theory approach to examine the facilitation of caregiver-child interactions during home visits. Home visit video recordings previously coded using the Home Visit Rating Scale (HOVRS) A+ were selected based on facilitation quality. Sixteen home visits (8 lower- and 8 higher-quality facilitation scores) were examined for differences in home visitor behaviors that support parent-child interactions during visits. We identified contextual and specific behaviors that home visitors used to actively engage caregivers and children together in developmentally supportive interactions. Results revealed 11 home visitor behaviors that discriminated higher quality facilitation. These behaviors were categorized into four domains: environmental conditions, executing the activity, strengths-based focus, and caregiver responses. This qualitative study highlights specific behaviors and professional development areas to support more effective home visiting services for a diverse population of families with young children.
Facilitar las interacciones progenitor-niño es un componente clave de los programas de visita a casa en la temprana niñez con base en la evidencia. Varias medidas de observación se han creado para captar eficazmente las actividades de visita a casa desde una perspectiva operacional. A pesar de que el campo tiene una comprensión razonable de lo que los visitantes a casa pueden hacer para facilitar las interacciones de apoyo al desarrollo, y el por qué, el cómo permanece aún esquivo para muchos visitantes a casa. Este estudio cualitativo usó un bien fundado acercamiento teórico modificado para examinar la manera de facilitar las interacciones cuidador-niño durante las visitas a casa. Con base en la calidad del proceso facilitador, se seleccionaron grabaciones en video de visitas a casa previamente codificadas usando la Escala de Puntuación de Visitas a Casa (HOVRS) A+. Dieciséis visitas a casa (8 con puntajes del proceso facilitador de más baja calidad y 8 de más alta calidad) se examinaron en cuanto a las diferencias en el comportamiento del visitador a casa que apoya las interacciones progenitor-niño durante las visitas. Identificamos comportamientos contextuales y específicos que los visitadores a casa usaron para hacer que los cuidadores y los niños participaran juntos activamente en las interacciones de apoyo al desarrollo. Los resultados revelaron 11 comportamientos del visitador a casa en que se comprometía la más alta calidad del proceso facilitador. Se categorizaron estos comportamientos en cuatro dominios: condiciones ambientales, ejecución de la actividad, enfoque con base en los puntos fuertes, así como las respuestas del cuidador. Este estudio cualitativo resalta comportamientos específicos y áreas de desarrollo profesional para apoyar servicios de visita a casa más eficaces para un diverso grupo de población de familias con niños pequeños.
La facilitation des interactions parent-enfant est une composante clé des programmes de visite à domicile de le petite enfance, fondés sur des données probantes. Plusieurs mesures d\'observation ont été créées afin de capturer efficacement les activités de visite à domicile du point de vue de l\'opération. Le domaine a une compréhension raisonnable de ce que les visiteurs à domicile peuvent faire pour facilité des interactions qui soutiennent le développement mais le pourquoi et le comment demeurent insaisissables pour bien des visiteurs à domicile. Cette étude qualitative a utilisé une approche théorique fondée modifiée pour faciliter les interactions personne prenant soin de l\'enfant - enfant durant les visites à domicile. Des enregistrements vidéo de visite à domicile, préalablement codés en utilisant l\'Echelle d\'Evaluation de Visite à Domicile (HOVRS en anglais), A+ ont été sélectionnées basé sur la qualité de la facilitation. Seize visites à domicile (8 de scores de plus faible qualité et 8 de scores de la meilleure qualité de facilitation) ont été examinées pour leurs différences dans les comportements du visiteur à domicile qui soutiennent les interactions parent-enfant durant ces visites. Nous avons identifié des comportements contextuels et spécifiques que les visiteurs à domicile ont utilisés afin d\'engager activement les personnes prenant soin des enfants et les enfants ensemble dans des interactions soutenant le développement. Les résultats ont révélé 11 comportements de visiteur à domicile qui dans la facilitation distinguant la facilitation de haute qualité. Ces comportements ont été catégorisés en quatre domaines: conditions environnementales, exécuter l\'activité, attention mise sur les forces, et réponses de la personne prenant soin de l\'enfant. Cette étude qualitative met en lumière des comportements spécifiques et des domaines de développement professionnel pour soutenir des services efficaces de visite à domicile pour une population diverse de familles avec de jeunes enfants.
Die Förderung von Eltern-Kind-Interaktionen ist eine Schlüsselkomponente von evidenzbasierten Hausbesuchsprogrammen für Kleinkinder. Es wurden mehrere Beobachtungsinstrumente entwickelt, um Hausbesuchsaktivitäten aus einer operationalisierten Perspektive effektiv zu erfassen. Während die Fachöffentlichkeit ein vernünftiges Verständnis von entwicklungsfördernden Interaktionen hat, bleibt die Umsetzung für viele Hausbesuchende schwer greifbar. In dieser qualitativen Studie wurde ein modifizierter Grounded-Theory-Ansatz verwendet, um die Förderung von Betreuungsperson-Kind-Interaktionen durch Hausbesuche zu untersuchen. Videoaufnahmen von Hausbesuchen, die zuvor mit der Bewertungsskala für Hausbesuche (Home Visit Rating Scale; HOVRS) A+ kodiert worden waren, wurden nach ihrer Qualität ausgewählt. Sechzehn Hausbesuche (8 mit niedriger und 8 mit hoher Qualität) wurden auf Unterschiede in den Verhaltensweisen der Hausbesuchenden untersucht, die die Eltern-Kind-Interaktionen während der Besuche unterstützen sollten. Wir identifizierten kontextbezogene und spezifische Verhaltensweisen, die die Hausbesuchenden einsetzten, um Betreuungspersonen und Kinder aktiv in entwicklungsfördernde Interaktionen einzubinden. Die Ergebnisse zeigten 11 Verhaltensweisen der Hausbesuchenden, die sich durch eine höhere Qualität der Förderung auszeichneten. Diese Verhaltensweisen wurden in vier Kategorien eingeteilt: Umgebungsbedingungen, Durchführung der Aktivität, Stärkenorientierung und Reaktionen der Betreuungspersonen. Diese qualitative Studie hebt spezifische Verhaltensweisen und professionelle Entwicklungsbereiche hervor, um effektivere Hausbesuchsdienste für eine vielfältige Population von Familien mit kleinen Kindern zu unterstützen.
親-子相互交流の促進は、エビデンスに基づいた乳幼児期家庭訪問プログラムの重要な要素である。いくつかの観察尺度が考案され、運用上の視点から家庭訪問の活動を効果的に捉えてきた。発達支援的な相互交流を促進するために家庭訪問員は何をすることができ、なぜできるのかを現場は合理的な理解をしているものの、多くの家庭訪問員は、どのようにするのかについては曖昧なままである。この質的な研究では、修正版グラウンデッド・セオリー・アプローチを用いて、家庭訪問中の養育者と子どもの相互交流の促進を検討した。家庭訪問評価尺度 (HOVRS) A+を用いて事前にコード化した家庭訪問ビデオ記録を、促進の質に基づいて選別した。16件の家庭訪問 (促進の質評価が低い8件と高い8件) の訪問中の親-子相互交流を支援する家庭訪問員の行動の違いについて検討した。養育者と子どもと共に発達支援的な相互交流を積極的に行わせるために家庭訪問員が用いた、文脈的かつ具体的な行動を特定した。その結果、より質の高い促進を可能にする11の家庭訪問員の行動が明らかになった。これらの行動は、「環境条件」「活動の実行」「強みに注目」「養育者の反応」の4つの領域に分類された。この質的な研究は、乳幼児のいる多様な家族に対するより効果的な家庭訪問サービスを支援するために、具体的な行動と専門家の開発領域を明らかにした。 家庭訪問、養育者-子どもの相互交流、促進、質的方法論.
促进亲子互动是循证幼儿家访计划的关键组成部分。已经制定了几项观察性测量指标, 以从可操作的角度有效地捕捉家访活动。虽然该领域对于家访者能够采取哪些措施促进发展支持性互动, 以及为什么, 有了相对清晰的理解, 但是对于许多家访者来说, 具体的操作方法仍然难以捉摸。本定性研究使用改进的扎根理论方法来检验家访期间看护者与儿童互动的促进情况。根据促进质量选择之前使用“家访评分量表” (HOVRS) A+编码过的家访录像。研究对16次家访 (其中8次促进质量得分较低, 8次得分较高) 进行了分析, 以了解家访者在访问期间支持亲子互动的行为差异。我们确定了家访者用来积极让看护者和儿童一起参与发展支持性互动的情境和特定行为。结果揭示了11种区分高质量促进的家访者行为。这些行为被归类为四个领域:环境条件、活动执行、基于优势的关注和看护者反应。本定性研究强调了特定的行为和专业发展领域, 以支持为有幼儿的不同家庭群体提供更有效的家访服务。.
يعد تسهيل التفاعلات بين الوالدين والطفل مكوناً رئيسياً لبرامج الزيارات المنزلية في مرحلة الطفولة المبكرة القائمة على الأدلة. وقد تم تصميم العديد من مقاييس الملاحظة لمتابعة أنشطة الزيارة المنزلية بشكل فعال من منظور عملي. وبينما نجد في المجال فهماً معقولاً لما يمكن لزوار المنزل القيام به لتسهيل التفاعلات الداعمة للنمو ، ولماذا ، ولكن تظل الكيفية مبهمة وغير واضحة بالنسبة للعديد من زوار المنزل. استخدمت هذه الدراسة الوصفية نهجاً معدلاً لنظرية الأساس لتناول عملية تسهيل تفاعلات مقدم الرعاية والطفل أثناء الزيارات المنزلية. تم اختيار تسجيلات الفيديو للزيارات المنزلية التي تم ترميزها مسبقاً باستخدام مقياس تقييم الزيارات المنزلية (HOVRS) A +. تم فحص ستة عشر زيارة منزلية لملاحظات الاختلافات في سلوكيات زائر المنزل التي تدعم تفاعلات الوالدين والطفل أثناء الزيارات. وتم تحديد السلوكيات السياقية والمحددة التي يستخدمها زوار المنزل لإشراك مقدمي الرعاية والأطفال بنشاط معاً في تفاعلات داعمة للنمو. كشفت النتائج 11 سلوكاً للزائر المنزلي تميز التسهيلات عالية الجودة. وتم تصنيف هذه السلوكيات إلى أربعة مجالات: الظروف البيئية ، وتنفيذ النشاط ، والتركيز القائم على نقاط القوة ، واستجابات مقدم الرعاية. هذه الدراسة الوصفية تسلط الضوء على سلوكيات محددة ومجالات التطوير المهني لدعم خدمات الزيارات المنزلية الأكثر فعالية لمجموعة متنوعة من العائلات التي لديها أطفال صغار.

Identify improvement proposals for approaching violence against women through the evaluation of 2009s Protocol for approaching Violence Against Women in Health Care in Cataluña (PAVIM).
Qualitative ethnographic study, 2019.
Public Health Care in Catalonia.
One hundred eighty one participants, of which: 104 health care professionals, 43 women\'s associations and/or experts in violence against women and 34 experts on health and violence against women.
Intentional sampling. Eighteen focus groups and 34 semi-structured interviews. Evaluation with a gender and intersectional perspective.
Results are structured along PAVIM\'s phases.
mandatory and institutionally recognized training for the whole professional team, with a gender and intersectional perspective. Detection: diagnostic code standardization for violence against women and improve coordination between primary care, emergency service, pediatrics and Assistance to Sexual and Reproductive Health. Care and recovery: territorial equity in the applied resources on cases of violence against women care (in the 9 sanitary regions of Catalonia) and improves communication between health and associative fields.
The improvement proposals identified are those that have generated a greater consensus among participants and are the most interesting to primary care. As limitations, stand out the temporality and heterogeneity of the Catalan territory.

OBJECTIVE: To analyze and classify the communication strategies developed by primary health care professionals in the Valencian Community (Spain), in view of the use of the Internet as a source of health information by the user population through the analytical categories of power and control which, according to Basil Bernstein, characterize the communication processes of therapeutic meetings.
METHODS: Qualitative study through in-depth interviews with primary health care professionals of the Valencian Community (n=18). The language of description of Bernstein\'s theory was applied to the analysis of the speeches in order to classify the strategies developed by the professionals and to propose a typology.
RESULTS: A sociological typology of strategies used by professionals in the face of Internet use by the user population is provided, which classifies them according to the classification and framing modulation in rejection strategies, validation strategies, filtering strategies and opening strategies.
CONCLUSIONS: The different strategies developed by professionals when faced with the use of the Internet as a source of information have different implications for the power and control relationships inherent to the therapeutic encounter. Professionals should be aware of these implications in order to increase the participation of the user population in therapeutic meetings.

During the economic crisis, developed countries have experienced financial fraud, with effects on the physical and mental health of the people affected, and on social domains. Based on the theoretical framework in literature reviews and in quantitative studies, this paper aims to obtain evidence on the effects of financial fraud on health and on the family and social environments of those affected. An intentional sample of 32 people affected by abusive and multi-currency mortgages, preferred and swap stock in Madrid was approached. In-depth interviews were conducted, and the resulting data was analysed using content analysis. Fraud-affected individuals had conditions of age, sex, educational level and occupations that possibly allowed them to accumulate economic resources throughout the course of their lives and, predictably in many cases, to take out fraudulent financial products, based on trust in the financial institutions. Financial fraud has led to the emergence of various processes of anomia and adverse health effects. The consequences on health were physical ailments (symptoms and diseases in various systems and parts of the body) and mental disorders (anxiety, depression, suicidal ideation), all affecting lifestyles, behaviour and personal and social relationships, both in affected individuals and their families. The increase in the use of medical drugs and health services serves as a final corollary to the imbalances on the affected people\'s health. Individuals and the Spanish society demand public health policy measures to mitigate the effects on health and the recovery of their confidence in the banking and political system.

Qualitative methods may help to understand features related to health urban inequalities as a way to include citizens\' perceptions of their neighbourhoods in relation to their health-related behaviours. The aim of this article is to describe the methods and design of a qualitative urban health study.
The Heart Healthy Hoods (HHH) analyses cardiovascular health in an urban environment using mixed methods: electronic health records, quantitative individual questionnaires, physical examination, semi-structured Interviews (SSIs), focus groups (FGs) and participatory technics such as photovoice. This article focuses on the HHH qualitative methods and design. A case study was used to select three neighbourhoods in Madrid with different socioeconomic levels: low, medium, and high. The selection process for these three neighbourhoods was as follows: classification of all Madrid\'s neighbourhoods (128) according to their socioeconomic level; after ranking this classification, nine neighbourhoods, three by socioeconomic level, were short-listed; different urban sociology criteria and non-participant observation were used for the final selection of three neighbourhoods. After selecting the three neighbourhoods, thirty SSIs were held with residents and six SSIs were held with key informants. Finally, twenty-nine FGs will be conducted over the course of 8 months, between May and December of 2018.
Systematization in the selection of neighbourhoods and the use of adequate techniques are essential for the qualitative study of urban health inequalities.

An important aspect that requires special attention by researchers using qualitative methods is the construction of theoretical categories, or more specifically, the step between coding and categorization. One of the most structured methodological proposals used in health sciences is grounded theory. In this paper an analytical technique called \"family categorization\" is proposed. Its aim is to facilitate the steps of creating the initial categories, based on intra- and inter-family codes analysis.

Scene-Based Psychodramatic Family Therapy (SB-PFT) is an innovative treatment used with troubled adolescents and their parents to improve family relationships and reduce adolescents\' problematic behavior. It integrates the principles of family therapy, psychodrama, and multiple-family group methodology. This research is a pilot study to obtain empirical evidence on the SB-PFT therapeutic process by gauging the perception of change of troubled adolescents and their parents, and assess the perceived helpfulness of its methodology and techniques. Ten multiple-family intervention groups were drawn up, with 110 participants (63 adolescents and 47 parents), and we adopted a qualitative methodology with focus groups, using an inductive analysis of 290 active constructions of participant narratives. Concerning perception of change, the adolescents reported mainly gaining in social support, prosocial attitudes, keys to problem solving, and expression of emotions due to the treatment. The parents perceived improvement in social support, keys for educational practices, emotional well-being, and expression of emotions due to the treatment. Regarding the perceived helpfulness of methodology and techniques, both adolescents and parents highlighted the usefulness of the group methodology for gaining social support, relativizing the problem, and expressing emotions. Additionally, participants referred to role-playing and mirror techniques as the most useful techniques. In conclusion, this first study on SB-PFT presents and describes its treatment for troubled adolescents and their parents. The participants\' positive perception of their personal and relational change after treatment should serve to promote further studies with quantitative methodology in order to verify the effectiveness of SB-PFT treatment.
La terapia familiar psicodramática basada en escenas (SB-PFT, por sus siglas en inglés) es un tratamiento innovador usado con adolescentes conflictivos y sus padres para mejorar las relaciones familiares y disminuir el comportamiento problemático de los adolescentes. Integra los principios de la terapia familiar, del psicodrama y de la metodología grupal multifamiliar. Esta investigación es un estudio piloto para obtener conocimiento empírico sobre el proceso terapéutico de la SB-PFT mediante la medición de la percepción de cambio de los adolescentes conflictivos y sus padres, y para evaluar la utilidad percibida de esta metodología y técnica. Se formaron diez grupos multifamiliares de intervención con 110 participantes (63 adolescentes y 47 padres), y adoptamos una metodología cualitativa con grupos focales utilizando un análisis inductivo de 290 construcciones activas de historias de los participantes. Con respecto a la percepción de cambio, los adolescentes informaron un aumento pricipalmente del apoyo social, de las actitudes prosociales, de las claves para resolver problemas y de la expresión de emociones debido al tratamiento. Los padres percibieron una mejora del apoyo social, de las claves para las prácticas educativas, del bienestar emocional y de la expresión de emociones debido al tratamiento. Con respecto a la utilidad percibida de la metodología y las técnicas, tanto los adolescentes como los padres destacaron la utilidad de la metodología de grupo para obtener apoyo social, relativizar el problema y expresar emociones. Además, los participantes se refirieron al juego de roles y a las técnicas del espejo como las más útiles. En resumen, este primer estudio sobre la SB-PFT presenta y describe su tratamiento para adolescentes conflictivos y sus padres. La percepción positiva de los participantes de su cambio personal y relacional después del tratamiento debería servir para promover más estudios con una metodología cuantitativa a fin de verificar la eficacia del tratamiento con la SB-PFT.
情景为基础的心理戏剧化家庭心理咨询(SB-PFT) 是一项应用于帮助有困扰青少年及其家长改善家庭关系并减少青少年问题行为的创新性治疗方法。该方法整合了家庭心理咨询原则,心理戏剧以及多家庭小组方法。该研究是旨在通过测量有困扰青少年及其家长感知到的变化来获得关于SB-PFT实证证据,并评估其方法和技巧感知到的有效性的试点研究。我们组织了共110名参与者(63名青少年和47名家长)的十个多家庭干预小组。我们对焦点小组采用定性方法,使用了一项针对参与者叙述290个活性建构的感应分析。关于对于变化的感知,青少年主要报告了得到社会支持,有益于社会的态度,由于治疗获得解决问题和表达情感的钥匙。由于治疗,家长感受到社会支持,教育做法,情感健康以及情绪表达的该进。关于对于方法和技巧感受到的帮助,青少年和家长都强调了小组方法对于获得社会支持,将问题相对化以及情感表达方面的有用性。此外,参与者认为角色扮演和镜面技巧最有效。结论是,第一个关于SB-PFT的研究描述并提出针对有困扰青少年及其家长的治疗。参与者对于治疗后个人以及关系改变正面感知会促进更多为确定SB-PFT治疗有效性的定量方法研究。.

This article presents the findings of a qualitative study of maternal perceptions of parenting following participation in Legacy for ChildrenTM (Legacy), an evidence-based parenting program for low-income mothers of young children and infants. To further examine previous findings and better understand participant experiences, we analyzed semistructured focus-group discussions with predominantly Hispanic and Black, non-Hispanic Legacy mothers at two sites (n = 166) using thematic analysis and grounded theory techniques. The qualitative study presented here investigated how mothers view their parenting following participation in Legacy, allowing participants to describe their experience with the program in their own words, thus capturing an \"insider\" perspective. Mothers at both sites communicated knowledge and use of positive parenting practices targeted by the goals of Legacy; some site-specific differences emerged related to these parenting practices. These findings align with the interpretation of quantitative results from the randomized controlled trials and further demonstrate the significance of the Legacy program in promoting positive parenting for mothers living in poverty. This study emphasizes the importance of understanding real-world context regarding program efficacy and the benefit of using qualitative research to understand participant experiences.

OBJECTIVE: To identify barriers and facilitators in the implementation of quality standards in hospital day care units (HDCU) in rheumatology.
METHODS: We analyzed appraisals of HDCU in terms of standards for structure, processes and results. The qualitative approach was conducted through 13 discussion groups created by rheumatology health professionals (7), nursing professionals (4) and HDCU patients (2). The recruitment of informants was done through purposive sampling, attending to variables that form the perceptions of the HDCU. Data analysis was performed using a descriptive-interpretive method.
RESULTS: The specialization of the HDCU and specific training in rheumatology for nursing are perceived as the main facilitator for the implementation of standards. Conversely, the delay in the availability of medicines at the HDCU is identified as a barrier that prolongs patient stay and wastes resources. Differences in local regulations are perceived as a potential barrier to equitable access to medicines. The patients gave higher ratings to the care received than to structural variables or those related to process.
CONCLUSIONS: The findings of this study suggest that improvements in the implementation of quality standards in HDCU may include three levels of action: the HDCU, the hospital and a third related to local regulations to access to medicines.

In this study, an ambiguous loss framework as described by Boss (1999, Ambiguous loss: Learning to live with unresolved grief, First Harvard University Press, Cambridge, MA) was used to examine and understand the family experiences of Mexican immigrant agricultural workers in Minnesota. Transcripts from interviews with 17 workers in Minnesota and 17 family members in Mexico were analyzed using qualitative methodology to identify experiences of ambiguous loss in the participants\' narratives. Key dimensions of ambiguous loss identified in the transcripts include: psychological family, feelings of chronic/recurring loss, finding support, and meaning making. In the category of psychological family, participants in both Mexico and the United States mourned the physical absence of their family members and experienced ambiguity regarding family responsibilities, but worked to maintain their psychological roles within the family. In the category of chronic/recurring loss, participants in both countries experienced chronic worry from not knowing if family members were safe, ambiguity regarding when the immigrant would return, and chronic stressors that compounded these feelings of loss. Participants in both countries coped with both real and ambiguous losses by accessing family support and by using ambiguous communication to minimize worry. Participants in Mexico also accessed work and community-based support. Participants in both countries made meaning of the ambiguous loss by identifying ways their lives were improved and goals were met as a result of the immigration for agricultural work in Minnesota.