Williamson et al noted a gap in research on parental experiences of
supporting their children post-traumatic event. To address this, they
investigated parental perceptions of the impact of the traumatic event on
family processes, on their need for support and support of their child.
The authors used semistructured qualitative interviews with 20
parents recruited in one of two emergency departments in the south...
Williamson et al noted a gap in research on parental experiences of
supporting their children post-traumatic event. To address this, they
investigated parental perceptions of the impact of the traumatic event on
family processes, on their need for support and support of their child.
The authors used semistructured qualitative interviews with 20
parents recruited in one of two emergency departments in the south of
England. Parents and children's post-traumatic stress were assessed via
standardized test. Five themes were identified in the data: "post-trauma
perception of the child and event", "strategies to support the child",
"perceptions and impact of medical treatment", "perceptions of
psychological treatment and support" and "impact of trauma on the parent".
To begin with, Williamson et al effectively analyzed the content of
their interviews, clearly supporting the more abstract themes they
identified with striking quotes from parents. They also identified
questionable beliefs held by parents about their children's perceptions
(ex.: "if children did not broach the subject, they were considered to be
coping well"). Assumptions made by parents were included and the data's
trustworthiness was enhanced via validation from respondents. This
represents a useful starting point for future research which could explore
children's subjective experiences in parallel with their parents and the
way their two perceptions interact.
On the other hand, more elaboration by the authors regarding the
actual traumatic events would have added to our understanding of the data.
Williamson et al state that children had experienced a traumatic event as
defined by criterion A for PTSD in the DSM-V, but this criterion was not
made explicit. Traumatic events in the sample were divided into six
categories (traffic accidents, assault, falls, acute medical emergencies,
sporting injuries and 'others'). In addition to improving readability by
stating the DSM-V criteria, discussing the types of trauma would have
provided an additional layer of nuance to their analysis. Parental
experiences may differ greatly based on several factors including the type
of trauma experienced by their child and whether or not the parent was
present at the traumatic event. Making these distinctions in the analysis
could provide useful evidence supporting different coping and psycho-
education strategies to help families adapt after a child has experienced
a traumatic event.
The study, "Effect of an evidence-based website on healthcare usage:
an interrupted time-series study" conducted by Spoelman and al, highlights
relevant findings that are timely for the practice. An evidenced-based
website about healthcare has been launched throughout the Netherlands in
2012. This is a nationwide study to determine whether this evidence-based
health website was associated with a reduction in healthcare us...
The study, "Effect of an evidence-based website on healthcare usage:
an interrupted time-series study" conducted by Spoelman and al, highlights
relevant findings that are timely for the practice. An evidenced-based
website about healthcare has been launched throughout the Netherlands in
2012. This is a nationwide study to determine whether this evidence-based
health website was associated with a reduction in healthcare usage. The
authors concluded that 2 years after the launch of the website,
"nationwide primary care usage decreased by 12%". (Spoelman & al,
2016). Although the effect was greater among phone consultations, the
effect was present in all types of consultations and subgroups such as
sex, socioeconomic status and age (older than 16 years old).
This research has great importance as it brings a new and concrete
way to decrease the amount of primary care visits while providing medical
information to the population. In Quebec, the healthcare system is under
huge budget cuts. (Derfel, 2015). The emergency rooms often reach over
their capacity. This is an interesting idea that could be generalized and
implemented in Canada, particularly the province of Quebec to address this
issue.
This initiative could be beneficial to both the healthcare system and
the population. It could alleviate the overcrowding emergency rooms while
making the healthcare system more efficient. According to the authors,
there is a reduction of consultations for non-life-threatening or non -
essential conditions when adequate online information is provided. This
would encourage mostly patients in need to consult primary care. In
addition, the communication during consultations could be more efficient
as the patients are better informed. Nowadays, the general population
often uses the internet to answer their medical questions and decide if
they need to consult a physician. The patients are often misinformed given
the vast amount of different information found on the internet, which is
not always reliable. This evidence-based website provides reliable medical
information and advice from the most recent general practitioners (GPs)
guidelines. It is written in plain understandable language and includes
illustrations, short videos, patient decision aids and e-health self-
management tools for 600 health topics. Hence, it is appropriate for the
general population and can even stimulate self-management of the
population.
The authors offer a detailed section on strengths and limitations.
Consideration for any cofounding variables and ensuring data quality
appeared to be a priority. Many cofounding variables are discussed such as
including only GPs recording more than 95% of their consultations, having
changes over time of the general practice characteristics, or an increase
in the population's age over time (increased by 0.9 years). A natural
before-after quasi experimental design seems appropriate for this
interrupted time-series (ITS) study. In order to control some factors that
could have affected healthcare usage after the release of the website, a
reference group was included. Since it is a nationwide website, having a
reference group not exposed at all during the study period is almost
impossible. The control group was tested in regards to three specific
topics that were not found in the website or had low page views, in order
to provide insight into the stability of healthcare usage without exposure
to the website. Yet, since the control group was tested on different
topics than the rest of the study participants, the results are not
necessarily comparable, which is a limit.
Furthermore, because the study evaluates a longitudinal impact of the
website on the healthcare usage, a longer follow-up period could have
enhanced reliability of results. It would have been interesting to know if
the website would keep the same number of page views with time. The
results must also be understood carefully. The healthcare usage for the
top 10 topics combined decreased significantly, but was not all
significant when analyzed separately. The same results can be found
related to the types of healthcare usage, where only a decline of
telephone consultations was significant (p=0.001) compared to short and
long consultations.
Finally, the results of this study suggests that providing evidence-
based information on certain types of topics could help decrease the
healthcare usage but not for all health topics. The intervention also
shows a greater reduction with telephone consultations, thus having a
lesser impact than anticipated on certain primary care settings such as
emergency rooms. The results of this study could be generalized to other
countries, such as Canada. They are both western countries, where patients
are accustomed to looking online for health information. This evidence-
based website could be a realistic project in this country. To create this
website, a collaborative approach between many healthcare professionals
would be encouraged. Hence, having an evidence-based website on health
could improve the population's knowledge and self-management, thus
reducing the strain on the healthcare system suffering from budget cuts.
References:
1. Spoelman, WA., Bonten, TN., de Waal, MWM., Drenthen, T., Smeele,
IJM., Nielen, MMJ, Chavannes, NH. (2016). Effect of an evidence-based
website on healthcare usage: an interrupted time-series study. BMJ Open,
6. doi: 10.1136/bmjopen-2016-013166
2. Derfel, A. (2015, July 28th). Quebec orders hospitals to cut $150
million in direct care to patients. Montreal Gazette.
http://montrealgazette.com/news/local-news/quebec-orders-hospitals-to-cut-
150-million-in-direct-care-to-patients
I am writing in reference to an article written by Williamson,
Creswell, Butler, Christie and Halligan, titled "Parental responses to
child experiences of trauma following presentation at emergency
departments: a qualitative study". The article highlights parents'
perceptions of these traumatic events, with regards to changes in their
child after the trauma occurred, strategies to support their child, the
medical as we...
I am writing in reference to an article written by Williamson,
Creswell, Butler, Christie and Halligan, titled "Parental responses to
child experiences of trauma following presentation at emergency
departments: a qualitative study". The article highlights parents'
perceptions of these traumatic events, with regards to changes in their
child after the trauma occurred, strategies to support their child, the
medical as well as psychological treatment and support in the hospital
setting, and the overall impact on the parent. Working as a nurse in a
pediatric critical care setting, this article resonated with me. It has
drawn some attention to areas that I think can be improved in emergency
units.
In particular, the participants in this study highlighted the lack of
information regarding the physical recovery of the child, and what this
might look like once the child is discharged, as distressing. It was also
noted that not being informed about what was "normal", increased feelings
of uncertainty. I appreciate these valuable pieces of information, and I
think that topics such as these can and should be implemented into
critical care settings. However, I think another aspect that is
important to draw attention to is the lack of information for parents on
how to provide emotional support for their child, as well as potential
strategies to support their coping. Moreover, what emotional changes
should the parents be observing for. I think that this is important
information for parents so they can recognize if their child is having
difficulty coping with the event and require additional support.
Additionally, as suggested by participants, information about where to
seek psychological treatment for children should be provided. An example
seen in my practice is children becoming very frustrated and angry. When
explored further, these were coming from a place of anxiety and
discouragement which would be important emotions for parents to recognize
and address.
It was also interesting to me to read about how the parents perceived
their children coping following the trauma. Children's perception of
injuries depends on their appraisal of the severity of the event, as well
as the explanation of the cause of the injury. Both of these concepts may
influence how children cope and respond to the situation (Dale,
Hasaselberg, Jakobson & Hensing, 2013). Similarly, it would have been
interesting to know if parents' assessment of their children's coping was
also influenced by their own perceptions of the trauma, including its
severity and potential long term consequences.
Reference
Dale, R. A., Hasaselberg, M., Jakobson, A. & Hensing, G. (2013)
Children's perceptions of injuries: a qualitative study in Sweden.
Paediatric Nursing. 39(5): 225-232
Response to article titled: Parental responses to child experiences
of trauma following presentation at emergency departments: a qualitative
study.
This study sought to explore parents' experiences of supporting their
child following trauma exposure and presentation at one of two emergency
departments (ED) in the South of England. The findings of this study
provide insight into parental perspectives including th...
Response to article titled: Parental responses to child experiences
of trauma following presentation at emergency departments: a qualitative
study.
This study sought to explore parents' experiences of supporting their
child following trauma exposure and presentation at one of two emergency
departments (ED) in the South of England. The findings of this study
provide insight into parental perspectives including their experiences,
challenges, and strategies used to support child recovery post-trauma.
This study addresses a gap in the literature, as little is known regarding
parental experiences following child trauma exposure. Parents highlighted
their need for formal information, guidance, and support regarding their
child's physical and emotional recovery. The findings suggest that there
is a need for early psychological interventions and assessment of trauma-
specific distress and family needs post-trauma. The authors propose that
such findings may inform clinical practice and contribute to the
development of meaningful and acceptable guidance for families.
Within the abstract, the authors describe the design of the study as
"semistructured qualitative interviews analysed using thematic analysis."
This is a description of the methods used in this study and not the
design. A more appropriate description for the design of this study would
be a "qualitative description." The chosen design was appropriate for
addressing the proposed objectives of this study as qualitative research
allows for in-depth description of complex phenomena and the nature of
individuals' experiences (Polit & Beck, 2012). The authors increased
trustworthiness of the results through the use of quality enhancement
strategies such as probing, audio-recording and transcribing interviews
verbatim, member checking, reflexivity, investigator triangulation, and
peer debriefing. Though the authors provided a thorough description of the
participants in this study, transferability could have been further
increased by providing detailed descriptive information about the research
setting (EDs) so as to allow the reader to make inferences about
extrapolating the findings to other settings.
Additionally, it was not mentioned whether the "experiences of
trauma" were the children's very first exposure to trauma or if they had
previous experiences of trauma requiring admittance to an ED. An
interesting area for future study would be to explore whether previous
exposure to trauma has an impact on parent perceptions or experiences in
supporting their children following subsequent exposure to trauma. It
would also be interesting to explore if parents' personal history of
childhood trauma events impacts parental experiences of supporting their
children post-trauma. Moreover, the study could have been further
strengthened if the authors explored how the trauma event impacted family
relationships or parenting role towards other children in the household.
Finally, the authors did not mention whether children were left with long
lasting issues that might impede their resumption of normalcy or previous
activities. This is significant as it is likely these families would
experience additional grief related to loss of previous function (for
example). With that said, a future qualitative study could explore
parental perspectives of children that have chronic negative sequelae
following trauma exposure.
References:
Polit, DF, & Beck CT (2012). Nursing Research: Generating and
Assessing Evidence for Nursing Practice (9th ed). Philadelphia: Lippincott
Williams & Wilkins.
I am writing in reference to Levy I, Maor Y, Mahroum N, et al.
(2016). "Missed opportunities for earlier diagnosis of HIV in patients who
presented with advanced HIV disease: a retrospective cohort study". The
quantitative design provided a clear understanding of the characteristics
of of patients diagnosed with advanced or late HIV and the risk factors
for being diagnosed at such a late stage....
I am writing in reference to Levy I, Maor Y, Mahroum N, et al.
(2016). "Missed opportunities for earlier diagnosis of HIV in patients who
presented with advanced HIV disease: a retrospective cohort study". The
quantitative design provided a clear understanding of the characteristics
of of patients diagnosed with advanced or late HIV and the risk factors
for being diagnosed at such a late stage.
The authors' focus on patients who had gone through the healthcare
system multiple times with a presentation of a HIV-related clinical
condition without having been offered HIV testing highlighted the
important gaps in the system. In fact, all patients in this study who were
diagnosed with advanced or late HIV disease had presented to the Sheba
Medical Centre multiple times prior to their final diagnosis. The two most
common barriers to being offered an HIV test, as expressed by the
physicians and specialists themselves, were the misidentification of the
patient as belonging to a risk group and not thinking of HIV at all. I
appreciated that the study design included consultations with the
physicians involved in the clinical process as it helped contextualized
the data. I also appreciated that authors addressed the fact that not all
patients identify with a given risk group, nor would they necessarily
volunteer such information for a variety of reasons. When considering HIV
testing, these findings emphasize the need to look at the established
definitions of risk factors or risk groups in conjunction with clinical
indications.
What I found particularly salient was the way in which social stigma
limited dialogue surrounding HIV: physicians reporting communication
issues stated being afraid of insulting the patient when raising the
question of HIV testing. As far as we have come in the technological
development of rapid diagnosis and treatment therapies, stigmatization is
still an issue and healthcare professionals must be made aware of any
implicit biases that may be informing their practice and clinical decision
-making processes. The de-stigmatization of HIV can be addressed with
appropriate knowledge of the clinical presentation of HIV and AIDS-related
illnesses and with the implementation of additional guidelines and
training in health centres, thereby allowing physicians and other
healthcare professionals to open a constructive and health-promoting
dialogue.
Dear editor,
I am commenting in reference to article: "Perceived barriers to accessing
mental health services among black and minority ethnic (BME) communities:
a qualitative study in Southeast England"
The article openly examines the views of the black minority ethnic
(BME) individuals on the perceived barriers to accessing mental health.
The data was collected from focus groups, analyzed and separated into t...
Dear editor,
I am commenting in reference to article: "Perceived barriers to accessing
mental health services among black and minority ethnic (BME) communities:
a qualitative study in Southeast England"
The article openly examines the views of the black minority ethnic
(BME) individuals on the perceived barriers to accessing mental health.
The data was collected from focus groups, analyzed and separated into two
main themes: (1) personal and environmental factors and (2) relationship
between service user and health care provider.
I felt the two themes and their subthemes presented were particularly
intriguing and the article had a lot of strengths. It did, however, have
some areas that would require further clarification.
I appreciated the emphasis on culture and communication. Nursing
research has demonstrated that effective communication is essential for
working relationships to improve outcomes for clients with mental illness
(Ennis et al., 2013). Furthermore, the participants of this study
highlighted the need of minority-based practitioners, who know and
understand the language and culture. This would facilitate their
discussion and fully grasp the client's interpretations of their
experience. This was repeated consistently throughout the article in the
focus group quotes.
To add, I commend the researcher's transparency and analysis on the
impact of mental health access in black minority ethnic groups. There were
several instances where the views of their white majority counterparts
were not dissimilar to those implicated in the study. This was not only
discussed by participants but also reiterated in the discussion section.
The researcher even goes as far as saying that only half the participants
completed the ethnicity question in the questionnaire. Unfortunately, this
failure to respond is reflective on the fact that the study was unable to
capture an analysis of ethnic specific barriers to accessing service.
Conversely, one critique was when the article stated: "Also, the
majority of our participants were university educated and therefore may
not represent the views/perceptions of all strata of the BME population."
There was no concrete literature to support the claim that the majority of
BME population in Southeast England was not university educated and in
fact the sample was representative of the population.
Another area that requires clarification, is that the researchers did
not explicitly highlight the theory supporting their qualitative analysis.
On the other hand, the authors increased the credibility and
trustworthiness of the article with a detailed coding process and
investigator triangulation. It was also coherent and easy to read.
Overall, I found the article findings not limited to BME culture.
Perceptions regarding stigma, gender and inability for health
practitioners to respond needs are concerns that reach all cultures. This
shows that there are many perceived barriers to mental illness as whole. I
reward the researchers for their intention of exploring the views of
ethnic minorities because often they are not given that voice.
Ennis, G., Happell, B., Broadbent, M., & Reid-Searl, K. (2013).
The Importance of Communication for Clinical Leaders in Mental Health
Nursing: The Perspective of Nurses Working in Mental Health. Issues in
Mental Health Nursing, 34(11), 814-819. doi:10.3109/01612840.2013.829539
I write in reference to the article "Perceived barriers to accessing
mental health services among black and minority ethnic (BME) communities:
a qualitative study in Southeast England" (2016), which explored the
perceived barriers to accessing mental health services from the
perspective of racial minorities. Through focused group discussions and
thematic analysis of the data, this study was able...
I write in reference to the article "Perceived barriers to accessing
mental health services among black and minority ethnic (BME) communities:
a qualitative study in Southeast England" (2016), which explored the
perceived barriers to accessing mental health services from the
perspective of racial minorities. Through focused group discussions and
thematic analysis of the data, this study was able to capture the
multifaceted nature of this issue, illustrating that minority ethnic
groups encountered barriers to access both in their own community as well
as within the current healthcare system. What I liked particularly was the
inclusion of participants from different age groups and the use of
abundant and relevant quotations in support of the major themes; it lent
direct insight into the experiences of BME patients across a wide age and
racial spectra. To further enhance the trustworthiness of the study, one
suggestion would be to include the process through which investigators
reflected on their own preconceived beliefs and how it could potentially
impact the study.
The current study proposed several important policy recommendations,
including antistigma programmes, increasing the role of BME staff within
mental health services, and formal training for healthcare providers to
improve their understanding of cultural issues. While I agree that it is
essential for practitioners to recognize and appreciate the influence of
culture, I would also caution against overemphasizing cultural identity
for the risk of underappreciating variations in the experience of persons
within a specific race. As one of the key issues arising from this study
was physician's "perceived inability to listen to the concerns and needs
of service users", perhaps future efforts could be directed towards
bettering personalized care, where attention is granted not only to
patients' cultural needs but their needs as individuals.
Even though this study was done in England, it has rich implications
for other ethnically diverse countries. An example of such country is
Canada, which has significant immigrant presence in many of its major
cities (Statistics Canada, 2016). Given the current political atmosphere
and the growth in numbers of refugees, it is imperative for healthcare
workers to be sensitive to the mental health needs of those who have been
through a traumatic migration process. This paper examined the perspective
of adult immigrants (+18 y.o.), but the wellbeing of parents in immigrant
families may be directly affected by the wellbeing of their children
(Pitt, Sherman & MacDonald, 2015). An interesting next step would be
to look at the mental health experience of immigrant youths growing up
under the competing influence of their local culture and their ethnic
culture. Overall, this was a very informative read.
Statistics Canada. (2016). Immigration and Ethnocultural Diversity in
Canada. Retrieved November 21, 2016, from https://www12.statcan.gc.ca/nhs
-enm/2011/as-sa/99-010-x/99-010-x2011001-eng.cfm
Pitt, R. S., Sherman, J., & Macdonald, M. E. (2016). Low-income
working immigrant families in Quebec: Exploring their challenges to well-
being. Can J Public Health, 106(8), 539-545.
The study, "understanding the delayed prescribing of antibiotics for
respiratory tract infection in primary care: a qualitative analysis",
conducted by R Ryves et al. investigates general practitioner's (GP) views
and understanding about delayed prescribing (DP) antibiotic for
respiratory tract infection (RTI) in primary care. The authors used
qualitative semi-structured telephone interviews for the study, and
participan...
The study, "understanding the delayed prescribing of antibiotics for
respiratory tract infection in primary care: a qualitative analysis",
conducted by R Ryves et al. investigates general practitioner's (GP) views
and understanding about delayed prescribing (DP) antibiotic for
respiratory tract infection (RTI) in primary care. The authors used
qualitative semi-structured telephone interviews for the study, and
participant recruitment is well explained and themes and subthemes are
explained. Clearly the authors indicate the lack of agreed prescribing
strategy and they come to the conclusion that there is a need for further
clarity over which method is best to delay a prescription during a
consultation. They argue that the GP experience can be helpful in this
sense. They also mention that the way in which GPs communicate with
patients to clarify the rationale behind the DP can be beneficial.
The topic is very important since understanding why and how DP is
being used in primary care and what is the best strategy is an important
question not only in the UK but also in others countries. This is because
inappropriately prescribed antibiotics result in bacteria resistant and
antibiotic-resistant infections are serious issues. For example, 30% to
60% of the antibiotics prescribed in intensive care units (ICUs) have been
reported to be unnecessary or inappropriate (Ventola, C. L., 2015).
Unfortunately, overprescribing is seen worldwide. I would be really
interested in seeing such a study in my country, Iran, where the
unnecessary use of antibiotics are too high and doctors easily prescribe
antibiotics even for simple, viral diseases.
It should be noted that there is another qualitative study on the
same topic in the UK (Peters et al. 2011) which also is referenced by this
paper [14]. The authors have briefly mentioned this work in the
introduction but have not highlighted the main differences between this
work and their study or the key new findings. This is particularly
important, as the conclusion in this paper is quite the opposite of the
conclusion of Peters et al. As such, I would say that the article could
have been much more useful and relevant if the authors would have compared
their findings with that paper.
References:
1. Ventola, C. L. (2015). The Antibiotic Resistance Crisis: Part 1:
Causes and Threats. Pharmacy and Therapeutics, 40(4), 277-283.
2. Peters, S., Rowbotham, S., Chisholm, A., Wearden, A.,
Moschogianis, S., Cordingley, Lis Cordingley, David Baker, Catherine Hyde,
and Carolyn Chew-Graham, C. (2011). Managing self-limiting respiratory
tract infections: a qualitative study of the usefulness of the delayed
prescribing strategy. Br J Gen Pract, 61(590), e579-e589.
This phenomenological qualitative study sought to examine teenagers'
post-school weight-related concerns and weight-loss efforts as they
transitioned into adulthood. The findings are the result of a secondary
analysis of qualitative data from a previous study. This data was a
subsample of a longitudinal study that tracked changes in obese teenager's
body mass indexes at ages 11, 13, 15, and 19 [1]. While the sources of
s...
This phenomenological qualitative study sought to examine teenagers'
post-school weight-related concerns and weight-loss efforts as they
transitioned into adulthood. The findings are the result of a secondary
analysis of qualitative data from a previous study. This data was a
subsample of a longitudinal study that tracked changes in obese teenager's
body mass indexes at ages 11, 13, 15, and 19 [1]. While the sources of
successful weight loss remain elusive, this paper identifies the
transition to adulthood as a time when weight-related concerns increase
among obese individuals. This paper effectively builds on prior research,
which showed a general lack of concern towards weight throughout mid-
adolescence [2], and identifies the transition to adulthood as a potential
key life stage for weight loss interventions.
This significance of this study comes from a furthered understanding
of the experience and perceptions of previously or currently overweight or
obese young adults. Nearly every participant expressed that they had
growing concerns about their weight or a desire to lose weight as they
transitioned into adulthood. This was associated with graduating from high
school, greater maturity, or increased personal responsibility. Increased
concern about weight is attributed towards increased autonomy, self-
determination, or self-esteem [3].
This paper benefits from a wide variety of respondents. Granted, of
the 35 participants, all of whom were 24 years old, 33 were White Scottish
and 2 mixed/Asian ethnicity. Yet the analysis revealed four categories.
There were 'slimmers', who had lowered their BMI scores from adolescence,
'relapsers' who had initially decreased their BMI from their peak at
adolescence, followed by an increase, 'stable' who had a relatively
constant BMI, and 'gainers' whose BMI progressively increased since
adolescence. Within these respondents, factors such as increased exercise,
diet, professional support, and young adult transitions varied too greatly
among respondents to be generalized into weight-loss or weight-gaining
factors. The common thread among these respondents was a greater readiness
towards weight loss upon leaving high school. This adds insight towards a
demographic group not as frequently studied [4].
However, it is also because this demographic group is so elusive that
this paper has limitations that must be addressed. The paper addresses
most of these, stating young adults "become largely invisible to
researchers once they leave school". So a secondary analysis of this data
can lead to significant findings. But, the fact that participants had to
recall this period of transition leads to unreliable data. Participants
"described weight changes not apparent in these study measurements and
discussed the circumstances in which they had occurred". There were also
"gaps and possible weight changes between measurements, and the sometimes
vague nature of participants' recollections mean that precise
chronological mapping of these against weight changes is impossible" [5].
In line with these addressed limitations, it is important to
highlight that recall memory has been shown to be not only unreliable, but
also dependent on gender, and mental status. Research has shown a
reciprocal link between depression and obesity [6][7][8]. It has equally
been demonstrated that individuals with major depressive disorders "recall
fewer specific and more categorical autobiographical memories" [9].
Further, female genders show greater recall of autobiographical events
than male genders [10]. The data for this paper only provides information
on age, gender, and BMIs. As such, the reliability of the data is
questionable considering the omission of these confounding variables.
Finally, questions relating to transitions towards adulthood were
quite limited within this semi-structured interview. There were prompts
for interests, friends, and fashion after high school, but very little
beyond this. The article addresses this limitation, and acknowledges that
some of these subjects are even viewed as taboo to discuss with a
professional. Most data analyzed emerged organically, yet analysis of this
data would have been more reliable had questions been more directed
towards transition to adulthood.
Overall, the article is an excellent resource in terms of
highlighting the importance of young adulthood as a beneficial time period
for receiving weight-loss interventions. The paper effectively builds on
prior research that demonstrated that teenagers were mostly not ready to
receive weight-loss interventions. This promotes further qualitative and
quantitative research on understanding the readiness of young adults to
receive specific weight-loss interventions.
Works Cited:
[1] Smith E. Bothered enough to change? A qualitative investigation
of recalled adolescent experiences of obesity. University of Glasgow, 2010
[2] Smith E, Sweeting H, Wright C. 'Do I care?' Young adults'
recalled experiences of early adolescent overweight and obesity: a
qualitative study. Int J Obes (Lond) 2013;37:303-8.doi:10.1038/ijo.2012.40
[3] Sweeting, H., Smith, E., Neary, J., & Wright, C. (2016,
November 2). 'Now I care': A qualitative study of how overweight
adolescents managed their weight in the transition to adulthood. BMJ Open,
6(11). doi:10.1136/bmjopen-2015-010774
[4] Ibid
[5] Ibid
[6] Van Vreeswijk MF, De Wilde EJ. Autobiographical memory
specificity, psychopathology, depressed mood and the use of the
Autobiographical Memory Test: a meta-analysis. Behav Res Ther.
2004;42(6):731-743
[7] Williams JM, Barnhofer T, Crane C, et al. Autobiographical
memory specificity and emotional disorder. Psychol Bull. 2007;133(1):122-
148.
[8] Young, K. D., Bellgowan, P. S., Bodurka, J., & Drevets, W. C.
(2013). Behavioral and Neurophysiological Correlates of Autobiographical
Memory Deficits in Patients With Depression and Individuals at High Risk
for Depression. JAMA Psychiatry, 70(7), 698.
doi:10.1001/jamapsychiatry.2013.1189
[9] Luppino, F. S., Wit, L. M., Bouvy, P. F., Stijnen, T., Cuijpers,
P., Penninx, B. W., & Zitman, F. G. (2010, March 0). Overweight,
Obesity, and Depression. Archives of General Psychiatry, 67(3), 220.
doi:10.1001/archgenpsychiatry.2010.2
[10] Grysman, A., & Fivush, R. (2016). Gender Identity Predicts
Autobiographical Memory Phenomenology. Applied Cognitive Psychology,
30(4), 613-621. doi:10.1002/acp.3235
I write in reference to the article by authors Nordgren and Soderlund
(2015), entitled, "Emotions and encounters with healthcare professionals
as predictors for the self-estimated ability to return to work: a cross-
sectional study of people with heart failure" (BMJ Open 2016;6:e009896
doi:10.1136/bmjopen-2015-009896).
Firstly, I commend the authors on having recognized a gap in the
rese...
I write in reference to the article by authors Nordgren and Soderlund
(2015), entitled, "Emotions and encounters with healthcare professionals
as predictors for the self-estimated ability to return to work: a cross-
sectional study of people with heart failure" (BMJ Open 2016;6:e009896
doi:10.1136/bmjopen-2015-009896).
Firstly, I commend the authors on having recognized a gap in the
research on the subject of individuals living with heart failure related
to sick leave, while acknowledging the impacts of this condition on these
individuals' work life. While the study was conducted in Sweden, the
findings are applicable globally, and particularly here in Canada, where
heart failure is a condition with increasing annual incidence rates
(approximately 50,000 new cases per year), according to the Heart &
Stroke Foundation. Furthermore, previous psychological research has linked
unemployment with reduced self-esteem and significant personal
consequences such as emotional distress, anxiety and depression (Redek,
Susjan, & Kostevc, 2013; Smari et al., 2007).
The findings of this exploratory study revealed that when people who
are on sick leave due to heart failure perceive to be "positively
encountered" by health care professionals (nurses, physicians,
physiotherapists, counsellors/psychologists, occupational therapists,
chiropractors, or 'other professionals'), the perception of their ability
to be able to return to work is enhanced. I find this information to be
quite compelling, as it demonstrates how healthcare professionals can
affect the varied aspects of one's emotional well-being, in response to
experiences with the healthcare system.
While the study focuses primarily on patients' perceptions of their
ability to return to work, I am curious if such data could in fact be used
as a predictor of 'actual' return to work. It could thus have been
interesting to follow-up on participants with this in mind, in order to
ascertain if such a relationship can be found. In addition, I am curious
about participants' baseline data, in regards to how they may have
differed in terms of their initial perceptions of ability to return to
work, before either experiencing either positive or negative encounters
with healthcare professionals. It would be informative to see how
individuals may be variedly affected, based on initial sentiment.
Finally, the authors concluded that emotions such as "feeling
strengthened in a situation," "feeling happy," and "receiving
encouragement about paid work" were all factors associated with "positive
encounters," serving to increase perceived ability to return to work.
These findings can provide a foundation for future, qualitative studies,
seeking to further explore the nature of such positive encounters, in
order to identify specific behavioural approaches undertaken by healthcare
professionals that serve to enhance perceived or actual ability to return
to work.
Regards,
Lianne Barile M.Sc. (Applied) - Nursing candidate
References
Chai, C. (2016, February 2). Heart failure rates rising in Canada:
Heart and Stroke Foundation. Global News. Retrieved from
http://globalnews.ca/news/2490589/heart-failure-rates-rising-in-canada-
heart-and-stroke-foundation/
Redek, T. Susjan, A., & Kostevc, C. (2013). Unemployment and self
-concept. Ekonomska Istrazivanja, 26(1), 185-200.
Smari, J., Arason, E., Hafsteinsson, H., & Ingimarsson, S.
(1997). Unemployment, coping and psychological distress. Scandinavian
Journal of Psychology, 38(1), 151-156.
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Dear Editor,
I write in reference to the article by authors Nordgren and Soderlund (2015), entitled, "Emotions and encounters with healthcare professionals as predictors for the self-estimated ability to return to work: a cross- sectional study of people with heart failure" (BMJ Open 2016;6:e009896 doi:10.1136/bmjopen-2015-009896).
Firstly, I commend the authors on having recognized a gap in the rese...
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