자연주의적 탐구조사(Naturalistic Inquiry)

XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

Lincoln, Yvonna, and Egon Guba, "Postpositivism and the Naturalist Paradigm," pp. 14-46 in Yvonna Lincoln and Egon Guba, Naturalistic Inquiry . Beverly Hills, CA: Sage, 1985.*

The Wretched of the Earth

Qualitative Research Methods: A Health Focus

Bullying in the workplace is associated with negative job satisfaction and retention. It has also been found to have adverse effects on the health of employees. Using a qualitative descriptive design, this study examined the stories of bullying among nurses based on actual or witnessed experiences. One hundred eighty-four newly licensed U.S. nurses responded to an open-ended question on a survey about bullying mailed to their homes. Four major themes emerged that related to varying types of bullying behaviors, perceived causes of bullying, and the impact of bullying behaviors. The themes included structural bullying; nurses "eating their young"; being out of the clique; and leaving the job. Bullying is experienced firsthand and secondhand by nurses, and particularly by vulnerable, newly graduated nurses. Workplace bullying must be explored fully to develop effective strategies to eliminate it.

https://journals.sagepub.com/doi/pdf/10.1177/216507991005800705

Bullying in the workplace--a qualitative study of newly licensed registered nurses.

Due to the complexity of human health, emphasis is increasingly being placed on the need for and conduct of multidisciplinary and/or interdisciplinary health research. Yet many academic and research organizations—and the discipline-specific associations and journals—may not yet be prepared to adopt changes necessary to optimally support interdisciplinary work. This article presents an ongoing interdisciplinary research project's efforts to investigate mechanisms and pathways that lead to occupational health disparities among healthcare workers. It describes the promises and pitfalls encountered during the research, and outlines effective strategies that emerged as a result. Lessons learned include: conflict resolution regarding theoretical and methodological differences; establishing a sense of intellectual ownership of the research, as well as guidelines for multiple authorship; and development and utilization of protocols, communication systems, and tools. This experience suggests a need for the establi...

/pdf/conducting-interdisciplinary-research-to-promote-healthy-and-as7vlmc0j9.pdf

Conducting Interdisciplinary Research to Promote Healthy and Safe Employment in Health Care: Promises and Pitfalls

Over the past decade, changing demographics, new technology, an increased focus on health promotion, and radical shifts in health care reimbursement have significantly impacted the nursing role. The purpose of this article is to review the process of change at one university as its curriculum evolved from an integrated acute-care focus to a community-based, health promotion framework. A review of the literature and survey data from students, alumnae, faculty, other universities, and curriculum consultants laid the groundwork for this process. Curriculum generation followed guided by data analysis, template design and revision, values clarification, sacrificing "sacred cows," and consensus building. Implications for nursing and nursing education are explored.

Reconfiguring a Curriculum for the New Millennium: The Process of Change

Background and methodology Unintended pregnancy is a concern in the USA due to its association with adverse physical, mental, social and economic outcomes. Few studies have examined this issue among married women from a social and contextual perspective. This study targeted married women to examine factors associated with unintended pregnancy using the ecological model of health promotion that focuses attention on both individual and social environmental factors. Data from the National Survey of Family Growth (NSFG) were merged with NSFG contextual files to examine the major predictive factors. Results Multilevel logistic regression modelling revealed that married women of lower socioeconomic status, higher parity, who lived in communities with a high rate of marital dissolution had a higher probability of an unintended pregnancy. Women reported that their husbands were likely to concur with the unintended designation of the pregnancy. Discussion and conclusions This study utilised a unique perspective to examine contextual factors related to unintended pregnancy among married women. The results support the need to focus on the couple as a unit for prevention efforts. Social policies to enhance access to family planning services are necessary to improve outcomes and prevent unintended pregnancies.

https://srh.bmj.com/content/familyplanning/36/3/150.full.pdf

The context of unintended pregnancy among married women in the USA

The purpose of this phenomenological qualitative study was to examine the quality of life among college students living with Type 1 diabetes (T1D). Inclusion criteria included age 18 to 24, current college student, and a diagnosis of T1D for at least 1 year. Semi-structured interviews were conducted, in-person and by phone. During these interviews, college students shared stories of living with T1D and its impact on their quality of life. Three major themes emerged, which included "planning ahead," "thinking positive," and "seeking support." These findings provide a better understanding of the transitional experience of living with T1D and the impact on perceived quality of life while attending college. Techniques and strategies aimed at the enhancement of perceived quality of life for college students living with T1D were identified. These findings will provide valuable insight for professionals working with this population.

Barbara Mawn

Papers

Bullying in the workplace--a qualitative study of newly licensed registered nurses.

Conducting Interdisciplinary Research to Promote Healthy and Safe Employment in Health Care: Promises and Pitfalls

Reconfiguring a Curriculum for the New Millennium: The Process of Change

The context of unintended pregnancy among married women in the USA

Quality of Life of College Students Living With Type 1 Diabetes: A Qualitative View.