A Qualitative Study of Healthcare Providers’ Perspectives on the Implications of Genome-Wide Testing in Pediatric Clinical Practice

The utilization of genome-wide chromosomal microarray analysis (CMA) in pediatric clinical practice provides an opportunity to consider how genetic diagnostics is evolving, and to prepare for the clinical integration of genome-wide sequencing technologies. We conducted semi-structured interviews with 15 healthcare providers (7 genetic counselors, 4 medical geneticists, and 4 non-genetics providers) to investigate the impact of CMA on clinical practice, and implications for providers, patients and families. Interviews were analyzed qualitatively using content analysis. Most providers reported that genomic testing enhanced their professional experience and was beneficial to patients, primarily due to the improved diagnostic rate compared with earlier chromosomal studies. Other effects on practice included moving towards genotype-first diagnosis and broadening indications for chromosomal testing. Opinions varied concerning informed consent and disclosure of results. The duty to disclose incidental findings (IFs) was noted; however concerns were raised about potential psychosocial harms of disclosing pre-symptomatic findings. Tensions were revealed between the need for comprehensive informed consent for all families and the challenges of communicating time-consuming and potentially anxiety-provoking information regarding uncertain and incidental findings that may be relevant only in rare cases. Genetic counselors can play an important role in liaising with families, health professionals and testing laboratories, providing education and guidance to non-genetics providers, and enabling families to receive adequate pre-and post-test information and follow-up care.     

The Evolving Landscape of Global Surgery: A Qualitative Study of North American Surgeons’ Perspectives on Faith-Based and Academic Initiatives

Journal of Religion and Health - Faith-based missions have played a large role in surgical care delivery in low- and middle-income countries (LMIC). As global surgery is now an academic discipline,...     

Uncertainty in Clergy’s Perspectives on Homosexuality: A Research Note

This research note analyzes expressions of uncertainty in clergy??s perspectives on homosexuality. We conducted interviews with forty Christian clergy who lead congregations in the vicinity of one large southeastern US city. Seven in ten clergy interviewed expressed uncertainty in their personal opinions about homosexuality, uncertainty about how they should act pursuant to the issue, or both. We describe clergy??s experiences with these uncertainties and analyze the patterns in which it appears in their opinions and actions regarding homosexuality. The nuance evident in these patterns illustrates how a range of superseding factors influence clergy??s opinions about homosexuality and the extent to which they feel constrained in taking action with regard to the issue. We argue for the conceptual value of a framework that provides space for analysis of uncertainty in public opinion about contentious social issues such as homosexuality.     

Effects of Facebook Maintenance Behaviors on Partners’ Experience of Love

This study collected data from 75 heterosexual couples. Partners self-reported their own Facebook behaviors as well as their perceptions of their partner’s Facebook behaviors. Partners also completed the Partner Relationship Quality Components inventory. Analyses used a pairwise data set according to the Actor Partner Interdependence Model. Confirmatory factor analysis demonstrated that two factors explained 59 % of the variance regarding Facebook behaviors: Partner Facebook Maintenance (PFM) and Actor Facebook Maintenance (AFM). Two structural equation models were created, one proposing that PFM and AFM would predict Actor Love and Partner Love when controlling for length of relationship, relationship status, and gender, the other proposing that Actor Love and Partner Love would predict PFM and AFM. Overall analysis indicates good model fit for both models. These results suggest that partners who perceive higher levels of love in their relationship actually participate in less Facebook Maintenance behaviors, and couples who engage in more Facebook Maintenance behaviors experience less love in the relationship. Implications for couples and therapists are discussed.     

Effects of Self-Control Training on Tinnitus in a Deaf Patient — A Case Study

Abstract

The treatment of a deaf woman with severe tinnitus using a behavioural approach including relaxation and various forms of behavioural and cognitive coping strategies is described. The patient received therapy in five one-hour sessions during which specially adapted methods like the use of sign interpretation, visual prompts and written instructions were used. Positive results in various self-reports made both after treatment and at a five-month follow-up are discussed.     

Effects of Training and Environment on Graduate Students’ Self-Rated Knowledge and Judgments of Responsible Research Behavior

Training programs, departmental/disciplinary norms, and individual factors (e.g., personality traits) have been hypothesized to influence (un)ethical behavior. This exploratory study surveyed graduate students from a single university in the American Southeast. Relationships were examined among 496 participants’ individual characteristics, training, self-rated knowledge and decision-making skills in research conduct, and judgments of ethically questionable vignettes. Key findings include the increased likelihood of unethical action by students in online programs, a negative relationship between age and unethical actions, and a negative relationship between agreeableness and reports that a peer would take an unethical action. Graduate training was unrelated to judgments of ethicality.     

Therapists’ Perspectives of the Cotherapy Experience in a Training Setting

The experience of cotherapy has been sparsely addressed in the literature. This qualitative study’s goals were to explore (a) the usefulness of cotherapy as a training model (b) the impact of cotherapy on services provided; (c) the impact of being trained in a cotherapy model; and (d) factors that both facilitated and hindered the process of cotherapy. The authors conducted a focus group interview with seven participants who graduated from a COAMFTE accredited MFT master’s program. Participants unanimously reported they believed cotherapy impacted client outcomes and training. They also expressed that cotherapists’ unwillingness to address issues within the cotherapy team negatively impacted the cotherapy relationship and client outcomes. Data analysis yielded four main themes, including cotherapy as a vehicle for personal growth, accountability in the cotherapy relationship, need for safety in the cotherapy relationship, and cotherapy team’s need for supervision.     

Deconstructing the Myth of the Monolithic Male Athlete: A Qualitative Study of Men’s Participation in Athletics

A qualitative study using field-based methods examined motivations for participation in collegiate team sports, the psychological and emotional rewards of team membership, and the dynamics of relationships with teammates among male athletes. Previous cross-disciplinary research largely reinforces clear and consistent gender differences within communal and agentic domains. In-depth, oral bibliographic interviews with 11 varsity athletes from basketball and soccer teams were conducted at a university in the USA. Participants spoke freely about multiple dimensions of their experiences as athletes—experiences frequently dichotomized by researchers as masculine or feminine. Analyses document that male athletes rated the importance of interpersonal and emotional relationships with teammates as valuably as they did instrumental needs. Results are discussed in terms of cultural imperatives that polarize domains presumed to be highly gender based and sex-segregated.     

An Exploration of Trainees’ Perception of Clinical Psychology Training in India: A Qualitative Analysis

This study explored trainees’ perception of clinical psychology training in India. A sample of 20 (18 females; 2 males; Mean age?=?25 years) clinical psychology trainees participated in the study following written informed consent. Participants were interviewed individually (40–50 min) using a semi-structured interview schedule developed for the study. Interviews were audio recorded and transcribed. Broader themes were identified using principles of content analysis. The findings indicated trainees’ great enthusiasm about practical training, supervisor supervision and hospital based training. Results also showed poor recognition of the role of research and theory in training, unilateral view of supervision, poor perception of secondary goals and components of training and limited awareness about variety of clinical material. The results are indicative of trainees’ preference of clinical component of training over theory and research components of training, the backbone of prevailing systems of training globally. The preliminary findings suggest the need for further research in this area.     

Patients’ Perceptions on Their Involvement in Medical Education: A Qualitative Pilot Study

Patients’ perception with regards to their use in medical teaching is an under-researched area in Pakistan. The objective of this qualitative, pilot study was to determine the perspectives of hospital admitted patients on their being used in the medical education of students in a private medical institution. An attempt to understand the dynamics of interactions between patients, students and doctors was also made and to see how this affected the doctor-patient relationship. A qualitative study with in-depth interviews was conducted in a private medical college of Islamabad, Pakistan with a total of 20 adult patients. The focus was on their experiences with bedside teaching. This pilot study reveals interesting findings about patient-physician interactions in Pakistan. Patients had a traditionally passive role in medical education putting more onuses on the doctor to impart knowledge to the medical students. Patients comforted themselves in the knowledge that they were following Allah’s command when they were involved in the teaching of medical students. The apparent altruism of Pakistani patients in this study was influenced mainly by religious reasons, following the commandments of Allah to help develop future healers for humanity. The culture evident in the medical college where this study was conducted is reflective of the social power ladders that pervade Pakistani society. The positions of doctors and medical teachers in Pakistani society are hardly challenged to debate. Little attention has been paid to the values that influence the cultural and social frameworks within which Pakistani medical teachers, medical students and the patients function.     

A Qualitative Study of Faith Leaders’ Perceptions of Health and Wellness

The effectiveness of faith-based health and wellness interventions is moderated by the attitudes, perceptions, and participation of key leaders within faith-based organizations. This qualitative study examined perceptions about the link between health, spirituality, and religion among a volunteer sample of faith leaders (n = 413) from different denominations. The major themes included: influences on health and wellness promotion and a relationship between spirituality and health. The results indicated that perceptions about the link among health, spirituality, and religion vary among faith leaders, regardless of denomination. Future faith-based interventions should be developed with consideration for denomination as a socially and culturally relevant factor.     

A Study of Rural Church Health Promotion Environments: Leaders’ and Members’ Perspectives

This study examined the beliefs of church leaders about health and associations between these beliefs and the church health promotion environment (CHPE). Perceptions of the CHPE by leaders and members of the same churches were also compared. Interviews were conducted with pastors (n = 40) and members (n = 96) of rural churches. They were Baptist (60%), and 57.5% were predominantly White, while 42.5% were Black. Leaders’ beliefs regarding talking about health topics in sermons were associated with the presence of health messages in the church. There was also a significant association between leaders’ beliefs about members’ receptivity to health messages and the presence of messages in the church. Leaders’ and members’ perceptions of the CHPE were discordant. While some leaders’ beliefs may be related to the CHPE, other factors may explain why programs and policies exist in some churches and not others.     

A Qualitative Study on Children’s Digital Media Use and Parents’ Self-interest

Journal of Child and Family Studies - This qualitative study provides insight into the role of parents’ self-interest in digital media use of children in different age groups. We conducted 31...     

Chronic Patients’ Autonomy in Iranian Hospitals: A Qualitative Study

The autonomy of chronic patients in Iranian hospitals is challenged by impaired functioning resulting from chronic illness, a negative image in society, and effects related to hospitalization. Comprehensive interviews and observations of 34 patients, nurses, and physicians were performed to assess the autonomy of chronic patients in Iran. Conceptualization, constant comparison, and the combination of data resulted in the identification of 5 main categories related to autonomy: welcoming paternalism, self-expression, self-proof, shared decision making, and self-determination. Authority scrambling was a central category describing chronic patients’ perceptions of their autonomy during hospitalization. These patients sought to maintain their independence despite serious threats to their autonomy.