Objective: Paramedicine in Canada has experienced significant growth in recent years, which has resulted in a misalignment between existing guiding conceptualizations and how the profession is ...structured and enacted in practice. As a result, well-established boundaries, directions, and priorities may be poorly aligned with existing frameworks. The objective of this study was to explore emerging and future states of paramedicine in Canada such that guiding principles could be derived. We asked: How should paramedicine be conceptualized and enacted in Canada going forward, and, what might be the necessary enablers? Methods: This study involved in-depth one-on-one semi-structured interviews with Canadian paramedicine thought leaders. We used purposive and snowball sampling strategies to identify potential participants. Interview guide questions were used to stimulate discussion about the future of paramedicine in Canada and suggestions for implementation. We used inductive qualitative content analysis as our analytical approach, informed by a constructivist and interpretivist orientation. Results: Thirty-five key informants from across Canada participated in interviews. Ten themes were identified: (1) prioritizing patients and their communities; (2) providing health care along a health and social continuum; (3) practicing within an integrated health care framework, and partnering across sectors; (4) being socially responsive; (5) enacting professional autonomy; (6) integrating the health of professionals; (7) using quality-based frameworks; (8) enacting intelligent access to and distribution of services; (9) enacting a continuous learning environment; and, (10) being evidence-informed in practice and systems. Six enablers were also identified: shift professional culture and identity, enhance knowledge, promote shared understanding of paramedicine, integrate data environments, leverage advancing technology, advance policy, regulation and legislation. Conclusions: Our results provide a conceptual framework made up of guiding principles and enablers that provide a consolidated lens to advance the paramedicine profession in Canada (and elsewhere as appropriate) while ensuring contextual and regional needs and differences can be accounted for.
Objective
This study explored the experiences and essences of growing up and living with Treacher Collins syndrome (TCS) from an adolescent perspective.
Design
A qualitative approach using the long ...interview method was used to explore the adolescents’ experiences. Semistructured interviews and peer debriefing techniques were used to gather and verify data with each participant.
Participants
A purposive sampling technique was used to recruit a sample of six adolescents with TCS, ranging in age from 12 to 18 years, who received care from a craniofacial center in a large pediatric hospital.
Results
The themes central to the adolescents’ experiences were balancing sameness and difference and the journey toward social and self-acceptance. Five subthemes further described this experience: reconstructing perceptions of others; making meaning of the difference; forming friendships and fitting in; handling staring and teasing; and excelling.
Conclusions
The study group described good psychosocial adjustment, experienced an increasing acceptance of self, TCS, and social acceptance over time and demonstrated resilient adaptive strategies (optimism, motivation, and positive meaning making). They were, however, also challenged by the social stigma associated with difference and by the challenges of finding a good fit in their school environments in meeting unique needs, particularly in their early grades. This study highlights the value of using a qualitative research approach in furthering our understanding of the experiences of children and youth with facial differences.
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