Aim and objectives
The aim of this study was to describe and understand how heterosexual women with Turner Syndrome experience sexuality.
Background
Turner Syndrome is a genetic condition that is the ...result of one of the X chromosomes missing or partially missing, and it affects women of all ages. Turner Syndrome may lead to psychological, relational and sex life disorders.
Design
This is a qualitative study, and the COREQ checklist was employed to report on the current study.
Methods
The study was conducted in a region of southern Spain. Convenience and snowball sampling were used to recruit 18 women, aged 22–51 years, who had been diagnosed with Turner Syndrome. Participants' experiences were explored through semi‐structured interviews between January and May 2021. Thematic analysis was used for data analysis.
Results
Three main themes and eight sub‐themes emerge from the data analysis: (1) Sexuality linked to corporeality, with the sub‐themes: ‘Discovering that your body is different’, ‘Social stigma limits one's sex life’ and ‘Fear of penetration surpresses sexual desire’. (2) Adapting one's sexuality to Turner Syndrome, with the sub‐themes: ‘Feeling like a woman’ and ‘Suffering from and adapting to comorbidities’. (3) When infertility overshadows sexuality, with the sub‐themes: ‘Prolonging childhood by ignoring sexuality’, ‘Fertility treatment: always a possibility’ and ‘Lack of specialised professional knowledge’.
Conclusion
Heterosexual women with Turner Syndrome suffer from sexual problems, delayed diagnosis and treatment, and lack of information. Unawareness and relational problems may also lead to scarce and late sexual relations, jealousy and a fear of being left. The women with Turner Syndrome refer to little self‐exploration or masturbation as well as a fear of penetration.
Relevance to clinical practice
Understanding the experiences of sexuality in heterosexual women with Turner Syndrome is a challenge for clinical nurses, who could provide quality care to these women in contextualised services.
Aims
The objective of this study was to describe and understand irregular migrants' (IMs') experiences of health disparities while living in informal settlements (ISs) during the COVID‐19 pandemic.
...Design
Qualitative descriptive study.
Methods
Thirty‐four IMs originating from different African countries living in ISs took part in this study. Data were collected between January and March 2022 through three focus groups and 17 in‐depth interviews. Thematic analysis was used to analyse qualitative data with ATLAS.ti computer software.
Results
Three main themes emerged: (1) Extreme vulnerability: ISs and abuse; (2) Inequality in health treatment has increased during COVID‐19; and (3) The impact of COVID‐19 on the health of IMs: help from non‐governmental organizations and nurses.
Conclusion
Irregular migrants are at a higher risk of exposure to COVID‐19 due to their precarious living conditions, administrative situation and access to the health system. It is recommended that specific programmes be strengthened to improve health care for this population.
Impact
What problem did the study address? This study examines IMs' experiences of health disparities during the COVID‐19 pandemic.
What were the main findings? IMs are at higher risk of exposure to COVID‐19 due to social, health, housing and work inequalities. Community health nurses alongside non‐governmental organizations have facilitated the implementation of measures to protect this population against COVID‐19.
Where and on whom will the research have an impact? With the aim of improving care for IMs, strategies have been suggested for health institutions to address problems relating to accessing the health system, and to promote networking between non‐governmental organizations and community health nurses.
Aims
To explore and understand the experiences of patients with advanced illness in relation to dignity during end‐of‐life care in emergency departments.
Design
Qualitative study based on Gadamer's ...hermeneutics.
Methods
Between September 2019 and February 2020, 16 in‐depth interviews were carried out with advanced illness patients who attended emergency departments. The participants were informed priorly and signed informed consent. The data were analysed using an inductive strategy for finding emerging themes. The Consolidated Criteria for Reporting Qualitative Research was used for writing the study's report.
Results
In the data analysis process, two main themes emerged that glean the experiences of patients in relation to dignity during end‐of‐life care in emergency departments. ‘Dignity as an individual's attribute’ and ‘Acting with dignity: Dignity as a behavioural attribute’.
Conclusion
Patient dignity in end‐of‐life care is centred around the principle of control (of oneself, one's death and one's emotions). The strategies required for patients to preserve their dignity can be somewhat incompatible with the dynamics and objectives of healthcare professionals who work in emergency departments.
Impact statement
The dignity of patients with advanced illness who attend emergency departments is a relevant issue that merits being addressed from the patients' perspective. Participants have identified that dignity is a way of being and behaving in the face of illness. Emergency departments need to respect end‐of‐life patients' desires by supporting and accompanying them, avoiding therapeutic obstinacy. We recommend care to be centred on patients' well‐being, to respect their autonomy and decision‐making processes, and to allow prompt referrals to palliative care services.
Patient or Public Contribution
Managers from the Emergency Departments participated in the study design and patients' recruitment. Patients' relatives were informed about the study's aim, and they contributed to the development of the interview protocol.
Perceived health in caregivers is related to caregiver burden, psychological well‐being and social support. Women perceive poorer health and are more likely than men to experience caregiver overload. ...The objectives of this study were to analyse perceived health, perceived social support and caregiver overload in family caregivers of patients with Alzheimer's disease, as well as to study the effect of the perceived social support as a mediating variable between perceived health and caregiver overload was also analysed, taking into account the caregivers’ gender. A cross‐sectional descriptive design was used. The sample consisted of 255 family caregivers of individuals with Alzheimer's disease in the Almería Health District (Spain). This study was conducted from January to December 2015. The caregivers’ mean age was 55.35 years (SD = 12.35), with 85.5% (n = 218) being women and 14.5% (n = 37) being men. The following questionnaires were administered: Goldberg's General Health Questionnaire‐28; the Caregiver Strain Index, measuring caregiver overload; and the Duke‐UNC‐11 functional social support questionnaire. Poor perceived health, high caregiver overload and high perceived social support were found. Differences in perceived health and perceived social support were significantly higher in women than in men. In women, perceived social support was a mediating variable between perceived health and family caregiver overload. This mediation was not observed in men. This study suggests that perceived social support influences the emotional well‐being and the caregiver overload of family caregivers of patients with Alzheimer's. However, its effect differs according to gender. It would, therefore, be necessary to have an in‐depth understanding of the variables determining these differences in family caregivers.
Aims
The objective of this study is to describe and understand the experiences of sexuality amongst heterosexual women with morbid obesity (MO) who are in a bariatric surgery program.
Background
...Morbid obesity is a chronic, metabolic disease that affects women's physical, psychological and sexual health. MO is associated with anxiety, depression and body image disorders. Bariatric surgery is a reliable method for weight loss in people with MO.
Design
A qualitative descriptive study research design was adopted.
Methods
Twenty‐one heterosexual women with MO in a bariatric surgery program were recruited through purposive sampling. Data collection included individual semi‐structured interviews conducted between November 2018 and May 2019. Interviews were audio recorded, transcribed verbatim and analysed using a computer‐assisted qualitative data.
Findings
Three main themes emerged from the analysis: (1) trapped in a body that limits my sexuality; (2) between neglect and hope and (3) the partner as a source of support for sexuality in women with MO.
Conclusion
Women hide a body that they do not accept and ignore their own sexuality, focusing on that of their partner. Although the women have doubts about their partners’ desire for them, they share the decision‐making process with them whilst waiting for bariatric surgery, on which they place all of their hopes for improved sexuality and quality of life.
Impact
The findings highlight the importance of exploring the experiences and sexual issues faced by heterosexual women with MO in a bariatric surgery program. Bariatric nurses have a privileged position to assess these women's sexuality, recommend alternatives to sexual intercourse or refer them to sexologists. As part of the multidisciplinary team, nurses can contribute to managing the expectations of women with MO and their partners in relation to the improvement of their sex lives following bariatric surgery.
Aims
To understand how the social patterns about death influence end‐of‐life care from the perspective of healthcare professionals.
Design
A qualitative study according to the theory of Glaser and ...Strauss.
Methods
A purposeful sample of 47 participants with different roles (nurses, physicians and clinical psychologists) were involved in four focus groups and 17 interviews in 2017–2019. Responses were audio‐recorded, transcribed verbatim and analysed using computer‐assisted qualitative data.
Results
A core category ‘the theory of social patterns about death’ emerged, which is explained by three categories: the culture of concealment and stubbornness towards death, the effort and internal work to make death a part of existence, and the influence of the social patterns of coping with death on end‐of life care and healthcare professionals. Our results suggest that social coping with death is affected by a network of concealment and obstinacy towards death.
Conclusion
Recognizing death as part of life and thinking about death itself are social coping strategies. Although healthcare professionals occupy a privileged place in this process, the culture of concealment of death influences end‐of‐life care.
Impact
The social process that leads to the loneliness of the dying in our days has been theorized. However, social acceptance of death also influences healthcare professionals’ attitudes towards death. Thus, healthcare professionals’ own attitudes may affect the end‐of‐life care given to dying individuals and their families. The social patterns of death may contribute to the healthcare professionals’ negative attitudes towards death. The concept of dignified death has been linked to the notion of humanization of healthcare. Death should be approached from a more naturalistic perspective by healthcare professionals, healthcare and academic institutions.
Rationale, Aims and Objectives
The healthcare system and professionals working in the sector have experienced a high caseload during the coronavirus disease 2019 (COVID‐19) pandemic. This has ...increased the potential for morally harmful events that violate professionals' moral codes and values. The aim of this study was to understand and explore experiences of new moral challenges emerging among physicians and nurses caring for individuals during the COVID‐19 pandemic.
Method
The consolidated criteria for reporting qualitative research (COREQ) checklist was used in this qualitative study based on Gadamer's phenomenology. Participants were selected using a convenience sampling method. Thirteen medicine and nursing graduates were interviewed in depth. The participants all worked on the frontline at the start of the COVID‐19 pandemic. Data were gathered in two basic healthcare districts in Spain, encompassing both primary care and hospital care.
Results
Four main themes emerged from the data analysis: (1) Betrayal of moral and ethical values as a key source of suffering; (2) Ethical and moral sense of failure accompanying loss of meaning; (3) Lack of confidence in performance; (4) Self‐demand and self‐punishment as personal condemnation among healthcare workers.
Conclusions
Health institutions must implement interventions for health professionals to help mitigate the consequences of experiencing complex ethical scenarios during the pandemic. In addition, they should promote training in moral and ethical deliberation and prepare them to make decisions of great ethical significance.
Aims
To explore and understand the experiences of terminally ill patients and their relatives regarding dignity during end‐of‐life care in the emergency department.
Background
The respect given to ...the concept of dignity is significantly modifying the clinical relationship and the care framework involving the end‐of‐life patient in palliative care units, critical care units, hospices and their own homes. This situation is applicable to in‐hospital emergency departments, where there is a lack of research which takes the experiences of end‐of‐life patients and their relatives into account.
Design
A phenomenological qualitative study.
Methods
The protocol was approved in December 2016 and will be carried out from December 2016–December 2020. The Gadamer's philosophical underpinnings will be used in the design and development of the study. The data collection will include participant observation techniques in the emergency department, in‐depth interviews with terminally ill patients and focus groups with their relatives. For the data analysis, the field notes and verbatim transcriptions will be read and codified using ATLAS.ti software to search for emerging themes.
Discussion
Emerging themes that contribute to comprehending the phenomenon of dignity in end‐of‐life care in the emergency department are expected to be found. This study's results could have important implications in the implementation of new interventions in emergency departments. These interventions would be focused on improving: the social acceptance of death, environmental conditions, promotion of autonomy and accompaniment and assumption (takeover) of dignified actions and attitudes (respect for human rights).
Aim and Objectives
To describe and understand the experiences of sexuality amongst heterosexual men diagnosed with morbid obesity (MO) who are in a bariatric surgery programme.
Background
Morbid ...obesity is a chronic metabolic disease that affects men’s physical, psychological and sexual health. Evidence suggests that MO could be linked to anxiety, depression, low self‐esteem, sexual life and social disorders. Bariatric surgery is a reliable method for weight loss in patients with MO.
Design
This is a qualitative study based on Merleau‐Ponty’s phenomenology, and the COREQ checklist was employed to report on the current study.
Methods
Convenience and purposive sampling was carried out and included 24 in‐depth interviews with heterosexual men with MO in a bariatric surgery programme between October 2018–March 2019 in Spain.
Results
Two main themes emerged from the analysis: (a) a corporality which is judged and condemned; and (b) adapting sexual practices to bariatric surgery.
Conclusions
Men with MO reject a body that limits their physical, social and sexual life. A negative body image and low self‐esteem, which do not respond to the traditional masculine role or new masculinities, reduce men's self‐concept. Men with MO feel rejection, stigma and isolation. Support from their partner is fundamental to adapt.
Relevance to clinical practice
The results of the study draw attention to how heterosexual men with MO experience their sexuality in a bariatric surgery programme and the challenges nurses face. Recognising the problem, helping to develop coping strategies or referring to specialists in sexuality could improve the quality of life in patients and their partners.
Milk Donation Following a Perinatal Loss: A Phenomenological Study Fernández‐Medina, Isabel María; Jiménez‐Lasserrotte, María del Mar; Ruíz‐Fernández, María Dolores ...
Journal of midwifery & women's health,
July/August 2022, Letnik:
67, Številka:
4
Journal Article
Recenzirano
Introduction
Perinatal loss is a traumatic event for women with negative consequences for their well‐being and mental health. After perinatal loss, some women choose to not suppress lactation and to ...donate their breast milk. Donating milk can be a grief ritual to cope with the loss. The aim of this study was to explore women's experiences of donating their breast milk following a perinatal loss.
Methods
A hermeneutic phenomenology was carried out. Thirteen semistructured interviews were conducted. Data was recorded, transcribed, and categorized into themes and subthemes.
Results
Two main themes emerged from the data: (1) lactation after loss: a forgotten aspect of the care, with the subthemes “the silence surrounding grieving lactation” and “experiencing lactation amidst a sea of tears”; and (2) milk donation: a resource to alleviate pain and offer hope, with the subthemes “expressing and donating breast milk: a healing ritual” and “breaking the taboo of the grieving lactation.”
Discussion
Information about lactation options is not typically included in participants’ care plan. Women's experiences highlight the need for the support of health care professionals. Donating milk helps some women to cope with the loss and accept and integrate it into their daily lives. Milk donation is also an opportunity to educate society about options following a perinatal loss.
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