More than a cognitive experience: unfamiliarity, invalidation, and emotion in organizational learning

Literature on organizational learning (OL) lacks an integrative framework that captures the emotions involved as OL proceeds. Drawing on personal construct theory, we suggest that organizations learn where their members reconstrue meaning around questions of strategic significance for the organization. In this 5-year study of an electronics company, we explore the way in which emotions change as members perceive progress or a lack of progress around strategic themes. Our framework also takes into account whether OL involves experiences that are familiar or unfamiliar and the implications for emotions. We detected similar patterns of emotion arising over time for three different themes in our data, thereby adding to OL perspectives that are predominantly cognitive in orientation

The impact of living with long-term conditions in young adulthood on mental health and identity: What can help?

Background: It has been suggested that the mental health impacts of living with long-term conditions are greater in young adulthood compared to older adulthood, due to greater disruption to identity and routine life events. Objectives: To explore the impact of living with long-term conditions in young adulthood on mental health and identity, and what helps living well with these conditions. Methods: Fifteen in-depth interviews with young adults with various conditions were conducted and analysed thematically. Results: Themes related to the impacts on mental health and identity include: negative mood and depression; anxiety and fear for the future; identity as ‘ill’/abnormal compared to former self and ‘normal’ others. Themes related to suggestions for addressing negative impacts include: promotion of positive thinking; support reaching acceptance with altered identity and limitations (through stages of denial, anger, depression, then acceptance); and more professional mental health support. Discussion: In order to promote mental health and a positive sense of self/identity, young adults with long-term conditions should be offered advice and support on: positive thinking; the long and difficult process of reconstructing identity; and reaching acceptance. This is particularly important for young adults for whom the identity reconstruction process is more complex and psychologically damaging than for older adults; as this life stage is associated with health/vitality and illness represents a shift from a perceived normal trajectory to one that appears and feels abnormal

Managing lifestyle change to reduce coronary risk: a synthesis of qualitative research on peoples’ experiences

Background Coronary heart disease is an incurable condition. The only approach known to slow its progression is healthy lifestyle change and concordance with cardio-protective medicines. Few people fully succeed in these daily activities so potential health improvements are not fully realised. Little is known about peoples’ experiences of managing lifestyle change. The aim of this study was to synthesise qualitative research to explain how participants make lifestyle change after a cardiac event and explore this within the wider illness experience. Methods A qualitative synthesis was conducted drawing upon the principles of meta-ethnography. Qualitative studies were identified through a systematic search of 7 databases using explicit criteria. Key concepts were identified and translated across studies. Findings were discussed and diagrammed during a series of audiotaped meetings. Results The final synthesis is grounded in findings from 27 studies, with over 500 participants (56% male) across 8 countries. All participants experienced a change in their self-identity from what was ‘familiar’ to ‘unfamiliar’. The transition process involved ‘finding new limits and a life worth living’ , ‘finding support for self’ and ‘finding a new normal’. Analyses of these concepts led to the generation of a third order construct, namely an ongoing process of ‘reassessing past, present and future lives’ as participants considered their changed identity. Participants experienced a strong urge to get back to ‘normal’. Support from family and friends could enable or constrain life change and lifestyle changes. Lifestyle change was but one small part of a wider ‘life’ change that occurred. Conclusions The final synthesis presents an interpretation, not evident in the primary studies, of a person-centred model to explain how lifestyle change is situated within ‘wider’ life changes. The magnitude of individual responses to a changed health status varied. Participants experienced distress as their notion of self identity shifted and emotions that reflected the various stages of the grief process were evident in participants’ accounts. The process of self-managing lifestyle took place through experiential learning; the level of engagement with lifestyle change reflected an individual’s unique view of the balance needed to manage ‘realistic change’ whilst leading to a life that was perceived as ‘worth living’. Findings highlight the importance of providing person centred care that aligns with both psychological and physical dimensions of recovery which are inextricably linked

Psychological process from hospitalization to death among uninformed terminal liver cancer patients in Japan

BACKGROUND: Although the attitude among doctors toward disclosing a cancer diagnosis is becoming more positive, informing patients of their disease has not yet become a common practice in Japan. We examined the psychological process, from hospitalization until death, among uninformed terminal cancer patients in Japan, and developed a psychological model. METHODS: Terminal cancer patients hospitalized during the recruiting period voluntarily participated in in-depth interviews. The data were analyzed by grounded theory. RESULTS: Of the 87 uninformed participants at the time of hospitalization, 67% (N = 59) died without being informed of their diagnosis. All were male, 51–66 years of age, and all experienced five psychological stages: anxiety and puzzlement, suspicion and denial, certainty, preparation, and acceptance. At the end of each stage, obvious and severe feelings were observed, which were called "gates." During the final acceptance stage, patients spent a peaceful time with family, even talking about their dreams with family members. CONCLUSION: Unlike in other studies, the uninformed patients in this study accepted death peacefully, with no exceptional cases. Despite several limitations, this study showed that almost 70% of the uninformed terminal cancer patients at hospitalization died without being informed, suggesting an urgent need for culturally specific and effective terminal care services for cancer patients in Japan

Modelling Everyday Understandings of Mortality: A Qualitative Enquiry

With few exceptions, much of the literature on mortality awareness (MA; the realization of one’s own and other’s mortality), though based on quantitative research, is focused on its negative effects and processes associated with fearing its occurrence. However, recent studies have demonstrated that MA is multifaceted and can be associated with positive processes and outcomes. Here, everyday understandings of MA were investigated using grounded theory. Ten participants engaged in one-off semistructured interviews about their everyday experiences of MA. Grounded theory analysis revealed four main themes: (a) Moments of MA, (b) Functionality of MA, (c) Coping strategies for MA, and (d) Inability to cope with MA. Each of these themes is composed of two to five subthemes. The results supported the notion that MA is experienced in a multidimensional manner, which appears to align with elements of the Multidimensional Mortality Awareness Measure and Model. Furthermore, positive and/or negative outcomes appeared to depend on the function attributed to MA by the individual. Therefore, the ability to attribute such function to MA appears to be important in our understanding of this key existential issue

The interplay between structure and agency in shaping the mental health consequences of job loss

Main themes that emerged from the qualitative exploration of the psychological distress of job loss included stress, changes to perceived control, loss of self-esteem, shame and loss of status, experiencing a grieving process, and financial strain. Drawing on two models of agency we identified the different ways workers employed their agency, and how their agency was enabled, but mainly constrained, when dealing with job loss consequences. Respondents’ accounts support the literature on the moderating effects of economic resources such as redundancy packages. The results suggest the need for policies to put more focus on social, emotional and financial investment to mediate the structural constraints of job loss. Our study also suggests that human agency must be understood within an individual’s whole of life circumstances, including structural and material constraints, and the personal or interior factors that shape these circumstances.The authors acknowledge support from the National Health and Medical Research Council Capacity Building Grant (324724). The research was supported by the SA Department of Health and the SA Department of Families and Communities through the Human Services Research and Innovation Program (HSRIP), and the Australian Research Council Linkage Program (LP0562288), with the Department of Health (DOH) serving as Industry Partner. Professor Fran Baum was supported by an ARC Federation Fellowship and Drs Newman and Ziersch by the SA Premier’s Science and Research Fund

Understanding the experience of parents of pre-pubescent children with gender identity issues

Whilst in recent times there has been an increasing interest in the popular media in families with gender variant children, there is still a paucity of academic research into the experience of parenting a pre-pubescent child with gender identity issues. Gender dysphoria in young children engenders emotive reactions in adults meaning that social workers need to be aware of the various discourses surrounding gender identity in order to work sensitively with families affected. This research explores highly sensitive and intimate aspects of family life, requiring parents to talk and think about difficult issues and explores how it might feel for families to parent a child with gender identity issues. The psychosocial research method of Free Association Narrative Interviews was used in order to gather the data which was then coded and analysed drawing on a constructivist version of grounded theory. Five key themes relating to the process of mourning emerged from the data: loss, uncertainty, ambivalence, being unable to think and acceptance. Recommendations for both social work and clinical practice are also offere

Patients’ and practice nurses’ perceptions of depression in patients with type 2 diabetes and/or coronary heart disease screened for subthreshold depression

Background Comorbid depression is common in patients with type 2 diabetes (DM2) and/or coronary heart disease (CHD) and is associated with poor quality of life and adverse health outcomes. However, little is known about patients’ and practice nurses’ (PNs) perceptions of depression. Tailoring care to these perceptions may affect depression detection and patient engagement with treatment and prevention programs. This study aimed to explore patients’ and PNs’ perceptions of depression in patients with DM2/CHD screened for subthreshold depression. Methods A qualitative study was conducted as part of a Dutch stepped-care prevention project. Using a purposive sampling strategy, data were collected through semi-structured interviews with 15 patients and 9 PNs. After consent, all interviews were recorded, transcribed verbatim and analyzed independently by two researchers with Atlas.ti.5.7.1 software. The patient and PN datasets were inspected for commonalities using a constant comparative method, from which a final thematic framework was generated. Results Main themes were: illness perception, need for care and causes of depression. Patients generally considered themselves at least mildly depressed, but perceived severity levels were not always congruent with Patient Health Questionnaire 9 scores at inclusion. Initially recognizing or naming their mental state as a (subthreshold) depression was difficult for some. Having trouble sleeping was frequently experienced as the most burdensome symptom. Most experienced a need for care; psycho-educational advice and talking therapy were preferred. Perceived symptom severity corresponded with perceived need for care, but did not necessarily match help-seeking behaviour. Main named barriers to help-seeking were experienced stigma and lack of awareness of depression and mental health care possibilities. PNs frequently perceived patients as not depressed and with minimal need for specific care except for attention. Participants pointed to a mix of causes of depression, most related to negative life events and circumstances and perceived indirect links with DM2/CHD. Conclusion Data of the interviewed patients and PNs suggest that they have different perceptions about (subthreshold) depressive illness and the need for care, although views on its causes seem to overlap more