Participation in environmental health research by placenta donation – a perception study

<p>Abstract</p> <p>Background</p> <p>Much environmental health research depends on human volunteers participating with biological samples. The perception study explores why and how people participate in a placenta perfusion study in Copenhagen. The participation implies donation of the placenta after birth and some background information but no follow up.</p> <p>Methods</p> <p>Nineteen semi-structured qualitative interviews were conducted with participants in the placenta perfusion study after donation of placenta. Observation studies were made of recruitment sessions.</p> <p>Results</p> <p>The interviewed participants are generally in favour of medical research. They participated in the placenta perfusion study due to a belief that societal progress follows medical research. They also felt that participating was a way of giving something back to the Danish health care system. The participants have trust in medical science and scientists, but trust is something which needs to be created through "trust-work". Face-to-face interaction, written information material and informed consent forms play important parts in creating trusting relationships in medical research.</p> <p>Conclusion</p> <p>Medical research ethics do not only amount to specific types of written information material but should also be seen as a number of trust making performances involving researchers as well as research participants.</p

Patients' perception of using telehealth for type 2 diabetes management: a phenomenological study

BACKGROUND: There is a growing body of evidence that supports the uses of telehealth to monitor and manage people with diabetes at a distance. Despite this, the uptake of telehealth has been low. The objective of this study is to explore patients' perceptions of using telehealth for type 2 diabetes management. METHODS: Semi-structured interviews were undertaken with 10 patients from the NHS Newham area in London, UK. Data were collected using recorded semi-structured interviews. The interviews were transcribed verbatim and the analysis was guided by the phenomenological analysis approach. RESULTS: We identified three main themes for facilitating positive patient experience or acceptance of telehealth and these included: technology consideration, service perceptions and empowerment. All patients asserted that they were pleased with the technology and many also proclaimed that they could not see themselves being without it. Moreover, very few negative views were reported with respect to the use of telehealth. CONCLUSION: The patients' perceived telehealth as a potential to enhance their quality of life, allow them to live independently at home as well as help them take and be in more control over their own health state. The findings of this study therefore supports the use of telehealth for the routine care of people with type 2 diabetes. However, one must interpret the results with caution due to limitations identified in the sample

Development of non-invasive ventilation treatment practice for patients with chronic obstructive pulmonary disease:Results from a participatory research project

Objectives: Non-invasive ventilation treatment for patients with acute exacerbation of chronic obstructive pulmonary disease is well documented. Communication with patients during treatment is inhibited because of the mask, the noise from the machine and patient distress. Assessing life expectancy and identifying end-stage chronic obstructive pulmonary disease posed difficulties and caused doubts concerning initiation and continuation of non-invasive ventilation as life-sustaining treatment. Health professionals expressed a need for knowledge of patients’ perspectives and attitude towards non-invasive ventilation. Methods: The study adheres to principles of Critical psychological practice research. Data on patients’ and health professionals’ perspectives were obtained from observations from the ward and semi-structured interviews with 16 patients. A group of health professionals was set up to form a co-researcher group. The co-researcher group described and analysed treatment practice at the department, drawing on research literature, results from observations and patients’ interviews. Results: Interviews revealed that 15 patients evaluated treatment with non-invasive ventilation positively, although 13 had experienced fear and 14 discomfort during treatment. The co-researcher group described health professionals’ perspectives and analysed treatment practice based on data from patients’ perspectives developing new management strategies in clinical practice with non-invasive ventilation. Conclusion: The participatory approach enabled continuous and complementary development of knowledge and treatment practice. The investigation of patient perspectives was particularly productive in qualifying cooperation among health professionals. The study resulted in preparing, and implementing, new clinical strategies

The Politics of Mental Illness and Involvement-"A Discourse Analysis of Danish Anti-Stigma and Social Inclusion Campaigns"

The present study is a part of a broader multisited field study on involvement of relatives in Danish psychiatry. The article aims to elucidate which political classifications of normality and mental illness that are displayed in two health political campaigns regarding anti-stigmatization and social inclusion and how such classifications co-constitute the subjectivity of individuals suffering from mental illness and their relatives. Drawing on a discourse theoretical perspective laid out by political theorists Laclau and Mouffe, we analyze how the campaigns bring into effect a weak and ineffective subject of deviance and how it is constituted by a subject of normality characterized by opposing traits. The article takes up the discussion of how the campaigns’ articulations of the subjects of normality and deviance are imbedded in a hegemonic discourse of neoliberalism and individualism that asserts involvement as an expanded division of responsibility for the identification, classification and regulation of mentally ill subjects between public and private spheres of the Danish welfare state

The Politics of Mental Illness and Involvement-"A Discourse Analysis of Danish Anti-Stigma and Social Inclusion Campaigns"

The present study is a part of a broader multisited field study on involvement of relatives in Danish psychiatry. The article aims to elucidate which political classifications of normality and mental illness that are displayed in two health political campaigns regarding anti-stigmatization and social inclusion and how such classifications co-constitute the subjectivity of individuals suffering from mental illness and their relatives. Drawing on a discourse theoretical perspective laid out by political theorists Laclau and Mouffe, we analyze how the campaigns bring into effect a weak and ineffective subject of deviance and how it is constituted by a subject of normality characterized by opposing traits. The article takes up the discussion of how the campaigns’ articulations of the subjects of normality and deviance are imbedded in a hegemonic discourse of neoliberalism and individualism that asserts involvement as an expanded division of responsibility for the identification, classification and regulation of mentally ill subjects between public and private spheres of the Danish welfare state

Ethical challenges assessed in the clinical ethics Committee of Psychiatry in the region of Southern Denmark in 2010–2015: a qualitative content analyses

Background The aim of this article is to give more insight into what ethical challenges clinicians in mental healthcare experience and discuss with a Clinical Ethics Committee in psychiatry in the Region of Southern Denmark. Ethical considerations are an important part of the daily decision-making processes and thereby for the quality of care in mental healthcare. However, such ethical challenges have been given little systematic attention – both in research and in practices. Methods A qualitative content analysis of 55 written case-reports from the Clinical Ethics Committee. The Committee offers clinicians in mental healthcare structured ethical analyses of ethical challenges and makes a thorough written case-report. Results The ethical challenges are grouped into three overarching topics: 1. Clinicians and their relation to patients and relatives. 2. Clinicians and institutional aspects of mental healthcare 3. Clinicians and mental healthcare in a wider social context. Through presentation of illustrative examples the complexity of daily clinical life in mental healthcare becomes evident, as well as typical interests, values and arguments. Conclusions This qualitative study indicates that difficult ethical challenges are an inherent part of mental healthcare that requires time, space and competence to be dealt with adequately

Hospital ethics reflection groups: a learning and development resource for clinical practice

Background An ethics reflection group (ERG) is one of a number of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the significance of ERGs in psychiatric and general hospital departments in Denmark. Methods This is a qualitative action research study, including systematic text condensation of 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. Short written descriptions of the ethical challenges presented in the ERGs also informed the analysis of significance. Results A recurring ethical challenge for clinicians, in a total of 63 cases described and assessed in 3 ethical reflection groups, is to strike a balance between respect for patient autonomy, paternalistic responsibility, professional responsibilities and institutional values. Both in psychiatric and general hospital departments, the study participants report a positive impact of ERG, which can be divided into three categories: 1) Significance for patients, 2) Significance for clinicians, and 3) Significance for ward managers. In wards characterized by short-time patient admissions, the cases assessed were retrospective and the beneficiaries of improved dialogue mainly future patients rather than the patients discussed in the specific ethical challenge presented. In wards with longer admissions, the patients concerned also benefitted from the dialogue in the ERG. Conclusion This study indicates a positive significance and impact of ERGs; constituting an interdisciplinary learning resource for clinicians, creating significance for themselves, the ward managers and the organization. By introducing specific examples, this study indicates that ERGs have significance for the patients discussed in the specific ethical challenge, but mostly indirectly through learning among clinicians and development of clinical practice. More research is needed to further investigate the impact of ERGs seen from the perspectives of patients and relatives