Poststroke Trajectories: The Process of Recovery Over the Longer Term Following Stroke

We adopted a grounded theory approach to explore the process of recovery experienced by stroke survivors over the longer term who were living in the community in the United Kingdom, and the interacting factors that are understood to have shaped their recovery trajectories. We used a combination of qualitative methods. From the accounts of 22 purposively sampled stroke survivors, four different recovery trajectories were evident: (a) meaningful recovery, (b) cycles of recovery and decline, (c) ongoing disruption, (d) gradual, ongoing decline. Building on the concept of the illness trajectory, our findings demonstrate how multiple, interacting factors shape the process and meaning of recovery over time. Such factors included conception of recovery and meanings given to the changing self, the meanings and consequences of health and illness experiences across the life course, loss, sense of agency, and enacting relationships. Awareness of the process of recovery will help professionals better support stroke survivors

Systematic review of grounded theory studies in physiotherapy

Aim: This systematic review aimed at appraising the methodological rigor of grounded theory research published in the field of physiotherapy to assess how the methodology is understood and applied. A secondary aim was to provide research implications drawn from the findings to guide future grounded theory methodology research. Methods: A systematic search was conducted in MEDLINE, CINHAL, SPORT Discus, Science Direct, PubMed, Scopus and Web of Science to identify studies in the field of physiotherapy that reported using grounded theory methodology and/or methods in the study title and/or abstract. The descriptive characteristics and methodological quality of eligible studies were examined using the assessment guidelines developed by Hutchison, Johnston and Breckon (2011). Findings: The review included sixty-eight studies conducted between 1998 and 2017. The findings showed that grounded theory methodology is becoming increasingly used by physiotherapy researchers. Thirty-six studies (53%) demonstrated a good understanding and appropriate application of grounded theory methodology. Thirty-two studies (47%) presented descriptive findings and were considered to be of poor methodological quality. Conclusions: There are several key tenets of grounded theory methodology that are integral to the iterative process of qualitative theorizing and need to be applied throughout all research practices including sampling, data collection and analysis

Promoting survival: A grounded theory study of consequences of modern health practices in Ouramanat region of Iranian Kurdistan

The aim of this qualitative study is to explore the way people using modern health care perceive its consequences in Ouraman-e-Takht region of Iranian Kurdistan. Ouraman-e-Takht is a rural, highly mountainous and dry region located in the southwest Kurdistan province of Iran. Recently, modern health practices have been introduced to the region. The purpose of this study was to investigate, from the Ouramains' point of view, the impact that modern health services and practices have had on the Ouraman traditional way of life. Interview data from respondents were analyzed by using grounded theory. Promoting survival was the core category that explained the impact that modern health practices have had on the Ouraman region. The people of Ouraman interpreted modern health practices as increasing their quality of life and promoting their survival. Results are organized around this core category in a paradigm model consisting of conditions, interactions, and consequences. This model can be used to understand the impact of change from the introduction of modern health on a traditional society

What is traditional acupuncture - exploring goals and processes of treatment in the context of women with early breast cancer

Background: Despite the increasing popularity of acupuncture, there remains uncertainty as to its effectiveness and how it brings about change. Particular questions are posed over whether acupuncture research has sufficient model validity and reflects acupuncture as practised. Exploring traditional acupuncture (TA) in practice should help to expose processes essential to the theory of TA. The aim of this study was to examine what TA practitioners aim to achieve, their rationale and how they follow this through in their practice. Methods: A longitudinal study of TA for women with early breast cancer (EBC) was performed. Study participants comprised 14 women with EBC and two experienced TA practitioners, all taking part in in-depth interviews, conducted before and after receipt of up to 10 treatment sessions, and analysed using grounded theory methods. Additional data came from practitioner treatment logs and diaries. Results: Practitioners sought long-term goals of increasing strength and enabling coping as well as immediate relief of symptoms. They achieved this through a continuous process of treatment, following through the recursive and individualized nature of TA and adjusted, via differential diagnosis, to the rapidly fluctuating circumstances of individual women. Establishing trust and good rapport with the women aided disclosure which was seen as essential in order to clarify goals during chemotherapy. This process was carefully managed by the practitioners and the resultant therapeutic relationship was highly valued by the women. Conclusion: This study provided insight into the interdependent components of TA helping to demonstrate the multiple causal pathways to change through the continuous process of new information, insights and treatment changes. A good therapeutic relationship was not simply something valued by patients but explicitly used by practitioners to aid disclosure which in turn affected details of the treatment. The therapeutic relationship was therefore a vital and integral part of the treatment process

Staff experiences of Providing Maternity Services in Rural Southern Tanzania -- A Focus on Equipment, Drug and Supply Issues.

The poor maintenance of equipment and inadequate supplies of drugs and other items contribute to the low quality of maternity services often found in rural settings in low- and middle-income countries, and raise the risk of adverse maternal outcomes through delaying care provision. We aim to describe staff experiences of providing maternal care in rural health facilities in Southern Tanzania, focusing on issues related to equipment, drugs and supplies. Focus group discussions and in-depth interviews were conducted with different staff cadres from all facility levels in order to explore experiences and views of providing maternity care in the context of poorly maintained equipment, and insufficient drugs and other supplies. A facility survey quantified the availability of relevant items. The facility survey, which found many missing or broken items and frequent stock outs, corroborated staff reports of providing care in the context of missing or broken care items. Staff reported increased workloads, reduced morale, difficulties in providing optimal maternity care, and carrying out procedures that carried potential health risks to themselves as a result. Inadequately stocked and equipped facilities compromise the health system's ability to reduce maternal and neonatal mortality and morbidity by affecting staff personally and professionally, which hinders the provision of timely and appropriate interventions. Improving stock control and maintaining equipment could benefit mothers and babies, not only through removing restrictions to the availability of care, but also through improving staff working conditions

Dealing with daily emotions—supportive activities for the elderly in a municipal care setting

There are diverse descriptions of supportive activities in nursing to be found in the literature. What they have in common is their association with good care outcomes, but they may differ depending on the context in which the care is given. In a Swedish municipal elderly care setting, registered nurses (RN) work in a consultative way and they describe a part of their tasks as comprising supportive activities without specifying what kind of supportive activities they mean. The aim of the study was to explore the main concern of the support given by RN to a group of patients in an elderly home care setting. The study was conducted using Grounded Theory. Data were collected using nonparticipant observations regarding the supportive activities of 12 RN at the home of 36 patients between the ages of 80 and 102. Most of the home visit lasted about 40 min but some lasted for 90 min. The central category was about dealing with daily emotions. This was done by encouraging the situation and reducing the patient's limitations, but situations also occurred in which there was a gap of support. Support was about capturing the emotions that the patient expressed for a particular moment, but there were also situations in which RN chose not to give support. To develop a holistic eldercare, more knowledge is needed about the factors causing the RN to choose not to provide support on some occasions

How Emerging Organizations Take Form: The Role of Imprinting and Values in Organizational Bricolage

We examine how emerging organizations acquire shape by drawing on multiple organizational forms, a process we call organizational bricolage. Studying Indymedia London, a grassroots media collective, we propose a grounded theory of organizational bricolage that identifies how various types of organizational forms are selected and how they are instantiated into the organization. Whereas extant research has emphasized imprinting as a primary mechanism shaping newly founded organizations, we point to the additional role of organizational values. Emerging organizations augment their imprinted forms by using ancillary forms aligned with their organizational values and reinforce their core features by differentiating themselves from antagonistic forms that conflict with their values. We contribute to the literature on organizational formation by developing a process model that details how imprinted forms are subsequently modified. Moreover, we extend theories of bricolage by specifying the limits to the relative arbitrariness of bricolage as an activity, and we contribute to the study of organizational values by suggesting that they act as a focusing device shaping organizational structure

Only the Lonely: H I Imaging of Void Galaxies

Void galaxies, residing within the deepest underdensities of the Cosmic Web, present an ideal population for the study of galaxy formation and evolution in an environment undisturbed by the complex processes modifying galaxies in clusters and groups, as well as provide an observational test for theories of cosmological structure formation. We have completed a pilot survey for the HI imaging aspects of a new Void Galaxy Survey (VGS), imaging 15 void galaxies in HI in local (d < 100 Mpc) voids. HI masses range from 3.5 x 10^8 to 3.8 x 10^9 M_sun, with one nondetection with an upper limit of 2.1 x 10^8 M_sun. Our galaxies were selected using a structural and geometric technique to produce a sample that is purely environmentally selected and uniformly represents the void galaxy population. In addition, we use a powerful new backend of the Westerbork Synthesis Radio Telescope that allows us to probe a large volume around each targeted galaxy, simultaneously providing an environmentally constrained sample of fore- and background control sample of galaxies while still resolving individual galaxy kinematics and detecting faint companions in HI. This small sample makes up a surprisingly interesting collection of perturbed and interacting galaxies, all with small stellar disks. Four galaxies have significantly perturbed HI disks, five have previously unidentified companions at distances ranging from 50 to 200 kpc, two are in interacting systems, and one was found to have a polar HI disk. Our initial findings suggest void galaxies are a gas-rich, dynamic population which present evidence of ongoing gas accretion, major and minor interactions, and filamentary alignment despite the surrounding underdense environment.Comment: 53 pages, 18 figures, accepted for publication in AJ. High resolution available at http://www.astro.columbia.edu/~keejo/kreckel2010.pd