Evaluation of an online educational tool designed to reduce stress and boost well-being for people living with an ileostomy : a framework analysis

Ileostomies, in which the small intestine is re-directed out of a stoma in the stomach so that waste is collected using a bag, are using to treat conditions such as bowel cancer and Inflammatory Bowel Disease. Previous research has shown that life with an ileostomy can be challenging. In our own previous work, we piloted an Online Educational Tool (OET) designed to reduce stress and boost well-being in people living with an ileostomy. The current study utilised the qual-itative method framework analysis in order to evaluate the effectiveness of our OET. We asked nine OET users questions about their experience of using the tool and the impact it may have had on their lives. Feedback was generally positive. Participants described facilitators and barriers for remaining engaged, and discussed a wide range of elements which were successful or unsuccessful. Stress levels were generally reduced and well-being boosted; participants gave examples of how this played out for them. Feelings about whether the impact of the tool would last were mixed. There was one participant who felt the tool was not inclusive enough and too repetitive. Findings from this study add weight to previous findings that the OET was successful in its aims

An online educational tool to promote psychological well-being, optimism, and coping self-efficacy among people living with an ileostomy : a pilot study

We assessed an online educational tool designed for people living with an ileostomy. Thirty-nine participants took part in a 10-week online educational tool, which included elements such as happiness profiling, understanding stress and coping, utilising social support, mindfulness skills, and emotional intelligence training. Participants completed questionnaires to assess the effects of the online educational tool on well-being, optimism, and coping self-efficacy at Time 1 (baseline), Time 2 (after the intervention), and Time 3 (three months after completing the online educational tool). Psychological well-being, optimism, use of problem-focused coping self-efficacy, and stop unpleasant emotions and thoughts coping self-efficacy were significantly higher, with large effect sizes, at both Time 2 and Time 3, than Time 1. The online educational tool appears to be a promising time and cost effective method of promoting positive outcomes, although additional testing is required before it could be used in conjunction with existing healthcare treatment

Waiting for a kidney from a deceased donor: an interpretative phenomenological analysis

Demand for kidneys from deceased donors far outstrips supply. Despite this, there appears to be little research that focuses solely on the experience of waiting for a kidney from a deceased donor. This study uses the qualitative methodology Interpretative Phenomenological Analysis (IPA) to explore the lives of 10 people on the transplant list, with the aims of illuminating the potential psychological challenges those on the list may face during this time, and providing information to help clinicians more fully support such people in the future. Two themes connected to the experience of waiting – adjustment to the uncertainty of waiting and thinking about receiving a kidney from a living donor – are presented here. Participants describe a sense of confusion and uncertainty around life on the list, and discuss their strategies for dealing with this. Novel complexities around the ambiguous challenge of receiving an organ from a deceased donor are revealed. It is recommended that healthcare teams provide a forum for this patient group to work through these feelings of confusion and ambiguity

The Impact of Race and Gender-Related Discrimination on the Psychological Distress Experienced by Junior Doctors in the UK:A Qualitative Secondary Data Analysis

Almost half of NHS doctors are junior doctors, while high proportions are women and/or Black, Asian, and Minority Ethnic (BAME) individuals. Discrimination against this population is associated with poorer career-related outcomes and unequal representation. We aimed to qualitatively explore junior doctors' experience of workplace racial and gender-based discrimination, and its impact on their psychological distress (PD). In this study, we carried out a secondary analysis of data from a UK-based parent study about junior doctors' working cultures and conditions. Interview data was examined using thematic analysis. Transcripts (n = 14) documenting experiences of race and/or gender-based discrimination were sampled and analysed from 21 in-depth interviews conducted with UK junior doctors. Four themes were generated about the experiences and perpetrators of discrimination, the psychological impact of discrimination, and organisational interventions that tackle discrimination. Discrimination in various forms was reported, from racially charged threats to subtle microaggressions. Participants experienced profoundly elevated levels of PD, feeling fearful, undermined, and under-confident. Discrimination is associated with elevated levels of PD, whilst negatively impacting workforce sustainability and retention. This reduces the opportunity for more diversity in NHS medical leadership. We encourage NHS hospitals to review their policies about discrimination and develop in-person workshops that focus on recognising, challenging, and reporting workplace discrimination.</p

The experiences of general practitioner partners living with distress::An interpretative phenomenological analysis

Doctors, including general practitioners, experience higher levels of mental illness than the general population. General practitioners who are partners in their practices may face heightened stress. In total, 10 general practitioner partners living with work-related distress were interviewed, and transcripts were analysed using interpretative phenomenological analysis. Three major themes arose: (1) extreme distress, (2) conflicted doctor identity and (3) toxic versus supportive workplace relationships. Participants detailed symptoms of depression, anxiety and burnout; reported conflicted identities; and discussed the impact of bullying partnerships. We recommend that organisational interventions tackling issues such as bullying be implemented and opportunities to debrief be offered as protected time activities to general practitioner partners

The experience of antiretroviral treatment for Black West African women who are HIV positive and living in London: an interpretative phenomenological analysis

Antiretroviral therapy (ART) offers a powerful intervention in HIV but effectiveness can be compromised by inadequate adherence. This paper is a detailed examination of the experience of medication in a purposively selected group of people living with HIV. In-depth interviews were conducted with 10 HIV positive, West African women of black heritage living in London, UK. This group was of interest since it is the second largest group affected by HIV in the UK. Interviews were subjected to interpretative phenomenological analysis, an idiographic, experiential, qualitative approach. The paper details the women’s negative experience of treatment. ART can be considered difficult and unrelenting and may be disconnected from the women’s sense of health or illness. Participants’ social context often exacerbated the difficulties. Some reported an improvement in their feelings about the medication over time. These findings point to some intrinsic and social motivators which could act as spurs to adherence

The psychological challenges of living with an ileostomy: an interpretative phenomenological analysis

Objectives: Ileostomy, in which the small intestine is re-directed out of an abdominal wall so that waste is collected using a bag, is used to treat conditions including Inflammatory Bowel Disease and colorectal cancer. This paper reports an in depth idiographic analysis of the experience of living with an ileostomy. Methods: 21 participants took part in semi-structured interviews about their lives and relationships. Those interviews were transcribed verbatim and analysed using the experiential qualitative methodology Interpretative Phenomenological Analysis (IPA). Results: Two super-ordinate themes arose from the data: Ileostomy’s intra-personal impact; the impact of ileostomy on relationships with others. We found that ileostomy may destabilise the sense of self, disrupt body image, and alter experience of age and sexuality. Other participants were able to employ their illness to positively reframe the self. Disclosure of ileostomy status was difficult for some. Intimate and friend relationships were often challenged by stoma status, whilst other family relationships were largely characterised as supportive. Conclusions: Ileostomy may impact upon both intra and interpersonal aspects of the lives of those who live with it, in both negative and positive ways. Consequently, the sense of self can appear challenged, and relationships with partners, family members and friendships could be causes of distress. On the other hand, some partners were supportive, and children were found to be sources of comfort

A longitudinal interpretative phenomenological analysis of the process of kidney recipients’ resolution of complex ambiguities within relationships with their living donors

Much previous research into living kidney donation has focused on the decision making of the donor, despite evidence suggesting this may be a more psychologically challenging time for the recipient. This longitudinal study explores the experiences of four recipients of kidneys from living donors throughout the transplant process. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA). Three themes arose from the data, which were: Changing perceptions of relationships with kidney donors; Upbeat, temporal strategies for remaining positive; and Journey of the self. Findings from the first theme are presented in detail here. It was found that each participants’ relationship with their donor grew and developed in different ways, presenting their own complex challenges in terms of developing relationships and ambiguity around the decision to use the chosen donor