Health promotion roles shaped by professional identity: an ethnographic study in the Netherlands
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PROVIDER: S-EPMC10787352 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:ObjectivesTo understand identity tensions experienced by health professionals when patient partners join a quality improvement committee.DesignQualitative ethnographic study based on participatory observation.SettingAn interdisciplinary quality improvement committee of a Canadian urban academic family medicine clinic with little previous experience in patient partnership.ParticipantsTwo patient partners, seven health professionals (two family physicians, two residents, one pharmacist, one nurse clinician and one nurse practitioner) and three members of the administrative team.Data collectionData collection included compiled participatory observations, logbook notes and semi-structured interviews, collected between the summer of 2017 to the summer of 2019.Data analysisGhadiri's identity threats theoretical framework was used to analyse qualitative material and to develop conceptualising categories, using QDA Miner software (V.5.0).ResultsAll professionals with a clinical care role and patient partners (n=9) accepted to participate in the ethnographic study and semi-structured interviews (RR=100%). Transforming the 'caregiver-patient' relationship into a 'colleague-colleague' relationship generated identity upheavals among professionals. Identity tensions included competing ideals of the 'good professional', challenges to the impermeability of the patient and professional categories, the interweaving of symbols associated with one or the other of these identities, and the inner balance between the roles of caregiver and colleague.ConclusionThis research provides a new perspective on understanding how working in partnership with patients transform health professionals' identity. When they are called to work with patients outside of a simple therapeutic relationship, health professionals may feel tensions between their identity as caregivers and their identity as colleague. This allows us to better understand some underlying tensions elicited by the arrival of different patient engagement initiatives (eg, professionals' resistance to working with patients, patients' status and remuneration, professionals' concerns toward patient 'representativeness'). Partnership with patients imply the construction of a new relational framework, flexible and dynamic, that takes into account this coexistence of identities.
| S-EPMC8273447 | biostudies-literature
Project description:Health Professional Follow-Up Study
| PRJNA736489 | ENA
Project description:Health Professional Follow-Up Study
| PRJNA736488 | ENA
Project description:Recovery colleges (RCs) represent an innovation in mental health services. Facilitators with experiential knowledge or formal mental health training collaborate with students with lived experience or formal training to deliver courses in RCs. This paper examines the transformation of roles when co-creating new mental health services. We conducted a critical ethnographic study, collecting data from participatory observations in RCs at two locations and interviews with facilitators with formal mental health training and those with experiential knowledge. Drawing on "communitas" and "social ties," we analyse the social dynamics of co-creation practices in RCs. Our findings reveal that traditional service roles and normative structures in mental health services are dissolved or redefined through these co-creation practices. Facilitators initiate sharing rituals that foster equality and communitas and continuously assess their disclosures. We understand this dissolution of the normative social structure as a liminal state in which facilitators gradually transition into new positions. However, significant differences in social status and the daily lives of facilitators and students challenge communitas, indicating that the dissolution of roles can be temporary. While co-creation practices in RCs demonstrate significant potential in transforming roles and enhancing mental health interventions, sustaining these changes in broader mental health services remains challenging. Further research is needed to explore the sustainability of these transformed roles and their integration into broader mental health services.
| S-EPMC11889808 | biostudies-literature
Project description:ObjectivesEducational initiatives in residency may lack alignment with residents' learning objectives. Furthermore, they may overlook residents' struggle to find fulfilment in their work. Professional identity formation (PIF) is a conceptual lens through which to explore the alignment of educational initiatives with residents' learning objectives. Few empirical studies have examined PIF in residency in general. PIF outcomes in general practice (GP) residency, from the perspective of residents, are poorly represented in the current literature. This study aimed to explore residents' perspectives on their professional identity to inform PIF learning objectives in GP residency.DesignA qualitative descriptive study using a list of predetermined questions to guide focus group interviews.SettingData collection took place between winter and autumn 2019 at four GP training institutes across the Netherlands.Participants92 third (final) year GP residents participated in focus group interviews.ResultsResidents' overall perspectives hinged on how to negotiate the endlessness of the profession. This endlessness was reported to manifest in four areas, namely, the GP: as an accessible healthcare provider, as a spider in the care-web, providing personalised care and maintaining a work-life balance.ConclusionsGP residents' narratives highlighted an increasingly challenging profession and posited the importance of guided negotiation for their PIF. Deploying the concept of subjectification in residents' guided negotiation of the profession's endlessness possibly improves the supervisor-resident educational alliance. Furthermore, awareness of issues related to work-life balance and fostering residents' sense of belonging and collegiality may contribute to improving their well-being and sense of fulfilment in their work.
| S-EPMC11683983 | biostudies-literature
Project description:IntroductionEducational health promotion interventions for people with early-stage dementia have shown promising results, including empowering the person with dementia to live well and cope with their condition.ObjectivesThe aim of this study was to explore how group interactions, course structure, and facilitation by healthcare professionals in a 12-week educational health promotion course promote coping, healthy behaviors, and empowerment in people with early-stage dementia.MethodA focused ethnographic approach was employed, collecting data through moderate participant observations of people with early-stage dementia who attended the health promotion course and field conversations with the facilitators. Additionally, before and after the participants had completed the course, the participants and their care partners were interviewed individually.ResultsThe findings showed that group discussions provided an opportunity for the facilitators to identify knowledge gaps, correct misinterpretations of symptoms, and tailor the information to the participants' specific needs, thereby promoting healthy behaviors and empowering the participants. The consistent and structured format of the course appeared to reduce stress and promote learning. Learning about dementia first-hand, reminiscing, using humor, receiving support from others facing similar challenges, and receiving support and validation from facilitators all contributed to participants coping with their condition, processing negative emotions, and reducing internalized stigma.ConclusionThis study emphasized the importance of providing people living with early-stage dementia educational opportunities that combine first-hand information, peer and facilitator support, reminiscing, humor, recognition, and validation. These interventions can contribute to promote coping, healthy behaviors, and empowerment in people living with early-stage dementia.
| S-EPMC11273591 | biostudies-literature
Project description:BackgroundThe quality of the learning environment significantly impacts student engagement and professional identity formation in health professions education. Despite global recognition of its importance, research on student perceptions of learning environments across different health education programs is scarce. This study aimed to explore how health professional students perceive their learning environment and its influence on their professional identity development.MethodsAn explanatory mixed-methods approach was employed. In the quantitative phase, the Dundee Ready Education Environment Measure [Minimum-Maximum possible scores = 0-200] and Macleod Clark Professional Identity Scale [Minimum-Maximum possible scores = 1-45] were administered to Qatar University-Health students (N = 908), with a minimum required sample size of 271 students. Data were analyzed using SPSS, including descriptive statistics and inferential analysis. In the qualitative phase, seven focus groups (FGs) were conducted online via Microsoft Teams. FGs were guided by a topic guide developed from the quantitative results and the framework proposed by Gruppen et al. (Acad Med 94:969-74, 2019), transcribed verbatim, and thematically analyzed using NVIVO®.ResultsThe questionnaire response rate was 57.8% (525 responses out of 908), with a usability rate of 74.3% (390 responses out of 525) after excluding students who only completed the demographic section. The study indicated a "more positive than negative" perception of the learning environment (Median [IQR] = 132 [116-174], Minimum-Maximum obtained scores = 43-185), and a "good" perception of their professional identity (Median [IQR] = 24 [22-27], Minimum-Maximum obtained scores = 3-36). Qualitative data confirmed that the learning environment was supportive in developing competence, interpersonal skills, and professional identity, though opinions on emotional support adequacy were mixed. Key attributes of an ideal learning environment included mentorship programs, a reward system, and measures to address fatigue and boredom.ConclusionsThe learning environment at QU-Health was effective in developing competence and interpersonal skills. Students' perceptions of their learning environment positively correlated with their professional identity. Ideal environments should include mentorship programs, a reward system, and strategies to address fatigue and boredom, emphasizing the need for ongoing improvements in learning environments to enhance student satisfaction, professional identity development, and high-quality patient care.
| S-EPMC11330008 | biostudies-literature
Project description:Community-based programmes are a widely implemented approach for population health promotion. Due to the context-dependent and dynamic nature of these programmes, evaluating their implementation is challenging. Identifying key events in the implementation process in evaluation could enable us to support future implementation, while acknowledging the complexity of real-world implementation. We studied the nationwide implementation of the Dutch Healthy Youth, Healthy Future (JOGG) approach, a community-based programme for childhood overweight prevention. The aims of our study were (i) to gain insights into the implementation process of the JOGG approach, and (ii) to identify key events that influenced said process. In nine communities, we conducted interviews (n = 24) with coordinators and stakeholders involved in the implementation of the JOGG approach and collected documents on the programme's implementation. We applied the analytical tool 'Critical Event Card' to identify key events in the implementation process. Results showed that in 5-10 years of implementing the JOGG approach, communities have undergone different phases: preparation, upscaling, resource mobilization, integration with other policy initiatives and adaptation of the implementation strategy. Key events influencing the implementation process included national policy developments (e.g. new health programmes), framing of the JOGG approach in local policy, staff turnover and coordination teams' experiences and actions. Furthermore, changes in implementation were often triggered by the destabilization of the implementation process and linked to opportunities for change in the policy process. The identified key events can inform future implementation of the JOGG approach as well as other community-based health promotion programmes.
| S-EPMC10893857 | biostudies-literature
Project description:This article focuses on how children, independent of abilities, create healthy identities and spaces in kindergarten,and is based on a qualitative CGT-study carried out in Norwegian Kindergartens. Data sources include Life-forminterviews with 24 children, with and without disabilities. Children placed health in the context of their daily-lifeexperiences. They underlined the importance of aspiring to social well-being and creating healthy spaces throughinternally driven physical exertion and child-controlled activities. Children described how they relate to the staff?srestrictions and legal requirements as "the staff" versus "we, the children?. They advocate for the staff?sengagement in play and activities.Supplementary informationThe online version contains supplementary material available at 10.1007/s10643-022-01382-7.
| S-EPMC9549454 | biostudies-literature
Project description:IntroductionProfessional identity formation (PIF) is recognized worldwide as an outcome of medical education grounded in the psychology of adult development and the literature on medical professionalism. However, instruments to assess and support PIF are scarce. The Professional Identity Essay (PIE) is an open-ended question assessment of PIF that elicits short narrative responses from learners and that can be analyzed to provide formative feedback and an overall stage of development. In this study, our aim was to translate and adapt the PIE to Brazilian Portuguese.MethodsWe followed a systematic procedure for the translation and cross-cultural adaptation of the instrument. A pilot study was conducted with medical students from the University of São Paulo. After providing individual formative feedback, we administered an online questionnaire to the Brazilian students to better understand the consequences of using the PIE. Content analyses of qualitative data were performed, we employ manifest content analysis, and the categories of analysis emerged from the participants' speeches.ResultsStudents found the instrument's questions easy to interpret and self-reflective. It also gave students the opportunity to consider their PIF. The PIE was perceived as reliable and brought more awareness of the students' own processes in addition to a sense of capability to foster their own development. In the same way, the students emphasized the importance of being helped in this process.ConclusionWe found sufficient evidence of the validity of the PIE in terms of content, face validity, and consequences of use. The PIE enhances self-assurance in PIF through formative assessment and is sensitive to different cultures, making it a potential tool for educators.
| S-EPMC10559411 | biostudies-literature