The observer effect in a hospital setting - Experiences from the observed and the observers

BackgroundObservation studies are used in health care research, e.g. to explore behaviors of patients or health care professionals in hospitals. A methodological challenge in observation studies is the observer effect, as it can jeopardize the quality of a study.ObjectivesTo capture different dimensions of the observer effect through health care professionals' and patients' experiences, and their reactions to being observed in a hospital setting, and in addition, observers' experiences from performing an observation study.MethodFour focus group interviews (health care professionals and observers) and 10 individual interviews (patients) were conducted with participants from a Norwegian observation study focusing on medication communication at a hospital ward. In all 26 persons were interviewed, whereof 3 were observers (pharmacist, pharmacy students). Data were collected between September 2019 and January 2020 and analyzed by an inductive, thematic analysis approach.ResultsFive main themes were identified; Experiencing being observed; Temporarily adapting medication communication behavior; Consequences for the patients; To interact or not - reflections on the relations and Observing the observers. Respondents reported some observer effects, but also that these diminished with time. Even though minimal interaction was used as a strategy, observers and the observed still built rapport.ConclusionsThe observer effect in relation to medication communication seemed to be small and temporary in this specific hospital setting, among other things as staff and patients were used to extra persons (e.g. students) being around. Medication communication in hospital settings is a complex behavior, and appears to not be strongly impacted by the presence of observers, especially with a long observation time. It is important for researchers to monitor and record the observer effect in the specific setting of the study. This can be done by interviews with the observed and the observers by someone not connected to the observation study.     

Knowledge of the patient as decision‐making power: staff members' perceptions of interprofessional collaboration in challenging situations in psychiatric inpatient care

Challenging situations in psychiatric inpatient settings call for interprofessional collaboration, but the roles and responsibilities held by members of different professions is unclear. The aim of this study was to describe staff members' perceptions of interprofessional collaboration in the context of challenging situations in psychiatric inpatient care. Prior to the study taking place, ethical approval was granted. Focus group interviews were conducted with 26 physicians, ward managers, psychiatric nurses, and nursing assistants. These interviews were then transcribed and analysed using qualitative content analysis. Results described participants' perceptions of shared responsibilities, profession‐specific responsibilities and professional approaches. In this, recognising knowledge of the patient as decision‐making power was understood to be a recurring theme. This is a delimited qualitative study that reflects the specific working conditions of the participants at the time the study was conducted. The findings suggest that nursing assistants are the most influential professionals due to their closeness to and first‐hand knowledge of patients. The results also point to the possibility of other professionals gaining influence by getting closer to patients and utilising their professional knowledge, thus contributing to a more person‐centred care.     

Nonfinancial Barriers to Prenatal Care

No abstract available for this article.     

Synthesis of S‐thiomethyl DMSA and S‐thiomethyl ECD,radiolabelling with technetium‐99m and biological evaluation

Protection of the thiolate function of dimercaptosuccinic acid (DMSA) and ethylenedi‐l ‐cysteine diethyl ester (ECD) by S‐thiomethylation allowed automatic deprotection during technetium‐99m (^99mTc) radiolabelling by direct reduction with stannous chloride dihydrate. Protection of the free thiolate group increased the stability of the ligands as well as deprotection during complexation, which resulted in the desired radiopharmaceuticals. The complexes obtained from the protected ligands were chromatographically (HPLC) and biologically compared with the corresponding ^99mTc complexes of the unprotected ligands. The results suggest that the aforementioned method of protection by S‐thiomethylation could be utilized for the development of single‐vial DMSA and ECD kit. Copyright © 2012 John Wiley & Sons, Ltd.     

‘If your husband doesn't humiliate you,other people won't’: Gendered attitudes towards sexual violence in eastern Democratic Republic of Congo

More than a decade of fighting in the Democratic Republic of the Congo (DRC) has resulted in extensive human rights abuses, of which sexual and gender-based violence (SGBV) is one of the most salient and disturbing features. This paper uses qualitative data, based on 10 focus groups with 86 women and men to better understand gendered community perspectives on SGBV and its consequences in South Kivu. We conclude that for many survivors, rape has consequences far beyond the physiological and psychological trauma associated with the attack. Respondents say sexual violence has become a societal phenomenon, in which the community isolation and shame experienced as a result of the attack become as important as concerns about the attack itself. Male focus group participants explain their own feelings of shame and anger associated with knowing their female relatives were raped. These findings highlight the complexity of community reintegration for survivors and identify a number of programmatic and policy implications, such as the need for counselling for survivors of sexual violence with their families as well as individually; the importance of income-generating training; and the need for improved justice mechanisms to bring perpetrators to justice.     

Contributions to the Study of Immediate and Early X-ray Reactions with Regard to Chemoprotection

Summary

Irradiation causes atheromatotic changes in the coronary arteries, leading to occlusion of these vessels. In two out of ten animals, E.C.G. changes were found, which were characteristic for a myocardial infarct. This was confirmed at necropsy. One example is given of a young patient in whom radiotherapy was the cause of fatal pulmonary and myocardial fibrosis.