Communicating with Subjects: Special Challenges for Resuscitation Research

In May 2005, Academic Emergency Medicine sponsored a one‐day consensus conference held in association with the 2005 Society for Academic Emergency Medicine meeting in New York City. The conference, entitled “Ethical Conduct of Resuscitation Research,” addressed a variety of issues regarding the successful conduct of research in acute care settings. A number of important breakout sessions were convened based on challenges specific to resuscitation research. “Communicating with Subjects” was one such session, dedicated toward perfecting the conduct of informed consent for research. The breakout session was attended by 15 insightful emergency medicine investigators, administrators, and ethicists. Issues of research information disclosure, subject comprehension, and the voluntariness of research participation were addressed. Consensus statements were developed and are discussed within this report.     

Connecting with clinicians: Opportunities to strengthen rehabilitation research

Purpose. This article examines the distinctive opportunities and challenges involved in connecting with clinicians to strengthen rehabilitation research.

Method. The relevant literature on various factors that link researchers and clinicians is summarized and discussed.

Results. Links between researchers and clinicians are demonstrated by evidence-based practice, common conceptual background and the development of research capacity. Sustainable partnerships can evolve throughout the research process by using various enduring strategies such as experts' committee as well as novel approaches like communities of practice.

Conclusion. This paper reflects the conviction that reducing the gap between research and clinical practice will be facilitated by implementing partnerships originating from both researchers and clinicians.     

A systematic review of photovoice research methods with people with intellectual disabilities

Background

Photovoice is an arts-based participatory action research methodology that is growing in popularity. Our aim was to systematically review photovoice research with people with intellectual disabilities to describe the current ‘state of the art’ and identify areas for further methodological consideration.

Methods

We searched five databases using search terms relating to photovoice and intellectual disabilities. Thirty one studies met inclusion criteria. We used thematic analysis to identify common themes.

Findings

The themes identified—adaptations to the photovoice method, collaboration, participation and power, impact and outcomes—explored how far the ‘voice’ and agency of participants with intellectual disabilities taking part in photovoice research were supported and whether photovoice lived up to its promise as ‘action’ research.

Conclusion

Photovoice creates opportunities for self-representation of people with intellectual disabilities through photography. Participants could be further supported to engage with researchers in critical reflection on findings and collaborate on tangible outcomes.     

住院艾滋病患者心理感受的质性研究

目的 了解和探讨住院艾滋病患者的心理状况,以引导护士为患者提供全身心的护理服务.方法 采用质性研究中的现象学研究法,对12例艾滋病住院患者进行了深入访谈和观察.结果 住院艾滋病患者的心理感受主要有:获知患艾滋病后感到震惊、恐惧;不堪忍受疾病的折磨以致产生自杀的念头;渴求家人的陪伴;需要精神层面的支持;因经济拮据而产生病情好转后投入继续工作之中的打算;惦念与牵挂家中的孩子.结论 护士应正确识别、评估住院艾滋病患者的不同心理变化阶段,了解患者的生存状态,加强心理支持和护理,提高患者生存质量.     

乳腺癌患者对乳腺癌早期检测真实体验的质性研究

目的了解和理解乳腺癌患者对乳腺癌早期检测的体验.方法质性描述.采用深度访谈法收集了12例个案的资料,并用现象学分析法进行分析.结果乳腺癌患者对乳腺癌早期检测的体验主要有4个方面:①关心乳腺健康但认识不够.②缺乏早期检测的知识及技能.③提高对早期检测的认识和态度.④呼唤推广和推进早期检测.结论医护人员应提供乳腺癌早期检测的知识和技能,建立符合国情的乳腺癌的早期检测方案.     

Connecting what we do with what we know: building a community of research and practice

How to think about, develop, maintain and optimize connections between research and practice remains a vexed and contested area in the increasingly complex multidisciplinary and inter-professional practice that constitutes contemporary healthcare and service delivery. A body of literature challenging linear and passive notions of research uptake has emerged which views research uptake as a dynamic, contextualized and active process. This paper explores the development of a successful and exciting community of research and practice involving a university and an aged care organization in Australia. The community of research and practice is premised on dynamic, contextual and active interaction between research and practice; where the categories of research and practice are not mutually exclusive or static; and where community is more than just a structure to facilitate collaborative research projects. It is proposed that the idea of a community of research and practice is a useful one in terms of seeking to better understand and provide strategies for knowledge translation between researchers and practitioners and those who are both.     

Rehabilitation Guidelines for the Geriatric Patient with Diabetes

With the advancement of medical science and its accompanying technology, the longevity of diabetic persons has increased profoundly. Formerly, diabetic individuals had shorter lifespans than non-diabetic individuals because of the disease and its complications. Due to the genetic component of diabetes, its prevalence was self limiting. Today, on the other hand, there is an increased number of persons with diabetes seen in practice, either for the control of the disease directly or for treatment of its many complications. The physical or occupational therapist will encounter diabetic patients in the aging population with a variety of needs that differ from one patient to another. This paper introduces the therapist to diabetes mellitus, its complications, and the role of the therapist in the provision of treatment and education.     

Ethical issues in research with homeless youths

Title. Ethical issues in research with homeless youths. Aim. This paper is a report of a study to documente researcher, healthcare provider and programme administrators’ experiences with ethical issues in research with homeless youths in North America. Background. While there are legal and ethical guidelines for research with adolescents and with vulnerable populations in general, there are no specific guidelines for the ethical conduct of research with homeless youths. Methods. Using a web‐based questionnaire, healthcare and social service providers, programme administrators and researchers working with homeless young people throughout the United States of America and Canada were surveyed in 2005. The survey group consisted of 120 individuals; a total of 72 individuals completed the survey. Survey questions included experiences with using incentives in research with homeless youths, consent and experiences with ethics review boards. Numerical data were analysed using frequencies and cross‐tabulations. Text data were analysed qualitatively. Findings. Researchers doing mental health and/or substance use research tended to use money as a research incentive, whereas healthcare providers and programme administrators tended to use non‐monetary incentives. The majority of respondents reported using written consent for research from homeless youths, including minors. Respondents reporting difficulties with ethics review boards were mainly involved with intervention research. Conclusion. Consensus is needed from a variety of stakeholders, including homeless youths and service providers, on use of various types of research incentives for different types of research, as well as use of consent for homeless youths who are minors.     

高血压个体胰岛素抵抗发病状况的研究

目的 :探讨高血压个体胰岛素抵抗的发病状况以及与肥胖、血脂紊乱之间的关系。方法 :对 136例 4 0岁以上住院和门诊高血压病人以及 10 4例保健科健康体检者抽取空腹血糖和血浆胰岛素 ,将前者分为 4个亚组 ,即正常体重单纯高血压亚组、正常体重高血压合并高甘油三脂 (TG) /低高密度脂蛋白胆固醇 (HDL C)亚组、超重 /肥胖单纯高血压亚组及超重 /肥胖高血压合并高TG/低HDL C亚组、用稳态模式评估法的胰岛素抵抗指数 (HOMA IR)评价胰岛素抵抗 ,计算出各组胰岛素抵抗发病率。结果 :校正年龄、性别、体重指数等因素后 ,伴有高TG的各血脂异常亚组的胰岛素抵抗指数升高较明显。结论 :血脂紊乱是导致高血压个体胰岛素抵抗的主要因素     

Practical strategies for promoting full inclusion of individuals with disabilities in community-based participatory intervention research

Community-based participatory research (CBPR) with disability communities is directed toward facilitating full inclusion of individuals with disabilities and disability community organizations in all aspects of the research process. Within the CBPR framework, academic-disability community partners may value and wish to use experimental designs to test interventions. Being aware of and proactively addressing barriers and challenges to inclusion in the areas of human resources, training, productivity, accommodation, and inadequate funding for disability community organizations are critical for success. Some of the strategies discussed in this article for addressing these challenges include creating redundant systems, providing benefits counseling and individualized payment options for employment, designing trainings to be disability friendly, and carefully considering selection of partners in light of available community resources.     

本科学历护士对护理科研认识和体验的质性研究

目的 了解本科学历护士对护理科研的认知以及在进行科研过程中的体验和感受,为制定科学合理的科研培训方案提供参考和依据。 方法 采用目的抽样的方法,对13名本科学历护士进行半结构式访谈,并采用Colaizzi分析法对访谈资料进行分析、归纳及提炼主题。 结果 在对护理科研认知方面提炼出4个主题,包括肯定护理科研重要作用、影响科研因素较多、科研感受复杂以及渴望社会支持。 结论 护理管理者应充分了解本科学历护士对护理科研的认知,重视其护理科研体验,加强科研培训,完善团队及社会支持体系建设,以提高其科研积极性和科研质量。     

对老年痴呆亲属照顾者真实体验的质性研究

目的了解老年痴呆亲属照顾者在看护期间内心深处的感受,以探索促进照顾者心身健康的相关因素。方法质性描述。采用深度访谈法收集11名照顾者的资料,并用现象学分析法进行分析。结果通过阅读、分析、反思、分类和提炼主题,得出5个主题:①心理负担过重;②照顾任务繁重;③经济负担过重;④缺乏看护技能;⑤被患者的护理问题困扰。结论在研究和关注老年痴呆问题时,不应忽视亲属照顾者所承受的负担及相关问题,呼吁社会及政府提供行之有效的干预手段来帮助他们。     

Football reminiscence for men with dementia: lessons from a realistic evaluation

Football reminiscence for men with dementia: lessons from a realistic evaluation A major challenge of studies of non pharmacological dementia interventions is the likely modest intervention effect size and difficulties collecting data from individuals with behavioural, psychological and communicative symptoms. The reported Realist Evaluation is built around sets of contextually comparable case studies of Football Focussed Reminiscence for men with dementia. The study aim was to evaluate benefits of football related reminiscence for individuals and family carers. Four case studies were constructed; two community groups, one nursing home groups and individual sessions within their family home. Data was collected as field notes from non-participation observation of reminiscence sessions, notes of conversations with people with dementia, audio recorded interviews with family members, facilitators and dementia link workers. The analysis was framed around identification and extraction of data pertaining to Context-Mechanism-Outcome configurations within each data set, and patterns and threads were compared across the cases. An important finding was that anticipation of pleasure in tandem with a sense of continuity appeared to be important mechanisms triggering optimal benefit. The paper explores design considerations, project delivery experiences and the contribution that innovative theory driven research adds to the study of complex interventions including those with behavioural and communicative symptoms of dementia.