Background And Objectives: Gerontologists have long been interested in longitudinal qualitative research (LQR), yet ambiguity remains about best practices. The purpose of this review was to conduct a qualitative evidence synthesis to identify strengths and limitations in existing gerontological LQR.
Research Design And Methods: We searched for studies published in English before September 2017, using longitudinal qualitative methods and focusing on gerontology.
Family-centered care (FCC) is vital for children with special health-care needs and serious chronic illnesses. Family-clinician collaboration and partnership formation are key FCC elements associated with improved health outcomes. However, FCC implementation barriers persist.
View Article and Find Full Text PDFFamily-clinician partnership including communication, trust, respect, and power leveling is essential in pediatrics. Our case study illustrates elements supporting/hindering partnership in a high-risk urban pediatric asthma clinic. Data from observation of a 100-minute visit were qualitatively analyzed by applying codes to themes, using family-centered principles.
View Article and Find Full Text PDFJ Appl Gerontol
October 2017
New ways of planning, assessing, and measuring cultural change are needed in long-term care. Much effort is focused on person-centered care; less attention is paid to achieving localized change. Long-term-care communities need innovative approaches for identifying local cultural features to preserve and others to reconfigure.
View Article and Find Full Text PDFMany childhood deaths in the United States occur in pediatric intensive care units (PICUs) and parents have special needs in this death context. As an interdisciplinary research team, we discuss conceptual and design issues encountered in creating a new instrument, the Bereaved Parent Needs Assessment-PICU, for assessing parents' needs in this setting. Using a qualitative approach, our team previously explored how the culture and related ways of providing care in one urban Midwestern children's hospital PICU affected parents' bereavement needs and experiences.
View Article and Find Full Text PDFObjectives: To evaluate the reliability and validity of the Bereaved Parent Needs Assessment, a new instrument to measure parents' needs and need fulfillment around the time of their child's death in the pediatric intensive care unit. We hypothesized that need fulfillment would be negatively related to complicated grief and positively related to quality of life during bereavement.
Design: Cross-sectional survey.
Background: Pediatric intensive care units (PICUs) are highly technological settings in which advanced care is used to restore health to critically ill children; however, they are also places where children die. Understanding the needs of parents bereaved in this setting is essential for better family care.
Objective: To systematically review the extant literature to identify instruments potentially useful for assessing the needs of parents bereaved in the PICU.
The pediatric intensive care unit (PICU) is a high-tech setting aimed at restoring health to critically ill children. When childhood death occurs in the PICU, it constitutes a special context for parent bereavement. The purpose of this interdisciplinary qualitative research was to gain a deeper understanding of parents' needs around the time of their child's death in the PICU.
View Article and Find Full Text PDFObjective: Many childhood deaths in the United States occur in intensive care settings. The environmental needs of parents experiencing their child's death in a pediatric intensive care unit must be understood to design facilities that comfort at the time of death and promote healing after loss. The purpose of this study is to explore parents' environmental needs during their child's hospitalization and death in the pediatric intensive care unit.
View Article and Find Full Text PDFTriangulation is a comparative strategy for examining data that strengthens qualitative and multi-method research. Despite the benefits of triangulation noted in the research methods literature, few concrete models for operationalization of protocols exist. Lack of documentation of explicit triangulation procedures is especially true in the area of bereavement research.
View Article and Find Full Text PDFFocus groups conducted with grieving people pose special challenges. However, this method can be successfully used in bereavement research especially when group interaction is central to the research aim. This article builds on key articles discussing ethical, methodological, logistical, and analytical issues in conducting focus groups with vulnerable populations (Owen, 2001; Seymour, Bellamy, Gott, Ahmedzai, & Clark, 2002).
View Article and Find Full Text PDFIn death-averse American society, the field of thanatology is often socially and academically isolating. The purpose of this article is to describe the experiences of a group of death scholars and share insights gained as members of an interdisciplinary team. They discuss the ways in which they have created a special "safe" space for death study collaboration.
View Article and Find Full Text PDFObjective: Death is common in pediatric intensive care units. A child's death can shatter parents' personal identities, disrupt their relationships, and challenge their worldviews. Spirituality is a human characteristic that engenders transcendence; seeks meaning, purpose, and connection to others; and helps to construct a coherent worldview.
View Article and Find Full Text PDFA study evaluating whether a lay public education program caused initiation of health-related behaviors was conducted at the Cleveland Clinic Foundation. Attendees of three individual "Health Talks" were surveyed: endometriosis (n = 78), men's health (n = 62) and cancer (n = 57). Participants were surveyed at three points: (a) before the talk, (b) immediately following the talk and (c) six weeks after the talk concerning their knowledge and health behaviors.
View Article and Find Full Text PDFIEEE Trans Biomed Eng
September 1990
This paper describes a new approach to ECG arrhythmia analysis based on "hidden Markov modeling" (HMM), a technique successfully used since the mid-1970's to model speech waveforms for automatic speech recognition. Many ventricular arrhythmias can be classified by detecting and analyzing QRS complexes and determining R-R intervals. Classification of supraventricular arrhythmias, however, often requires detection of the P wave in addition to the QRS complex.
View Article and Find Full Text PDFHidden Markov modelling (HMM) is a powerful stochastic modelling technique that has been successfully applied to automatic speech recognition problems. We are currently investigating the application of HMM to electrocardiographic signal analysis with the goal of improving ambulatory ECG analysis. The HMM approach specifies a Markov chain to model a "hidden" sequence that in this case is the underlying state of the heart.
View Article and Find Full Text PDFJ Electrocardiol
June 1991
Observation of low amplitude components in the ECG motivated our interest in time-sequenced adaptive filtering. This technique is applicable to signals that are cyclic in nature. Two simultaneously acquired signals are used in the technique.
View Article and Find Full Text PDFRecent studies have shown small deflections in the terminal portion of the QRS complex in postmyocardial infarction (MI) patients with episodes of potentially dangerous ventricular arrhythmias. These very small deflections, termed late potentials, are difficult to observe in ECGs acquired with electrodes on the chest surface owing to myoelectric noise from underlying muscle and other environmental noise. Most research into enhancement of late potentials has focused on signal averaging.
View Article and Find Full Text PDFA lead system was constructed to extract dipole and quadrupole components of cardiac sources from surface electrocardiograms (ECGs) recorded at 16 sites. The lead system was based on an analysis of a computerized model of a multipole equivalent cardiac generator in a homogeneous torso. The model was previously determined from extensive geometric and electrocardiographic data obtained from one subject.
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