Background: Experience-based knowing in general practice includes advanced interpretation of subjective, complex and particular phenomena in a social context. Enabling different metapositions for reflexivity may provide the accountability needed for such knowing to be recognized as evidence-based practice.
Objective: To demonstrate and discuss the potential of substantive theories to enhance interpretation of complex challenges in clinical knowing in general practice.
Methods: We present a fictional case to demonstrate how interdisciplinary substantive theories, with a relevant and specific match to concrete questions, can situate the clinical interaction at an accountable platform. A female patient with Parkinson's disease consults her GP complaining that the disease is restraining her life and threatening her future. The GP has some new ideas from Bandura's theory of self-efficacy and introduces the patient to strategies for further action.
Findings: The case presents an example of how a relevant substantive theory may offer the GP: 1) a sharper focus for achievement: recognising the issues of fear and identity in chronic, progressive illness, 2) a subsequent position for individualized understanding of adequate strategies: encouraging physical and social activity in a well-known context, and 3) an invitation to consider further possibilities: finding ways to alleviate the burden of fear and progressive decline; engaging in joyful living.
Implications: General practice knowledge embraces a diversity of sources with different evidence power. The transparency mediated to clinical practice when supported by relevant substantive theories may contribute to recognition of experience-based knowing as evidence-based practice.
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http://dx.doi.org/10.1080/02813432.2024.2368852 | DOI Listing |
Alzheimers Dement
December 2024
University of Pennsylvania, Philadelphia, PA, USA.
Background: People living with Alzheimer's disease and related dementias confront numerous decisions that affect their wellbeing, as well as that of their family members. Research demonstrates the importance of family involvement in such decision making, yet there is a lack of knowledge about how patients and families work together to make decisions and how families can best provide decisional support.
Methods: Semi-structured interviews were conducted separately with 15 patients diagnosed with mild cognitive impairment (MCI) or mild dementia, identified through a National Institute on Aging-funded Alzheimer's Disease Research Center, and 14 care partners.
J Community Med Public Health
September 2024
Center for Health Research, Kaiser Permanente Northwest, 3800 N Interstate Avenue, Portland, OR 97227, USA.
Background: Health behavior change theories provide a conceptual basis to promote physical activity, one of which is the Self-Determination Theory (SDT). This cross-sectional study compared SDT constructs, specifically exercise goal setting, exercise planning, and outcome expectations, with objectively assessed Moderate-To-Vigorous Physical Activity (MVPA) among a demographically diverse cohort of adults.
Methods: Participants were 18 to 74 years with prediabetes or type 2 diabetes not prescribed insulin and were physically inactive by self-report.
Nurse Educ Today
December 2024
Faculty of Nursing, University of Calgary, Canada.
Background: Nursing students are tasked with connecting theoretical knowledge with clinical practice to ensure patient safety and provide quality care. However, there is a distinct lack of research on nursing student learning transfer. More exploration and research are necessary to understand how nursing students apply their learning in complex and evolving clinical situations.
View Article and Find Full Text PDFAm J Community Psychol
December 2024
School of Education and Human Development, University of Miami, Coral Gables, Florida, USA.
Understanding the experiences of unaccompanied youths in refugee foster care is important to tailor such systems to support the complex needs and desires of these youth. This instrumental case study sought to understand how a cohort of unaccompanied refugee youth experience refugee foster care as they navigate the "in-betweenness" of adolescence. Eight youth (ages 17-21) from Guatemala and Honduras, nine foster parents, and two staff were interviewed.
View Article and Find Full Text PDFBMC Palliat Care
December 2024
University of Northumbria at Newcastle, Newcastle Upon Tyne, England.
Background: For many patients and caregivers, attending to dying and death at home will be a new and fearful experience. This research brings new evidence on the central support of the Rapid Response Service (RRS), provided to those who chose to die at home. RRS's are variable, although all seek to avoid unwanted hospital admissions and to respond flexibly to suit individual preferences for support.
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