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institutional ethnography

Marie L Campbell, Janet M Rankin
Institutional ethnography (IE) is used to examine transformations in a professional nurse's work associated with her engagement with a hospital's electronic health record (EHR) which is being updated to integrate professional caregiving and produce more efficient and effective health care. We review in the technical and scholarly literature the practices and promises of information technology and, especially of its applications in health care, finding useful the more critical and analytic perspectives. Among the latter, scholarship on the activities of economising is important to our inquiry into the actual activities that transform 'things' (in our case, nursing knowledge and action) into calculable information for objective and financially relevant decision-making...
October 10, 2016: Sociology of Health & Illness
Alex Abramovich
This study examined the experiences that lesbian, gay, bisexual, transgender, queer, questioning, and 2-Spirit (LGBTQ2S) homeless youth have in shelters and the disjunctures that occur for this population in Toronto's shelter system. The attitudes and behaviours of shelter workers and management towards LGBTQ2S youth were also explored. A Critical Action Research approach, informed by Critical Ethnography and Institutional Ethnography was employed. Thirty-three people participated in this study in the Greater Toronto Area...
October 3, 2016: Journal of Homosexuality
Stella L Ng, Laura Bisaillon, Fiona Webster
CONTEXT: Qualitative, social science approaches to research have surged in popularity within health professions education (HPE) over the past decade. Institutional ethnography (IE) offers the field another sociological approach to inquiry. Although widely used in nursing and health care research, IE remains relatively uncommon in the HPE research community. This article provides a brief introduction to IE and suggests why HPE researchers may wish to consider it for future studies. METHODS: Part 1 of this paper presents IE's conceptual grounding in: (i) the entry point to inquiry ('materiality'), (ii) a generous definition of 'work' and (iii) a focus on how 'texts' such as policies, forms and written protocols influence activity...
September 1, 2016: Medical Education
Tirsa Colmenares-Roa, Gabriela Huerta-Sil, Claudia Infante-Castañeda, Leticia Lino-Pérez, Everardo Alvarez-Hernández, Ingris Peláez-Ballestas
The aim of this article was to describe and analyze the doctor-patient relationship between fibromyalgia patients and rheumatologists in public and private health care contexts within the Mexican health care system. This medical anthropological study drew on hospital ethnography and patients' illness narratives, as well as the experiences of rheumatologists from both types of health care services. The findings show how each type of medical care subsystem shape different relationships between patients and doctors...
October 2016: Qualitative Health Research
Patricia Kingori, René Gerrets
Data fabrication, incorrect collection strategies and poor data management, are considered detrimental to high-quality scientific research. While poor data management have been occasionally excused, fabrication constitutes a cardinal sin - scientific misconduct. Scholarly examinations of fabrication usually seek to expose and capture its prevalence and, less frequently, its consequences and causes. Most accounts centre on high-income countries, individual senior researchers and scientists who are portrayed as irrational, immoral or deceptive...
October 2016: Social Science & Medicine
Leslie Rittenmeyer, Dolores Huffman, Michael Alagna, Ellen Moore
BACKGROUND: "Watchful waiting" or "active surveillance" is an alternative approach in the medical management of certain diseases. Most often considered appropriate as an approach to treatment for low-risk prostate cancer, it is also found in the literature in breast cancer surveillance, urinary lithiasis, lymphocytic leukemia, depression and small renal tumors. OBJECTIVES: This systematic review sought to:Identify and synthesize the best available international evidence on the experience of adults who choose watchful waiting or active surveillance as an approach to medical treatment...
February 2016: JBI Database of Systematic Reviews and Implementation Reports
Andrea Petriwskyj, Deborah Parker, Siobhan O'Dwyer, Wendy Moyle, Nikki Nucifora
BACKGROUND: Recent studies have indicated that family caregivers of people with dementia have higher rates of depression, anxiety and hopelessness, as well as higher levels of burden, stress and distress. Not all caregivers, however, succumb to the negative effects of caring. Caregivers who are able to recover from, resist or adapt to the physical and psychological demands of caring can be considered "resilient". OBJECTIVES: The objective of this review was to examine the existing evidence regarding interventions for building resilience in family caregivers of people living with dementia...
June 2016: JBI Database of Systematic Reviews and Implementation Reports
Asahngwa Tanywe, Chelea Matchawe, Ritin Fernandez
BACKGROUND: Epilepsy is a global public health problem affecting people of all ages, sex, races, nations and social class. The majority of the 50 million people with epilepsy live in developing countries, with a prevalence rate of five to 10 people per 1000. The disease poses an enormous psychological, social and economic burden on patients. An estimated 90% of people with epilepsy in developing countries do not receive treatment due to sociocultural, economic and political factors. Current treatment interventions are limited to the clinical management of the disease and are largely driven by the healthcare provider's perspective, ignoring the experiences of people living with epilepsy (PLWE)...
May 2016: JBI Database of Systematic Reviews and Implementation Reports
Kylie Eddy, Zoe Jordan, Matthew Stephenson
BACKGROUND: Teamwork is seen as an important element of patient care in acute hospital settings. The complexity of the journey of care for patients highlights the need for health professionals to collaborate and communicate clearly with each other. Health organizations in western countries are committed to improving patient safety through education of staff and teamwork education programs have been integral to this focus. There are no current systematic reviews of the experience of health professionals who participate in teamwork education in acute hospital settings...
April 2016: JBI Database of Systematic Reviews and Implementation Reports
Inge Schjoedt, Irene Sommer, Merete Bender Bjerrum
BACKGROUND: Fatigue, a common and distressing symptom of heart failure, is a non-specific, invisible and subjective experience, which is difficult to describe and for which there are no effective interventions. Fatigue negatively impacts on patients' everyday life, prognosis and quality of life, therefore it is important that patients can manage, monitor and respond to changes in fatigue. To cope with fatigue patients may need or seek advice on self-management strategies. OBJECTIVES: To synthesize the best available evidence on the experiences and management of fatigue in everyday life among adult patients with stable heart failure...
March 2016: JBI Database of Systematic Reviews and Implementation Reports
Quinn Grundy, Ruth E Malone
The "as-if" world of nursing is a well-constructed, institutionally preserved and defended myth that asserts clinicians who are "just nurses" do not make decisions in the absence of "doctor's orders." Drawing on data from an ethnography exploring the interactions between nurses and industry, we explore the finding that many nurses did not identify as "decision makers" and were mystified by the attention of sales representatives. Many nurses experienced marketing as benign as there was no "decision" to sway...
August 11, 2016: ANS. Advances in Nursing Science
Rhiannon Evans, Chloe Hurrell
BACKGROUND: Evidence reports that schools influence children and young people's health behaviours across a range of outcomes. However there remains limited understanding of the mechanisms through which institutional features may structure self-harm and suicide. This paper reports on a systematic review and meta-ethnography of qualitative research exploring how schools influence self-harm and suicide in students. METHODS: Systematic searches were conducted of nineteen databases from inception to June 2015...
2016: BMC Public Health
Craig M Dale, Jan E Angus, Tasnim Sinuff, Louise Rose
BACKGROUND: Oral care plays a clear and important role in the prevention of ventilator-associated pneumonia. However, few studies have explored the actual work of oral care by nurses in the intensive care unit. OBJECTIVE: To explore intensive care nurses' knowledge of and experiences with the delivery of oral care to reveal less visible aspects of this work. METHODS: In an institutional ethnography, go-along and semistructured interview methods were used to explore the oral care practices and perspectives of 12 bedside nurses and 12 interprofessional (intensivist, allied health, and management) participants in an intensive care unit at a large urban teaching hospital in Ontario, Canada...
May 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Lina Nilsson, Sara Eriksén, Christel Borg
AIM: To describe and obtain a deeper understanding of social challenges and their influence on the implementation process when implementing Information systems in a Swedish health-care organisation. BACKGROUND: Despite positive effects when implementing Information systems in health-care organisations, there are difficulties in the implementation process. Nurses' experiences of being neglected have been dismissed as reasons for setbacks in implementation. METHODS: An Institutional Ethnography design was used...
September 2016: Journal of Nursing Management
P K Franklin
OBJECTIVES: This article reviews how Organized Civil Society (OCS) groups in the field of public health work across the boundaries between European institutions and policy areas. In particular, it explores 1) how the Health in All Policies (HiAP) approach is conducted by these groups informally within the formal governance structures, and 2) how this advocacy work creates space for public health within the broader political determinants of health. STUDY DESIGN: A qualitative mixed-methods framework...
July 2016: Public Health
Michael Nijhawan
This paper explores the institutional and everyday conditions that define 'deportability' as a lived experience at the social margin. Focusing on Germany as a paradigmatic case for the new immigration and deportation policies of the new Europe, it investigates state rationales through which certain bodies are produced as 'deportable' and takes a specific look at the role of medicine in this matter. The first part of the text traces a genealogy of various forms of medical intervention. Based on ethnographic fieldwork carried out from September 2003 to April 2005 in an institutional setting in Frankfurt/Main, the main focus of the discussion is the situation of traumatized refugees and asylum seekers, for whom German asylum and immigration law reserves special conditions...
December 2005: Anthropology & Medicine
Diana Rose, Dee MacDonald, Aaron Wilson, Mike Crawford, Marian Barnes, Edward Omeni
BACKGROUND: Since 1990, health policy in England has stressed the importance of user involvement in shaping and delivering services. AIMS: To explore mental health service user-led organisations (ULOs) in England, as they interact with decision-makers to bring about change desired by them with a focus on institutional norms behaviour and specialised knowledge impacting service users' relationships with services. METHOD: An ethnography of five ULOs in two provider organisations (NHS Trusts) including observing their meetings and interactions with decision-makers, conducting in-depth interviews and collecting reflective diaries kept by two members of each group...
June 2016: Journal of Mental Health
Madrean M Schober, Kate Gerrish, Ann McDonnell
AIM: To report on a study examining policy development for advanced practice nursing from intent of policy to realization in practice. BACKGROUND: Inclusion of advanced practice nursing roles in the healthcare workforce is a worldwide trend. Optimal advanced nursing practice requires supportive policies. Little is known about how policy is developed and implemented. DESIGN: Ethnography using an instrumental case study approach was selected to give an in-depth understanding of the experiences of one country (Singapore) to contribute to insight into development elsewhere...
June 2016: Journal of Advanced Nursing
Alice Cruz
This paper questions the relation between human health and society from the case study of leprosy. To discuss the cultural and social mediator factors of both the experience of leprosy and outcomes of medical practices, it examines the biomedical twist in the dialectic between citizenship and public good that aimed to turn leprosy into a disease like any other, with the advent of multidrug therapy during the 1980s. Such analysis is based on a multisited ethnography, developed between 2008 and 2013 in two divergent contexts from the global South and North: Brazil, which remains the country in the world with the highest relative cases of leprosy, and Portugal, in which leprosy has become an imported disease...
January 2016: Clinics in Dermatology
Sienna Caspar, Pamela A Ratner, Alison Phinney, Karen MacKinnon
Person-centered care is heavily dependent on effective information exchange among health care team members. We explored the organizational systems that influence resident care attendants' (RCAs) access to care information in long-term care (LTC) settings. We conducted an institutional ethnography in three LTC facilities. Investigative methods included naturalistic observations, in-depth interviews, and textual analysis. Practical access to texts containing individualized care-related information (e.g., care plans) was dependent on job classification...
June 2016: Qualitative Health Research
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