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31.

Problem

Clinical practice guidelines indicate that over 80% of women with a previous caesarean should be offered a planned vaginal birth after caesarean (VBAC), however only one third of eligible women choose to plan a VBAC. To support informed choices for birth after caesarean, it is necessary to understand the factors that influence women’s decision-making.

Aim

The goal of this study was to explore attitudes towards and experiences with decision-making for mode of delivery after caesarean from the perspectives of Canadian women.

Methods

In-depth, semi-structured interviews were conducted with 23 women eligible for VBAC in three rural and two urban communities in British Columbia, Canada, during summer 2015. Constructivist grounded theory informed iterative data collection and analysis.

Findings

Women’s decision-making experiences were a process of “seeking control in the midst of uncertainty.” Women formed early preferences for mode of delivery after their primary caesareans and engaged in careful deliberation during their inter-pregnancy interval, consisting of: reflecting on their birth, clarifying their values, becoming informed, considering the feasibility of options, deliberating with the care team, and making an actual choice. Women struggled to make trade-offs between having a healthy baby and social attributes of delivery, such as uninterrupted bonding with their newborn.

Conclusions

Women begin decision-making for birth after caesarean earlier than previously reported and their choices are influenced by personal experience and psychosocial concerns. Future interventions to support choice of mode of delivery should begin early after the primary caesarean, to reflect when women begin to form preferences.  相似文献   
32.
This study identifies the conceptual underpinnings of effective school-based drug education practice in light of contemporary research evidence and the practical experience of a broad range of drug education stakeholders. The research involved a review of the literature, a national survey of 210 Australian teachers and others involved in drug education, and structured interviews with 22 key Australian drug education policy stakeholders. The findings from this research have been distilled and presented as a list of 16 principles that underpin effective drug education. In broad terms, drug education should be evidence-based, developmentally appropriate, sequential, and contextual. Programs should be initiated before drug use commences. Strategies should be linked to goals and should incorporate harm minimization. Teaching should be interactive and use peer leaders. The role of the classroom teacher is central. Certain program content is important, as is social and resistance skills training. Community values, the social context of use, and the nature of drug harm have to be addressed. Coverage needs to be adequate and supported by follow-up. It is envisaged that these principles will provide all those involved in the drug education field with a set of up-to-date, research-based guidelines against which to reference decisions on program design, selection, implementation, and evaluation.  相似文献   
33.
Over the last decade, marriage and family therapy (MFT) researchers have developed a growing interest in qualitative research. In this article, we review substantive and methodological trends in the published qualitative studies within the MFT field. The research is compared and contrasted in the following areas: General topic, epistemological theory, methodological theory, sampling and sample, data collection, data analysis procedure, and approach to reliability and validity. We also provide recommendations for future research.  相似文献   
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This article explores the relationships between housing and health inequalities. It locates housing within a network of health resources that can either promote well-being or increase susceptibility to disease. Housing thereby contributes to the accumulation, or depletion, of the health capital of individuals and communities. Qualitative interviews in three British regions help specify the links between health capital, on the one hand, and the network of resources, environments, events, institutions, and social relations comprising the housing system, on the other. The findings show why, from a health capital/health-resources-network perspective, a segment of the housing system (owner-occupation) that generally appears therapeutic can have the opposite effect for people whose resilience is low or whose health is in decline .  相似文献   
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La présente étude a pour objet la relation qui existe entre une attitude verbale à l'égard de la légalisation de la marijuana et la façon de se comporter manifestement opposée à cette attitude. Le sujet principal de l'étude avait donc pour but de déterminer si oui ou non le comportement d'une personne reste le même lorsque, dans la cas d'une situation d'intérraction, on ajoute des données variées de participation sociale et certaines attitudes dictées par les convenances. Est abordée aussi la question de savoir si oui ou non le besoin d'une personne de se sentir approuvée a quelque effet sur la constance des résultats. En conclusion, on s'aperçoit que la participation sociale, les attitudes de convenance et le besoin d'aquiescement, influent fortement sur les relations: ‘attitude —comportement.’ The present study is concerned with the relationship between verbal attitudes toward the legalization of marijuana and the overt behaviour expressed toward this attitude object. The main concern is to determine whether or not an individual's behaviour will remain consistent when variations of ‘social participation’ and ‘attitudinal congruence’ are injected into an interactional situation. Also investigated is the question of whether or not the personality variable of ‘need for approval’ has any effect on the consistency issue. The findings suggest that social participation, attitudinal congruence and the individual's need for approval are powerful influences in attitude-behaviour relationships.  相似文献   
38.
Preserving the autonomy of individuals with intellectual disabilities in group work is challenging. Group workers often experience inadequate guidance about autonomy—an individual's capability to act independently without influence by others. Group workers can enhance autonomy through group activities that promote self-efficacy, empowerment, and the ability to make decisions. Fostering autonomy requires that the group workers be knowledgeable and aware of personal biases, analyzing their expectations and actions. To promote the autonomy of persons with intellectual disabilities in group work practice, the authors make recommendations to strengthen the IASWG Standards for Social Work Practice with Groups in this area.  相似文献   
39.
This paper provides a review of the reception of Foucault's later work on biopolitics within management and organization studies and contrasts this with the reception of these ideas in sister fields of research in the social sciences. In his later work, Foucault developed original conceptions of power, including ‘biopolitics’, ‘the apparatus of security’ and ‘neo‐liberal governmentality’, which marked a departure from his conception of disciplinary power. This paper explores these concepts and elaborates the implications of these ideas for management studies. The structure of this argument is divided as follows. The first section outlines Foucault's concept of biopolitics and neo‐liberal governmentality, distinguishing these systems of control clearly from the concept of disciplinary power. The second section then undertakes a synthesis and evaluation of the extent to which these ideas have been developed within the field of management and organization studies. The final section provides a discussion of how these concepts have been used within other social sciences, distinguishing between three key approaches to their development in terms of: (a) the concept of governmentality; (b) the concept of immaterial labour; and (c) the concept of biocapital. Based on this analysis, a framework is developed which can serve as a basis for future research into the significance of these new biopolitical systems of control for management studies.  相似文献   
40.
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