Browsing by Subject "qualitative"
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Item Embargo Finding the Context in Self-Regulation: Definition, Applications, and Implications of a Context-Based Organizational Framework(2024) Chardulo Dias De Andrade, FernandaThere is wide variation in the empirical evidence of a relationship between self-regulation and health-related behaviors. This variability owes to, at least in part, a lack of systematic distinction between instances in which self-regulation could influence behavior and instances in which it could not, regardless of a person’s standing on this construct. Without this distinction, the true influence of self-regulation on behavior is aggregated with irrelevant relationships. This dissertation introduces a framework that systematically organizes the context into features common to and shared by self-regulation strategies, with the aim of improving the understanding of when and how self-regulation influences behavior. To start, Chapter 1 provides a brief overview of the ways in which context has been studied in social psychology and personality fields. Based on this summary, Chapter 2 introduces the framework for describing and organizing the features of contexts and then applies the framework to four self-regulation strategies. Chapter 2 ends with an illustration of how the framework can help identify when and how self-regulation can influence behavior. Chapters 3 through 6 empirically examine this framework by presenting the accepted versions of four published manuscripts. Specifically, Chapter 3 reports a qualitative study of descriptions of self-control challenges and their consequences, demonstrating that the contexts in which people make decisions about their behaviors shape what is possible, desirable, and overall adaptive. Chapter 4 reports a meta-analysis of the published and unpublished literature on the relationship between self-control and several behaviors within the domains of physical activity, healthy eating, and healthier sleep. The chapter discusses possible explanations for the variable associations between self-control and behaviors in these domains, including a lack of fit between what self-control assumes and what studies assess and the possibility that certain behaviors—as they were defined—relied on strategies other than self-control. Chapters 5 and 6 build upon Chapter 4 by examining how contextual changes shift the dynamic between self-regulation and behavior. Specifically, Chapter 5 reports a study that examined the influence of context on the relationship between self-regulation strategies and ten categories of behaviors. This study showed that context changes influenced the extent to which behaviors were habitual or routine-like, but that self-control reduced the likelihood that behavior changed along with the severity of context changes. Chapter 6 reports a secondary analysis of longitudinal data on substance use in adolescence. This study examined whether the context could overwhelm the protective effect of self-control against adolescent alcohol use. To conclude this dissertation, Chapter 7 offers a general discussion of how my work has investigated the various features of the proposed framework, how the proposed framework may be extended, and the directions of my future research.
Item Open Access Living with long-term consequences: Experience of follow-up care and support needs among Asian long-term colorectal cancer survivors.(Psycho-oncology, 2020-10) Yoon, Sungwon; Chua, Teck Beng; Tan, Iain Beehuat; Matchar, David; Ong, Marcus Eng Hock; Tan, EmileObjectives
This study aimed to provide an in-depth exploration of follow-up care experiences and supportive care needs in long-term colorectal cancer (CRC) survivors within multiethnic Asian communities.Methods
Semi-structured in-depth interviews were conducted on a purposive sample of 30 long-term CRC survivors who had completed all treatment without recurrence ranging 2 to 17 years in Singapore. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was conducted following grounded theory approach.Results
Four themes represented the experience of the Asian long-term CRC survivors: (a) living with long-term consequences, (b) dealing with unceasing adaptation demands, (c) navigating a healthcare journey with limited direction, (d) regaining mastery through adversity. CRC and its treatment had profound physical impacts on some long-term survivors and these effected their psychological well-being. A sense of abandonment and vulnerability following the cessation of a 5-year follow-up care was repeatedly expressed. Participants defined recovery from CRC as not merely surviving but also having high physical function and full independence. They often sought less conventional remedies and medicine based on cultural beliefs rather than current evidence. Participants noted pervasive social stigma associated with CRC that impeded their inclusion in the workforce.Conclusions
Asian long-term CRC survivors experienced multiple challenges and needs relating to the care experience, information provision and workforce stigmatization, and several of which were unique to the Asian context. Future work will need to consider the implementation of culturally tailored cancer survivorship care plans that incorporate the specific needs of Asian CRC survivors.Item Open Access Multifactorial influences underpinning a decision on COVID-19 vaccination among healthcare workers: a qualitative analysis.(Human vaccines & immunotherapeutics, 2022-06-10) Yoon, Sungwon; Goh, Hendra; Matchar, David; Sung, Sharon C; Lum, Elaine; Lam, Sean Shao Wei; Low, Jenny Guek Hong; Chua, Terrance; Graves, Nicholas; Ong, Marcus EhCOVID-19 vaccination in healthcare workers (HCW) is essential for improved patient safety and resilience of health systems. Despite growing body of literature on the perceptions of COVID vaccines in HCWs, existing studies tend to focus on reasons for 'refusing' the vaccines, using surveys almost exclusively. To gain a more nuanced understanding, we explored multifactorial influences underpinning a decision on vaccination and suggestions for decision support to improve vaccine uptake among HCWs in the early phase of vaccination rollout. Semi-structured interviews were undertaken with thirty-three HCWs in Singapore. Transcribed data was thematically analyzed. Decisions to accept vaccines were underpinned by a desire to protect patients primarily driven by a sense of professional integrity, collective responsibility to protect others, confidence in health authorities and a desire to return to a pre-pandemic way of life. However, there were prevailing concerns with respect to the vaccines, including long-term benefits, safety and efficacy, that hampered a decision. Inadequate information and social media representation of vaccination appeared to add to negative beliefs, impeding a decision to accept while low perceived susceptibility played a moderate role in the decision to delay or decline vaccination. Participants made valuable suggestions to bolster vaccination. Our findings support an approach to improving vaccine uptake in HCWs that features routine tracking and transparent updates on vaccination status, use of institutional platforms for sharing of experience, assuring contingency management plans and tailored communications to emphasize the duty of care and positive outlook associated with vaccination.Item Open Access The Missed Opportunity of Patient-Centered Medical Homes to Thrive in an Asian Context.(International journal of environmental research and public health, 2021-02-13) Surendran, Shilpa; Foo, Chuan De; Tam, Chen Hee; Ho, Elaine Qiao Ying; Matchar, David Bruce; Car, Josip; Koh, Gerald Choon HuatIn recent years, there is growing interest internationally to implement patient-centered medical homes (PCMHs), and Singapore is no exception. However, studies understanding the influence of contextual policy factors on the implementation of PCMHs are limited. We conducted 10 semi-structured in-depth interviews with general practitioners working in seven out of the nine PCMHs. Audio recordings were transcribed and analyzed by two study team members in NVivo 12 Software using grounded theory techniques. Power dynamics between the stakeholders and lack of shared decision-making among them in selecting the locale of the PCMH and formulating the practice fee and pharmacy structure were the key factors which negatively affected the implementation of PCMHs on a larger scale. Over time, lack of funding to hire dedicated staff to transfer patients and misalignment of various stakeholders' interest to other right-siting programs also resulted in low number of patients with chronic conditions and revenue. Countries seeking to implement a successful PCMH may benefit from building trust and relationship between stakeholders, engaging in shared decision-making, ongoing cost-efficiency efforts, and formulating a clear delineation of responsibilities between stakeholders. For a healthcare delivery model to succeed in the primary care landscape, policies should be developed keeping mind the realities of primary care practice.