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Background:When patients experience unexpected events, some health professionals become “second victims”. These care givers feel as though they have failed the patient, second guessing clinical skills, knowledge base and career choice. Although some information exists, a complete understanding of this phenomenon is essential to design and test supportive interventions that achieve a healthy recovery.Methods:The purpose of this article is to report interview findings with 31 second victims. After institutional review board approval, second victim volunteers representing different professional groups were solicited for private, hour-long interviews. The semistructured interview covered demographics, participant recount of event, symptoms experienced and recommendations for improving institutional support. After interviews, transcripts were analyzed independently for themes, followed by group deliberation and reflective use with current victims.Results:Participants experienced various symptoms that did not differ by sex or professional group. Our analysis identified six stages that delineate the natural history of the second victim phenomenon. These are (1) chaos and accident response, (2) intrusive reflections, (3) restoring personal integrity, (4) enduring the inquisition, (5) obtaining emotional first aid and (6) moving on. We defined the characteristics and typical questions second victims are desperate to have answered during these stages. Several reported that involvement in improvement work or patient safety advocacy helped them to once again enjoy their work.Conclusions:We now believe the post-event trajectory is largely predictable. Institutional programs could be developed to successfully screen at-risk professionals immediately after an event, and appropriate support could be deployed to expedite recovery and mitigate adverse career outcomes.

When choosing clinicians, patients often rely on comments available on consumer websites. The authors argue that public reporting of standardized patient satisfaction surveys could be improved if they were augmented by narrative accounts of patients' experiences. Sometimes a picture is not worth a thousand words — or even a few sentences. So it appears for the public reporting of patients’ experiences with doctors and clinics. Millions of dollars have been invested in the collection of standardized, quantitative measures of patient experience and in reporting them with the use of colorful icons that highlight the best and worst performers. 1 However, consumers’ use of these measures remains limited because of a lack of timely exposure, doubts about the trustworthiness and relevance of metrics, and the complexity of reports and websites that incorporate multiple ratings. 1 – 4 By contrast, websites . . .

Information about potential danger is a central component of many rumors, urban legends, ritual prescriptions, religious prohibitions and witchcraft crazes. We investigate a potential factor in the cultural success of such material, namely that a source of threat-related information may be intuitively judged as more competent than a source that does not convey such information. In five studies, we asked participants to judge which of two sources of information, only one of which conveyed threat-related information, was more knowledgeable. Results suggest that mention of potential danger makes a source appear more competent than others, that the effect is not due to a general negativity bias, and that it concerns competence rather than a more generally positive evaluation of the source.

Diabetes always was a marathon, however the incline of the track steepens noticeably by the day. Doctors and patients press up that incline together, panting, often daunted, but ever striving.

There is controversy about the nature of women's sexual desire. The aim was to explore narrative descriptions of sexual desire among mid-aged women in hopes of clarifying how women define and experience sexual desire, and how these might differ among women with and without female sexual arousal disorder (FSAD). Mid-aged women without (age: M = 45, n = 12) and with (age: M = 55, n = 10) FSAD took part in in-depth interviews that invited them to share personal stories of sexual desire. Women also completed the Brief Index of Sexual Functioning and the Female Sexual Function Index (FSFI). Women in both groups described sexual desire in genital, non-genital physical, and in cognitive-emotional terms. Although women with FSAD had low ratings of sexual desire on the FSFI, they could recall recent experiences of desire that did not differ from the control group. Women identified a number of triggers of desire including touch, memories, and partner's responses-the latter of which acted as both a trigger and an inhibitor. Women in the control group were more likely to express conflation about the distinction between desire and arousal. Among the different \"objects\" of women's desire, most women acknowledged emotional connection as most important.

Background Continuity of care has been explored largely from academic and service provider perspectives, and in relation to adult patient/client groups. We interviewed parents of children with complex chronic health conditions to examine how their experiences and perceptions of continuity of care fit with these perspectives; and to identify the salient factors in the experience of, and factors contributing to, continuity in this population. Methods Parents of 47 elementary school-aged children with spina bifida, Down syndrome, attention-deficit/hyperactivity disorder, Duchenne muscular dystrophy or cystic fibrosis participated in semi-structured interviews. Parents described and mapped the pattern of their interactions with service providers over time in all domains relevant to their child's health, well-being, and development (medical, rehabilitational, educational, and social supportive services), with particular attention paid to their perceptions of connectedness or coherency in these interactions. Verbatim transcripts were analyzed thematically using a framework approach to impose structure regarding parents' perspectives on continuity of care. Results Existing academic concepts of relational, informational and management continuity were all discernable in parents' narratives. A thorough knowledge of the child on the part of service providers emerged as extremely important to parents; such knowledge was underpinned by continuity of personal relationships, principally, and also by written information. For this population, notions of continuity extend to the full range of service providers these children and families need to achieve optimal health status, and are not limited to physicians and nurses. Communication among providers was seen as integral to perceived continuity. Compartmentalization of services and information led to parents assuming a necessary, though at times, uncomfortable, coordinating role. Geographic factors, institutional structures and practices, provider attitudes, and, on occasion, parent preferences and judgments, were all found to create barriers to \"seamless\" management and provision of care continuity across providers, settings, and sectors. Conclusions These findings add new perspectives to the understanding of continuity within chronically ill children's health care. They are relevant to contemporary initiatives to improve continuity of services to children with special health care needs, demonstrate the need for parental support of their important role in maintaining continuity, and suggest avenues for further research.

Funny, how easily we're disorientated by feeling. After all, it's probably what compels us to practise medicine in the first place: feeling for other lives, patients' lives vicariously felt, tugging at us and insisting we reason, act, and care well.

The aim of this study was to inform the development of a questionnaire to assess a woman's tendency to respond with sexual excitation/inhibition in different situations. Nine focus groups, involving 80 women (M age = 34.3 years; range, 18-84), were conducted. Women described a wide range of physical (genital and nongenital), cognitive/emotional, and behavioral cues to arousal. The relationship between sexual interest (desire) and sexual arousal was complex; sexual interest was reported as sometimes preceding arousal, but at other times following it. Many women did not clearly differentiate between arousal and interest. Qualitative data on the factors that women perceived as \"enhancers\" and \"inhibitors\" of sexual arousal are presented, with a focus on the following themes: feelings about one's body; concern about reputation; unwanted pregnancy/contraception; feeling desired versus feeling used by a partner; feeling accepted by a partner; style of approach/initiation; and negative mood. The findings can help inform conceptualizations of sexual arousal in women.

Hearing knocking at my door and with urgent messages flashing on the computer screen, I tried to close the chat by saying goodbye, but I also managed to gush, \"Love you!\"-I had never met him. [...]humour often gets people through the stoma problems, the tiresome ongoing need for injections, or the readmission to hospital.

The aim of this study was to identify the role of exposure to family violence and parental discipline in the development of child-to-parent violence (CPV). A qualitative in-depth interview design was used. Fifteen adolescents (10 boys) who have perpetrated CPV (Mage = 16 years; SDage = 1.33 years) and their parents or foster parents took part in the study. Individually, they answered questions about exposure to violence and parenting practices. Results suggest that adolescents were frequently direct victims and also witnesses of violence. Furthermore, emotional neglect in the parent-child relationship was frequent and families were characterized by rules that are not consistently implemented. Different forms of violence seem to coexist in these families, and CPV should also be a target in the interventions.