This study aimed to explore the responses of Iranian young people with type 1 diabetes to the diabetes-related stigma. Conventional qualitative content analysis approach guided this inquiry. Volunteered people with type 1 diabetes were recruited by purposeful sampling from one endocrine and metabolism center in Isfahan in 2012. Data gathering was done through 17 individual unstructured in-depth interviews and 3 focus groups. Data saturation was achieved through 33 participants. The data were analyzed using qualitative content analysis. All participants acknowledged stigma and responded it in different ways, which was categorized in two main categories including living in the shadow (hide and seek, missing diabetes, withdrawal) and moving toward light (diabetes disclosure, destruction of the false bubbles). The most response especially for girls was to live in the shadow of silence that can be associated with negative consequences affecting diabetes management. Moving towards the light, suggests that it is possible to help people with type-1-diabetes to achieve a normal life as much as possible. It is necessary to plan the anti-stigma programs and engage them actively to reduce stigma and mitigate or prevent its negative impacts.
Generally, adolescents cared more about the psychosocial aspects of health than the physical dimensions. They also considered factors such as independence, communication, socioeconomic conditions, mental health, religion, and educational facilities synonymous with the concept of health. Therefore, in formulation and implementation of health promotion programs for adolescents, the concept of health and its various dimensions must be considered from adolescent perspectives.
Objectives:Clinical reasoning is at the heart of clinical work; it is affected by different field factors. A clear understanding of the reasoning process could solve practitioners' problems on how to make their underlying theories, assumptions and values more explicit. The aim of this research is to understand how clinical reasoning process is formed in the context of occupational therapists working in different clinical settings in Iran.
Methods:A purposeful and theoretical sampling of 15 occupational therapists working in clinical settings was performed through semi-structured interviews. All the data were recorded, transcribed, and analyzed using Strauss and Corbin's (2008) grounded theory approach and constant comparative analyses.
Results:Conceptual model was developed to explain the relationships among the main categories extracted through the grounded theory. Achieve an observable change emerged as the core category. Other important categories linked to the core category were, performing the continuum of clinical reasoning, context of clinical reasoning, and effective factors in clinical reasoning.Discussion: Findings showed that achieving an observable change in the client was the main consequence of the action/interaction strategies. Some facilitating factors related to the therapist, helped to process reasoning with a holistic and client-centered view, while also helping to develop the self-belief and professional identity. The dominance of medical views and a lack of health insurance were two intervening factors that constrained the dynamics of clinical reasoning within the context of practice.
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