Browsing by Author "Yelden, Kudret"

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    A Grounded Theory Analysis of a Focus Group Study
    (Sage, 2017-01) Sargent, Sarah; Samanta, Jo; Yelden, Kudret
    Decisions about whether to reassess the clinical condition of patients in a minimally conscious state are a cornerstone of clinical care and management. The outcome of clinical reassessment determines whether efforts to rehabilitate should be escalated, maintained, or targeted more specifically to achieve optimal outcomes. The results of reassessment also underpin decisions to withhold or withdraw life-sustaining treatment from this patient group. Actual decisions about whether to reassess tend to be taken by members of multidisciplinary teams. For this reason, focus groups were chosen to ascertain the views and perceptions of senior decision-makers as to whether minimally conscious patients should have a fundamental “right” to be reassessed. Constructivist grounded theory was used to analyze the data. The results reveal that a range of factors will influence ...
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    A Grounded Theory Analysis of a Focus Group Study
    (Sage, 2016) Sargent, Sarah; Samanta, Jo; Yelden, Kudret
    Decisions about whether to reassess the clinical condition of patients in a minimally conscious state are a cornerstone of clinical care and management. The outcome of clinical reassessment determines whether efforts to rehabilitate should be escalated, maintained or targeted more specifically to achieve optimal outcomes. The results of reassessment also underpins decisions to withhold or withdraw life-sustaining treatment from this patient group. Actual decisions about whether to reassess tend to be taken by members of multidisciplinary teams. For this reason, focus groups were chosen to ascertain the views and perceptions of senior decision-makers as to whether minimally conscious patients should have a fundamental ‘right’ to be reassessed. constructivist grounded theory was used to analyze the data. The results reveal that a range of factors influence whether these patients are reassessed clinically. This case study discusses why focus groups using a grounded theory analysis were chosen to address the research question. A description is provided of the coding process that was used to develop theory from the focus group data. This case study will help researchers to understand how these methodologies are carried out as well as to identify the types of insight that can be gained from their use.
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    Should People in the Minimally Conscious State have a (recognised) Right to Reassessment?
    (Lawtext Publishing, 2016) Samanta, Jo; Yelden, Kudret; Sargent, Sarah
    Developments in medical sciences mean that more people survive serious brain injuries than in previous years. Nevertheless, some survivors are left with protracted or permanent severely disordered consciousness. Expert care and treatment of people in the minimally conscious state is expensive and accur¬ate assessment, and reassessment, of their condition is necessary for optimal management and targeting of healthcare resources. This empirical study sought to identify whether minimally conscious people should have a ‘right’ to be reassessed. A grounded theory approach was used to ascertain policy and perspectives of senior decision-makers (including clinicians, lawyers, commissioners and healthcare managers). The results are contextualised within a theoretical framework of recent common law and professional guidance in England and Wales. The findings reveal that whether minimally conscious patients have access to specialist assessment and treatment services depends largely on the vagaries of circumstances, expertise and the availability of validated neurological assessment tools.
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    Understanding the decision-making environment for people in minimally conscious state
    (Taylor and Francis, 2017-05-11) Yelden, Kudret; Sargent, Sarah; Samanta, Jo
    ABSTRACT Patients in Minimally Conscious States (MCS) show minimal, fluctuating but definitive signs of awareness of themselves and their environments. They may exhibit behaviors ranging from the ability to track objects or people with their eyes, to the making of simple choices which requires ability to recognize objects and follow simple commands. While patients with MCS have higher chances of further recovery than people in vegetative states, this is not guaranteed and their prognosis is fundamentally uncertain. Therefore, patients with MCS need regular input from healthcare professionals to monitor their progress (or non-progress); to address their needs for rehabilitation, for the provision of an appropriate environment and equipment. These requirements form a backdrop to the potentially huge variety of ethical-legal dilemmas that may be faced by their families, care-givers and ultimately, the courts. This paper analyses the decision-making environment for people with MCS using data obtained through four focus groups which included 29 senior decision makers in the area. The results of the focus group study are presented and further explored with attention on recurrent and strong themes such as lack of expertise, resource issues, and the families of people with MCS.