Hadass Goldblatt

Strategies of Coping Among Adolescents Experiencing Interparental Violence

This article presents findings of a qualitative study, using a phenomenological perspective, aimed at understanding the meaning of interparental violence for adolescents. The professional literature emphasizes the negative effects of exposure to interparental violence. Yet coping with these effects has been largely overlooked. Whereas most knowledge is based on information about young children, adolescents’ perception of their experience has rarely been addressed. The study sample was composed of 21 Israeli-born Jewish youths, males and females, aged 13 to 18. All participants were interviewed using an in-depth semistructured interview format. Thematic content analysis of the data was performed, revealing coping strategies that serve as (a) a mode of action to survive in a violent ecology and (b) a positive outcome of life in spite of negative influences. The meaning of these coping strategies for the youths at present and for their future development is discussed. Implications for further research and intervention are proposed.

Partner Accounts of Intimate Violence: Towards a Theoretical Model

The purpose of this study is to provide a structural and contextual analysis of accounts of intimate violence given by cohabiting partners and to identify the dynamics of the interrelationships among the various categories of accounts. The purposive sample consisted of forty respondents (twenty couples) from Northern Israel who had reported at least one incident of violence during the year prior to the study. All respondents were interviewed using an in-depth semi-structured interview format. Thematic content analysis yielded three broad content categories of accounts: (1) what happened in the violent event; (2) why did it happen; and (3) what are the meanings attributed to such violent events. The dynamic interaction among these content categories was examined along personal, interpersonal and social dimensions. A theoretical model summarizing and illustrating the content categories and the dynamic interaction among them is suggested. Finally, some implications for hypothesizing and providing differential interventions are proposed.

Determinants of physician empathy during medical education: hypothetical conclusions from an exploratory qualitative survey of practicing physicians

BackgroundEmpathy is an outcome-relevant physician characteristic and thus a crucial component of high-quality communication in health care. However, the factors that promote and inhibit the development of empathy during medical education have not been extensively researched. Also, currently there is no explicit research on the perspective of practicing physicians on the subject. Therefore the aim of our study was to explore physicians’ views of the positive and negative influences on the development of empathy during their medical education, as well as in their everyday work as physicians.MethodWe administered a written Qualitative Short Survey to 63 physicians in seven specialties. They were able to respond anonymously. Our open-ended question was: “What educational content in the course of your studies and/or your specialist training had a positive or negative effect on your empathy?” We analyzed the data using thematic content analysis following Mayring’s approach.ResultsForty-two physicians took part in our survey. All together, they mentioned 68 specific factors (37 positive, 29 negative, 2 neutral) from which six themes emerged: 1. In general, medical education does not promote the development of empathy. 2. Recognizing the psycho-social dimensions of care fosters empathy. 3. Interactions with patients in medical practice promote empathy. 4. Physicians’ active self-development through reflective practice helps the development of empathy. 5. Interactions with colleagues can both promote and inhibit empathy through their role modeling of empathic and non-empathic behavior. 6. Stress, time pressure, and adverse working conditions are detrimental to empathy development.ConclusionsOur results provide an overview of what might influence the development of clinical empathy, as well as hypothetical conclusions about how to promote it. Reflective practice seems to be lacking in current medical curricula and could be incorporated. Raising physicians’ awareness of the psycho-social dimension of disease, and of the impact of peer influence and role modeling, seems promising in this regard, too. Stress and well-being seem to be closely related to physician empathy, and their modulation must take into account individual, social, and organizational factors. Further research should investigate whether or how these hypothetical conclusions can deepen our understanding of the determinants of physician empathy in order to help its promotion.

Challenging Gender Roles

This article presents findings of a phenomenological study exploring how gender roles of social work students are affected through the process of intervention with battered women. We suggest that such intervention continuously challenges the worker to reexamine identity-related topics. The study was done through in-depth semistructured interviews conducted with 20 Israeli female undergraduate students, both Jewish and Arab. Their narratives revealed how encounters with battered women shape their experiences in domains such as family of origin, current intimate relationships, and gender attitudes. The meanings of the transformed narratives for the students are discussed along with implications for social work supervision and practice.

Barriers to using psycho-oncology services: a qualitative research into the perspectives of users, their relatives, non-users, physicians, and nurses

PurposeThe present explorative study was designed as a qualitative evaluation of the psycho-oncology services (POS) available at a psycho-oncology institution (POI) in Germany. The study focused on barriers to using these services.MethodsSeven focus groups and five complementary individual interviews were conducted with POS users, their relatives, and POS non-users from a German POI, as well as with oncology physicians and nurses from an affiliated hospital. The focus groups and individual interviews were audiotaped and fully transcribed. Data were analyzed using the documentary method.ResultsFour utilization barriers were identified: (1) patients’ and physicians’ information deficits about POI and POS, (2) patients’ and physicians’ subjective norms regarding POS, (3) lack of organizational and therapeutic integration of POI and POS into routine oncology care on the ward, and (4) specific characteristics of cancer patients. The most important finding was that lack of organizational and therapeutic integration of POS in routine oncology care on the ward might have a lasting, negative effect on patients’ and physicians’ information deficits and subjective norms. Furthermore, the identified utilization barriers seem to be a multi-causal problem with complex interdependencies.ConclusionBased on these results, the organizational and therapeutic integration of POS in routine oncology care on the POI ward appears to be a useful tool in offering widely accessible therapies and providing patients with concise, straightforward information via different channels, such as personnel, brochures, and the Internet. Nevertheless, the results should be interpreted tentatively, due to the explorative character of this study.

Role Taking of Youths in a Family Context: Adolescents Exposed to Interparental Violence

This qualitative study examines the roles enacted by adolescents who lived with interparental violence and the impact of such roles on the formation of their identity. The study sample was composed of 21 Israeli-born Jewish youths ages 13-18 years. Data analysis revealed an emic perspective on the roles enacted by youths at various points in the development of interparental conflict. These roles were described and analyzed in relation to the temporal and spatial dimensions of violent situations and according to the type of involvement, the range of authority and responsibility assumed by the youths, and the extent of choice they exercised in role taking. The results are discussed in terms of current role theory, and some practical implications are suggested.

The twilight zone between health and sickness: a qualitative exploration with asymptomatic BRCA1 and 2 mutation carriers.

Purpose. To explore the way in which asymptomatic women diagnosed with mutation in BRCA1 or BRCA2 genes give meaning to their family scripts and to the dialectic between being concurrently healthy and at high risk for breast and ovarian cancer, vis-à-vis their way of coping with risks. Methods. Seventeen asymptomatic Israeli women diagnosed as BRCA1 or 2 mutation carriers participated in the study. In-depth semi-structured interviews were conducted. Data were analyzed using qualitative-phenomenological methods. Results. The following themes were revealed: (1) Cancer or surgery: the dominant fear; (2) Family clock; (3) Knowledge is power, and (4) Mothers story shapes daughters construction of experience. Conclusion. Breast and ovarian cancer worry was a major factor in opting for prophylactic oophorectomy. Family scripts, the hope to be healthy and the wish to live through significant stages in family life may lead to the choice of prophylactic oophorectomy among asymptomatic BRCA1 or 2 mutation carriers. However, it does not propel these women to opt for bilateral prophylactic mastectomy. Listening to different voices regarding risk reduction modalities is crucial among genetic counselors and health providers for health promotion in women at high risk.

The Hidden Dropout Phenomenon among Immigrant High-School Students The Case of Ethiopian Adolescents in Israel — A Pilot Study

The high school dropout rate among immigrant students has become a serious problem in many places around the world. Hidden dropout or irregular school attendance may be the first stage of school dropout. This article examines the hidden dropout phenomenon among Ethiopian immigrant adolescents aged 14—18 in Israel, as a prototype of immigration from a traditional, rural society to a western one. Sixty irregular school attendees were compared with 28 regular attendees, regarding the following characteristics: family and socio-economic background, psychological distress symptoms (BSI), self-efficacy (SEF), perceived social support (MSPSS) and cognitive skills (ROcF). Results indicated that both groups came from similar low socio-economic backgrounds and showed similarly poor cognitive performance levels. However, among the hidden dropout group, the perceived social support was significantly higher and feelings of stress were significantly lower. Several explanations are provided for these unexpected results, and research and practice implications are discussed.

Being within or being between? The cultural context of Arab women's experience of coping with breast cancer in Israel

Coping with cancer is affected by cultural norms, beliefs, and perceptions. To date, only a few studies have examined how Arab women cope with breast cancer and how the illness affects their lives. We aimed to study how Arab women perceive and ascribe meaning to their illness and its personal, familial, and social implications and to examine their coping strategies within the religious and traditional cultural context.

Giving Voice to ‘Age at the Edge’ – A Challenge for Social Workers Intervening with Elder Abuse and Neglect

The purpose of this qualitative study was to learn about social workers’ experience of the therapeutic encounter with victims and perpetrators of elder abuse and neglect and its implications for their personal and professional lives. Participants were 17 experienced women social workers, who worked with abused and neglected older adults in Israel. Data were collected by in-depth semi-structured interviews, which were later transcribed and content analyzed. Four main themes were revealed: (1) The Complexity of the Experience of the Therapeutic Encounter; (2) Circles Echoing Between the Professional and the Personal; (3) Between Growth and Attrition; and (4) Experiencing the Mission and its Meaning. As time is running out for older adults, the “now or never” perspective shapes social workers’ encounter with elder abuse opening a unique kind of dialogue. Implications for practice and further research are discussed.