Ethical challenges embedded in qualitative research interviews with close relatives.

PubMed

Haahr, Anita; Norlyk, Annelise; Hall, Elisabeth Oc

2014-02-01

Nurse researchers engaged in qualitative interviews with patients and spouses in healthcare may often experience being in unforeseen ethical dilemmas. Researchers are guided by the bioethical principles of justice, beneficence, non-maleficence, respect for human rights and respect for autonomy through the entire research process. However, these principles are not sufficient to prepare researchers for unanticipated ethical dilemmas related to qualitative research interviews. We describe and discuss ethically challenging and difficult moments embedded in two cases from our own phenomenological interview studies. We argue that qualitative interviews involve navigation between being guided by bioethics as a researcher, being a therapist/nurse and being a fellow human being or even a friend. The researchers' premises to react to unexpected situations and act in a sound ethical manner must be enhanced, and there is a need for an increased focus on the researchers' ethical preparation and to continually address and discuss cases from their own interviews.

'Questerviews': using questionnaires in qualitative interviews as a method of integrating qualitative and quantitative health services research.

PubMed

Adamson, Joy; Gooberman-Hill, Rachael; Woolhead, Gillian; Donovan, Jenny

2004-07-01

Multi-method approaches are increasingly advocated in health services research (HSR). This paper examines the use of standardised self-completion questionnaires and questions, during in-depth interviews, a technique termed 'questerviews'. 'Questerview' techniques were used in four empirical studies of health perceptions conducted by the authors. The studies included both standardised self-completion questions or questionnaires and in-depth interviews. Respondents were tape-recorded while they completed the standardised questionnaires and were encouraged to discuss their definitions of terms and responses to items in-depth. In all studies, 'questerviews' were fully transcribed and data analysis involved the scrutinising of transcripts to identify emergent themes. Responses to the standardised items led to rich sources of qualitative data. They proved to be useful triggers as respondents discussed their understanding and definitions of terms, often explaining their responses with stories from their own experiences. The items triggered detailed exploration of the complex factors that comprise health, illness and healthcare seeking, and gave considerable insight into the ways in which people respond to standardised questions. Apparently simple questions and response categories conceal considerable complexity. Inclusion of standardised survey questions in qualitative interviews can provide an easy and fruitful method to explore research issues and provide triggers to difficult or contested topics. Well designed and validated questionnaires produce data of immense value to HSR, and this value could be further enhanced by their use within a qualitative interview. We suggest that the technique of 'questerviews' is a tangible and pragmatic way of doing this.

[Quality control and assessment of qualitative interview in health care research].

PubMed

Xie, Yan-ming; Liao, Xing

2008-07-01

It is not finally concluded how to standardize the use of qualitative research in the world. Qualitative researchers disagree with each other about this issue. As we know, there have been a large number of articles written in different ways about qualitative research due to the "flexibility", one of its features. Qualitative research is quite different from quantitative research which is easy to control its quality and quality assessment. A series of criteria has been set up for quantitative research. However qualitative research needs to be improved in these aspects, in which qualitative interviews are mostly used at home and abroad at present. Hence, it becomes an important and urgent issue for qualitative researchers to standardly control and assess the quality of qualitative interview.

Comparing appropriateness and equivalence of email interviews to phone interviews in qualitative research on reproductive decisions.

PubMed

Hershberger, Patricia E; Kavanaugh, Karen

2017-10-01

Despite an increasing use of qualitative email interviews by nurse researchers, there is little understanding about the appropriateness and equivalence of email interviews to other qualitative data collection methods, especially on sensitive topics research. The purpose is to describe our procedures for completing asynchronous, email interviews and to evaluate the appropriateness and equivalency of email interviews to phone interviews in two qualitative research studies that examined reproductive decisions. Content analysis guided the methodological appraisal of appropriateness and equivalency of in-depth, asynchronous email interviews to single phone interviews. Appropriateness was determined by: (a) participants' willingness to engage in email or phone interviews, (b) completing data collection in a timely period, and (c) participants' satisfaction with the interview. Equivalency was evaluated by: (a) completeness of the interview data, and (b) insight obtained from the data. Of the combined sample in the two studies (N=71), 31% of participants chose to participate via an email interview over a phone interview. The time needed to complete the email interviews averaged 27 to 28days and the number of investigator probe-participant response interchanges was 4 to 5cycles on average. In contrast, the phone interviews averaged 59 to 61min in duration. Most participants in both the email and phone interviews reported they were satisfied or very satisfied with their ability to express their true feelings throughout the interview. Regarding equivalence, 100% of the email and phone interviews provided insight into decision processes. Although insightful, two of the email and one phone interview had short answers or, at times, underdeveloped responses. Participants' quotes and behaviors cited within four published articles, a novel evaluation of equivalency, revealed that 20% to 37.5% of the citations about decision processes were from email participants, which is

Is there a bias against telephone interviews in qualitative research?

PubMed

Novick, Gina

2008-08-01

Telephone interviews are largely neglected in the qualitative research literature and, when discussed, they are often depicted as a less attractive alternative to face-to-face interviewing. The absence of visual cues via telephone is thought to result in loss of contextual and nonverbal data and to compromise rapport, probing, and interpretation of responses. Yet, telephones may allow respondents to feel relaxed and able to disclose sensitive information, and evidence is lacking that they produce lower quality data. This apparent bias against telephone interviews contrasts with a growing interest in electronic qualitative interviews. Research is needed comparing these modalities, and examining their impact on data quality and their use for studying varying topics and populations. Such studies could contribute evidence-based guidelines for optimizing interview data. 2008 Wiley Periodicals, Inc

Is There a Bias Against Telephone Interviews In Qualitative Research?

PubMed Central

Novick, Gina

2011-01-01

Telephone interviews are largely neglected in the qualitative research literature and, when discussed, they are often depicted as a less attractive alternative to face-to-face interviewing. The absence of visual cues via telephone is thought to result in loss of contextual and nonverbal data and to compromise rapport, probing, and interpretation of responses. Yet, telephones may allow respondents to feel relaxed and able to disclose sensitive information, and evidence is lacking that they produce lower quality data. This apparent bias against telephone interviews contrasts with a growing interest in electronic qualitative interviews. Research is needed comparing these modalities, and examining their impact on data quality and their use for studying varying topics and populations. Such studies could contribute evidence-based guidelines for optimizing interview data. PMID:18203128

Characteristic Interviews, Different Strategies: Methodological Challenges in Qualitative Interviewing among Respondents with Mild Intellectual Disabilities

ERIC Educational Resources Information Center

Sigstad, Hanne Marie Høybråten

2014-01-01

Conducting qualitative research interviews among individuals with intellectual disabilities, including cognitive limitations and difficulties in communication, presents particular research challenges. One question is whether the difficulties that informants encounter affect interviews to such an extent that the validity of the results is weakened.…

Insights into Chronic Functional Movement Disorders: The Value of Qualitative Psychiatric Interviews.

PubMed

Epstein, Steven A; Maurer, Carine W; LaFaver, Kathrin; Ameli, Rezvan; Sinclair, Stephen; Hallett, Mark

Patients with functional movement disorders (FMDs) are commonly seen by neurologists and psychosomatic medicine psychiatrists. Research literature provides scant information about the subjective experiences of individuals with this often chronic problem. To enhance our understanding of psychologic aspects of FMDs by conducting qualitative interviews of research subjects. In total, 36 patients with FMDs were recruited from the Human Motor Control clinic at the National Institutes of Health. Each subject participated in a qualitative psychiatric interview and a structured diagnostic psychiatric interview. Of our 36 subjects, 28 had current or lifetime psychiatric disorders in addition to conversion disorder and 22 had current disorders. Qualitative interviews provided rich information on patients' understanding of their illnesses and impaired cognitive processing of emotions. Our study supports the addition of open-ended qualitative interviews to delineate emotional dynamics and conceptual frameworks among such patients. Exploratory interviews generate enhanced understanding of such complex patients, above and beyond that gained by assessing DSM diagnostic comorbidities. Copyright © 2016 The Academy of Psychosomatic Medicine. All rights reserved.

African Primary Care Research: qualitative interviewing in primary care.

PubMed

Reid, Steve; Mash, Bob

2014-06-05

This article is part of a series on African Primary Care Research and focuses on the topic of qualitative interviewing in primary care. In particular it looks at issues of study design, sample size, sampling and interviewing in relation to individual and focus group interviews.There is a particular focus on helping postgraduate students at a Masters level to write their research proposals.

Interviewing Objects: Including Educational Technologies as Qualitative Research Participants

ERIC Educational Resources Information Center

Adams, Catherine A.; Thompson, Terrie Lynn

2011-01-01

This article argues the importance of including significant technologies-in-use as key qualitative research participants when studying today's digitally enhanced learning environments. We gather a set of eight heuristics to assist qualitative researchers in "interviewing" technologies-in-use (or other relevant objects), drawing on concrete…

A Critical Review of Qualitative Interviews in Applied Linguistics

ERIC Educational Resources Information Center

Mann, Steve

2011-01-01

This article asks what applied linguistics can learn from related disciplines with regard to the collection, analysis and representation of qualitative interviews. It assesses the contributions of qualitative sociology, anthropology, discursive psychology and outlines four "discourse dilemmas" which might provide the basis for a more critical and…

Methodological and ethical issues related to qualitative telephone interviews on sensitive topics.

PubMed

Mealer, Meredith; Jones Rn, Jacqueline

2014-03-01

To explore the methodological and ethical issues of conducting qualitative telephone interviews about personal or professional trauma with critical care nurses. The most common method for conducting interviews is face-to-face. However, there is evidence to support telephone interviewing on a variety of sensitive topics including post-traumatic stress disorder (PTSD). Qualitative telephone interviews can limit emotional distress because of the comfort experienced through virtual communication. Critical care nurses are at increased risk of developing PTSD due to the cumulative exposure to work-related stress in the intensive care unit. We explored the methodological and ethical issues of conducting qualitative telephone interviews, drawing on our experiences communicating with a group of critical care nurses. Qualitative research interviews with 27 critical care nurses. Fourteen of the nurses met the diagnostic criteria for PTSD; 13 did not and had scores consistent with high levels of resilience. This is a methodology paper on the authors' experiences of interviewing critical care nurses on sensitive topics via the telephone. The authors found that establishing rapport and connections with the participants and the therapeutic use of non-verbal communication were essential, and fostered trust and compassion. The ethical issues of this mode of communication include protecting the privacy and confidentiality associated with the disclosure of sensitive information, and minimising the risk of psychological harm to the researcher and participants. Qualitative telephone interviews are a valuable method of collecting information on sensitive topics. This paper explores a method of interviewing in the workplace. It will help inform interventions to promote healthy adaptation following trauma exposure in the intensive care unit.

Using Multiple Interviewers in Qualitative Research Studies: The Influence of Ethic of Care Behaviors in Research Interview Settings

ERIC Educational Resources Information Center

Matteson, Shirley M.; Lincoln, Yvonna S.

2009-01-01

This study considered the methodological implications of a qualitative study that involved two research practitioners as interviewers, one male and one female, who conducted semistructured cognitive interviews with middle school students. During the reading and analysis of interview transcriptions, differences were noted between the interviewers'…

[Suffering at work among medical students: qualitative study using semi-structured interviews].

PubMed

Le Provost, A-S; Loddé, B; Pietri, J; De Parscau, L; Pougnet, L; Dewitte, J-D; Pougnet, R

2018-01-01

Suffering at work among health professionals is a hot topic. Medical students, doctors of tomorrow, are far from being spared. Prevalence of anxiety and mood disorders range from 20.3 to 69 % for the former and from 12 to 30 % for the latter. The purpose of this article is to determine these factors by qualitative research, according to medical students' points of view. It is a qualitative study using semistructured interviews. The analysis is done according to the Grounded Theory. 12 medical students are interviewed. They expressed difficulties at work and positive factors. Three major themes are identified in selective coding: occupational factors, " study " factors and individual factors. All themes are both a source of well-being and ill-being according to the situations specified in the results. Studying medicine includes positive and negative aspects. Abandonment issues, lack of recognition and insufficient coaching emerge from our study. Screening of suffering at work should be systematic for medical students.

Conducting a qualitative child interview: methodological considerations.

PubMed

Kortesluoma, Riitta-Liisa; Hentinen, Maija; Nikkonen, Merja

2003-06-01

Studies of children have a long history, but the literature related to young children consists for the most part of studies on rather than with children and taking little account of what is regarded as significant and meaningful by children themselves. Researchers have relied almost exclusively on adults when collecting data about children's thoughts, feelings and experiences. Interviewing children, however, gives an opportunity to gain information about their subjective experiences. The purpose of this article is to illustrate the theoretical premises of child interviewing, as well as to describe some practical methodological solutions used during interviews. Factors that influence data gathered from children and strategies for taking these factors into consideration during the interview are also described. This paper is based on literature and the experience of one of the authors in interviewing children aged from 4 to 11 years about their experiences of pain. A consideration of literature dealing with the principles of child interviewing shows that there is surprisingly little guidance available on conversational methods involving children. The empirical and conceptual foundation for child interviewing is not very clear. Novice researchers especially may need recommendations about how to conduct a qualitative child interview. The method must suit both the purpose and the context.

Mentoring doctoral students for qualitative research: interviews with experienced nursing faculty in Japan.

PubMed

Kayama, Mami; Gregg, Misuzu F; Asahara, Kiyomi; Yamamoto-Mitani, Noriko; Okuma, Keiko; Ohta, Kikuko; Kinoshita, Yasuhito

2013-05-01

This study aimed to describe the process of mentoring doctoral students for qualitative research in Japanese graduate programs in nursing. Nine experienced faculty-seven nurse researchers and two sociologists-were interviewed. Participants were asked about their process of mentoring students for qualitative nursing dissertations. Data analysis was conducted using a qualitative descriptive method. Participants' age ranged from 48 to 60 years. The first theme in the mentoring process is about the individualized, one-on-one mentorship process. The second theme occurs in a group process. The third theme is coordinating mentors and establishing a network to support the evaluation system. The mentoring processes identified in this study will be useful for future faculty development. The study elucidated much room for improvement in doctoral education programs for qualitative research methods in nursing science. Copyright 2013, SLACK Incorporated.

Innovation in qualitative interviews: "Sharing Circles" in a First Nations community.

PubMed

Rothe, J P; Ozegovic, D; Carroll, L J

2009-10-01

There is growing recognition that different research approaches are necessary to understand the complex interaction between individual and social processes that contribute to risk-taking and injuries. Therefore, qualitative studies have an important role in injury prevention research. This article describes qualitative research in general and outlines some of the ways qualitative research can add to our understanding of injury. It also describes the role, format and methods of interviews (person-to-person and focus groups) commonly performed in qualitative studies, and proposes a novel approach to interviewing that has special relevance and value in injury research with indigenous populations. This methodology adapts focus group methods to be consistent with the goals and procedures of the traditional First Nations communities' Sharing Circles. This adaptation provides a culturally appropriate and sensitive method of developing a deep and broad understanding of indigenous participants' verbal descriptions of their feelings, their experiences and their modes of reasoning. After detailing of this adaptation of the Sharing Circle as a vibrant and vital interview and analysis method, the use of Sharing Circle interview methodology will be illustrated in a study investigating how an Alberta First Nations community experiences and deals with disproportionate levels of injuries arising from impaired driving, outlining important findings uncovered using this novel interviewing method. These findings have been informative to First Nations communities themselves, have informed policy makers provincially and nationally, and have instigated culturally appropriate intervention techniques for Canadian First Nations communities.

Older Adults’ Perspectives on Successful Aging: Qualitative Interviews

PubMed Central

Reichstadt, Jennifer; Sengupta, Geetika; Depp, Colin A.; Palinkas, Lawrence A.; Jeste, Dilip V.

2010-01-01

OBJECTIVES Lay perceptions of “successful aging” are important for understanding this multifaceted construct and developing ways to assist older adults to age well. The purpose of this qualitative study was to obtain older adults’ individual perspectives on what constitutes successful aging, along with their views regarding activities and interventions to enhance its likelihood. METHODS Qualitative interviews were conducted with 22 community-dwelling adults over age 60. Participants were recruited from retirement communities, a low-income senior housing complex, and a continued learning center in San Diego County. Interview transcripts were analyzed using a “Coding Consensus, Co-occurrence, and Comparison” grounded theory framework. RESULTS The mean age of participants was 80 years (range: 64 to 96), with 59% being women. Two primary themes were identified as key to successful aging - i.e., self-acceptance/self-contentment (with sub-themes of realistic self-appraisal, a review of one’s life, and focusing on the present) and engagement with life/self-growth (with sub-themes of novel pursuits, giving to others, social interactions, and positive attitude). A balance between these two constructs appeared critical. A need for interventions that address support systems and personally tailored information to make informed decisions and enhance coping strategies were also emphasized. CONCLUSIONS Older adults viewed successful aging as a balance between self-acceptance and self-contentedness on one hand and engagement with life and self-growth in later life on the other. This perspective supports the concept of wisdom as a major contributor to successful aging. Interventions to enhance successful aging may include those that promote productive and social engagement along with effective coping strategies. PMID:20593536

Exploring Performativity and Resistance in Qualitative Research Interviews: A Play in Four Acts

ERIC Educational Resources Information Center

Beaunae, Cathrine; Wu, Chiu-Hui; Koro-Ljungberg, Mirka

2011-01-01

This play describes how the authors become aware of the complexities of resistance and performativity in the qualitative interview process. It also illustrates how this awareness and subsequent acquisition of knowledge changed and informed the way they viewed qualitative research interviewing. More specifically, performativity is put into work in…

Understanding resolution of deliberate self harm: qualitative interview study of patients' experiences

PubMed Central

Sinclair, Julia; Green, Judith

2005-01-01

Objective To explore the accounts of those with a history of deliberate self harm but who no longer do so, to understand how they perceive this resolution and to identify potential implications for provision of health services. Design Qualitative in-depth interview study. Setting Interviews in a community setting. Participants 20 participants selected from a representative cohort identified in 1997 after an episode of deliberate self poisoning that resulted in hospital treatment. Participants were included if they had no further episodes for at least two years before interview. Results We identified three recurrent themes: the resolution of adolescent distress; the recognition of the role of alcohol as a precipitating and maintaining factor in self harm; and the understanding of deliberate self harm as a symptom of untreated or unrecognised illness. Conclusion Patients with a history of deliberate self harm who no longer harm themselves talk about their experiences in terms of lack of control over their lives, either through alcohol dependence, untreated depression, or, in adolescents, uncertainty within their family relationships. Hospital management of deliberate self harm has a role in the identification and treatment of depression and alcohol misuse, although in adolescents such interventions may be less appropriate. PMID:15843425

Identifying the conditions needed for integrated knowledge translation (IKT) in health care organizations: qualitative interviews with researchers and research users.

PubMed

Gagliardi, Anna R; Dobrow, Mark J

2016-07-12

Collaboration among researchers and research users, or integrated knowledge translation (IKT), enhances the relevance and uptake of evidence into policy and practice. However, it is not widely practiced and, even when well-resourced, desired impacts may not be achieved. Given that large-scale investment is not the norm, further research is needed to identify how IKT can be optimized. Interviews were conducted with researchers and research users (clinicians, managers) in a health care delivery (HCDO) and health care monitoring (HCMO) organization that differed in size and infrastructure, and were IKT-naïve. Basic qualitative description was used. Participants were asked about IKT activities and challenges, and recommendations for optimizing IKT. Data were analysed inductively using constant comparative technique. Forty-three interviews were conducted (28 HCDO, 15 HCMO) with 13 researchers, 8 clinicians, and 22 managers. Little to no IKT took place. Participants articulated similar challenges and recommendations revealing that a considerable number of changes were needed at the organizational, professional and individual levels. Given the IKT-absent state of participating organizations, this research identified a core set of conditions which must be addressed to prepare an environment conducive to IKT. These conditions were compiled into a framework by which organizations can plan for, or evaluate their capacity for IKT. The IKT capacity framework is relevant for organizations in which there is no current IKT activity. Use of the IKT framework may result in more organizations that are ready to initiate and establish IKT, perhaps ultimately leading to more, and higher-quality collaboration for health system innovation. Further research is needed to confirm these findings in other organizations not yet resourced for, or undertaking IKT, and to explore the resource implications and mechanisms for establishing the conditions identified here as essential to preparing for

Characteristic interviews, different strategies: Methodological challenges in qualitative interviewing among respondents with mild intellectual disabilities.

PubMed

Sigstad, Hanne Marie Høybråten

2014-06-01

Conducting qualitative research interviews among individuals with intellectual disabilities, including cognitive limitations and difficulties in communication, presents particular research challenges. One question is whether the difficulties that informants encounter affect interviews to such an extent that the validity of the results is weakened. This article focuses on voluntary informed consent and the specific challenges with the greatest effects on such interviews. The discussion shows that complementary and meaningful descriptions from informants imply the need to employ alternative strategies and methods that may, in other contexts, challenge the traditional understanding of what is acceptable in research. © The Author(s) 2014.

Exploring Culture from a Distance: The Utility of Telephone Interviews in Qualitative Research

ERIC Educational Resources Information Center

Lechuga, Vicente M.

2012-01-01

Qualitative studies that utilize telephone interviews, as a primary data collection mode, often are not discussed in the qualitative research literature. Data excerpts from a study that sought to understand the culture of for-profit universities are used to illustrate the types of data that can be garnered through telephone interviews. In…

Guidelines to support nurse-researchers reflect on role conflict in qualitative interviewing.

PubMed

Jack, Susan

2008-01-01

The conduct of a qualitative research interview is a complex social interaction that has the potential to influence, or be influenced by, both the researcher and the study participant. When a researcher is identified as a professional nurse, the identification of this role has the potential to influence the researcher-participant interaction. To understand the effect of a nurse-researcher's involvement in an in-depth interview and on the data collected, issues to address include: clearly identifying the paradigmatic approach in which the research design is situated, examining the study participants' past experiences with research and the researcher's profession, establishing appropriate boundaries with participants, deciding how to introduce the role of nurse-researcher to the participant and deciding if, or when, it would be appropriate to intervene within the research context. As nurse-researchers, professional knowledge and experiences have the potential to affect relationship development with study participants and obfuscate the purpose of the research interview. It is the researcher's responsibility to participate in the activity of reflexivity to understand the effect of the nurse-researcher's involvement on the data and make decisions that protect the participant's integrity.

Guidelines to Support Nurse-Researchers Reflect on Role Conflict in Qualitative Interviewing

PubMed Central

Jack, Susan

2008-01-01

The conduct of a qualitative research interview is a complex social interaction that has the potential to influence, or be influenced by, both the researcher and the study participant. When a researcher is identified as a professional nurse, the identification of this role has the potential to influence the researcher-participant interaction. To understand the effect of a nurse-researcher’s involvement in an in-depth interview and on the data collected, issues to address include: clearly identifying the paradigmatic approach in which the research design is situated, examining the study participants' past experiences with research and the researcher’s profession, establishing appropriate boundaries with participants, deciding how to introduce the role of nurse-researcher to the participant and deciding if, or when, it would be appropriate to intervene within the research context. As nurse-researchers, professional knowledge and experiences have the potential to affect relationship development with study participants and obfuscate the purpose of the research interview. It is the researcher’s responsibility to participate in the activity of reflexivity to understand the effect of the nurse-researcher’s involvement on the data and make decisions that protect the participant’s integrity. PMID:19319221

The Contribution of Qualitative Methods for Identifying the Educational Needs of Adults

ERIC Educational Resources Information Center

Boz, Hayat; Dagli, Yakup

2017-01-01

This study addresses the contribution of applying qualitative research methods for identifying the educational activities planned for adults. The paper is based on the experience gained during in-depth interviews with 39 elderly and 33 middle-aged participants, by purposive sampling method and maximum variation technique, within a needs analysis…

Qualitative interviews regarding pharmacist prescribing in the community setting.

PubMed

Feehan, Michael; Durante, Richard; Ruble, Jim; Munger, Mark A

2016-09-15

The perceived demand for and barriers to pharmacist prescribing in the community pharmacy setting were studied. Qualitative interviews were conducted with 19 consumers, 20 community pharmacists, and 8 reimbursement decision-makers from payer organizations between April and June 2015. Respondents were invited to participate in a daylong interview process online. Interviews with consumers and pharmacists were conducted using online bulletin board technology. Telephone interviews were conducted with reimbursement decision-makers. As with all qualitative research, the sample sizes used were restrictive and sufficient to gauge the perceptions of those respondents only. Interview responses were not intended to be generalizable to the groups or populations from which the respondents came. There was a continuum of interest in pharmacist prescribing across the three constituencies. Consumers were predominantly resistant to the notion; however, one third were more positive about the idea. Community pharmacists were more open, particularly when prescribing was restricted to a limited set of conditions or medications. Reimbursement decision-makers were most receptive to the notion. Key barriers to pharmacist prescribing included low awareness of current pharmacist prescribing authority among consumers, concerns about the adequacy of pharmacist training, potential conflicts of interest when the prescriber was also a dispenser, and potential liability issues. Consumer respondents were generally resistant to the notion of pharmacist prescribing, with most viewing pharmacists as dispensers and not prescribers. Community pharmacists were more open to the idea, while reimbursement decision-makers were the most receptive to the notion of pharmacist prescribing. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Co-interviewing across gender and culture: expanding qualitative research methods in Melanesia.

PubMed

Redman-MacLaren, Michelle L; Api, Unia K; Darius, Matupit; Tommbe, Rachael; Mafile'o, Tracie A; MacLaren, David J

2014-09-06

The social and cultural positions of both researchers and research participants influence qualitative methods and study findings. In Papua New Guinea (PNG), as in other contexts, gender is a key organising characteristic and needs to be central to the design and conduct of research. The colonial history between researcher and participant is also critical to understanding potential power differences. This is particularly relevant to public health research, much of which has emerged from a positivist paradigm. This paper describes our critical reflection of flexible researcher responses enacted during qualitative research in PNG. Led by a senior male HIV researcher from PNG, a male from a PNG university and a female from an Australian university conducted qualitative interviews about faith-based responses to HIV in PNG. The two researchers planned to conduct one-on-one interviews matching gender of participants and interviewer. However, while conducting the study, four participants explicitly requested to be interviewed by both researchers. This experience led us to critically consider socially and culturally situated ways of understanding semi-structured interviewing for public health research in Melanesia. New understandings about public health research include: (i) a challenge to the convention that the researcher holds more power than the research participant, (ii) the importance of audience in Melanesia, (iii) cultural safety can be provided when two people co-interview and (iv) the effect an esteemed leader heading the research may have on people's willingness to participate. Researchers who occupy insider-outsider roles in PNG may provide participants new possibilities to communicate key ideas. Our recent experience has taught us public health research methods that are gender sensitive and culturally situated are pivotal to successful research in Melanesia. Qualitative research requires adaptability and reflexivity. Public health research methods must continue

Introducing dyadic interviews as a method for collecting qualitative data.

PubMed

Morgan, David L; Ataie, Jutta; Carder, Paula; Hoffman, Kim

2013-09-01

In dyadic interviews, two participants interact in response to open-ended research questions. There are few precedents for using dyadic interviews as a technique for qualitative research. We introduce this method largely in comparison to focus groups, because both represent forms of interactive interviewing. We do not, however, view dyadic interviews as miniature focus groups, and treat them as generating their own opportunities and issues. To illustrate the nature of dyadic interviewing, we present summaries of three studies using this method. In the first study, we used dyadic interviews and photovoice techniques to examine experiences of people with early-stage dementia. In the second study, we explored the experiences of staff who provided services to elderly housing residents. In the third study, we examined barriers and facilitators to substance abuse treatment among Asian Americans and Pacific Islanders in Hawaii. We conclude with a discussion of directions for future research using dyadic interviews.

The limitations of language: male participants, stoicism, and the qualitative research interview.

PubMed

Affleck, William; Glass, Kc; Macdonald, Mary Ellen

2013-03-01

The semistructured, open-ended interview has become the gold standard for qualitative health research. Despite its strengths, the long interview is not well suited for studying topics that participants find difficult to discuss, or for working with those who have limited verbal communication skills. A lack of emotional expression among male research participants has repeatedly been described as a significant and pervasive challenge by health researchers in a variety of different fields. This article explores several prominent theories for men's emotional inexpression and relates them to qualitative health research. The authors argue that investigators studying emotionally sensitive topics with men should look beyond the long interview to methods that incorporate other modes of emotional expression. This article concludes with a discussion of several such photo-based methods, namely, Photovoice, Photo Elicitation, and Visual Storytelling.

Teaching Qualitative Research: Experiential Learning in Group-Based Interviews and Coding Assignments

ERIC Educational Resources Information Center

DeLyser, Dydia; Potter, Amy E.

2013-01-01

This article describes experiential-learning approaches to conveying the work and rewards involved in qualitative research. Seminar students interviewed one another, transcribed or took notes on those interviews, shared those materials to create a set of empirical materials for coding, developed coding schemes, and coded the materials using those…

Underdeveloped Themes in Qualitative Research: Relationship With Interviews and Analysis.

PubMed

Connelly, Lynne M; Peltzer, Jill N

2016-01-01

In this methodological article, the authors address the problem of underdeveloped themes in qualitative studies they have reviewed. Various possible reasons for underdeveloped themes are examined, and suggestions offered. Each problem area is explored, and literature support is provided. The suggestions that are offered are supported by the literature as well. The problem with underdeveloped themes in certain articles is related to 3 interconnected issues: (a) lack of clear relationship to the underlying research method, (b) an apparent lack of depth in interviewing techniques, and (c) lack of depth in the analysis. Underdeveloped themes in a qualitative study can lead to a lack of substantive findings that have meaningful implications for practice, research, and the nursing profession, as well as the rejection of articles for publication. Fully developed themes require knowledge about the paradigm of qualitative research, the methodology that is proposed, the effective techniques of interviewing that can produce rich data with examples and experiences, and analysis that goes beyond superficial reporting of what the participants have said. Analytic problem areas include premature closure, anxiety about how to analyze, and confusion about categories and themes. Effective qualitative research takes time and effort and is not as easy as is sometimes presumed. The usefulness of findings depends on researchers improving their research skills and practices. Increasingly researchers are using qualitative research to explore clinically important issues. As consumers of research or members of a research team, clinical nurse specialists need to understand the nature of this research that can provide in-depth insight and meaning.

Barriers to medication adherence for the secondary prevention of stroke: a qualitative interview study in primary care.

PubMed

Jamison, James; Graffy, Jonathan; Mullis, Ricky; Mant, Jonathan; Sutton, Stephen

2016-08-01

Medications are highly effective at reducing risk of recurrent stroke, but success is influenced by adherence to treatment. Among survivors of stroke and transient ischaemic attack (TIA), adherence to medication is known to be suboptimal. To identify and report barriers to medication adherence for the secondary prevention of stroke/TIA. A qualitative interview study was conducted within general practice surgeries in the East of England, UK. Patients were approached by letter and invited to take part in a qualitative research study. Semi-structured interviews were undertaken with survivors of stroke, caregivers, and GPs to explore their perspectives and views around secondary prevention and perceived barriers to medication adherence. Key themes were identified using a grounded theory approach. Verbatim quotes describing the themes are presented here. In total, 28 survivors of stroke, including 14 accompanying caregivers and five GPs, were interviewed. Two key themes were identified. Patient level barriers included ability to self-care, the importance people attach to a stroke event, and knowledge of stroke and medication. Medication level barriers included beliefs about medication and beliefs about how pills work, medication routines, changing medications, and regimen complexity and burden of treatment. Patients who have had a stroke are faced with multiple barriers to taking secondary prevention medications in UK general practice. This research suggests that a collaborative approach between caregivers, survivors, and healthcare professionals is needed to address these barriers and facilitate medication-taking behaviour. © British Journal of General Practice 2016.

Strategies for obtaining unpublished drug trial data: a qualitative interview study

PubMed Central

2013-01-01

Background Authors of systematic reviews have difficulty obtaining unpublished data for their reviews. This project aimed to provide an in-depth description of the experiences of authors in searching for and gaining access to unpublished data for their systematic reviews, and to give guidance on best practices for identifying, obtaining and using unpublished data. Methods This is a qualitative study analyzing in-depth interviews with authors of systematic reviews who have published Cochrane reviews or published systematic reviews outside of The Cochrane Library. We included participants who 1) were the first or senior author of a published systematic review of a drug intervention, 2) had expertise in conducting systematic reviews, searching for data, and assessing methodological biases, and 3) were able to participate in an interview in English. We used non-random sampling techniques to identify potential participants. Eighteen Cochrane authors were contacted and 16 agreed to be interviewed (89% response rate). Twenty-four non-Cochrane authors were contacted and 16 were interviewed (67% response rate). Results Respondents had different understandings of what was meant by unpublished data, including specific outcomes and methodological details. Contacting study authors was the most common method used to obtain unpublished data and the value of regulatory agencies as a data source was underappreciated. Using the data obtained was time consuming and labor intensive. Respondents described the collaboration with other colleagues and/or students required to organize, manage and use the data in their reviews, generally developing and using templates, spreadsheets and computer programs for data extraction and analysis. Respondents had a shared belief that data should be accessible but some had concerns about sharing their own data. Respondents believed that obtaining unpublished data for reviews has important public health implications. There was widespread support for

The Influence of Power Shifts in Data Collection and Analysis Stages: A Focus on Qualitative Research Interview

ERIC Educational Resources Information Center

Anyan, Frederick

2013-01-01

This paper analyzes the power relation between the interviewer and the interviewee in the qualitative research interview methodology. The paper sets out to grapple with the extent to which the dynamisms in power shifts influence data collection and analysis in the interview methodology. The exploration of power shifts in the qualitative research…

Feasibility of Using Qualitative Interviews to Explore Patients' Treatment Goals: Experience from Dermatology.

PubMed

Blome, Christine; von Usslar, Kathrin; Augustin, Matthias

2016-06-01

Qualitative interviews are used to assess understandability and content validity of patient-reported outcomes. However, the common approach of asking patients to paraphrase items may not be sufficient to completely reveal item content as understood by patients. We used qualitative interviews to elicit more detailed information about patients' understanding of treatment goal items for the Patient Benefit Index 2.0 (PBI 2.0). This questionnaire measures patient-relevant benefit from treatments for skin diseases by assessing goal importance prior to and goal attainment after treatment. We interviewed 16 patients with psoriasis, atopic dermatitis, leg ulcers, and vitiligo. Patients were asked to elaborate in detail on their understanding of 15 treatment goal items. Subsequently, they were asked to suggest changes in item wording and to name missing treatment goals. Interview transcripts were analyzed according to an adapted approach of content analysis. The task was easy for the patients to understand, and they shared detailed information on what each goal meant to them. Results of the content analysis induced a range of revisions of the PBI 2.0 items, including changes in wording (four items) and item order (two items). Four items were deleted because they were found to be redundant or irrelevant, and one item was added to the list of treatment goals. Asking patients to elaborate on their item understanding in qualitative interviews provided detailed insight into item content and understandability. This method has helped considerably to improve feasibility and content validity of the PBI 2.0.

Children and youth with disabilities: innovative methods for single qualitative interviews.

PubMed

Teachman, Gail; Gibson, Barbara E

2013-02-01

There is a paucity of explicit literature outlining methods for single-interview studies with children, and almost none have focused on engaging children with disabilities. Drawing from a pilot study, we address these gaps by describing innovative techniques, strategies, and methods for engaging children and youth with disabilities in a single qualitative interview. In the study, we explored the beliefs, assumptions, and experiences of children and youth with cerebral palsy and their parents regarding the importance of walking. We describe three key aspects of our child-interview methodological approach: collaboration with parents, a toolkit of customizable interview techniques, and strategies to consider the power differential inherent in child-researcher interactions. Examples from our research illustrate what worked well and what was less successful. Researchers can optimize single interviews with children with disabilities by collaborating with family members and by preparing a toolkit of customizable interview techniques.

Traveler Information Services in Rural Tourism Areas. Appendix B: Qualitative Interviews and Focus Groups

DOT National Transportation Integrated Search

2000-06-30

Qualitative interviews were conducted with key informants and with tourists in northwest Arizona in Flagstaff and near the Grand Canyon National Park, Arizona, and in Branson, Missouri, in August and September 1998 (respectively). The interviews aske...

Examining the practice of generalist expertise: a qualitative study identifying constraints and solutions

PubMed Central

Reeve, Joanne; Dowrick, Christopher F; Freeman, George K; Gunn, Jane; Mair, Frances; May, Carl; Mercer, Stewart; Palmer, Victoria; Howe, Amanda; Irving, Greg; Shiner, Alice; Watson, Jessica

2013-01-01

Objectives Provision of person-centred generalist care is a core component of quality primary care systems. The World Health Organisation believes that a lack of generalist primary care is contributing to inefficiency, ineffectiveness and inequity in healthcare. In UK primary care, General Practitioners (GPs) are the largest group of practising generalists. Yet GPs fulfil multiple roles and the pressures of delivering these roles along with wider contextual changes create real challenges to generalist practice. Our study aimed to explore GP perceptions of enablers and constraints for expert generalist care, in order to identify what is needed to ensure health systems are designed to support the generalist role. Design Qualitative study in General Practice. Setting UK primary care. Main outcome measures A qualitative study – interviews, surveys and focus groups with GPs and GP trainees. Data collection and analysis was informed by Normalisation Process Theory. Design and setting Qualitative study in General Practice. We conducted interviews, surveys and focus groups with GPs and GP trainees based mainly, but not exclusively, in the UK. Data collection and analysis were informed by Normalization Process Theory. Participants UK based GPs (interview and surveys); European GP trainees (focus groups). Results Our findings highlight key gaps in current training and service design which may limit development and implementation of expert generalist practice (EGP). These include the lack of a consistent and universal understanding of the distinct expertise of EGP, competing priorities inhibiting the delivery of EGP, lack of the consistent development of skills in interpretive practice and a lack of resources for monitoring EGP. Conclusions We describe four areas for change: Translating EGP, Priority setting for EGP, Trusting EGP and Identifying the impact of EGP. We outline proposals for work needed in each area to help enhance the expert generalist role. PMID:24475347

Factors associated with Taiwanese lesbians' breast health-care behavior and intentions: Qualitative interview findings.

PubMed

Wang, Ya-Ching; Griffiths, Jane; Grande, Gunn

2017-09-01

This article presents the qualitative findings of a mixed-methods study that explored factors influencing lesbians' breast health-care behavior and intentions. A total of 37 semi-structured face-to-face interviews were conducted among women who self-identified as lesbians or women who partnered with the same gender who were aged 20 years or above in four areas of Taiwan (North, Central, South, and East Taiwan) between August 2012 and October 2012. Interviews were audio recorded with participants' consent. The interviews were analyzed using constant comparative analysis with Nvivo audio-coding support. Four themes were identified to be strongly associated with the lesbians' breast health-care behavior and their intentions, namely, gender identity, gender role expression, partners' support, and concerns about health-care providers' reactions. Important barriers to the women's breast health-care behavior and intentions were masculine identity ("T-identity" in Taiwan), masculine appearance, concerns about health-care providers' lack of knowledge of multiple gender diversity, and their attitudes toward lesbians. Conversely, their partners' support was a factor facilitating the women's breast health-care behavior and intentions, particularly for the T-identity lesbians. These findings suggest the significance of and need for culturally competent care and are important for improving Taiwanese lesbians' breast health.

The Impact of a Qualitative Research Interview on Workers' Views of Their Situation

ERIC Educational Resources Information Center

Butterfield, Lee D.; Borgen, William A.; Amundson, Norman E.

2009-01-01

The purpose of this research was to explore whether qualitative research interviews impacted participants' views of their situations. Forty-five workers who reported handling well changes that affected their work were interviewed to explore their experiences of change, factors that helped and hindered their ability to handle change, and assess the…

What factors influence the production of orthopaedic research in East Africa? A qualitative analysis of interviews.

PubMed

Elliott, Iain S; Sonshine, Daniel B; Akhavan, Sina; Slade Shantz, Angelique; Caldwell, Amber; Slade Shantz, Jesse; Gosselin, Richard A; Coughlin, R Richard

2015-06-01

Research addressing the burden of musculoskeletal disease in low- and middle-income countries does not reflect the magnitude of the epidemic in these countries as only 9% of the world's biomedical resources are devoted to addressing problems that affect the health of 90% of the world's population. Little is known regarding the barriers to and drivers of orthopaedic surgery research in such resource-poor settings, the knowledge of which would help direct specific interventions for increasing research capacity and help surgeons from high-income countries support the efforts of our colleagues in low- and middle-income countries. We sought to identify through surveying academic orthopaedic surgeons in East Africa: (1) barriers impeding research, (2) factors that support or drive research, and (3) factors that were identified by some surgeons as barriers and others as drivers (what we term barrier-driver overlap) as they considered the production of clinical research in resource-poor environments. Semistructured interviews were conducted with 21 orthopaedic surgeon faculty members at four academic medical centers in Ethiopia, Kenya, Tanzania, and Uganda. Qualitative content analysis of the interviews was conducted using methods based in grounded theory. Grounded theory begins with qualitative data, such as interview transcripts, and analyzes the data for repeated ideas or concepts which then are coded and grouped into categories which allow for identification of subjects or problems that may not have been apparent previously to the interviewer. We identified and quantified 19 barriers to and 21 drivers of orthopaedic surgery research (mentioned n = 1688 and n = 1729, respectively). Resource, research process, and institutional domains were identified to categorize the barriers (n = 7, n = 5, n = 7, respectively) and drivers (n = 7, n = 8, n = 6, respectively). Resource barriers (46%) were discussed more often by interview subjects compared with the

Using the cognitive interviewing process to improve survey design by allied health: A qualitative study.

PubMed

Howlett, Owen; McKinstry, Carol; Lannin, Natasha A

2018-04-01

Allied health professionals frequently use surveys to collect data for clinical practice and service improvement projects. Careful development and piloting of purpose-designed surveys is important to ensure intended measuring (that respondents correctly interpret survey items when responding). Cognitive interviewing is a specific technique that can improve the design of self-administered surveys. The aim of this study was to describe the use of the cognitive interviewing process to improve survey design, which involved a purpose-designed, online survey evaluating staff use of functional electrical stimulation. A qualitative study involving one round of cognitive interviewing with three occupational therapists and three physiotherapists. The cognitive interviewing process identified 11 issues with the draft survey, which could potentially influence the validity and quality of responses. The raised issues included difficulties with: processing the question to be able to respond, determining a response to the question, retrieving relevant information from memory and comprehending the written question. Twelve survey amendments were made following the cognitive interviewing process, comprising four additions, seven revisions and one correction. The cognitive interviewing process applied during the development of a purpose-designed survey enabled the identification of potential problems and informed revisions to the survey prior to its use. © 2017 Occupational Therapy Australia.

Interview-based Qualitative Research in Emergency Care Part II: Data Collection, Analysis and Results Reporting.

PubMed

Ranney, Megan L; Meisel, Zachary F; Choo, Esther K; Garro, Aris C; Sasson, Comilla; Morrow Guthrie, Kate

2015-09-01

Qualitative methods are increasingly being used in emergency care research. Rigorous qualitative methods can play a critical role in advancing the emergency care research agenda by allowing investigators to generate hypotheses, gain an in-depth understanding of health problems or specific populations, create expert consensus, and develop new intervention and dissemination strategies. In Part I of this two-article series, we provided an introduction to general principles of applied qualitative health research and examples of its common use in emergency care research, describing study designs and data collection methods most relevant to our field (observation, individual interviews, and focus groups). Here in Part II of this series, we outline the specific steps necessary to conduct a valid and reliable qualitative research project, with a focus on interview-based studies. These elements include building the research team, preparing data collection guides, defining and obtaining an adequate sample, collecting and organizing qualitative data, and coding and analyzing the data. We also discuss potential ethical considerations unique to qualitative research as it relates to emergency care research. © 2015 by the Society for Academic Emergency Medicine.

Interview-Based Qualitative Research in Emergency Care Part II: Data Collection, Analysis and Results Reporting

PubMed Central

Ranney, Megan L.; Meisel, Zachary; Choo, Esther K.; Garro, Aris; Sasson, Comilla; Morrow, Kathleen

2015-01-01

Qualitative methods are increasingly being used in emergency care research. Rigorous qualitative methods can play a critical role in advancing the emergency care research agenda by allowing investigators to generate hypotheses, gain an in-depth understanding of health problems or specific populations, create expert consensus, and develop new intervention and dissemination strategies. In Part I of this two-article series, we provided an introduction to general principles of applied qualitative health research and examples of its common use in emergency care research, describing study designs and data collection methods most relevant to our field (observation, individual interviews, and focus groups). Here in Part II of this series, we outline the specific steps necessary to conduct a valid and reliable qualitative research project, with a focus on interview-based studies. These elements include building the research team, preparing data collection guides, defining and obtaining an adequate sample, collecting and organizing qualitative data, and coding and analyzing the data. We also discuss potential ethical considerations unique to qualitative research as it relates to emergency care research. PMID:26284572

Video Elicitation Interviews: A Qualitative Research Method for Investigating Physician-Patient Interactions

PubMed Central

Henry, Stephen G.; Fetters, Michael D.

2012-01-01

We describe the concept and method of video elicitation interviews and provide practical guidance for primary care researchers who want to use this qualitative method to investigate physician-patient interactions. During video elicitation interviews, researchers interview patients or physicians about a recent clinical interaction using a video recording of that interaction as an elicitation tool. Video elicitation is useful because it allows researchers to integrate data about the content of physician-patient interactions gained from video recordings with data about participants’ associated thoughts, beliefs, and emotions gained from elicitation interviews. This method also facilitates investigation of specific events or moments during interactions. Video elicitation interviews are logistically demanding and time consuming, and they should be reserved for research questions that cannot be fully addressed using either standard interviews or video recordings in isolation. As many components of primary care fall into this category, high-quality video elicitation interviews can be an important method for understanding and improving physician-patient interactions in primary care. PMID:22412003

Video elicitation interviews: a qualitative research method for investigating physician-patient interactions.

PubMed

Henry, Stephen G; Fetters, Michael D

2012-01-01

We describe the concept and method of video elicitation interviews and provide practical guidance for primary care researchers who want to use this qualitative method to investigate physician-patient interactions. During video elicitation interviews, researchers interview patients or physicians about a recent clinical interaction using a video recording of that interaction as an elicitation tool. Video elicitation is useful because it allows researchers to integrate data about the content of physician-patient interactions gained from video recordings with data about participants' associated thoughts, beliefs, and emotions gained from elicitation interviews. This method also facilitates investigation of specific events or moments during interactions. Video elicitation interviews are logistically demanding and time consuming, and they should be reserved for research questions that cannot be fully addressed using either standard interviews or video recordings in isolation. As many components of primary care fall into this category, high-quality video elicitation interviews can be an important method for understanding and improving physician-patient interactions in primary care.

Using Qualitative Comparative Analysis of Key Informant Interviews in Health Services Research: Enhancing a Study of Adjuvant Therapy Use in Breast Cancer Care.

PubMed

McAlearney, Ann Scheck; Walker, Daniel; Moss, Alexandra D; Bickell, Nina A

2016-04-01

Qualitative comparative analysis (QCA) is a methodology created to address causal complexity in social sciences research by preserving the objectivity of quantitative data analysis without losing detail inherent in qualitative research. However, its use in health services research (HSR) is limited, and questions remain about its application in this context. To explore the strengths and weaknesses of using QCA for HSR. Using data from semistructured interviews conducted as part of a multiple case study about adjuvant treatment underuse among underserved breast cancer patients, findings were compared using qualitative approaches with and without QCA to identify strengths, challenges, and opportunities presented by QCA. Ninety administrative and clinical key informants interviewed across 10 NYC area safety net hospitals. Transcribed interviews were coded by 3 investigators using an iterative and interactive approach. Codes were calibrated for QCA, as well as examined using qualitative analysis without QCA. Relative to traditional qualitative analysis, QCA strengths include: (1) addressing causal complexity, (2) results presentation as pathways as opposed to a list, (3) identification of necessary conditions, (4) the option of fuzzy-set calibrations, and (5) QCA-specific parameters of fit that allow researchers to compare outcome pathways. Weaknesses include: (1) few guidelines and examples exist for calibrating interview data, (2) not designed to create predictive models, and (3) unidirectionality. Through its presentation of results as pathways, QCA can highlight factors most important for production of an outcome. This strength can yield unique benefits for HSR not available through other methods.

Cognitive Interviewing: A Qualitative Tool for Improving Questionnaires in Sport Science

ERIC Educational Resources Information Center

Dietrich, Hanno; Ehrlenspiel, Felix

2010-01-01

Cognitive models postulate that respondents to a questionnaire follow a four-stage process when answering a question: comprehension, memory retrieval, decision, and response. Cognitive interviewing is a qualitative tool to gain insight into this process by means of letting respondents think aloud or asking them specific questions (Willis, 2005).…

Why patients self-refer to the Emergency Department: A qualitative interview study.

PubMed

Kraaijvanger, Nicole; Rijpsma, Douwe; Willink, Lisa; Lucassen, Peter; van Leeuwen, Henk; Edwards, Michael

2017-06-01

There have been multiple studies investigating reasons for patients to self-refer to the Emergency Department (ED). The majority made use of questionnaires and excluded patients with urgent conditions. The goal of this qualitative study is to explore what motives patients have to self-refer to an ED, also including patients in urgent triage categories. In a large teaching hospital in the Netherlands, a qualitative interview study focusing on reasons for self-referring to the ED was performed. Self-referred patients were included until no new reasons for attending the ED were found. Exclusion criteria were as follows: not mentally able to be interviewed or not speaking Dutch. Patients who were in need of urgent care were treated first, before being asked to participate. Interviews followed a predefined topic guide. Practicing cyclic analysis, the interview topic guide was modified during the inclusion period. Interviews were recorded on an audio recorder, transcribed verbatim, and anonymized. Two investigators independently coded the information and combined the codes into meaningful clusters. Subsequently, these were categorized into themes to build a framework of reasons for self-referral to the ED. Characteristic quotes were used to illustrate the acquired theoretical framework. Thirty self-referred patients were interviewed. Most of the participants were male (63%), with a mean age of 46 years. Two main themes emerged from the interviews that are pertinent to the patients' decisions to attend the ED: (1) health concerns and (2) practical issues. This study found that there are 2 clearly distinctive reasons for self-referral to the ED: health concerns or practical motives. Self-referral because of practical motives is probably most suitable for strategies that aim to reduce inappropriate ED visits. © 2016 John Wiley & Sons, Ltd.

Social Network Analysis and Qualitative Interviews for Assessing Geographic Characteristics of Tourism Business Networks.

PubMed

Kelman, Ilan; Luthe, Tobias; Wyss, Romano; Tørnblad, Silje H; Evers, Yvette; Curran, Marina Martin; Williams, Richard J; Berlow, Eric L

2016-01-01

This study integrates quantitative social network analysis (SNA) and qualitative interviews for understanding tourism business links in isolated communities through analysing spatial characteristics. Two case studies are used, the Surselva-Gotthard region in the Swiss Alps and Longyearbyen in the Arctic archipelago of Svalbard, to test the spatial characteristics of physical proximity, isolation, and smallness for understanding tourism business links. In the larger Surselva-Gotthard region, we found a strong relationship between geographic separation of the three communities on compartmentalization of the collaboration network. A small set of businesses played a central role in steering collaborative decisions for this community, while a group of structurally 'peripheral' actors were less influential. By contrast, the business community in Svalbard showed compartmentalization that was independent of geographic distance between actors. Within towns of similar size and governance scale, Svalbard is more compartmentalized, and those compartments are not driven by geographic separation of the collaboration clusters. This compartmentalization in Svalbard was reflected in a lower density of formal business collaboration ties compared to the communities of the Alps. We infer that the difference is due to Svalbard having higher cultural diversity and population turnover than the Alps communities. We propose that integrating quantitative network analysis from simple surveys with qualitative interviews targeted from the network results is an efficient general approach to identify regionally specific constraints and opportunities for effective governance.

Social Network Analysis and Qualitative Interviews for Assessing Geographic Characteristics of Tourism Business Networks

PubMed Central

Luthe, Tobias; Wyss, Romano; Tørnblad, Silje H.; Evers, Yvette; Curran, Marina Martin; Williams, Richard J.; Berlow, Eric L.

2016-01-01

This study integrates quantitative social network analysis (SNA) and qualitative interviews for understanding tourism business links in isolated communities through analysing spatial characteristics. Two case studies are used, the Surselva-Gotthard region in the Swiss Alps and Longyearbyen in the Arctic archipelago of Svalbard, to test the spatial characteristics of physical proximity, isolation, and smallness for understanding tourism business links. In the larger Surselva-Gotthard region, we found a strong relationship between geographic separation of the three communities on compartmentalization of the collaboration network. A small set of businesses played a central role in steering collaborative decisions for this community, while a group of structurally ‘peripheral’ actors were less influential. By contrast, the business community in Svalbard showed compartmentalization that was independent of geographic distance between actors. Within towns of similar size and governance scale, Svalbard is more compartmentalized, and those compartments are not driven by geographic separation of the collaboration clusters. This compartmentalization in Svalbard was reflected in a lower density of formal business collaboration ties compared to the communities of the Alps. We infer that the difference is due to Svalbard having higher cultural diversity and population turnover than the Alps communities. We propose that integrating quantitative network analysis from simple surveys with qualitative interviews targeted from the network results is an efficient general approach to identify regionally specific constraints and opportunities for effective governance. PMID:27258007

The qualitative interview and challenges for clinicians undertaking research: a personal reflection.

PubMed

Fisher, Karin

2011-01-01

Drawing on my doctoral experience the aim of this article is to present my transition from practitioner to novice researcher and the challenges I encountered when undertaking qualitative in-depth interviews. The contents of my research diary were coded for words, sentences and paragraphs and were then grouped into themes and subsequently organised into concepts and categories. The analysis identified one core category: 'changing states: learning to become a researcher'. The related categories included 'guessing responses', 'confusing boundaries' and 'revealing hidden concepts'. These concepts provide a description of how I learnt to become a researcher and became a changed state. The paper provides practitioners with practical examples of my transition from practitioner to novice researcher. I offer some tips for practitioners who wish to undertake research in their clinical role.

Online stroke forum as source of data for qualitative research: insights from a comparison with patients’ interviews

PubMed Central

Jamison, James; Sutton, Stephen; Mant, Jonathan; De Simoni, Anna

2018-01-01

Objective To determine the appropriateness of an online forum compared with face-to-face interviews as a source of data for qualitative research on adherence to secondary prevention medications after stroke. Design A comparison of attributes of two data sources, interviews and a forum, using realistic evaluation; a comparison of themes around adherence according to the Perceptions and Practicalities Approach (PAPA) framework. Setting Interviews were conducted in UK GP practices in 2013 and 2014; online posts were written by UK stroke survivors and family members taking part in the online forum of the Stroke Association between 2004 and 2011. Participants 42 interview participants: 28 stroke survivors (age range 61–92 years) and 14 caregivers (85% spouses). 84 online forum participants: 49 stroke survivors (age range 32–72 years) and 33 caregivers (60% sons/daughters). Results 10 attributes were identified within the two data sources and categorised under three domains (context, mechanisms and outcomes). Participants’ characteristics of forum users were often missing. Most forum participants had experienced a stroke within the previous 12 months, while interviewees had done so 1–5 years previously. All interview themes could be matched with corresponding themes from the forum. The forum yielded three additional themes: influence of bad press on taking statins, criticisms of clinicians’ prescribing practices and caregiver burden in assisting with medications and being advocates for survivors with healthcare professionals. Conclusions An online forum is an appropriate source of data for qualitative research on patients’ and caregivers’ issues with adherence to secondary prevention stroke medications and may offer additional insights compared with interviews, which can be attributed to differences in the approach to data collection. PMID:29602848

Online stroke forum as source of data for qualitative research: insights from a comparison with patients' interviews.

PubMed

Jamison, James; Sutton, Stephen; Mant, Jonathan; De Simoni, Anna

2018-03-30

To determine the appropriateness of an online forum compared with face-to-face interviews as a source of data for qualitative research on adherence to secondary prevention medications after stroke. A comparison of attributes of two data sources, interviews and a forum, using realistic evaluation; a comparison of themes around adherence according to the Perceptions and Practicalities Approach (PAPA) framework. Interviews were conducted in UK GP practices in 2013 and 2014; online posts were written by UK stroke survivors and family members taking part in the online forum of the Stroke Association between 2004 and 2011. 42 interview participants: 28 stroke survivors (age range 61-92 years) and 14 caregivers (85% spouses). 84 online forum participants: 49 stroke survivors (age range 32-72 years) and 33 caregivers (60% sons/daughters). 10 attributes were identified within the two data sources and categorised under three domains (context, mechanisms and outcomes). Participants' characteristics of forum users were often missing. Most forum participants had experienced a stroke within the previous 12 months, while interviewees had done so 1-5 years previously.All interview themes could be matched with corresponding themes from the forum. The forum yielded three additional themes: influence of bad press on taking statins, criticisms of clinicians' prescribing practices and caregiver burden in assisting with medications and being advocates for survivors with healthcare professionals. An online forum is an appropriate source of data for qualitative research on patients' and caregivers' issues with adherence to secondary prevention stroke medications and may offer additional insights compared with interviews, which can be attributed to differences in the approach to data collection. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Identifying Motives of Midlife Black Triathlete Women Using Survey Transformation to Guide Qualitative Inquiry.

PubMed

Brown, Candace S; Masters, Kevin S; Huebschmann, Amy G

2018-03-01

Demonstrating health disparities related to race, age, and gender, older Black women (BW) are the most sedentary demographic group in the United States. Increasing PA in mid-life is important, as it improves health as BW age into their later years. Advancing our understanding of the exercise motives of BW triathletes presents a "reverse engineering" opportunity to identify motives that could influence sedentary mid-life BW to increase their activity. The purposes of this study were to: (a) utilize an innovative survey transformation method to adapt a measure developed primarily in Caucasian males, i.e., the Motivations of Marathoners Scale for Triathletes (MOMS-T) into a qualitative interview guide for use with BW triathletes; (b) use this interview guide to identify culturally based motives for triathlon participation among BW not previously addressed by the MOMS-T and; (c) interpret the novel motivational domains of the MOMS-T discovered, in order to gain understanding and influence subsequent interventions. Purposive sampling was used to select 12 interview participants from 121 self-identified Black female US residents aged ≥36 years with recent experience completing or training for a triathlon. The interviews identified four culturally based themes, including improving body composition to become "more lean", physical attractiveness, triathlete family, and camaraderie. These novel themes were related to existing MOMS-T scales, but the current MOMS-T questions did not illuminate their culturally distinct aspects. The process of survey transformation provides a viable approach to identify important culturally based characteristics and to adapt surveys to cultural minority populations, particularly when study resources are limited.

Patients’ experience of identifying and managing exacerbations in COPD: a qualitative study

PubMed Central

Williams, Veronika; Hardinge, Maxine; Ryan, Sara; Farmer, Andrew

2014-01-01

Background: Effective self-management in chronic obstructive pulmonary disease (COPD) is crucial to reduce hospital admissions and improve outcomes for patients. This includes early detection and treatment of exacerbations by patients themselves. Aims: To explore patients’ current understanding and experience of managing and identifying COPD exacerbations at home. Methods: A qualitative, interview-based study was carried out in patients’ homes. Interviews were audio-recorded, transcribed and analysed using a grounded theory approach. Forty-four patients (17 women, 27 men; age range 55–85 years), with moderate-to-very-severe COPD, were recruited to the interview study from primary and secondary care settings in Oxford, UK, during 2012–2013. Results: Patients identified exacerbations on the basis of measurable, ‘visible’ symptoms, such as cough and sputum and ‘invisible’ symptoms, such as chest sensations and bodily knowledge. Most patients seemed to use a combination of these approaches when identifying exacerbations, according to the symptoms that had the most impact on their well-being. Patients used additional self-management strategies during an exacerbation, such as self-medication (antibiotics and steroids) and monitored their recovery. Contact with health-care professionals usually occurred when patients felt no longer able to manage themselves. Conclusions: Patients use both assessment of objective biomarkers, which are aligned with medical knowledge, and subjective symptoms based on their experience, to identify and manage exacerbations of COPD. Health-care professionals and clinicians should acknowledge this ‘expert patient’ knowledge and integrate this into patients’ care plans to facilitate early recognition and treatment of exacerbations. PMID:25372181

Is the qualitative research interview an acceptable medium for research with palliative care patients and carers?

PubMed Central

Gysels, Marjolein; Shipman, Cathy; Higginson, Irene J

2008-01-01

Background Contradictory evidence exists about the emotional burden of participating in qualitative research for palliative care patients and carers and this raises questions about whether this type of research is ethically justified in a vulnerable population. This study aimed to investigate palliative care patients' and carers' perceptions of the benefits and problems associated with open interviews and to understand what causes distress and what is helpful about participation in a research interview. Methods A descriptive qualitative study. The data were collected in the context of two studies exploring the experiences of care of palliative care patients and carers. The interviews ended with questions about patients' and carers' thoughts on participating in the studies and whether this had been a distressing or helpful event. We used a qualitative descriptive analysis strategy generated from the interviews and the observational and interactional data obtained in the course of the study. Results The interviews were considered helpful: sharing problems was therapeutic and being able to contribute to research was empowering. However, thinking about the future was reported to be the most challenging. Consent forms were sometimes read with apprehension and being physically unable to sign was experienced as upsetting. Interviewing patients and carers separately was sometimes difficult and not always possible. Conclusion The open interview enables the perspectives of patients and carers to be heard, unfettered from the structure of closed questions. It also enables those patients or carers to take part who would be unable to participate in other study designs. The context is at least as important as the format of the research interview taking into account the relational circumstances with carers and appropriate ways of obtaining informed consent. Retrospective consent could be a solution to enhancing participants control over the interview. PMID:18435846

Using Qualitative Comparative Analysis (QCA) of Key Informant Interviews in Health Services Research: Enhancing a Study of Adjuvant Therapy Use in Breast Cancer Care

PubMed Central

McAlearney, Ann Scheck; Walker, Daniel; Moss, Alexandra DeNardis; Bickell, Nina A.

2015-01-01

Background Qualitative Comparative Analysis (QCA) is a methodology created to address causal complexity in social sciences research by preserving the objectivity of quantitative data analysis without losing detail inherent in qualitative research. However, its use in health services research (HSR) is limited, and questions remain about its application in this context. Objective To explore the strengths and weaknesses of using QCA for HSR. Research Design Using data from semi-structured interviews conducted as part of a multiple case study about adjuvant treatment underuse among underserved breast cancer patients, findings were compared using qualitative approaches with and without QCA to identify strengths, challenges, and opportunities presented by QCA. Subjects Ninety administrative and clinical key informants interviewed across ten NYC area safety net hospitals. Measures Transcribed interviews were coded by three investigators using an iterative and interactive approach. Codes were calibrated for QCA, as well as examined using qualitative analysis without QCA. Results Relative to traditional qualitative analysis, QCA strengths include: (1) addressing causal complexity, (2) results presentation as pathways as opposed to a list, (3) identification of necessary conditions, (4) the option of fuzzy-set calibrations, and (5) QCA-specific parameters of fit that allow researchers to compare outcome pathways. Weaknesses include: (1) few guidelines and examples exist for calibrating interview data, (2) not designed to create predictive models, and (3) unidirectionality. Conclusions Through its presentation of results as pathways, QCA can highlight factors most important for production of an outcome. This strength can yield unique benefits for HSR not available through other methods. PMID:26908085

The meaning and experience of bereavement support: A qualitative interview study of bereaved family caregivers.

PubMed

Kirby, Emma; Kenny, Katherine; Broom, Alex; MacArtney, John; Good, Phillip

2017-06-21

Experiences of bereavement can be stressful and are frequently complicated by emotional, familial, and financial issues. Some-though not all-caregivers may benefit from bereavement support. While considered standard within palliative care services in Australia, bereavement support is not widely utilized by family caregivers. There is little research focused on the forms of bereavement support desired or required by family caregivers, how such care is viewed, and/or how bereavement support is experienced. This study examined the experiences of bereaved family caregivers and their impressions of and interactions with bereavement support. This paper reports on one aspect of a broader study designed to explore a range of experiences of patients and caregivers to and through palliative care. Focusing on experiences of bereavement, it draws on qualitative semistructured interviews with 15 family caregivers of palliative care patients within a specialist palliative care unit of an Australian metropolitan hospital. The interviews for this stage of the study were initiated 3-9 months after an initial interview with a family caregiver, during which time the palliative patient had died, and they covered family caregivers' experiences of bereavement and bereavement support. Interviews were digitally audiotaped and transcribed in full. A thematic analysis was conducted utilizing the framework approach wherein interview transcripts were reviewed, key themes identified, and explanations developed. The research identified four prevalent themes: (1) sociocultural constructions of bereavement support as for the incapable or socially isolated; (2) perceptions of bereavement support services as narrow in scope; (3) the "personal" character of bereavement and subsequent incompatibility with formalized support, and (4) issues around the timing and style of approaches to being offered support. Systematic pre-bereavement planning and careful communication about the services offered by

Follow-Up of Young Adults With ADHD in the MTA: Design and Methods for Qualitative Interviews.

PubMed

Weisner, Thomas S; Murray, Desiree W; Jensen, Peter S; Mitchell, John T; Swanson, James M; Hinshaw, Stephen P; Wells, Karen; Hechtman, Lily; Molina, Brooke S G; Arnold, L Eugene; Sorensen, Page; Stehli, Annamarie

2017-06-01

Qualitative interviews with 183 young adults (YA) in the follow-up of the Multimodal Treatment Study of Children With and Without ADHD (MTA) provide rich information on beliefs and expectations regarding ADHD, life's turning points, medication use, and substance use (SU). Participants from four MTA sites were sampled to include those with persistent and atypically high SU, and a local normative comparison group (LNCG). Respondents were encouraged to "tell their story" about their lives, using a semistructured conversational interview format. Interviews were reliably coded for interview topics. ADHD youth more often desisted from SU because of seeing others going down wrong paths due to SU. Narratives revealed very diverse accounts and explanations for SU-ADHD influences. Qualitative methods captured the perspectives of YAs regarding using substances. This information is essential for improving resilience models in drug prevention and treatment programs and for treatment development for this at-risk population.

Exceptionally good? Positive experiences of NHS care and treatment surprises lymphoma patients: a qualitative interview study.

PubMed

Ziebland, Sue; Evans, Julie; Toynbee, Polly

2011-03-01

Initial analysis of an interview study with patients about their experiences of lymphoma identified a strong emergent theme suggesting people were surprised to receive good care in the UK National Health Service. This qualitative analysis helps illuminate the disparity between public perceptions of NHS care and individual experiences. Forty-one women and men with lymphoma were interviewed at home by an academic social scientist; nine who had had all their treatment before 1997 were excluded from this analysis. Initial qualitative thematic analysis used constant comparison and axial coding. Using narrative analytic methods, we explored how the accounts of positive experiences were structured and framed as well as what was said. Every person we interviewed described positive experiences of the NHS. These included the skills and humanity of the specialist staff involved in their care, the team work, the organization of care and communication and information. However, these positive experiences were often framed as personal good fortune rather than an indication that a high standard might be expected of NHS cancer care. Participants' accounts also suggest a discrepancy through the use of framing devices that imply that less professional, kind and caring treatment might be expected. People may be able to maintain the apparently contradictory opinions that the NHS is not very good, even if their own experience of care is excellent, if they construct their own experience as 'lucky'. Health professionals could help by reassuring patients with a more positive, realistic expectation of specialist care. © 2010 The Authors. Health Expectations © 2010 Blackwell Publishing Ltd.

Exceptionally good? Positive experiences of NHS care and treatment surprises lymphoma patients: a qualitative interview study

PubMed Central

Ziebland, Sue; Evans, Julie; Toynbee, Polly

2010-01-01

Abstract Objective  Initial analysis of an interview study with patients about their experiences of lymphoma identified a strong emergent theme suggesting people were surprised to receive good care in the UK National Health Service. This qualitative analysis helps illuminate the disparity between public perceptions of NHS care and individual experiences. Participants and setting  Forty‐one women and men with lymphoma were interviewed at home by an academic social scientist; nine who had had all their treatment before 1997 were excluded from this analysis. Design  Initial qualitative thematic analysis used constant comparison and axial coding. Using narrative analytic methods, we explored how the accounts of positive experiences were structured and framed as well as what was said. Results  Every person we interviewed described positive experiences of the NHS. These included the skills and humanity of the specialist staff involved in their care, the team work, the organization of care and communication and information. However, these positive experiences were often framed as personal good fortune rather than an indication that a high standard might be expected of NHS cancer care. Participants’ accounts also suggest a discrepancy through the use of framing devices that imply that less professional, kind and caring treatment might be expected. Conclusion  People may be able to maintain the apparently contradictory opinions that the NHS is not very good, even if their own experience of care is excellent, if they construct their own experience as ‘lucky’. Health professionals could help by reassuring patients with a more positive, realistic expectation of specialist care. PMID:20579116

Understanding Women's Differing Experiences of Distress after Colposcopy: A Qualitative Interview Study.

PubMed

O'Connor, Mairead; Waller, Jo; Gallagher, Pamela; Martin, Cara M; O'Leary, John J; D'Arcy, Tom; Prendiville, Walter; Flannelly, Grainne; Sharp, Linda

2015-01-01

Women who have an abnormal cervical cytology test may be referred for a colposcopy. Accumulating evidence suggests some women may experience distress after colposcopy. This exploratory study examined women's differing experiences of post-colposcopy distress with the aim of identifying factors that are predictive of, or protective against, distress. We carried out semistructured, qualitative interviews with 23 women who had undergone colposcopies. Interviews were transcribed verbatim, coded, and analyzed thematically. The Framework Approach was used to summarize and organize the data and identify emerging higher order themes. Two forms of post-colposcopy distress emerged: 1) short term and 2) long term. Short-term distress was experienced immediately after the colposcopy and in the days afterward, and was usually related to the physical experience of the colposcopy. Long-term distress typically persisted over time and was related to concerns about fertility, cervical cancer, and sexual intercourse. The drivers of short-term and long-term distress differed. Factors related to short-term distress were feeling unprepared for the procedure, having a negative experience of the procedure, and attending the clinic alone. Factors related to long-term distress were future intentions to have (more) children, having physical after-effects of the procedure that impacted on the woman's life, and being under on-going clinic surveillance. Absence of these factors (e.g., being accompanied to the clinic) was protective against short- and long-term distress. Colposcopy can lead to short- and long-term post-procedural distress for some women. We identified a range of factors, some potentially modifiable, that seem to influence the chances of experiencing distress. These results may inform the development of strategies or interventions aimed at preventing or minimizing distress after colposcopy and related procedures. Copyright © 2015 Jacobs Institute of Women's Health. Published by

Alcohol brief interventions practice following training for multidisciplinary health and social care teams: A qualitative interview study

PubMed Central

Fitzgerald, Niamh; Molloy, Heather; MacDonald, Fiona; McCambridge, Jim

2015-01-01

Introduction and Aims Few studies of the implementation of alcohol brief interventions (ABI) have been conducted in community settings such as mental health, social work and criminal justice teams. This qualitative interview study sought to explore the impact of training on ABI delivery by staff from a variety of such teams. Design and Methods Fifteen semi-structured telephone interviews were carried out with trained practitioners and with managers to explore the use of, perceived need for and approaches to ABI delivery and recording with clients, and compatibility of ABIs with current practice. Interviews were analysed thematically using an inductive approach. Results Very few practitioners reported delivery of any ABIs following training primarily because they felt ABIs to be inappropriate for their clients. According to practitioners, this was either because they drank too much or too little to benefit. Practitioners reported a range of current activities relating to alcohol, and some felt that their knowledge and confidence were improved following training. One practitioner reported ABI delivery and was considered a training success, while expectations of ABIs did not fit with current practice including assessment procedures for the remainder. Discussion and Conclusions Identified barriers to ABI delivery included issues relating to individual practitioners, their teams, current practice and the ABI model. They are likely to be best addressed by strategic team- and setting-specific approaches to implementation, of which training is only one part. [Fitzgerald N, Molloy H, MacDonald F, McCambridge J. Alcohol brief interventions practice following training for multidisciplinary health and social care teams: A qualitative interview study. Drug Alcohol Rev 2015;34:185–93] PMID:25196713

[Application of qualitative interviews in inheritance research of famous old traditional Chinese medicine doctors: ideas and experience].

PubMed

Luo, Jing; Fu, Chang-geng; Xu, Hao

2015-04-01

The inheritance of famous old traditional Chinese medicine (TCM) doctors plays an essential role in the fields of TCM research. Qualitative interviews allow for subjectivity and individuality within clinical experience as well as academic ideas of doctors, making it a potential appropriate research method for inheritance of famous old TCM doctors. We summarized current situations of inheritance research on famous old TCM doctors, and then discussed the feasibility of applying qualitative interviews in inheritance of famous old TCM doctors. By combining our experience in research on inheritance of famous old TCM doctors, we gave some advice on study design, interview implementation, data transcription and analyses , and report writing, providing a reference for further relevant research.

Senior Medical Student Mock Interview Program in Pediatrics.

PubMed

Multerer, Sara; Carothers, Becky; Patel, Pradip D; Ziegler, Craig; Rowland, Michael; Davis, Deborah Winders

2016-02-01

Residency interviews play an integral part in medical residency placement. We aimed to develop and evaluate a mock interview program for fourth-year medical students interested in a pediatric specialty. A mock interview program for fourth-year medical students interested in pediatrics was developed and implemented. Preinterview quantitative data and postinterview qualitative data were collected. Fifty-nine students completed the program across three consecutive academic years. Preinterview surveys were completed regarding comfort and confidence levels specific to aspects of the interview process. Descriptive analyses were used. In addition, a focus group was held with nine of the participating students to obtain qualitative data via a paper blog process. Themes in student responses were identified through constant comparative analysis. Before the mock interview, students were most uncomfortable with introductory and closing remarks and their confidence levels varied by topic. A thematic analysis of focus group data identified five themes (preparation, stress reduction, interview process familiarity, confidence of skills, and receiving feedback) for which the mock interviews were most helpful. Implementation of a mock interview program was feasible and acceptable for senior medical students and may improve comfort and confidence levels in the residency interview process. Further longitudinal research is needed.

Benefits of participating in internet interviews: women helping women.

PubMed

Beck, Cheryl Tatano

2005-03-01

Advantages of face-to-face qualitative interviews for participants have been addressed in the literature. The benefits of participating in qualitative interviews over the Internet, however, have yet to be discussed. Based on the experiences of 40 women who made up the sample for an Internet study on birth trauma, the author describes in this article the benefits reaped by these mothers through their participation in qualitative e-mail interviews. She used content analysis to identify these benefits. Seven themes emerged: experiencing caring by being listened to and acknowledged, sense of belonging, making sense of it all, letting go, being empowered, women helping women, and providing a voice.

Contraceptive counselling of women seeking abortion - a qualitative interview study of health professionals' experiences.

PubMed

Kilander, Helena; Salomonsson, Birgitta; Thor, Johan; Brynhildsen, Jan; Alehagen, Siw

2017-02-01

A substantial proportion of women who undergo an abortion continue afterwards without switching to more effective contraceptive use. Many subsequently have repeat unintended pregnancies. This study, therefore, aimed to identify and describe health professionalś experiences of providing contraceptive counselling to women seeking an abortion. We interviewed 21 health professionals (HPs), involved in contraceptive counselling of women seeking abortion at three differently sized hospitals in Sweden. The interviews were recorded and transcribed verbatim and analysed using conventional qualitative content analysis. Three clusters were identified: 'Complex counselling', 'Elements of counselling' and 'Finding a method'. HPs often experienced consultations including contraceptive counselling at the time of an abortion as complex, covering both pregnancy termination and contraceptive counselling. Women with vulnerabilities placed even greater demands on the HPs providing counselling. The HPs varied in their approaches when providing contraceptive counselling but also in their knowledge about certain contraception methods. HPs described challenges in finding out if women had found an effective method and in the practicalities of arranging intrauterine device (IUD) insertion post-abortion, when a woman asked for this method. HPs found it challenging to provide contraceptive counselling at the time of an abortion and to arrange access to IUDs post-abortion. There is a need to improve their counselling, their skills and their knowledge to prevent repeat unintended pregnancies.

Patients' perception of types of errors in palliative care - results from a qualitative interview study.

PubMed

Kiesewetter, Isabel; Schulz, Christian; Bausewein, Claudia; Fountain, Rita; Schmitz, Andrea

2016-08-11

Medical errors have been recognized as a relevant public health concern and research efforts to improve patient safety have increased. In palliative care, however, studies on errors are rare and mainly focus on quantitative measures. We aimed to explore how palliative care patients perceive and think about errors in palliative care and to generate an understanding of patients' perception of errors in that specialty. A semistructured qualitative interview study was conducted with patients who had received at least 1 week of palliative care in an inpatient or outpatient setting. All interviews were transcribed verbatim and analysed according to qualitative content analysis. Twelve patients from two centers were interviewed (7 women, median age 63.5 years, range 22-90 years). Eleven patients suffered from a malignancy. Days in palliative care ranged from 10 to 180 days (median 28 days). 96 categories emerged which were summed up under 11 umbrella terms definition, difference, type, cause, consequence, meaning, recognition, handling, prevention, person causing and affected person. A deductive model was developed assigning umbrella terms to error-theory-based factor levels (definition, type and process-related factors). 23 categories for type of error were identified, including 12 categories that can be considered as palliative care specific. On the level of process-related factors 3 palliative care specific categories emerged (recognition, meaning and consequence of errors). From the patients' perspective, there are some aspects of errors that could be considered as specific to palliative care. As the results of our study suggest, these palliative care-specific aspects seem to be very important from the patients' point of view and should receive further investigation. Moreover, the findings of this study can serve as a guide to further assess single aspects or categories of errors in palliative care in future research.

From Assessment to Implementation: Using Qualitative Interviews to Inform Distance Learning Library Services

ERIC Educational Resources Information Center

Wharton, Lindsey N.

2017-01-01

While broad assessment projects are often used to steer library strategic planning initiatives, this article will present the benefits of qualitative interviews with distance learning constituents as a framework for developing a focused vision and targeted services. This article will describe the planning and execution of an assessment project…

Understanding self-harm and suicide websites: a qualitative interview study of young adult website users.

PubMed

Baker, Darren; Fortune, Sarah

2008-01-01

Self-harm and suicide websites have been heavily criticized both in the literature and the wider media, despite the fact that very little is known about them. To date, no study has interviewed users of these sites about them. This qualitative study aims to explore the accounts of young adults who engage in self-harming and suicidal behaviors and use websites dedicated to these issues, in order to develop a broader understanding of these websites and to identify potential implications for future research. In-depth interviews were conducted via e-mail with 10 participants, who were recruited directly from self-harm and suicide websites. Using discourse analysis, we identified three main ways in which participants wrote about the sites. They constructed them as sources of empathy and understanding, as communities, and as a way of coping with social and psychological distress. These discourses gave users access to important, socially valued identities, such as being understood, belonging to a community and coping with their problems. If health professionals and researchers hope to understand people who use self-harm and suicide websites, and engage them in their services, they must take a more balanced view and not focus solely on the possible risks associated with using such sites.

Fatigue in hospital nurses - 'Supernurse' culture is a barrier to addressing problems: A qualitative interview study.

PubMed

Steege, Linsey M; Rainbow, Jessica G

2017-02-01

Fatigue in hospital nurses is associated with decreased nurse satisfaction, increased turnover and negative patient outcomes. Addressing fatigue in nurses has been identified as a priority by many organizations worldwide in an effort to promote both a culture of patient safety and a healthy nursing workforce. The overall aim of this study was to explore barriers and facilitators within the hospital nurse work system to nurse coping and fatigue. The purpose of this paper is to describe emergent themes that offer new insight describing the relationships among nurse perceptions of fatigue, nursing professional culture, and implications for the nursing workforce. A qualitative exploratory study was used to explore nurse identified sources, barriers to addressing, and consequences of fatigue. Twenty-two nurses working in intensive care and medical-surgical units within a large academic medical center in the United States participated in the interviews. Interviews with the participants followed a semi-structured interview guide that included questions eliciting participants' views on nurse fatigue levels, consequences of fatigue, and barriers to addressing fatigue. The interview transcripts were analyzed using directed content analysis guided by the Systems Engineering Initiative for Patient Safety (SEIPS) model. Additional themes that did not directly align with the SEIPS model were also identified. All nurses in the current study experienced fatigue; yet they had varying perspectives on the importance of addressing fatigue in relation to other health systems challenges. A new construct related to nursing professional culture was identified and defined as "Supernurse". Identified subthemes of Supernurse include: extraordinary powers used for good; cloak of invulnerability; no sidekick; Kryptonite, and an alterego. These values, beliefs, and behaviors define the specific aspects of nursing professional culture that can act as barriers to fatigue risk management programs

Use of interviews in nursing research.

PubMed

Mitchell, Gary

2015-06-24

Conducting interviews is one of the most common ways of collecting data in healthcare research. In particular, interviews are associated with qualitative research, where researchers seek to understand participants' experiences through their own words and perspectives. This article will help healthcare researchers prepare to carry out interviews as part of their research. It will also emphasise important skills to consider during the interview process. Consideration will also be given to remedying interviews that do not go according to plan, as well as identifying appropriate debriefing processes post-interview. With this knowledge, healthcare researchers are more likely to conduct effective interviews that will yield better quality data and protect the participant.

Substance Abuse and Prison Recidivism: Themes from Qualitative Interviews

ERIC Educational Resources Information Center

Phillips, Lindsay A.

2010-01-01

This qualitative analysis explores the role of substance abuse in reentry from prison to society. Participants who recidivated (N = 20) in an urban prison system identified substance abuse as their primary reason for recidivism. Treatment implications are discussed.

Nutritional rehabilitation after ICU - does it happen: a qualitative interview and observational study.

PubMed

Merriweather, Judith; Smith, Pam; Walsh, Timothy

2014-03-01

To compare and contrast current nutritional rehabilitation practices against recommendations from National Institute for Health and Excellence guideline Rehabilitation after critical illness (NICE) (2009, http://www.nice.org.uk/cg83). Recovery from critical illness has gained increasing prominence over the last decade but there is remarkably little research relating to nutritional rehabilitation. The study is a qualitative study based on patient interviews and observations of ward practice. Seventeen patients were recruited into the study at discharge from the intensive care unit (ICU) of a large teaching hospital in central Scotland in 2011. Semi-structured interviews were conducted on transfer to the ward and weekly thereafter. Fourteen of these patients were followed up at three months post-ICU discharge, and a semi-structured interview was carried out. Observations of ward practice were carried out twice weekly for the duration of the ward stay. Current nutritional practice for post-intensive care patients did not reflect the recommendations from the NICE guideline. A number of organisational issues were identified as influencing nutritional care. These issues were categorised as ward culture, service-centred delivery of care and disjointed discharge planning. Their influence on nutritional care was compounded by the complex problems associated with critical illness. The NICE guideline provides few nutrition-specific recommendations for rehabilitation; however, current practice does not reflect the nutritional recommendations that are detailed in the rehabilitation care pathway. Nutritional care of post-ICU patients is problematic and strategies to overcome these issues need to be addressed in order to improve nutritional intake. © 2013 John Wiley & Sons Ltd.

Non-technical skills for obstetricians conducting forceps and vacuum deliveries: qualitative analysis by interviews and video recordings.

PubMed

Bahl, Rachna; Murphy, Deirdre J; Strachan, Bryony

2010-06-01

Non-technical skills are cognitive and social skills required in an operational task. These skills have been identified and taught in the surgical domain but are of particular relevance to obstetrics where the patient is awake, the partner is present and the clinical circumstances are acute and often stressful. The aim of this study was to define the non-technical skills of an operative vaginal delivery (forceps or vacuum) to facilitate transfer of skills from expert obstetricians to trainee obstetricians. Qualitative study using interviews and video recordings. The study was conducted at two university teaching hospitals (St. Michael's Hospital, Bristol and Ninewells Hospital, Dundee). Participants included 10 obstetricians and eight midwives identified as experts in conducting or supporting operative vaginal deliveries. Semi-structured interviews were carried out using routine clinical scenarios. The experts were also video recorded conducting forceps and vacuum deliveries in a simulation setting. The interviews and video recordings were transcribed verbatim and analysed using thematic coding. The anonymised data were independently coded by the three researchers and then compared for consistency of interpretation. The experts reviewed the coded data for respondent validation and clarification. The themes that emerged were used to identify the non-technical skills required for conducting an operative vaginal delivery. The final skills list was classified into seven main categories. Four categories (situational awareness, decision making, task management, and team work and communication) were similar to the categories identified in surgery. Three further categories unique to obstetrics were also identified (professional relationship with the woman, maintaining professional behaviour and cross-monitoring of performance). This explicitly defined skills taxonomy could aid trainees' understanding of the non-technical skills to be considered when conducting an operative

Understanding delayed access to antenatal care: a qualitative interview study

PubMed Central

2014-01-01

Background Delayed access to antenatal care ('late booking’) has been linked to increased maternal and fetal mortality and morbidity. The aim of this qualitative study was to understand why some women are late to access antenatal care. Methods 27 women presenting after 19 completed weeks gestation for their first hospital booking appointment were interviewed, using a semi-structured format, in community and maternity hospital settings in South Yorkshire, United Kingdom. Interviews were transcribed verbatim and entered onto NVivo 8 software. An interdisciplinary, iterative, thematic analysis was undertaken. Results The late booking women were diverse in terms of: age (15–37 years); parity (0–4); socioeconomic status; educational attainment and ethnicity. Three key themes relating to late booking were identified from our data: 1) 'not knowing’: realisation (absence of classic symptoms, misinterpretation); belief (age, subfertility, using contraception, lay hindrance); 2) 'knowing’: avoidance (ambivalence, fear, self-care); postponement (fear, location, not valuing care, self-care); and 3) 'delayed’ (professional and system failures, knowledge/empowerment issues). Conclusions Whilst vulnerable groups are strongly represented in this study, women do not always fit a socio-cultural stereotype of a 'late booker’. We report a new taxonomy of more complex reasons for late antenatal booking than the prevalent concepts of denial, concealment and disadvantage. Explanatory sub-themes are also discussed, which relate to psychological, empowerment and socio-cultural factors. These include poor reproductive health knowledge and delayed recognition of pregnancy, the influence of a pregnancy 'mindset’ and previous pregnancy experience, and the perceived value of antenatal care. The study also highlights deficiencies in early pregnancy diagnosis and service organisation. These issues should be considered by practitioners and service commissioners in order to promote

Extending Beyond Qualitative Interviewing to Illuminate the Tacit Nature of Everyday Occupation: Occupational Mapping and Participatory Occupation Methods.

PubMed

Huot, Suzanne; Rudman, Debbie Laliberte

2015-07-01

The study of human occupation requires a variety of methods to fully elucidate its complex, multifaceted nature. Although qualitative approaches have commonly been used within occupational therapy and occupational science, we contend that such qualitative research must extend beyond the sole use of interviews. Drawing on qualitative methodological literature, we discuss the limits of interview methods and outline other methods, particularly visual methods, as productive means to enhance qualitative research. We then provide an overview of our critical ethnographic study that used narrative, visual, and observational methods to explore the occupational transitions experienced by immigrants to Canada. We describe our use of occupational mapping and participatory occupation methods and the contributions of these combined methods. We conclude that adopting a variety of methods can enable a deeper understanding of the tacit nature of everyday occupation, and is key to advancing knowledge regarding occupation and to informing occupational therapy practice.

The patient's perspective on the link between ADHD and substance use: a qualitative interview study.

PubMed

Nehlin, Christina; Nyberg, Fred; Öster, Caisa

2015-04-01

The primary aim of this study was to investigate how adult individuals with ADHD perceive the role of alcohol and drugs in their lives. A secondary aim was to identify factors that those individuals consider useful in the treatment and prevention of co-occurring ADHD and substance use disorders (SUDs). A qualitative interview study with ADHD outpatients (n = 14) at a psychiatric clinic. Data were analyzed based on pre-defined areas of interest using a deductive content analysis method. The yearning for belongingness was identified as an important driving force underlying substance use. The participants felt that alcohol/drugs helped them being normal and thus respected and accepted. Early diagnosis of ADHD was perceived essential to avoid SUD. Adults with ADHD may have strong rational and emotional reasons for the use of alcohol and drugs. When planning for the treatment of adult ADHD, investigation of personal reasons for alcohol/drug use deserves a place. © 2014 SAGE Publications.

Qualitative interviews on substance abuse relapse and prevention among female trauma survivors.

PubMed

Harris, Maxine; Fallot, Roger D; Berley, Rebecca Wolfson

2005-10-01

Complex relationships among trauma, substance abuse, and mental disorders raise significant questions for the study of long-term recovery. The purpose of this qualitative study was to examine key themes in sustaining recovery among women with co-occurring disorders who had survived trauma. In semistructured interviews conducted at one of the nine sites of the Women, Co-occurring Disorders, and Violence Study, 27 female trauma survivors described the influences they considered most important in sustaining and hindering their recovery, with an emphasis on recovery from substance abuse. Recurring themes in the interviews were identified. Seven themes emerged from this analysis. Four of these themes supported recovery: connection, self-awareness, a sense of purpose and meaning, and spirituality. Three others served as obstacles to recovery: battles with depression and despair, destructive habits and patterns, and lack of personal control. The women in this study reported that, although caring relationships provided important supports for sustained recovery, some of these same relationships increased emotional stress and conflict and thus may impede recovery. It is important for women and clinicians to place a high priority on the development of boundary management and other relationship skills. In addition, clinicians need to attend to negative feelings such as boredom and loneliness and to help women develop a range of meaningful activities that are consistent with a strong sense of identity. Individual relapse prevention skills by themselves seem insufficient to sustained abstinence.

Exploring the role of practical nursing wisdom in the care of patients with urinary problems at the end of life: a qualitative interview study.

PubMed

Farrington, Naomi; Fader, Mandy; Richardson, Alison; Sartain, Samantha

2015-10-01

This study examined how nurses understand urinary problems at the end of life, and identified sources of evidence upon which they base their practice through semi-structured qualitative interviews. The aim was to decide whether research or interventions (such as formulation of best practice guidelines) could improve continence care at the end of life. There is little evidence in nursing literature to indicate how nurses should manage urinary problems at the end of life. Evidence is particularly lacking regarding the insertion of indwelling urinary catheters. This was an applied qualitative interview study which used the 'guided interview' approach. Twelve participants who worked in two hospital wards and one hospice were interviewed about management of patients with urinary problems approaching the end of life. The transcribed interviews were organised using the qualitative analysis software qsr NVivo version 10 (QSR International, Melbourne, Australia). Constant comparison was used to analyse the interviews. The patient and their family were a key concern of all interviewees. Participants focused on processes including: giving care, making decisions, managing uncertainty and assimilating knowledge. These processes are mediated by 'phronesis' or practical wisdom. Within each of the processes (giving care, making decisions, managing uncertainty and assimilating knowledge), participants approached each patient as an individual, using experience, patient wishes, available resources, clinical knowledge and advice from colleagues to provide care. A generalised set of guidelines on managing urinary problems at the end of life would probably not be useful. There is uncertainty about what constitutes best practice in specific areas of continence care at the end of life such as indwelling urinary catheter insertion. A careful approach is needed to ensure that the intellectual and moral knowledge that constitutes practical wisdom is shared and developed throughout teams. �

Being a pedestrian with dementia: A qualitative study using photo documentation and focus group interviews.

PubMed

Brorsson, Anna; Öhman, Annika; Lundberg, Stefan; Nygård, Louise

2016-09-01

The aim of the study was to identify problematic situations in using zebra crossings. They were identified from photo documentations comprising film sequences and the perspectives of people with dementia. The aim was also to identify how they would understand, interpret and act in these problematic situations based on their previous experiences and linked to the film sequences.A qualitative grounded theory approach was used. Film sequences from five zebra crossings were analysed. The same film sequences were used as triggers in two focus group interviews with persons with dementia. Individual interviews with three informants were also performed.The core category, the hazard of meeting unfolding problematic traffic situations when only one layer at a time can be kept in focus, showed how a problematic situation as a whole consisted of different layers of problematic situations. The first category, adding layers of problematic traffic situations to each other, was characterized by the informants' creation of a problematic situation as a whole. The different layers were described in the subcategories of layout of streets and zebra crossings, weather conditions, vehicles and crowding of pedestrians. The second category, actions used to meet different layers of problematic traffic situations, was characterized by avoiding problematic situations, using traffic lights as reminders and security precautions, following the flow at the zebra crossing and being cautious pedestrians.In conclusion, as community-dwelling people with dementia commonly are pedestrians, it is important that health care professionals and caregivers take their experiences and management of problematic traffic situations into account when providing support. © The Author(s) 2014.

A Tale of Two Methods: Chart and Interview Methods for Identifying Delirium

PubMed Central

Saczynski, Jane S.; Kosar, Cyrus M.; Xu, Guoquan; Puelle, Margaret R.; Schmitt, Eva; Jones, Richard N.; Marcantonio, Edward R.; Wong, Bonnie; Isaza, Ilean; Inouye, Sharon K.

2014-01-01

Background Interview and chart-based methods for identifying delirium have been validated. However, relative strengths and limitations of each method have not been described, nor has a combined approach (using both interviews and chart), been systematically examined. Objectives To compare chart and interview-based methods for identification of delirium. Design, Setting and Participants Participants were 300 patients aged 70+ undergoing major elective surgery (majority were orthopedic surgery) interviewed daily during hospitalization for delirium using the Confusion Assessment Method (CAM; interview-based method) and whose medical charts were reviewed for delirium using a validated chart-review method (chart-based method). We examined rate of agreement on the two methods and patient characteristics of those identified using each approach. Predictive validity for clinical outcomes (length of stay, postoperative complications, discharge disposition) was compared. In the absence of a gold-standard, predictive value could not be calculated. Results The cumulative incidence of delirium was 23% (n= 68) by the interview-based method, 12% (n=35) by the chart-based method and 27% (n=82) by the combined approach. Overall agreement was 80%; kappa was 0.30. The methods differed in detection of psychomotor features and time of onset. The chart-based method missed delirium in CAM-identified patients laacking features of psychomotor agitation or inappropriate behavior. The CAM-based method missed chart-identified cases occurring during the night shift. The combined method had high predictive validity for all clinical outcomes. Conclusions Interview and chart-based methods have specific strengths for identification of delirium. A combined approach captures the largest number and the broadest range of delirium cases. PMID:24512042

Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study.

PubMed

Christenson, Anne; Johansson, Eva; Reynisdottir, Signy; Torgerson, Jarl; Hemmingsson, Erik

2016-01-01

Obesity in Sweden has doubled to 14% over the last 20 years. New strategies for treatment and prevention are needed. Excessive gestational weight gain has been found to contribute substantially to obesity, and there is a consistent association between postpartum weight retention and obesity later in life. We aimed to explore what factors women perceive as reasons for having substantial postpartum weight retention, to identify areas for new and improved interventions. Qualitative interview study (semi-structured) using an emergent design. Fifteen women, with a postpartum weight retention ≥ 10 kg, were interviewed by a trained cognitive therapist. Eight women had pre-pregnancy BMI below 30 kg/m2. Interviews were transcribed verbatim and data analysed using inductive manifest content analysis. Salient text passages were extracted, shortened, coded and clustered into categories. Participants reported no knowledge of current gestational weight gain recommendations or of risks for adverse pregnancy outcomes with excessive weight gain or postpartum weight retention. Excessive eating emerged as a common strategy to provide relief of psychological, emotional and physical discomfort, such as depression and morning sickness. Women perceived medical staff as being unconcerned about weight, and postpartum weight loss support was scarce or absent. Some women reported eating more due to a belief that breastfeeding would automatically lead to weight loss. There is a need to raise awareness about risks with unhealthy gestational weight development and postpartum weight retention in women of childbearing age. The common strategy to cope with psychological, emotional or physical discomfort by eating is an important factor to target with intervention. The postpartum year is a neglected period where additional follow-up on weight and weight loss support is strongly indicated.

Prescribing of Electronic Activity Monitors in Cardiometabolic Diseases: Qualitative Interview-Based Study

PubMed Central

Macé, Sandrine; Oppert, Jean-Michel

2017-01-01

Background The prevalence of noncommunicable diseases, including those such as type 2 diabetes, obesity, dyslipidemia, and hypertension, so-called cardiometabolic diseases, is high and is increasing worldwide. Strong evidence supports the role of physical activity in management of these diseases. There is general consensus that mHealth technology, including electronic activity monitors, can potentially increase physical activity in patients, but their use in clinical settings remains limited. Practitioners’ requirements when prescribing electronic activity monitors have been poorly described. Objective The aims of this qualitative study were (1) to explore how specialist physicians prescribe electronic activity monitors to patients presenting with cardiometabolic conditions, and (2) to better understand their motivation for and barriers to prescribing such monitors. Methods We conducted qualitative semistructured interviews in March to May 2016 with 11 senior physicians from a public university hospital in France with expertise in management of cardiometabolic diseases (type 1 and type 2 diabetes, obesity, hypertension, and dyslipidemia). Interviews lasted 45 to 60 minutes and were audiotaped, transcribed verbatim, and analyzed using directed content analysis. We report our findings following the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Results Most physicians we interviewed had never prescribed electronic activity monitors, whereas they frequently prescribed blood glucose or blood pressure self-monitoring devices. Reasons for nonprescription included lack of interest in the data collected, lack of evidence for data accuracy, concern about work overload possibly resulting from automatic data transfer, and risk of patients becoming addicted to data. Physicians expected future marketing of easy-to-use monitors that will accurately measure physical activity duration and intensity and provide understandable motivating feedback

Prescribing of Electronic Activity Monitors in Cardiometabolic Diseases: Qualitative Interview-Based Study.

PubMed

Bellicha, Alice; Macé, Sandrine; Oppert, Jean-Michel

2017-09-23

The prevalence of noncommunicable diseases, including those such as type 2 diabetes, obesity, dyslipidemia, and hypertension, so-called cardiometabolic diseases, is high and is increasing worldwide. Strong evidence supports the role of physical activity in management of these diseases. There is general consensus that mHealth technology, including electronic activity monitors, can potentially increase physical activity in patients, but their use in clinical settings remains limited. Practitioners' requirements when prescribing electronic activity monitors have been poorly described. The aims of this qualitative study were (1) to explore how specialist physicians prescribe electronic activity monitors to patients presenting with cardiometabolic conditions, and (2) to better understand their motivation for and barriers to prescribing such monitors. We conducted qualitative semistructured interviews in March to May 2016 with 11 senior physicians from a public university hospital in France with expertise in management of cardiometabolic diseases (type 1 and type 2 diabetes, obesity, hypertension, and dyslipidemia). Interviews lasted 45 to 60 minutes and were audiotaped, transcribed verbatim, and analyzed using directed content analysis. We report our findings following the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Most physicians we interviewed had never prescribed electronic activity monitors, whereas they frequently prescribed blood glucose or blood pressure self-monitoring devices. Reasons for nonprescription included lack of interest in the data collected, lack of evidence for data accuracy, concern about work overload possibly resulting from automatic data transfer, and risk of patients becoming addicted to data. Physicians expected future marketing of easy-to-use monitors that will accurately measure physical activity duration and intensity and provide understandable motivating feedback. Features of electronic activity monitors

Experiences of a Motivational Interview Delivered by a Robot: Qualitative Study

PubMed Central

Galvão Gomes da Silva, Joana; Kavanagh, David J; Belpaeme, Tony; Taylor, Lloyd; Beeson, Konna

2018-01-01

Background Motivational interviewing is an effective intervention for supporting behavior change but traditionally depends on face-to-face dialogue with a human counselor. This study addressed a key challenge for the goal of developing social robotic motivational interviewers: creating an interview protocol, within the constraints of current artificial intelligence, which participants will find engaging and helpful. Objective The aim of this study was to explore participants’ qualitative experiences of a motivational interview delivered by a social robot, including their evaluation of usability of the robot during the interaction and its impact on their motivation. Methods NAO robots are humanoid, child-sized social robots. We programmed a NAO robot with Choregraphe software to deliver a scripted motivational interview focused on increasing physical activity. The interview was designed to be comprehensible even without an empathetic response from the robot. Robot breathing and face-tracking functions were used to give an impression of attentiveness. A total of 20 participants took part in the robot-delivered motivational interview and evaluated it after 1 week by responding to a series of written open-ended questions. Each participant was left alone to speak aloud with the robot, advancing through a series of questions by tapping the robot’s head sensor. Evaluations were content-analyzed utilizing Boyatzis’ steps: (1) sampling and design, (2) developing themes and codes, and (3) validating and applying the codes. Results Themes focused on interaction with the robot, motivation, change in physical activity, and overall evaluation of the intervention. Participants found the instructions clear and the navigation easy to use. Most enjoyed the interaction but also found it was restricted by the lack of individualized response from the robot. Many positively appraised the nonjudgmental aspect of the interview and how it gave space to articulate their motivation for

Identifying fallacious arguments in a qualitative study of antipsychotic prescribing in dementia.

PubMed

Donyai, Parastou

2017-10-01

Dementia can result in cognitive, noncognitive and behavioural symptoms which are difficult to manage. Formal guidelines for the care and management of dementia in the UK state that antipsychotics should only be prescribed where fully justified. This is because inappropriate use, particularly problematic in care-home settings, can produce severe side effects including death. The aim of this study was to explore the use of fallacious arguments in professionals' deliberations about antipsychotic prescribing in dementia in care-home settings. Fallacious arguments have the potential to become unremarkable discourses that construct and validate practices which are counter to guidelines. This qualitative study involved interviews with 28 care-home managers and health professionals involved in caring for patients with dementia. Potentially fallacious arguments were identified using qualitative content analysis and a coding framework constructed from existing explanatory models of fallacious reasoning. Fallacious arguments were identified in a range of explanations and reasons that participants gave for in answer to questions about initiating, reducing doses of and stopping antipsychotics in dementia. The dominant fallacy was false dichotomy. Appeal to popularity, tradition, consequence, emotion, or fear, and the slippery slope argument was also identified. Fallacious arguments were often formulated to present convincing cases whereby prescribing antipsychotics or maintaining existing doses (versus not starting medication or reducing the dose, for example) appeared as the only acceptable decision but this is not always the case. The findings could help health professionals to recognise and mitigate the effect of logic-based errors in decisions about the prescribing of antipsychotics in dementia. © 2016 Royal Pharmaceutical Society.

Pregnancy Experiences of First-Time Fathers in Iran: A Qualitative Interview Study

PubMed Central

Golian Tehrani, Shahnaz; Bazzazian, Shahin; Dehghan Nayeri, Nahid

2015-01-01

Background: Fatherhood, similarly to motherhood, is an important role and responsibility. For accepting this role, one needs to be well-prepared. Awareness of father’s experiences of pregnancy can help us to develop plans for the promotion of the role of fatherhood. Objectives: The purpose of this study was to explore how first time fathers describe their experiences of pregnancy. Patients and Methods: The data in this qualitative study were collected by individual open-ended interviews in five public health prenatal care clinics in Tehran, Iran, during 2010 ‒ 2011. Participants were 26 Iranian and Moslem first-time fathers living in Tehran, whose partner was in the 32th to 40th week of her normal pregnancy. Qualitative content text analysis was used for analyzing interviews. Results: Through analysis of fathers’ experiences of their wives’ pregnancy, four categories, as well as associated subcategories, emerged. The categories include: “Emotional responses to pregnancy, Feeling of change, Accepting the reality and satisfaction, Developing identity as a father.” These categories describe the phenomenon of “Transition to fatherhood”. Conclusions: Transition to fatherhood extends beyond only moderate mental and social changes, and may be influenced by cultural background and beliefs. Therefore, caregivers should be aware of fathers' changes and needs during pregnancy, and support them while taking into consideration their culture and beliefs. PMID:25838928

Constructing Understandings of End-of-Life Care in Europe: A Qualitative Study Involving Cognitive Interviewing with Implications for Cross-National Surveys

PubMed Central

Bechinger-English, Dorothee; Bausewein, Claudia; Simon, Steffan T.; Harding, Richard; Higginson, Irene J.; Gomes, Barbara

2011-01-01

Abstract Background Although national findings regarding people's end-of-life care (EoLC) preferences and priorities are available within Europe, a lack of research coordination between countries has meant that cross-national understandings of EoLC remain unknown. Purpose To (1) identify English and German understandings of EoLC within the context of an EoLC survey, and (2) to synthesise these understandings to aid interpretation of results from a cross-national survey. Methods An inductive and interpretive two-phased sequential design involving (1) qualitative analysis of cognitive interview data from 15 English and 15 German respondents to develop country-related categories, and (2) qualitative synthesis to identify a conceptually coherent understanding of EoLC. Results Open and axial coding resulted in six English and six German categories. Commonalities included (a) the importance of social and relational dimensions, (b) dynamic decision making comprising uncertainty, (c) a valuing of life's quality and quantity, and (d) expectations for holistic care involving autonomy, choice, and timely information from trusted professionals. Differences involved attention to practical matters, and thoughts about prolongation of life, preferred place of death, and the role of media and context. Synthesis resulted in four concepts with underlying coherence: expectations of a high standard of EoLC involving autonomy, choice, and context; evolving decision making amid anticipated change; thoughts about living and existing; and worldviews shaping EoLC preferences in real and hypothetical scenarios. Conclusion Individual and country-related diversity must be remembered when quantifying EoLC understandings. Inductive-interpretive analysis of cognitive interview data aids interpretation of survey findings. Cross-national research coordination and qualitative synthesis assists EoLC in Europe. PMID:21306232

Experience of guilt and strategies for coping with guilt in patients with severe COPD: a qualitative interview study.

PubMed

Strang, Susann; Farrell, Mary; Larsson, Lars-Olof; Sjöstrand, Charlotte; Gunnarsson, Anna; Ekberg-Jansson, Ann; Strang, Peter

2014-01-01

Guilt is associated with an increased level of mood disturbance and a poorer quality of life. The aim of this study was to explore how patients with severe COPD view and experience guilt and the ways in which they cope with this guilt. A total of 31 COPD patients were interviewed about their perceptions and experiences of guilt. Qualitative content analysis was used to examine the interviews. In the descriptive (manifest) analysis, the categories "not feeling personal guilt" and "experiencing guilt" emerged; in the interpretative (latent) analysis, various strategies for dealing with guilt were identified--for example, acceptance or blaming others. Relatively few patients reported that they felt guilt on a conscious level, but those who did expressed anguish, and remorse before God; some felt blamed by others. It is important that healthcare providers acknowledge the guilt that their patients express, since guilt may have adverse effects on the patients' overall health.

Methodological developments in qualitative longitudinal research: the advantages and challenges of regular telephone contact with participants in a qualitative longitudinal interview study.

PubMed

Carduff, Emma; Murray, Scott A; Kendall, Marilyn

2015-04-11

Qualitative longitudinal research is an evolving methodology, particularly within health care research. It facilitates a nuanced understanding of how phenomena change over time and is ripe for innovative approaches. However, methodological reflections which are tailored to health care research are scarce. This article provides a synthesised and practical account of the advantages and challenges of maintaining regular telephone contact between interviews with participants in a qualitative longitudinal study. Participants with metastatic colorectal cancer were interviewed at 3 time points over the course of a year. Half the group also received monthly telephone calls to explore the added value and the feasibility of capturing change as close to when it was occurring as possible. The data gathered from the telephone calls added context to the participants' overall narrative and informed subsequent interviews. The telephone calls meant we were able to capture change close to when it happened and there was a more evolved, and involved, relationship between the researcher and the participants who were called on a monthly basis. However, ethical challenges were amplified, boundaries of the participant/researcher relationship questioned, and there was the added analytical burden. The telephone calls facilitated a more nuanced understanding of the illness experience to emerge, when compared with the interview only group. The findings suggest that intensive telephone contact may be justified if retention is an issue, when the phenomena being studied is unpredictable and when participants feel disempowered or lack control. These are potential issues for research involving participants with long-term illness.

Experiences of a Motivational Interview Delivered by a Robot: Qualitative Study.

PubMed

Galvão Gomes da Silva, Joana; Kavanagh, David J; Belpaeme, Tony; Taylor, Lloyd; Beeson, Konna; Andrade, Jackie

2018-05-03

Motivational interviewing is an effective intervention for supporting behavior change but traditionally depends on face-to-face dialogue with a human counselor. This study addressed a key challenge for the goal of developing social robotic motivational interviewers: creating an interview protocol, within the constraints of current artificial intelligence, which participants will find engaging and helpful. The aim of this study was to explore participants' qualitative experiences of a motivational interview delivered by a social robot, including their evaluation of usability of the robot during the interaction and its impact on their motivation. NAO robots are humanoid, child-sized social robots. We programmed a NAO robot with Choregraphe software to deliver a scripted motivational interview focused on increasing physical activity. The interview was designed to be comprehensible even without an empathetic response from the robot. Robot breathing and face-tracking functions were used to give an impression of attentiveness. A total of 20 participants took part in the robot-delivered motivational interview and evaluated it after 1 week by responding to a series of written open-ended questions. Each participant was left alone to speak aloud with the robot, advancing through a series of questions by tapping the robot's head sensor. Evaluations were content-analyzed utilizing Boyatzis' steps: (1) sampling and design, (2) developing themes and codes, and (3) validating and applying the codes. Themes focused on interaction with the robot, motivation, change in physical activity, and overall evaluation of the intervention. Participants found the instructions clear and the navigation easy to use. Most enjoyed the interaction but also found it was restricted by the lack of individualized response from the robot. Many positively appraised the nonjudgmental aspect of the interview and how it gave space to articulate their motivation for change. Some participants felt that the

Locum physicians' professional ethos: a qualitative interview study from Germany.

PubMed

Salloch, Sabine; Apitzsch, Birgit; Wilkesmann, Maximiliane; Ruiner, Caroline

2018-05-08

In contrast to other countries, the appearance of locum physicians as independent contractors constitutes a rather new phenomenon in the German health care system and emerged out of a growing economization and shortage of medical staff in the hospital sector. Locums are a special type of self-employed professionals who are only temporally embedded in organisational contexts of hospitals, and this might have consequences for their professional practice. Therefore, questions arise regarding how locums perceive their ethical duties as medical professionals. In this first qualitative study on German locum physicians, the locums' own perspective is complemented by the viewpoint of permanently employed physician colleagues. Eighteen semi-structured interviews were conducted in 2014 to explore the professional practice of locum physicians from both groups' perspectives with respect to doctor-patient-relationship, cooperation with colleagues and physicians' role in society. The data were analysed using qualitative content analysis, including a deductive application and an inductive development of codes. The results were related to key tenets of medical professionalism with respect to the question: how far do locums fulfil their ethical duties towards patients, colleagues and the society? The study indicates that although ethical requirements are met broadly, difficulties remain with respect to close doctor-patient contact and the sustainability of hiring locums as a remedy in times of staff shortage. Further qualitative and quantitative research on locum physicians' professional practice, including patient perspectives and economic health care system analyses, is needed to better understand the ethical impact of hiring independent contractors in the hospital sector.

From challenges to advanced practice registered nursing role development: Qualitative interview study.

PubMed

Jokiniemi, Krista; Haatainen, Kaisa; Pietilä, Anna-Maija

2015-12-01

The aim of this study is to describe the factors hindering and facilitating the implementation of the advanced practice registered nurses role at Finnish university hospitals, and to examine the implications for its future development. A descriptive qualitative approach, using thematic individual interviews, was conducted in 2011 with a sample of 11 advanced practice registered nurses. The data were analysed using qualitative content analysis. The advanced practice registered nurses role barriers had an impact on the role development needs. In turn, the facilitating factors helped encounter the challenges of the role, therefore having an impact on both the current role achievement, as well as contributing to the future role development. The factors hindering and facilitating the advanced practice registered nurses role need to be acknowledged to support the role implementation and planning of the future of the role. © 2014 Wiley Publishing Asia Pty Ltd.

Autism and Bilingualism: A Qualitative Interview Study of Parents' Perspectives and Experiences.

PubMed

Hampton, Sarah; Rabagliati, Hugh; Sorace, Antonella; Fletcher-Watson, Sue

2017-02-01

Research into how bilingual parents of children with autism spectrum disorder (ASD) make choices about their children's language environment is scarce. This study aimed to explore this issue, focusing on understanding how bilingual parents of children with ASD may make different language exposure choices compared with bilingual parents of children without ASD. Semistructured qualitative interviews were conducted with 17 bilingual parents with a child with ASD and 18 bilingual parents with a typically developing (TD) child. Thematic analysis revealed that, in contrast to parents of TD children, parents with a child with ASD expressed concerns that a bilingual environment would cause confusion for their child and exacerbate language delays. This was particularly common for parents of children with lower verbal ability. Parents also identified potential benefits of bilingualism, particularly in terms of maintaining a close and affectionate bond with their child. Parents of children with ASD have concerns about bilingualism not present for parents of TD children, and these concerns are greater for parents of children with lower verbal ability. Future research in this area should take into account factors such as parent-child bonds as well as communication and language development.

Using Email Interviews in Qualitative Educational Research: Creating Space to Think and Time to Talk

ERIC Educational Resources Information Center

James, Nalita

2016-01-01

The article explores how the Internet and email offer space for participants to think and make sense of their experiences in the qualitative research encounter. It draws on a research study that used email interviewing to generate online narratives to understand academic lives and identities through research encounters in virtual space. The…

Identifying psychotic defenses in a clinical interview.

PubMed

Berney, Sylvie; de Roten, Yves; Beretta, Véronique; Kramer, Ueli; Despland, Jean-Nicolas

2014-05-01

The Defense Mechanisms Rating Scales (DMRS), one of the most widely used and validated instruments in the study of defense mechanisms, does not include psychotic defenses. The Psychotic-DMRS (P-DMRS) has been developed to include 6 psychotic defense mechanisms: psychotic denial, autistic withdrawal, distortion, delusional projection, fragmentation, and concretization. We discuss psychotic defenses, including the difference between psychotic defenses and psychotic symptoms. Six clinical illustrations demonstrate how the 6 P-DMRS defenses can be identified in patients' narratives selected from the transcripts of dynamic interviews. Implications with respect to patient evaluation and treatment are discussed. © 2014 Wiley Periodicals, Inc.

Perceptions of Physical Activity by Older Adults: A Qualitative Study

ERIC Educational Resources Information Center

Jancey, Jonine M.; Clarke, Ann; Howat, Peter; Maycock, Bruce; Lee, Andy H.

2009-01-01

Objective: To identify issues and perceptions concerning physical activity in older adults. Design: Qualitative study. Setting: Perth, Western Australia. Methods: Sixteen adults aged 65 to 74 years were interviewed in their own homes using a semi-structured interview schedule. Data were analysed using a descriptive qualitative methodology.…

Difficulties experienced by migrant physicians working in German hospitals: a qualitative interview study.

PubMed

Klingler, Corinna; Marckmann, Georg

2016-09-23

With Germany facing a shortage of doctors, hospitals have been increasingly recruiting physicians from abroad. Studies in other countries have shown that migrant physicians experience various difficulties in their work, which might impact the quality of patient care, physician job satisfaction, and, accordingly, retention. The experiences of migrant doctors in Germany have not been systematically studied so far and will likely differ from experiences migrant physicians make in other contexts. A thorough understanding of challenges faced by this group, however, is needed to develop adequate support structures-as required by the WHO Global Code of Practice on the International Recruitment of Health Personnel. A qualitative study was conducted to give an overview of the multifaceted difficulties migrant physicians might face in German hospitals. Twenty semi-structured interviews with foreign-born and foreign-trained physicians were conducted in German. Participants were recruited via the State Chambers of Physicians and snowballing based on a maximum variation sampling strategy varying purposefully by source country and medical specialty. The interviews were recorded, transcribed verbatim, and analysed using qualitative content analysis. Participants described difficulties relating to healthcare institutions, own competencies, and interpersonal interactions. Participants experienced certain legal norms, the regulation of licensure and application for work, and the organization of the hospital environment as inadequate. Most struggled with their lack of setting-specific (language, cultural, clinical, and system) knowledge. Furthermore, behaviour of patients and co-workers was perceived as discriminating or inadequate for other reasons. This is the first study to describe the broad range of issues migrant physicians experience in Germany. Based on this information, institutional actors should devise support structures to ensure quality of care, physician wellbeing, and

Young women describe the ideal first pelvic examination: Qualitative research using semistructured interviews.

PubMed

Freyens, Anne; Dejeanne, Mélanie; Fabre, Elise; Rouge-Bugat, Marie-Eve; Oustric, Stéphane

2017-08-01

To explore representations of the first pelvic examination (PE) among adolescents who had not yet had this examination and to identify their criteria for a positive experience of it. Qualitative study using semistructured interviews. Midi-Pyrénées and Auvergne in France. Adolescents aged 15 to 19 years who had never had a PE. Participants were recruited through snowball sampling and targeted sampling until data saturation was reached. Maximum variation was sought in the profiles of the study participants. Open-ended questions dealt with the interviewee's sources of information, knowledge of the PE, criteria for a positive PE experience, and representations of the PE itself. Verbatim transcripts were immediately subjected to longitudinal analysis with the context (researchers' notes) and key themes of the interview. Cross-sectional analysis was then performed. Many adolescents lack knowledge about the PE and believe that it is mandatory. According to study participants, the ideal PE would take place when they felt ready. They would be given adequate information in advance and the option of being accompanied by a friend or family member. They described the ideal examining room as warm, comfortable, and reassuring. The quality of their relationship with the examining physician would also affect their acceptance of this examination. An information session before the consultation for the PE would make it possible to reduce the patient's apprehension, improve her level of knowledge, and set the right tone for the upcoming PE, both for her and for the physician. Copyright© the College of Family Physicians of Canada.

Qualitative interviewing with vulnerable populations: individuals' experiences of participating in suicide and self-harm based research.

PubMed

Biddle, Lucy; Cooper, Jayne; Owen-Smith, Amanda; Klineberg, Emily; Bennewith, Olive; Hawton, Keith; Kapur, Nav; Donovan, Jenny; Gunnell, David

2013-03-05

Concern exists that involving vulnerable individuals as participants in research into suicide and self-harm may cause distress and increase suicidal feelings. Actual understanding of participants' experiences is however limited, especially in relation to in-depth qualitative research. Data were collected from four separate studies focused on self-harm or suicide. These included people with varying levels of past distress, including some who had made nearly lethal suicide attempts. Each involved semi-structured qualitative interviewing. Participants (n=63) were asked to complete a visual analogue scale measuring current emotional state before and after their interview and then comment on how they had experienced the interview, reflecting on any score change. Most participants experienced a change in well-being. Between 50% and 70% across studies reported improvement, many describing the cathartic value of talking. A much smaller group in each study (18-27%) reported lowering of mood as they were reminded of difficult times or forced to focus on current issues. However, most anticipated that their distress would be transient and it was outweighed by a desire to contribute to research. An increase in distress did not therefore necessarily indicate a negative experience. There was no follow-up so the long-term effects of participation are unknown. Scores and post interview reflections were collected from participants by the researcher who had conducted the interview, which may have inhibited reporting of negative effects. These findings suggest individuals are more likely to derive benefit from participation than experience harm. Overprotective gate-keeping could prevent some individuals from gaining these benefits. Copyright © 2012 Elsevier B.V. All rights reserved.

Identifying professionals' needs in integrating electronic pain monitoring in community palliative care services: An interview study.

PubMed

Taylor, Sally; Allsop, Matthew J; Bekker, Hilary L; Bennett, Michael I; Bewick, Bridgette M

2017-07-01

Poor pain assessment is a barrier to effective pain control. There is growing interest internationally in the development and implementation of remote monitoring technologies to enhance assessment in cancer and chronic disease contexts. Findings describe the development and testing of pain monitoring systems, but research identifying the needs of health professionals to implement routine monitoring systems within clinical practice is limited. To inform the development and implementation strategy of an electronic pain monitoring system, PainCheck, by understanding palliative care professionals' needs when integrating PainCheck into routine clinical practice. Qualitative study using face-to-face interviews. Data were analysed using framework analysis Setting/participants: Purposive sample of health professionals managing the palliative care of patients living in the community Results: A total of 15 interviews with health professionals took place. Three meta-themes emerged from the data: (1) uncertainties about integration of PainCheck and changes to current practice, (2) appraisal of current practice and (3) pain management is everybody's responsibility Conclusion: Even the most sceptical of health professionals could see the potential benefits of implementing an electronic patient-reported pain monitoring system. Health professionals have reservations about how PainCheck would work in practice. For optimal use, PainCheck needs embedding within existing electronic health records. Electronic pain monitoring systems have the potential to enable professionals to support patients' pain management more effectively but only when barriers to implementation are appropriately identified and addressed.

The impact of using peer interviewers in a study of patient empowerment amongst people in cancer follow-up.

PubMed

Jørgensen, Clara R; Eskildsen, Nanna B; Thomsen, Thora G; Nielsen, Inger D; Johnsen, Anna T

2017-12-05

A range of benefits have been reported from engaging peer interviewers in qualitative interviews, but little systematic evaluation exists to assess their impact on both process and outcomes of qualitative interviews in health research. To investigate the impact of involving patient representatives as peer interviewers in a research project on patient empowerment. 18 interviews were carried out as part of the wider study, seven by the academic researcher alone and eleven jointly with a peer interviewer. The interviews were analysed quantitatively and qualitatively to explore potential differences between interviews conducted by the researcher alone and interviews conducted jointly by the researcher and the peer interviewers. A phone evaluation of the peer interviews was carried out with the research participants, and notes were thematically analysed to understand their experiences. Differences were identified between the academic researcher and the peer interviewers in the types of questions they asked and the degree to which personal narrative was used in the interview. Peer interviewers varied significantly in their approach. Research participants were positive about the experience of being interviewed by a peer interviewer. No firm conclusions could be made about impact on outcomes. The uniqueness and complexity of qualitative interviews made it difficult to provide any firm conclusions about the impact of having peer interviewers on the research outcomes, and the benefits identified from the analysis mostly related to the process of the interviews. Benefits from using peer interviewers need to be considered alongside relevant ethical considerations, and available resources for training and support. © 2017 The Authors Health Expectations published by John Wiley & Sons Ltd.

Patients' and Practitioners' Views of Knee Osteoarthritis and Its Management: A Qualitative Interview Study

PubMed Central

Alami, Sophie; Boutron, Isabelle; Desjeux, Dominique; Hirschhorn, Monique; Meric, Gwendoline; Rannou, François; Poiraudeau, Serge

2011-01-01

Purpose To identify the views of patients and care providers regarding the management of knee osteoarthritis (OA) and to reveal potential obstacles to improving health care strategies. Methods We performed a qualitative study based on semi-structured interviews of a stratified sample of 81 patients (59 women) and 29 practitioners (8 women, 11 general practitioners [GPs], 6 rheumatologists, 4 orthopedic surgeons, and 8 [4 GPs] delivering alternative medicine). Results Two main domains of patient views were identified: one about the patient–physician relationship and the other about treatments. Patients feel that their complaints are not taken seriously. They also feel that practitioners act as technicians, paying more attention to the knee than to the individual, and they consider that not enough time is spent on information and counseling. They have negative perceptions of drugs and a feeling of medical uncertainty about OA, which leads to less compliance with treatment and a switch to alternative medicine. Patients believe that knee OA is an inevitable illness associated with age, that not much can be done to modify its evolution, that treatments are of little help, and that practitioners have not much to propose. They express unrealistic fears about the impact of knee OA on daily and social life. Practitioners' views differ from those of patients. Physicians emphasize the difficulty in elaborating treatment strategies and the need for a tool to help in treatment choice. Conclusions This qualitative study suggests several ways to improve the patient–practitioner relationship and the efficacy of treatment strategies, by increasing their acceptability and compliance. Providing adapted and formalized information to patients, adopting more global assessment and therapeutic approaches, and dealing more accurately with patients' paradoxal representation of drug therapy are main factors of improvement that should be addressed. PMID:21573185

Life support decision making in critical care: Identifying and appraising the qualitative research evidence.

PubMed

Giacomini, Mita; Cook, Deborah; DeJean, Deirdre

2009-04-01

The objective of this study is to identify and appraise qualitative research evidence on the experience of making life-support decisions in critical care. In six databases and supplementary sources, we sought original research published from January 1990 through June 2008 reporting qualitative empirical studies of the experience of life-support decision making in critical care settings. Fifty-three journal articles and monographs were included. Of these, 25 reported prospective studies and 28 reported retrospective studies. We abstracted methodologic characteristics relevant to the basic critical appraisal of qualitative research (prospective data collection, ethics approval, purposive sampling, iterative data collection and analysis, and any method to corroborate findings). Qualitative research traditions represented include grounded theory (n = 15, 28%), ethnography or naturalistic methods (n = 15, 28%), phenomenology (n = 9, 17%), and other or unspecified approaches (n = 14, 26%). All 53 documents describe the research setting; 97% indicate purposive sampling of participants. Studies vary in their capture of multidisciplinary clinician and family perspectives. Thirty-one (58%) report research ethics board review. Only 49% report iterative data collection and analysis, and eight documents (15%) describe an analytically driven stopping point for data collection. Thirty-two documents (60%) indicated a method for corroborating findings. Qualitative evidence often appears outside of clinical journals, with most research from the United States. Prospective, observation-based studies follow life-support decision making directly. These involve a variety of participants and yield important insights into interactions, communication, and dynamics. Retrospective, interview-based studies lack this direct engagement, but focus on the recollections of fewer types of participants (particularly patients and physicians), and typically address specific issues (communication and

Learning about general practice through qualitative interviews: lessons from a seminar course with medical students.

PubMed

von Unger, Hella; Werwick, Katrin; Lichte, Thomas; Herrmann, Markus

2010-01-01

A seminar course was developed in order to train medical students in qualitative research methods, while providing an introduction to the field of General Practice. Students were enabled to conduct semi-structured interviews with general practitioners (GPs), during which they learned about the prevention, diagnosis, and treatment of frequently encountered medical problems. The course was carried out four times at two universities in Germany. The study explores the students' learning experiences focusing on their research experience. Data were collected in four focus groups and analyzed. The students perceived the course as very different from their usual medical education. This was appreciated, but also caused some difficulties. Three themes emerged: (1) Missing 'facts', (2) New horizons: 'Thinking outside the box', and (3) The challenge of interpretation: 'Reading between the lines'. Learning qualitative research methods can be particularly challenging for medical students as the tasks and epistemology of qualitative research run counter to the usual learning formats and research paradigms in medical education. When teaching qualitative research, special care should be taken to address the cognitive dissonance experienced by students and to explain the unique contribution of qualitative research to medical practice and the field of General Practice especially.

Parental views on childhood vaccination against viral gastroenteritis-a qualitative interview study.

PubMed

Lugg, Fiona V; Butler, Christopher C; Evans, Meirion R; Wood, Fiona; Francis, Nick A

2015-08-01

Gastroenteritis (GE) causes significant morbidity, especially in young children. A vaccine against rotavirus, a common cause of viral GE (vGE), was added to the childhood immunization schedule in the UK in July 2013 and further related vaccines are under development. To explore parents' beliefs about vGE and their attitudes towards vaccinating. Qualitative interview study with parents of children who had recently experienced an episode of GE. Twenty-eight semi-structured interviews were conducted over the phone with parents. Interviews were audio-recorded, transcribed and analysed using standard thematic approaches. Parents varied in their perception of the threat posed by GE, and parents who did not perceive GE as serious were less enthusiastic about vaccines. Other parents were supportive of vaccines in general and considered benefits to their child, their family and the wider community. Many parents said that they lacked knowledge about efficacy and effectiveness of GE vaccines but their underlying belief about the seriousness of illness motivated their attitudes. Acceptability of GE vaccines to parents could be improved by providing more information on both the burden of illness and the impact of rotavirus vaccine in other comparable countries. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

In-Depth Interviewing as Qualitative Investigation.

ERIC Educational Resources Information Center

Books, Marilyn

A discussion of in-depth interviewing as a method for research on language teaching and learning situates the technique within the continuum of research methodology and differentiates it from quantitative research methods. The strengths and weaknesses of in-depth interviewing are examined, methods of sampling are discussed, and advice on the…

Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study

PubMed Central

2013-01-01

Background Exclusive breastfeeding until six months followed by the introduction of solids and continued breastfeeding is recommended by the World Health Organisation. The dominant approach to achieving this has been to educate and support women to start and continue breastfeeding rather than understanding behaviour change processes from a broader perspective. Method Serial qualitative interviews examined the influences of significant others on women’s feeding behaviour. Thirty-six women and 37 nominated significant others participated in 220 interviews, conducted approximately four weekly from late pregnancy to six months after birth. Responses to summative structured questions at the end of each interview asking about significant influences on feeding decisions were compared and contrasted with formative semi-structured data within and between cases. Analysis focused on pivotal points where behaviour changed from exclusive breastfeeding to introducing formula, stopping breastfeeding or introducing solids. This enabled us to identify processes that decelerate or accelerate behaviour change and understand resolution processes afterwards. Results The dominant goal motivating behaviour change was family wellbeing, rather than exclusive breastfeeding. Rather than one type of significant other emerging as the key influence, there was a complex interplay between the self-baby dyad, significant others, situations and personal or vicarious feeding history. Following behaviour change women turned to those most likely to confirm or resolve their decisions and maintain their confidence as mothers. Conclusions Applying ecological models of behaviour would enable health service organisation, practice, policy and research to focus on enhancing family efficacy and wellbeing, improving family-centred communication and increasing opportunities for health professionals to be a constructive influence around pivotal points when feeding behaviour changes. A paradigm shift is

Experiences and attitudes about physical activity and exercise in patients with chronic pain: a qualitative interview study.

PubMed

Karlsson, Linn; Gerdle, Björn; Takala, Esa-Pekka; Andersson, Gerhard; Larsson, Britt

2018-01-01

The purpose of this study was to describe how patients with chronic pain experience physical activity and exercise (PA&E). This qualitative interview study included 16 women and two men suffering from chronic pain and referred to a multimodal pain rehabilitation program. Semi-structured interviews were conducted and qualitative content analysis was used to analyze the interviews. One main theme emerged: "To overcome obstacles and to seize opportunities to be physically active despite chronic pain." This main theme was abstracted from five themes: "Valuing a life with physical activity," "Physical activity and exercise - before and after pain," "A struggle - difficulties and challenges," "The enabling of physical activity," and "In need of continuous and active support." Although these participants valued PA&E, they seldom achieved desirable levels, and performance of PA&E was undermined by difficulties and failure. The discrepancy between the intention to perform physical activity and the physical activity accomplished could be related to motivation, self-efficacy, and action control. The participants desired high-quality interaction with healthcare providers. The findings can be applied to chronic pain rehabilitation that uses PA&E as treatment.

Identifying the essential components of cultural competence in a Chinese nursing context: A qualitative study.

PubMed

Cai, Duanying; Kunaviktikul, Wipada; Klunklin, Areewan; Sripusanapan, Acharaporn; Avant, Patricia Kay

2017-06-01

This qualitative study using semi-structured interviews was conducted to identify the essential components of cultural competence from the perspective of Chinese nurses. A purposive sample of 20 nurse experts, including senior clinical nurses, nurse administrators, and educators in transcultural nursing, was recruited. Using thematic analysis, four themes: awareness, attitudes, knowledge, and skills, with two subthemes for each, were identified. Notably, culture in China was understood in a broad way. The participants' responses focused upon demographic attributes, individuality, and efforts to facilitate quality care rather than on the cultural differences of ethnicity and race and developing the capacity to change discrimination or health disparities. A greater understanding of cultural competence in the Chinese nursing context, in which a dominant cultural group exists, is essential to facilitate the provision of culturally competent care to diverse populations. © 2016 John Wiley & Sons Australia, Ltd.

Qualitative Facets of Prospective Elementary Teachers' Diagnostic Proceeding: Collecting and Interpreting in One-on-One Interviews

ERIC Educational Resources Information Center

Reinhold, Simone

2015-01-01

The research presented in this paper focuses on the cognitive diagnostic strategies that prospective elementary mathematics teachers (PTs) use in their reflections of one-on-one diagnostic interviews with children in grade one. Thereby, it responds to the detected lack of knowledge regarding qualitative facets of diagnostic proceeding in interview…

Identifying the Barriers and Enablers to Nutrition Care in Head and Neck and Esophageal Cancers: An International Qualitative Study.

PubMed

Martin, Lisa; de van der Schueren, Marian A E; Blauwhoff-Buskermolen, Susanne; Baracos, Vickie; Gramlich, Leah

2016-03-01

The goal of this work was to identify barriers and enablers to the implementation of nutrition care in head and neck and esophageal (HNE) cancers and to prioritize barriers to help improve the nutrition care process. This study used a multimethod qualitative study design (including semistructured interviews, focus group). Interviews (n = 29) were conducted at 5 European sites providing care and treatment to patients with HNE cancers. A focus group (n = 21) reviewed and corroborated interview findings and identified priorities for nutrition care. Participants were healthcare providers and researchers with direct experience in the field of HNE cancer. Five themes with accompanying barriers and enablers were identified related to nutrition care: (1) evidence for the benefit of nutrition interventions, (2) implementation of nutrition care processes (assessment, intervention, and follow-up), (3) characteristics of healthcare providers, (4) site factors, and (5) patient characteristics. Focus group discussions identified 2 priorities that must be acted on to improve nutrition care: (1) improve the evidence base and (2) develop standardized nutrition care pathways. Themes related to nutrition care in HNE cancers were similar between sites, but barriers and enablers differed. Interview and focus group participants agreed the following actions will result in improvements in nutrition care: (1) enhance the evidence base to test the benefit of nutrition interventions, with a focus on resolving specific controversies regarding nutrition therapy, and (2) establish a minimum data set with a goal to create standardized nutrition care pathways where roles and responsibilities for care are clearly defined. © 2014 American Society for Parenteral and Enteral Nutrition.

Bereaved parents' experience of stillbirth in UK hospitals: a qualitative interview study.

PubMed

Downe, Soo; Schmidt, Ellie; Kingdon, Carol; Heazell, Alexander E P

2013-01-01

To obtain the views of bereaved parents about their interactions with healthcare staff when their baby died just before or during labour. Qualitative in-depth interview study, following an earlier national survey. All interviews took place during 2011, either face-to-face or on the telephone. Data analysis was informed by the constant comparative technique from grounded theory. Every National Health Service (NHS) region in the UK was represented. Bereaved parents who had completed an e-questionnaire, via the website of Sands (Stillbirth and Neonatal Death Society). Of the 304 survey respondents who gave provisional consent, 29 families were approached to take part, based on maximum variation sampling and data saturation. 22 families (n=25) participated. Births took place between 2002 and 2010. Specific practices were identified that were particularly helpful to the parents. Respondents talked about their interactions with hospital staff as having profound effects on their capacity to cope, both during labour and in the longer term. The data generated three key themes: 'enduring and multiple loss': 'making irretrievable moments precious'; and the 'best care possible to the worst imaginable'. The overall synthesis of findings is encapsulated in the meta-theme 'One chance to get it right.' This pertains to the parents and family themselves, clinical and support staff who care for them directly, and the NHS organisations that indirectly provide the resources and governance procedures that may (or may not) foster a caring ethos. Positive memories and outcomes following stillbirth depend as much on genuinely caring staff attitudes and behaviours as on high-quality clinical procedures. All staff who encounter parents in this situation need to see each meeting as their one chance to get it right.

Critical environmental factors for transportation cycling in children: a qualitative study using bike-along interviews.

PubMed

Ghekiere, Ariane; Van Cauwenberg, Jelle; de Geus, Bas; Clarys, Peter; Cardon, Greet; Salmon, Jo; De Bourdeaudhuij, Ilse; Deforche, Benedicte

2014-01-01

Environmental factors are found to influence transport-related physical activity, but have rarely been studied in relation with cycling for transport to various destinations in 10-12 yr old children. The current qualitative study used 'bike-along interviews' with children and parents to allow discussion of detailed environmental factors that may influence children's cycling for transport, while cycling in the participant's neighborhood. Purposeful convenience sampling was used to recruit 35 children and one of their parents residing in (semi-) urban areas. Bike-along interviews were conducted to and from a randomly chosen destination (e.g. library) within a 15 minutes' cycle trip in the participant's neighborhood. Participants wore a GoPro camera to objectively assess environmental elements, which were subsequently discussed with participants. Content analysis and arising themes were derived using a grounded theory approach. The discussed environmental factors were categorized under traffic, urban design, cycling facilities, road design, facilities at destination, aesthetics, topography, weather, social control, stranger danger and familiar environment. Across these categories many environmental factors were (in)directly linked to road safety. This was illustrated by detailed discussions of the children's visibility, familiarity with specific traffic situations, and degree of separation, width and legibility of cycle facilities. Road safety is of major concern in this 10-12 yr old study population. Bike-along interviews were able to identify new, detailed and context-specific physical environmental factors which could inform policy makers to promote children's cycling for transport. However, future studies should investigate whether hypothetical changes to such micro environmental features influence perceptions of safety and if this in turn could lead to changes in children's cycling for transport.

Enacting Subjectivities in Educational History: Methodological Reflections on the Use of Qualitative Interviews for History Writing

ERIC Educational Resources Information Center

Bjerg, Helle; Rasmussen, Lisa Rosen

2008-01-01

Two studies of the formation of pupils' subjectivities within the Danish school and educational system in the period 1945-2005 create the framework for a methodological discussion of how subjectivities in educational history can be studied. Both studies use qualitative interviews as a way of studying subject formations in educational history. This…

The Rest of the Story: A Qualitative Study of Complementing Standardized Assessment Data with Informal Interviews with Older Patients and Families.

PubMed

Lafortune, Claire; Elliott, Jacobi; Egan, Mary Y; Stolee, Paul

2017-04-01

While standardized health assessments capture valuable information on patients' demographic and diagnostic characteristics, health conditions, and physical and mental functioning, they may not capture information of most relevance to individual patients and their families. Given that patients and their informal caregivers are the experts on that patient's unique context, it is important to ensure they are able to convey all relevant personal information to formal healthcare providers so that high-quality, patient-centered care may be delivered. This study aims to identify information that older patients and families consider important but that might not be included in standardized assessments. Transcripts were analyzed from 29 interviews relating to eight patients with hip fractures from three sites (large urban, smaller urban, rural) in two provinces in Canada. These interviews were conducted as part of a larger ethnographic study. Each transcript was analyzed by two researchers using content analysis. Results were reviewed in two focus group interviews with older adults and family caregivers. Identified themes were compared with items from two standardized assessments used in healthcare settings. Three broad themes emerged from the qualitative analysis that were not covered in the standardized assessments: informal caregiver and family considerations, insider healthcare knowledge, and patients' healthcare attitudes and experiences. The importance of these themes was confirmed through focus group interviews. Focus group participants also emphasized the importance of conducting assessments in a patient-centered way and the importance of open-ended questions. A less structured interview approach may yield information that would otherwise be missed in standardized assessments. Combining both sources could yield better-informed healthcare planning and quality-improvement efforts.

Participants' views of telephone interviews within a grounded theory study.

PubMed

Ward, Kim; Gott, Merryn; Hoare, Karen

2015-12-01

To offer a unique contribution to the evolving debate around the use of the telephone during semistructured interview by drawing on interviewees' reflections on telephone interview during a grounded theory study. The accepted norm for qualitative interviews is to conduct them face-to-face. It is typical to consider collecting qualitative data via telephone only when face-to-face interview is not possible. During a grounded theory study, exploring users' experiences with overnight mask ventilation for sleep apnoea, the authors selected the telephone to conduct interviews. This article reports participants' views on semistructured interview by telephone. An inductive thematic analysis was conducted on data pertaining to the use of the telephone interview in a grounded theory study. The data were collected during 4 months of 2011 and 6 months in 2014. The article presents an inductive thematic analysis of sixteen participants' opinions about telephone interviewing and discusses these in relation to existing literature reporting the use of telephone interviews in grounded theory studies. Overall, participants reported a positive experience of telephone interviewing. From each participants reports we identified four themes from the data: being 'phone savvy; concentrating on voice instead of your face; easy rapport; and not being judged or feeling inhibited. By drawing on these data, we argue that the telephone as a data collection tool in grounded theory research and other qualitative methodologies need not be relegated to second best status. Rather, researchers can consider telephone interview a valuable first choice option. © 2015 John Wiley & Sons Ltd.

'One also needs a bit of trust in the doctor ... ': a qualitative interview study with pancreatic cancer patients about their perceptions and views on information and treatment decision-making.

PubMed

Schildmann, J; Ritter, P; Salloch, S; Uhl, W; Vollmann, J

2013-09-01

Information about diagnosis, treatment options and prognosis has been emphasized as a key to empower cancer patients to make treatment decisions reflecting their values. However, surveys indicate that patients' preferences regarding information and treatment decision-making differ. In this qualitative interview study, we explored pancreatic cancer patients' perceptions and preferences on information and treatment decision-making. Qualitative in-depth interviews with patients with pancreatic cancer. Purposive sampling and qualitative analysis were carried out. We identified two stages of information and treatment decision-making. Patients initially emphasize trust in their physician and indicate rather limited interest in details about surgical and medical treatment. In the latter stage of disease, patients perceive themselves more active regarding information seeking and treatment decision-making. All patients discuss their poor prognosis. Reflecting on their own situation, all patients interviewed pointed out that hope was an important driver to undergo further treatment also in advanced stages of the disease. Interviewees unanimously emphasized the difficulty of anticipating the time at which stopping cancer treatment would be the right decision. The findings can serve as starting point for reflection on professional decision-making in pancreatic cancer and larger representative surveys on ethical issues in treatment decision-making in pancreatic cancer.

A qualitative study to identify reasons for discharges against medical advice in the cardiovascular setting

PubMed Central

Saunders, Elijah; Mullins, C Daniel; Pradel, Françoise G; Zuckerman, Marni; Loh, F Ellen; Weir, Matthew R

2012-01-01

Background Cardiovascular disease (CVD) is responsible for the largest number of discharges against medical advice (AMA). However, there is limited information regarding the reasons for discharges AMA in the CVD setting. Objective To identify reasons for discharges AMA among patients with CVD. Design Qualitative study using focus group interviews (FGIs). Participants A convenience sample of patients with a CVD-related discharge diagnosis who left AMA and providers (physicians, nurses and social workers) whose patients have left AMA. Primary and secondary outcomes To identify patients' reasons for discharges AMA as identified by patients and providers. To identify strategies to reduce discharges AMA. Approach FGIs were grouped according to patients, physicians and nurses/social workers. A content analysis was performed independently by three coauthors to identify the nature and range of the participants' viewpoints on the reasons for discharges AMA. The content analysis involved specific categories of reasons as motivated by the Health Belief Model as well as reasons (ie, themes) that emerged from the interview data. Results 9 patients, 10 physicians and 23 nurses/social workers were recruited for the FGIs. Patients and providers reported the same three reasons for discharges AMA: (1) patient's preference for their own doctor, (2) long wait time and (3) factors outside the hospital. Patients identified an unmet expectation to be involved in setting the treatment plan as a reason to leave AMA. Participants identified improved communication as a solution for reducing discharges AMA. Conclusions Patients wanted more involvement in their care, exhibited a strong preference for their own primary physician, felt that they spent a long time waiting in the hospital and were motivated to leave AMA by factors outside the hospital. Providers identified similar reasons except the patients' desire for involvement. Additional research is needed to determine the applicability of

Unmarried women's decisions on pregnancy termination: Qualitative interviews in Colombo, Sri Lanka.

PubMed

Olsson, Pia; Wijewardena, Kumudu

2010-11-01

In Sri Lanka pregnancy termination is very restricted by law and social norms. Premarital sex, and pregnancies are not generally accepted and unmarried pregnant women are vulnerable in their decision-making on pregnancy termination. The objective of this study was to describe the circumstances of becoming pregnant and factors considered in the decision-making for seeking pregnancy termination in a sample of unmarried women in Colombo, Sri Lanka. Individual qualitative interviews were conducted with 19 unmarried women seeking pregnancy terminations at a reproductive health centre in Colombo, Sri Lanka. The interviews were later analysed using qualitative content analysis. Becoming pregnant in a love relationship was predominant in this sample. Awareness of contraceptives varied and initial reaction to the pregnancy involved strong contradictory emotions. Multiple interrelated factors were considered in the decision-making for termination. Family pressure was the most prominent factor followed by the partner's qualities and attitude towards the pregnancy, economic factors and own feelings, values and future fertility. The women described that their own emotional, religious and economic reasons for continuing the pregnancy were often outweighed by their responsibility to the family, male partner and unborn child. These unmarried women's sexual and reproductive rights were limited and for many the pregnancy termination was socially unsafe. They found themselves at the interface of two value systems. Modern values allow for relationships with men prior to marriage; whereas, traditional values did not. The limited possibilities to prevent pregnancies and little hope for support if continuing the pregnancy; made women seek pregnancy termination despite own doubts. Copyright © 2010 Elsevier B.V. All rights reserved.

The Qualitative Interview Study of Persistent and Nonpersistent Substance Use in the MTA: Sample Characteristics, Frequent Use, and Reasons for Use.

PubMed

Swanson, James M; Wigal, Timothy; Jensen, Peter S; Mitchell, John T; Weisner, Thomas S; Murray, Desiree; Arnold, L Eugene; Hechtman, Lily; Molina, Brooke S G; Owens, Elizabeth B; Hinshaw, Stephen P; Belendiuk, Katherine; Howard, Andrea; Wigal, Sharon B; Sorensen, Page; Stehli, Annamarie

2017-10-01

To evaluate participants' perceptions about frequent use and reasons for substance use (SU) in the qualitative interview study, an add-on to the multimodal treatment study of ADHD (MTA). Using the longitudinal MTA database, 39 ADHD cases and 19 peers with Persistent SU, and 86 ADHD cases and 39 peers without Persistent SU were identified and recruited. In adulthood, an open-ended interview was administered, and SU excerpts were indexed and classified to create subtopics (frequent use and reasons for use of alcohol, marijuana, and other drugs). For marijuana, the Persistent compared with Nonpersistent SU group had a significantly higher percentage of participants describing frequent use and giving reasons for use, and the ADHD group compared with the group of peers had a significantly higher percentage giving "stability" as a reason for use. Motivations for persistent marijuana use may differ for adults with and without a history of ADHD.

The Tanzanian trauma patients' prehospital experience: a qualitative interview-based study

PubMed Central

Kuzma, Kristin; Lim, Andrew George; Kepha, Bernard; Nalitolela, Neema Evelyne; Reynolds, Teri A

2015-01-01

Objectives We sought to characterise the prehospital experience of Tanzanian trauma patients, and identify barriers and facilitators to implement community-based emergency medical systems (EMS). Settings Our study was conducted in the emergency department of an urban national referral hospital in Tanzania. Participants A convenience sample of 34 adult trauma patients, or surrogate family members, presenting or referred to an urban referral emergency department in Tanzania for treatment of injury, participated in the study. Interventions Participation in semistructured, iteratively developed interviews until saturation of responses was reached. Outcomes A grounded theory-based approach to qualitative analysis was used to identify recurrent themes. Results We characterised numerous deficiencies within the existing clinic-to-hospital referral network, including missed/delayed diagnoses, limited management capabilities at pre-referral facilities and interfacility transfer delays. Potential barriers to EMS implementation include patient financial limitations and lack of insurance, limited public infrastructure and resources, and the credibility of potential first aid responders. Potential facilitators of EMS include communities’ tendency to pool resources, individuals’ trust of other community members to be first aid responders, and faith in community leaders to organise EMS response. Participants expressed a strong desire to learn first aid. Conclusions The composite themes generated by the data suggest that there are myriad structural, financial, institutional and cultural barriers to the implementation of a formal prehospital system. However, our analysis also revealed potential facilitators to a first-responder system that takes advantage of close-knit local communities and the trust of recognised leaders in society. The results suggest favourable acceptability for community-based response by trained lay people. There is significant opportunity for care

Methodological Aspects of Focus Groups in Health Research: Results of Qualitative Interviews With Focus Group Moderators.

PubMed

Tausch, Anja P; Menold, Natalja

2016-01-01

Although focus groups are commonly used in health research to explore the perspectives of patients or health care professionals, few studies consider methodological aspects in this specific context. For this reason, we interviewed nine researchers who had conducted focus groups in the context of a project devoted to the development of an electronic personal health record. We performed qualitative content analysis on the interview data relating to recruitment, communication between the focus group participants, and appraisal of the focus group method. The interview data revealed aspects of the focus group method that are particularly relevant for health research and that should be considered in that context. They include, for example, the preferability of face-to-face recruitment, the necessity to allow participants in patient groups sufficient time to introduce themselves, and the use of methods such as participant-generated cards and prioritization.

Use of the Blue Button Online Tool for Sharing Health Information: Qualitative Interviews With Patients and Providers.

PubMed

Klein, Dawn M; Fix, Gemmae M; Hogan, Timothy P; Simon, Steven R; Nazi, Kim M; Turvey, Carolyn L

2015-08-18

Information sharing between providers is critical for care coordination, especially in health systems such as the United States Department of Veterans Affairs (VA), where many patients also receive care from other health care organizations. Patients can facilitate this sharing by using the Blue Button, an online tool that promotes patients' ability to view, print, and download their health records. The aim of this study was to characterize (1) patients' use of Blue Button, an online information-sharing tool in VA's patient portal, My HealtheVet, (2) information-sharing practices between VA and non-VA providers, and (3) how providers and patients use a printed Blue Button report during a clinical visit. Semistructured qualitative interviews were conducted with 34 VA patients, 10 VA providers, and 9 non-VA providers. Interviews focused on patients' use of Blue Button, information-sharing practices between VA and non-VA providers, and how patients and providers use a printed Blue Button report during a clinical visit. Qualitative themes were identified through iterative rounds of coding starting with an a priori schema based on technology adoption theory. Information sharing between VA and non-VA providers relied primarily on the patient. Patients most commonly used Blue Button to access and share VA laboratory results. Providers recognized the need for improved information sharing, valued the Blue Button printout, and expressed interest in a way to share information electronically across settings. Consumer-oriented technologies such as Blue Button can facilitate patients sharing health information with providers in other health care systems; however, more education is needed to inform patients of this use to facilitate care coordination. Additional research is needed to explore how personal health record documents, such as Blue Button reports, can be easily shared and incorporated into the clinical workflow of providers.

Use of the Blue Button Online Tool for Sharing Health Information: Qualitative Interviews With Patients and Providers

PubMed Central

Fix, Gemmae M; Hogan, Timothy P; Simon, Steven R; Nazi, Kim M; Turvey, Carolyn L

2015-01-01

Background Information sharing between providers is critical for care coordination, especially in health systems such as the United States Department of Veterans Affairs (VA), where many patients also receive care from other health care organizations. Patients can facilitate this sharing by using the Blue Button, an online tool that promotes patients’ ability to view, print, and download their health records. Objective The aim of this study was to characterize (1) patients’ use of Blue Button, an online information-sharing tool in VA’s patient portal, My HealtheVet, (2) information-sharing practices between VA and non-VA providers, and (3) how providers and patients use a printed Blue Button report during a clinical visit. Methods Semistructured qualitative interviews were conducted with 34 VA patients, 10 VA providers, and 9 non-VA providers. Interviews focused on patients’ use of Blue Button, information-sharing practices between VA and non-VA providers, and how patients and providers use a printed Blue Button report during a clinical visit. Qualitative themes were identified through iterative rounds of coding starting with an a priori schema based on technology adoption theory. Results Information sharing between VA and non-VA providers relied primarily on the patient. Patients most commonly used Blue Button to access and share VA laboratory results. Providers recognized the need for improved information sharing, valued the Blue Button printout, and expressed interest in a way to share information electronically across settings. Conclusions Consumer-oriented technologies such as Blue Button can facilitate patients sharing health information with providers in other health care systems; however, more education is needed to inform patients of this use to facilitate care coordination. Additional research is needed to explore how personal health record documents, such as Blue Button reports, can be easily shared and incorporated into the clinical workflow of

The Voice Transcription Technique: Use of Voice Recognition Software to Transcribe Digital Interview Data in Qualitative Research

ERIC Educational Resources Information Center

Matheson, Jennifer L.

2007-01-01

Transcribing interview data is a time-consuming task that most qualitative researchers dislike. Transcribing is even more difficult for people with physical limitations because traditional transcribing requires manual dexterity and the ability to sit at a computer for long stretches of time. Researchers have begun to explore using an automated…

GPs' management strategies for patients with insomnia: a survey and qualitative interview study.

PubMed

Everitt, Hazel; McDermott, Lisa; Leydon, Geraldine; Yules, Harvey; Baldwin, David; Little, Paul

2014-02-01

Patients frequently experience sleep problems and present to primary care. However, information is limited regarding the management strategies that GPs employ. To gain an understanding of current GP management strategies for insomnia. A postal questionnaire survey and qualitative interviews with GPs in the south of England. A postal survey of 296 GPs and qualitative interviews were carried out with 23 of the GPs. The survey response rate was 56% (166/296). GPs look for signs of depression and anxiety in patients and if present treat these first. 'Sleep hygiene' advice is provided by 88% (147/166) of GPs but often seems insufficient and they feel under pressure to prescribe. Benzodiazepines and Z drugs are prescribed, often reluctantly, for short periods, because of known problems with dependence and tolerance. Many GPs prescribe low-dose amitriptyline for insomnia although it is not licensed for this indication. For insomnia 95% (157/166) of survey responders 'ever prescribe' amitriptyline, with 31% (52/166) stating they do so commonly. Most GPs perceived amitriptyline to be effective and a longer-term option for those with ongoing sleep problems. GPs report a lack of knowledge and confidence in the provision and use of psychological therapies, such as cognitive behavioural therapy (CBT), in the management of insomnia. GPs often find 'sleep hygiene' advice is insufficient for managing insomnia and report frequently prescribing medication, including amitriptyline (off licence), which is often based on perceived patient pressure for a prescription. Patients are rarely offered psychological therapies such as CBT for insomnia, despite evidence suggesting its potential effectiveness.

GP views on strategies to cope with increasing workload: a qualitative interview study.

PubMed

Fisher, Rebecca Fr; Croxson, Caroline Hd; Ashdown, Helen F; Hobbs, Fd Richard

2017-02-01

The existence of a crisis in primary care in the UK is in little doubt. GP morale and job satisfaction are low, and workload is increasing. In this challenging context, finding ways for GPs to manage that workload is imperative. To explore what existing or potential strategies are described by GPs for dealing with their workload, and their views on the relative merits of each. Semi-structured, qualitative interviews with GPs working within NHS England. All GPs working within NHS England were eligible. Of those who responded to advertisements, a maximum-variation sample was selected and interviewed until data saturation was reached. Data were analysed thematically. Responses were received from 171 GPs, and, from these, 34 were included in the study. Four main themes emerged for workload management: patient-level, GP-level, practice-level, and systems-level strategies. A need for patients to take greater responsibility for self-management was clear, but many felt that GPs should not be responsible for this education. Increased delegation of tasks was felt to be key to managing workload, with innovative use of allied healthcare professionals and extended roles for non-clinical staff suggested. Telephone triage was a commonly used tool for managing workload, although not all participants found this helpful. This in-depth qualitative study demonstrates an encouraging resilience among GPs. They are proactively trying to manage workload, often using innovative local strategies. GPs do not feel that they can do this alone, however, and called repeatedly for increased recruitment and more investment in primary care. © British Journal of General Practice 2017.

Understanding perceived determinants of nurses' eating and physical activity behaviour: a theory-informed qualitative interview study.

PubMed

Power, Brian T; Kiezebrink, Kirsty; Allan, Julia L; Campbell, Marion K

2017-01-01

Unhealthy eating and physical activity behaviours are common among nurses but little is known about determinants of eating and physical activity behaviour in this population. The present study used a theoretical framework which summarises the many possible determinants of different health behaviours (the Theoretical Domains Framework; TDF) to systematically explore the most salient determinants of unhealthy eating and physical activity behaviour in hospital-based nurses. Semi-structured qualitative interviews based on the TDF were conducted with nurses ( n  = 16) to explore factors that behavioural theories suggest may influence nurses' eating and physical activity behaviour. Important determinants of the target behaviours were identified using both inductive coding (of categories emerging from the data) and deductive coding (of categories derived from the TDF) of the qualitative data. Thirteen of the fourteen domains in the TDF were found to influence nurses' eating and physical activity behaviour. Within these domains, important barriers to engaging in healthy eating and physical activity behaviour were shift work, fatigue, stress, beliefs about negative consequences, the behaviours of family and friends and lack of planning. Important factors reported to enable engagement with healthy eating and physical activity behaviours were beliefs about benefits, the use of self-monitoring strategies, support from work colleagues, confidence, shift work, awareness of useful guidelines and strategies, good mood, future holidays and receiving compliments. This study used a theory-informed approach by applying the TDF to identify the key perceived determinants of nurses' eating and physical activity behaviour. The findings suggest that future efforts to change nurses' eating and physical activity behaviours should consider targeting a broad range of environmental, interpersonal and intrapersonal level factors, consistent with a socio-ecological perspective.

Telephone health services in the field of rare diseases: a qualitative interview study examining the needs of patients, relatives, and health care professionals in Germany.

PubMed

Babac, Ana; Frank, Martin; Pauer, Frédéric; Litzkendorf, Svenja; Rosenfeldt, Daniel; Lührs, Verena; Biehl, Lisa; Hartz, Tobias; Storf, Holger; Schauer, Franziska; Wagner, Thomas O F; Graf von der Schulenburg, J-Matthias

2018-02-09

Rare diseases are, by definition, very serious and chronic diseases with a high negative impact on quality of life. Approximately 350 million people worldwide live with rare diseases. The resulting high disease burden triggers health information search, but helpful, high-quality, and up-to-date information is often hard to find. Therefore, the improvement of health information provision has been integrated in many national plans for rare diseases, discussing the telephone as one access option. In this context, this study examines the need for a telephone service offering information for people affected by rare diseases, their relatives, and physicians. In total, 107 individuals participated in a qualitative interview study conducted in Germany. Sixty-eight individuals suffering from a rare disease or related to somebody with rare diseases and 39 health care professionals took part. Individual interviews were conducted using a standardized semi-structured questionnaire. Interviews were analysed using the qualitative content analysis, triangulating patients, relatives, and health care professionals. The fulfilment of qualitative data processing standards has been controlled for. Out of 68 patients and relatives and 39 physicians, 52 and 18, respectively, advocated for the establishment of a rare diseases telephone service. Interviewees expected a helpline to include expert staffing, personal contact, good availability, low technical barriers, medical and psychosocial topics of counselling, guidance in reducing information chaos, and referrals. Health care professionals highlighted the importance of medical topics of counselling-in particular, differential diagnostics-and referrals. Therefore, the need for a national rare diseases helpline was confirmed in this study. Due to limited financial resources, existing offers should be adapted in a stepwise procedure in accordance with the identified attributes.

Women's experiences of daily life after anterior cervical decompression and fusion surgery: A qualitative interview study.

PubMed

Hermansen, Anna; Peolsson, Anneli; Kammerlind, Ann-Sofi; Hjelm, Katarina

2016-04-01

To explore and describe women's experiences of daily life after anterior cervical decompression and fusion surgery. Qualitative explorative design. Fourteen women aged 39-62 years (median 52 years) were included 1.5-3 years after anterior cervical decompression and fusion for cervical disc disease. Individual semi-structured interviews were analysed by qualitative content analysis with an inductive approach. The women described their experiences of daily life in 5 different ways: being recovered to various extents; impact of remaining symptoms on thoughts and feelings; making daily life work; receiving support from social and occupational networks; and physical and behavioural changes due to interventions and encounters with healthcare professionals. This interview study provides insight into women's daily life after anterior cervical decompression and fusion. Whilst the subjects improved after surgery, they also experienced remaining symptoms and limitations in daily life. A variety of mostly active coping strategies were used to manage daily life. Social support from family, friends, occupational networks and healthcare professionals positively influenced daily life. These findings provide knowledge about aspects of daily life that should be considered in individualized postoperative care and rehabilitation in an attempt to provide better outcomes in women after anterior cervical decompression and fusion.

The needs and preferences of pregnant smokers regarding tailored Internet-based smoking cessation interventions: a qualitative interview study.

PubMed

Herbec, Aleksandra; Beard, Emma; Brown, Jamie; Gardner, Benjamin; Tombor, Ildiko; West, Robert

2014-10-14

Internet-based Smoking Cessation Interventions (ISCIs) may help pregnant smokers who are unable, or unwilling, to access face-to-face stop smoking support. Targeting ISCIs to specific groups of smokers could increase their uptake and effectiveness. The current study explored the needs and preferences of pregnant women seeking online stop smoking support with an aim to identify features and components of ISCIs that might be most attractive to this population. We conducted qualitative interviews with thirteen pregnant women who completed the intervention arm of a pilot randomized controlled trial of a novel ISCI for pregnant smokers ('MumsQuit'). The interviews explored women's views towards MumsQuit and online support with quitting smoking in general, as well as their suggestions for how ISCIs could be best targeted to pregnancy. Interview transcripts were analyzed using Framework Analysis. Participants expressed preferences for an accessible, highly engaging and targeted to pregnancy smoking cessation website, tailored to individuals' circumstances as well as use of cessation medication, offering comprehensive and novel information on smoking and quitting smoking in pregnancy, ongoing support with cravings management, as well as additional support following relapse to smoking. Participants also viewed as important targeting of the feedback and progress reports to baby's health and development, offering personal support from experts, and providing a discussion forum allowing for communication with other pregnant women wanting to quit . The present study has identified a number of potential building blocks for ISCIs targeted to quitting smoking in pregnancy. Pregnant smokers willing to try using ISCI may particularly value an engaging intervention offering a high degree of targeting of comprehensive information to them as a group and tailoring support and advice to their individual needs, as well as one providing post-relapse support, peer-to-peer communication and

Patient-reported Symptom Experiences in Patients With Carcinoid Syndrome After Participation in a Study of Telotristat Etiprate: A Qualitative Interview Approach.

PubMed

Gelhorn, Heather L; Kulke, Matthew H; O'Dorisio, Thomas; Yang, Qi M; Jackson, Jessica; Jackson, Shanna; Boehm, Kristi A; Law, Linda; Kostelec, Jacqueline; Auguste, Priscilla; Lapuerta, Pablo

2016-04-01

Telotristat etiprate, a tryptophan hydroxylase inhibitor, was previously evaluated in a Phase II randomized, placebo-controlled clinical trial in patients with carcinoid syndrome (CS) and diarrhea not adequately controlled by octreotide. The objective of the current study was to characterize the symptom experiences of patients participating in that trial. Consenting patients participated in one-on-one, qualitative interviews focused on eliciting symptoms they had experienced in association with their CS diagnosis and recollection of symptom changes they experienced while participating in the Phase II trial. Among the 23 patients who participated in the previous 4-week dose-escalation study, 16 were eligible for interviews and 11 participated in the present study. The median time from study completion to the interview was 31 months; 4 of 11 patients were receiving telotristat etiprate in a follow-up, open-label trial at the time of interview. All of the patients (100%) described diarrhea as a symptom of CS, with effects on the emotional, social, and physical aspects of their lives. Improvement in diarrhea during the study was described by 82% of participants, and was very impactful in several patients. Results led to the design and implementation of a larger interview program in Phase III and helped to establish a definition of clinically meaningful change for the clinical development program. The diarrhea associated with CS can have a large impact on daily lives, and patient interviews can characterize and capture clinically meaningful improvements with treatment. ClinicalTrials.gov Identifier: NCT00853047. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

The Roles of Motivation and Coping Behaviours in Managing Stress: Qualitative Interview Study of Hong Kong Expatriate Construction Professionals in Mainland China.

PubMed

Chan, Isabelle Yee Shan; Leung, Mei-Yung; Liang, Qi

2018-03-20

Driven by fast-growing economies worldwide, the number of international construction projects is booming, and employing expatriates has inevitably become a strategy used by construction firms. However, stress arising from expatriate assignments can lead to early return, assignment failure, and staff turnover, causing in significant losses to an organisation. Extensive research has focused on the effectiveness of coping behaviours in relation to stress. However, studies investigating the antecedents of coping are rare. The limited studies to date tend to focus on content-based motivations (identifying what), instead of on how coping behaviours can be motivated in the stress management process (identifying how). Focus on expatriate construction professionals (ECPs) is further limited. Hence, this study aims to investigate from a process theory perspective the role of motivation in the stress management process. Using a qualitative interview study approach, involving 22 in-depth interviews, this study first identifies the content of motivation, coping behaviours, performance, and stress in the context of Hong Kong ECPs working on cross-cultural projects in China; it then unveils and explains the associations between the identified variables. Based on the results, stakeholders are recommended to review pre-departure training, so as to ensure that key elements such as personal awareness of stress (cognitive, affective, and physical), expectancies of coping strategies on stress (adaptive or maladaptive), and expectancies of the influence of stress on performance are covered.

The Roles of Motivation and Coping Behaviours in Managing Stress: Qualitative Interview Study of Hong Kong Expatriate Construction Professionals in Mainland China

PubMed Central

Chan, Isabelle Yee Shan; Leung, Mei-yung; Liang, Qi

2018-01-01

Driven by fast-growing economies worldwide, the number of international construction projects is booming, and employing expatriates has inevitably become a strategy used by construction firms. However, stress arising from expatriate assignments can lead to early return, assignment failure, and staff turnover, causing in significant losses to an organisation. Extensive research has focused on the effectiveness of coping behaviours in relation to stress. However, studies investigating the antecedents of coping are rare. The limited studies to date tend to focus on content-based motivations (identifying what), instead of on how coping behaviours can be motivated in the stress management process (identifying how). Focus on expatriate construction professionals (ECPs) is further limited. Hence, this study aims to investigate from a process theory perspective the role of motivation in the stress management process. Using a qualitative interview study approach, involving 22 in-depth interviews, this study first identifies the content of motivation, coping behaviours, performance, and stress in the context of Hong Kong ECPs working on cross-cultural projects in China; it then unveils and explains the associations between the identified variables. Based on the results, stakeholders are recommended to review pre-departure training, so as to ensure that key elements such as personal awareness of stress (cognitive, affective, and physical), expectancies of coping strategies on stress (adaptive or maladaptive), and expectancies of the influence of stress on performance are covered. PMID:29558458

An Alternative Approach to Conceptualizing Interviews in HRD Research

ERIC Educational Resources Information Center

Wang, Jia; Roulston, Kathryn J.

2007-01-01

Qualitative researchers in human resource development (HRD) frequently use in-depth interviews as a research method. Yet reports from qualitative studies in HRD commonly pay little or no analytical attention to the co-construction of interview data. That is, reports of qualitative research projects often treat interviews as a transparent method of…

Alcohol brief interventions practice following training for multidisciplinary health and social care teams: a qualitative interview study.

PubMed

Fitzgerald, Niamh; Molloy, Heather; MacDonald, Fiona; McCambridge, Jim

2015-03-01

Few studies of the implementation of alcohol brief interventions (ABI) have been conducted in community settings such as mental health, social work and criminal justice teams. This qualitative interview study sought to explore the impact of training on ABI delivery by staff from a variety of such teams. Fifteen semi-structured telephone interviews were carried out with trained practitioners and with managers to explore the use of, perceived need for and approaches to ABI delivery and recording with clients, and compatibility of ABIs with current practice. Interviews were analysed thematically using an inductive approach. Very few practitioners reported delivery of any ABIs following training primarily because they felt ABIs to be inappropriate for their clients. According to practitioners, this was either because they drank too much or too little to benefit. Practitioners reported a range of current activities relating to alcohol, and some felt that their knowledge and confidence were improved following training. One practitioner reported ABI delivery and was considered a training success, while expectations of ABIs did not fit with current practice including assessment procedures for the remainder. Identified barriers to ABI delivery included issues relating to individual practitioners, their teams, current practice and the ABI model. They are likely to be best addressed by strategic team- and setting-specific approaches to implementation, of which training is only one part. © 2014 The Authors. Drug and Alcohol Review published by Wiley Publishing Asia Pty Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

The development of a model of dignity in illness based on qualitative interviews with seriously ill patients.

PubMed

van Gennip, Isis E; Pasman, H Roeline W; Oosterveld-Vlug, Mariska G; Willems, Dick L; Onwuteaka-Philipsen, Bregje D

2013-08-01

While knowledge on factors affecting personal dignity of patients nearing death is quite substantial, far less is known about how patients living with a serious disease understand dignity. To develop a conceptual model of dignity that illuminates the process by which serious illness can undermine patients' dignity, and that is applicable to a wide patient population. Qualitative interview study. 34 patients with either cancer, early stage dementia, or a severe chronic illness were selected from an extensive cohort study into advance directives. In-depth interviews were carried out exploring the experiences of seriously ill patients with regard to their personal dignity. The interview transcripts were analyzed using thematic analysis and a conceptual model was constructed based on the resulting themes. We developed a two-step dignity model of illness. According to this model, illness related conditions do not affect patients' dignity directly but indirectly by affecting the way patients perceive themselves. We identified three components shaping self-perception: (a) the individual self: the subjective experiences and internally held qualities of the patient; (b) the relational self: the self within reciprocal interaction with others; and, (c) the societal self: the self as a social object in the eyes of others. The merits of the model are two-folded. First, it offers an organizing framework for further research into patients' dignity. Secondly, the model can serve to facilitate care for seriously ill patients in practice by providing insight into illness and dignity at the level of the individual patient where intervention can be effectively targeted. Copyright © 2013 Elsevier Ltd. All rights reserved.

How to Design Tobacco Prevention and Control Games for Youth and Adolescents: A Qualitative Analysis of Expert Interviews.

PubMed

Hall, Amanda K; Mercado, Rebeccah; Anderson-Lewis, Charkarra; Darville, Gabrielle; Bernhardt, Jay M

2015-12-01

Games for health, including digital videogames and gaming-based approaches, are increasingly being used in health promotion research and practice. Recently published research has shown that videogames have significant potential to promote healthy behaviors among youth and adolescents. Yet, there is a lack of available evidence-based resources to guide practitioners on the integration of games into tobacco prevention and smoking cessation interventions. To address this gap, expert researchers and game developers were interviewed to further define games for health, explore the current research, and provide recommendations for developing, evaluating, and promoting effective anti-tobacco games. Nationally recognized experts on game development, games for health, tobacco, and health behavior were asked to participate. A qualitative analysis of 25 in-depth individual interviews using a constant comparative approach for emerging themes was conducted. Main themes that emerged from the data analysis included the following: (1) the current state of games for health research to facilitate health behavior change, (2) strategies for how to develop and evaluate games for quality and impact, and (3) recommendations for how to effectively design tobacco prevention and smoking cessation educational videogames that engage youth and adolescents. The synthesized findings identified through these expert interviews offer stakeholders strategies for how to incorporate games for health within their current and future work. Specific recommendations are presented for developers and researchers to consider when developing and evaluating videogames for tobacco prevention and smoking cessation targeted at youth and adolescents.

Optimising mobility through the sit-to-stand activity for older people living in residential care facilities: A qualitative interview study of healthcare aide experiences.

PubMed

Kagwa, Sharon A; Boström, Anne-Marie; Ickert, Carla; Slaughter, Susan E

2018-03-01

To explore the experience of HCAs encouraging residents living in residential care to complete the sit-to-stand activity and to identify the strategies HCAs used to integrate the activity into their daily work routines. Decreased mobility in advanced ageing is further reduced when entering a residential care facility. Interventions such as the sit-to-stand activity have been shown to have a positive effect on the mobility of older people. There is evidence to suggest that healthcare aides are able to support residents to complete the sit-to-stand activity as part of their daily work routines; however, little is known about how healthcare aides actually do this with residents living in residential care. A qualitative interview study included seven purposively sampled HCAs working in residential care facilities. Semistructured interviews were analysed using inductive qualitative content analysis. The HCAs' experience with the sit-to-stand activity was represented by the following four categories: Resident participation, Feeling misunderstood and disrespected, Time and workload, and Management involvement. HCAs identified three strategies to help them support residents to complete the sit-to-stand activity: Motivating residents, Completing activity in a group and Using time management skills. HCAs reported some encouragement from managers and cooperation from residents to complete the sit-to-stand activity with residents; however, they also felt constrained by time limitations and workload demands and they felt misunderstood and disrespected. HCAs were able to identify several strategies that helped them to integrate the sit-to-stand activity into their daily routines. This study highlights the challenges and supportive factors of implementing the sit-to-stand activity into the daily work routine of HCAs. The study also identifies the strategic role of nurse managers when implementing interventions in residential care facilities. © 2017 John Wiley & Sons Ltd.

Understanding the role of sleep in suicide risk: qualitative interview study

PubMed Central

Kyle, Simon D; Pratt, Daniel; Peters, Sarah

2016-01-01

Objective Sleep problems are associated with increased risk of suicide, independent of depression. This analysis explores narrative accounts of the role of sleep in relation to suicidal thoughts and behaviours. Design Qualitative study, based on in-depth semistructured interviews which were analysed with an inductive, latent thematic analysis. Participants A maximum variation sample of 18 people with experience of a major depressive episode, and suicidal thoughts and behaviours. Setting Primary care, North West England. Results Respondents emphasised the importance of sleep for recovery and management of their mental well-being. Moreover, three inter-related pathways were identified, whereby beliefs about sleep contributed to suicidal thoughts and behaviours. First, being awake during the biological night heightened risk of suicidal behaviours, as this was perceived to be an opportune time for a suicide attempt due to the decreased chances that a friend of family member would intervene during a suicide attempt. Additionally, the reduction in available support at night added to suicide risk. Second, failure to achieve good sleep was perceived to make life harder through contributing to core features of depression, such as negative thinking, attention difficulties and inactivity. Third, sleep acted as an alternative to suicide, by providing an escape from problems, including mental health problems, in waking life. However, this desire to sleep to escape was associated with excessive daytime sleeping, which subsequently may reinforce disturbed sleeping patterns. Conclusions Sleep problems should be an important treatment target when working with suicidal clients. More broadly, night-time service provision should be considered when developing suicide prevention initiatives. PMID:27550652

Impact of legal regulations and administrative policies on persons with SCI: identifying potential research priorities through expert interviews.

PubMed

Trezzini, Bruno; Phillips, Barbara

2014-01-01

To identify research gaps and potential research priorities regarding the impact that legal regulations and administrative policies might have on people with spinal cord injury (SCI) living in Switzerland. We conducted semi-structured interviews with 14 healthcare professionals working for or being associated with the largest SCI clinic in Switzerland. The transcribed interviews were content analyzed, involving qualitative description, and thematic analysis techniques. Four interrelated clusters of issues were corroborated: (1) social insurance, (2) caregiving, (3) work integration, and (4) aging. In addition, two overarching themes were identified: (1) fairness considerations and (2) unavailability of systematic empirical evidence. Work capacity assessment and family caregiving were deemed to be the most pressing research priority areas. Legal frameworks do play both a direct and an indirect role in the lives of people with SCI in Switzerland. This is particularly true with regard to various issues related to the social insurance system, such as family caregiving and work capacity assessment. The salience of these topics is closely related to major sociodemographic and political driving forces, i.e. aging and social insurance reforms. Research directly involving people with SCI is needed to further substantiate and refine the findings of this study. When dealing with issues related to work reintegration, aging, social insurance, and caregiving, rehabilitation professionals should take existing legal frameworks into account. Eligibility criteria for disability benefits may influence the therapy motivation of rehabilitation clients.

Barriers and facilitators to parents seeking and accessing professional support for anxiety disorders in children: qualitative interview study.

PubMed

Reardon, Tessa; Harvey, Kate; Young, Bridget; O'Brien, Doireann; Creswell, Cathy

2018-01-25

Anxiety disorders are among the most common mental health disorders experienced by children, but only a minority of these children access professional help. Understanding the difficulties parents face seeking support for child anxiety disorders could inform targeted interventions to improve treatment access. The aims of the study were to identify barriers and facilitators to seeking and accessing professional support for child anxiety disorders, and ways to minimise these barriers. A qualitative interview study was conducted with parents of 16 children (aged 7-11 years) with anxiety disorders identified through screening in schools. Barriers and facilitators were identified in relation to four distinct stages in the help-seeking process: parents recognising the anxiety difficulty, parents recognising the need for professional support, parents contacting professionals, and families receiving professional support. Barriers and facilitators at each stage related to the child's difficulties, the role of the parent, and parent perceptions of professionals and services. Findings illustrate the need (1) for readily available tools to help parents and professionals identify clinically significant anxiety in children, (2) to ensure that families and professionals can easily access guidance on the help-seeking process and available support, and (3) to ensure existing services offer sufficient provision for less severe difficulties that incorporates direct support for parents.

Breaking Up Is Hard to Do: A Qualitative Interview Study of How and Why Youth Mentoring Relationships End

ERIC Educational Resources Information Center

Spencer, Renée; Basualdo-Delmonico, Antoinette; Walsh, Jill; Drew, Alison L.

2017-01-01

Endings in youth mentoring relationships have received little empirical attention despite the fact that many relationships do end. The present study utilized qualitative interview data collected from participants in a longitudinal study of community-based mentoring relationships to examine how and why the relationships ended and how participants…

The benefits of discussing suicide with Alaska native college students: qualitative analysis of in-depth interviews.

PubMed

DeCou, Christopher R; Skewes, Monica C; López, Ellen D S; Skanis, Marie L

2013-01-01

Suicide represents a significant health disparity for communities in rural Alaska, and has implications for mental health among people who have lost loved ones from suicide. A qualitative interview study was conducted to examine the ways in which suicide has affected the lives of college students who have migrated from rural villages to an urban university (N = 25). The present research represents a secondary aim of the study-specifically, we examined the affective responses of Alaska Native college students from rural villages after completing in-depth semistructured interviews about their experiences related to suicide. Debriefing questions posed at the conclusion of the interviews revealed that the majority of participants (n 16) stated they felt "better" after completing the interview, and no participants reported feeling "worse." No participant required the use of the safety plan developed in case of severe emotional distress. All participants indicated they would be interested in participating in future research. Analysis of questions pertaining to the interview experience revealed the salience of foundation (the participant's prior experience discussing issues like suicide), process (the interview questions and questioning style), and outcomes (the challenges and benefits of participation described by the respondent). Findings provided important insights concerning the experience of discussing past trauma, perceived importance of research addressing coping with suicide, and the influence of past experiences in the process of talking about suicide.

Qualitative Interviews Exploring Palliative Care Perspectives of Latinos on Dialysis.

PubMed

Cervantes, Lilia; Jones, Jacqueline; Linas, Stuart; Fischer, Stacy

2017-05-08

Compared with non-Latino whites with advanced illness, Latinos are less likely to have an advance directive or to die with hospice services. To improve palliative care disparities, international ESRD guidelines call for increased research on culturally responsive communication of advance care planning (ACP). The objective of our study was to explore the preferences of Latino patients receiving dialysis regarding symptom management and ACP. Qualitative study design using semistructured face-to-face interviews of 20 Latinos on hemodialysis between February and July of 2015. Data were analyzed using thematic analysis. Four themes were identified: Avoiding harms of medication (fear of addiction and damage to bodies, effective distractions, reliance on traditional remedies, fatalism: the sense that one's illness is deserved punishment); barriers and facilitators to ACP: faith, family, and home (family group decision-making, family reluctance to have ACP conversations, flexible decision-making conversations at home with family, ACP conversations incorporating trust and linguistic congruency, family-first and faith-driven decisions); enhancing wellbeing day-to-day (supportive relationships, improved understanding of illness leads to adherence, recognizing new self-value, maintaining a positive outlook); and distressing aspects of living with their illness (dietary restriction is culturally isolating and challenging for families, logistic challenges and socioeconomic disadvantage compounded by health literacy and language barriers, required rapid adjustments to chronic illness, demanding dialysis schedule). Latinos described unique cultural preferences such as avoidance of medications for symptom alleviation and a preference to have family group decision-making and ACP conversations at home. Understanding and integrating cultural values and preferences into palliative care offers the potential to improve disparities and achieve quality patient-centered care for Latinos

Qualitative Interviews Exploring Palliative Care Perspectives of Latinos on Dialysis

PubMed Central

Jones, Jacqueline; Linas, Stuart; Fischer, Stacy

2017-01-01

Background and objectives Compared with non-Latino whites with advanced illness, Latinos are less likely to have an advance directive or to die with hospice services. To improve palliative care disparities, international ESRD guidelines call for increased research on culturally responsive communication of advance care planning (ACP). The objective of our study was to explore the preferences of Latino patients receiving dialysis regarding symptom management and ACP. Design, setting, participants, & measurements Qualitative study design using semistructured face-to-face interviews of 20 Latinos on hemodialysis between February and July of 2015. Data were analyzed using thematic analysis. Results Four themes were identified: Avoiding harms of medication (fear of addiction and damage to bodies, effective distractions, reliance on traditional remedies, fatalism: the sense that one’s illness is deserved punishment); barriers and facilitators to ACP: faith, family, and home (family group decision-making, family reluctance to have ACP conversations, flexible decision-making conversations at home with family, ACP conversations incorporating trust and linguistic congruency, family-first and faith-driven decisions); enhancing wellbeing day-to-day (supportive relationships, improved understanding of illness leads to adherence, recognizing new self-value, maintaining a positive outlook); and distressing aspects of living with their illness (dietary restriction is culturally isolating and challenging for families, logistic challenges and socioeconomic disadvantage compounded by health literacy and language barriers, required rapid adjustments to chronic illness, demanding dialysis schedule). Conclusions Latinos described unique cultural preferences such as avoidance of medications for symptom alleviation and a preference to have family group decision-making and ACP conversations at home. Understanding and integrating cultural values and preferences into palliative care offers

What does confidence mean to people who have had a stroke? A qualitative interview study.

PubMed

Horne, Jane; Lincoln, Nadina Berrice; Preston, Jenny; Logan, Pip

2014-11-01

To explore the meaning of confidence to stroke patients after stroke in order to inform the development of a measurement tool. Qualitative interview study using interpretative phenomenological analysis (IPA). Ten stroke survivors were purposively selected from those participating in a multi-centre randomised trial of outdoor mobility rehabilitation. Interviews about confidence were conducted in participants' homes, audio recorded and transcribed verbatim. Six themes emerged from the analysis. These were loss of identity, fear, social confidence, role confidence, mastering skill and attitudes and beliefs. Loss of identity was particularly evident in the early stages of stroke recovery. Fear was a barrier to regaining confidence and was associated with avoidance behaviours. Lack of social confidence was a common problem which appeared difficult to resolve. Life roles motivated participants to re-engage in daily life activities. Personal attitudes and beliefs, combined with the attitudes of significant others, contributed to personal feelings of competence. This study provides a coherent definition of the meaning of confidence through the experiences of stroke survivors. Being successful in gradually re-engaging in activities, including social activities and life roles helped to establish a positive self-belief. The influence of others, such as family and friends reinforce self-beliefs. Confidence and self-efficacy appear to be a similar construct. However, participants in this study also identified a relationship between confidence and self-esteem. The findings indicate that all six themes need to be included in a confidence measure to encompass the meaning of confidence as described by participants with stroke. © The Author(s) 2014.

Identifying symptoms of ovarian cancer: a qualitative and quantitative study.

PubMed

Bankhead, C R; Collins, C; Stokes-Lampard, H; Rose, P; Wilson, S; Clements, A; Mant, D; Kehoe, S T; Austoker, J

2008-07-01

Symptoms of ovarian cancer are often vague and consequently a high proportion of women with ovarian cancer are not referred to the appropriate clinic. To identify diagnostic factors for ovarian cancer. A qualitative and quantitative study. Four UK hospitals. One hundred and twenty-four women referred to hospital with suspected ovarian malignancy. Women were interviewed prior to diagnosis (n = 63), or soon after. A thematic analysis was conducted. Emergent symptoms were quantitatively analysed to identify distinguishing features of ovarian cancer. Symptoms in women with and without ovarian cancer. Diagnoses comprised 44 malignancies, 59 benign gynaecological pathologies and 21 normal findings. Of the malignancies, 25 women had stage III or more disease, with an average age of 59 years. The benign/normal cohort was significantly younger (48 years). Multivariate analysis revealed persistent abdominal distension (OR 5.2, 95% CI 1.3-20.5), postmenopausal bleeding (OR 9.2, 95% CI 1.1-76.1), appetite loss (OR 3.2, 95% CI 1.1-9.2), early satiety (OR 5.0, 95% CI 1.6-15.7) and progressive symptoms (OR 3.6, 95% CI 1.3-9.8) as independent, statistically significant variables associated with ovarian cancer. Fluctuating distension was not associated with ovarian cancer (OR 0.4, 95% CI 0-4.1). Women frequently used the term bloating, but this represented two distinct events: persistent abdominal distension and fluctuating distension/discomfort. Ovarian cancer is not a silent killer. Clinicians should distinguish between persistent and fluctuating distension. Recognition of the significance of symptoms described by women could lead to earlier and more appropriate referral.

Experiences of non-progressive and augmented labour among nulliparous women: a qualitative interview study in a Grounded Theory approach

PubMed Central

Kjaergaard, Hanne; Foldgast, Anne Maria; Dykes, Anna-Karin

2007-01-01

Background Non-progressive labour is the most common complication in nulliparas and is primarily treated by augmentation. Augmented labour is often terminated by instrumental delivery. Little qualitative research has addressed experiences of non-progressive and augmented deliveries. The aim of this study was to gain a deeper understanding of the experience of non-progressive and augmented labour among nulliparas and their experience of the care they received. Methods A qualitative study was conducted using individual interviews. Data was collected and analysed according to the Grounded Theory method. The participants were a purposive sample of ten women. The interviews were conducted 4–15 weeks after delivery. Results The women had contrasting experiences during the birth process. During labour there was a conflict between the expectation of having a natural delivery and actually having a medical delivery. The women experienced a feeling of separation between mind and body. Interacting with the midwife had a major influence on feelings of losing and regaining control. Reconciliation between the contrasting feelings during labour was achieved. The core category was named Dialectical Birth Process and comprised three categories: Balancing natural and medical delivery, Interacting, Losing and regaining control. Conclusion A dialectical process was identified in these women's experiences of non-progressive labour. The process is susceptible to interaction with the midwife; especially her support to the woman's feeling of being in control. Midwives should secure that the woman's recognition of the fact that the labour is non-progressive and augmentation is required is handled with respect for the dialectical process. Augmentation of labour should be managed as close to the course of natural labour and delivery as possible. PMID:17662152

The Tanzanian trauma patients' prehospital experience: a qualitative interview-based study.

PubMed

Kuzma, Kristin; Lim, Andrew George; Kepha, Bernard; Nalitolela, Neema Evelyne; Reynolds, Teri A

2015-04-27

We sought to characterise the prehospital experience of Tanzanian trauma patients, and identify barriers and facilitators to implement community-based emergency medical systems (EMS). Our study was conducted in the emergency department of an urban national referral hospital in Tanzania. A convenience sample of 34 adult trauma patients, or surrogate family members, presenting or referred to an urban referral emergency department in Tanzania for treatment of injury, participated in the study. Participation in semistructured, iteratively developed interviews until saturation of responses was reached. A grounded theory-based approach to qualitative analysis was used to identify recurrent themes. We characterised numerous deficiencies within the existing clinic-to-hospital referral network, including missed/delayed diagnoses, limited management capabilities at pre-referral facilities and interfacility transfer delays. Potential barriers to EMS implementation include patient financial limitations and lack of insurance, limited public infrastructure and resources, and the credibility of potential first aid responders. Potential facilitators of EMS include communities' tendency to pool resources, individuals' trust of other community members to be first aid responders, and faith in community leaders to organise EMS response. Participants expressed a strong desire to learn first aid. The composite themes generated by the data suggest that there are myriad structural, financial, institutional and cultural barriers to the implementation of a formal prehospital system. However, our analysis also revealed potential facilitators to a first-responder system that takes advantage of close-knit local communities and the trust of recognised leaders in society. The results suggest favourable acceptability for community-based response by trained lay people. There is significant opportunity for care improvements with short trainings and low-cost supply planning. Further research looking

A qualitative case study to identify possible barriers that limit effective elementary science education

NASA Astrophysics Data System (ADS)

Foster, Donald Carey

The purpose of this case study was to identify barriers that limit the effectiveness of elementary teachers in the teaching of science. It is of the utmost urgency that barriers be first identified, so that possible solutions can be explored to bring about the improvement of elementary science education. This urgency has been imposed by the scheduled national testing of students in science by 2007, as mandated by the No Child Left Behind Act of 2001. Using qualitative case study methods, the researcher conducted interviews with 8 elementary teachers from two schools within one school district who taught 3rd, 4th, and 5th grade. These interviews were designed to gain insight into barriers these elementary teachers perceived as factors limiting their effectiveness in teaching science and preparing students for high-stakes testing. Barriers in the areas of teacher background, typical teaching day, curriculum, inservices, and legislative influences were explored. This study concluded that the barriers explored do have a substantial negative affect on the teaching and learning of science in the elementary grades. Specifically, the barriers revealed in this study include the limited science background of elementary teachers, inadequate class time devoted to science, non-comprehensive curriculum, ineffective or lack of inservice training, and pressures from legislated mandates. But it is also clear that these barriers are so intertwined that one cannot remove these barriers one at a time. It will take a collective effort from all involved, including legislators, administrators, teachers, parents, and students, to alleviate these barriers and discover effective solutions to improve elementary science education.

Individual interviews and focus groups in patients with rheumatoid arthritis: a comparison of two qualitative methods.

PubMed

Coenen, Michaela; Stamm, Tanja A; Stucki, Gerold; Cieza, Alarcos

2012-03-01

To compare two different approaches to performing focus groups and individual interviews, an open approach, and an approach based on the International Classification of Functioning, Disability and Health (ICF). Patients with rheumatoid arthritis attended focus groups (n = 49) and individual interviews (n = 21). Time, number of concepts, ICF categories identified, and sample size for reaching saturation of data were compared. Descriptive statistics, Chi-square tests, and independent t tests were performed. With an overall time of 183 h, focus groups were more time consuming than individual interviews (t = 9.782; P < 0.001). In the open approach, 188 categories in the focus groups and 102 categories in the interviews were identified compared to the 231 and 110 respective categories identified in the ICF-based approach. Saturation of data was reached after performing five focus groups and nine individual interviews in the open approach and five focus groups and 12 individual interviews in the ICF-based approach. The method chosen should depend on the objective of the study, issues related to the health condition, and the study's participants. We recommend performing focus groups if the objective of the study is to comprehensively explore the patient perspective.

Breast-feeding difficulties experienced by women taking part in a qualitative interview study of postnatal depression.

PubMed

Shakespeare, Judy; Blake, Fiona; Garcia, Jo

2004-09-01

to explore how women experience breast-feeding difficulties. This theme emerged unexpectedly during a study of women's experiences of screening with the Edinburgh postnatal depression scale (EPDS) and subsequent care from primary health-care professionals. qualitative in-depth interview study. postnatal women of 22 general practices within Oxford City Primary Care Group area. 39 postnatal women from a purposeful sample were interviewed at an average of 15 months postnatal. They were chosen from different general practices and with a range of emotional difficulties after birth, judged using EPDS results at eight weeks and eight months postnatal, and whether they received 'listening visits' from health visitors. a qualitative thematic analysis was used, including searches for anticipated and emergent themes. Fifteen women had breast-feeding difficulties. Five themes emerged which explore the difficulties. Firstly, commitment to breast feeding and high expectations of success; secondly, unexpected difficulties; thirdly, seeking professional support for difficulties; fourthly, finding a way to cope; and fifthly, guilt. in this study breast-feeding difficulties were common, caused emotional distress and interactions with professionals could be difficult. Current breast-feeding policy, such as the 'Baby Friendly Initiative', may be a contributing factor. This needs to be explored in a further study.

Identifying parents' perceptions about physical activity: a qualitative exploration of salient behavioural, normative and control beliefs among mothers and fathers of young children.

PubMed

Hamilton, Kyra; White, Katherine M

2010-11-01

Drawing on the belief-based framework of the Theory of Planned Behaviour, this study employs qualitative methodology involving individual and group interviews to examine the beliefs associated with regular physical activity performance among parents of young children (N = 40). The data were analysed using thematic content analysis. A range of advantages (e.g. improves parenting practices), disadvantages (e.g. interferes with commitments), barriers (e.g. time), and facilitators (e.g. social support) to performing physical activity are identified. Normative pressures are also identified as affecting parents' activity behaviour. These identified beliefs can be used to inform interventions to challenge inactivity among this at-risk group.

Family Caregivers' Reflections on Experiences of Assisted Suicide in Switzerland: A Qualitative Interview Study.

PubMed

Gamondi, C; Pott, Murielle; Preston, Nancy; Payne, Sheila

2018-04-01

Thousands of family members worldwide are annually involved in assisted dying. Family participation in assisted dying has rarely been investigated and families' needs typically are not considered in assisted dying legislation and clinical guidelines. To explore family caregivers' reflections on experiences of assisted suicide in Switzerland. A cross-sectional qualitative interview study conducted in the Italian- and French-speaking regions of Switzerland. Interpretation and analysis were performed using qualitative content analysis. Twenty-eight close relatives and family carers of 18 patients who died by assisted suicide in Switzerland were interviewed. Family members perceived their involvement in assisted suicide as characterized by five phases; 1) contemplation, 2) gaining acceptance, 3) gaining permission, 4) organization, and 5) aftermath. Families can participate in these phases at diverse levels and with varying degrees of involvement. Important triggers for families and patients for transition between phases include patients' experiences of their life-threatening illnesses and related treatments, their increasing awareness of approaching death, and family member recognition of their loved one's unbearable suffering. Participating in assisted suicide created further demanding tasks for families in addition to their role of caregivers. Families appeared to be involved in the preparation of assisted suicide along with patients, irrespective of their personal values regarding assisted dying. Support for family members is essential if they are involved in tasks preparatory to assisted suicide. Clinical guidelines and policies concerning assisted dying should acknowledge and address family needs. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Deliberate and emergent strategies for implementing person-centred care: a qualitative interview study with researchers, professionals and patients.

PubMed

Naldemirci, Öncel; Wolf, Axel; Elam, Mark; Lydahl, Doris; Moore, Lucy; Britten, Nicky

2017-08-04

The introduction of innovative models of healthcare does not necessarily mean that they become embedded in everyday clinical practice. This study has two aims: first, to analyse deliberate and emergent strategies adopted by healthcare professionals to overcome barriers to normalization of a specific framework of person-centred care (PCC); and secondly, to explore how the recipients of PCC understand these strategies. This paper is based on a qualitative study of the implementation of PCC in a Swedish context. It draws on semi-structured interviews with 18 researchers and 17 practitioners who adopted a model of PCC on four different wards and 20 patients who were cared for in one of these wards. Data from these interviews were first coded inductively and emerging themes are analysed in relation to normalization process theory (NPT). In addition to deliberate strategies, we identify emergent strategies to normalize PCC by (i) creating and sustaining coherence in small but continuously communicating groups (ii) interpreting PCC flexibly when it meets specific local situations and (iii) enforcing teamwork between professional groups. These strategies resulted in patients perceiving PCC as bringing about (i) a sense of ease (ii) appreciation of inter-professional congruity (ii) non-hierarchical communication. NPT is useful to identify and analyse deliberate and emergent strategies relating to mechanisms of normalization. Emergent strategies should be interpreted not as trivial solutions to problems in implementation, but as a possible repertoire of tools, practices and skills developed in situ. As professionals and patients may have different understandings of implementation, it is also crucial to include patients' perceptions to evaluate outcomes.

Technology and Career Preparation: Using Virtual Interview Recordings (VIRs) in an Apparel, Design, and Textiles (ADT) Professional Seminar Course

ERIC Educational Resources Information Center

Eike, Rachel J.; Rowell, Amy; Mihuta, Tiffani

2016-01-01

The purpose of this study was to identify key virtual-recorded interview (VIR) skills that are essential to Apparel, Design, and Textile (ADT) student performance. The virtual, computer-recording interview platform, InterviewStream, was used as the data collection instrument in this qualitative, exploratory case study. Virtual interviews have been…

How to Design Tobacco Prevention and Control Games for Youth and Adolescents: A Qualitative Analysis of Expert Interviews

PubMed Central

Hall, Amanda K.; Mercado, Rebeccah; Anderson-Lewis, Charkarra; Darville, Gabrielle

2015-01-01

Abstract Objective: Games for health, including digital videogames and gaming-based approaches, are increasingly being used in health promotion research and practice. Recently published research has shown that videogames have significant potential to promote healthy behaviors among youth and adolescents. Yet, there is a lack of available evidence-based resources to guide practitioners on the integration of games into tobacco prevention and smoking cessation interventions. To address this gap, expert researchers and game developers were interviewed to further define games for health, explore the current research, and provide recommendations for developing, evaluating, and promoting effective anti-tobacco games. Materials and Methods: Nationally recognized experts on game development, games for health, tobacco, and health behavior were asked to participate. A qualitative analysis of 25 in-depth individual interviews using a constant comparative approach for emerging themes was conducted. Results: Main themes that emerged from the data analysis included the following: (1) the current state of games for health research to facilitate health behavior change, (2) strategies for how to develop and evaluate games for quality and impact, and (3) recommendations for how to effectively design tobacco prevention and smoking cessation educational videogames that engage youth and adolescents. Conclusions: The synthesized findings identified through these expert interviews offer stakeholders strategies for how to incorporate games for health within their current and future work. Specific recommendations are presented for developers and researchers to consider when developing and evaluating videogames for tobacco prevention and smoking cessation targeted at youth and adolescents. PMID:26230046

Practical Qualitative Research Strategies: Training Interviewers and Coders.

PubMed

Goodell, L Suzanne; Stage, Virginia C; Cooke, Natalie K

2016-09-01

The increased emphasis on incorporating qualitative methodologies into nutrition education development and evaluation underscores the importance of using rigorous protocols to enhance the trustworthiness of the findings. A 5-phase protocol for training qualitative research assistants (data collectors and coders) was developed as an approach to increase the consistency of the data produced. This training provides exposure to the core principles of qualitative research and then asks the research assistant to apply those principles through practice in a setting structured on critical reflection. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Conducting qualitative interviews by telephone: Lessons learned from a study of alcohol use among sexual minority and heterosexual women.

PubMed

Drabble, Laurie; Trocki, Karen F; Salcedo, Brenda; Walker, Patricia C; Korcha, Rachael A

2016-01-01

This study explored effective interviewer strategies and lessons-learned based on collection of narrative data by telephone with a sub-sample of women from a population-based survey, which included sexual minority women. Qualitative follow-up, in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009-2010 National Alcohol Survey. Questions explored the lives and experiences of women, including use of alcohol and drugs, social relationships, identity, and past traumatic experiences. Strategies for success in interviews emerged in three overarching areas: 1) cultivating rapport and maintaining connection, 2) demonstrating responsiveness to interviewee content, concerns, and 3) communicating regard for the interviewee and her contribution. Findings underscore both the viability and value of telephone interviews as a method for collecting rich narrative data on sensitive subjects among women, including women who may be marginalized.

Parents' and carers' views about emollients for childhood eczema: qualitative interview study

PubMed Central

Muller, I; Yardley, L; Lewis-Jones, S; Ersser, S; Little, P

2016-01-01

Objective Leave-on emollients form the mainstay of eczema treatment, but adherence is poor. We aimed to explore parents’/carers' views on effectiveness and acceptability of leave-on emollients for childhood eczema through secondary analysis of data from 2 qualitative data sets. Setting Study 1 recruited through mail-out from 6 general practices in southern England. Study 2 recruited from a feasibility trial of an intervention to support eczema self-care in 31 practices in the same area. Participants Study 1 included 28 interviews with carers of children aged ≤5 years with eczema. Study 2 included 26 interviews with carers of children aged ≤5 years with eczema. Methods Interviews followed semistructured guides: study 1 explored carers' understandings around eczema treatments in order to develop a web-based self-care support intervention; study 2 explored carers' understandings of eczema and eczema treatments after using the intervention. Interviews were carried out face to face or by telephone, audio-recorded and transcribed. Secondary analysis of data from both studies focused on views and experiences of emollient use. Data were analysed using an inductive thematic approach facilitated by NVivo V.10 software. Results In study 1, most participants felt emollients improved eczema but held mixed views about long-term use to prevent flare-ups. In study 2, where carers had used the web-based intervention, all participants held positive views about long-term emollient use. In both studies, participants expressed a range of preferences about emollient ‘thickness’; some felt that ‘thick’ emollients (ointments) were most effective, while others found these difficult to use. Carers described a process of ‘trial and error’, trying emollients suggested by professionals, friends and family, or bought over-the-counter. Carers expressed a need for understanding differences between products and their effective use. Conclusions Providing a rationale for long

Managing uncertainty in advanced liver disease: a qualitative, multiperspective, serial interview study.

PubMed

Kimbell, Barbara; Boyd, Kirsty; Kendall, Marilyn; Iredale, John; Murray, Scott A

2015-11-19

To understand the experiences and support needs of people with advanced liver disease and those of their lay and professional carers to inform improvements in the supportive and palliative care of this rapidly growing but currently neglected patient group. Multiperspective, serial interviews. We conducted up to three qualitative in-depth interviews with each patient and lay carer over 12 months and single interviews with case-linked healthcare professionals. Data were analysed using grounded theory techniques. Patients with advanced liver disease of diverse aetiologies recruited from an inpatient hepatology ward, and their lay carers and case-linked healthcare professionals nominated by the patients. Primary and secondary care in South-East Scotland. 37 participants (15 patients, 11 lay and 11 professional carers) completed 51 individual and 13 joint patient-carer interviews. Nine patients died during the study. Uncertainty dominated experiences throughout the course of the illness, across patients' considerable physical, psychological, social and existential needs and affected patients, lay carers and professionals. This related to the nature of the condition, the unpredictability of physical deterioration and prognosis, poor communication and information-sharing, and complexities of care. The pervasive uncertainty also shaped patients' and lay carers' strategies for coping and impeded care planning. While patients' acute medical care was usually well coordinated, their ongoing care lacked structure and focus. Living, dying and caring in advanced liver disease is dominated by pervasive, enduring and universally shared uncertainty. In the face of high levels of multidimensional patient distress, professionals must acknowledge this uncertainty in constructive ways that value its contribution to the person's coping approach. Pervasive uncertainty makes anticipatory care planning in advanced liver disease challenging, but planning 'just in case' is vital to ensure

How Do Patients with Chronic Neck Pain Experience the Effects of Qigong and Exercise Therapy? A Qualitative Interview Study.

PubMed

Holmberg, Christine; Farahani, Zubin; Witt, Claudia M

2016-01-01

Background. The high prevalence of chronic neck pain in high income countries impacts quality of life and the social and work-related activities of those afflicted. We aimed to understand how mind-body therapies and exercise therapy may influence the experience of pain among patients with chronic neck pain. Methods. This qualitative interview study investigated how patients with chronic neck pain experienced the effects of exercise or qigong therapy at two time points: during an intervention at three months and after the intervention at six months. Interviews were analysed thematically across interviews and within person-cases. Based on other qualitative studies, a sample size of 20 participants was deemed appropriate. Results. The sample (n = 20) consisted of 16 women and four men (age range: 29 to 59). Patients' experiences differed according to the therapies' philosophies. Exercise therapy group interviewees described a focus on correct posture and muscle tension release. Qigong group interviewees discussed calming and relaxing effects. Maintaining regular exercise was easier to achieve with exercise therapy. Conclusions. The findings of this study may help health care providers when counselling chronic pain patients on self-help interventions by informing them of different bodily and emotional experiences of mind-body interventions compared to exercise therapy.

How Do Patients with Chronic Neck Pain Experience the Effects of Qigong and Exercise Therapy? A Qualitative Interview Study

PubMed Central

Holmberg, Christine; Farahani, Zubin; Witt, Claudia M.

2016-01-01

Background. The high prevalence of chronic neck pain in high income countries impacts quality of life and the social and work-related activities of those afflicted. We aimed to understand how mind-body therapies and exercise therapy may influence the experience of pain among patients with chronic neck pain. Methods. This qualitative interview study investigated how patients with chronic neck pain experienced the effects of exercise or qigong therapy at two time points: during an intervention at three months and after the intervention at six months. Interviews were analysed thematically across interviews and within person-cases. Based on other qualitative studies, a sample size of 20 participants was deemed appropriate. Results. The sample (n = 20) consisted of 16 women and four men (age range: 29 to 59). Patients' experiences differed according to the therapies' philosophies. Exercise therapy group interviewees described a focus on correct posture and muscle tension release. Qigong group interviewees discussed calming and relaxing effects. Maintaining regular exercise was easier to achieve with exercise therapy. Conclusions. The findings of this study may help health care providers when counselling chronic pain patients on self-help interventions by informing them of different bodily and emotional experiences of mind-body interventions compared to exercise therapy. PMID:27418938

Motivators, Facilitators, and Barriers to Physical Activity in Older Adults: A Qualitative Study.

PubMed

Miller, Wendy; Brown, Patrick R

In this descriptive, qualitative research study, the researchers used semistructured interviews with older adults who engaged in regular physical activity to identify common motivators, facilitators, and barriers to participating in regular exercise. The authors used these interviews to identify major themes and discuss implications for population health.

Conducting Qualitative Research on Desertification in Western Lesvos, Greece

ERIC Educational Resources Information Center

Iosifides, Theodoros; Politidis, Theodoros

2005-01-01

The main aim of this article is to present some critical methodological strategies employed in a qualitative research study on local socioeconomic development and desertification in western Lesvos, Greece. Through in-depth qualitative interviews with local producers in western Lesvos, Greece, an effort was made to identify and analyze the links…

Code Saturation Versus Meaning Saturation: How Many Interviews Are Enough?

PubMed

Hennink, Monique M; Kaiser, Bonnie N; Marconi, Vincent C

2017-03-01

Saturation is a core guiding principle to determine sample sizes in qualitative research, yet little methodological research exists on parameters that influence saturation. Our study compared two approaches to assessing saturation: code saturation and meaning saturation. We examined sample sizes needed to reach saturation in each approach, what saturation meant, and how to assess saturation. Examining 25 in-depth interviews, we found that code saturation was reached at nine interviews, whereby the range of thematic issues was identified. However, 16 to 24 interviews were needed to reach meaning saturation where we developed a richly textured understanding of issues. Thus, code saturation may indicate when researchers have "heard it all," but meaning saturation is needed to "understand it all." We used our results to develop parameters that influence saturation, which may be used to estimate sample sizes for qualitative research proposals or to document in publications the grounds on which saturation was achieved.

Conducting qualitative interviews by telephone: Lessons learned from a study of alcohol use among sexual minority and heterosexual women

PubMed Central

Trocki, Karen F.; Salcedo, Brenda; Walker, Patricia C.; Korcha, Rachael A.

2015-01-01

This study explored effective interviewer strategies and lessons-learned based on collection of narrative data by telephone with a sub-sample of women from a population-based survey, which included sexual minority women. Qualitative follow-up, in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009–2010 National Alcohol Survey. Questions explored the lives and experiences of women, including use of alcohol and drugs, social relationships, identity, and past traumatic experiences. Strategies for success in interviews emerged in three overarching areas: 1) cultivating rapport and maintaining connection, 2) demonstrating responsiveness to interviewee content, concerns, and 3) communicating regard for the interviewee and her contribution. Findings underscore both the viability and value of telephone interviews as a method for collecting rich narrative data on sensitive subjects among women, including women who may be marginalized. PMID:26811696

Structural violence against Kothi-identified men who have sex with men in Chennai, India: a qualitative investigation.

PubMed

Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali; McLuckie, Alan; Melwin, Fredrick

2007-08-01

This qualitative investigation explored the experiences and contexts of stigma and discrimination among HIV-positive and high-risk kothi-identified men who have sex with men (MSM) in Chennai, India, and ramifications for HIV prevention. MSM were recruited through community agencies (n = 10) and public sex environments (n = 8), along with three key informants. In-depth, semistructured interviews were conducted, audiotaped, and transcribed. Narrative thematic analysis and a constant comparative method were used to identify themes. Findings revealed multiple intersecting social and institutional contexts and experiences of stigmatization, discrimination, and violence across police, community, family, and health care systems, as well as illuminating consequences for MSM. Multisystemic structural violence places kothis at extreme vulnerability for HIV infection and AIDS. Public mass media antidiscrimination campaigns, education and training of health care providers and police, funding of indigenous MSM community organizations, and decriminalization of consensual sex between same-sex adults may help to combat stigma, discrimination, and violence against MSM, which is fundamental to effective HIV prevention.

A Qualitative Secondary Evaluation of Statewide Follow-Up Interviews for Abnormal Newborn Screening Results for Cystic Fibrosis and Sickle Cell Hemoglobinopathy

PubMed Central

La Pean, Alison; Collins, Jenelle L.; Christopher, Stephanie A.; Eskra, Kerry L.; Roedl, Sara; Tluczek, Audrey; Farrell, Michael H.

2011-01-01

Purpose The purpose of this qualitative analysis was to assess parental acceptability of large-scale, telephone follow-up regarding their infants' newborn screening (NBS) results indicating carrier status for sickle cell hemoglobinopathy (SCH) and cystic fibrosis (CF). Methods Analysis of 195 interview transcripts focused on parents' responses to two open-ended questions “What was your reaction to being called by me?” and “What do you think of the state newborn screening program having follow-up people calling parents like you?” Responses were coded using conventional content analysis procedures and non-parametric tests were performed to analyze quantitative data. Results Most parents reported favorable opinions about the follow-up. Favorable opinions were associated with several emotional reactions to receiving follow-up (p<0.001), and three reasons why parents found the interview beneficial (p<0.05): it provided information, clarified NBS results, and answered questions. Seventeen parents of SCH carriers reportedly had not been told their infant's NBS results and received them for the first time during the follow-up interview. Conclusion Parents of CF and SCH carrier infants had favorable opinions and identified specific benefits to receiving follow-up contact. This analysis demonstrates an information deficit among carrier parents and illustrates the importance of NBS follow-up and need for comprehensive communication and counseling. PMID:22261754

Qualitative interviews with non-national tuberculosis patients in Cairo, Egypt: understanding the financial and social cost of treatment adherence.

PubMed

Lohiniva, Anna L; Mokhtar, Alaa; Azer, Ashraf; Elmoghazy, Esaam; Kamal, Eman; Benkirane, Manal; Dueger, Erica

2016-11-01

Limited data are available about the challenges of non-national TB patients undergoing long-term treatment courses in an urban setting. This study aimed to understand the financial and social cost of adherence of non-national TB patients in Cairo, Egypt as a means to inform the development of context-specific interventions to support treatment adherence. In 2011, 22 in-depth interviews were conducted with TB patients from Sudan, Ethiopia, Eritrea, Somalia and Djibouti to obtain qualitative data. Analysis was based on thematic analysis that aimed to identify recurrent themes and codes from the narratives. The study identified a number of factors that influence TB treatment adherence. Uncertain financial status due to limited or no employment was frequently discussed in interviews, which resulted in fear of not being able to support family, loss of pride, dependence on family and friends, fear of losing housing, food insecurity and limited food options. Respondents also feared infecting other household members and longed for opportunities to discuss their illness and treatment experiences with other individuals but their social networks were often limited. TB-related stigma was driven by shame and blame of infection. Respondents also believed stigma was based on their foreign origin. Stigma manifested in distancing and exclusion in various ways, resulting in isolation, psychological distress and reluctance to disclose TB status to others. Poverty-related factors and social context with a special focus on stigma should be considered when developing strategies for supporting long-term treatment courses for non-national patients in Cairo and other similar urban settings. © 2015 John Wiley & Sons Ltd.

The experience of sleep in chronic fatigue syndrome: A qualitative interview study with patients.

PubMed

Gotts, Zoe M; Newton, Julia L; Ellis, Jason G; Deary, Vincent

2016-02-01

Sleep disturbances are common in chronic fatigue syndrome (CFS), and one of the key symptom complaints, yet it has been neglected by previous qualitative research. The aim was to explore the specific role of sleep in patients' experience of their illness. A qualitative semi-structured interview format facilitated a detailed and open exploration of sleep, and the extent to which its management and problems were linked to the lived experience of CFS. Eleven semi-structured interviews were conducted with individuals with CFS. Data were transcribed verbatim and analysed thematically, to explore and describe patients' experience of their sleep, and its impact on their condition. Sleep emerged as a key aspect of the illness experience, and its management and effect on daytime functioning was a central pre-occupation for all 11 participants; all of them saw sleep as playing a critical role in their illness through either maintaining or exacerbating existing symptoms. Exploration of individual experiences presented three overarching themes: (1) sleep pattern variability over illness course and from day to day; (2) effect of sleep on daytime functioning; and (3) attempts at coping and sleep management. Each patient with CFS has a unique experience of sleep. Despite the differing narratives regarding the role of sleep in CFS, all participants held the belief that sleep is a vital process for health and well-being which has had a direct bearing on the course and progression of their CFS. Also, every participant regarded their sleep as in some way 'broken' and in need of management/repair. Patients' insights demonstrate sleep-specific influences on their CFS, and the impact of disturbed sleep should be a consideration for clinical and research work. What is already known on this subject? Sleep disturbances are common in CFS, and one of the key symptom complaints, yet it has been neglected by previous qualitative research. Ontology of CFS is a matter of dispute, with models

Identifying nurses' rewards: a qualitative categorization study in Belgium

PubMed Central

De Gieter, Sara; De Cooman, Rein; Pepermans, Roland; Caers, Ralf; Du Bois, Cindy; Jegers, Marc

2006-01-01

Background Rewards are important in attracting, motivating and retaining the most qualified employees, and nurses are no exception to this rule. This makes the establishment of an efficient reward system for nurses a true challenge for every hospital manager. A reward does not necessarily have a financial connotation: non-financial rewards may matter too, or may even be more important. Therefore, the present study examines nurses' reward perceptions, in order to identify potential reward options. Methods To answer the research question "What do nurses consider a reward and how can these rewards be categorized?", 20 in-depth semi-structured interviews with nurses were conducted and analysed using discourse and content analyses. In addition, the respondents received a list of 34 rewards (derived from the literature) and were asked to indicate the extent to which they perceived each of them to be rewarding. Results Discourse analysis revealed three major reward categories: financial, non-financial and psychological, each containing different subcategories. In general, nurses more often mentioned financial rewards spontaneously in the interview, compared to non-financial and psychological rewards. The questionnaire results did not, however, indicate a significant difference in the rewarding potential of these three categories. Both the qualitative and quantitative data revealed that a number of psychological and non-financial rewards were important for nurses in addition to their monthly pay and other remunerations. In particular, appreciation for their work by others, compliments from others, presents from others and contact with patients were highly valued. Moreover, some demographical variables influenced the reward perceptions. Younger and less experienced nurses considered promotion possibilities as more rewarding than the older and more senior ones. The latter valued job security and working for a hospital with a good reputation higher than their younger and more

Understanding the role of sleep in suicide risk: qualitative interview study.

PubMed

Littlewood, Donna L; Gooding, Patricia; Kyle, Simon D; Pratt, Daniel; Peters, Sarah

2016-08-22

Sleep problems are associated with increased risk of suicide, independent of depression. This analysis explores narrative accounts of the role of sleep in relation to suicidal thoughts and behaviours. Qualitative study, based on in-depth semistructured interviews which were analysed with an inductive, latent thematic analysis. A maximum variation sample of 18 people with experience of a major depressive episode, and suicidal thoughts and behaviours. Primary care, North West England. Respondents emphasised the importance of sleep for recovery and management of their mental well-being. Moreover, three inter-related pathways were identified, whereby beliefs about sleep contributed to suicidal thoughts and behaviours. First, being awake during the biological night heightened risk of suicidal behaviours, as this was perceived to be an opportune time for a suicide attempt due to the decreased chances that a friend of family member would intervene during a suicide attempt. Additionally, the reduction in available support at night added to suicide risk. Second, failure to achieve good sleep was perceived to make life harder through contributing to core features of depression, such as negative thinking, attention difficulties and inactivity. Third, sleep acted as an alternative to suicide, by providing an escape from problems, including mental health problems, in waking life. However, this desire to sleep to escape was associated with excessive daytime sleeping, which subsequently may reinforce disturbed sleeping patterns. Sleep problems should be an important treatment target when working with suicidal clients. More broadly, night-time service provision should be considered when developing suicide prevention initiatives. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Identifying early indicators in bipolar disorder: a qualitative study.

PubMed

Benti, Liliane; Manicavasagar, Vijaya; Proudfoot, Judy; Parker, Gordon

2014-06-01

The identification of early markers has become a focus for early intervention in bipolar disorder. Using a retrospective, qualitative methodology, the present study compares the early experiences of participants with bipolar disorder to those with unipolar depression up until their first diagnosed episode. The study focuses on differences in early home and school environments as well as putative differences in personality characteristics between the two groups. Finally we a compare and contrast prodromal symptoms in these two populations. Thirty-nine participants, 20 diagnosed with unipolar depression and 19 diagnosed with bipolar disorder, took part in the study. A semi-structured interview was developed to elicit information about participants' experiences prior to their first episode. Participants with bipolar disorder reported disruptive home environments, driven personality features, greater emotion dysregulation and adverse experiences during the school years, whereas participants with depression tended to describe more supportive home environments, and more compliant and introvert personality traits. Retrospective data collection and no corroborative evidence from other family members. No distinction was made between bipolar I and bipolar II disorder nor between melancholic and non-melancholic depression in the sample. Finally the study spanned over a 12-month period which does not allow for the possibility of diagnostic reassignment of some of the bipolar participants to the unipolar condition. These findings indicate that there may be benefits in combining both proximal and distal indicators in identifying a bipolar disorder phenotype which, in turn, may be relevant to the development of early intervention programs for young people with bipolar disorder.

Living with uncertainty: a Swedish qualitative interview study of women at home on sick leave due to premature labour.

PubMed

Höglund, Eva; Dykes, Anna-Karin

2013-05-01

to highlight the experiences of pregnant women, experiencing preterm labour, being on sick leave at home and how they handled their daily life. qualitative, descriptive using open interviews. 10 antenatal clinics in the south of Sweden. 15 pregnant women who were on sick leave for premature labour. four categories were identified: how to interpret unpredictable contractions in the uterus? Having concern regarding premature labour of their child, handling the new situation and finding a balance, and from work to sick leave. to be on sick leave for premature contractions can be compared with enduring a situation of inactivity. The woman finds herself in a stressful situation which she must learn to handle this and find a balance. it appears that supportive information offers the women in premature labour the opportunity of increased participation and responsibility which thereby positively affects her well-being. Copyright © 2012 Elsevier Ltd. All rights reserved.

Identifying configurations of behavior change techniques in effective medication adherence interventions: a qualitative comparative analysis.

PubMed

Kahwati, Leila; Viswanathan, Meera; Golin, Carol E; Kane, Heather; Lewis, Megan; Jacobs, Sara

2016-05-04

Interventions to improve medication adherence are diverse and complex. Consequently, synthesizing this evidence is challenging. We aimed to extend the results from an existing systematic review of interventions to improve medication adherence by using qualitative comparative analysis (QCA) to identify necessary or sufficient configurations of behavior change techniques among effective interventions. We used data from 60 studies in a completed systematic review to examine the combinations of nine behavior change techniques (increasing knowledge, increasing awareness, changing attitude, increasing self-efficacy, increasing intention formation, increasing action control, facilitation, increasing maintenance support, and motivational interviewing) among studies demonstrating improvements in adherence. Among the 60 studies, 34 demonstrated improved medication adherence. Among effective studies, increasing patient knowledge was a necessary but not sufficient technique. We identified seven configurations of behavior change techniques sufficient for improving adherence, which together accounted for 26 (76 %) of the effective studies. The intervention configuration that included increasing knowledge and self-efficacy was the most empirically relevant, accounting for 17 studies (50 %) and uniquely accounting for 15 (44 %). This analysis extends the completed review findings by identifying multiple combinations of behavior change techniques that improve adherence. Our findings offer direction for policy makers, practitioners, and future comparative effectiveness research on improving adherence.

Considerations and recommendations for conducting qualitative research interviews with palliative and end-of-life care patients in the home setting: a consensus paper.

PubMed

Sivell, Stephanie; Prout, Hayley; Hopewell-Kelly, Noreen; Baillie, Jessica; Byrne, Anthony; Edwards, Michelle; Harrop, Emily; Noble, Simon; Sampson, Catherine; Nelson, Annmarie

2015-12-08

To present and discuss the views of researchers at an academic palliative care research centre on research encounters with terminally ill patients in the home setting and to generate a list of recommendations for qualitative researchers working in palliative and end-of-life care. Eight researchers took part in a consensus meeting to discuss their experiences of undertaking qualitative interviews. The researchers were of varying backgrounds and all reported having experience in interviewing terminally ill patients, and all but one had experience of interviewing patients in their home environment. The main areas discussed by researchers included: whether participation in end-of-life research unintentionally becomes a therapeutic experience or an ethical concern; power relationships between terminally ill patients and researchers; researcher reflexivity and reciprocity; researchers' training needs. Qualitative methods can complement the home environment; however, it can raise ethical and practical challenges, which can be more acute in the case of research undertaken with palliative and patients at the end-of-life. The ethical and practical challenges researchers face in this context has the potential to place both participant and researcher at risk for their physical and psychological well-being. We present a set of recommendations for researchers to consider prior to embarking on qualitative research in this context and advocate researchers in this field carefully consider the issues presented on a study-by-study basis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Parents' and carers' views about emollients for childhood eczema: qualitative interview study.

PubMed

Santer, M; Muller, I; Yardley, L; Lewis-Jones, S; Ersser, S; Little, P

2016-08-19

Leave-on emollients form the mainstay of eczema treatment, but adherence is poor. We aimed to explore parents'/carers' views on effectiveness and acceptability of leave-on emollients for childhood eczema through secondary analysis of data from 2 qualitative data sets. Study 1 recruited through mail-out from 6 general practices in southern England. Study 2 recruited from a feasibility trial of an intervention to support eczema self-care in 31 practices in the same area. Study 1 included 28 interviews with carers of children aged ≤5 years with eczema. Study 2 included 26 interviews with carers of children aged ≤5 years with eczema. Interviews followed semistructured guides: study 1 explored carers' understandings around eczema treatments in order to develop a web-based self-care support intervention; study 2 explored carers' understandings of eczema and eczema treatments after using the intervention. Interviews were carried out face to face or by telephone, audio-recorded and transcribed. Secondary analysis of data from both studies focused on views and experiences of emollient use. Data were analysed using an inductive thematic approach facilitated by NVivo V.10 software. In study 1, most participants felt emollients improved eczema but held mixed views about long-term use to prevent flare-ups. In study 2, where carers had used the web-based intervention, all participants held positive views about long-term emollient use. In both studies, participants expressed a range of preferences about emollient 'thickness'; some felt that 'thick' emollients (ointments) were most effective, while others found these difficult to use. Carers described a process of 'trial and error', trying emollients suggested by professionals, friends and family, or bought over-the-counter. Carers expressed a need for understanding differences between products and their effective use. Providing a rationale for long-term emollient use and choice of emollients could help improve adherence

Patient Experience of Symptoms and Side Effects when Treated with Osimertinib for Advanced Non-Small-Cell Lung Cancer: A Qualitative Interview Substudy.

PubMed

Rydén, Anna; Blackhall, Fiona; Kim, Hye Ryun; Pillai, Rathi N; Braam, Lauren; Martin, Mona L; Walding, Andrew

2017-10-01

Capturing the patient experience during treatment is important to both regulatory authorities and to patients starting treatment. We identified the symptoms and side effects experienced by patients with advanced non-small-cell lung cancer during osimertinib treatment, to understand treatment expectations, satisfaction, and the level of difficulty coping with the side effects experienced during treatment. Qualitative interviews (approximately 4-6 weeks after treatment initiation and again after approximately 4 months of treatment) were conducted during the phase I/II AURA clinical trial of osimertinib, a tyrosine kinase inhibitor of epidermal growth factor receptor-sensitizing and T790M resistance mutations. During the first interview (23 patients), the most commonly reported symptoms/side effects were coughing, itching, tiredness (each reported by 56.5% of patients), and rash (43.5%). During the second interview (21 patients), compared with the first interview, shortness of breath and diarrhea were reported by more patients (57.1 and 38.1%, respectively; both increased from 34.8%); tiredness remained predominant (42.9%); and itching (38.1%), coughing (38.1%), and rash (14.3%) were reported by fewer patients. At both interviews, the most frequently reported symptoms/side effects were also those most often rated by patients for bothersomeness and severity, and generally received mean scores in the low-to-moderate range. However, several rarely expressed symptoms/side effects (e.g., abdominal pain, frequent day time urination) received high bothersomeness ratings. At the second interview, patients were highly satisfied with osimertinib and had a low level of difficulty in coping with side effects during treatment. These data enhance our understanding of patients' experiences of symptoms/side effects, which could increase the accuracy of the osimertinib benefit-risk assessment, guide management of adverse events, and improve the information given to patients

Critical Environmental Factors for Transportation Cycling in Children: A Qualitative Study Using Bike-Along Interviews

PubMed Central

Ghekiere, Ariane; Van Cauwenberg, Jelle; de Geus, Bas; Clarys, Peter; Cardon, Greet; Salmon, Jo; De Bourdeaudhuij, Ilse; Deforche, Benedicte

2014-01-01

Background Environmental factors are found to influence transport-related physical activity, but have rarely been studied in relation with cycling for transport to various destinations in 10–12 yr old children. The current qualitative study used ‘bike-along interviews’ with children and parents to allow discussion of detailed environmental factors that may influence children's cycling for transport, while cycling in the participant's neighborhood. Methods Purposeful convenience sampling was used to recruit 35 children and one of their parents residing in (semi-) urban areas. Bike-along interviews were conducted to and from a randomly chosen destination (e.g. library) within a 15 minutes' cycle trip in the participant's neighborhood. Participants wore a GoPro camera to objectively assess environmental elements, which were subsequently discussed with participants. Content analysis and arising themes were derived using a grounded theory approach. Results The discussed environmental factors were categorized under traffic, urban design, cycling facilities, road design, facilities at destination, aesthetics, topography, weather, social control, stranger danger and familiar environment. Across these categories many environmental factors were (in)directly linked to road safety. This was illustrated by detailed discussions of the children's visibility, familiarity with specific traffic situations, and degree of separation, width and legibility of cycle facilities. Conclusion Road safety is of major concern in this 10–12 yr old study population. Bike-along interviews were able to identify new, detailed and context-specific physical environmental factors which could inform policy makers to promote children's cycling for transport. However, future studies should investigate whether hypothetical changes to such micro environmental features influence perceptions of safety and if this in turn could lead to changes in children's cycling for transport. PMID:25250738

Elderly patients' and GPs' perspectives of patient-GP communication concerning polypharmacy: a qualitative interview study.

PubMed

Schöpf, Andrea C; von Hirschhausen, Maike; Farin, Erik; Maun, Andy

2017-12-26

Aim The aim of this study was to explore elderly patients' and general practitioners' (GPs') perceptions of communication about polypharmacy, medication safety and approaches for empowerment. To manage polypharmacy, GPs need to know patients' real medication consumption. However, previous research has shown that patients do not always volunteer all information about their medication regimen, for example, such as the intake of over-the-counter medication or the alteration or discontinuation of prescribed medication. A qualitative interview study including patients of at least 65 years old with polypharmacy (⩾5 medications) and their GPs in a German Primary Healthcare Centre. The transcripts from the semi-structured interviews (n=6 with patients; n=3 with GPs) were analysed using a framework analytical approach. Findings We identified three themes: differing medication plans: causes?; dialogue concerning medication: whose responsibility?; supporting patients' engagement: how? While GPs stated that patients do not always report or might even conceal information, all patients reported that they could speak openly about everything with their GPs. In this context, trust might act as a double-edged sword, as it can promote open communication but also prevent patients from asking questions. Both GPs and patients could name very few ways in which patients could be supported to become more informed and active in communication concerning polypharmacy and medication safety. This study shows that patients' awareness of the significance of their active role in addressing polypharmacy needs to be increased. This includes understanding that trusting the doctor does not preclude asking questions or seeking more information. Thus, interventions which improve patients' communication skills and address specific issues of polypharmacy, particularly in elderly patients, should be designed. GPs might support patients by 'inviting' their contribution.

Qualitative studies using in-depth interviews with older people from multiple language groups: methodological systematic review.

PubMed

Fryer, Caroline; Mackintosh, Shylie; Stanley, Mandy; Crichton, Jonathan

2012-01-01

This paper is a report of a methodological review of language appropriate practice in qualitative research, when language groups were not determined prior to participant recruitment. When older people from multiple language groups participate in research using in-depth interviews, additional challenges are posed for the trustworthiness of findings. This raises the question of how such challenges are addressed. The Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Web of Science, Ageline, PsycINFO, Sociological abstracts, Google Scholar and Allied and Complementary Medicine databases were systematically searched for the period 1840 to September 2009. The combined search terms of 'ethnic', 'cultural', 'aged', 'health' and 'qualitative' were used. In this methodological review, studies were independently appraised by two authors using a quality appraisal tool developed for the review, based on a protocol from the McMaster University Occupational Therapy Evidence-Based Practice Research Group. Nine studies were included. Consideration of language diversity within research process was poor for all studies. The role of language assistants was largely absent from study methods. Only one study reported using participants' preferred languages for informed consent. More examples are needed of how to conduct rigorous in-depth interviews with older people from multiple language groups, when languages are not determined before recruitment. This will require both researchers and funding bodies to recognize the importance to contemporary healthcare of including linguistically diverse people in participant samples. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

Traveler information services in rural tourism areas : appendix B, qualitative interviews and focus groups

DOT National Transportation Integrated Search

2000-06-30

This report documents results from surveys which were conducted for qualitatively assessing the use of traveler information services in rural areas. The focus of the surveys was to identify those factors which influence travel planning and thus impro...

Towards program theory validation: Crowdsourcing the qualitative analysis of participant experiences.

PubMed

Harman, Elena; Azzam, Tarek

2018-02-01

This exploratory study examines a novel tool for validating program theory through crowdsourced qualitative analysis. It combines a quantitative pattern matching framework traditionally used in theory-driven evaluation with crowdsourcing to analyze qualitative interview data. A sample of crowdsourced participants are asked to read an interview transcript and identify whether program theory components (Activities and Outcomes) are discussed and to highlight the most relevant passage about that component. The findings indicate that using crowdsourcing to analyze qualitative data can differentiate between program theory components that are supported by a participant's experience and those that are not. This approach expands the range of tools available to validate program theory using qualitative data, thus strengthening the theory-driven approach. Copyright © 2017 Elsevier Ltd. All rights reserved.

How Many Interviews Are Enough to Identify Metathemes in Multisited and Cross-Cultural Research? Another Perspective on Guest, Bunce, and Johnson's (2006) Landmark Study

ERIC Educational Resources Information Center

Hagaman, Ashley K.; Wutich, Amber

2017-01-01

There is much debate over the number of interviews needed to reach data saturation for themes and metathemes in qualitative research. The primary purpose of this study is to determine the number of interviews needed to reach data saturation for metathemes in multisited and cross-cultural research. The analysis is based on a cross-cultural study on…

Identifying Patterns in Implementation of Hospital Pressure Ulcer Prevention Programs: A Multisite Qualitative Study.

PubMed

Soban, Lynn M; Finley, Erin P; Miltner, Rebecca S

2016-01-01

To describe the presence or absence of key components of hospital pressure ulcer (PU) prevention programs in 6 acute care hospitals. Multisite comparative case study. Using purposeful selection based on PU rates (high vs low) and hospital size, 6 hospitals within the Veterans Health Administration health care system were invited to participate. Key informant interviews (n = 48) were conducted in each of the 6 participating hospitals among individuals playing key roles in PU prevention: senior nursing leadership (n = 9), nurse manager (n = 7), wound care specialist (n = 6), frontline RNs (n = 26). Qualitative data were collected during face-to-face, semistructured interviews. Interview protocols were tailored to each interviewee's role with a core set of common questions covering 3 major content areas: (1) practice environment (eg, policies and wound care specialists), (2) current prevention practices (eg, conduct of PU risk assessment and skin inspection), and (3) barriers to PU prevention. We conducted structured coding of 5 key components of PU prevention programs and cross-case analysis to identify patterns in operationalization and implementation of program components across hospitals based on facility size and PU rates (low vs high). All hospitals had implemented all PU prevention program components. Component operationalization varied considerably across hospitals. Wound care specialists were integral to the operationalization of the 4 other program components examined; however, staffing levels and work assignments of wound care specialists varied widely. Patterns emerged among hospitals with low and high PU rates with respect to wound care specialist staffing, data monitoring, and staff education. We found hospital-level variations in PU prevention programs. Wound care specialist staffing may represent a potential point of leverage in achieving other PU program components, particularly performance monitoring and staff education.

GPs' Perceptions of Cardiovascular Risk and Views on Patient Compliance: A Qualitative Interview Study.

PubMed

Barfoed, Benedicte Lind; Jarbøl, Dorte Ejg; Paulsen, Maja Skov; Christensen, Palle Mark; Halvorsen, Peder Andreas; Nielsen, Jesper Bo; Søndergaard, Jens

2015-01-01

Objective. General practitioners' (GPs') perception of risk is a cornerstone of preventive care. The aims of this interview study were to explore GPs' professional and personal attitudes and experiences regarding treatment with lipid-lowering drugs and their views on patient compliance. Methods. The material was drawn from semistructured qualitative interviews. We sampled GPs purposively from ten selected practices, ensuring diversity of demographic, professional, and personal characteristics. The GPs were encouraged to describe examples from their own practices and reflect on them and were informed that the focus was their personal attitudes and experiences. Systematic text condensation was applied for analysis in order to uncover the concepts and themes. Results. The analysis revealed the following 3 main themes: (1) use of cardiovascular guidelines and risk assessment tools, (2) strategies for managing patient compliance, and (3) GPs' own risk management. There were substantial differences in the attitudes concerning all three themes. Conclusions. The substantial differences in the GPs' personal and professional risk perceptions may be a key to understanding why GPs do not always follow cardiovascular guidelines. The impact on daily clinical practice, personal consultation style, and patient behaviour with regard to prevention is worth studying further.

GPs' Perceptions of Cardiovascular Risk and Views on Patient Compliance: A Qualitative Interview Study

PubMed Central

Barfoed, Benedicte Lind; Jarbøl, Dorte Ejg; Paulsen, Maja Skov; Christensen, Palle Mark; Halvorsen, Peder Andreas; Nielsen, Jesper Bo; Søndergaard, Jens

2015-01-01

Objective. General practitioners' (GPs') perception of risk is a cornerstone of preventive care. The aims of this interview study were to explore GPs' professional and personal attitudes and experiences regarding treatment with lipid-lowering drugs and their views on patient compliance. Methods. The material was drawn from semistructured qualitative interviews. We sampled GPs purposively from ten selected practices, ensuring diversity of demographic, professional, and personal characteristics. The GPs were encouraged to describe examples from their own practices and reflect on them and were informed that the focus was their personal attitudes and experiences. Systematic text condensation was applied for analysis in order to uncover the concepts and themes. Results. The analysis revealed the following 3 main themes: (1) use of cardiovascular guidelines and risk assessment tools, (2) strategies for managing patient compliance, and (3) GPs' own risk management. There were substantial differences in the attitudes concerning all three themes. Conclusions. The substantial differences in the GPs' personal and professional risk perceptions may be a key to understanding why GPs do not always follow cardiovascular guidelines. The impact on daily clinical practice, personal consultation style, and patient behaviour with regard to prevention is worth studying further. PMID:26495143

Impact of Repeated Questioning on Interviewers: Learning From a Forensic Interview Training Project.

PubMed

Duron, Jacquelynn F; Cheung, Monit

2016-01-01

Forensic interviewers have a difficult job with high risk for career burnout and secondary trauma. Few studies have addressed how new forensic interviewers or trainees experience repeated questioning and multiple interviews. This study simulated the process of training new forensic interviewers through the creation of two interview videos in which social work graduate students participated as actors portraying the roles of interviewer and child. These films served as instructional aids preparing graduate social work students for professional child welfare roles while promoting research-based approaches to interviewing children about sexual abuse allegations. Qualitative data from two cohorts of student actors were collected to analyze interviewers' perspectives on repeated questioning and interviews in child sexual abuse cases. Two themes were extracted from the subjects' experiences: "It is emotionally taxing" and "Navigating the interviewer role is unexpectedly complex." Exposure to repeated questions and multiple interviews affected the performance and confidence of the interviewers.

Improving continence services for older people from the service-providers’ perspective: a qualitative interview study

PubMed Central

Orrell, Alison; McKee, Kevin; Dahlberg, Lena; Gilhooly, Mary; Parker, Stuart

2013-01-01

Objective To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI). Design Qualitative semistructured interviews using a purposive sample recruited across 16 continence services. Setting 3 acute and 13 primary care National Health Service Trusts in England. Participants 16 continence service leads in England actively treating and managing older people with UI. Results In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and high-quality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work. Conclusions Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service

Nursing home staff's views on residents' dignity: a qualitative interview study.

PubMed

Oosterveld-Vlug, Mariska G; Pasman, H Roeline W; van Gennip, Isis E; Willems, Dick L; Onwuteaka-Philipsen, Bregje D

2013-09-16

Maintaining dignity is an important element of end-of-life care and also of the care given in nursing homes. Factors influencing personal dignity have been studied from both nursing home residents' and staff's perspective. Little is however known about the way nursing home staff perceive and promote the personal dignity of individual residents in daily practice, or about staff's experiences with preserving dignity within the nursing home. The aim of this study is to gain more insight in this. A qualitative descriptive interview study was designed, in which in-depth interviews were performed with 13 physicians and 15 nurses. They expressed their views on the personal dignity of 30 recently admitted nursing home residents on the general medical wards of four nursing homes in The Netherlands. Interviews were transcribed and analyzed following the principles of thematic analysis. According to both physicians and nurses, physical impairment and being dependent on others threatened the residents' dignity. Whether or not this led to a violation of an individual resident's dignity, depended--in staff's opinion--on the resident's ability to show resilience and to keep his/her individuality. Staff mentioned treating residents with respect and taking care of their privacy as most important elements of dignity-conserving care and strived to treat the residents as they would like to be treated themselves. They could often mention aspects that were important for a particular resident's dignity. But, when asked what they could contribute to a particular resident's dignity, they often mentioned general aspects of dignity-conserving care, which could apply to most nursing home residents. By attempting to give dignity-conserving care, physicians and nurses often experienced conflicting values in daily care and barriers caused by the lack of resources. Tailoring dignity-conserving care to an individual nursing home resident appears hard to bring about in daily practice. Both

The stories we tell: qualitative research interviews, talking technologies and the 'normalisation' of life with HIV.

PubMed

Mazanderani, Fadhila; Paparini, Sara

2015-04-01

Since the earliest days of the HIV/AIDS epidemic, talking about the virus has been a key way affected communities have challenged the fear and discrimination directed against them and pressed for urgent medical and political attention. Today, HIV/AIDS is one of the most prolifically and intimately documented of all health conditions, with entrenched infrastructures, practices and technologies--what Vinh-Kim Nguyen has dubbed 'confessional technologies'--aimed at encouraging those affected to share their experiences. Among these technologies, we argue, is the semi-structured interview: the principal methodology used in qualitative social science research focused on patient experiences. Taking the performative nature of the research interview as a talking technology seriously has epistemological implications not merely for how we interpret interview data, but also for how we understand the role of research interviews in the enactment of 'life with HIV'. This paper focuses on one crucial aspect of this enactment: the contemporary 'normalisation' of HIV as 'just another' chronic condition--a process taking place at the level of individual subjectivities, social identities, clinical practices and global health policy, and of which social science research is a vital part. Through an analysis of 76 interviews conducted in London (2009-10), we examine tensions in the experiential narratives of individuals living with HIV in which life with the virus is framed as 'normal', yet where this 'normality' is beset with contradictions and ambiguities. Rather than viewing these as a reflection of resistances to or failures of the enactment of HIV as 'normal', we argue that, insofar as these contradictions are generated by the research interview as a distinct 'talking technology', they emerge as crucial to the normative (re)production of what counts as 'living with HIV' (in the UK) and are an inherent part of the broader performative 'normalisation' of the virus. Copyright © 2015

Saving lives, maintaining safety, and science-based policy: qualitative interview findings from the Blood Donation Rules Opinion Study (Blood DROPS).

PubMed

Hughes, Shana; Sheon, Nicolas; Siedle-Khan, Bob; Custer, Brian

2015-12-01

Indefinite deferral from donation for any man who discloses having had sex with another man even once since 1977 (MSM77) is the US FDA's standing policy. This qualitative component of the Blood Donation Rules and Opinion Study was designed to provide insight into the perceptions and practices of current or previous donors with MSM history. Forty human immunodeficiency virus (HIV)-negative MSM completed an online survey, indicating that they had donated blood and were willing to be interviewed. Semistructured, individual interviews with these key informants covered donation experience and motivations, perceptions of MSM77, policy change preferences, and possible impact of a change to a time-limited deferral. Transcripts were coded deductively and inductively, following a modified Grounded Theory approach. Analysis identified recurrent and divergent themes. Ninety-five percent of participants endorsed modifying MSM77. Preferred deferral length ranged from none to 5 years; a common opinion was that a science-based deferral period would be less than 1 year. Other policy change recommendations included incorporating questions about specific HIV risk behaviors to the donor questionnaire for all potential donors. Interviewees recognized HIV infection rates are higher in MSM than the general US population, but participants considered themselves low-risk for HIV, donated blood "to save lives," and justified their recommendations as being more effective ways to identify donors at risk for HIV. Results suggest that MSM donors are concerned with blood safety; they can be appealed to as such. Communications about a new deferral policy should include scientific explanations and acknowledge altruistic motivations of potential donors. © 2015 AABB.

Added value of involving patients in the first step of multidisciplinary guideline development: a qualitative interview study among infertile patients.

PubMed

den Breejen, Elvira M E; Hermens, Rosella P M G; Galama, Wienke H; Willemsen, Wim N P; Kremer, Jan A M; Nelen, Willianne L D M

2016-06-01

Patient involvement in scoping the guideline is emphasized, but published initiatives actively involving patients are generally limited to the writing and reviewing phase. To assess patients' added value to the scoping phase of a multidisciplinary guideline on infertility. Qualitative interview study. We conducted interviews among 12 infertile couples and 17 professionals. We listed and compared the couples' and professionals' key clinical issues (=care aspects that need improvement) to be addressed in the guideline according to four domains: current guidelines, professionals, patients and organization of care. Main key clinical issues suggested by more than three quarters of the infertile couples and/or at least two professionals were identified and compared. Overall, we identified 32 key clinical issues among infertile couples and 23 among professionals. Of the defined main key clinical issues, infertile couples mentioned eight issues that were not mentioned by the professionals. These main key clinical issues mainly concerned patient-centred (e.g. poor information provision and poor alignment of care) aspects of care on the professional and organizational domain. Both groups mentioned two main key clinical issues collectively that were interpreted differently: the lack of emotional support and respect for patients' values. Including patients from the first phase of the guideline development process leads to valuable additional main key clinical issues for the next step of a multidisciplinary guideline development process and broadens the scope of the guideline, particularly regarding patient-centredness and organizational issues from a patients' perspective. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Qualitative interviews vs standardized self-report questionnaires in assessing quality of life in heart transplant recipients.

PubMed

Abbey, Susan E; De Luca, Enza; Mauthner, Oliver E; McKeever, Patricia; Shildrick, Margrit; Poole, Jennifer M; Gewarges, Mena; Ross, Heather J

2011-08-01

Quality of life (QoL) studies in heart transplant recipients (HTRs) using validated, quantitative, self-report questionnaires have reported poor QoL in approximately 20% of patients. This consecutive mixed methods study compared self-report questionnaires, the Medical Outcomes Study 36-item Short Form Health Survey (MOS SF-36) and the Atkinson Life Satisfaction Scale, with phenomenologically informed audiovisual (AV) qualitative interview data in 27 medically stable HTRs (70% male; age 53 ± 13.77 years; time since transplant 4.06 ± 2.42 years). Self-report questionnaire data reported poor QoL and more distress compared with previous studies and normative population samples; in contrast, 52% of HTRs displayed pervasive distress according to visual methodology. Using qualitative methods to assess QoL yields information that would otherwise remain unobserved by the exclusive use of quantitative QOL questionnaires. Copyright © 2011 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Meta-analysis, complexity, and heterogeneity: a qualitative interview study of researchers' methodological values and practices.

PubMed

Lorenc, Theo; Felix, Lambert; Petticrew, Mark; Melendez-Torres, G J; Thomas, James; Thomas, Sian; O'Mara-Eves, Alison; Richardson, Michelle

2016-11-16

Complex or heterogeneous data pose challenges for systematic review and meta-analysis. In recent years, a number of new methods have been developed to meet these challenges. This qualitative interview study aimed to understand researchers' understanding of complexity and heterogeneity and the factors which may influence the choices researchers make in synthesising complex data. We conducted interviews with a purposive sample of researchers (N = 19) working in systematic review or meta-analysis across a range of disciplines. We analysed data thematically using a framework approach. Participants reported using a broader range of methods and data types in complex reviews than in traditional reviews. A range of techniques are used to explore heterogeneity, but there is some debate about their validity, particularly when applied post hoc. Technical considerations of how to synthesise complex evidence cannot be isolated from questions of the goals and contexts of research. However, decisions about how to analyse data appear to be made in a largely informal way, drawing on tacit expertise, and their relation to these broader questions remains unclear.

General Practitioners' Perspective on eHealth and Lifestyle Change: Qualitative Interview Study.

PubMed

Brandt, Carl Joakim; Søgaard, Gabrielle Isidora; Clemensen, Jane; Sndergaard, Jens; Nielsen, Jesper Bo

2018-04-17

Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further. This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior for their patients and themselves. A total of 10 (5 female and 5 male) GPs were recruited by purposive sampling, aged 38 to 69 years (mean 51 years), of which 4 had an urban uptake of patients and 6 a rural uptake. All of them worked in the region of Southern Denmark where GPs typically work alone or in partnership with 1 to 4 colleagues and all use electronic patient health records for prescription, referral, and asynchronous electronic consultations. We performed qualitative, semistructured, individual in-depth interviews with the GPs in their own office about how they used eHealth and mHealth devices to help patients challenged with lifestyle issues and themselves. We also interviewed how they treated lifestyle-challenged patients in general and how they imagined eHealth could be used in the future. All GPs had smartphones or tablets, and everyone communicated on a daily basis with patients about disease and medicine via their electronic health record and the internet. We identified 3 themes concerning the use of eHealth: (1) how eHealth is used for patients; (2) general practitioners' own experience with improving lifestyle and eHealth support; and (3) relevant coaching techniques for transformation into eHealth. GPs used eHealth frequently for themselves but only infrequently for their patients. GPs are familiar with behavioral change techniques and are ready to use them in eHealth if they are used to

Limited capacity in US pediatric drug trials: qualitative analysis of expert interviews.

PubMed

Wasserman, Richard; Bocian, Alison; Harris, Donna; Slora, Eric

2011-04-01

The recently renewed Best Pharmaceuticals for Children and Pediatric Research Equity Acts (BPCA/PREA) have continued industry incentives and opportunities for pediatric drug trials (PDTs). However, there is no current assessment of the capacity to perform PDTs. The aim of this study was to deepen understanding of the capacity for US PDTs by assessing PDT infrastructure, present barriers to PDTs, and potential approaches and solutions to identified issues. Pediatric clinical research experts participated in semi-structured interviews on current US pediatric research capacity (February-July 2007). An initial informant list was developed using purposive sampling, and supplemented and refined to generate a group of respondents to explore emerging themes. Each phone interview included a physician researcher and two health researchers who took notes and recorded the calls. Health researchers produced detailed summaries, which were verified by the physician researcher and informants. We then undertook qualitative analysis of the summaries, employing multiple coding, with the two health researchers and the physician researcher independently coding each summary for themes and subthemes. Coding variations were resolved by physician researcher/health researcher discussion and consensus achieved on themes and subthemes. The 33 informants' primary or secondary roles included academia (n = 21), federal official (5), industry medical officer (8), pediatric research network leader (10), pediatric specialist leader (8), pediatric clinical pharmacologist (5), and practitioner/research site director (9). While most experts noted an increase in PDTs since the initial passage of BPCA/PREA, a dominant theme of insufficient US PDT capacity emerged. Subthemes included (i) lack of systems for finding, incentivizing, and/or maintaining trial sites; (ii) complexity/demands of conducting PDTs in clinical settings; (iii) inadequate numbers of qualified pediatric pharmacologists and

Staying well with bipolar disorder: A qualitative analysis of five-year follow-up interviews with young people.

PubMed

Crowe, M; Inder, M

2018-05-01

WHAT IS ALREADY KNOWN ABOUT THE TOPIC?: Bipolar disorder is a long-term condition which causes ongoing disruptions to the individual's life. Current evidence suggests that a combination of medication in combination with psychotherapy is more effective than medication alone. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: There are few published reports of the effects of interventions (pharmacological or psychotherapeutic) for treatment in bipolar disorder. While both psychotherapies provided a framework for understanding bipolar disorder each had specific strategies that participants identified as effective. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Because bipolar disorder is a long-term condition, its treatment needs to incorporate psychotherapeutic approaches that address the unique nature of its impact on each individual and provide individualized strategies for managing the disorder. Both Interpersonal and Social Rhythm Therapy and Specialist Supportive Care provide strategies that promote personal recovery. Introduction The primary outcomes from this study of psychotherapy for young people with bipolar disorder identified that most participants had continued to remain well. Given that up to 80% of people relapse within 2 years, it was important to establish how these participants described the process of staying well. Aim To examine how participants in a psychotherapy for young people with bipolar disorder study at 5-year follow-up described their experiences of the intervention and its impact on living with the disorder. Methods This qualitative study was conducted 5 years after participants had completed a psychotherapy intervention in a randomized controlled trial for young people with bipolar disorder. Thirty people were recruited into this qualitative study and interviewed regarding their experiences. The data were analysed using an inductive thematic analysis. Findings Three themes were identified from the data: self-awareness in the context of bipolar

Exploring Dutch surgeons' views on volume-based policies: a qualitative interview study.

PubMed

Mesman, Roos; Faber, Marjan J; Westert, Gert P; Berden, Bart

2018-01-01

Objective In many countries, the evidence for volume-outcome associations in surgery has been transferred into policy. Despite the large body of research that exists on the topic, qualitative studies aimed at surgeons' views on, and experiences with, these volume-based policies are lacking. We interviewed Dutch surgeons to gain more insight into the implications of volume-outcome policies for daily clinical practice, as input for effective surgical quality improvement. Methods Semi-structured interviews were conducted with 20 purposively selected surgeons from a stratified sample for hospital type and speciality. The interviews were recorded, transcribed verbatim and underwent inductive content analysis. Results Two overarching themes were inductively derived from the data: (1) minimum volume standards and (2) implications of volume-based policies. Although surgeons acknowledged the premise 'more is better', they were critical about the validity and underlying evidence for minimum volume standards. Patients often inquire about caseload, which is met with both understanding and discomfort. Surgeons offered many examples of controversies surrounding the process of determining thresholds as well as the ways in which health insurers use volume as a purchasing criterion. Furthermore, being held accountable for caseload may trigger undesired strategic behaviour, such as unwarranted operations. Volume-based policies also have implications for the survival of low-volume providers and affect patient travel times, although the latter is not necessarily problematic in the Dutch context. Conclusions Surgeons in this study acknowledged that more volume leads to better quality. However, validity issues, undesired strategic behaviour and the ways in which minimum volume standards are established and applied have made surgeons critical of current policy practice. These findings suggest that volume remains a controversial quality measure and causes polarization that is not

Qualitative data collection with children.

PubMed

Spratling, Regena; Coke, Sallie; Minick, Ptlene

2012-02-01

Qualitative researchers have clear methods to guide them in data collection with adult participants, but little is known about effective interview techniques with children. The findings from this methodological study on qualitative interviews with children indicate that children are able to articulate their experiences in interviews. Copyright © 2012 Elsevier Inc. All rights reserved.

A meta-ethnography of interview-based qualitative research studies on medical students' views and experiences of empathy.

PubMed

Jeffrey, David

2016-12-01

Quantitative research suggests that medical students' empathy declines during their training. This meta-ethnography asks: What new understanding may be gained by a synthesis of interview-based qualitative research on medical students' views and experiences of empathy? How can such a synthesis be undertaken? A meta-ethnography synthesizes individual qualitative studies to generate knowledge increasing understanding and informing debate. A literature search yielded eight qualitative studies which met the inclusion criteria. These were analyzed from a phenomenological and interpretative perspective. The meta-ethnography revealed a conceptual confusion around empathy and a tension in medical education between distancing and connecting with patients. Barriers to empathy included a lack of patient contact and a strong emphasis on the biomedical over the psycho-social aspects of the curriculum. A number of influences discussed in the paper lead students to adopt less overt ways of showing their empathy. These insights deepen our understanding of the apparent decline in empathy in medical students. The lessons from these studies suggest that future curriculum development should include earlier patient contact, more emphasis on psycho-social aspects of care and address the barriers to empathy to ensure that tomorrow's doctors are empathetic as well as competent.

Communicative barriers and resources in nursing homes from the enrolled nurses' perspective: A qualitative interview study.

PubMed

Forsgren, Emma; Skott, Carola; Hartelius, Lena; Saldert, Charlotta

2016-02-01

Managing communicative disability is a pervasive issue in long-term care facilities. The aim of this study was to explore how enrolled nurses experience their everyday interactions with residents in nursing homes, particularly focusing on interactions with residents with communicative disability. A qualitative exploratory design including content analysis was used. Eight individuals working at six nursing homes in western Sweden were interviewed. The interviews were semi-structured with questions about the participants' experiences in communicating with residents, feelings associated with interactions involving residents with communicative disability, meaning ascribed to interactions, and factors influencing interactions. The interviews were analysed using content analysis. A dynamic interplay between interpersonal relations, daily interactions and the managing of communicative disability was revealed. The enrolled nurses had good knowledge of supportive strategies and an awareness of the importance of the development of personal relationships with residents in order to facilitate interaction. However, factors in the environment presented barriers to communication. The organisation and physical environment of nursing homes prevent the enrolled nurses from taking full advantage of the communicative resources they have in interaction with residents with communicative disability, hence affecting staff-resident relationships and the delivery of person-centred care. Copyright © 2015 Elsevier Ltd. All rights reserved.

General practitioners' views on (long-term) prescription and use of problematic and potentially inappropriate medication for oldest-old patients-A qualitative interview study with GPs (CIM-TRIAD study).

PubMed

Pohontsch, Nadine Janis; Heser, Kathrin; Löffler, Antje; Haenisch, Britta; Parker, Debora; Luck, Tobias; Riedel-Heller, Steffi G; Maier, Wolfgang; Jessen, Frank; Scherer, Martin

2017-02-17

Potentially inappropriate medication (PIM) is defined as medication with uncertain therapeutic effects and/or potential adverse drug reactions outweighing the clinical benefits. The prescription rate of PIM for oldest-old patients is high despite the existence of lists of PIM (e.g. the PRISCUS list) and efforts to raise awareness. This study aims at identifying general practitioners' views on PIM and aspects affecting the (long-term) use of PIM. As part of the CIM-TRIAD study, we conducted semi-structured, qualitative interviews with 47 general practitioners, discussing 25 patients with and 22 without PIM (according to the PRISCUS list). The interview guideline included generic and patient-specific questions. Interviews were digitally recorded and transcribed verbatim. We content analyzed the interviews using deductive and inductive category development. The majority of the general practitioners were not aware of the PRISCUS list. Agents deemed potentially inappropriate from the general practitioners' point of view and the PRISCUS list are not completely superimposable. General practitioners named their criteria to identify appropriate medication for elderly patients (e.g. renal function, cognitive state) and emphasized the importance of monitoring. We identified prescription- (e.g. benzodiazepines on alternative private prescription), medication- (e.g. subjective perception that PIM has no alternative), general practitioner- (e.g. general practitioner relies on specialists), patient- (e.g. "demanding high-user", positive subjective benefit-risk-ratio) and system-related aspects (e.g. specialists lacking holistic view, interface problems) related to the (long term) use of PIM. While the PRISCUS list does not seem to play a decisive role in general practice, general practitioners are well aware of risks associated with PIM. Our study identifies some starting points for a safer handling of PIM, e.g. stronger dissemination of the PRISCUS list, better compensation of

A Qualitative Study to Identify Skills and Competency Required for Hospital Managers

PubMed Central

Barati, Omid; Sadeghi, Ahmad; Khammarnia, Mohammad; Siavashi, Elham; Oskrochi, Gholamreza

2016-01-01

Introduction Hospital managers aim to improve the efficiency and effectiveness of their institutions through leadership and guidance of medical personnel. Fulfilling these objectives requires a holistic approach to both the management of people and institutional prioritization. The aim of this study was to identify the skills and competencies that hospital managers must demonstrate in order to achieve their objectives. Methods In 2015, a regional, multi-center qualitative study was undertaken in Shiraz, Iran. Interviews and focus group discussions were conducted with university hospital managers, senior managers, faculty members, and post-graduate students, and the results were analyzed using the content analysis method by MAXQDA software. Results Eight key skill themes (communication, experience, appreciation of institution logistics/infrastructure, management skills, motivation, systematic problem solving, ethics, and financial/legal awareness) were identified among the hospital managers. The common challenges that face hospital institutions include problems with hierarchical and organizational structure, excessive rules and regulations, lack of resources, poor post-graduate education, and overall management. Recurring themes with respect to how these could be addressed included changing the culture and belief structure of the hospital, restructuring the organizational hierarchy, and empowering the people. Conclusion In our cohort, practical skills, such as communication and experience, were considered more important than theoretical skills for the effective management and administration of hospitals. Therefore, we suggest that practical, skill-based training should be emphasized for students of these disciplines so they will be better suited to deal with real world challenges. Further organizational improvements also can be attained by the active and constructive involvement of senior university managers. PMID:27504159

A Qualitative Study to Identify Skills and Competency Required for Hospital Managers.

PubMed

Barati, Omid; Sadeghi, Ahmad; Khammarnia, Mohammad; Siavashi, Elham; Oskrochi, Gholamreza

2016-06-01

Hospital managers aim to improve the efficiency and effectiveness of their institutions through leadership and guidance of medical personnel. Fulfilling these objectives requires a holistic approach to both the management of people and institutional prioritization. The aim of this study was to identify the skills and competencies that hospital managers must demonstrate in order to achieve their objectives. In 2015, a regional, multi-center qualitative study was undertaken in Shiraz, Iran. Interviews and focus group discussions were conducted with university hospital managers, senior managers, faculty members, and post-graduate students, and the results were analyzed using the content analysis method by MAXQDA software. Eight key skill themes (communication, experience, appreciation of institution logistics/infrastructure, management skills, motivation, systematic problem solving, ethics, and financial/legal awareness) were identified among the hospital managers. The common challenges that face hospital institutions include problems with hierarchical and organizational structure, excessive rules and regulations, lack of resources, poor post-graduate education, and overall management. Recurring themes with respect to how these could be addressed included changing the culture and belief structure of the hospital, restructuring the organizational hierarchy, and empowering the people. In our cohort, practical skills, such as communication and experience, were considered more important than theoretical skills for the effective management and administration of hospitals. Therefore, we suggest that practical, skill-based training should be emphasized for students of these disciplines so they will be better suited to deal with real world challenges. Further organizational improvements also can be attained by the active and constructive involvement of senior university managers.

A serial qualitative interview study of infant feeding experiences: idealism meets realism

PubMed Central

Craig, Leone C A; Britten, Jane; McInnes, Rhona M

2012-01-01

Objective To investigate the infant feeding experiences of women and their significant others from pregnancy until 6 months after birth to establish what would make a difference. Design Qualitative serial interview study. Setting Two health boards in Scotland. Participants 72 of 541 invited pregnant women volunteered. 220 interviews approximately every 4 weeks with 36 women, 26 partners, eight maternal mothers, one sister and two health professionals took place. Results The overarching theme was a clash between overt or covert infant feeding idealism and the reality experienced. This is manifest as pivotal points where families perceive that the only solution that will restore family well-being is to stop breast feeding or introduce solids. Immediate family well-being is the overriding goal rather than theoretical longer term health benefits. Feeding education is perceived as unrealistic, overly technical and rules based which can undermine women's confidence. Unanimously families would prefer the balance to shift away from antenatal theory towards more help immediately after birth and at 3–4 months when solids are being considered. Family-orientated interactive discussions are valued above breastfeeding-centred checklist style encounters. Conclusions Adopting idealistic global policy goals like exclusive breast feeding until 6 months as individual goals for women is unhelpful. More achievable incremental goals are recommended. Using a proactive family-centred narrative approach to feeding care might enable pivotal points to be anticipated and resolved. More attention to the diverse values, meanings and emotions around infant feeding within families could help to reconcile health ideals with reality. PMID:22422915

Reflections on the Swiss Consensus Statement in the context of qualitative interviews with heterosexuals living with HIV.

PubMed

Persson, A

2010-12-01

In 2008, the Swiss Federal AIDS Commission released a statement concluding that people with HIV who are on treatment and have an undetectable viral load are non-infectious and can safely practice unprotected sex with their HIV-negative partner under certain conditions. Contradicting over 25 years of HIV prevention messages, the so called Swiss Consensus Statement sparked a polarised international debate. One key concern is that the Statement will be misinterpreted to imply that everybody on treatment can have unprotected sex. Therefore, critics warn against any departure from the emphasis on condoms as the most effective prevention method. Given this concern, it is useful to reflect on what relevance the Swiss Statement may have for those concerned. This paper draws on qualitative interviews with HIV-positive heterosexuals and HIV-negative partners in Australia. Conducted both before and after the release of the Statement, these interviews revealed that sexual decision-making was not based solely on calculations of risk, but shaped by complex emotions and relationship priorities. The interviews also revealed that participants were sceptical towards the Statement's prevention message. These findings call into question the central concerns that drive this debate.

Religion, assessment and the problem of 'normative uncertainty' for mental health student nurses: a critical incident-informed qualitative interview study.

PubMed

Bassett, A M; Baker, C; Cross, S

2015-10-01

There is limited research around how mental health (MH) student nurses interpret and differentiate between people's religious and cultural beliefs and the existence of psychopathological symptomatology and experiences. Here we focus on one cultural issue that arose from research exploring how MH student nurses approach and interpret religion and culture in their practice - that is, the difficulties in determining the clinical significance of the religious beliefs and experiences expressed by the people they care for. While problems with establishing the cultural boundaries of normality in clinical assessments are an important area of debate in cultural psychiatry, it remains a peripheral issue in MH nurse education. An anthropologically informed qualitative research design underpinned 'critical incident' (CI)-focused ethnographic interviews with 36 second and third-year MH nursing field students and seven undergraduate MH branch lecturers. Follow up focus groups were also carried out. Interview transcripts were subject to thematic analysis. Four subthemes were identified under the broad theme of the clinical significance of religious-type expression and experience: (1) identifying the difference between delusions and religious belief; (2) identifying whether an experience was hallucination or religious experience; (3) the clinical implications of such challenges; and (4) applying religion-specific knowledge. There are clinical implications that may result from the difficulties with assessing the clinical significance of religious beliefs and experiences, identified in both our research and within international cultural psychiatry literature and research. Misinterpretation and therefore wrongly assessing someone's experience as pathological is a significant concern. It is suggested that CI analysis could be adapted to help nurses, nursing students and nurse educators recognize the religious dimensions of mental distress, particularly those that then potentially

What happens during annual appraisal interviews? How leader-follower interactions unfold and impact interview outcomes.

PubMed

Meinecke, Annika L; Lehmann-Willenbrock, Nale; Kauffeld, Simone

2017-07-01

Despite a wealth of research on antecedents and outcomes of annual appraisal interviews, the ingredients that make for a successful communication process within the interview itself remain unclear. This study takes a communication approach to highlight leader-follower dynamics in annual appraisal interviews. We integrate relational leadership theory and recent findings on leader-follower interactions to argue (a) how supervisors' task- and relation-oriented statements can elicit employee involvement during the interview process and (b) how these communication patterns affect both supervisors' and employees' perceptions of the interview. Moreover, we explore (c) how supervisor behavior is contingent upon employee contributions to the appraisal interview. We audiotaped 48 actual annual appraisal interviews between supervisors and their employees. Adopting a multimethod approach, we used quantitative interaction coding (N = 32,791 behavioral events) as well as qualitative open-axial coding to explore communication patterns among supervisors and their employees. Lag sequential analysis revealed that supervisors' relation-oriented statements triggered active employee contributions and vice versa. These relation-activation patterns were linked to higher interview success ratings by both supervisors and employees. Moreover, our qualitative findings highlight employee disagreement as a crucial form of active employee contributions during appraisal interviews. We distinguish what employees disagreed about, how the disagreement was enacted, and how supervisors responded to it. Overall employee disagreement was negatively related to ratings of supervisor support. We discuss theoretical implications for performance appraisal and leadership theory and derive practical recommendations for promoting employee involvement during appraisal interviews. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Intervention fidelity in primary care complex intervention trials: qualitative study using telephone interviews of patients and practitioners.

PubMed

Dyas, Jane V; Togher, Fiona; Siriwardena, A Niroshan

2014-01-01

Treatment fidelity has previously been defined as the degree to which a treatment or intervention is delivered to participants as intended. Underreporting of fidelity in primary care randomised controlled trials (RCTs) of complex interventions reduces our confidence that findings are due to the treatment or intervention being investigated, rather than unknown confounders. We aimed to investigate treatment fidelity (for the purpose of this paper, hereafter referred to as intervention fidelity), of an educational intervention delivered to general practice teams and designed to improve the primary care management of insomnia. We conducted telephone interviews with patients and practitioners participating in the intervention arm of the trial to explore trial fidelity. Qualitative analysis was undertaken using constant comparison and a priori themes (categories): 'adherence to the delivery of the intervention', 'patients received and understood intervention' and 'patient enactment'. If the intervention protocol was not adhered to by the practitioner then patient receipt, understanding and enactment levels were reduced. Recruitment difficulties in terms of the gap between initially being recruited into the study and attending an intervention consultation also reduced the effectiveness of the intervention. Patient attributes such as motivation to learn and engage contributed to the success of the uptake of the intervention. Qualitative methods using brief telephone interviews are an effective way of collecting the depth of data required to assess intervention fidelity. Intervention fidelity monitoring should be an important element of definitive trial design. ClinicalTrials. gov id isrctn 55001433 - www.controlled-trials.com/isrctn55001433.

'Wouldn't it be easier if you continued to be a guy?' - a qualitative interview study of transsexual persons' experiences of encounters with healthcare professionals.

PubMed

von Vogelsang, Ann-Christin; Milton, Camilla; Ericsson, Ingrid; Strömberg, Lars

2016-12-01

To describe transsexual persons' experiences of encounters with healthcare professionals during the sex reassignment process. Transsexual persons are individuals who use varying means to alter their natal sex via hormones and/or surgery. Transsexual persons may experience stigma, which increases the risk of psychological distress. Mistreatments by healthcare professionals are common. Qualitative studies addressing transsexual persons' experiences of healthcare are scarce. Qualitative descriptive design. A Swedish non-clinical convenience sample was used, consisting of six persons who had been diagnosed as transsexual, gone through sex reassignment surgery or were at the time of the interview awaiting surgery. Semi-structured interviews were undertaken, and data were analysed using manifest qualitative content analysis. Three categories and 15 subcategories were identified. The encounters were perceived as good when healthcare professionals showed respect and preserved the transsexual person's integrity, acted in a professional manner and were responsive and built trust and confidence. However, the participants experienced that healthcare professionals varied in their level of knowledge, exploited their position of power, withheld information, expressed gender stereotypical attitudes and often used the wrong name. They felt vulnerable by having a condescending view of themselves, and they could not choose not to be transsexual. They felt dependent on healthcare professionals, and that the external demands were high. Transsexual persons are in a vulnerable position during the sex reassignment surgery process. The encounters in healthcare could be negatively affected if healthcare professionals show inadequate knowledge, exploit their position of power or express gender stereotypical attitudes. A good encounter is characterised by preserved integrity, respect, responsiveness and trust. Improved education on transgender issues in nursing and medical education is

The Characteristics and Motivations of Online Health Information Seekers: Cross-Sectional Survey and Qualitative Interview Study

PubMed Central

Inglis, Nadia; Ronnie, Jennifer; Large, Shirley

2011-01-01

Background Most households in the United Kingdom have Internet access, and health-related Internet use is increasing. The National Health Service (NHS) Direct website is the major UK provider of online health information. Objective Our objective was to identify the characteristics and motivations of online health information seekers accessing the NHS Direct website, and to examine the benefits and challenges of the health Internet. Methods We undertook an online questionnaire survey, offered to users of the NHS Direct website. A subsample of survey respondents participated in in-depth, semistructured, qualitative interviews by telephone or instant messaging/email. Questionnaire results were analyzed using chi-square statistics. Thematic coding with constant comparison was used for interview transcript analysis. Results In total 792 respondents completed some or all of the survey: 71.2% (534/750 with data available) were aged under 45 years, 67.4% (511/758) were female, and 37.7% (286/759) had university-level qualifications. They sought information for themselves (545/781, 69.8%), someone else (172/781, 22.0%), or both (64/781, 8.2%). Women were more likely than men to seek help for someone else or both themselves and someone else (168/509 vs 61/242, χ2 2 = 6.35, P = .04). Prior consultation with a health professional was reported by 44.9% (346/770), although this was less common in younger age groups (<36 years) (χ2 1 = 24.22, P < .001). Participants aged 16 to 75 years (n = 26, 20 female, 6 male) were recruited for interview by telephone (n = 23) and instant messaging/email (n = 3). Four major interview themes were identified: motivations for seeking help online; benefits of seeking help in this way and some of the challenges faced; strategies employed in navigating online health information provision and determining what information to use and to trust; and specific comments regarding the NHS Direct website service. Within the motivation category, four

Movie making as a cognitive distraction for paediatric patients receiving radiotherapy treatment: qualitative interview study.

PubMed

Shrimpton, Bradley J M; Willis, David J; Tongs, Cáthal D; Rolfo, Aldo G

2013-01-16

To establish the outcomes achieved by using an innovative movie-making programme designed to reduce fear of radiotherapy among paediatric patients. Qualitative descriptive evaluation based on semistructured, qualitative interviews with purposeful sampling and thematic analysis. Tertiary Cancer Centre. 20 parents of paediatric patients who had produced a movie of their radiation therapy experience and were in a follow-up phase of cancer management. Participants attributed a broad range of outcomes to the movie-making program. These included that the programme had helped reduce anxiety and distress exhibited by paediatric patients and contributed to a willingness to receive treatment. Other outcomes were that the completed movies had been used in school reintegration and for maintaining social connections. Allowing children to create a video of their experience of radiotherapy provided a range of benefits to paediatric patients that varied according to their needs. For some patients, movie-making offered a valuable medium for overcoming fear of the unknown as well as increasing understanding of treatment processes. For others, the development of a personalised video offered an important cognitive/attentional distraction through engaging with an age-appropriate activity. Together these outcomes helped children maintain self-control and a positive outlook.

Interviewing clinicians and advocates who work with sexual assault survivors: a personal perspective on moving from quantitative to qualitative research methods.

PubMed

Ullman, Sarah E

2005-09-01

This article describes the author's personal experiences of conducting a qualitative semistructured interview study, after having done predominantly quantitative survey research in the social sciences. The author describes the process of learning how to approach conducting semistructured interviews with female advocates and clinicians who provide services to sexual assault survivors in the community. The author describes making the transition from a logical positivist deductive approach to thinking about and conducting research to a more social constructionist stance in which one learns from participants about their experiences and perspectives in narrative form to discover knowledge and develop theory inductively.

Help seeking for cancer 'alarm' symptoms: a qualitative interview study of primary care patients in the UK.

PubMed

Whitaker, Katriina L; Macleod, Una; Winstanley, Kelly; Scott, Suzanne E; Wardle, Jane

2015-02-01

Delay in help seeking for cancer 'alarm' symptoms has been identified as a contributor to delayed diagnosis. To understand people's help-seeking decision making for cancer alarm symptoms, without imposing a cancer context. Community-based, qualitative interview study in the UK, using purposive sampling by sex, socioeconomic status, and prior help seeking, with framework analysis of transcripts. Interviewees (n = 48) were recruited from a community-based sample (n = 1724) of adults aged ≥50 years who completed a health survey that included a list of symptoms. Cancer was not mentioned. Participants reporting any of 10 cancer alarm symptoms (n = 915) and who had consented to contact (n = 482) formed the potential pool from which people were invited to an interview focusing on their symptom experiences. Reasons for help seeking included symptom persistence, social influence, awareness/fear of a link with cancer, and 'just instinct'. Perceiving the symptom as trivial or 'normal' was a deterrent, as was stoicism, adopting self-management strategies, and fear of investigations. Negative attitudes to help seeking were common. Participants did not want to be seen as making a fuss, did not want to waste the doctor's time, and were sometimes not confident that the GP could help. Decision making about cancer alarm symptoms was complex. Recognition of cancer risk almost always motivated help seeking (more so than the fear of cancer being a deterrent), assisted by recent public-awareness campaigns. As well as symptom persistence motivating help seeking, it could also have the reverse effect. Negative attitudes to help seeking were significant deterrents. © British Journal of General Practice 2015.

Early recovery following lower limb arthroplasty: Qualitative interviews with patients undergoing elective hip and knee replacement surgery. Initial phase in the development of a patient-reported outcome measure.

PubMed

Strickland, Louise H; Kelly, Laura; Hamilton, Thomas W; Murray, David W; Pandit, Hemant G; Jenkinson, Crispin

2017-09-27

To explore the patients' perspective of surgery and early recovery when undergoing lower limb (hip or knee) arthroplasty. Lower limb arthroplasty is a commonly performed procedure for symptomatic arthritis, which has not responded to conservative medical treatment. Each patient's perspective of the surgical process and early recovery period impacts on their quality of life. Open, semistructured qualitative interviews were used to allow for a deeper understanding of the patient perspective when undergoing a hip or knee arthroplasty. Following ethical approval, 30 patients were interviewed between August and November 2016 during the perioperative period while undergoing an elective hip or knee arthroplasty (n = 30). The interviews were performed between the day of surgery and a nine-week postoperative clinic appointment. Data were analysed using an in-depth narrative thematic analysis method. NVivo qualitative data analysis software was used. Seven main themes evolved from the interviews: "improving function and mobility", "pain", "experiences of health care", "support from others", "involvement and understanding of care decisions", "behaviour and coping" and "fatigue and sleeping". The early postoperative recovery period is of vital importance to all surgical patients. This is no different for the orthopaedic patient. However, identifying key self-reported areas of importance from patients can guide clinical focus for healthcare professionals. To have specific patient-reported information regarding key areas of importance during the perioperative phase is invaluable when caring for the orthopaedic surgical patient. It gives insight and understanding in to this increasing population group. This study has also served as a starting point in the development of a questionnaire which could be used to assess interventions in the lower limb arthroplasty population. These results will influence both items and content of the questionnaire. © 2017 John Wiley & Sons Ltd.

"We can't get along without each other": Qualitative interviews with physicians about device industry representatives, conflict of interest and patient safety.

PubMed

Gagliardi, Anna R; Lehoux, Pascale; Ducey, Ariel; Easty, Anthony; Ross, Sue; Bell, Chaim; Trbovich, Patricia; Urbach, David R

2017-01-01

Physician relationships with device industry representatives have not been previously assessed. This study explored interactions with device industry representatives among physicians who use implantable cardiovascular and orthopedic devices to identify whether conflict of interest (COI) is a concern and how it is managed. A descriptive qualitative approach was used. Physicians who implant orthopedic and cardiovascular devices were identified in publicly available directories and web sites, and interviewed about their relationships with device industry representatives. Sampling was concurrent with data collection and analysis. Data were analyzed and discussed using constant comparative technique by all members of the research team. Twenty-two physicians (10 cardiovascular, 12 orthopedic) were interviewed. Ten distinct representative roles were identified: purchasing, training, trouble-shooting, supplying devices, assisting with device assembly and insertion, supporting operating room staff, mitigating liability, conveying information about recalls, and providing direct and indirect financial support. Participants recognized the potential for COI but representatives were present for the majority of implantations. Participants revealed a tension between physicians and representatives that was characterized as "symbiotic", but required physicians to be vigilant about COI and patient safety, particularly because representatives varied regarding disclosure of device defects. They described a concurrent tension between hospitals, whose policies and business practices were focused on cost-control, and physicians who were required to comply with those policies and use particular devices despite concerns about their safety and effectiveness. Given the potential for COI and threats to patient safety, further research is needed to establish the clinical implications of the role of, and relationship with device industry representatives; and whether and how hospitals do and

Parents of Youth Who Identify as Transgender: An Exploratory Study

ERIC Educational Resources Information Center

Johnson, Danielle; Sikorski, Jonathon; Savage, Todd A.; Woitaszewski, Scott A.

2014-01-01

This article explores the experiences, perceptions, support systems, and coping strategies on which parents of youth who identify as transgender rely. Based on data gathered via interviews with parents of youth who identify as transgender and analyzed using the consensual qualitative research method, parental challenges and concerns about their…

Structured methodology review identified seven (RETREAT) criteria for selecting qualitative evidence synthesis approaches.

PubMed

Booth, Andrew; Noyes, Jane; Flemming, Kate; Gerhardus, Ansgar; Wahlster, Philip; van der Wilt, Gert Jan; Mozygemba, Kati; Refolo, Pietro; Sacchini, Dario; Tummers, Marcia; Rehfuess, Eva

2018-07-01

To compare and contrast different methods of qualitative evidence synthesis (QES) against criteria identified from the literature and to map their attributes to inform selection of the most appropriate QES method to answer research questions addressed by qualitative research. Electronic databases, citation searching, and a study register were used to identify studies reporting QES methods. Attributes compiled from 26 methodological papers (2001-2014) were used as a framework for data extraction. Data were extracted into summary tables by one reviewer and then considered within the author team. We identified seven considerations determining choice of methods from the methodological literature, encapsulated within the mnemonic Review question-Epistemology-Time/Timescale-Resources-Expertise-Audience and purpose-Type of data. We mapped 15 different published QES methods against these seven criteria. The final framework focuses on stand-alone QES methods but may also hold potential when integrating quantitative and qualitative data. These findings offer a contemporary perspective as a conceptual basis for future empirical investigation of the advantages and disadvantages of different methods of QES. It is hoped that this will inform appropriate selection of QES approaches. Copyright © 2018 Elsevier Inc. All rights reserved.

Perceived stress at transition to workplace: a qualitative interview study exploring final-year medical students’ needs

PubMed Central

Moczko, Tobias R; Bugaj, Till J; Herzog, Wolfgang; Nikendei, Christoph

2016-01-01

Objectives This study was designed to explore final-year medical students’ stressors and coping strategies at the transition to the clinical workplace. Methods In this qualitative study, semi-standardized interviews with eight final-year medical students (five male, three female; aged 25.9±1.4 years) were conducted during their internal medicine rotation. After verbatim transcription, a qualitative content analysis of students’ impressions of stress provoking and easing factors during final-year education was performed. Results Students’ statements regarding burdens and dealing with stress were classified into four main categories: A) perceived stressors and provoking factors, B) stress-induced consequences, C) personal and external resources for preventing and dealing with stress, and D) final-year students’ suggestions for workplace improvement. Conclusion Final-year medical students perceived different types of stress during their transition to medical wards, and reported both negative consequences and coping resources concerning perceived stress. As supervision, feedback, and coping strategies played an important role in the students’ perception of stress, final-year medical education curricula development should focus on these specifically. PMID:26834503

Family members' expectations regarding nurses' competence in care homes: a qualitative interview study.

PubMed

Kiljunen, Outi; Kankkunen, Päivi; Partanen, Pirjo; Välimäki, Tarja

2017-11-22

Structural and cultural changes in the care of older people have influenced nursing practice, creating a need to identify current competency requirements for nurses working in care homes. Family members have an important role in ensuring the well-being of older people living in care homes, and family members' can provide valuable information about competence requirements. To explore the expectations of the care home residents' family members regarding the competence of nurses in care homes for older people. A qualitative descriptive design was used. Semi-structured interviews were conducted with 18 care home residents' family members between March and September 2016. Participants were recruited with help from regional associations and member associations of The Central Association of Carers in Finland and from regional associations of The Alzheimer's Society of Finland. The snowball technique was also used. The data were analysed using inductive content analysis. Ethics committee approval was obtained from the university committee on research ethics, and written informed consent was obtained from participants. The care home residents' family members expected that nurses would be able to interact with and treat people respectfully. Reflective collaboration between the nurse and a family member was also emphasised. Family members expected nurses to provide high-quality basic care and nursing and support residents' well-being individually and holistically. Family members' expectations reflect the need for ethical and interactional competence in the care home. In addition, evidence-based practice competencies are required to provide high-quality care. Nurses' ability to provide person-centred, individual and holistic care is vital to ensure care home residents' well-being. © 2017 Nordic College of Caring Science.

Individuals with knee impairments identify items in need of clarification in the Patient Reported Outcomes Measurement Information System (PROMIS®) pain interference and physical function item banks - a qualitative study.

PubMed

Lynch, Andrew D; Dodds, Nathan E; Yu, Lan; Pilkonis, Paul A; Irrgang, James J

2016-05-11

The content and wording of the Patient Reported Outcome Measurement Information System (PROMIS) Physical Function and Pain Interference item banks have not been qualitatively assessed by individuals with knee joint impairments. The purpose of this investigation was to identify items in the PROMIS Physical Function and Pain Interference Item Banks that are irrelevant, unclear, or otherwise difficult to respond to for individuals with impairment of the knee and to suggest modifications based on cognitive interviews. Twenty-nine individuals with knee joint impairments qualitatively assessed items in the Pain Interference and Physical Function Item Banks in a mixed-methods cognitive interview. Field notes were analyzed to identify themes and frequency counts were calculated to identify items not relevant to individuals with knee joint impairments. Issues with clarity were identified in 23 items in the Physical Function Item Bank, resulting in the creation of 43 new or modified items, typically changing words within the item to be clearer. Interpretation issues included whether or not the knee joint played a significant role in overall health and age/gender differences in items. One quarter of the original items (31 of 124) in the Physical Function Item Bank were identified as irrelevant to the knee joint. All 41 items in the Pain Interference Item Bank were identified as clear, although individuals without significant pain substituted other symptoms which interfered with their life. The Physical Function Item Bank would benefit from additional items that are relevant to individuals with knee joint impairments and, by extension, to other lower extremity impairments. Several issues in clarity were identified that are likely to be present in other patient cohorts as well.

The participant's perspective: learning from an aggression management training course for nurses. Insights from a qualitative interview study.

PubMed

Heckemann, Birgit; Breimaier, Helga Elisabeth; Halfens, Ruud J G; Schols, Jos M G A; Hahn, Sabine

2016-09-01

Aggression management training for nurses is an important part of a comprehensive strategy to reduce patient and visitor aggression in healthcare. Although training is commonplace, few scientific studies examine its benefits. To explore and describe, from a nurse's perspective, the learning gained from attending aggression management training. This was a descriptive qualitative interview study. We conducted semi-structured individual interviews with seven nurses before (September/October 2012) and after they attended aggression management training (January/February 2013). Interview transcripts were content-analysed qualitatively. The study plan was reviewed by the responsible ethics committees. Participants gave written informed consent. Aggression management training did not change nurses' attitude. Coping emotionally with the management of patient and visitor aggression remained a challenge. Nurses' theoretical knowledge increased, but they did not necessarily acquire new strategies for managing patient/visitor aggression. Instead, the course refreshed or activated existing knowledge of prevention, intervention and de-escalation strategies. The training increased nurses' environmental and situational awareness for early signs of patient and visitor. They also acquired some strategies for emotional self-management. Nurses became more confident in dealing with (potentially) aggressive situations. While the training influenced nurses' individual clinical practice, learning was rarely shared within teams. Aggression management training increases skills, knowledge and confidence in dealing with patient or visitor aggression, but the emotional management remains a challenge. Future research should investigate how aggression management training courses can strengthen nurses' ability to emotionally cope with patient and visitor aggression. More knowledge is needed on how the theoretical and practical knowledge gained from the training may be disseminated more effectively

Considerations for conducting qualitative research with pediatric patients for the purpose of PRO development.

PubMed

Patel, Zabin S; Jensen, Sally E; Lai, Jin-Shei

2016-09-01

To provide an overview of methodological considerations when conducting qualitative research with pediatric patients for the purpose of patient-reported outcome measure development A literature review of qualitative methods in pediatric measure development was completed. Eight clinicians providing care to pediatric patients were interviewed for their expert input. Thematic analysis of the literature and clinician interviews was used to identify themes for consideration. Findings from the literature and expert interviews emphasized the way in which cognitive, linguistic, and social developmental factors affect pediatric patients' understanding of their condition and ability to communicate about their experiences in an interview. There was consensus among the experts that traditional semi-structured interviews with children younger than eight lack characteristics necessary to yield meaningful information about condition and symptom report because they may fail to capture children's understanding and awareness of their condition and may limit their ability to express themselves comfortably. Our findings include recommended strategies to optimize data collected in qualitative interviews with pediatric patients, including modifications to the interview process to establish rapport, construction of interview questions to ensure they are developmentally appropriate, and the use of supplementary techniques to facilitate communication. When employing qualitative methods in pediatric measure development, interview guides, methods, and length require careful tailoring to ensure the child's perspectives are captured. This may be best achieved through research performed with narrow age bands that employs flexibility in methods to allow children a comfortable way in which to communicate about their experiences.

The use of triangulation in qualitative research.

PubMed

Carter, Nancy; Bryant-Lukosius, Denise; DiCenso, Alba; Blythe, Jennifer; Neville, Alan J

2014-09-01

Triangulation refers to the use of multiple methods or data sources in qualitative research to develop a comprehensive understanding of phenomena (Patton, 1999). Triangulation also has been viewed as a qualitative research strategy to test validity through the convergence of information from different sources. Denzin (1978) and Patton (1999) identified four types of triangulation: (a) method triangulation, (b) investigator triangulation, (c) theory triangulation, and (d) data source triangulation. The current article will present the four types of triangulation followed by a discussion of the use of focus groups (FGs) and in-depth individual (IDI) interviews as an example of data source triangulation in qualitative inquiry.

Long-term experiences of Norwegian live kidney donors: qualitative in-depth interviews.

PubMed

Meyer, Käthe B; Bjørk, Ida Torunn; Wahl, Astrid Klopstad; Lennerling, Annette; Andersen, Marit Helen

2017-02-16

Live kidney donation is generally viewed as a welcome treatment option for severe kidney disease. However, there is a disparity in the body of research on donor experiences and postdonation outcome, and lack of knowledge on long-term consequences described by the donors. This study was conducted to provide insight into donors' subjective meanings and interpretation of their experiences ∼10 years after donation. Qualitative explorative in-depth interviews. The sampling strategy employed maximum variation. Setting Oslo University Hospital is the national centre for organ transplantation and donation in Norway, and there are 26 local nephrology centres. 16 donors representing all parts of Norway who donated a kidney in 2001-2004 participated in the study. The interviews were analysed using an interpretative approach. The analysis resulted in 4 main themes; the recipient outcome justified long-term experiences, family dynamics-tension still under the surface, ambivalence-healthy versus the need for regular follow-up, and life must go on. These themes reflect the complexity of live kidney donation, which fluctuated from positive experiences such as pride and feeling privileged to adverse experiences such as altered family relationships or reduced health. Live kidney donors seemed to possess resilient qualities that enabled them to address the long-term consequences of donation. The challenge is to provide more uniform information about long-term consequences. In future research, resilient qualities could be a topic to explore in live donation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Perceived motivational factors for female football players during rehabilitation after sports injury - a qualitative interview study.

PubMed

Hildingsson, Malin; Fitzgerald, Ulrika Tranaeus; Alricsson, Marie

2018-04-01

Compliance with a rehabilitation program is significant among athletes following a sports injury. It is also one of the main factors that influence the rehabilitation process; moreover, the outcome is also influenced by the athlete's motivation. It is primarily an autonomous motivation, resulting in rehabilitation adherence. The aim of this study was to investigate the perceived motivation of female football players during rehabilitation after a sports injury and the extent to which these motivating factors were autonomous. Qualitative interviews, based on a semistructured interview guide with injured female football players undergoing rehabilitation, were analyzed using content analysis. The motivational factors that were described were their set goals, social support as well as external and internal pressures during rehabilitation. The perceived autonomy varied somewhat but overall, they experienced external motivation; therefore, the behavior was not entirely self-determined. Results are expected to provide a better understanding of women football players' motivation in relation to their rehabilitation; hence, physiotherapists and coaches who are part of the rehabilitation process can contribute by increasing the autonomous motivation, thus, improving the compliance and outcome of the rehabilitation.

Arts on prescription: a qualitative outcomes study.

PubMed

Stickley, T; Eades, M

2013-08-01

In recent years, participatory community-based arts activities have become a recognized and regarded method for promoting mental health. In the UK, Arts on Prescription services have emerged as a prominent form of such social prescribing. This follow-up study reports on the findings from interviews conducted with participants in an Arts on Prescription programme two years after previous interviews to assess levels of 'distance travelled'. This follow-up study used a qualitative interview method amongst participants of an Arts on Prescription programme of work. Ten qualitative one-to-one interviews were conducted in community-based arts venues. Each participant was currently using or had used mental health services, and had been interviewed two years earlier. Interviews were digitally recorded, transcribed and analysed. For each of the 10 participants, a lengthy attendance of Arts on Prescription had acted as a catalyst for positive change. Participants reported increased self-confidence, improved social and communication skills, and increased motivation and aspiration. An analysis of each of the claims made by participants enabled them to be grouped according to emerging themes: education: practical and aspirational achievements; broadened horizons: accessing new worlds; assuming and sustaining new identities; and social and relational perceptions. Both hard and soft outcomes were identifiable, but most were soft outcomes. Follow-up data indicating progress varied between respondents. Whilst hard outcomes could be identified in individual cases, the unifying factors across the sample were found predominately in the realm of soft outcomes. These soft outcomes, such as raised confidence and self-esteem, facilitated the hard outcomes such as educational achievement and voluntary work. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Identifying content-based and relational techniques to change behaviour in motivational interviewing.

PubMed

Hardcastle, Sarah J; Fortier, Michelle; Blake, Nicola; Hagger, Martin S

2017-03-01

Motivational interviewing (MI) is a complex intervention comprising multiple techniques aimed at changing health-related motivation and behaviour. However, MI techniques have not been systematically isolated and classified. This study aimed to identify the techniques unique to MI, classify them as content-related or relational, and evaluate the extent to which they overlap with techniques from the behaviour change technique taxonomy version 1 [BCTTv1; Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., … Wood, C. E. (2013). The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: Building an international consensus for the reporting of behavior change interventions. Annals of Behavioral Medicine, 46, 81-95]. Behaviour change experts (n = 3) content-analysed MI techniques based on Miller and Rollnick's [(2013). Motivational interviewing: Preparing people for change (3rd ed.). New York: Guildford Press] conceptualisation. Each technique was then coded for independence and uniqueness by independent experts (n = 10). The experts also compared each MI technique to those from the BCTTv1. Experts identified 38 distinct MI techniques with high agreement on clarity, uniqueness, preciseness, and distinctiveness ratings. Of the identified techniques, 16 were classified as relational techniques. The remaining 22 techniques were classified as content based. Sixteen of the MI techniques were identified as having substantial overlap with techniques from the BCTTv1. The isolation and classification of MI techniques will provide researchers with the necessary tools to clearly specify MI interventions and test the main and interactive effects of the techniques on health behaviour. The distinction between relational and content-based techniques within MI is also an important advance, recognising that changes in motivation and behaviour in MI is a function of both intervention content and the interpersonal style

Modification of motivational interviewing for use with people with mild intellectual disability and challenging behaviour.

PubMed

Frielink, Noud; Embregts, Petri

2013-12-01

Motivational interviewing is a promising method to increase treatment motivation for people with mild intellectual disability and challenging behaviour. The purpose of the present study was to identify how professionals could adapt motivational interviewing techniques for use with clients. We conducted semistructured qualitative interviews and focus groups with 26 clients, parents, and professionals. A general inductive approach led to the identification of multiple core themes. The authors recommend several modifications to accommodate motivational interviewing for use with clients: adapt to language level, adjust to cognitive abilities, and control for social desirability of responding. In addition, certain characteristics of professionals were also found to be critical for effective motivational interviewing: trustworthiness, engagement, acceptance, empathy, and honesty. Concrete recommendations for the adaptation of the motivational interviewing techniques for use with people with mild intellectual disability and challenging behaviour are identified. Certain characteristics of professionals are also critical for maximising the treatment motivation of clients.

Artifact-based reflective interviews for identifying pragmatic epistemological resources

NASA Astrophysics Data System (ADS)

Shubert, Christopher Walden

Physics Education Research studies the science of teaching and learning physics. The process of student learning is complex, and the factors that affect it are numerous. Describing students' understanding of physics knowledge and reasoning is the basis for much productive research; however, such research fails to account for certain types of student learning difficulties. In this dissertation, I explore one source of student difficulty: personal epistemology, students' ideas about knowledge and knowing. Epistemology traditionally answers three questions: What is knowledge? How is knowledge created? And, how do we know what we know? An individual's responses to these questions can affect learning in terms of how they approach tasks involving the construction and application of knowledge. The key issue addressed in this dissertation is the effect of methodological choices on the validity and reliability of claims concerning personal epistemology. My central concern is contextual validity, how what is said about one's epistemology is not identical to how one behaves epistemologically. In response to these issues, I present here a new methodology for research on student epistemology: video artifact-based reflective interview protocols. These protocols begin with video taping students in their natural classroom activities, and then asking the participants epistemological questions immediately after watching selected scenes from their activity, contextually anchoring them in their actual learning experience. The data from these interviews is viewed in the framework of Epistemological Resource Theory, a framework of small bits of knowledge whose coordination in a given context is used to describe personal epistemology. I claim that the privileged data from these interviews allows detailed epistemological resources to be identified, and that these resources can provide greater insight into how student epistemologies are applied in learning activities. This research

Nursing home staff’s views on residents’ dignity: a qualitative interview study

PubMed Central

2013-01-01

Background Maintaining dignity is an important element of end-of-life care and also of the care given in nursing homes. Factors influencing personal dignity have been studied from both nursing home residents’ and staff’s perspective. Little is however known about the way nursing home staff perceive and promote the personal dignity of individual residents in daily practice, or about staff’s experiences with preserving dignity within the nursing home. The aim of this study is to gain more insight in this. Methods A qualitative descriptive interview study was designed, in which in-depth interviews were performed with 13 physicians and 15 nurses. They expressed their views on the personal dignity of 30 recently admitted nursing home residents on the general medical wards of four nursing homes in The Netherlands. Interviews were transcribed and analyzed following the principles of thematic analysis. Results According to both physicians and nurses, physical impairment and being dependent on others threatened the residents’ dignity. Whether or not this led to a violation of an individual resident’s dignity, depended - in staff’s opinion - on the resident’s ability to show resilience and to keep his/her individuality. Staff mentioned treating residents with respect and taking care of their privacy as most important elements of dignity-conserving care and strived to treat the residents as they would like to be treated themselves. They could often mention aspects that were important for a particular resident’s dignity. But, when asked what they could contribute to a particular resident’s dignity, they often mentioned general aspects of dignity-conserving care, which could apply to most nursing home residents. By attempting to give dignity-conserving care, physicians and nurses often experienced conflicting values in daily care and barriers caused by the lack of resources. Conclusions Tailoring dignity-conserving care to an individual nursing home resident

[Living and dying with frailty : Qualitative interviews with elderly people in the domestic environment].

PubMed

Klindtworth, Katharina; Geiger, Karin; Pleschberger, Sabine; Bleidorn, Jutta; Schneider, Nils; Müller-Mundt, Gabriele

2017-02-01

Frail older people are becoming an increasingly more important target group in healthcare provision. Little is known about patients' views on frailty and its various impacts, especially towards the end of life. This study was carried out to analyze the needs of frail elderly people at the end of life. A qualitative, longitudinal case study design was applied and included 31 frail older patients (≥ 70 year) with a Canadian study of health and aging (CSHA) clinical frailty scale (CFS) grade 6/7 from urban and rural areas within the region of Lower Saxony. The analysis was based on guided interviews and followed the principles of grounded theory. From the patients' perspective frailty is perceived as a process of increasing complexity of health problems, increased vulnerability and reduced ability to perform tasks. Frailty is experienced as various deficits including the physical, psychological, social and existential dimensions. Living and dying in a familiar environment and maintaining autonomy was identified as a core category. Key determinants were access to and quality of healthcare services as well as various individual and social resources. A palliative biopsychosocial care approach should be established early in the process of frailty, including advance care planning in order to meet the patients' needs of staying in a familiar environment. General practitioners as well as home care nursing personnel have to collaborate in order to balance issues of autonomy with increased care needs and the support of informal carers as key partners towards the end of life.

The experiences of health-related quality of life in patients with nonspecific symptoms who undergo a diagnostic evaluation for cancer: a qualitative interview study.

PubMed

Moseholm, Ellen; Lindhardt, Bjarne Oerskov; Rydahl-Hansen, Susan

2017-09-01

The diagnostic phase of cancer can affect health-related quality of life (HRQoL). The aim of this study was to investigate how patients with nonspecific symptoms experience HRQoL while undergoing diagnostic evaluations for cancer. Twenty-one participants who had completed a fast-track evaluation for possible cancer at one of three hospitals in the Capital Region, Denmark were interviewed 2-4 weeks after completing diagnostic evaluations. The interviews were semi-structured and were supported by an interview guide based on the same themes as in The European Organisation for Research and Treatment of Cancer Quality of Life questionnaire (EORCT-QLQ-C30). Data analysis was based on qualitative content analysis by Krippendorff. The analysis generated six categories: symptoms, physical-, role-, emotional-, cognitive- and social functioning, and the diagnostic fast-track experience. From these categories, a main theme was identified: Health-related quality of life is not solely affected by the diagnostic process. The results provide a comprehensive understanding of HRQoL in the diagnostic phase of possible cancer, which can be used not only to enhance evidence-based care, but also in the interpretation of the EORTC-QLQ-C30 scores. Psycho-social support with a focus on individual informational needs during the diagnostic phase may be warranted. © 2016 Nordic College of Caring Science.

Motivational interviewing: experiences of primary care nurses trained in the method.

PubMed

Östlund, Ann-Sofi; Wadensten, Barbro; Kristofferzon, Marja-Leena; Häggström, Elisabeth

2015-03-01

Motivational interviewing is a person-centered counseling style used to promote behavioral change regarding a wide variety of lifestyle problems. Use of motivational interview is growing worldwide and among many different healthcare professions, including primary care nursing. The study aim was to describe motivational interview trained nurses' experiences of motivational interviewing in primary care settings. The study had a qualitative descriptive design. It was carried out in Swedish primary care settings in two county council districts, with 20 primary care nurses trained in motivational interviewing. Half of them used the method in their work, half did not. Qualitative semi-structured interviews were used. Data were analyzed using qualitative content analysis. The nurses experienced that openness to the approach and an encouraging working climate are required to overcome internal resistance and to increase use of motivational interviewing. They also experienced mutual benefit: motivational interviewing elicits and develops abilities in both nurses and patients. For the nurses using it, motivational interviewing is perceived to facilitate work with patients in need of lifestyle change. Lack of training/education, support, interest and appropriate work tasks/patients are reasons for not using motivational interviewing.

The role and position of passive intervertebral motion assessment within clinical reasoning and decision-making in manual physical therapy: a qualitative interview study.

PubMed

van Trijffel, Emiel; Plochg, Thomas; van Hartingsveld, Frank; Lucas, Cees; Oostendorp, Rob A B

2010-06-01

Passive intervertebral motion (PIVM) assessment is a characterizing skill of manual physical therapists (MPTs) and is important for judgments about impairments in spinal joint function. It is unknown as to why and how MPTs use this mobility testing of spinal motion segments within their clinical reasoning and decision-making. This qualitative study aimed to explore and understand the role and position of PIVM assessment within the manual diagnostic process. Eight semistructured individual interviews with expert MPTs and three subsequent group interviews using manual physical therapy consultation platforms were conducted. Line-by-line coding was performed on the transcribed data, and final main themes were identified from subcategories. Three researchers were involved in the analysis process. Four themes emerged from the data: contextuality, consistency, impairment orientedness, and subjectivity. These themes were interrelated and linked to concepts of professionalism and clinical reasoning. MPTs used PIVM assessment within a multidimensional, biopsychosocial framework incorporating clinical data relating to mechanical dysfunction as well as to personal factors while applying various clinical reasoning strategies. Interpretation of PIVM assessment and subsequent decisions on manipulative treatment were strongly rooted within practitioners' practical knowledge. This study has identified the specific role and position of PIVM assessment as related to other clinical findings within clinical reasoning and decision-making in manual physical therapy in The Netherlands. We recommend future research in manual diagnostics to account for the multivariable character of physical examination of the spine.

The role and position of passive intervertebral motion assessment within clinical reasoning and decision-making in manual physical therapy: a qualitative interview study

PubMed Central

van Trijffel, Emiel; Plochg, Thomas; van Hartingsveld, Frank; Lucas, Cees; Oostendorp, Rob A B

2010-01-01

Passive intervertebral motion (PIVM) assessment is a characterizing skill of manual physical therapists (MPTs) and is important for judgments about impairments in spinal joint function. It is unknown as to why and how MPTs use this mobility testing of spinal motion segments within their clinical reasoning and decision-making. This qualitative study aimed to explore and understand the role and position of PIVM assessment within the manual diagnostic process. Eight semistructured individual interviews with expert MPTs and three subsequent group interviews using manual physical therapy consultation platforms were conducted. Line-by-line coding was performed on the transcribed data, and final main themes were identified from subcategories. Three researchers were involved in the analysis process. Four themes emerged from the data: contextuality, consistency, impairment orientedness, and subjectivity. These themes were interrelated and linked to concepts of professionalism and clinical reasoning. MPTs used PIVM assessment within a multidimensional, biopsychosocial framework incorporating clinical data relating to mechanical dysfunction as well as to personal factors while applying various clinical reasoning strategies. Interpretation of PIVM assessment and subsequent decisions on manipulative treatment were strongly rooted within practitioners’ practical knowledge. This study has identified the specific role and position of PIVM assessment as related to other clinical findings within clinical reasoning and decision-making in manual physical therapy in The Netherlands. We recommend future research in manual diagnostics to account for the multivariable character of physical examination of the spine. PMID:21655394

Complementary medicine for cancer patients in general practice: qualitative interviews with german general practitioners.

PubMed

Dahlhaus, Anne; Siebenhofer, Andrea; Guethlin, Corina

2015-01-01

The aim of this study was to investigate how general practitioners react when their cancer patients show interest in complementary medicine, and how their reaction is related to their knowledge in the field. We conducted semi-structured interviews with 10 German general practitioners. Interviewees came from 5 different federal states and varied in terms of urban/rural setting, single/joint practice, additional certifications, gender and length of professional experience. Interviews were electronically recorded, transcribed and then analysed using qualitative content analysis according to Mayring. General practitioners feel largely responsible for providing information on complementary medicine to their cancer patients. However, uncertainty and a lack of knowledge concerning CAM lead mainly to reactive responses to patients' needs, and the general practitioners base their recommendations on personal experiences and attitudes. They wish to support their cancer patients and thus, in order to keep their patients' hopes up and maintain a trusting relationship, sometimes support complementary medicine, regardless of their own convictions. Although general practitioners see themselves as an important source of information on complementary medicine for their cancer patients, they also speak of their uncertainties and lack of knowledge. General practitioners would profit from training in complementary medicine enabling them to discuss this topic with their cancer patients in a proactive, open and honest manner. © 2015 S. Karger GmbH, Freiburg

Interviewing to develop Patient-Reported Outcome (PRO) measures for clinical research: eliciting patients’ experience

PubMed Central

2014-01-01

Patient-reported outcome (PRO) measures must provide evidence that their development followed a rigorous process for ensuring their content validity. To this end, the collection of data is performed through qualitative interviews that allow for the elicitation of in-depth spontaneous reports of the patients’ experiences with their condition and/or its treatment. This paper provides a review of qualitative research applied to PRO measure development. A clear definition of what is a qualitative research interview is given as well as information about the form and content of qualitative interviews required for developing PRO measures. Particular attention is paid to the description of interviewing approaches (e.g., semi-structured and in-depth interviews, individual vs. focus group interviews). Information about how to get prepared for a qualitative interview is provided with the description of how to develop discussion guides for exploratory or cognitive interviews. Interviewing patients to obtain knowledge regarding their illness experience requires interpersonal and communication skills to facilitate patients’ expression. Those skills are described in details, as well as the skills needed to facilitate focus groups and to interview children, adolescents and the elderly. Special attention is also given to quality assurance and interview training. The paper ends on ethical considerations since interviewing for the development of PROs is performed in a context of illness and vulnerability. Therefore, it is all the more important that, in addition to soliciting informed consent, respectful interactions be ensured throughout the interview process. PMID:24499454

Language Minority Experience: A Qualitative Study of Seven Bilinguals

ERIC Educational Resources Information Center

Orlov, Leonid Y.; Ting, Siu-Man Raymond; Tyler, Richard E.

2009-01-01

This study investigates language minority experiences of 7 heritage bilinguals via ethnographic interviewing and analytic induction. Themes are identified after qualitative clustering and contrasting of the data. Results are presented for all levels of participant-reported linguistic proficiency and researcher-inferred bilingual identity.…

Distrust and patients in intercultural healthcare: A qualitative interview study.

PubMed

Alpers, Lise-Merete

2018-05-01

The importance of trust between patients and healthcare personnel is emphasised in nurses' and physicians' ethical codes. Trust is crucial for an effective healthcare personnel-patient relationship and thus for treatment and treatment outcomes. Cultural and linguistic differences may make building a trusting and positive relationship with ethnic minority patients particularly challenging. Although there is a great deal of research on cultural competence, there is a conspicuous lack of focus on the concepts of trust and distrust concerning ethnic minority patients, particularly in relation to the concept of 'othering'. To study which factors help build trust or create distrust in encounters between healthcare professionals and hospitalised ethnic minority patients, as well as study the dynamic complexities inherent within the process of 'othering'. Qualitative design, in-depth interviews and hermeneutic analysis. Participants and research context: The interviewees were 10 immigrant patients (six women and four men - eight Asians, two Africans - ages 32-85 years) recruited from a south-eastern Norwegian hospital. Ethical considerations: Study approval was obtained from the hospital's Privacy Ombudsman for Research and the hospital's leadership. Participation was voluntary and participants signed an informed consent form. Distrust and othering may be caused by differences in belief systems, values, perceptions, expectations, and style of expression and behaviour. Othering is a reciprocal phenomenon in minority ethnic patient-healthcare personnel encounters, and it influences trust building negatively. Besides demonstrating general professional skill and competence, healthcare personnel require cultural competence to create trust.

Understanding why GPs see pharmaceutical representatives: a qualitative interview study.

PubMed Central

Prosser, Helen; Walley, Tom

2003-01-01

BACKGROUND: Doctors are aware of the commercial bias in pharmaceutical representative information; nevertheless, such information is known to change doctors' prescribing, and augment irrational prescribing and prescribing costs. AIM: To explore GPs, reasons for receiving visits from pharmaceutical representatives. DESIGN OF STUDY: Qualitative study with semi-structured interviews. SETTING: One hundred and seven general practitioners (GPs) in practices from two health authorities in the North West of England. RESULTS: The main outcome measures of the study were: reasons for receiving/not receiving representative visits; advantages/disadvantages in receiving visits; and quality of representative-supplied information. Most GPs routinely see pharmaceutical representatives, because they bring new drug information speedily; they are convenient and accessible; and can be consulted with a saving of time and effort. Many GPs asserted they had the skills to critically appraise the evidence. Furthermore, the credibility and social characteristics of the representative were instrumental in shaping GPs' perceptions of representatives as legitimate information providers. GPs also received visits from representatives for reasons other than information acquisition. These reasons are congruent with personal selling techniques used in marketing communications. CONCLUSIONS: The study draws attention to the social and cultural contexts of GP-representative encounters and the way in which the acquisition of pharmacological information within the mercantile context of representative visits is legitimated. This highlights the need for doctors to critically appraise information supplied by representatives in relation to other information sources. PMID:12879831

Relation between a career and family life for English hospital consultants: qualitative, semistructured interview study.

PubMed

Dumelow, C; Littlejohns, P; Griffiths, S

2000-05-27

To explore the relation between work and family life among hospital consultants and their attitude towards the choices and constraints that influence this relation. Qualitative study of consultants' experiences and views based on tape recorded semistructured interviews. Former South Thames health region in southeast England. 202 male and female NHS hospital consultants aged between 40 to 50 years representing all hospital medical specialties. Three types of relation between work and family life (career dominant, segregated, and accommodating) were identified among hospital consultants. Most consultants had a segregated relation, although female consultants were more likely than male consultants to have a career dominant or an accommodating relation. Many male consultants and some female consultants expressed considerable dissatisfaction with the balance between their career and family life. A factor influencing this dissatisfaction was the perceived lack of choice to spend time on their personal or family life, because of the working practices and attitudes within hospital culture, if they wanted a successful career. Consultants are currently fitting in with the profession rather than the profession adapting to enable doctors to have fulfilling professional and personal lives. Current government policies to increase the medical workforce and promote family friendly policies in the NHS ought to take account of the need for a fundamental change in hospital culture to enable doctors to be more involved in their personal or family life without detriment to their career progress.

Experiences of living with dementia: qualitative content analysis of semi-structured interviews.

PubMed

Mazaheri, Monir; Eriksson, Lars E; Heikkilä, Kristiina; Nasrabadi, Alireza Nikbakht; Ekman, Sirkka-Liisa; Sunvisson, Helena

2013-11-01

To describe people's experiences of living with dementia in Iran. A knowledge gap exists regarding the experiences of living with dementia in nonWestern contexts. This gap may be especially apparent within the Iranian context, where dementia research is relatively new. Deeper understanding about context-related experiences of dementia is a prerequisite for nurses' ability to provide adequate and meaningful care. Qualitative, cross-sectional design. Qualitative content analysis of semi-structured interviews with people living with dementia in urban Iran (six women and nine men; 60-87 years old). The participants experienced their condition as a state of forgetfulness that was accompanied by losses and dependency on others. They wanted to feel good about themselves and feel important, but they continually struggled with matters such as a loss of accountability, feelings of futility and the frustration of others. Economic dependency and a lack of economic resources were sources of feelings of futility. Experiences of living with dementia in Iran included a substantial struggle to stay connected to the social world and to deal with dramatic life changes, aspects of living with dementia that seem to be universal. However, the feelings of financial burden and the experience of being nagged for their shortfalls by family members have seldom been described in other studies and seem to represent a cultural aspect of their experience. The results of the study call for further nursing efforts in supporting people living with dementia in their struggle with their altered lives and in retaining their connections to everyday life. Furthermore, their family members might benefit from specific nursing interventions including information about dementia and advice on how to help the family members with dementia to interact with others while exercising their individual strengths. © 2013 John Wiley & Sons Ltd.

Referrals to integrative medicine in a tertiary hospital: findings from electronic health record data and qualitative interviews.

PubMed

Griffin, Kristen H; Nate, Kent C; Rivard, Rachael L; Christianson, Jon B; Dusek, Jeffery A

2016-07-25

To examine patterns of, and decision-making processes, informing referrals for inpatient access to integrative medicine (IM) services at a large, acute care hospital. Retrospective electronic health record review and structured qualitative interviews. A 630-bed tertiary care hospital with an IM service available to inpatients. IM referrals of all inpatients aged ≥18 years between July 2012 and December 2014 were identified using the hospital's electronic health record. Fifteen physicians, 15 nurses and 7 administrators were interviewed to better understand roles and perspectives in referring patients for IM services. In the study hospital, primary sources of referrals for IM services were the orthopaedic and neuroscience/spine service lines. While the largest absolute number of IM referrals was made for patients with lengths of stay of 3 days or fewer, a disproportionate number of total IM referrals was made for patients with long lengths of stay (≥10 days), compared with a smaller percentage of patients in the hospital with lengths of stay ≥10 days. Physicians and nurses were more likely to refer patients who displayed strong symptoms (eg, pain and anxiety) and/or did not respond to conventional therapies. IM referrals were predominantly nurse-initiated. A built-in delay in the time from referral initiation to service delivery discouraged referrals of some patients. Conventional providers refer patients for IM services when these services are available in a tertiary hospital. Referral patterns are influenced by patient characteristics, operational features and provider perspectives. Nurses play a key role in the referral process. Overcoming cultural and knowledge differences between conventional and IM providers is likely to be a continuing challenge to providing IM in inpatient settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

What Do Children with Chronic Diseases and Their Parents Think About Pediatricians? A Qualitative Interview Study.

PubMed

Konstantynowicz, Jerzy; Marcinowicz, Ludmiła; Abramowicz, Paweł; Abramowicz, Magdalena

2016-08-01

Objectives The aim of this study was to determine how pediatric patients and their parents perceive health care during hospital stays, what are their expectations of doctor behaviors, and which components of care do they consider to be the most important. Methods A qualitative descriptive study was carried out using the open interview technique. Twenty-six parents and 22 children undergoing hospital treatment participated. Results Our analysis identified two major themes: (1) doctor verbal and non-verbal behaviors, which included informing and explaining, conversations on topics other than the illness, tone of voice and other behaviors; and (2) perceived strategies used by doctors. This category included claims of doctors' intentional use of medical jargon to avoid addressing parental questions directly. Parents admitted that they did not understand medical vocabulary, but they also thought they might understand more of the medical issues if the doctor spoke using terms comprehensible to them. Conlcusions Our study shows the importance of interpersonal relationship affecting patient perception of quality of pediatric care. Parents of pediatric patients perceive that doctors behave in ways that deflect parents' questions and avoid providing them with medical information. Such behaviors include doctors excusing themselves by saying they are busy and using medical jargon. Medical students and doctors should be trained to communicate effectively with patients and their parents and develop skills to convey information in a simple and comprehensible way.

Making meaning in a burn peer support group: qualitative analysis of attendee interviews.

PubMed

Davis, Trevor; Gorgens, Kim; Shriberg, Janet; Godleski, Matthew; Meyer, Laura

2014-01-01

There is a paucity of literature on the personal experiences of burn support group members, the members' perceived benefits of group participation, and the meaning the survivors make of the support they receive. In order to provide effective psychosocial rehabilitation services and to meet the needs of burn survivors, it is important to understand the influence a support group has on its members as well as the personal experiences of those individuals who attend these groups. The purpose of this study was to explore the experiences of burn survivors in a burn survivor support group. Six self-identified burn survivors were interviewed by using a guided in-depth interview technique to explore their experiences in the support group. Key informant interviews and group observations served to triangulate the findings from the individual interviews. The experiences of the group members coalesced around four main themes: acceptance of self, perspective change, value of community, and reciprocity. The findings demonstrated the overall perceived positive impact the support group had on psychosocial recovery. For these members, the group aided the process of adjustment through the encouragement of adaptive coping strategies and the facilitation of community and relationships. Their experiences mirrored much of the literature on psychological growth from adversity. Burn survivors reported unique opportunities that allowed them to integrate their injury into their identity within an encouraging and safe environment. Using these accounts, the authors generated clinical suggestions that may encourage similar growth in other support group settings.

Focused Group Interviews as an Innovative Quanti-Qualitative Methodology (QQM): Integrating Quantitative Elements into a Qualitative Methodology

ERIC Educational Resources Information Center

Grim, Brian J.; Harmon, Alison H.; Gromis, Judy C.

2006-01-01

There is a sharp divide between quantitative and qualitative methodologies in the social sciences. We investigate an innovative way to bridge this gap that incorporates quantitative techniques into a qualitative method, the "quanti-qualitative method" (QQM). Specifically, our research utilized small survey questionnaires and experiment-like…

Unmarried women’s ways of facing single motherhood in Sri Lanka – a qualitative interview study

PubMed Central

2013-01-01

Background In Sri Lanka, motherhood within marriage is highly valued. Sex out of wedlock is socially unacceptable and can create serious public health problems such as illegal abortions, suicide and infanticide, and single motherhood as a result of premarital sex is considered shameful. The way unmarried women facing single motherhood reflect on and make use of their agency in their social environments characterised by limited social and financial support has consequences for the health and well-being of both themselves and their children. The aim of this study was to explore and describe how unmarried women facing single motherhood in Sri Lanka handle their situation. Methods This qualitative study comprised semi-structured interviews with 28 unmarried pregnant women or single mothers. The data were analysed by qualitative content analysis and the results related to the conceptual framework of social navigation. Results The women facing single motherhood expressed awareness of having trespassed norms of sexuality through self-blame, victimhood and obedience, and by considering or attempting suicide. They demonstrated willingness to take responsibility for becoming pregnant before marriage by giving the child up for adoption, bringing up the child themselves, claiming a father for their child, refraining from marriage in the future, permanently leave their home environment, and taking up employment. Throughout the interviews, the women expressed fear of shame, and striving for familial and societal acceptance and financial survival. Conclusions A social environment highly condemning of unmarried motherhood hindered these women from making strategic choices on how to handle their situation. However, to achieve acceptance and survival, the women tactically navigated norms of femininity, strong family dependence, a limited work market, and different sources of support. Limited access to resources restricted the women’s sexual and reproductive health and rights

Sample Size in Qualitative Interview Studies: Guided by Information Power.

PubMed

Malterud, Kirsti; Siersma, Volkert Dirk; Guassora, Ann Dorrit

2015-11-27

Sample sizes must be ascertained in qualitative studies like in quantitative studies but not by the same means. The prevailing concept for sample size in qualitative studies is "saturation." Saturation is closely tied to a specific methodology, and the term is inconsistently applied. We propose the concept "information power" to guide adequate sample size for qualitative studies. Information power indicates that the more information the sample holds, relevant for the actual study, the lower amount of participants is needed. We suggest that the size of a sample with sufficient information power depends on (a) the aim of the study, (b) sample specificity, (c) use of established theory, (d) quality of dialogue, and (e) analysis strategy. We present a model where these elements of information and their relevant dimensions are related to information power. Application of this model in the planning and during data collection of a qualitative study is discussed. © The Author(s) 2015.

Identifying Facilitators and Barriers for Patient Safety in a Medicine Label Design System Using Patient Simulation and Interviews.

PubMed

Dieckmann, Peter; Clemmensen, Marianne Hald; Sørensen, Trine Kart; Kunstek, Pina; Hellebek, Annemarie

2016-12-01

Medicine label design plays an important role in improving patient safety. This study aimed at identifying facilitators and barriers in a medicine label system to prevent medication errors in clinical use by health care professionals. The study design is qualitative and exploratory, with a convenience sample of 10 nurses and 10 physicians from different acute care specialties working in hospitals in the Capital Region of Denmark. In 2 patient simulation scenarios and a sorting task, the participants selected the medicines from a range of ampules, vials, and infusion bags. After each scenario and in the end of the study, the participants were interviewed. Notes were validated with the participants, and content was analyzed. The label design benefited from the standardized construction of the labels, the clear layout and font, and some warning signs. The complexity of the system and some inconsistencies (different meaning of colors) posed challenges, when considered with the actual application context, in which there is little time to get familiar with the design features. For optimizing medicine labels and obtaining the full benefit of label design features on patient safety, it is necessary to consider the context in which they are used.

Help seeking for cancer ‘alarm’ symptoms: a qualitative interview study of primary care patients in the UK

PubMed Central

Whitaker, Katriina L; Macleod, Una; Winstanley, Kelly; Scott, Suzanne E; Wardle, Jane

2015-01-01

Background Delay in help seeking for cancer ‘alarm’ symptoms has been identified as a contributor to delayed diagnosis. Aim To understand people’s help-seeking decision making for cancer alarm symptoms, without imposing a cancer context. Design and setting Community-based, qualitative interview study in the UK, using purposive sampling by sex, socioeconomic status, and prior help seeking, with framework analysis of transcripts. Method Interviewees (n = 48) were recruited from a community-based sample (n = 1724) of adults aged ≥50 years who completed a health survey that included a list of symptoms. Cancer was not mentioned. Participants reporting any of 10 cancer alarm symptoms (n = 915) and who had consented to contact (n = 482) formed the potential pool from which people were invited to an interview focusing on their symptom experiences. Results Reasons for help seeking included symptom persistence, social influence, awareness/fear of a link with cancer, and ‘just instinct’. Perceiving the symptom as trivial or ‘normal’ was a deterrent, as was stoicism, adopting self-management strategies, and fear of investigations. Negative attitudes to help seeking were common. Participants did not want to be seen as making a fuss, did not want to waste the doctor’s time, and were sometimes not confident that the GP could help. Conclusion Decision making about cancer alarm symptoms was complex. Recognition of cancer risk almost always motivated help seeking (more so than the fear of cancer being a deterrent), assisted by recent public-awareness campaigns. As well as symptom persistence motivating help seeking, it could also have the reverse effect. Negative attitudes to help seeking were significant deterrents. PMID:25624313

Resilience for family carers of advanced cancer patients-how can health care providers contribute? A qualitative interview study with carers.

PubMed

Røen, Ingebrigt; Stifoss-Hanssen, Hans; Grande, Gunn; Brenne, Anne-Tove; Kaasa, Stein; Sand, Kari; Knudsen, Anne Kari

2018-05-01

Caring for advanced cancer patients affects carers' psychological and physical health. Resilience has been defined as "the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of threat." The aim of this study was to explore factors promoting carer resilience, based on carers' experiences with and preferences for health care provider support. Qualitative, semi-structured, individual interviews with family carers of advanced cancer patients were performed until data saturation. The interviews were recorded, transcribed, and analyzed using systematic text condensation. Carers ( n = 14) of advanced cancer patients, not receiving curative treatment, admitted to an integrated curative and palliative care cancer outpatient clinic or to a university hospital cancer clinic, were included. 14 carers of advanced cancer patients were included; 7 men, 7 women, and mean age of 59 years; 3 were bereaved; 12 were partners; 5 had young and teenage children. Four main resilience factors were identified: (1) being seen and known by health care providers-a personal relation; (2) availability of palliative care; (3) information and communication about illness, prognosis, and death; and (4) facilitating a good carer-patient relation. Health care providers may enhance carers' resilience by a series of simple interventions. Education should address carers' support needs and resilience. Systematic assessment of carers' support needs is recommended. Further investigation is needed into how health care providers can help carers and patients communicate about death.

Mind mapping in qualitative research.

PubMed

Tattersall, Christopher; Powell, Julia; Stroud, James; Pringle, Jan

We tested a theory that mind mapping could be used as a tool in qualitative research to transcribe and analyse an interview. We compared results derived from mind mapping with those from interpretive phenomenological analysis by examining patients' and carers' perceptions of a new nurse-led service. Mind mapping could be used to rapidly analyse simple qualitative audio-recorded interviews. More research is needed to establish the extent to which mind mapping can assist qualitative researchers.

Facing the dilemma of patient-centred psoriasis care: a qualitative study identifying patient needs in dermatological outpatient clinics.

PubMed

Khoury, L R; Skov, L; Møller, T

2017-08-01

Caregivers must be aware of patients' current needs by providing care responsive to patients' values and preferences and by identifying what approach improves and encourages patients to participate in their treatment and disease management. Patients with psoriasis healthcare needs perhaps change as medical knowledge improves, new drugs emerge and the healthcare system improves its efficiency as a result of constant structural development. To explore the unmet needs and health perceptions of people with psoriasis, regarding interaction with clinicians and the structure inherent to consultations in a hospital outpatient dermatological clinic. A qualitative investigation with data generated from semi-structured interviews. Transcriptions were subsequently analysed using the template analysis method. Sixteen patients with psoriasis were interviewed. Challenges and dilemmas of patient-centred psoriasis care were identified. Patients have a strong need to be met as individuals as the burden of living with psoriasis goes beyond the skin. Patients strive for efficient treatment and ultimately dream of being cured of psoriasis. They prefer individualized health education in order to adjust their knowledge and self-management skills. These central issues are as yet rarely addressed in clinical consultations. Consultations with a standardized structure do not match the individual challenges and healthcare needs of patients with psoriasis. In order to achieve a more patient-centred approach, health professionals should implement minor structural changes to dermatological services to meet patients' current needs and invite dialogue about the patients' emotional well-being and concerns that go beyond biomedical factors, as well as offer individualized health education. © 2016 British Association of Dermatologists.

Improving Outcomes for Students with Disabilities: Identifying Characteristics of Successful Districts

ERIC Educational Resources Information Center

DeVries, Melissa; Tkatchov, Oran

2017-01-01

The common characteristics among Arizona districts and charters with high academic outcomes for student disabilities were identified in a qualitative study involving site visits and interviews. In 2014, the Arizona Department of Education examined over three years of state testing data to identify districts and charter schools that closed the…

Qualitative Comparative Analysis: A Hybrid Method for Identifying Factors Associated with Program Effectiveness.

PubMed

Cragun, Deborah; Pal, Tuya; Vadaparampil, Susan T; Baldwin, Julie; Hampel, Heather; DeBate, Rita D

2016-07-01

Qualitative comparative analysis (QCA) was developed over 25 years ago to bridge the qualitative and quantitative research gap. Upon searching PubMed and the Journal of Mixed Methods Research , this review identified 30 original research studies that utilized QCA. Perceptions that QCA is complex and provides few relative advantages over other methods may be limiting QCA adoption. Thus, to overcome these perceptions, this article demonstrates how to perform QCA using data from fifteen institutions that implemented universal tumor screening (UTS) programs to identify patients at high risk for hereditary colorectal cancer. In this example, QCA revealed a combination of conditions unique to effective UTS programs. Results informed additional research and provided a model for improving patient follow-through after a positive screen.

Qualitative Comparative Analysis: A Hybrid Method for Identifying Factors Associated with Program Effectiveness

PubMed Central

Cragun, Deborah; Pal, Tuya; Vadaparampil, Susan T.; Baldwin, Julie; Hampel, Heather; DeBate, Rita D.

2015-01-01

Qualitative comparative analysis (QCA) was developed over 25 years ago to bridge the qualitative and quantitative research gap. Upon searching PubMed and the Journal of Mixed Methods Research, this review identified 30 original research studies that utilized QCA. Perceptions that QCA is complex and provides few relative advantages over other methods may be limiting QCA adoption. Thus, to overcome these perceptions, this article demonstrates how to perform QCA using data from fifteen institutions that implemented universal tumor screening (UTS) programs to identify patients at high risk for hereditary colorectal cancer. In this example, QCA revealed a combination of conditions unique to effective UTS programs. Results informed additional research and provided a model for improving patient follow-through after a positive screen. PMID:27429602

Using Student Interviews for becoming a Reflective Geographer

ERIC Educational Resources Information Center

Adriansen, Hanne Kirstine; Madsen, Lene Møller

2014-01-01

This paper presents a case for interviewing students as an effective yet complex way to integrate reflexive practice into teaching and research. Even though many human geographers are accustomed to conducting qualitative interviews in various contexts, it is not straightforward to interview one's own students. This paper addresses three…

General practitioners' perceptions of their ability to identify and refer patients with suspected axial spondyloarthritis: a qualitative study.

PubMed

van Onna, Marloes; Gorter, Simone; van Meerendonk, Aniek; van Tubergen, Astrid

2014-05-01

To explore the knowledge, beliefs, and experiences of general practitioners (GP) about inflammatory back pain (IBP) and axial spondyloarthritis (axSpA) and potential barriers for referral of patients suspected of having axSpA. A qualitative study involving semistructured interviews with GP was conducted. Transcripts of the interviews were independently read and annotated by 2 readers. Illustrative themes were identified and a coding system to categorize the data was developed. Ten GP (all men; mean age 49 yrs) were interviewed. All could adequately describe "classic" ankylosing spondylitis (AS) and mentioned chronic back pain and/or stiffness as key features. All GP thought that AS is almost exclusively diagnosed in men. Six GP knew that there is a difference between mechanical back pain and IBP, but could recall only a limited number of variables indicative of IBP, such as awakening night pain (4 GP), insidious onset of back pain (1 GP), improvement with movement (1 GP), and (morning) stiffness (2 GP). Two GP mentioned peripheral arthritis as other SpA features, none mentioned dactylitis or enthesitis. GP awareness of associated extraarticular manifestations was low. Most GP expressed that (practical) referral measures would be useful. GP are aware of "classic", but longterm features of axSpA. Knowledge about the disease spectrum and early detection is, however, limited. Addressing these issues in training programs may improve recognition of axSpA in primary care. This may ultimately contribute to earlier referral, diagnosis, and initiation of effective treatment in patients with axSpA.

Using qualitative methods in developing an instrument to identify barriers to self-care among persons with type 2 diabetes mellitus.

PubMed

Caro-Bautista, Jorge; Martín-Santos, Francisco Javier; Villa-Estrada, Francisca; Morilla-Herrera, Juan Carlos; Cuevas-Fernández-Gallego, Magdalena; Morales-Asencio, José Miguel

2015-04-01

To develop a questionnaire to address barriers and self-care behaviour among persons with type 2 diabetes mellitus. Several instruments are available in the literature to measure barriers to self-care in this population, but many of them present limitations in its psychometric validation process, and lack of theoretical background. Content validation study using multiple qualitative methods. A systematic review was conducted, and two focus groups with fifteen participants (n = 15) were analysed to identify key topics and categories concerning barriers and self-care behaviour. These categories were used to generate items that were subjected to expert scrutiny, using the Delphi technique. The resulting list of items was tested for readability and comprehension by nine diabetic patients (n = 9), through cognitive interviews. The whole process was conducted in accordance with the Theory of Planned Behaviour. The mean age (standard deviation) of participants in the focus groups and cognitive interviews was 66·05 (8·47) and 63·11 (6·13) years, respectively. 46·7% of the members of the focus groups and 44·4% of those interviewed were female, and the mean duration (standard deviation) of their diabetes was 6·53 (3·17) and 4·89 (3·84) years, respectively. After the qualitative analysis, 27 codes were obtained. Thereafter, items were generated in accordance with the dimensions of this theory: attitudes towards the behaviour (n = 23), social norms (n = 13), perceived behavioural control (n = 17) and behavioural intention (n = 15). A rigorous process of content validation with multiple methods was implemented to obtain an instrument aimed at addressing barriers and self-care behaviour of patients with type 2 Diabetes Mellitus. An instrument theoretically rooted and supported on professional and patients' views is available to assess self-care behaviours in patients with type 2 Diabetes Mellitus. The evaluation of its reliability and construct validity will determine

Factors affecting ethical behavior in pediatric occupational therapy: A qualitative study

PubMed Central

Kalantari, Minoo; Kamali, Mohammad; Joolaee, Soodabeh; Shafarodi, Narges; Rassafiani, Mehdi

2015-01-01

Background: It is the responsibility of each occupational therapist to always act ethically and professionally in a clinical setting. However, there is little information available concerning the factors influencing ethical behavior of occupational therapists at work. Since no study has been conducted in Iran on this topic, this qualitative study aimed to identify the factors influencing ethical behavior of pediatric occupational therapists. Methods: Twelve pediatric occupational therapists participated in this study. The sampling was purposeful, and the interviews continued until reaching data saturation. All interviews were recorded and transcribed. The data were analyzed by qualitative content analysis, and the ethics of qualitative research was considered. Results: The factors influencing ethical behavior were classified into four main categories including organizational factors, therapist related factors, client’s family issues, and social factors. Conclusion: This study identified numerous factors influencing the ethical behavior of pediatric occupational therapists that could be used to train occupational therapists, human resources managers, professional policy makers, and could also be used to conduct future researches, and produce tools. PMID:26913245

What perceptions do patients have of decision making (DM)? Toward an integrative patient-centered care model. A qualitative study using focus-group interviews.

PubMed

Moreau, Alain; Carol, Laurent; Dedianne, Marie Cécile; Dupraz, Christian; Perdrix, Corinne; Lainé, Xavier; Souweine, Gilbert

2012-05-01

To understand patients' perceptions of decision making and identify relationships among decision-making models. This qualitative study was made up of four focus group interviews (elderly persons, users of health support groups, students, and rural inhabitants). Participants were asked to report their perceptions of decision making in three written clinical scenarios (hypertension, breast cancer, prostate cancer). The analysis was based on the principles of grounded theory. Most patients perceived decision making as shared decision making, a deliberative question-response interaction with the physician that allowed patients to be experts in obtaining clearer information, participating in the care process, and negotiating compromises with physician preferences. Requesting second opinions allowed patients to maintain control, even within the paternalistic model preferred by elderly persons. Facilitating factors (trust, qualitative non-verbal communication, time to think) and obstacles (serious/emergency situations, perceived inadequate scientific competence, problems making requests, fear of knowing) were also part of shared decision making. In the global concept of patient-centered care, shared decision making can be flexible and can integrate paternalistic and informative models. Physicians' expertise should be associated with biomedical and relational skills through listening to, informing, and advising patients, and by supporting patients' choices. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study.

PubMed

Jackson, Cath; Dyson, Lisa; Bedford, Helen; Cheater, Francine M; Condon, Louise; Crocker, Annie; Emslie, Carol; Ireland, Lana; Kemsley, Philippa; Kerr, Susan; Lewis, Helen J; Mytton, Julie; Overend, Karen; Redsell, Sarah; Richardson, Zoe; Shepherd, Christine; Smith, Lesley

2016-09-01

Gypsies, Travellers and Roma (referred to as Travellers) are less likely to access health services, including immunisation. To improve immunisation rates, we need to understand what helps and hinders individuals in these communities in taking up immunisations. (1) Investigate the barriers to and facilitators of acceptability and uptake of immunisations among six Traveller communities across four UK cities; and (2) identify possible interventions to increase uptake of immunisations in these Traveller communities that could be tested in a subsequent feasibility study. Three-phase qualitative study underpinned by the social ecological model. Phase 1: interviews with 174 Travellers from six communities: Romanian Roma (Bristol); English Gypsy/Irish Traveller (Bristol); English Gypsy (York); Romanian/Slovakian Roma (Glasgow); Scottish Showpeople (Glasgow); and Irish Traveller (London). Focus on childhood and adult vaccines. Phase 2: interviews with 39 service providers. Data were analysed using the framework approach. Interventions were identified using a modified intervention mapping approach. Phase 3: 51 Travellers and 25 service providers attended workshops and produced a prioritised list of potentially acceptable and feasible interventions. There were many common accounts of barriers and facilitators across communities, particularly across the English-speaking communities. Scottish Showpeople were the most similar to the general population. Roma communities experienced additional barriers of language and being in a new country. Men, women and service providers described similar barriers and facilitators. There was widespread acceptance of childhood and adult immunisation, with current parents perceived as more positive than their elders. A minority of English-speaking Travellers worried about multiple/combined childhood vaccines, adult flu and whooping cough. Cultural concerns about vaccines offered during pregnancy and about human papillomavirus were most evident in

Methodology Series Module 10: Qualitative Health Research

PubMed Central

Setia, Maninder Singh

2017-01-01

Although quantitative designs are commonly used in clinical research, some studies require qualitative methods. These designs are different from quantitative methods; thus, researchers should be aware of data collection methods and analyses for qualitative research. Qualitative methods are particularly useful to understand patient experiences with the treatment or new methods of management or to explore issues in detail. These methods are useful in social and behavioral research. In qualitative research, often, the main focus is to understand the issue in detail rather than generalizability; thus, the sampling methods commonly used are purposive sampling; quota sampling; and snowball sampling (for hard to reach groups). Data can be collected using in-depth interviews (IDIs) or focus group discussions (FGDs). IDI is a one-to-one interview with the participant. FGD is a method of group interview or discussion, in which more than one participant is interviewed at the same time and is usually led by a facilitator. The commonly used methods for data analysis are: thematic analysis; grounded theory analysis; and framework analysis. Qualitative data collection and analysis require special expertise. Hence, if the reader plans to conduct qualitative research, they should team up with a qualitative researcher. PMID:28794545

Methodology Series Module 10: Qualitative Health Research.

PubMed

Setia, Maninder Singh

2017-01-01

Although quantitative designs are commonly used in clinical research, some studies require qualitative methods. These designs are different from quantitative methods; thus, researchers should be aware of data collection methods and analyses for qualitative research. Qualitative methods are particularly useful to understand patient experiences with the treatment or new methods of management or to explore issues in detail. These methods are useful in social and behavioral research. In qualitative research, often, the main focus is to understand the issue in detail rather than generalizability; thus, the sampling methods commonly used are purposive sampling; quota sampling; and snowball sampling (for hard to reach groups). Data can be collected using in-depth interviews (IDIs) or focus group discussions (FGDs). IDI is a one-to-one interview with the participant. FGD is a method of group interview or discussion, in which more than one participant is interviewed at the same time and is usually led by a facilitator. The commonly used methods for data analysis are: thematic analysis; grounded theory analysis; and framework analysis. Qualitative data collection and analysis require special expertise. Hence, if the reader plans to conduct qualitative research, they should team up with a qualitative researcher.

The Effect of Positive Group Psychotherapy and Motivational Interviewing on Smoking Cessation: A Qualitative Descriptive Study.

PubMed

Lee, Eun Jin

The purpose of this study was to describe the process and evaluate the effect of positive group psychotherapy and motivational interviewing as an intervention for smoking cessation. A qualitative descriptive study was conducted at a university in South Korea. Positive group psychotherapy and motivational interviewing were attended by 36 smokers for 1 hour once a week, for 6 hours. A recorded exit interview was conducted after the intervention. The resulting transcripts were analyzed with content analysis and thematic analysis. Among the 36 study participants, the importance of stopping smoking was rated higher in the successful cessation (defined as those who ceased smoking for at least 3 months; hereafter, success group) group (8.6 ± 0.4, n = 10) than in the failed cessation (defined as those who did not cease smoking for at least 3 months; hereafter, failure group) group (7.75 ± 0.3, n = 26; p < .01). The confidence to stop smoking was rated higher by the successes (8.4 ± 0.3) than by the failures (5.5 ± 0.4; p < .01). More successes wanted to stop smoking for the sake of their loved ones (60%) and health (50%), whereas more failures wanted to stop smoking for saving money (45.5%). Failures had more cross-addiction than successes (three to four addictions: 31.5% vs. 20%). When participants were asked to find 10 personality merits, 78% of the successes and 47% of the failures found their 10 merits. The therapeutic process was described as "sharing the smoking cessation process with others," "detailed guidance for stress management and smoking cessation," and "compliments about efforts for smoking cessation." The importance of and confidence in smoking cessation were predictors for successful cessation for 3-6 months. Motivational interviewing increased motivations, whereas positive group psychotherapy increased positive thoughts and confidence.

"They Think I Am a Pervert:" a Qualitative Analysis of Lesbian and Gay Teachers' Experiences with Stress at School

ERIC Educational Resources Information Center

Lineback, Sally; Allender, Molly; Gaines, Rachel; McCarthy, Christopher J.; Butler, Andrea

2016-01-01

Qualitative methodologies were used to identify the demands and resources lesbian and gay (LG) teachers face in their schools. Data sources included 2 interviews each with 11 teachers who each identified as lesbian or gay. Analyses of interview data indicated 3 main findings. First, although all teachers experienced demands because of their sexual…

Online interviewing with interpreters in humanitarian contexts.

PubMed

Chiumento, Anna; Machin, Laura; Rahman, Atif; Frith, Lucy

2018-12-01

Recognising that one way to address the logistical and safety considerations of research conducted in humanitarian emergencies is to use internet communication technologies to facilitate interviews online, this article explores some practical and methodological considerations inherent to qualitative online interviewing. Reflections from a case study of a multi-site research project conducted in post-conflict countries are presented.  Synchronous online cross-language qualitative interviews were conducted in one country.  Although only a small proportion of interviews were conducted online (six out of 35), it remains important to critically consider the impact upon data produced in this way. A range of practical and methodological considerations are discussed, illustrated with examples.  Results suggest that whilst online interviewing has methodological and ethical potential and versatility, there are inherent practical challenges in settings with poor internet and electricity infrastructure.  Notable methodological limitations include barriers to building rapport due to partial visual and non-visual cues, and difficulties interpreting pauses or silences. Drawing upon experiences in this case study, strategies for managing the practical and methodological limitations of online interviewing are suggested, alongside recommendations for supporting future research practice.  These are intended to act as a springboard for further reflection, and operate alongside other conceptual frameworks for online interviewing.

Fostering sustainability: A qualitative interview study exploring how educators work to cultivate nature awareness in young children

NASA Astrophysics Data System (ADS)

Keller, Rebecca A.

The purpose of this study is to examine how educators are working to foster sustainability through cultivating nature awareness in young children. Data were collected in the form of qualitative semi-structured interviews, which were analyzed using descriptive and deductive coding methods. Findings were viewed through the lens of critical pedagogy and the methods and models of teaching for nature awareness, which included ecological literacy, place based education, and education for sustainable development. There were five major themes and findings that emerged from the interviews with the participants in this study: terms and definitions used, personal stories, strategies for teaching nature awareness and sustainability, barriers, and current issues. This study may benefit those wishing to begin or continue to foster sustainability through teaching nature awareness. The literature review presented in the study aims to address the gap between the practice and pedagogy in teaching for nature awareness and sustainability. Keywords: teaching, nature awareness, sustainability, educators, young children, elementary, preschool, school, natural world, ecological literacy, place-based education, education for sustainable development, critical pedagogy

Interviewer as instrument: accounting for human factors in evaluation research.

PubMed

Brown, Joel H

2006-04-01

This methodological study examines an original data collection model designed to incorporate human factors and enhance data richness in qualitative and evaluation research. Evidence supporting this model is drawn from in-depth youth and adult interviews in one of the largest policy/program evaluations undertaken in the United States, the Drug, Alcohol, and Tobacco Education evaluation (77 districts, 118 schools). When applying the explicit observation technique (EOT)--the strategic and nonjudgmental disclosure of nonverbal human factor cues by the interviewer to the respondent during interview--data revealed the observation disclosure pattern. Here, respondents linked perceptions with policy or program implementation or effectiveness evidence. Although more research is needed, it is concluded that the EOT yields richer data when compared with traditional semistructured interviews and, thus, holds promise to enhance qualitative and evaluation research methods. Validity and reliability as well as qualitative and evaluation research considerations are discussed.

What does physicians' clinical expertise contribute to oncologic decision-making? A qualitative interview study.

PubMed

Salloch, Sabine; Otte, Ina; Reinacher-Schick, Anke; Vollmann, Jochen

2018-02-01

Physicians' clinical expertise forms an exclusive body of competences, which helps them to find the appropriate diagnostics and treatment for each individual patient. Empirical evidence, however, suggests that there is an inverse relationship between the number of years in practice and the quality of care provided by a physician. Knowledge and adherence to professional standards (such as clinical guidelines) are often used as indicators in previous research. Semistructured interviews and the Q method were used for an explorative study on oncologists' views on the interplay between their own clinical expertise, intuition, and the external evidence incorporated in clinical guidelines. The interviews were audio recorded, transcribed ad verbatim, and analysed using qualitative content analysis. Data analysis shows the complex character of clinical expertise with respect to experience, professional development, and intuition. An irreplaceable role is attributed to personal and bodily experience during the providing of care for a patient. Professional experience becomes important, particularly in those situations that lie out of the focus of "guideline medicine." Intuition is regarded as having a strong emotional component and helps for deciding which therapeutic option the patient can deal with. Using measurable knowledge and adherence to standards as indicators does not account for the complexity of clinical expertise. Other factors, such as the importance of bodily experience and physicians' intuitive knowledge, must be considered, also with respect to the occurrence of treatment biases. © 2017 John Wiley & Sons, Ltd.

Bereaved relatives’ experiences during the incurable phase of cancer: a qualitative interview study

PubMed Central

Wijnhoven, Marleen N; Terpstra, Wim E; van Rossem, Ronald; Haazer, Carolien; Gunnink-Boonstra, Nicolette; Sonke, Gabe S; Buiting, Hilde M

2015-01-01

Objective To examine bereaved relatives’ experiences from time of diagnosis of incurable cancer until death with specific emphasis on their role in the (end-of-life) decision-making concerning chemotherapy. Design Qualitative interview study. Setting Hospital-based. Participants and methods In-depth interviews with 15 close relatives of patients who died from non-small cell lung cancer or pancreatic cancer, using a thematic content analysis. Results All relatives reported that patients’ main reason to request chemotherapy was the possibility to prolong life. Relatives reported that patients receiving chemotherapy had more difficulty to accept the incurable nature of their disease than patients who did not. They mostly followed the patients’ treatment wish and only infrequently suggested ceasing chemotherapy (because of side effects) despite sometimes believing that this would be a better option. Relatives continuously tried to support the patient in either approaching the death or in attaining hope to continue life satisfactorily. Most relatives considered the chemotherapy period meaningful, since it sparked patients’ hope and was what patients wanted. Cessation of chemotherapy caused a relief but coincided with physical deterioration and an increased caregivers’ role; many relatives recalled this latter period as more burdensome. Conclusions Relatives tend to follow patients’ wish to continue or cease chemotherapy, without expressing their own feelings, although they were more inclined to opt cessation. They experience a greater caregiver role after cessation and their feelings of responsibility associated with the disease can be exhausting. More attention is needed to reduce relatives’ distress at the end of life, also to fully profit from this crucial form of (informal) healthcare. PMID:26608635

Unmet health needs identified by Haitian women as priorities for attention: a qualitative study.

PubMed

Peragallo Urrutia, Rachel; Merisier, Delson; Small, Maria; Urrutia, Eugene; Tinfo, Nicole; Walmer, David K

2012-06-01

This 2009 qualitative study investigated Haitian women's most pressing health needs, barriers to meeting those needs and proposed solutions, and how they thought the community and outside organizations should be involved in addressing their needs. The impetus for the study was to get community input into the development of a Family Health Centre in Leogane, Haiti. Individual interviews and focus group discussions were conducted with 52 adult women in six communities surrounding Leogane. The most pressing health needs named by the women were accessible, available and affordable health care, potable water, enough food to eat, improved economy, employment, sanitation and education, including health education. Institutional corruption, lack of infrastructure and social organization, the cost of health care, distance from services and lack of transport as barriers to care were also important themes. The involvement of foreign organizations and local community groups, including grassroots women's groups who would work in the best interests of other women, were identified as the most effective solutions. Organizations seeking to improve women's health care in Haiti should develop services and interventions that prioritize community partnership and leadership, foster partnerships with government, and focus on public health needs. Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

How and when do expert emergency physicians generate and evaluate diagnostic hypotheses? A qualitative study using head-mounted video cued-recall interviews.

PubMed

Pelaccia, Thierry; Tardif, Jacques; Triby, Emmanuel; Ammirati, Christine; Bertrand, Catherine; Dory, Valérie; Charlin, Bernard

2014-12-01

The ability to make a diagnosis is a crucial skill in emergency medicine. Little is known about the way emergency physicians reach a diagnosis. This study aims to identify how and when, during the initial patient examination, emergency physicians generate and evaluate diagnostic hypotheses. We carried out a qualitative research project based on semistructured interviews with emergency physicians. The interviews concerned management of an emergency situation during routine medical practice. They were associated with viewing the video recording of emergency situations filmed in an "own-point-of-view" perspective. The emergency physicians generated an average of 5 diagnostic hypotheses. Most of these hypotheses were generated before meeting the patient or within the first 5 minutes of the meeting. The hypotheses were then rank ordered within the context of a verification procedure based on identifying key information. These tasks were usually accomplished without conscious effort. No hypothesis was completely confirmed or refuted until the results of investigations were available. The generation and rank ordering of diagnostic hypotheses is based on the activation of cognitive processes, enabling expert emergency physicians to process environmental information and link it to past experiences. The physicians seemed to strive to avoid the risk of error by remaining aware of the possibility of alternative hypotheses as long as they did not have the results of investigations. Understanding the diagnostic process used by emergency physicians provides interesting ideas for training residents in a specialty in which the prevalence of reasoning errors leading to incorrect diagnoses is high. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

“We can’t get along without each other”: Qualitative interviews with physicians about device industry representatives, conflict of interest and patient safety

PubMed Central

Lehoux, Pascale; Ducey, Ariel; Easty, Anthony; Ross, Sue; Bell, Chaim; Trbovich, Patricia

2017-01-01

Objectives Physician relationships with device industry representatives have not been previously assessed. This study explored interactions with device industry representatives among physicians who use implantable cardiovascular and orthopedic devices to identify whether conflict of interest (COI) is a concern and how it is managed. Design A descriptive qualitative approach was used. Physicians who implant orthopedic and cardiovascular devices were identified in publicly available directories and web sites, and interviewed about their relationships with device industry representatives. Sampling was concurrent with data collection and analysis. Data were analyzed and discussed using constant comparative technique by all members of the research team. Results Twenty-two physicians (10 cardiovascular, 12 orthopedic) were interviewed. Ten distinct representative roles were identified: purchasing, training, trouble-shooting, supplying devices, assisting with device assembly and insertion, supporting operating room staff, mitigating liability, conveying information about recalls, and providing direct and indirect financial support. Participants recognized the potential for COI but representatives were present for the majority of implantations. Participants revealed a tension between physicians and representatives that was characterized as “symbiotic”, but required physicians to be vigilant about COI and patient safety, particularly because representatives varied regarding disclosure of device defects. They described a concurrent tension between hospitals, whose policies and business practices were focused on cost-control, and physicians who were required to comply with those policies and use particular devices despite concerns about their safety and effectiveness. Conclusions Given the potential for COI and threats to patient safety, further research is needed to establish the clinical implications of the role of, and relationship with device industry representatives

Meta-Analysis: An Approach to Interview Success.

ERIC Educational Resources Information Center

McCaslin, Mark; Carlson, Nancy M.

An initial research step, developing an effective interview strategy, presents unique challenges for novice and master research alike. To focus qualitative research in the human ecology of the study, the strategy presented in this paper used an initial interview protocol and preanalysis process, called meta-analysis, prior to developing the formal…

Implementation of a Medication Reconciliation Assistive Technology: A Qualitative Analysis

PubMed Central

Wright, Theodore B.; Adams, Kathleen; Church, Victoria L.; Ferraro, Mimi; Ragland, Scott; Sayers, Anthony; Tallett, Stephanie; Lovejoy, Travis; Ash, Joan; Holahan, Patricia J.; Lesselroth, Blake J.

2017-01-01

Objective: To aid the implementation of a medication reconciliation process within a hybrid primary-specialty care setting by using qualitative techniques to describe the climate of implementation and provide guidance for future projects. Methods: Guided by McMullen et al’s Rapid Assessment Process1, we performed semi-structured interviews prior to and iteratively throughout the implementation. Interviews were coded and analyzed using grounded theory2 and cross-examined for validity. Results: We identified five barriers and five facilitators that impacted the implementation. Facilitators identified were process alignment with user values, and motivation and clinical champions fostered by the implementation team rather than the administration. Barriers included a perceived limited capacity for change, diverging priorities, and inconsistencies in process standards and role definitions. Discussion: A more complete, qualitative understanding of existing barriers and facilitators helps to guide critical decisions on the design and implementation of a successful medication reconciliation process. PMID:29854251

'Two sides of the coin'--the value of personal continuity to GPs: a qualitative interview study.

PubMed

Ridd, Matthew; Shaw, Alison; Salisbury, Chris

2006-08-01

Continuity is thought to be important to GPs but the values behind this are unknown. To explore the values that doctors working in general practice attach to continuity of patient care and to outline how these values are applied in practice. In-depth qualitative interview with 24 GPs in England. Participants were purposefully sampled according to personal and practice characteristics. Analysis was thematic, drawing on the constant comparative method. The majority of doctors valued doctor-patient, or personal, continuity in their everyday work. It was most valued in patients with serious, complex or psychological problems. GPs believed that through their personal knowledge of the patient and the doctor-patient relationship, personal continuity enabled them to provide higher quality care. However, the benefits of personal continuity were balanced against problems, and GPs identified personal, professional and external constraints that limited its provision. GPs seemed to have resolved the tension between the benefits, limits and constraints they described by accepting an increased reliance on continuity being provided within teams. Personal continuity may offer important benefits to doctors and patients, but we do not know how unique its values are. In particular, it is not clear whether the same benefits can be achieved within teams, the level at which continuity is increasingly being provided. The relative advantages and limits of the different means of delivering continuity need to be better understood, before further policy changes that affect personal continuity are introduced.

Gender-related aspects of transmasculine people's vocal situations: insights from a qualitative content analysis of interview transcripts.

PubMed

Azul, David

2016-11-01

Transmasculine people assigned female gender at birth but who do not identify with this classification have traditionally received little consideration in the voice literature. Existing analyses tend to be focused on evaluating speaker voice characteristics, whereas other factors that contribute to the production of vocal gender have remained underexplored. Most studies rely on researcher-centred perspectives, whereas very little is known about how transmasculine people themselves experience and make sense of their vocal situations. To explore how participants described their subjective gender positionings; which gender attributions they wished to receive from others; which gender they self-attributed to their voices; which gender attributions they had received from others; and how far participants were satisfied with the gender-related aspects of their vocal situations. Transcripts of semi-structured interviews with 14 German-speaking transmasculine people served as the original data corpus. Sections in which participants described the gender-related aspects of their vocal situations and that were relevant to the current research objectives were selected and explored using qualitative content analysis. The analysis revealed diverse accounts pertaining to the factors that contribute to the production of vocal gender for individual participants and variable levels of satisfaction with vocal gender presentation and attribution. Transmasculine people need to be regarded as a heterogeneous population and clinical practice needs to follow a client-centred, individualized approach. © 2016 Royal College of Speech and Language Therapists.

A description of the "event manager" role in resuscitations: A qualitative study of interviews and focus groups of resuscitation participants.

PubMed

Taylor, Katherine L; Parshuram, Christopher S; Ferri, Susan; Mema, Briseida

2017-06-01

Communication during resuscitation is essential for the provision of coordinated, effective care. Previously, we observed 44% of resuscitation communication originated from participants other than the physician team leader; 65% of which was directed to the team, exclusive of the team leader. We called this outer-loop communication. This institutional review board-approved qualitative study used grounded theory analysis of focus groups and interviews to describe and define outer-loop communication and the role of "event manager" as an additional "leader." Participants were health care staff involved in the medical management of resuscitations in a quaternary pediatric academic hospital. The following 3 domains were identified: the existence and rationale of outer-loop communication; the functions fulfilled by outer-loop communication; and the leadership and learning of event manager skills. The role was recognized by all team members and evolved organically as resuscitation complexity increased. A "good" manager has similar qualities to a "good team leader" with strong nontechnical skills. Event managers were not formally identified and no specific training had occurred. "Outer-loop" communication supports resuscitation activities. An event manager gives direction to the team, coordinates activities, and supports the team leader. We describe a new role in resuscitation in light of structural organizational theory and cognitive load with a view to incorporating this structure into resuscitation training. Copyright © 2017 Elsevier Inc. All rights reserved.

Online interviewing with interpreters in humanitarian contexts

PubMed Central

Chiumento, Anna; Rahman, Atif; Frith, Lucy

2018-01-01

ABSTRACT Purpose: Recognising that one way to address the logistical and safety considerations of research conducted in humanitarian emergencies is to use internet communication technologies to facilitate interviews online, this article explores some practical and methodological considerations inherent to qualitative online interviewing. Method: Reflections from a case study of a multi-site research project conducted in post-conflict countries are presented.  Synchronous online cross-language qualitative interviews were conducted in one country.  Although only a small proportion of interviews were conducted online (six out of 35), it remains important to critically consider the impact upon data produced in this way. Results: A range of practical and methodological considerations are discussed, illustrated with examples.  Results suggest that whilst online interviewing has methodological and ethical potential and versatility, there are inherent practical challenges in settings with poor internet and electricity infrastructure.  Notable methodological limitations include barriers to building rapport due to partial visual and non-visual cues, and difficulties interpreting pauses or silences. Conclusions: Drawing upon experiences in this case study, strategies for managing the practical and methodological limitations of online interviewing are suggested, alongside recommendations for supporting future research practice.  These are intended to act as a springboard for further reflection, and operate alongside other conceptual frameworks for online interviewing. PMID:29532739

Lesbians with Physical Disabilities: A Qualitative Study of Their Experiences with Counseling

ERIC Educational Resources Information Center

Hunt, Brandon; Matthews, Connie; Milsom, Amy; Lammel, Julie A.

2006-01-01

The authors interviewed 25 lesbians with physical disabilities about their counseling experiences. Using a phenomenological qualitative approach, the authors identified 9 themes. Five themes addressed participants' perceptions of their counselors: general satisfaction or dissatisfaction, counselors' general effectiveness, counselors' awareness and…

Overcoming Barriers to Skills Training in Borderline Personality Disorder: A Qualitative Interview Study.

PubMed

Barnicot, Kirsten; Couldrey, Laura; Sandhu, Sima; Priebe, Stefan

2015-01-01

Despite evidence suggesting that skills training is an important mechanism of change in dialectical behaviour therapy, little research exploring facilitators and barriers to this process has been conducted. The study aimed to explore clients' experiences of barriers to dialectical behaviour therapy skills training and how they felt they overcame these barriers, and to compare experiences between treatment completers and dropouts. In-depth qualitative interviews were conducted with 40 clients with borderline personality disorder who had attended a dialectical behaviour therapy programme. A thematic analysis of participants' reported experiences found that key barriers to learning the skills were anxiety during the skills groups and difficulty understanding the material. Key barriers to using the skills were overwhelming emotions which left participants feeling unable or unwilling to use them. Key ways in which participants reported overcoming barriers to skills training were by sustaining their commitment to attending therapy and practising the skills, personalising the way they used them, and practising them so often that they became an integral part of their behavioural repertoire. Participants also highlighted a number of key ways in which they were supported with their skills training by other skills group members, the group therapists, their individual therapist, friends and family. Treatment dropouts were more likely than completers to describe anxiety during the skills groups as a barrier to learning, and were less likely to report overcoming barriers to skills training via the key processes outlined above. The findings of this qualitative study require replication, but could be used to generate hypotheses for testing in further research on barriers to skills training, how these relate to dropout, and how they can be overcome. The paper outlines several such suggestions for further research.

Overcoming Barriers to Skills Training in Borderline Personality Disorder: A Qualitative Interview Study

PubMed Central

Barnicot, Kirsten; Couldrey, Laura; Sandhu, Sima; Priebe, Stefan

2015-01-01

Despite evidence suggesting that skills training is an important mechanism of change in dialectical behaviour therapy, little research exploring facilitators and barriers to this process has been conducted. The study aimed to explore clients’ experiences of barriers to dialectical behaviour therapy skills training and how they felt they overcame these barriers, and to compare experiences between treatment completers and dropouts. In-depth qualitative interviews were conducted with 40 clients with borderline personality disorder who had attended a dialectical behaviour therapy programme. A thematic analysis of participants’ reported experiences found that key barriers to learning the skills were anxiety during the skills groups and difficulty understanding the material. Key barriers to using the skills were overwhelming emotions which left participants feeling unable or unwilling to use them. Key ways in which participants reported overcoming barriers to skills training were by sustaining their commitment to attending therapy and practising the skills, personalising the way they used them, and practising them so often that they became an integral part of their behavioural repertoire. Participants also highlighted a number of key ways in which they were supported with their skills training by other skills group members, the group therapists, their individual therapist, friends and family. Treatment dropouts were more likely than completers to describe anxiety during the skills groups as a barrier to learning, and were less likely to report overcoming barriers to skills training via the key processes outlined above. The findings of this qualitative study require replication, but could be used to generate hypotheses for testing in further research on barriers to skills training, how these relate to dropout, and how they can be overcome. The paper outlines several such suggestions for further research. PMID:26465757

Development of an Interview Guide Identifying the Rehabilitation Needs of Women from the Middle East Living with Chronic Pain.

PubMed

Zander, Viktoria; Eriksson, Henrik; Christensson, Kyllike; Müllersdorf, Maria

2015-09-25

The purpose of this study was to develop an interview guide for use by primary healthcare professionals to support them in identifying the rehabilitation needs of forced resettled women from the Middle East living with chronic pain. Previous findings together with the existing literature were used as the basis for developing the interview guide in three steps: item generation, cognitive interviews, and a pilot study. The study resulted in a 16-item interview guide focusing on patients' concerns and expectations, with consideration of pre-migration, migration, and post-migration factors that might affect their health. With the help of the guide, patients were also invited to identify difficulties in their daily activities and to take part in setting goals and planning their rehabilitation. The current interview guide provides professional guidance to caretakers, taking a person-centered participative point of departure when meeting and planning care, for and together, with representatives from dispersed ethnic populations in Sweden. It can be used together with the patient by all staff members working in primary healthcare, with the aim of contributing to continuity of care and multi-professional collaboration.

Development of an Interview Guide Identifying the Rehabilitation Needs of Women from the Middle East Living with Chronic Pain

PubMed Central

Zander, Viktoria; Eriksson, Henrik; Christensson, Kyllike; Müllersdorf, Maria

2015-01-01

The purpose of this study was to develop an interview guide for use by primary healthcare professionals to support them in identifying the rehabilitation needs of forced resettled women from the Middle East living with chronic pain. Previous findings together with the existing literature were used as the basis for developing the interview guide in three steps: item generation, cognitive interviews, and a pilot study. The study resulted in a 16-item interview guide focusing on patients’ concerns and expectations, with consideration of pre-migration, migration, and post-migration factors that might affect their health. With the help of the guide, patients were also invited to identify difficulties in their daily activities and to take part in setting goals and planning their rehabilitation. The current interview guide provides professional guidance to caretakers, taking a person-centered participative point of departure when meeting and planning care, for and together, with representatives from dispersed ethnic populations in Sweden. It can be used together with the patient by all staff members working in primary healthcare, with the aim of contributing to continuity of care and multi-professional collaboration. PMID:26404332

Identifying priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India: a qualitative inquiry

PubMed Central

Chamania, Shobha; Potokar, Tom; Ivers, Rebecca

2018-01-01

Objectives This study aimed to identify priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India. Design Qualitative inquiry; data were collected through semistructured in-depth interviews and focus group discussions. Setting Nine sites in urban and rural settings across India, through primary, secondary and tertiary health facilities. Participants Healthcare providers, key informants, burns survivors and/or their carers. Results Participants acknowledged the challenges of burns care and recovery, and identified the need for prolonged rehabilitation. Challenges identified included poor communication between healthcare providers and survivors, limited rehabilitation services, difficulties with transportation to health facility and high cost associated with burns care. Burns survivors and healthcare providers identified the stigma attached with burns as the biggest challenge within the healthcare system, as well as in the community. Systems barriers (eg, limited infrastructure and human resources), lack of economic and social support, and poor understanding of recovery and rehabilitation were identified as major barriers to recovery. Conclusions Though further research is needed for addressing gaps in data, strengthening of health systems can enable providers to address issues such as developing/providing, protocols, capacity building, effective coordination between key organisations and referral networks. PMID:29523568

Qualitative Analysis of Cognitive Interviews With School Children: A Web-Based Food Intake Questionnaire

PubMed Central

Kupek, Emil

2016-01-01

Background The use of computers to administer dietary assessment questionnaires has shown potential, particularly due to the variety of interactive features that can attract and sustain children’s attention. Cognitive interviews can help researchers to gain insights into how children understand and elaborate their response processes in this type of questionnaire. Objective To present the cognitive interview results of children who answered the WebCAAFE, a Web-based questionnaire, to obtain an in-depth understanding of children’s response processes. Methods Cognitive interviews were conducted with children (using a pretested interview script). Analyses were carried out using thematic analysis within a grounded theory framework of inductive coding. Results A total of 40 children participated in the study, and 4 themes were identified: (1) the meaning of words, (2) understanding instructions, (3) ways to resolve possible problems, and (4) suggestions for improving the questionnaire. Most children understood questions that assessed nutritional intake over the past 24 hours, although the structure of the questionnaire designed to facilitate recall of dietary intake was not always fully understood. Younger children (7 and 8 years old) had more difficulty relating the food images to mixed dishes and foods eaten with bread (eg, jam, cheese). Children were able to provide suggestions for improving future versions of the questionnaire. Conclusions More attention should be paid to children aged 8 years or below, as they had the greatest difficulty completing the WebCAAFE. PMID:27895005

Qualitative to quantitative: linked trajectory of method triangulation in a study on HIV/AIDS in Goa, India.

PubMed

Bailey, Ajay; Hutter, Inge

2008-10-01

With 3.1 million people estimated to be living with HIV/AIDS in India and 39.5 million people globally, the epidemic has posed academics the challenge of identifying behaviours and their underlying beliefs in the effort to reduce the risk of HIV transmission. The Health Belief Model (HBM) is frequently used to identify risk behaviours and adherence behaviour in the field of HIV/AIDS. Risk behaviour studies that apply HBM have been largely quantitative and use of qualitative methodology is rare. The marriage of qualitative and quantitative methods has never been easy. The challenge is in triangulating the methods. Method triangulation has been largely used to combine insights from the qualitative and quantitative methods but not to link both the methods. In this paper we suggest a linked trajectory of method triangulation (LTMT). The linked trajectory aims to first gather individual level information through in-depth interviews and then to present the information as vignettes in focus group discussions. We thus validate information obtained from in-depth interviews and gather emic concepts that arise from the interaction. We thus capture both the interpretation and the interaction angles of the qualitative method. Further, using the qualitative information gained, a survey is designed. In doing so, the survey questions are grounded and contextualized. We employed this linked trajectory of method triangulation in a study on the risk assessment of HIV/AIDS among migrant and mobile men. Fieldwork was carried out in Goa, India. Data come from two waves of studies, first an explorative qualitative study (2003), second a larger study (2004-2005), including in-depth interviews (25), focus group discussions (21) and a survey (n=1259). By employing the qualitative to quantitative LTMT we can not only contextualize the existing concepts of the HBM, but also validate new concepts and identify new risk groups.

Mothers' perceptions of their health choices, related duties and responsibilities: A qualitative interview study.

PubMed

Kangasniemi, Mari; Blomberg, Katja; Korhonen, Anne

2015-11-01

to describe mothers' perceptions of their health choices, related duties and responsibilities. descriptive exploratory study with qualitative research method. interviews conducted after the clients' regular health visits to one publicly provided maternity clinic in a southern city in Finland. 13 mothers aged between 21 and 40-years-old, who were pregnant or had given birth in the past four weeks. Six of participants were pregnant or had delivered for first time and it was the second to fourth pregnancy for the remainder. one-to-one semi-structured interviews using the inductive content analysis method. women reported increased responsibility for their health choices for themselves and their baby during pregnancy. However, their duties and responsibilities were seldom discussed at maternity clinics. The duty to reconsider their health choices was described as a predictor of commitment to their pregnancy and motherhood, but they recognised that it required sufficient knowledge to realise this. In addition, the mothers said their health choices changed from private to one of public interest during this period. health choices are connected to maternal duties and responsibilities, but they can sometimes lack clarity during this new phase of life. In future, more research should be conducted to study maternal duties and responsibilities in different contexts. findings highlight the skills of nurses and midwives at maternity clinics to discuss and support mothers' moral pondering during pregnancy. Although health choices in general are well recognised as a part of maternal counselling, these findings suggest a moral perspective should be incorporated into the advice that is provided. Copyright © 2015 Elsevier Ltd. All rights reserved.

Patients' views and needs about systemic sclerosis and its management: a qualitative interview study.

PubMed

Mouthon, Luc; Alami, Sophie; Boisard, Anne-Sophie; Chaigne, Benjamin; Hachulla, Eric; Poiraudeau, Serge

2017-05-30

Systemic sclerosis (SSc) is a chronic connective-tissue disease responsible for reduced life expectancy, disability and a decreased quality of life. In order to optimize patients-physicians relationship and care strategy we aimed to survey views of patients on SSc and its management to reveal potential hurdles and improve health care strategies. A qualitative study combined semi-structured interviews, focus groups, and a direct observation of an information session was performed between November 2008 and January 2009. Twenty-five patients with SSc were included. They encounter difficulties to have a clear representation of their disease. Physical, psychological, and social repercussions of SSc may lead to a psychological distress and different coping strategies, which widely differ among interviewed patients. Patients' views on their therapeutic journey and the management of their disease highlighted strong expectations about patient-physician relationship. These expectations were numerous, complex and sometimes ambivalent. Patients expected physicians to be human and attentive but also involved in research in the field and to provide psychological and affective support to help them to accept the uncertainty of disease evolution and lack of curative treatment. They also expected more individualized management, improvements in diagnosis and follow-up organization, more efforts in education and information, comprehensive behaviors and support from working colleagues and relatives, and increased funding from the health care system. Our results suggest that SSc management could be optimized, particularly with more attention to the patient-practitioner relationship. Patient profiles should be more precisely defined in terms of coping strategies and treatment preferences to propose more individualized options.

GPs’ perceptions of workload in England: a qualitative interview study

PubMed Central

Croxson, Caroline HD; Ashdown, Helen F; Hobbs, FD Richard

2017-01-01

Background GPs report the lowest levels of morale among doctors, job satisfaction is low, and the GP workforce is diminishing. Workload is frequently cited as negatively impacting on commitment to a career in general practice, and many GPs report that their workload is unmanageable. Aim To gather an in-depth understanding of GPs’ perceptions and attitudes towards workload. Design and setting All GPs working within NHS England were eligible. Advertisements were circulated via regional GP e-mail lists and national social media networks in June 2015. Of those GPs who responded, a maximum-variation sample was selected until data saturation was reached. Method Semi-structured, qualitative interviews were conducted. Data were analysed thematically. Results In total, 171 GPs responded, and 34 were included in this study. GPs described an increase in workload over recent years, with current working days being long and intense, raising concerns over the wellbeing of GPs and patients. Full-time partnership was generally not considered to be possible, and many participants felt workload was unsustainable, particularly given the diminishing workforce. Four major themes emerged to explain increased workload: increased patient needs and expectations; a changing relationship between primary and secondary care; bureaucracy and resources; and the balance of workload within a practice. Continuity of care was perceived as being eroded by changes in contracts and working patterns to deal with workload. Conclusion This study highlights the urgent need to address perceived lack of investment and clinical capacity in general practice, and suggests that managing patient expectations around what primary care can deliver, and reducing bureaucracy, have become key issues, at least until capacity issues are resolved. PMID:28093422

GPs' perceptions of workload in England: a qualitative interview study.

PubMed

Croxson, Caroline Hd; Ashdown, Helen F; Hobbs, Fd Richard

2017-02-01

GPs report the lowest levels of morale among doctors, job satisfaction is low, and the GP workforce is diminishing. Workload is frequently cited as negatively impacting on commitment to a career in general practice, and many GPs report that their workload is unmanageable. To gather an in-depth understanding of GPs' perceptions and attitudes towards workload. All GPs working within NHS England were eligible. Advertisements were circulated via regional GP e-mail lists and national social media networks in June 2015. Of those GPs who responded, a maximum-variation sample was selected until data saturation was reached. Semi-structured, qualitative interviews were conducted. Data were analysed thematically. In total, 171 GPs responded, and 34 were included in this study. GPs described an increase in workload over recent years, with current working days being long and intense, raising concerns over the wellbeing of GPs and patients. Full-time partnership was generally not considered to be possible, and many participants felt workload was unsustainable, particularly given the diminishing workforce. Four major themes emerged to explain increased workload: increased patient needs and expectations; a changing relationship between primary and secondary care; bureaucracy and resources; and the balance of workload within a practice. Continuity of care was perceived as being eroded by changes in contracts and working patterns to deal with workload. This study highlights the urgent need to address perceived lack of investment and clinical capacity in general practice, and suggests that managing patient expectations around what primary care can deliver, and reducing bureaucracy, have become key issues, at least until capacity issues are resolved. © British Journal of General Practice 2017.

Use of strategies to improve retention in primary care randomised trials: a qualitative study with in-depth interviews.

PubMed

Brueton, V C; Stevenson, F; Vale, C L; Stenning, S P; Tierney, J F; Harding, S; Nazareth, I; Meredith, S; Rait, G

2014-01-24

To explore the strategies used to improve retention in primary care randomised trials. Qualitative in-depth interviews and thematic analysis. 29 UK primary care chief and principal investigators, trial managers and research nurses. In-depth face-to-face interviews. Primary care researchers use incentive and communication strategies to improve retention in trials, but were unsure of their effect. Small monetary incentives were used to increase response to postal questionnaires. Non-monetary incentives were used although there was scepticism about the impact of these on retention. Nurses routinely used telephone communication to encourage participants to return for trial follow-up. Trial managers used first class post, shorter questionnaires and improved questionnaire designs with the aim of improving questionnaire response. Interviewees thought an open trial design could lead to biased results and were negative about using behavioural strategies to improve retention. There was consensus among the interviewees that effective communication and rapport with participants, participant altruism, respect for participant's time, flexibility of trial personnel and appointment schedules and trial information improve retention. Interviewees noted particular challenges with retention in mental health trials and those involving teenagers. The findings of this qualitative study have allowed us to reflect on research practice around retention and highlight a gap between such practice and current evidence. Interviewees describe acting from experience without evidence from the literature, which supports the use of small monetary incentives to improve the questionnaire response. No such evidence exists for non-monetary incentives or first class post, use of which may need reconsideration. An exploration of barriers and facilitators to retention in other research contexts may be justified.

Use of strategies to improve retention in primary care randomised trials: a qualitative study with in-depth interviews

PubMed Central

Brueton, V C; Stevenson, F; Vale, C L; Stenning, S P; Tierney, J F; Harding, S; Nazareth, I; Meredith, S; Rait, G

2014-01-01

Objective To explore the strategies used to improve retention in primary care randomised trials. Design Qualitative in-depth interviews and thematic analysis. Participants 29 UK primary care chief and principal investigators, trial managers and research nurses. Methods In-depth face-to-face interviews. Results Primary care researchers use incentive and communication strategies to improve retention in trials, but were unsure of their effect. Small monetary incentives were used to increase response to postal questionnaires. Non-monetary incentives were used although there was scepticism about the impact of these on retention. Nurses routinely used telephone communication to encourage participants to return for trial follow-up. Trial managers used first class post, shorter questionnaires and improved questionnaire designs with the aim of improving questionnaire response. Interviewees thought an open trial design could lead to biased results and were negative about using behavioural strategies to improve retention. There was consensus among the interviewees that effective communication and rapport with participants, participant altruism, respect for participant's time, flexibility of trial personnel and appointment schedules and trial information improve retention. Interviewees noted particular challenges with retention in mental health trials and those involving teenagers. Conclusions The findings of this qualitative study have allowed us to reflect on research practice around retention and highlight a gap between such practice and current evidence. Interviewees describe acting from experience without evidence from the literature, which supports the use of small monetary incentives to improve the questionnaire response. No such evidence exists for non-monetary incentives or first class post, use of which may need reconsideration. An exploration of barriers and facilitators to retention in other research contexts may be justified. PMID:24464427

Bereaved relatives' experiences during the incurable phase of cancer: a qualitative interview study.

PubMed

Wijnhoven, Marleen N; Terpstra, Wim E; van Rossem, Ronald; Haazer, Carolien; Gunnink-Boonstra, Nicolette; Sonke, Gabe S; Buiting, Hilde M

2015-11-25

To examine bereaved relatives' experiences from time of diagnosis of incurable cancer until death with specific emphasis on their role in the (end-of-life) decision-making concerning chemotherapy. Qualitative interview study. Hospital-based. In-depth interviews with 15 close relatives of patients who died from non-small cell lung cancer or pancreatic cancer, using a thematic content analysis. All relatives reported that patients' main reason to request chemotherapy was the possibility to prolong life. Relatives reported that patients receiving chemotherapy had more difficulty to accept the incurable nature of their disease than patients who did not. They mostly followed the patients' treatment wish and only infrequently suggested ceasing chemotherapy (because of side effects) despite sometimes believing that this would be a better option. Relatives continuously tried to support the patient in either approaching the death or in attaining hope to continue life satisfactorily. Most relatives considered the chemotherapy period meaningful, since it sparked patients' hope and was what patients wanted. Cessation of chemotherapy caused a relief but coincided with physical deterioration and an increased caregivers' role; many relatives recalled this latter period as more burdensome. Relatives tend to follow patients' wish to continue or cease chemotherapy, without expressing their own feelings, although they were more inclined to opt cessation. They experience a greater caregiver role after cessation and their feelings of responsibility associated with the disease can be exhausting. More attention is needed to reduce relatives' distress at the end of life, also to fully profit from this crucial form of (informal) healthcare. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Perceived motivational factors for female football players during rehabilitation after sports injury – a qualitative interview study

PubMed Central

Hildingsson, Malin; Fitzgerald, Ulrika Tranaeus; Alricsson, Marie

2018-01-01

Compliance with a rehabilitation program is significant among athletes following a sports injury. It is also one of the main factors that influence the rehabilitation process; moreover, the outcome is also influenced by the athlete’s motivation. It is primarily an autonomous motivation, resulting in rehabilitation adherence. The aim of this study was to investigate the perceived motivation of female football players during rehabilitation after a sports injury and the extent to which these motivating factors were autonomous. Qualitative interviews, based on a semistructured interview guide with injured female football players undergoing rehabilitation, were analyzed using content analysis. The motivational factors that were described were their set goals, social support as well as external and internal pressures during rehabilitation. The perceived autonomy varied somewhat but overall, they experienced external motivation; therefore, the behavior was not entirely self-determined. Results are expected to provide a better understanding of women football players’ motivation in relation to their rehabilitation; hence, physiotherapists and coaches who are part of the rehabilitation process can contribute by increasing the autonomous motivation, thus, improving the compliance and outcome of the rehabilitation. PMID:29740552

Attitudes and perceptions of health professionals towards management of hypothyroidism in general practice: a qualitative interview study

PubMed Central

Dew, Rosie; King, Kathryn; Okosieme, Onyebuchi E; Pearce, Simon H; Donovan, Gemma; Taylor, Peter N; Hickey, Janis; Dayan, Colin M; Leese, Graham; Razvi, Salman; Wilkes, Scott

2018-01-01

Objective To explore the attitudes and perceptions of health professionals towards management of hypothyroidism that contributes to the suboptimal treatment of hypothyroidism in general practice. Design A qualitative interview study using semistructured interviews. Participants Sixteen participants were interviewed between March and August 2016 comprising nine general practitioners (GPs), four pharmacists, two practice nurses and one nurse practitioner. Setting General practice and community pharmacies in the counties of Northumberland, Tyne and Wear, Stockton-on-Tees and North Cumbria, North of England, UK. Method A grounded-theory approach was used to generate themes from interviews, which were underpinned by the theory of planned behaviour to give explanation to the data. Results Although health professionals felt that hypothyroidism was easy to manage, GPs and nurses generally revealed inadequate knowledge of medication interactions and levothyroxine pharmacokinetics. Pharmacists felt limited in the advice that they provide to patients due to lack of access to patient records. Most GPs and nurses followed local guidelines, and relied on blood tests over clinical symptoms to adjust levothyroxine dose. The information exchanged between professional and patient was usually restricted by time and often centred on symptoms rather than patient education. Health professionals felt that incorrect levothyroxine adherence was the main reason behind suboptimal treatment, although other factors such as comorbidity and concomitant medication were mentioned. Enablers perceived by health professionals to improve the management of hypothyroidism included continuity of care, blood test reminders, system alerts for interfering medications and prescription renewal, and accessible blood tests and levothyroxine prescriptions for patients. Conclusion There is a significant health professional behavioural component to the management of hypothyroidism. Addressing the differences in

Experiences of intervertebral motion palpation in osteopathic practice - A qualitative interview study among Swedish osteopaths.

PubMed

Sposato, Niklas S; Bjerså, Kristofer

2017-01-01

Assessment in manual therapy includes quantitative and qualitative procedures, and intervertebral motion palpation (IMP) is one of the core assessment methods in osteopathic practice. The aim of this study was to explore osteopathic practitioners' experiences of clinical decision-making and IMP as a diagnostic tool for planning and evaluation of osteopathic interventions. The study was conducted with semi-structured interviews that included eight informants. Content analysis was used as the analytical procedure. In total, three categories emerged from the analysis: strategic decision-making, diagnostic usability of IMP, and treatment applicability of IMP. The study indicated that IMP was considered relevant and was given particular importance in cases where IMP findings confirmed clinical information attained from other stages in the diagnostic process as a whole. However, IMP findings were experienced as less important if they were not correlated to other findings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Re-focusing the ethical discourse on personalized medicine: a qualitative interview study with stakeholders in the German healthcare system.

PubMed

Schleidgen, Sebastian; Marckmann, Georg

2013-05-24

In recent years, personalized medicine (PM) has become a highly regarded line of development in medicine. Yet, it is still a relatively new field. As a consequence, the discussion of its future developments, in particular of its ethical implications, in most cases can only be anticipative. Such anticipative discussions, however, pose several challenges. Nevertheless, they play a crucial role for shaping PM's further developments. Therefore, it is vital to understand how the ethical discourse on PM is conducted, i.e. on what - empirical and normative - assumptions ethical arguments are based regarding PM's current and future developments. To gather this information, we conducted a qualitative interview study with stakeholders in the German health care system. Our purposive sample included 17 representatives of basic research, clinical research, health economics, regulatory authorities, reimbursement institutions, pharmaceutical industry, patient organizations, as well as clinicians and legal experts involved in PM developments or policy making. We used an interview guide with open-ended questions and analyzed transcriptions of the interviews by means of qualitative content analysis. The respondents addressed a multitude of concerns in the context of research on as well as application of personalized preventive and therapeutic measures both on the individual and on the societal level. Interestingly, regarding future developments of PM the ethical evaluation seemed to follow the rule: the less likely its application, the more problematic a PM measure is assessed. The more likely its application, on the other hand, the less problematic it is evaluated. The results of our study suggest re-focusing the ethical discourse on PM in Germany towards a constructive ethical monitoring which ensures to include only, nevertheless all of the actual and/or potential concerns that are ethically relevant in order to allow balancing them against the actual and potential ethically

[The interview as a research data collection method].

PubMed

Debout, Christophe

2016-04-01

The interview is a widely-used method for collecting research data, notably in qualitative and mixed protocols. However, it is an umbrella term which groups together numerous types of interviews adapted to the methodological diversity which characterises nursing science. Copyright © 2016. Published by Elsevier Masson SAS.

Improving core outcome set development: qualitative interviews with developers provided pointers to inform guidance.

PubMed

Gargon, Elizabeth; Williamson, Paula R; Young, Bridget

2017-06-01

The objective of the study was to explore core outcome set (COS) developers' experiences of their work to inform methodological guidance on COS development and identify areas for future methodological research. Semistructured, audio-recorded interviews with a purposive sample of 32 COS developers. Analysis of transcribed interviews was informed by the constant comparative method and framework analysis. Developers found COS development to be challenging, particularly in relation to patient participation and accessing funding. Their accounts raised fundamental questions about the status of COS development and whether it is consultation or research. Developers emphasized how the absence of guidance had affected their work and identified areas where guidance or evidence about COS development would be useful including, patient participation, ethics, international development, and implementation. They particularly wanted guidance on systematic reviews, Delphi, and consensus meetings. The findings raise important questions about the funding, status, and process of COS development and indicate ways that it could be strengthened. Guidance could help developers to strengthen their work, but over specification could threaten quality in COS development. Guidance should therefore highlight common issues to consider and encourage tailoring of COS development to the context and circumstances of particular COS. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Search strategies for identifying qualitative studies in CINAHL.

PubMed

Wilczynski, Nancy L; Marks, Susan; Haynes, R Brian

2007-05-01

Nurses, allied health professionals, clinicians, and researchers increasingly use online access to evidence in the course of patient care or when conducting reviews on a particular topic. Qualitative research has an important role in evidence-based health care. Online searching for qualitative studies can be difficult, however, resulting in the need to develop search filters. The objective of this study was to develop optimal search strategies to retrieve qualitative studies in CINAHL for the 2000 publishing year. The authors conducted an analytic survey comparing hand searches of journals with retrievals from CINAHL for candidate search terms and combinations. Combinations of search terms reached peak sensitivities of 98.9% and peak specificities of 99.5%. Combining search terms optimized both sensitivity and specificity at 94.2%. Empirically derived search strategies combining indexing terms and textwords can achieve high sensitivity and high specificity for retrieving qualitative studies from CINAHL.

Learning to manage vasoactive drugs-A qualitative interview study with critical care nurses.

PubMed

Häggström, Marie; Bergsman, Ann-Christin; Månsson, Ulrika; Holmström, Malin Rising

2017-04-01

Being a nurse in an intensive care unit entails caring for seriously ill patients. Vasoactive drugs are one of the tools that are used to restore adequate circulation. Critical care nurses often manage and administer these potent drugs after medical advice from physicians. To describe the experiences of critical care nurses learning to manage vasoactive drugs, and to highlight the competence required to manage vasoactive drugs. Twelve critical care nurses from three hospitals in Sweden were interviewed. Qualitative content analysis was applied. The theme "becoming proficient requires accuracy, practice and precaution" illustrated how critical care nurses learn to manage vasoactive drugs. Learning included developing cognitive, psychomotor, and effective skills. Sources for knowledge refers to specialist education combined with practical exercises, collegial support, and accessible routine documents. The competence required to manage vasoactive drugs encompassed well-developed safety thinking that included being careful, in control, and communicating failures. Specific skills were required such as titrating doses, being able to analyse and evaluate the technological assessments, adapting to the situation, and staying calm. Learning to manage vasoactive drugs requires a supportive introduction for novices, collegial support, lifelong learning, and a culture of safety. Copyright © 2016 Elsevier Ltd. All rights reserved.

Problematic Situations in the Lives of Urban African American Middle School Students: A Qualitative Study

ERIC Educational Resources Information Center

Farrell, Albert D.; Erwin, Elizabeth H.; Allison, Kevin W.; Meyer, Aleta; Sullivan, Terri; Camou, Suzanne; Kliewer, Wendy; Esposito, Layla

2007-01-01

Qualitative methods were used to identify problem situations encountered by adolescents in urban middle schools serving a predominantly African American student population. Interviews focusing on identifying problem situations and the context in which they occur were conducted with 60 adolescents including students and peer mediators at middle…

"One-night stands" - risky trips between lust and trust: qualitative interviews with Chlamydia trachomatis infected youth in North Sweden.

PubMed

Christianson, Monica; Johansson, Eva; Emmelin, Maria; Westman, Göran

2003-01-01

The aim of the study was to get a deeper understanding of sexual risk-taking, by interviewing young people diagnosed with Chlamydia trachomatis. This qualitative study was conducted at a youth clinic in Umeå, Sweden. Five young women and four men, aged 18-22, participated. In-depth interviews were performed. Open questions around certain themes were posed, such as thoughts about getting CT, sexual encounters, and attitudes towards condoms. Interviews were tape-recorded and transcribed verbatim. Data were analysed according to grounded theory. Norms, events, and emotions were explored. The goal was to develop credible and applicable concepts concerning sexual relationships, risk-taking, and experiences of CT. Informants revealed that behind their sexual risk-taking was a drive to "go steady". Lust and trust were the guidelines if sex was going to take place. When discussing "one-night stands" gender stereotypes occurred. Females were expected to be less forward compared with males. We found an uneven distribution of responsibility concerning condoms. Males expected females to be "condom promoters". By catching CT, females experienced guilt, while males felt content through knowing "the source of contamination". An important public health issue is to implement how males should play an equal part in reproductive health. General CT screening of males is one suggestion.

Improving health care proxy documentation using a web-based interview through a patient portal

PubMed Central

Crotty, Bradley H; Kowaloff, Hollis B; Safran, Charles; Slack, Warner V

2016-01-01

Objective Health care proxy (HCP) documentation is suboptimal. To improve rates of proxy selection and documentation, we sought to develop and evaluate a web-based interview to guide patients in their selection, and to capture their choices in their electronic health record (EHR). Methods We developed and implemented a HCP interview within the patient portal of a large academic health system. We analyzed the experience, together with demographic and clinical factors, of the first 200 patients who used the portal to complete the interview. We invited users to comment about their experience and analyzed their comments using established qualitative methods. Results From January 20, 2015 to March 13, 2015, 139 of the 200 patients who completed the interview submitted their HCP information for their clinician to review in the EHR. These patients had a median age of 57 years (Inter Quartile Range (IQR) 45–67) and most were healthy. The 99 patients who did not previously have HCP information in their EHR were more likely to complete and then submit their information than the 101 patients who previously had a proxy in their health record (odds ratio 2.4, P = .005). Qualitative analysis identified several ways in which the portal-based interview reminded, encouraged, and facilitated patients to complete their HCP. Conclusions Patients found our online interview convenient and helpful in facilitating selection and documentation of an HCP. Our study demonstrates that a web-based interview to collect and share a patient’s HCP information is both feasible and useful. PMID:26568608

Advance Care Planning in Nursing Home Patients With Dementia: A Qualitative Interview Study Among Family and Professional Caregivers.

PubMed

van Soest-Poortvliet, Mirjam C; van der Steen, Jenny T; Gutschow, Giselka; Deliens, Luc; Onwuteaka-Philipsen, Bregje D; de Vet, Henrica C W; Hertogh, Cees M P M

2015-11-01

The aim of this study was to describe the process of advance care planning (ACP) and to explore factors related to the timing and content of ACP in nursing home patients with dementia, as perceived by family, physicians, and nurses. A qualitative descriptive study. A total of 65 in-depth qualitative interviews were held with families, on-staff elderly care physicians, and nurses of 26 patients with dementia who died in the Dutch End Of Life in Dementia (DEOLD) study. Interviews were coded and analyzed to find themes. Family, nurses, and physicians of all patients indicated they had multiple contact moments during nursing home stay in which care goals and treatment decisions were discussed. Nearly all interviewees indicated that physicians took the initiative for these ACP discussions. Care goals discussed and established during nursing home stay and the terminology to describe care goals varied between facilities. Regardless of care goals and other factors, cardiopulmonary resuscitation (CPR) and hospitalization were always discussed in advance with family and commonly resulted in a do-not-resuscitate (DNR) and a do-not-hospitalize (DNH) order. The timing of care planning discussions about other specific treatments or conditions and the content of treatment decisions varied. The factors that emerged from the interviews as related to ACP were general strategies that guided physicians in initiating ACP discussions, patient's condition, wishes expressed by patient or family, family's willingness, family involvement, continuity of communication, consensus with or within family, and general nursing home policy. Two influential underlying strategies guided physicians in initiating ACP discussions: (1) wait for a reason to initiate discussions, such as a change in health condition and (2) take initiative to discuss possible treatments (actively, including describing scenarios). ACP is a multifactorial process, which may lean on professional caregivers' guidance. The most

[Recognition and communication of early preventive services in obstetrics : A qualitative interview study with parents].

PubMed

Prüßmann, Christiane; Stindt, Daniela; Brunke, Jana; Klinkhammer, Ursula; Thyen, Ute

2016-10-01

The perception of patients' needs of support and sensitive communication about psychosocial stress all represent new, exacting tasks for nursing staff, midwives, social workers and physicians in obstetrics. As part of Good Start into the Family (GuStaF), a learning and teaching project in a university hospital, we were able to interview parents about their experiences with the intervention. Evaluation of the process of establishing contacts, the communication with professionals in obstetrics and the support offered from the perspective of parents. Qualitative guided interviews with seven families one year after the delivery. Problem areas reported by parents were predominately related to increased parental care and the feeling of being overwhelmed in addition to social stress. Core themes in communication addressed the entry into conversations, which was remembered negatively when advice was perceived as improper, patronizing or stigmatizing, and positively when professionals had listened sensitively and had provided tangible support. Some conversations increased stress. Relating to assistance and support, parents reported both positive and negative experiences. Justness and reliability emerged as particularly important topics. The attendance of families around the time of the delivery poses varying demands upon the hospital staff, not necessarily in keeping with traditional professional attitudes and competencies. Careful attention to the personal physical and emotional well-being of mothers and newborns, non-stigmatizing entry into the conversations, justness of the support and avoiding inconsistencies within the institution and the network all appear to be of great importance.

Bridging the gap between interviewer and interviewee: developing an interview guide for individual interviews by means of a focus group.

PubMed

Pedersen, Birgith; Delmar, Charlotte; Falkmer, Ursula; Grønkjaer, Mette

2016-09-01

In developing an interview guide, pre-existing knowledge about the research topic is essential. In a recent study, we were interested in exploring the experiences of weight changes among women treated for breast cancer using individual interviews. However, to develop an interview guide for the individual interviews that covered relevant thematic and dynamic dimensions, we found existing literature insufficient. Thus, we turned our attention to the benefit of the focus group method. This study aims to discuss how a focus group prior to individual interviews may contribute in developing the thematic dimension and translating the dynamic dimension of an interview guide into everyday language. We conducted one focus group interview of five women treated for breast cancer with experiences in weight changes. Data were analysed using content and conversation analysis and discussed with relevant literature on interview guide development. The study is approved by the Danish Data Protection Agency (2008-58-0028) and follows the ethical guidelines for qualitative research. Data generation and analysis resulted in themes for the thematic dimension, as well as three dynamic areas to consider in the individual interviews to bridge the gap between the interviewer and the interviewee. The dynamic areas are as follows: The use of words, images and metaphors - a shield and self-protection, Multiple meanings to explore and Staying close to the everyday language. The analysis made us more familiar with the content and meaning of weight changes among breast cancer survivors. Furthermore, it provided images and metaphors, multiple meanings and a sense of the women's everyday language that calls for an open interview frame to be used in subsequent individual interviews. © 2015 Nordic College of Caring Science.

Factors Influencing Psychological Help Seeking in Adults: A Qualitative Study

ERIC Educational Resources Information Center

Topkaya, Nursel

2015-01-01

The aim of the current research is to identify which factors, and in what direction these factors influence adults' decisions to seek psychological help for their personal problems. The research was designed as a phenomenology model; the data was gathered through the semi-structured interview technique, which is mostly used in qualitative research…

Effect of Educational Debt on Emergency Medicine Residents: A Qualitative Study Using Individual Interviews.

PubMed

Young, Timothy P; Brown, Madison M; Reibling, Ellen T; Ghassemzadeh, Sassan; Gordon, Dawn M; Phan, Tammy H; Thomas, Tamara L; Brown, Lance

2016-10-01

In 2001, less than 20% of emergency medicine residents had more than $150,000 of educational debt. Our emergency medicine residents anecdotally reported much larger debt loads. Surveys have reported that debt affects career and life choices. Qualitative approaches are well suited to explore how and why such complex phenomena occur. We aim to gain a better understanding of how our emergency medicine residents experience debt. We conducted individual semistructured interviews with emergency medicine residents. We collected self-reported data related to educational debt and asked open-ended questions about debt influence on career choices, personal life, future plans, and financial decisions. We undertook a structured thematic analysis using a qualitative approach based in the grounded theory method. Median educational debt was $212,000. Six themes emerged from our analysis: (1) debt influenced career and life decisions by altering priorities; (2) residents experienced debt as a persistent source of background stress and felt powerless to change it; (3) residents made use of various techniques to negotiate debt in order to focus on day-to-day work; (4) personal debt philosophy, based on individual values and obtained from family, shaped how debt affected each individual; (5) debt had a normative effect and was acculturated in residency; and (6) residents reported a wide range of financial knowledge, but recognized its importance to career success. Our emergency medicine residents' debt experience is complex and involves multiple dimensions. Given our current understanding, simple solutions are unlikely to be effective in adequately addressing this issue. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Accessing health services through the back door: a qualitative interview study investigating reasons why people participate in health research in Canada.

PubMed

Townsend, Anne; Cox, Susan M

2013-10-12

Although there is extensive information about why people participate in clinical trials, studies are largely based on quantitative evidence and typically focus on single conditions. Over the last decade investigations into why people volunteer for health research have become increasingly prominent across diverse research settings, offering variable based explanations of participation patterns driven primarily by recruitment concerns. Therapeutic misconception and altruism have emerged as predominant themes in this literature on motivations to participate in health research. This paper contributes to more recent qualitative approaches to understanding how and why people come to participate in various types of health research. We focus on the experience of participating and the meanings research participation has for people within the context of their lives and their health and illness biographies. This is a qualitative exploratory study informed by grounded theory strategies. Thirty-nine participants recruited in British Columbia and Manitoba, Canada, who had taken part in a diverse range of health research studies participated in semi-structured interviews. Participants described their experiences of health research participation including motivations for volunteering. Interviews were recorded, transcribed, and analyzed using constant comparisons. Coding and data management was supported by Nvivo-7. A predominant theme to emerge was 'participation in health research to access health services.' Participants described research as ways of accessing: (1) Medications that offered (hope of) relief; (2) better care; (3) technologies for monitoring health or illness. Participants perceived standard medical care to be a "trial and error" process akin to research, which further blurred the boundaries between research and treatment. Our findings have implications for recruitment, informed consent, and the dichotomizing of medical/health procedures as either research or

Applying conversation analysis to foster accurate reporting in the diet history interview.

PubMed

Tapsell, L C; Brenninger, V; Barnard, J

2000-07-01

Inaccuracy in reporting dietary intakes is a major problem in managing diet-related disease. There is no single best method of dietary assessment, but the diet history lends itself well to the clinical setting. In many diet histories data are collected orally, so analysis of interviews can provide insights into reporting behaviors. Conversation analysis is a qualitative method that describes the systematic organization of talk between people. Patterns are identified and checked for consistency within and among individual interviews. The aim of this study was to describe consistent ways of reporting diet histories and to identify conversational features of problematic reporting. Diet history interviews from 62 overweight and insulin-resistant adult volunteers (50 women, 12 men) attending an outpatient clinic and 14 healthy volunteers (7 men, 7 women) participating in an energy balance study were audiotaped and transcribed. Conversation analysis identified a remarkably consistent pattern of reporting diet histories and 3 conversational features that indicated problematic reporting: "it depends," denoting variability (least of all at breakfast); "probably," suggesting guesswork (related to portion sizes); and elaborated talk on certain foods, distinguishing sensitive topics (e.g., alcohol, chocolate, butter/margarine, take-out foods) from safe topics. These findings indicate that there are ways in which dietetics practitioners may conduct the diet history interview to foster more accurate reporting.

How anaesthesiologists understand difficult airway guidelines-an interview study.

PubMed

Knudsen, Kati; Pöder, Ulrika; Nilsson, Ulrica; Högman, Marieann; Larsson, Anders; Larsson, Jan

2017-11-01

In the practice of anaesthesia, clinical guidelines that aim to improve the safety of airway procedures have been developed. The aim of this study was to explore how anaesthesiologists understand or conceive of difficult airway management algorithms. A qualitative phenomenographic design was chosen to explore anaesthesiologists' views on airway algorithms. Anaesthesiologists working in three hospitals were included. Individual face-to-face interviews were conducted. Four different ways of understanding were identified, describing airway algorithms as: (A) a law-like rule for how to act in difficult airway situations; (B) a cognitive aid, an action plan for difficult airway situations; (C) a basis for developing flexible, personal action plans for the difficult airway; and (D) the experts' consensus, a set of scientifically based guidelines for handling the difficult airway. The interviewed anaesthesiologists understood difficult airway management guidelines/algorithms very differently.

Attitudes, access and anguish: a qualitative interview study of staff and patients' experiences of diabetic retinopathy screening.

PubMed

Hipwell, A E; Sturt, J; Lindenmeyer, A; Stratton, I; Gadsby, R; O'Hare, P; Scanlon, P H

2014-12-15

To examine the experiences of patients, health professionals and screeners; their interactions with and understandings of diabetic retinopathy screening (DRS); and how these influence uptake. Purposive, qualitative design using multiperspectival, semistructured interviews and thematic analysis. Three UK Screening Programme regions with different service-delivery modes, minority ethnic and deprivation levels across rural, urban and inner-city areas, in general practitioner practices and patients' homes. 62 including 38 patients (22 regular-screening attenders, 16 non-regular attenders) and 24 professionals (15 primary care professionals and 9 screeners). Antecedents to attendance included knowledge about diabetic retinopathy and screening; antecedents to non-attendance included psychological, pragmatic and social factors. Confusion between photographs taken at routine eye tests and DRS photographs was identified. The differing regional invitation methods and screening locations were discussed, with convenience and transport safety being over-riding considerations for patients. Some patients mentioned significant pain and visual disturbance from mydriasis drops as a deterrent to attendance. In this, the first study to consider multiperspectival experiential accounts, we identified that proactive coordination of care involving patients, primary care and screening programmes, prior to, during and after screening is required. Multiple factors, prior to, during and after screening, are involved in the attendance and non-attendance for DRS. Further research is needed to establish whether patient self-management educational interventions and the pharmacological reformulation of shorter acting mydriasis drops, may improve uptake of DRS. This might, in turn, reduce preventable vision loss and its associated costs to individuals and their families, and to health and social care providers, reducing current inequalities. Published by the BMJ Publishing Group Limited. For

Identifying frailty in primary care: a qualitative description of family physicians' gestalt impressions of their older adult patients.

PubMed

Korenvain, Clara; Famiyeh, Ida-Maisie; Dunn, Sheila; Whitehead, Cynthia R; Rochon, Paula A; McCarthy, Lisa M

2018-05-14

Many tools exist to guide family physicians' impressions about frailty status of older adults, but no single tool, instrument, or set of criteria has emerged as most useful. The role of physicians' subjective impressions in frailty decisions has not been studied. This study explores how family physicians conceptualize frailty, and the factors that they consider when making subjective decisions about patients' frailty statuses. Descriptive qualitative study of family physicians who practice in a large urban academic family medicine center as they participated in one-on-one "think-aloud" interviews about the frailty status of their patients aged 80 years and over. Of 23 eligible family physicians, 18 shared their impressions about the frailty status of their older adult patients and the factors influencing their decisions. Interviews were audio-recorded, transcribed, and thematically analyzed. Four themes were identified, the first of which described how physicians conceptualized frailty as a spectrum and dynamic in nature, but also struggled to conceptualize it without a formal definition in place. The remaining three themes described factors considered before determining patients' frailty statuses: physical characteristics (age, weight, medical conditions), functional characteristics (physical, cognitive, social) and living conditions (level of independence, availability of supports, physical environment). Family physicians viewed frailty as multifactorial, dynamic, and inclusive of functional and environmental factors. This conceptualization can be useful to make comprehensive and flexible evaluations of frailty status in conjunction with more objective frailty tools.

Discovering untapped relationship potential with patients in telehealth: a qualitative interview study

PubMed Central

Wolf, Axel; Ali, Lilas; Sonntag, Steffen Mark; Ekman, Inger

2016-01-01

Objectives To explore factors that influence relationship building between telehealth professionals and patients with chronic illness over a distance, from a telehealth professional's perspective. Design 4 focus group interviews were conducted in June 2014. Digital recordings were transcribed verbatim and qualitative content analysis was performed using an iterative process of 3 coding rounds. Participants 20 telehealth professionals. Setting A telehealth service centre in the south of Germany that provided care for 12 000 patients with chronic heart failure across Germany. Results Non-video telehealth technology creates an atmosphere that fosters sharing of personal information and a non-judgemental attitude. This facilitates the delivery of fair and equal healthcare. A combination of a protocol-driven service structure along with shared team and organisational values provide a basis for establishing long-term healthcare relationships. However, each contact between a telehealth professional and a patient has an uncertain outcome and requires skilful negotiation of the relationship. Although care provision was personalised, there was scope to include the patients as ‘experts on their own illness’ to a greater extent as advocated by person-centred care. Currently, provision of person-centred care is not sufficiently addressed in telehealth professional training. Conclusions Telehealth offers a viable environment for the delivery of person-centred care for patients with long-standing disease. Current telehealth training programmes may be enhanced by teaching person-centred care skills. PMID:26936904

Conceptual bases of Christian, faith-based substance abuse rehabilitation programs: qualitative analysis of staff interviews.

PubMed

McCoy, Lisa K; Hermos, John A; Bokhour, Barbara G; Frayne, Susan M

2004-09-01

Faith-based substance abuse rehabilitation programs provide residential treatment for many substance abusers. To determine key governing concepts of such programs, we conducted semi-structured interviews with sample of eleven clinical and administrative staff referred to us by program directors at six, Evangelical Christian, faith-based, residential rehabilitation programs representing two large, nationwide networks. Qualitative analysis using grounded theory methods examined how spirituality is incorporated into treatment and elicited key theories of addiction and recovery. Although containing comprehensive secular components, the core activities are strongly rooted in a Christian belief system that informs their understanding of addiction and recovery and drives the treatment format. These governing conceptions, that addiction stems from attempts to fill a spiritual void through substance use and recovery through salvation and a long-term relationship with God, provide an explicit, theory-driven model upon which they base their core treatment activities. Knowledge of these core concepts and practices should be helpful to clinicians in considering referrals to faith-based recovery programs.

Health Information-Seeking Practices of African American Young Men Who Have Sex with Men: A Qualitative Study

ERIC Educational Resources Information Center

Rose, India D.; Friedman, Daniela B.; Spencer, S. Melinda; Annang, Lucy; Lindley, Lisa L.

2016-01-01

The current study used a qualitative, phenomenological approach to investigate the health information-seeking practices of African American young men who have sex with men (AAYMSM). Forty-two self-identified AAYMSM, aged 18 to 21, residing in a Southeastern U.S. city participated in a qualitative focus group or face-to-face interview to examine…

Identifying content for the glaucoma-specific item bank to measure quality-of-life parameters.

PubMed

Khadka, Jyoti; McAlinden, Colm; Craig, Jamie E; Fenwick, Eva K; Lamoureux, Ecosse L; Pesudovs, Konrad

2015-01-01

Patient-reported outcomes (PROs) have become essential clinical trial end points. However, a comprehensive, multidimensional, patient-relevant, and precise glaucoma-specific PRO instrument is not available. Therefore, the purpose of this study was to identify content for a new, glaucoma-specific, quality-of-life (QOL) item bank. Content identification was undertaken in 5 phases: (1) identification of extant items in glaucoma-specific instruments and the qualitative literature; (2) focus groups and interviews with glaucoma patients; (3) item classification and selection; (4) expert review and revision of items; and (5) cognitive interviews with patients. A total of 737 unique items (extant items from PRO instruments, 247; qualitative articles, 14 items; focus groups and semistructured interviews, 476 items) were identified. These items were classified into 10 QOL domains. Four criteria (item redundancy, item inconsistent with domain definition, item content too narrow to have wider applicability, and item clarity) were used to remove and refine the items. After the cognitive interviews, the final minimally representative item set had a total of 342 unique items belonging to 10 domains: activity limitation (88), mobility (20), visual symptoms (19), ocular surface symptoms (22), general symptoms (15), convenience (39), health concerns (45), emotional well-being (49), social issues (23), and economic issues (22). The systematic content identification process identified 10 QOL domains, which were important to patients with glaucoma. The majority of the items were identified from the patient-specific focus groups and semistructured interviews suggesting that the existing PRO instruments do not adequately address QOL issues relevant to individuals with glaucoma.

Changes in physical activity during the retirement transition: a theory-based, qualitative interview study.

PubMed

McDonald, Suzanne; O'Brien, Nicola; White, Martin; Sniehotta, Falko F

2015-02-21

There are considerable inter-individual differences in the direction and degree of change in physical activity (PA) levels during the retirement transition. There is currently a limited theoretical understanding of how these differences can be explained. This study aimed to explore and compare perceptions about how theory-based factors influence PA change during the transition from employment to retirement among individuals approaching retirement and recently retired. Theory-based, one-to-one, semi-structured interviews were conducted with a purposive sample of 28 adults (15 retired) within 24 months of retirement. Participants were sampled to reflect a diverse range of socio-economic and occupational backgrounds. The interview was based on the 12 domains within the Theory Domain Framework and designed to elicit anticipated or experienced retirement-related changes in PA behaviour and perceived determinants. Interview transcripts were analysed using Framework analysis to explore intra- and inter-individual perceptions of how PA changes after retirement and the factors which may influence this change. The majority of participants perceived retirement to be related to an increase in PA levels. Four themes emerged from the data regarding factors perceived to influence changes in PA behaviour after retirement: (1) resources for PA; (2) structure of daily life in retirement; (3) opportunities for PA; and (4) transitional PA phases after retirement. Retirement is associated with a number of inter-related changes and opportunities which can have a positive or negative impact on PA behaviour. The influence of these factors does not appear to be static and may change over time. A number of different transitional phases may be experienced after leaving work and each phase may have a differential impact on PA behaviour. The findings of this qualitative study contribute to the theoretical understanding of PA change during the retirement transition. Each post-retirement PA

End-of-Life Decision Making in Palliative Care and Recommendations of the Council of Europe: Qualitative Secondary Analysis of Interviews and Observation Field Notes.

PubMed

Martins Pereira, Sandra; Fradique, Emília; Hernández-Marrero, Pablo

2018-05-01

End-of-life decisions (ELDs) are embedded in clinical, sociocultural, political, economic, and ethical concerns. In 2014, the Council of Europe (CoE) through its Committee on Bioethics launched the "Guide on the decision-making process regarding medical treatment in end-of-life situations," aiming at improving decision-making processes and empowering professionals in making ELDs. To analyze if end-of-life decision making in palliative care (PC) is consistent with this Guide and to identify if disputed/controversial issues are part of current ELDs. Qualitative secondary analysis. Four qualitative datasets, including 44 interviews and 9 team observation field notes from previous studies with PC teams/professionals in Portugal. An analysis grid based on the abovementioned guide was created considering three dimensions: ethical and legal frameworks, decision-making process, and disputed/controversial issues. The majority of the professionals considered the ethical principle of autonomy paramount in end-of-life decision making. Justice and beneficence/nonmaleficence were also valued. Although not mentioned in the Guide, the professionals also considered other ethical principles when making ELDs, namely, responsibility, integrity, and dignity. Most of the interviewees and field notes referred to the collective interprofessional dimension of the decision-making process. Palliative sedation and the wish to hasten death were the most mentioned disputed/controversial issues. The nature, limitations, and benefits of qualitative secondary analysis are discussed. End-of-life decision-making processes made by Portuguese PC teams seem to be consistent with the guidelines of the CoE. Further research is needed about disputed/controversial issues and the actual use, effectiveness, and impact of ethical guidelines for end-of-life decision making on professionals' empowerment and for all parties involved.

Respondents as Interlocutors: Translating Deliberative Democratic Principles to Qualitative Interviewing Ethics

ERIC Educational Resources Information Center

Curato, Nicole

2012-01-01

The epistemic interview is a conversational practice, which aims to generate knowledge by subjecting respondents' beliefs to dialectical tests of reasons. Developed by Svend Brinkmann, this model draws inspiration from Socratic dialogues where the interviewer asks confronting questions to press respondents to articulate the normative bases of…

Coping Well with Advanced Cancer: A Serial Qualitative Interview Study with Patients and Family Carers

PubMed Central

Roberts, Diane; Appleton, Lynda; Calman, Lynn; Large, Paul; Lloyd-Williams, Mari; Grande, Gunn

2017-01-01

Objectives To understand successful strategies used by people to cope well when living with advanced cancer; to explore how professionals can support effective coping strategies; to understand how to support development of effective coping strategies for patients and family carers. Design Qualitative serial (4–12 week intervals) interview study with people with advanced cancer and their informal carers followed by focus groups. The iterative design had a novel focus on positive coping strategies. Interview analysis focused on patients and carers as individuals and pairs, exploring multiple dimensions of their coping experiences. Focus group analysis explored strategies for intervention development. Participants 26 people with advanced (stage 3–4) breast, prostate, lung or colorectal cancer, or in receipt of palliative care, and 24 paired nominated informal/family carers. Setting Participants recruited through outpatient clinics at two tertiary cancer centres in Merseyside and Manchester, UK, between June 2012 and July 2013. Results 45 patient and 41 carer interviews were conducted plus 4 focus groups (16 participants). People with advanced cancer and their informal/family carers develop coping strategies which enable effective management of psychological wellbeing. People draw from pre-diagnosis coping strategies, but these develop through responding to the experience of living with advanced cancer. Strategies include being realistic, indulgence, support, and learning from others, which enabled participants to regain a sense of wellbeing after emotional challenge. Learning from peers emerged as particularly important in promoting psychological wellbeing through the development of effective ‘everyday’, non-clinical coping strategies. Conclusions Our findings challenge current models of providing psychological support for those with advanced cancer which focus on professional intervention. It is important to recognise, enable and support peoples’ own

Development of a patient-centred, patient-reported outcome measure (PROM) for post-stroke cognitive rehabilitation: qualitative interviews with stroke survivors to inform design and content.

PubMed

Patchick, Emma L; Horne, Maria; Woodward-Nutt, Kate; Vail, Andy; Bowen, Audrey

2015-12-01

Improving cognition is service users' top research priority for life after stroke, and future research should include outcomes that they deem important. Patient perspectives on outcomes are collected using patient-reported outcome measures (PROMs). There is currently no patient-centred PROM specific for cognitive rehabilitation trials. Inform PROM development by exploring stroke survivor perspectives on the important, measurable impacts of persisting post-stroke cognitive problems. Qualitative semi-structured interviews in participants' homes. Purposive sample of 16 cognitively impaired stroke survivors at least six months post-stroke. Interviews used a schedule and communication aids developed through patient consultation. Interviews were transcribed verbatim with non-verbal communication recorded using field notes. Data were analysed using a framework approach to find commonalities to shape the focus and content of an outcome measure. Participants identified important impacts of their 'invisible' cognitive problems, outside of other stroke-related impairments. Cognitive problems exacerbated emotional issues and vice versa. Changes in self-identity and social participation were prominent. Impact was not spoken about in terms of frequency but rather in terms of the negative affect associated with problems; terms like 'bothered' and 'frustration' were often used. The results support the development of a PROM specifically designed to address the impact of cognitive problems. It should: include items addressing a comprehensive range of cognitive skills; ask questions about mood, self-identity and social participation; use accessible wording that respondents understand and endorse; measure impact rather than frequency; and explore perceived impact on carers. © 2014 John Wiley & Sons Ltd.

Social participation of children and adolescents with cochlear implants: a qualitative analysis of parent, teacher, and child interviews.

PubMed

Punch, Renée; Hyde, Merv

2011-01-01

Psychosocial factors, including socioemotional well-being, peer relationships, and social inclusion with hearing and deaf peers, are increasingly becoming a focus of research investigating children with cochlear implants. The study reported here extends the largely quantitative findings of previous research through a qualitative analysis of interviews with parents, teachers, and pediatric cochlear implant users themselves in three eastern states of Australia. We interviewed 24 parents, 15 teachers, and 11 children and adolescents. The findings displayed commonalities across the three groups of participants, indicating positive experiences around the children's psychosocial development with their cochlear implants, but also ongoing difficulties communicating in groups of people and problems related to social skills. Some children had little contact with other deaf children (with or without cochlear implants) despite parents and teachers perceiving such contact beneficial. Children attending schools where there were other deaf children valued friendships with both deaf and hearing peers. Adolescence was a particularly difficult time for some as they struggled with feelings of self-consciousness about their deafness and external cochlear implant equipment and worries around friendships, dating, and their future place in the world. Recommendations for practice and further research are made.

Understanding the relationships between the physical environment and physical activity in older adults: a systematic review of qualitative studies.

PubMed

Moran, Mika; Van Cauwenberg, Jelle; Hercky-Linnewiel, Rachel; Cerin, Ester; Deforche, Benedicte; Plaut, Pnina

2014-07-17

While physical activity (PA) provides many physical, social, and mental health benefits for older adults, they are the least physically active age group. Ecological models highlight the importance of the physical environment in promoting PA. However, results of previous quantitative research revealed inconsistencies in environmental correlates of older adults' PA that may be explained by methodological issues. Qualitative studies can inform and complement quantitative research on environment-PA relationships by providing insight into how and why the environment influences participants' PA behaviors. The current study aimed to provide a systematic review of qualitative studies exploring the potential impact of the physical environment on older adults' PA behaviors. A systematic search was conducted in databases of various disciplines, including: health, architecture and urban planning, transportation, and interdisciplinary databases. From 3,047 articles identified in the physical activity, initial search, 31 articles published from 1996 to 2012 met all inclusion criteria. An inductive content analysis was performed on the extracted findings to identify emerging environmental elements related to older adults' PA. The identified environmental elements were then grouped by study methodologies [indoor interviews (individual or focus groups) vs spatial methods (photo-voice, observations, walk-along interviews)]. This review provides detailed information about environmental factors that potentially influence older adults' PA behaviors. These factors were categorized into five themes: pedestrian infrastructure, safety, access to amenities, aesthetics, and environmental conditions. Environmental factors especially relevant to older adults (i.e., access to facilities, green open spaces and rest areas) tended to emerge more frequently in studies that combined interviews with spatial qualitative methods. Findings showed that qualitative research can provide in

Improving health care proxy documentation using a web-based interview through a patient portal.

PubMed

Bajracharya, Adarsha S; Crotty, Bradley H; Kowaloff, Hollis B; Safran, Charles; Slack, Warner V

2016-05-01

Health care proxy (HCP) documentation is suboptimal. To improve rates of proxy selection and documentation, we sought to develop and evaluate a web-based interview to guide patients in their selection, and to capture their choices in their electronic health record (EHR). We developed and implemented a HCP interview within the patient portal of a large academic health system. We analyzed the experience, together with demographic and clinical factors, of the first 200 patients who used the portal to complete the interview. We invited users to comment about their experience and analyzed their comments using established qualitative methods. From January 20, 2015 to March 13, 2015, 139 of the 200 patients who completed the interview submitted their HCP information for their clinician to review in the EHR. These patients had a median age of 57 years (Inter Quartile Range (IQR) 45-67) and most were healthy. The 99 patients who did not previously have HCP information in their EHR were more likely to complete and then submit their information than the 101 patients who previously had a proxy in their health record (odds ratio 2.4, P = .005). Qualitative analysis identified several ways in which the portal-based interview reminded, encouraged, and facilitated patients to complete their HCP. Patients found our online interview convenient and helpful in facilitating selection and documentation of an HCP. Our study demonstrates that a web-based interview to collect and share a patient's HCP information is both feasible and useful. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

(In-)formal caregivers' and general practitioners' views on hospitalizations of people with dementia - an exploratory qualitative interview study.

PubMed

Pohontsch, Nadine Janis; Scherer, Martin; Eisele, Marion

2017-08-04

Dementia is an irreversible chronic disease with wide-ranging effects on patients', caregivers' and families' lives. Hospitalizations are significant events for people with dementia. They tend to have poorer outcomes compared to those without dementia. Most of the previous studies focused on diagnoses leading to hospitalizations using claims data. Further factors (e.g. context factors) for hospitalizations are not reproduced in this data. Therefore, we investigated the factors leading to hospitalization with an explorative, qualitative study design. We interviewed informal caregivers (N = 12), general practitioners (GPs, N = 12) and formal caregivers (N = 5) of 12 persons with dementia using a semi-structured interview guideline. The persons with dementia were sampled using criteria regarding their living situation (home care vs. nursing home care) and gender. The transcripts were analyzed using the method of structuring content analysis. Almost none of the hospitalizations, discussed with the (in-)formal caregivers and GPs, seemed to have been preventable or seemed unjustifiable from the interviewees' points of view. We identified several dementia-specific factors promoting hospitalizations (e.g. the neglect of constricted mobility, the declining ability to communicate about symptoms/accidents and the shift of responsibility from person with dementia to informal or formal caregivers) and context-specific factors promoting hospitalizations (e.g. qualification of nursing home personal, the non-availability of the GP and hospitalizations for examinations/treatments also available in ambulatory settings). Hospitalizations were always the result of the interrelation of two factors: illnesses/accidents and context factors. The impact of both seems to be stronger in presence of dementia. Points for action in terms of reducing hospitalization rates were: better qualified nurses, a 24-h-GP-emergency service and better compensation for ambulatory monitoring

How family caregivers' medical and moral assumptions influence decision making for patients in the vegetative state: a qualitative interview study.

PubMed

Kuehlmeyer, Katja; Borasio, Gian Domenico; Jox, Ralf J

2012-06-01

Decisions on limiting life-sustaining treatment for patients in the vegetative state (VS) are emotionally and morally challenging. In Germany, doctors have to discuss, together with the legal surrogate (often a family member), whether the proposed treatment is in accordance with the patient's will. However, it is unknown whether family members of the patient in the VS actually base their decisions on the patient's wishes. To examine the role of advance directives, orally expressed wishes, or the presumed will of patients in a VS for family caregivers' decisions on life-sustaining treatment. A qualitative interview study with 14 next of kin of patients in a VS in a long-term care setting was conducted; 13 participants were the patient's legal surrogates. Interviews were analysed according to qualitative content analysis. The majority of family caregivers said that they were aware of aforementioned wishes of the patient that could be applied to the VS condition, but did not base their decisions primarily on these wishes. They gave three reasons for this: (a) the expectation of clinical improvement, (b) the caregivers' definition of life-sustaining treatments and (c) the moral obligation not to harm the patient. If the patient's wishes were not known or not revealed, the caregivers interpreted a will to live into the patient's survival and non-verbal behaviour. Whether or not prior treatment wishes of patients in a VS are respected depends on their applicability, and also on the medical assumptions and moral attitudes of the surrogates. We recommend repeated communication, support for the caregivers and advance care planning.

The impact of prescription charges on asthma patients is uneven and unpredictable: evidence from qualitative interviews.

PubMed

Schafheutle, Ellen I

2009-12-01

To explore whether, and how, prescription charges affect asthma patients' disease management behaviour. Thirty qualitative interviews. Interviewees were aged between 21 and 59, 21 were women, 24 were paying individual prescription charges, and six had prepayment certificates (PPCs). Most had a beta2-agonist 'reliever' and a steroid 'preventer' inhaler. Prescription charges posed affordability issues for some, and for two patients cost-related reduction in 'preventer' use affected asthma control negatively. Many described various ways of keeping medication cost down. Affordability issues, negative views on paying charges, and whether interviewees viewed their asthma medication as essential, were influential factors. Steroid inhalers were viewed more commonly as being less essential and affected by cost. The episodic nature of asthma meant that predicting benefit from PPCs was difficult. This study strengthens existing evidence that medication cost is a factor in asthma patients' management decisions, with a potential cost-related impact on asthma control.

The use of semi-structured interviews for the characterisation of farmer irrigation practices

NASA Astrophysics Data System (ADS)

O'Keeffe, J.; Buytaert, W.; Mijic, A.; Brozovic, N.; Sinha, R.

2015-08-01

Generating information on the behaviours, characteristics and drivers of users, as well on the resource itself, is vital in developing sustainable and realistic water security options. In this paper we present a methodology for collecting qualitative and quantitative data on water use practices through semi-structured interviews. This approach facilitates the collection of detailed information on actors' decisions in a convenient and cost-effective manner. The interview is organised around a topic guide, which helps lead the conversation in a standardised way while allowing sufficient opportunity to identify relevant issues previously unknown to the researcher. In addition, semi-structured interviews can be used to obtain certain types of quantitative data. While not as accurate as direct measurements, it can provide useful information on local practices and farmers' insights. We present an application of the methodology on two districts in the State of Uttar Pradesh in North India. By means of 100 farmer interviews, information was collected on various aspects of irrigation practices, including irrigation water volumes, irrigation cost, water source and their spatial variability. A statistical analysis of the information, along with some data visualisation is also presented, which highlights a significant variation in irrigation practices both within and between the districts. Our application shows that semi-structured interviews are an effective and efficient method of collecting both qualitative and quantitative information for the assessment of drivers, behaviours and their outcomes in a data scarce region. The collection of this type of data could significantly improve insight on water resources, leading to more realistic management options and increased water security in the future.

How anaesthesiologists understand difficult airway guidelines—an interview study

PubMed Central

Knudsen, Kati; Nilsson, Ulrica; Larsson, Anders; Larsson, Jan

2017-01-01

Background In the practice of anaesthesia, clinical guidelines that aim to improve the safety of airway procedures have been developed. The aim of this study was to explore how anaesthesiologists understand or conceive of difficult airway management algorithms. Methods A qualitative phenomenographic design was chosen to explore anaesthesiologists’ views on airway algorithms. Anaesthesiologists working in three hospitals were included. Individual face-to-face interviews were conducted. Results Four different ways of understanding were identified, describing airway algorithms as: (A) a law-like rule for how to act in difficult airway situations; (B) a cognitive aid, an action plan for difficult airway situations; (C) a basis for developing flexible, personal action plans for the difficult airway; and (D) the experts’ consensus, a set of scientifically based guidelines for handling the difficult airway. Conclusions The interviewed anaesthesiologists understood difficult airway management guidelines/algorithms very differently. PMID:29299973

A simple technique to identify key recruitment issues in randomised controlled trials: Q-QAT - Quanti-Qualitative Appointment Timing.

PubMed

Paramasivan, Sangeetha; Strong, Sean; Wilson, Caroline; Campbell, Bruce; Blazeby, Jane M; Donovan, Jenny L

2015-03-11

Recruitment to pragmatic randomised controlled trials (RCTs) is acknowledged to be difficult, and few interventions have proved to be effective. Previous qualitative research has consistently revealed that recruiters provide imbalanced information about RCT treatments. However, qualitative research can be time-consuming to apply. Within a programme of research to optimise recruitment and informed consent in challenging RCTs, we developed a simple technique, Q-QAT (Quanti-Qualitative Appointment Timing), to systematically investigate and quantify the imbalance to help identify and address recruitment difficulties. The Q-QAT technique comprised: 1) quantification of time spent discussing the RCT and its treatments using transcripts of audio-recorded recruitment appointments, 2) targeted qualitative research to understand the obstacles to recruitment and 3) feedback to recruiters on opportunities for improvement. This was applied to two RCTs with different clinical contexts and recruitment processes. Comparisons were made across clinical centres, recruiters and specialties. In both RCTs, the Q-QAT technique first identified considerable variations in the time spent by recruiters discussing the RCT and its treatments. The patterns emerging from this initial quantification of recruitment appointments then enabled targeted qualitative research to understand the issues and make suggestions to improve recruitment. In RCT1, presentation of the treatments was balanced, but little time was devoted to describing the RCT. Qualitative research revealed patients would have considered participation, but lacked awareness of the RCT. In RCT2, the balance of treatment presentation varied by specialists and centres. Qualitative research revealed difficulties with equipoise and confidence among recruiters presenting the RCT. The quantitative and qualitative findings were well-received by recruiters and opportunities to improve information provision were discussed. A blind coding

Dying from cancer in developed and developing countries: lessons from two qualitative interview studies of patients and their carers

PubMed Central

Murray, Scott A; Grant, Elizabeth; Grant, Angus; Kendall, Marilyn

2003-01-01

Objective To describe the experiences of illness and needs and use of services in two groups of patients with incurable cancer, one in a developed country and the other in a developing country. Design Scotland: longitudinal study with qualitative interviews. Kenya: cross sectional study with qualitative interviews. Settings Lothian region, Scotland, and Meru District, Kenya. Participants Scotland: 20 patients with inoperable lung cancer and their carers. Kenya: 24 patients with common advanced cancers and their main informal carers. Main outcome measures Descriptions of experiences, needs, and available services. Results 67 interviews were conducted in Scotland and 46 in Kenya. The emotional pain of facing death was the prime concern of Scottish patients and their carers, while physical pain and financial worries dominated the lives of Kenyan patients and their carers. In Scotland, free health and social services (including financial assistance) were available, but sometimes underused. In Kenya, analgesia, essential equipment, suitable food, and assistance in care were often inaccessible and unaffordable, resulting in considerable unmet physical needs. Kenyan patients thought that their psychological, social, and spiritual needs were met by their families, local community, and religious groups. Some Scottish patients thought that such non-physical needs went unmet. Conclusions In patients living in developed and developing countries there are differences not only in resources available for patients dying from cancer but also in their lived experience of illness. The expression of needs and how they are met in different cultural contexts can inform local assessment of needs and provide insights for initiatives in holistic cancer care. What is already known on this topic?Cancer treatment is a priority and is well developed in the United KingdomThere is an increasing burden on inadequately funded health services in developing countriesWhat this study adds

Meeting and treating cultural difference in primary care: a qualitative interview study.

PubMed

Wachtler, Caroline; Brorsson, Annika; Troein, Margareta

2006-02-01

Primary care doctors see patients from diverse cultural backgrounds and communication plays an important role in diagnosis and treatment. Communication problems can arise when patient and doctor do not share the same cultural background. The aim of this study was to examine how consultations with immigrant patients are understood by GPs and how GPs manage these consultations. Semi-structured interviews with GPs about their experiences with immigrant patients were recorded on audio-tape, transcribed and analysed using a qualitative thematic analysis methodology. A constructivist approach was taken to analysis and interpretation. Culture is not in focus when GPs meet immigrant patients. The consultation is seen as a meeting between individuals, where cultural difference is just one of many individual factors that influence how well doctor and patient understand each other. However, when mutual understanding is poor and the consultation not successful, cultural differences are central. The GPs try to conduct their consultations with immigrant patients in the same way that they conduct all their consultations. There is no specific focus on culture, instead, GPs tend to avoid addressing even pronounced cultural differences. This study indicates that cultural difference is not treated in GPs consultation with immigrant patients. Learning about cultural difference's effect on mutual understanding between doctor and patient could improve GPs cross-cultural communication. Increased awareness of the culture the doctor brings to the consultation could facilitate management of cross-cultural consultations.

General practitioners' perceptions of COPD treatment: thematic analysis of qualitative interviews.

PubMed

Molin, Katrine Rutkær; Egerod, Ingrid; Valentiner, Laura Staun; Lange, Peter; Langberg, Henning

2016-01-01

In Denmark, the treatment of COPD is mainly managed by general practitioners (GPs). Pulmonary rehabilitation (PR) is available to patients with COPD in the local community by GP referral, but in practice, many patients do not participate in rehabilitation. The aim of our study was to explore 1) GPs' perceptions of their role and responsibility in the rehabilitation of patients with COPD, and 2) GPs' perceptions of how patients manage their COPD. The study was based on a qualitative design with semi-structured key-informant interviews with GPs. Investigator triangulation was applied during data generation, and analysis was done using thematic analysis methodology. Our main findings were that GPs relied on patients themselves to take the initiative to make clinic appointments and on professionals at health centers to provide the PR including consultations on lifestyle changes. The GPs experienced that patients chose to come to the clinic when they were in distress and that patients either declined or had poor adherence to rehabilitation when offered. The GPs were relieved that the health centers had taken over the responsibility of rehabilitation as GPs lacked the resources to discuss rehabilitation and follow up on individual plans. Our study suggested a potential self-reinforcing problem with the treatment of COPD being mainly focused on medication rather than on PR. Neither GPs nor patients used a proactive approach. Further, GPs were not fully committed to discuss non-pharmacological treatment and perceived the patients as unmotivated for PR. As such, there is a need for optimizing non-pharmacological treatment of COPD and in particular the referral process to PR.

[Personality structure and subjective illness concepts of neurotically depressed patients. Qualitative comparison of 11 individual cases analyses of initial psychotherapy interviews].

PubMed

Frommer, J; Jüttemann-Lembke, A; Stratkötter, A; Tress, W

1995-07-01

Verbatim transcripts of 11 psychotherapeutic interviews with patients suffering from depressive neurosis were examined, focusing on subjective theories of illness, biography, and descriptions of the patient's own personality. The results of our qualitative content analysis allow reconstruction of some characteristic features of these patients, like over identification with social roles and norms (1), feeling of being dependent and injured by another person (2), problems of self-esteem (3), shyness (4), unfulfilled wishes to be loved and accepted (5). These findings are discussed in the context of psychopathological and psychoanalytic concepts of depression.

Direct and Indirect Benefits Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews.

PubMed

Gladwell, Peter William; Badlan, Kathryn; Cramp, Fiona; Palmer, Shea

2015-11-01

There is no consensus regarding the effectiveness of transcutaneous electrical nerve stimulation (TENS) for management of chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methodology identified significant problems with low treatment fidelity. There is little information available to guide selection of patient-reported outcome measures appropriate for TENS evaluation. The purpose of this study was to explore the experiences of patients at a secondary care pain clinic who successfully used TENS to help manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. A mini focus group informed the development of a discussion guide for semistructured interviews with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Data analysis indicated that distraction from pain and a reduction in the sensations associated with muscle tension or spasm should be considered as separate outcomes from pain relief. These direct benefits led to a wide range of indirect benefits dependent on patient decision making, including medication reduction, enhanced function, psychological benefits, and enhanced ability to rest. The findings indicate that evaluating TENS using a unidimensional pain scale is likely to overlook potential benefits. The complex pattern of TENS usage, as well as multiple direct and indirect outcomes, indicates that TENS could be considered as a complex intervention. © 2015 American Physical Therapy Association.

Getting More out of Your Interview Data: Toward a Framework for Debriefing the Transcriber of Interviews

ERIC Educational Resources Information Center

Weinbaum, Rebecca K.; Onwuegbuzie, Anthony J.

2016-01-01

In most qualitative research studies involving the creation of interview transcriptions, researchers seldom demonstrate much reflexivity about the transcription process, rarely making mention of transcription processes as part of their reporting of data collection and analysis procedures beyond a simple statement that audio- or videotaped data…

Communicating with disabled children when inpatients: barriers and facilitators identified by parents and professionals in a qualitative study.

PubMed

Sharkey, Siobhan; Lloyd, Claire; Tomlinson, Richard; Thomas, Eleanor; Martin, Alice; Logan, Stuart; Morris, Christopher

2016-06-01

Communication is a fundamental part of health care, but can be more difficult with disabled children. Disabled children are more frequently admitted to hospital than other children. To explore experiences of ward staff and families to identify barriers and facilitators to effective communication with disabled children whilst inpatients. This was an exploratory qualitative study. We consulted 25 staff working on paediatric wards and 15 parents of disabled children recently admitted to those wards. We had difficulty in recruiting children and evaluating their experiences. Data were collected through interviews and focus groups. A thematic analysis of the data supported by the Framework Approach was used to explore experiences and views about communication. Emerging themes were subsequently synthesised to identify barriers and facilitators to good communication. Barriers to communication included time, professionals not prioritising communication in their role and poor information sharing between parents and professionals. Facilitators included professionals building rapport with a child, good relationships between professionals and parents, professionals having a family-centred approach, and the use of communication aids. Communication with disabled children on the ward was perceived as less than optimal. Parents are instrumental in the communication between their children and professionals. Although aware of the importance of communication with disabled children, staff perceived time pressures and lack of priority given to communicating directly with the child as major barriers. © 2014 John Wiley & Sons Ltd.

Long-term psychological consequences of symptomatic pulmonary embolism: a qualitative study.

PubMed

Noble, Simon; Lewis, Rhian; Whithers, Jodie; Lewis, Sarah; Bennett, Paul

2014-04-02

To explore the psychological consequences of experiencing symptomatic pulmonary embolism (PE). Qualitative interview-based study using interpretative phenomenological analysis. Outpatients who attended an anticoagulation clinic in a district general hospital. Patients attending an anticoagulation clinic following hospital admission for symptomatic PE were approached to participate. A total of 9 (4 women, 5 men) of 11 patients approached agreed to be interviewed. Participants were aged between 26 and 72 years and had previously experienced a PE between 9 and 60 months (median=26 months, mean=24 months). Audiotaped semistructured qualitative interviews were undertaken to explore participants experiences of having a PE and how it had affected their lives since. Data were transcribed and analysed using interpretative phenomenological analysis to identify emergent themes. Three major themes with associated subthemes were identified. Participants described having a PE as a life-changing experience comprising initial shock, followed by feeling of loss of self, life-changing decisions and behaviour modification. Features of post-traumatic stress disorder (PTSD) were described with flashbacks, hypervigilance and intrusive thoughts being most prevalent. Participants identified several areas of support needed for such patients including easier access to support through information giving and emotional support. Long-term consequences of venous thromboembolism go beyond the physical alone. Patients describe experiencing symptomatic PE to be a life-changing distressing event leading to behaviour modification and in some PTSD. It is likely that earlier psychological intervention may reduce such long-term sequelae.

Staff perceptions of a Productive Community Services implementation: A qualitative interview study.

PubMed

Bradley, Dominique Kim Frances; Griffin, Murray

2015-06-01

The Productive Series is a collection of change programmes designed by the English National Health Service (NHS) Institute for Innovation and Improvement to help frontline healthcare staff improve quality and reduce wasted time, so that this time can be reinvested into time spent with patients. The programmes have been implemented in at least 14 countries around the world. This study examines an implementation of the Productive Community Services programme that took place in a Community healthcare organisation in England from July 2010 to March 2012. To explore staff members' perceptions of a Productive Community Services implementation. Cross-sectional interview. Community Healthcare Organisation in East Anglia, England. 45 participants were recruited using purposive, snowballing and opportunistic sampling methods to represent five main types of staff group in the organisation; clinical team members, administrative team members, service managers/team leaders, senior managers and software support staff. Team members were recruited on the basis that they had submitted data for at least one Productive Community Services module. Semi-structured individual and group interviews were carried out after the programme concluded and analysed using thematic analysis. This report focuses on six of the themes identified. The analysis found that communication was not always effective, and there was a lack of awareness, knowledge and understanding of the programme. Many staff did not find the Productive Community Services work relevant, and although certain improvements were sustained, suboptimal practices crept back. Although negative outcomes were reported, such as the programme taking time away from patients initially, many benefits were described including improved stock control and work environments, and better use of the Electronic Patient Record system. One of the themes identified highlighted the positive perceptions of the programme, however a focus on five other themes

Thinking Globally, Interviewing Locally: Using an Intensive Interview Project to Teach Globalization and Social Change

ERIC Educational Resources Information Center

Anderson, Norma J.

2017-01-01

In this article, I connect globalization and qualitative methodological practice, describing a semester-long intensive interview project about the anti-apartheid movement. I provide a detailed overview of the project as well as considerations for those who might want to adapt it for their own courses. Using students' reflections on the projects…

Experiences of health care in women with Peripartum Cardiomyopathy in Sweden: a qualitative interview study.

PubMed

Patel, Harshida; Schaufelberger, Maria; Begley, Cecily; Berg, Marie

2016-12-08

Peripartum cardiomyopathy is often associated with severe heart failure occurring towards the end of pregnancy or in the months following birth with debilitating, exhausting and frightening symptoms requiring person-centered care. The aim of this study was to explore women's experiences of health care while being diagnosed with peripartum cardiomyopathy. Qualitative interviews were conducted with 19 women with peripartum cardiomyopathy in Sweden, following consent. Data were analysed using qualitative content analysis. Confirmability was ensured by peer-debriefing, and an audit trail was kept to establish the credibility of the study. The main theme in the experience of health care was, 'Exacerbated Suffering', expressed in three subthemes; 'not being cared about', 'not being cared for' and 'not feeling secure.' The suffering was present in relation to the illness with failing health symptoms, but most of all in relation to not being taken seriously and adequately cared for by healthcare professionals. Women felt they were on an assembly line in midwives' routine work where knowledge about peripartum cardiomyopathy was lacking and they showed distrust and dissatisfaction with care related to negligence and indifference experienced from healthcare professionals. Feelings of being alone and lost were prominent and related to a sense of insecurity, distress and uneasiness. This study shows a knowledge gap of peripartum cardiomyopathy in maternity care personnel. This is alarming as the deprecation of symptoms and missed diagnosis of peripartum cardiomyopathy can lead to life-threatening consequences. To prompt timely diagnosis and avoid unnecessary suffering it is important to listen seriously to, and respect, women's narratives and act on expressions of symptoms of peripartum cardiomyopathy, even those overlapping normal pregnancy symptoms.

Impact of the Career Style Interview on Individuals with Career Concerns

ERIC Educational Resources Information Center

Rehfuss, Mark C.; Del Corso, Jennifer; Galvin, Kevin; Wykes, Scott

2011-01-01

A total of 18 participants ranging in age from 20 to 55 were administered the career style interview (CSI) and completed a follow-up interview 2 weeks later. Consensual qualitative research analysis of follow-up interview data indicated that after completing the CSI, participants "generally" felt helped and also "typically" experienced awareness,…

The ethics in qualitative health research: special considerations.

PubMed

Peter, Elizabeth

2015-09-01

A sound knowledge of the nature of qualitative research, along with an appreciation of some special ethical considerations, is needed for rigorous reviews to be conducted. The overall character of qualitative research is described with an emphasis on the tendency of qualitative researchers to explore sensitive topics using theoretically informed methods. A number of specific features of qualitative that require additional ethical attention and awareness are also examined including the following: 1) participants are frequently quite vulnerable and require protection because the data collection methods, such as in-depth interviews, can delve into personally and politically charged matters; 2) naturalistic observation can raise concerns regarding privacy and consent; 3) the potential for the identifiability of the results of this research may require extra efforts to maintain confidentiality. Ultimately, Reseach Ethics Committee members must be knowledgeable about qualitative approaches to be able to assess the potential harms and benefits in a protocol carefully. Without this knowledge gaining ethics approval can be overly difficult for researchers and the best practices for protecting human participants can be overlooked.

Choices and Challenges: A Qualitative Exploration of Professional Women's Career Patterns

ERIC Educational Resources Information Center

Whitmarsh, Lona; Brown, Donalee; Cooper, Jane; Hawkins-Rodgers, Yolanda; Wentworth, Diane Keyser

2007-01-01

With the rapid changes occurring in the role of work in women's lives, this research project was designed to examine the career planning, career decision making, and work history of women in both female-dominated and gender-neutral careers (U.S. Department of Labor, n.d.-a). A qualitative analysis of structured interviews identified 6 emerging…

A Qualitative Investigation into the Characteristics and Effects of Music Accompanying Exercise

ERIC Educational Resources Information Center

Priest, David-Lee; Karageorghis, Costas I.

2008-01-01

The purpose of the present study was to identify the characteristics of music used to accompany physical exercise and investigate the effects of such music using a qualitative approach. This work underpins the further development of a theoretical structure that is still relatively new. Semi-structured interviews were conducted with a sample of…

Linking Strengths: Identifying and Exploring Protective Factor Clusters in Academically Resilient Low-Socioeconomic Urban Students of Color

ERIC Educational Resources Information Center

Morales, Erik E.

2010-01-01

Based on data from qualitative interviews with 50 high-achieving low-socioeconomic students of color, two "clusters" of important and symbiotic protective factors are identified and explored. Each cluster consists of a series of interrelated protective factors identified by the participants as crucial to their statistically exceptional academic…

Accessing health services through the back door: a qualitative interview study investigating reasons why people participate in health research in Canada

PubMed Central

2013-01-01

Background Although there is extensive information about why people participate in clinical trials, studies are largely based on quantitative evidence and typically focus on single conditions. Over the last decade investigations into why people volunteer for health research have become increasingly prominent across diverse research settings, offering variable based explanations of participation patterns driven primarily by recruitment concerns. Therapeutic misconception and altruism have emerged as predominant themes in this literature on motivations to participate in health research. This paper contributes to more recent qualitative approaches to understanding how and why people come to participate in various types of health research. We focus on the experience of participating and the meanings research participation has for people within the context of their lives and their health and illness biographies. Methods This is a qualitative exploratory study informed by grounded theory strategies. Thirty-nine participants recruited in British Columbia and Manitoba, Canada, who had taken part in a diverse range of health research studies participated in semi-structured interviews. Participants described their experiences of health research participation including motivations for volunteering. Interviews were recorded, transcribed, and analyzed using constant comparisons. Coding and data management was supported by Nvivo-7. Results A predominant theme to emerge was 'participation in health research to access health services.’ Participants described research as ways of accessing: (1) Medications that offered (hope of) relief; (2) better care; (3) technologies for monitoring health or illness. Participants perceived standard medical care to be a “trial and error” process akin to research, which further blurred the boundaries between research and treatment. Conclusions Our findings have implications for recruitment, informed consent, and the dichotomizing of medical

How family caregivers' medical and moral assumptions influence decision making for patients in the vegetative state: a qualitative interview study

PubMed Central

Borasio, Gian Domenico; Jox, Ralf J

2012-01-01

Background Decisions on limiting life-sustaining treatment for patients in the vegetative state (VS) are emotionally and morally challenging. In Germany, doctors have to discuss, together with the legal surrogate (often a family member), whether the proposed treatment is in accordance with the patient's will. However, it is unknown whether family members of the patient in the VS actually base their decisions on the patient's wishes. Objective To examine the role of advance directives, orally expressed wishes, or the presumed will of patients in a VS for family caregivers' decisions on life-sustaining treatment. Methods and sample A qualitative interview study with 14 next of kin of patients in a VS in a long-term care setting was conducted; 13 participants were the patient's legal surrogates. Interviews were analysed according to qualitative content analysis. Results The majority of family caregivers said that they were aware of aforementioned wishes of the patient that could be applied to the VS condition, but did not base their decisions primarily on these wishes. They gave three reasons for this: (a) the expectation of clinical improvement, (b) the caregivers' definition of life-sustaining treatments and (c) the moral obligation not to harm the patient. If the patient's wishes were not known or not revealed, the caregivers interpreted a will to live into the patient's survival and non-verbal behaviour. Conclusions Whether or not prior treatment wishes of patients in a VS are respected depends on their applicability, and also on the medical assumptions and moral attitudes of the surrogates. We recommend repeated communication, support for the caregivers and advance care planning. PMID:22375077

Competencies necessary for becoming a leader in the field of community medicine: a Japanese qualitative interview study.

PubMed

Kainuma, Mosaburo; Kikukawa, Makoto; Nagata, Masaharu; Yoshida, Motofumi

2018-04-17

To clarify competencies for inclusion in our curriculum that focuses on developing leaders in community medicine. Qualitative interview study. All six regions of Japan, including urban and rural areas. Nineteen doctors (male: 18, female: 1) who play an important leadership role in their communities participated in semistructured interviews (mean age 48.3 years, range 34-59; mean years of clinical experience 23.1 years, range 9-31). Semistructured interviews were held and transcripts were independently analysed and coded by the first two authors. The third and fourth authors discussed and agreed or disagreed with the results to give a consensus agreement. Doctors were recruited by maximum variation sampling until thematic saturation was achieved. Six themes emerged: (1)'Medical ability': includes psychological issues and difficult cases in addition to basic medical problems. High medical ability gives confidence to other medical professionals. (2)'Long term perspective': the ability to develop a long-term, comprehensive vision and to continuously work to achieve the vision. Cultivation of future generations of doctors is included. (3) 'Team building':the ability to drive forward programmes that include residents and local government workers, to elucidate a vision, to communicate and to accept other medical professionals. (4)'Ability to negotiate': the ability to negotiate with others to ensure that programmes and visions progress smoothly (5) 'Management ability': the ability to run a clinic, medical unit or medical association. (6) 'Enjoying oneself': doctors need to feel an attraction to community medicine, that it be fun and challenging for them. We found six competencies that are needed by leaders in the field of community medicine. The results of this study will contribute to designing a curriculum that develops such leaders. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial

Show what you know and deal with stress yourself: a qualitative interview study of medical interns’ perceptions of stress and gender

PubMed Central

2014-01-01

Background Medical students report high stress levels and in particular, the clinical phase is a demanding one. The field of medicine is still described as having a patriarchal culture which favors aspects like a physicians’ perceived certainty and rationalism. Also, the Effort-Recovery Model explains stress as coming from a discrepancy between job demands, job control, and perceived work potential. Gendered differences in stress are reported, but not much is known about medical interns’ perceptions of how gender plays in relation to stress. The aim of this study is to explore how medical interns experience and cope with stress, as well as how they reflect on the gendered aspects of stress. Methods In order to do this, we have performed a qualitative study. In 2010–2011, semi-structured qualitative interviews were conducted with seventeen medical interns across all three years of the Masters programme (6 male, 11 female) at a Dutch medical school. The interview guide is based on gender theory, the Effort-Recovery Model, and empirical literature. Transcribed interviews have been analyzed thematically. Results First, stress mainly evolves from having to prove one’s self and show off competencies and motivation (“Show What You Know…”). Second, interns seek own solutions for handling stress because it is not open for discussion (… “And Deal With Stress Yourself”). Patient encounters are a source of pride and satisfaction rather than a source of stress. But interns report having to present themselves as ‘professional and self-confident’, remaining silent about experiencing stress. Female students are perceived to have more stress and to study harder in order to live up to expectations. Conclusions The implicit message interns hear is to remain silent about insecurities and stress, and, in particular, female students might face disadvantages. Students who feel less able to manifest the ‘masculine protest’ may benefit from a culture that

Show what you know and deal with stress yourself: a qualitative interview study of medical interns' perceptions of stress and gender.

PubMed

Verdonk, Petra; Räntzsch, Viktoria; de Vries, Remko; Houkes, Inge

2014-05-17

Medical students report high stress levels and in particular, the clinical phase is a demanding one. The field of medicine is still described as having a patriarchal culture which favors aspects like a physicians' perceived certainty and rationalism. Also, the Effort-Recovery Model explains stress as coming from a discrepancy between job demands, job control, and perceived work potential. Gendered differences in stress are reported, but not much is known about medical interns' perceptions of how gender plays in relation to stress. The aim of this study is to explore how medical interns experience and cope with stress, as well as how they reflect on the gendered aspects of stress. In order to do this, we have performed a qualitative study. In 2010-2011, semi-structured qualitative interviews were conducted with seventeen medical interns across all three years of the Masters programme (6 male, 11 female) at a Dutch medical school. The interview guide is based on gender theory, the Effort-Recovery Model, and empirical literature. Transcribed interviews have been analyzed thematically. First, stress mainly evolves from having to prove one's self and show off competencies and motivation ("Show What You Know…"). Second, interns seek own solutions for handling stress because it is not open for discussion (… "And Deal With Stress Yourself"). Patient encounters are a source of pride and satisfaction rather than a source of stress. But interns report having to present themselves as 'professional and self-confident', remaining silent about experiencing stress. Female students are perceived to have more stress and to study harder in order to live up to expectations. The implicit message interns hear is to remain silent about insecurities and stress, and, in particular, female students might face disadvantages. Students who feel less able to manifest the 'masculine protest' may benefit from a culture that embraces more collaborative styles, such as having open conversation

The Raison D’être for the Community Pharmacy and the Community Pharmacist in Sweden: A Qualitative Interview Study

PubMed Central

Wisell, Kristin; Sporrong, Sofia Kälvemark

2015-01-01

Community pharmacies are balancing between business (selling medicines and other products) and healthcare (using the pharmacists’ knowledge in order to improve drug utilization). This balance could be affected by regulations decided upon by politicians, but also influenced by others. The aim of this study was to explore important stakeholders’ views on community pharmacy and community pharmacists in Sweden. The method used was that of semi-structured qualitative interviews. Political, professional, and patient organization representatives were interviewed. The results show that informants who are pharmacists or representatives of a professional pharmacist organization generally have a healthcare-centered view on community pharmacy/pharmacists. However, different views on how this orientation should be performed were revealed, ranging from being specialists to dealing with uncomplicated tasks. Political organization representatives generally had a more business-oriented view, where competition in the market was believed to be the main driving force for development. A third dimension in which competition was not stressed also emerged; that community pharmacies should primarily distribute medicines. This dimension was most prevalent among the political and patient organization representatives. One conclusion to be drawn is that no stakeholder seemed to have a clear vision or was willing to take the lead for the development of the community pharmacy sector. PMID:28970376

Barriers to diabetic foot care in a developing country with a high incidence of diabetes related amputations: an exploratory qualitative interview study.

PubMed

Guell, Cornelia; Unwin, Nigel

2015-09-14

Diabetes related foot disease is a major cause of morbidity and mortality in people with diabetes. This is despite the fact that interventions to reduce the burden of diabetic foot disease are estimated to be highly cost effective, even cost saving in both developed and developing countries. This exploratory qualitative study was undertaken in a developing country known to have a very high rate of diabetes related amputations. The aim of the study was to explore barriers to foot care from the perspectives of health care professionals and patients, with a view to informing further work to develop effective interventions. Semi-structured interviews, each of 30 to 60 minutes, were conducted with a purposive sample of 20 individuals (11 health carers and 9 patients with diabetes). Participants were asked how diabetic foot care was experienced and practised, and about knowledge and attitudes relevant to care. Health carers were also asked how they negotiated issues of priority setting within the available resources. Interviews were recorded, transcribed and underwent thematic analysis. Three broad categories of potential barriers to diabetic foot care were identified. First, health carers reported that they and their patients tended to prioritise glycaemic control and that this often eclipsed foot care. Second, health carers described resistance to changing professional roles, particularly within the context of limited resources. Newly assigned foot screening and care duties did not fit in easily with their main work schedule. The overall effect of this was to lead to increased referrals to already overstretched, and difficult to access, podiatrists. Finally, patients reported a health care system with significant reliance on 'self-care' ability, including the need for time and expertise to negotiate access to scarce professional foot care appointments. The findings from this exploratory study provide insight on broad barriers to diabetic foot care within a developing

Analyzing Storytelling in TESOL Interview Research

ERIC Educational Resources Information Center

Kasper, Gabriele; Prior, Matthew T.

2015-01-01

Autobiographic research interviews have become an accepted and valued method of qualitative inquiry in TESOL and applied linguistics more broadly. In recent discussions surrounding the epistemological treatment of autobiographic stories, TESOL researchers have increasingly called for more attention to the ways in which stories are embedded in…

Combining survey data, GIS and qualitative interviews in the analysis of health service access for persons with disabilities.

PubMed

Eide, Arne H; Dyrstad, Karin; Munthali, Alister; Van Rooy, Gert; Braathen, Stine H; Halvorsen, Thomas; Persendt, Frans; Mvula, Peter; Rød, Jan Ketil

2018-06-26

Equitable access to health services is a key ingredient in reaching health for persons with disabilities and other vulnerable groups. So far, research on access to health services in low- and middle-income countries has largely relied on self-reported survey data. Realizing that there may be substantial discrepancies between perceived and actual access, other methods are needed for more precise knowledge to guide health policy and planning. The objective of this article is to describe and discuss an innovative methodological triangulation where statistical and spatial analysis of perceived distance and objective measures of access is combined with qualitative evidence. The data for the study was drawn from a large household and individual questionnaire based survey carried out in Namibia and Malawi. The survey data was combined with spatial data of respondents and health facilities, key informant interviews and focus group discussions. To analyse access and barriers to access, a model is developed that takes into account both measured and perceived access. The geo-referenced survey data is used to establish four outcome categories of perceived and measured access as either good or poor. Combined with analyses of the terrain and the actual distance from where the respondents live to the health facility they go to, the data allows for categorising areas and respondents according to the four outcome categories. The four groups are subsequently analysed with respect to variation in individual characteristics and vulnerability factors. The qualitative component includes participatory map drawing and is used to gain further insight into the mechanisms behind the different combinations of perceived and actual access. Preliminary results show that there are substantial discrepancies between perceived and actual access to health services and the qualitative study provides insight into mechanisms behind such divergences. The novel combination of survey data, geographical

Identifying mechanisms of change in a conversation therapy for aphasia using behaviour change theory and qualitative methods

PubMed Central

Best, Wendy; Beckley, Firle Christina; Maxim, Jane; Beeke, Suzanne

2016-01-01

Abstract Background Conversation therapy for aphasia is a complex intervention comprising multiple components and targeting multiple outcomes. UK Medical Research Council (MRC) guidelines published in 2008 recommend that in addition to measuring the outcomes of complex interventions, evaluation should seek to clarify how such outcomes are produced, including identifying the hypothesized mechanisms of change. Aims To identify mechanisms of change within a conversation therapy for people with aphasia and their partners. Using qualitative methods, the study draws on behaviour change theory to understand how and why participants make changes in conversation during and after therapy. Methods & Procedures Data were derived from 16 participants (eight people with aphasia; eight conversation partners) who were recruited to the Better Conversations with Aphasia research project and took part in an eight session conversation therapy programme. The dataset consists of in‐therapy discussions and post‐therapy interviews, which are analysed using Framework Analysis. Outcomes & Results Seven mechanisms of conversational behaviour change are identified and linked to theory. These show how therapy can activate changes to speakers’ skills and motivation for using specific behaviours, and to the conversational opportunities available for strategy use. Conclusions & Implications These clinically relevant findings offer guidance about the processes involved in producing behavioural change via conversation therapy. A distinction is made between the process involved in motivating change and that involved in embedding change. Differences are also noted between the process engaged in reducing unhelpful behaviour and that supporting new uses of compensatory strategies. Findings are expected to have benefits for those seeking to replicate therapy's core processes both in clinical practice and in future research. PMID:27882642

Identifying mechanisms of change in a conversation therapy for aphasia using behaviour change theory and qualitative methods.

PubMed

Johnson, Fiona M; Best, Wendy; Beckley, Firle Christina; Maxim, Jane; Beeke, Suzanne

2017-05-01

Conversation therapy for aphasia is a complex intervention comprising multiple components and targeting multiple outcomes. UK Medical Research Council (MRC) guidelines published in 2008 recommend that in addition to measuring the outcomes of complex interventions, evaluation should seek to clarify how such outcomes are produced, including identifying the hypothesized mechanisms of change. To identify mechanisms of change within a conversation therapy for people with aphasia and their partners. Using qualitative methods, the study draws on behaviour change theory to understand how and why participants make changes in conversation during and after therapy. Data were derived from 16 participants (eight people with aphasia; eight conversation partners) who were recruited to the Better Conversations with Aphasia research project and took part in an eight session conversation therapy programme. The dataset consists of in-therapy discussions and post-therapy interviews, which are analysed using Framework Analysis. Seven mechanisms of conversational behaviour change are identified and linked to theory. These show how therapy can activate changes to speakers' skills and motivation for using specific behaviours, and to the conversational opportunities available for strategy use. These clinically relevant findings offer guidance about the processes involved in producing behavioural change via conversation therapy. A distinction is made between the process involved in motivating change and that involved in embedding change. Differences are also noted between the process engaged in reducing unhelpful behaviour and that supporting new uses of compensatory strategies. Findings are expected to have benefits for those seeking to replicate therapy's core processes both in clinical practice and in future research. © 2016 Royal College of Speech and Language Therapists.

Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine.

PubMed

Forero, Roberto; Nahidi, Shizar; De Costa, Josephine; Mohsin, Mohammed; Fitzgerald, Gerry; Gibson, Nick; McCarthy, Sally; Aboagye-Sarfo, Patrick

2018-02-17

The main objective of this methodological manuscript was to illustrate the role of using qualitative research in emergency settings. We outline rigorous criteria applied to a qualitative study assessing perceptions and experiences of staff working in Australian emergency departments. We used an integrated mixed-methodology framework to identify different perspectives and experiences of emergency department staff during the implementation of a time target government policy. The qualitative study comprised interviews from 119 participants across 16 hospitals. The interviews were conducted in 2015-2016 and the data were managed using NVivo version 11. We conducted the analysis in three stages, namely: conceptual framework, comparison and contrast and hypothesis development. We concluded with the implementation of the four-dimension criteria (credibility, dependability, confirmability and transferability) to assess the robustness of the study, RESULTS: We adapted four-dimension criteria to assess the rigour of a large-scale qualitative research in the emergency department context. The criteria comprised strategies such as building the research team; preparing data collection guidelines; defining and obtaining adequate participation; reaching data saturation and ensuring high levels of consistency and inter-coder agreement. Based on the findings, the proposed framework satisfied the four-dimension criteria and generated potential qualitative research applications to emergency medicine research. We have added a methodological contribution to the ongoing debate about rigour in qualitative research which we hope will guide future studies in this topic in emergency care research. It also provided recommendations for conducting future mixed-methods studies. Future papers on this series will use the results from qualitative data and the empirical findings from longitudinal data linkage to further identify factors associated with ED performance; they will be reported

Genetic Test Results and Disclosure to Family Members: Qualitative Interviews of Healthcare Professionals' Perceptions of Ethical and Professional Issues in France.

PubMed

D' Audiffret Van Haecke, Diane; de Montgolfier, Sandrine

2016-06-01

The benefit of disclosing test results to next of kin is to improve prognosis and-in some cases-even prevent death though earlier monitoring or preventive therapies. Research on this subject has explored the question of intra-familial communication from the standpoint of patients and relatives but rarely, from the standpoint of healthcare professionals. The purpose of this study was to interview relevant healthcare professionals in France, where legislation framing the issue was recently passed. A qualitative study consisting of semi-structured interviews was set up to get a clearer picture of the challenges arising from this issue, its consequences in terms of medical care-service practices, and the positions that frontline professionals have taken in response to this new legal framework. The findings from eight interviews with 7 clinical geneticists and 1 genetic counselor highlight very different patterns of practices among care services and among the genetic diseases involved. It is equally crucial to investigate other issues such as the nature of genetic testing and its consequences in terms of disclosing results to kin, the question of the role of genetic counseling in the disclosure process, the question of prescription by non-geneticist clinicians, and practical questions linked to information content, consent and medical follow-up for patients and their relatives.

Shame and avoidance as barriers in midwives' communication about body weight with pregnant women: A qualitative interview study.

PubMed

Christenson, Anne; Johansson, Eva; Reynisdottir, Signy; Torgerson, Jarl; Hemmingsson, Erik

2018-04-26

Excessive gestational weight gain, regardless of initial BMI, is associated with perinatal risks for both mother and offspring and contributes to obesity in women. Studies report that healthcare professionals find it difficult to communicate about weight and pregnant women perceive healthcare professionals as unconcerned, leaving many women uninformed about weight recommendations and risks. We aimed to explore how midwives approach communication about gestational weight gain recommendations, and to characterize communication barriers and facilitators. Seventeen midwives from different areas in Sweden were interviewed by a therapist using semi-structured interviews. Interviews were transcribed verbatim and analysed by three researchers using latent content analysis. Recurrent themes were identified and formulated. The main theme identified in the latent part of the analysis was "midwives use avoidant behaviours to cope with fear of inflicting worries, shame or feelings of guilt in pregnant women". Avoidant behaviours include: adjusting weight recommendations, toning down risks and avoid talking about weight. Subthemes identified were (I) Conflicting responsibilities in midwives' professional identity (II) Perceived deficiencies in the working situation. Midwives' empathy and awareness of weight stigma strongly affects communication about weight with pregnant women, and midwives' use of avoidant behaviours constitutes salient information barriers. More research is needed on whether gestational weight guidelines and weighing routines for all women, resources for extra visits, training in specific communication skills and backup access to other professions can facilitate for midwives to initiate and communicate about healthy gestational weight development, enabling more pregnant women to make well-informed lifestyle choices. Copyright © 2018 Elsevier Ltd. All rights reserved.

Exploring representations and experiences of case-management users: towards difficulties and solutions to leading qualitative interviews with older people with complex living conditions.

PubMed

Balard, Frédéric; Corre, Stéphanie Pin Le; Trouvé, Hélène; Saint-Jean, Olivier; Somme, Dominique

2013-01-01

By matching needs to resource services, case management could be a useful tool for improving the care of older people with complex living conditions. Collecting and analysing the users' experiences represents a good way to evaluate the effectiveness and efficiency of a case-management service. However, in the literature, fieldwork is very rarely considered and the users included in qualitative research seem to be the most accessible. This study was undertaken to describe the challenges of conducting qualitative research with older people with complex living conditions in order to understand their experiences with case-management services. Reflective analysis was applied to describe the process of recruiting and interviewing older people with complex living conditions in private homes, describing the protocol with respect to fieldwork chronology. The practical difficulties inherent in this type of study are addressed, particularly in terms of defining a sample, the procedure for contacting the users and conducting the interview. The users are people who suffer from a loss of autonomy because of cognitive impairment, severe disease and/or psychiatric or social problems. Notably, most of them refuse care and assistance. Reflective analysis of our protocol showed that the methodology and difficulties encountered constituted the first phase of data analysis. Understanding the experience of users of case management to analyse the outcomes of case-management services requires a clear methodology for the fieldwork.

How women who have experienced one or more miscarriages manage their feelings and emotions when they become pregnant again - a qualitative interview study.

PubMed

Andersson, Ida-Maria; Nilsson, Sandra; Adolfsson, Annsofie

2012-06-01

The aim of this study was to investigate how women who have experienced one or more miscarriages manage their feelings when they become pregnant again. Individual qualitative interviews were conducted with 16 women who were pregnant again after experiencing one or more miscarriages. The interviews were analysed using qualitative content analysis with an inductive approach. The analysis of the material ended up in five categories: distancing herself from her pregnancy, focusing on her pregnancy symptoms, searching for confirming information, asking for ultrasound examination and asking for professional and social support. Because of their past experience with miscarriage, it could be painful to have another pregnancy terminate in disappointment. Therefore, the women manage their feelings by distancing themselves from their pregnancies. Simultaneously, they are managing their emotions by seeking affirmation that their current pregnancy is normal. Generally speaking, women manage their emotions by themselves. They feel isolated with their worries and concerns, and they are in need of the support provided from their intimate circle of friends and family as well as from the staff of the maternity health care ward. Unfortunately, the women do not feel that they get the support they need from the staff, instead they have to rely on their friends, family and partners to help them manage their emotions. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

Stroke survivors', caregivers' and GPs' attitudes towards a polypill for the secondary prevention of stroke: a qualitative interview study.

PubMed

Jamison, James; Graffy, Jonathan; Mullis, Ricky; Mant, Jonathan; Sutton, Stephen

2016-05-13

To understand the perspectives of stroke survivors, caregivers and general practitioners (GPs) on a polypill approach, consisting of blood pressure and cholesterol-lowering therapies, with or without aspirin, for the secondary prevention of stroke. A qualitative interview study was undertaken in 5 GP surgeries in the East of England. 28 survivors of stroke/transient ischaemic attack (TIA) were interviewed, 14 of them with a caregiver present, along with a convenience sample of 5 GPs, to assess attitudes towards a polypill and future use. Topic guides explored participants attitudes, potential uptake and long-term use, management of polypill medication and factors influencing the decision to prescribe. Data were analysed using a grounded theory approach. Key themes are presented and illustrated with verbatim quotes. The analysis identified 3 key themes: polypill benefits, polypill concerns and polypill lessons for implementation. Stroke/TIA survivors were positive about the polypill concept and considered it acceptable in the secondary prevention of stroke. Perceived benefits of a polypill included convenience resulting in improved adherence and reduced burden of treatment. Caregivers felt that a polypill would improve medication-taking practices, and GPs were open to prescribing it to those at increased cardiovascular risk. However, concerns raised included whether a polypill provided equivalent therapeutic benefit, side effects through combining medications, consequences of non-adherence, lack of flexibility in regulating dosage, disruption to current treatment and suitability to the wider stroke population. Participants acknowledged potential advantages in a polypill approach for secondary prevention of stroke; however, significant concerns remain. Further research on the efficacy of a polypill is needed to reassure practitioners whose concerns around inflexibility and treatment suitability are likely to influence the decision to prescribe a polypill for

Identifying the Strengths, Needs, and Barriers to Student Success for First Generation, Low-Income, First Year College Students

ERIC Educational Resources Information Center

Hayes, Linda A.

2013-01-01

This participatory action research needs assessment was to empower the students in a large urban research university to explore and to identify the strengths of the program, to identify the needs, and to identify the barriers to student success during their first year of college. Using qualitative methods of Group Level Interviews (GLA) and…

Experiences of burden, needs, rewards and resilience in family caregivers of people living with Motor Neurone Disease/Amyotrophic Lateral Sclerosis: A secondary thematic analysis of qualitative interviews.

PubMed

Weisser, Fabia B; Bristowe, Katherine; Jackson, Diana

2015-09-01

Family caregivers of people with Motor Neurone Disease/Amyotrophic Lateral Sclerosis, an incurable, mostly rapidly fatal neurodegenerative disease, face many challenges. Although there is considerable research on caregiver burden in Motor Neurone Disease/Amyotrophic Lateral Sclerosis, there is less knowledge of the positive aspects of caring. To explore the experiences of family caregivers of people with Motor Neurone Disease/Amyotrophic Lateral Sclerosis, specifically the relationship between positive and negative experiences of caring, and to identify possible ways to better support these caregivers. Secondary thematic analysis of 24 semi-structured qualitative interviews conducted longitudinally with 10 family caregivers. Interviews explored rewarding and unrewarding aspects of caring. Themes emerged around burden, needs, rewards and resilience. Resilience included getting active, retaining perspective and living for the moment. Burden was multifaceted, including social burden, responsibility, advocacy, ambivalence, guilt and struggling with acceptance. Rewards included being helped and 'ticking along'. Needs were multifaceted, including social, practical and psychological needs. The four main themes were interrelated. A model of coping was developed, integrating resilience (active/positive), burden (active/negative), needs (passive/negative) and reward (passive/positive). Burden, resilience, needs and rewards are interrelated. Caregivers' ability to cope with caring for a person with Motor Neurone Disease/Amyotrophic Lateral Sclerosis oscillates between positive and negative aspects of caring, being at times active, at times passive. Coping is a non-linear process, oscillating between different states of mind. The proposed model could enable clinicians to better understand the caregiver experience, help family caregivers foster resilience and identify rewards, and develop appropriate individualised caregiver support plans. © The Author(s) 2015.

Discovering untapped relationship potential with patients in telehealth: a qualitative interview study.

PubMed

Heckemann, Birgit; Wolf, Axel; Ali, Lilas; Sonntag, Steffen Mark; Ekman, Inger

2016-03-02

To explore factors that influence relationship building between telehealth professionals and patients with chronic illness over a distance, from a telehealth professional's perspective. 4 focus group interviews were conducted in June 2014. Digital recordings were transcribed verbatim and qualitative content analysis was performed using an iterative process of 3 coding rounds. 20 telehealth professionals. A telehealth service centre in the south of Germany that provided care for 12,000 patients with chronic heart failure across Germany. Non-video telehealth technology creates an atmosphere that fosters sharing of personal information and a non-judgemental attitude. This facilitates the delivery of fair and equal healthcare. A combination of a protocol-driven service structure along with shared team and organisational values provide a basis for establishing long-term healthcare relationships. However, each contact between a telehealth professional and a patient has an uncertain outcome and requires skillful negotiation of the relationship. Although care provision was personalised, there was scope to include the patients as 'experts on their own illness' to a greater extent as advocated by person-centred care. Currently, provision of person-centred care is not sufficiently addressed in telehealth professional training. Telehealth offers a viable environment for the delivery of person-centred care for patients with long-standing disease. Current telehealth training programmes may be enhanced by teaching person-centred care skills. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Widespread mosquito net fishing in the Barotse floodplain: Evidence from qualitative interviews.

PubMed

Larsen, David A; Welsh, Rick; Mulenga, Angela; Reid, Robert

2018-01-01

The insecticide-treated mosquito net (ITN) is a crucial component of malaria control programs, and has prevented many malaria cases and deaths due to scale up. ITNs also serve effectively as fishing nets and various sources have reported use of ITNs for fishing. This article examines how widespread the practice of mosquito net fishing with ITNs is. We conducted in-depth interviews with fishery personnel and traditional leadership from the Barotse Royal Establishment in Western Province, Zambia, to better understand the presence or absence of the use of ITNs as fishing nets. We then coded the interviews for themes through content analysis. Additionally we conducted a desk review of survey data to show trends in malaria indicators, nutritional status of the population and fish consumption. All those interviewed reported that ITNs are regularly used for fishing in Western Zambia and the misuse is widespread. Concurrently those interviewed reported declines in fish catches both in terms of quantity and quality leading to threatened food security in the area. In addition to unsustainable fishing practices those interviewed referenced drought and population pressure as reasons for fishery decline. Malaria indicators do not show a trend in declining malaria transmission, fish consumption has dropped dramatically and nutritional status has not improved over time. Despite the misuse of the ITNs for fishing all those interviewed maintained that ITN distribution should continue. Donors, control programs and scientists should realize that misuse of ITNs as fishing nets is a current problem for malaria control and potentially for food security that needs to be addressed.

Widespread mosquito net fishing in the Barotse floodplain: Evidence from qualitative interviews

PubMed Central

Mulenga, Angela; Reid, Robert

2018-01-01

Background The insecticide-treated mosquito net (ITN) is a crucial component of malaria control programs, and has prevented many malaria cases and deaths due to scale up. ITNs also serve effectively as fishing nets and various sources have reported use of ITNs for fishing. This article examines how widespread the practice of mosquito net fishing with ITNs is. Methods We conducted in-depth interviews with fishery personnel and traditional leadership from the Barotse Royal Establishment in Western Province, Zambia, to better understand the presence or absence of the use of ITNs as fishing nets. We then coded the interviews for themes through content analysis. Additionally we conducted a desk review of survey data to show trends in malaria indicators, nutritional status of the population and fish consumption. Results All those interviewed reported that ITNs are regularly used for fishing in Western Zambia and the misuse is widespread. Concurrently those interviewed reported declines in fish catches both in terms of quantity and quality leading to threatened food security in the area. In addition to unsustainable fishing practices those interviewed referenced drought and population pressure as reasons for fishery decline. Malaria indicators do not show a trend in declining malaria transmission, fish consumption has dropped dramatically and nutritional status has not improved over time. Conclusions Despite the misuse of the ITNs for fishing all those interviewed maintained that ITN distribution should continue. Donors, control programs and scientists should realize that misuse of ITNs as fishing nets is a current problem for malaria control and potentially for food security that needs to be addressed. PMID:29719003

Barriers and facilitators to cooking from 'scratch' using basic or raw ingredients: A qualitative interview study.

PubMed

Lavelle, Fiona; McGowan, Laura; Spence, Michelle; Caraher, Martin; Raats, Monique M; Hollywood, Lynsey; McDowell, Dawn; McCloat, Amanda; Mooney, Elaine; Dean, Moira

2016-12-01

Previous research has highlighted an ambiguity in understanding cooking related terminology and a number of barriers and facilitators to home meal preparation. However, meals prepared in the home still include convenience products (typically high in sugars, fats and sodium) which can have negative effects on health. Therefore, this study aimed to qualitatively explore: (1) how individuals define cooking from 'scratch', and (2) their barriers and facilitators to cooking with basic ingredients. 27 semi-structured interviews were conducted with participants (aged 18-58 years) living on the island of Ireland, eliciting definitions of 'cooking from scratch' and exploring the reasons participants cook in a particular way. The interviews were professionally transcribed verbatim and Nvivo 10 was used for an inductive thematic analysis. Our results highlighted that although cooking from 'scratch' lacks a single definition, participants viewed it as optimal cooking. Barriers to cooking with raw ingredients included: 1) time pressures; (2) desire to save money; (3) desire for effortless meals; (4) family food preferences; and (5) effect of kitchen disasters. Facilitators included: 1) desire to eat for health and well-being; (2) creative inspiration; (3) ability to plan and prepare meals ahead of time; and (4) greater self-efficacy in one's cooking ability. Our findings contribute to understanding how individuals define cooking from 'scratch', and barriers and facilitators to cooking with raw ingredients. Interventions should focus on practical sessions to increase cooking self-efficacy; highlight the importance of planning ahead and teach methods such as batch cooking and freezing to facilitate cooking from scratch. Copyright © 2016 Elsevier Ltd. All rights reserved.

The efficacy of interviewing young drug users through online chat.

PubMed

Barratt, Monica J

2012-06-01

Despite the fact that most young people who use 'party drugs' also use the Internet, accounts of drugs research involving qualitative interviewing using real-time instant messaging or online chat are yet to be published. This paper assesses the efficacy of conducting qualitative research interviews with young party drug users through instant messaging. In 2007-2008, 837 Australian residents who reported recent use of psychostimulants and/or hallucinogens and participated in online drug discussion completed a web survey and a subsample of 27 completed online interviews (median age 21, range 17-37, 59% male). Experienced drug users were more likely to volunteer to be interviewed than novices. The time and space flexibility provided by the online interviews was convenient; however, interviews were more prone to interruption. Establishing legitimacy, personal disclosure, appropriate linguistic style and humour facilitated the development of rapport and enabled the production of more detailed and in-depth data. These strategies were not successful in all cases and when unsuccessful, interviewees were more easily able to exit the interview by choosing not to respond. Young drug users already using the Internet to chat about drugs find online interviewing an acceptable and convenient way to contribute to research. With adequate preparation to develop technical and cultural competencies, online interviewing offers an effective way of engaging with young people that is worthy of consideration by researchers in the alcohol and other drug field. © 2011 Australasian Professional Society on Alcohol and other Drugs.

Women's experience of transfer from midwifery unit to hospital obstetric unit during labour: a qualitative interview study.

PubMed

Rowe, Rachel E; Kurinczuk, Jennifer J; Locock, Louise; Fitzpatrick, Ray

2012-11-15

Midwifery units offer care to women with straightforward pregnancies, but unforeseen complications can arise during labour or soon after birth, necessitating transfer to a hospital obstetric unit. In England, 21% of women planning birth in freestanding midwifery units are transferred; in alongside units, the transfer rate is 26%. There is little high quality contemporary evidence on women's experience of transfer. We carried out a qualitative interview study, using semi-structured interviews, with women who had been transferred from a midwifery unit (freestanding or alongside) in England up to 12 months prior to interview. Maximum variation sampling was used. Interviews with 30 women took place between March 2009 and March 2010. Thematic analysis using constant comparison and exploration of deviant cases was carried out. Most women hoped for or expected a natural birth and did not expect to be transferred. Transfer was disappointing for many; sensitive and supportive care and preparation for the need for transfer helped women adjust to their changing circumstances. A small number of women, often in the context of prolonged labour, described transfer as a relief. For women transferred from freestanding units, the ambulance journey was a "limbo" period. Women wondered, worried or were fearful about what was to come and could be passive participants who felt like they were being "transported" rather than cared for. For many this was a direct contrast with the care they experienced in the midwifery unit. After transfer, most women appreciated the opportunity to talk about their experience to make sense of what happened and help them plan for future pregnancies, but did not necessarily seek this out if it was not offered. Transfer affects a significant minority of women planning birth in midwifery units and is therefore a concern for women and midwives. Transfer is not expected by women, but sensitive care and preparation can help women adjust to changing circumstances

Maximising the value of combining qualitative research and randomised controlled trials in health research: the QUAlitative Research in Trials (QUART) study--a mixed methods study.

PubMed

O'Cathain, Alicia; Thomas, Kate J; Drabble, Sarah J; Rudolph, Anne; Goode, Jackie; Hewison, Jenny

2014-06-01

Researchers sometimes undertake qualitative research with randomised controlled trials (RCTs) of health interventions. To systematically explore how qualitative research is being used with trials and identify ways of maximising its value to the trial aim of providing evidence of effectiveness of health interventions. A sequential mixed methods study with four components. (1) Database search of peer-reviewed journals between January 2008 and September 2010 for articles reporting the qualitative research undertaken with specific trials, (2) systematic search of database of registered trials to identify studies combining qualitative research and trials, (3) survey of 200 lead investigators of trials with no apparent qualitative research and (4) semistructured telephone interviews with 18 researchers purposively sampled from the first three methods. Qualitative research was undertaken with at least 12% of trials. A large number of articles reporting qualitative research undertaken with trials (n=296) were published between 2008 and 2010. A total of 28% (82/296) of articles reported qualitative research undertaken at the pre-trial stage and around one-quarter concerned drugs or devices. The articles focused on 22 aspects of the trial within five broad categories. Some focused on more than one aspect of the trial, totalling 356 examples. The qualitative research focused on the intervention being trialled (71%, 254/356), the design and conduct of the trial (15%, 54/356), the outcomes of the trial (1%, 5/356), the measures used in the trial (3%, 10/356), and the health condition in the trial (9%, 33/356). The potential value of the qualitative research to the trial endeavour included improving the external validity of trials and facilitating interpretation of trial findings. This value could be maximised by using qualitative research more at the pre-trial stage and reporting findings with explicit attention to the implications for the trial endeavour. During interviews

Problems, Solutions, and Strategies Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews.

PubMed

Gladwell, Peter William; Badlan, Kathryn; Cramp, Fiona; Palmer, Shea

2016-07-01

Transcutaneous electrical nerve stimulation (TENS) could offer a non-drug form of pain relief, but there is no consensus regarding its effectiveness for chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methods identified significant problems with low treatment fidelity. There is little information available to inform the development of a pragmatic implementation design for a TENS evaluation. The aim of this study was to explore the experiences of patients who were receiving secondary care in a pain clinic and who had expertise in using TENS to manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. Semistructured interviews were conducted with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Data analysis indicated that patients learned to address a range of problems in order to optimize TENS use. Patients may need to personalize the positioning of electrodes and the TENS settings and to readjust them over time. Patients learned to use TENS in a strategic manner, and the outcomes of each strategy varied. The findings indicated that a pragmatic TENS evaluation may need to incorporate a learning phase to allow patients to optimize this complex pattern of TENS usage, and evaluation may need to be sensitive to the outcomes of strategic use. These findings also have implications for clinical practice. © 2016 American Physical Therapy Association.

The impact of a father's presence during newborn resuscitation: a qualitative interview study with healthcare professionals.

PubMed

Harvey, Merryl E; Pattison, Helen M

2013-03-27

To explore healthcare professionals' experiences around the time of newborn resuscitation in the delivery room, when the baby's father was present. A qualitative descriptive, retrospective design using the critical incident approach. Tape-recorded semistructured interviews were undertaken with healthcare professionals involved in newborn resuscitation. Participants recalled resuscitation events when the baby's father was present. They described what happened and how those present, including the father, responded. They also reflected upon the impact of the resuscitation and the father's presence on themselves. Participant responses were analysed using thematic analysis. A large teaching hospital in the UK. Purposive sampling was utilised. It was anticipated that 35-40 participants would be recruited. Forty-nine potential participants were invited to take part. The final sample consisted of 37 participants including midwives, obstetricians, anaesthetists, neonatal nurse practitioners, neonatal nurses and paediatricians. Four themes were identified: 'whose role?' 'saying and doing' 'teamwork' and 'impact on me'. While no-one was delegated to support the father during the resuscitation, midwives and anaesthetists most commonly took on this role. Participants felt the midwife was the most appropriate person to support fathers. All healthcare professional groups said they often did not know what to say to fathers during prolonged resuscitation. Teamwork was felt to be of benefit to all concerned, including the father. Some paediatricians described their discomfort when fathers came to the resuscitaire. None of the participants had received education and training specifically on supporting fathers during newborn resuscitation. This is the first known study to specifically explore the experiences of healthcare professionals of the father's presence during newborn resuscitation. The findings suggest the need for more focused training about supporting fathers. There is also

Understanding sharps injuries in home healthcare: The Safe Home Care qualitative methods study to identify pathways for injury prevention.

PubMed

Markkanen, Pia; Galligan, Catherine; Laramie, Angela; Fisher, June; Sama, Susan; Quinn, Margaret

2015-04-11

Home healthcare is one of the fastest growing sectors in the United States. Percutaneous injuries from sharp medical devices (sharps) are a source of bloodborne pathogen infections among home healthcare workers and community members. Sharps use and disposal practices in the home are highly variable and there is no comprehensive analysis of the system of sharps procurement, use and disposal in home healthcare. This gap is a barrier to effective public health interventions. The objectives of this study were to i) identify the full range of pathways by which sharps enter and exit the home, stakeholders involved, and barriers for using sharps with injury prevention features; and ii) assess the leverage points for preventive interventions. This study employed qualitative research methods to develop two systems maps of the use of sharps and prevention of sharps injuries in home healthcare. Twenty-six in-depth interview sessions were conducted including home healthcare agency clinicians, public health practitioners, sharps device manufacturers, injury prevention advocates, pharmacists and others. Interview transcripts were audio-recorded and analyzed thematically using NVIVO qualitative research analysis software. Analysis of supporting archival material also was conducted. All findings guided development of the two maps. Sharps enter the home via multiple complex pathways involving home healthcare providers and home users. The providers reported using sharps with injury prevention features. However, home users' sharps seldom had injury prevention features and sharps were commonly re-used for convenience and cost-savings. Improperly discarded sharps present hazards to caregivers, waste handlers, and community members. The most effective intervention potential exists at the beginning of the sharps systems maps where interventions can eliminate or minimize sharps injuries, in particular with needleless treatment methods and sharps with injury prevention features

Physician cooperation in outpatient cancer care. An amplified secondary analysis of qualitative interview data.

PubMed

Engler, J; Güthlin, C; Dahlhaus, A; Kojima, E; Müller-Nordhorn, J; Weißbach, L; Holmberg, C

2017-11-01

The importance of outpatient cancer care services is increasing due to the growing number of patients having or having had cancer. However, little is known about cooperation among physicians in outpatient settings. To understand what inter- and multidisciplinary care means in community settings, we conducted an amplified secondary analysis that combined qualitative interview data with 42 general practitioners (GPs), 21 oncologists and 21 urologists that mainly worked in medical practices in Germany. We compared their perspectives on cooperation relationships in cancer care. Our results indicate that all participants regarded cooperation as a prerequisite for good cancer care. Oncologists and urologists mainly reported cooperating for tumour-specific treatment tasks, while GPs' reasoning for cooperation was more patient-centred. While oncologists and urologists reported experiencing reciprocal communication with other physicians, GPs had to gather the information they needed. GPs seldom reported engaging in formal cooperation structures, while for specialists, participation in formal spaces of cooperation, such as tumour boards, facilitated a more frequent and informal discussion of patients, for instance on the phone. Further research should focus on ways to foster GPs' integration in cancer care and evaluate if this can be reached by incorporating GPs in formal cooperation structures such as tumour boards. © 2017 John Wiley & Sons Ltd.

Amalgamation of Marginal Gains (AMG) as a potential system to deliver high-quality fundamental nursing care: A qualitative analysis of interviews from high-performance AMG sports and healthcare practitioners.

PubMed

Pentecost, Claire; Richards, David A; Frost, Julia

2017-11-28

To investigate the components of the Amalgamation of Marginal Gains (AMG) performance system to identify a set of principles that can be built into an innovative fundamental nursing care protocol. Nursing is urged to refocus on its fundamental care activities, but little evidence exists to guide practising nurses. Fundamental care is a combination of many small behaviours aimed at meeting a person's care needs. AMG is a successful system of performance management that focusses on small (or marginal) gains, and might provide a new delivery framework for fundamental nursing care. Qualitative interview study. We undertook in-depth interviews with healthcare and sports professionals experienced in AMG. We analysed data using open coding in a framework analysis, and then interrogated the data using Normalisation Process Theory (NPT). We triangulated findings with AMG literature to develop an intervention logic model. We interviewed 20 AMG practitioners. AMG processes were as follows: focusing on many details to optimise performance, identification of marginal gains using different sources, understanding current versus optimum performance, monitoring at micro and macro level and strong leadership. Elements of normalisation were as follows: whole team belief in AMG to improve performance, a collective desire for excellence using evidence-based actions, whole team engagement to identify choose and implement changes, and individual and group responsibility for monitoring performance. We have elicited the processes described by AMG innovators in health care and sport and have mapped the normalisation potential and work required to embed such a system into nursing practice. The development of our logic model based on AMG and NPT may provide a practical framework for improving fundamental nursing care and is ripe for further development and testing in clinical trials. © 2017 The Authors Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Using internet-based approaches to collect qualitative data from vulnerable groups: reflections from the field.

PubMed

Neville, Stephen; Adams, Jeffery; Cook, Catherine

2016-12-01

Undertaking qualitative research with vulnerable populations is a complex and challenging process for researchers. Traditional and common modes of collecting qualitative data with these groups have been via face-to-face recorded interviews. This article reports on three internet-based data collection methods; email and synchronous online interviews, as well as online qualitative survey. The key characteristics of using email, sychronous online interviews and an online qualitative survey including the strengths and limitations of each are presented. Reflections and insights on the use of these internet-based data collection methods are provided to encourage researchers to embrace technology and move away from using traditional face-to-face interviews when researching with vulnerable populations. Using the internet to collect qualitative data offers additional ways to gather qualitative data over traditional data collection methods. The use of alternative interview methods may encourage participation of vulnerable participants.

A human factors systems approach to understanding team-based primary care: a qualitative analysis

PubMed Central

Mundt, Marlon P.; Swedlund, Matthew P.

2016-01-01

Background. Research shows that high-functioning teams improve patient outcomes in primary care. However, there is no consensus on a conceptual model of team-based primary care that can be used to guide measurement and performance evaluation of teams. Objective. To qualitatively understand whether the Systems Engineering Initiative for Patient Safety (SEIPS) model could serve as a framework for creating and evaluating team-based primary care. Methods. We evaluated qualitative interview data from 19 clinicians and staff members from 6 primary care clinics associated with a large Midwestern university. All health care clinicians and staff in the study clinics completed a survey of their communication connections to team members. Social network analysis identified key informants for interviews by selecting the respondents with the highest frequency of communication ties as reported by their teammates. Semi-structured interviews focused on communication patterns, team climate and teamwork. Results. Themes derived from the interviews lent support to the SEIPS model components, such as the work system (Team, Tools and Technology, Physical Environment, Tasks and Organization), team processes and team outcomes. Conclusions. Our qualitative data support the SEIPS model as a promising conceptual framework for creating and evaluating primary care teams. Future studies of team-based care may benefit from using the SEIPS model to shift clinical practice to high functioning team-based primary care. PMID:27578837

Social and Physical Environmental Factors Influencing Adolescents' Physical Activity in Urban Public Open Spaces: A Qualitative Study Using Walk-Along Interviews.

PubMed

Van Hecke, Linde; Deforche, Benedicte; Van Dyck, Delfien; De Bourdeaudhuij, Ilse; Veitch, Jenny; Van Cauwenberg, Jelle

2016-01-01

Most previous studies examining physical activity in Public Open Spaces (POS) focused solely on the physical environment. However, according to socio-ecological models the social environment is important as well. The aim of this study was to determine which social and physical environmental factors affect adolescents' visitation and physical activity in POS in low-income neighbourhoods. Since current knowledge on this topic is limited, especially in Europe, qualitative walk-along interviews were used to obtain detailed and context-specific information. Participants (n = 30, aged 12-16 years, 64% boys) were recruited in POS in low-income neighbourhoods in Brussels, Ghent and Antwerp (Belgium). Participants were interviewed while walking in the POS with the interviewer. Using this method, the interviewer could observe and ask questions while the participant was actually experiencing the environment. All audio-recorded interviews were transcribed and analysed using Nvivo 10 software and thematic analysis was used to derive categories and subcategories using a grounded theory approach. The most important subcategories that were supportive of visiting POS and performing physical activity in POS were; accessibility by foot/bicycle/public transport, located close to home/school, presence of (active) friends and family, cleanliness of the POS and features, availability of sport and play facilities, large open spaces and beautiful sceneries. The most important subcategories that were unsupportive of visiting POS and physical activity in POS were; presence of undesirable users (drug users, gangs and homeless people), the behaviour of other users and the cleanliness of the POS and features. Social factors appeared often more influential than physical factors, however, it was the combination of social and physical factors that affected adolescents' behaviour in POS. Easily accessible POS with high quality features in the proximity of adolescents' home or school may stimulate

Social and Physical Environmental Factors Influencing Adolescents’ Physical Activity in Urban Public Open Spaces: A Qualitative Study Using Walk-Along Interviews

PubMed Central

Van Hecke, Linde; Deforche, Benedicte; Van Dyck, Delfien; De Bourdeaudhuij, Ilse; Veitch, Jenny; Van Cauwenberg, Jelle

2016-01-01

Most previous studies examining physical activity in Public Open Spaces (POS) focused solely on the physical environment. However, according to socio-ecological models the social environment is important as well. The aim of this study was to determine which social and physical environmental factors affect adolescents’ visitation and physical activity in POS in low-income neighbourhoods. Since current knowledge on this topic is limited, especially in Europe, qualitative walk-along interviews were used to obtain detailed and context-specific information. Participants (n = 30, aged 12–16 years, 64% boys) were recruited in POS in low-income neighbourhoods in Brussels, Ghent and Antwerp (Belgium). Participants were interviewed while walking in the POS with the interviewer. Using this method, the interviewer could observe and ask questions while the participant was actually experiencing the environment. All audio-recorded interviews were transcribed and analysed using Nvivo 10 software and thematic analysis was used to derive categories and subcategories using a grounded theory approach. The most important subcategories that were supportive of visiting POS and performing physical activity in POS were; accessibility by foot/bicycle/public transport, located close to home/school, presence of (active) friends and family, cleanliness of the POS and features, availability of sport and play facilities, large open spaces and beautiful sceneries. The most important subcategories that were unsupportive of visiting POS and physical activity in POS were; presence of undesirable users (drug users, gangs and homeless people), the behaviour of other users and the cleanliness of the POS and features. Social factors appeared often more influential than physical factors, however, it was the combination of social and physical factors that affected adolescents’ behaviour in POS. Easily accessible POS with high quality features in the proximity of adolescents’ home or school may

Practice variation amongst preventive child healthcare professionals in the prevention of child maltreatment in the Netherlands: Qualitative and quantitative data.

PubMed

Visscher, Simeon J A; van Stel, Henk F

2017-12-01

This article provides both qualitative and quantitative data on practice variation amongst preventive child healthcare professionals in the prevention of child maltreatment in the Netherlands. Qualitative data consist of topics identified during interviews with 11 experts (with quotes), resulting in an online survey. The quantitative data are survey responses from 1104 doctors and nurses working in 29 preventive child healthcare organizations. Additionally, the interview topic list, the qualitative data analysis methodology, the survey (in English and Dutch) and anonymized raw survey data (http://hdl.handle.net/10411/5LJOGH) are provided as well. This data-in-brief article accompanies the paper "Variation in prevention of child maltreatment by Dutch child healthcare professionals" by Simeon Visscher and Henk van Stel [1].

Comparing the application of two theoretical frameworks to describe determinants of adverse medical device event reporting: secondary analysis of qualitative interview data.

PubMed

Desveaux, Laura; Gagliardi, Anna R

2018-06-04

Post-market surveillance of medical devices is reliant on physician reporting of adverse medical device events (AMDEs). Few studies have examined factors that influence whether and how physicians report AMDEs, an essential step in the development of behaviour change interventions. This study was a secondary analysis comparing application of the Theoretical Domains Framework (TDF) and the Tailored Implementation for Chronic Diseases (TICD) framework to identify potential behaviour change interventions that correspond to determinants of AMDE reporting. A previous study involving qualitative interviews with Canadian physicians that implant medical devices identified themes reflecting AMDE reporting determinants. In this secondary analysis, themes that emerged from the primary analysis were independently mapped to the TDF and TICD. Determinants and corresponding intervention options arising from both frameworks (and both mappers) were compared. Both theoretical frameworks were useful for identifying interventions corresponding to behavioural determinants of AMDE reporting. Information or education strategies that provide evidence about AMDEs, and audit and feedback of AMDE data were identified as interventions to target the theme of physician beliefs; improving information systems, and reminder cues, prompts and awards were identified as interventions to address determinants arising from the organization or systems themes; and modifying financial/non-financial incentives and sharing data on outcomes associated with AMDEs were identified as interventions to target device market themes. Numerous operational challenges were encountered in the application of both frameworks including a lack of clarity about how directly relevant to themes the domains/determinants should be, how many domains/determinants to select, if and how to resolve discrepancies across multiple mappers, and how to choose interventions from among the large number associated with selected domains

Entry Points When Undergraduate Research Mentors Reflect on Their Role: A Qualitative Case Study

ERIC Educational Resources Information Center

Wallin, Patric; Adawi, Tom

2018-01-01

Graduate students and postdoctoral researchers are increasingly taking on mentoring roles in undergraduate research (UR). There is, however, a paucity of research focusing on how they conceptualize their mentoring role. In this qualitative interview study, we identified three entry points that mentors reflect on to define their role: (1) What are…

Identifying strategies to improve access to credible and relevant information for public health professionals: a qualitative study

PubMed Central

LaPelle, Nancy R; Luckmann, Roger; Simpson, E Hatheway; Martin, Elaine R

2006-01-01

Background Movement towards evidence-based practices in many fields suggests that public health (PH) challenges may be better addressed if credible information about health risks and effective PH practices is readily available. However, research has shown that many PH information needs are unmet. In addition to reviewing relevant literature, this study performed a comprehensive review of existing information resources and collected data from two representative PH groups, focusing on identifying current practices, expressed information needs, and ideal systems for information access. Methods Nineteen individual interviews were conducted among employees of two domains in a state health department – communicable disease control and community health promotion. Subsequent focus groups gathered additional data on preferences for methods of information access and delivery as well as information format and content. Qualitative methods were used to identify themes in the interview and focus group transcripts. Results Informants expressed similar needs for improved information access including single portal access with a good search engine; automatic notification regarding newly available information; access to best practice information in many areas of interest that extend beyond biomedical subject matter; improved access to grey literature as well as to more systematic reviews, summaries, and full-text articles; better methods for indexing, filtering, and searching for information; and effective ways to archive information accessed. Informants expressed a preference for improving systems with which they were already familiar such as PubMed and listservs rather than introducing new systems of information organization and delivery. A hypothetical ideal model for information organization and delivery was developed based on informants' stated information needs and preferred means of delivery. Features of the model were endorsed by the subjects who reviewed it. Conclusion

Patients' views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury-A qualitative interview-based study.

PubMed

Scheel-Sailer, Anke; Post, Marcel W; Michel, Franz; Weidmann-Hügle, Tatjana; Baumann Hölzle, Ruth

2017-10-01

Involving patients in decision making is a legal requirement in many countries, associated with better rehabilitation outcomes, but not easily accomplished during initial inpatient rehabilitation after severe trauma. Providing medical treatment according to the principles of shared decision making is challenging as a point in case for persons with spinal cord injury (SCI). The aim of this study was to retrospectively explore the patients' views on their participation in decision making during their first inpatient rehabilitation after onset of SCI, in order to optimize treatment concepts. A total of 22 participants with SCI were interviewed in-depth using a semi-structured interview scheme between 6 months and 35 years post-onset. Interviews were transcribed verbatim and analysed with the Mayring method for qualitative content analysis. Participants experienced a substantially reduced ability to participate in decision making during the early phase after SCI. They perceived physical, psychological and environmental factors to have impacted upon this ability. Patients mentioned regaining their ability to make decisions was an important goal during their first rehabilitation. Receiving adequate information in an understandable and personalized way was a prerequisite to achieve this goal. Other important factors included medical and psychological condition, personal engagement, time and dialogue with peers. During the initial rehabilitation of patients with SCI, professionals need to deal with the discrepancy between the obligation to respect a patient's autonomy and their diminished ability for decision making. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

The use of semi-structured interviews for collection of qualitative and quantitative data in hydrological studies

NASA Astrophysics Data System (ADS)

O'Keeffe, Jimmy; Buytaert, Wouter; Mijic, Ana; Brozovic, Nicholas

2015-04-01

To build an accurate, robust understanding of the environment, it is important to not only collect information describing its physical characteristics, but also the drivers which influence it. As environmental change, from increasing CO2 levels to decreasing water levels, is often heavily influenced by human activity, gathering information on anthropogenic as well as environmental variables is extremely important. This can mean collecting qualitative, as well as quantitative information. In reality studies are often bound by financial and time constraints, limiting the depth and detail of the research. It is up to the researcher to determine what the best methodology to answer the research questions is likely to be. Here we present a methodology of collecting qualitative and quantitative information in tandem for hydrological studies through the use of semi-structured interviews. This is applied to a case study in two districts of Uttar Pradesh, North India, one of the most intensely irrigated areas of the world. Here, decreasing water levels exacerbated by unchecked water abstraction, an expanding population and government subsidies, have put the long term resilience of the farming population in doubt. Through random selection of study locations, combined with convenience sampling of the participants therein, we show how the data collected can provide valuable insight into the drivers which have led to the current water scenario. We also show how reliable quantitative information can, using the same methodology, be effectively and efficiently extracted for modelling purposes, which along with developing an understanding of the characteristics of the environment is vital in coming up with realistic and sustainable solutions for water resource management in the future.

Social and Virtual Networks: Evaluating Synchronous Online Interviewing Using Instant Messenger

ERIC Educational Resources Information Center

Hinchcliffe, Vanessa; Gavin, Helen

2009-01-01

This paper describes an evaluation of the quality and utility of synchronous online interviewing for data collection in social network research. Synchronous online interviews facilitated by Instant Messenger as the communication medium, were undertaken with ten final year university students. Quantitative and qualitative content analysis of…

Overview of qualitative research.

PubMed

Grossoehme, Daniel H

2014-01-01

Qualitative research methods are a robust tool for chaplaincy research questions. Similar to much of chaplaincy clinical care, qualitative research generally works with written texts, often transcriptions of individual interviews or focus group conversations and seeks to understand the meaning of experience in a study sample. This article describes three common methodologies: ethnography, grounded theory, and phenomenology. Issues to consider relating to the study sample, design, and analysis are discussed. Enhancing the validity of the data, as well reliability and ethical issues in qualitative research are described. Qualitative research is an accessible way for chaplains to contribute new knowledge about the sacred dimension of people's lived experience.

How do health service professionals consider human factors when purchasing interactive medical devices? A qualitative interview study.

PubMed

Vincent, Christopher James; Blandford, Ann

2017-03-01

We present findings of a UK study into how those involved in purchasing interactive medical devices go about evaluating usability, the challenges that arise, and opportunities for improvement. The study focused on procurement of infusion devices because these are used by various professionals across healthcare. A semi-structured interview study was carried out involving a range of stakeholders (20 in total) involved in or impacted by medical device procurement. Data was analysed using thematic analysis, a qualitative method designed to support the identification, analysis and reporting of patterns. In principle, health service purchasing was found to accommodate consideration of equipment usability. In practice, the evaluation process was driven primarily by engineering standards; assessment of local needs did not accommodate substantive assessment of usability; and choice was limited by the availability of equipment on the marketplace. We discuss ways in which purchasing could be improved through techniques that account for social circumstances. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Relationship between Health Professionals and the Elderly Patient Facing Drug Prescription: A Qualitative Approach

ERIC Educational Resources Information Center

Lefevre, Fernando; Teixeira, Jorge Juarez Vieira; Lefevre, Ana Maria Cavalcanti; de Castro, Lia Lusitana Cardozo; Spinola, Aracy Witt de Pinho

2004-01-01

Aiming at identifying the relationship between the elderly patient facing drug prescription and health professionals, an exploratory and descriptive study of a qualitative cut was carried out using semi-structured interviews. To this end, the Collective Subject Discourse analysis technique was employed. Thirty elderly patients living in the urban…

Experience of Being Gay, Lesbian or Bisexual at an Australian Medical School: A Qualitative Study

ERIC Educational Resources Information Center

Chur-Hansen, Anna

2004-01-01

Six undergraduate students were interviewed in a qualitative study about their experiences as gay, lesbian or bisexual students studying Medicine. Informants, who were identified by snowball sampling, spoke about their experiences both freely and in response to a series of prompt questions derived from previous research. The transcribed interviews…

Perceptions of a cognitive rehabilitation group by older people living with cognitive impairment and their caregivers: A qualitative interview study.

PubMed

Moebs, Isabelle; Gee, Susan; Miyahara, Motohide; Paton, Helen; Croucher, Matthew

2017-05-01

Cognitive rehabilitation has been developed to improve quality of life, activities of daily living and mood for people with cognitive impairment, but the voice of people with cognitive impairment has been underrepresented. This study aimed to understand the experience of people living with cognitive impairment, as well as their caregivers who took part in a cognitive rehabilitation intervention programme. Twelve individuals with cognitive impairment and 15 caregivers participated in individual qualitative interviews. The interview data were analysed in three steps: 1) familiarisation of the transcripts; 2) identification of themes; 3) re-interpretation, refinement and integration of themes with methodological auditors. Both participants living with cognitive impairment and caregivers valued the comfortable environment with friendly, caring and supportive group leaders who taught practical tips and strategies. The participants living with cognitive impairment enjoyed socialising with like others. Caregivers benefited from learning about memory problems and sharing their challenges with other caregivers. The participants living with cognitive impairment emphasised the benefits of relational and practical aspects, whereas the caregivers valued the informational and emotional support. In conclusion, both participants living with cognitive impairment and caregivers found the cognitive rehabilitation group useful.

Adapting qualitative research strategies to technology savvy adolescents.

PubMed

Mason, Deanna Marie; Ide, Bette

2014-05-01

To adapt research strategies involving adolescents in a grounded theory qualitative research study by conducting email rather than face-to-face interviews. Adolescent culture relies heavily on text-based communication and teens prefer interactions mediated through technology. Traditional qualitative research strategies need to be rethought when working with adolescents. Adapting interviewing strategies to electronic environments is timely and relevant for researching adolescents. Twenty three adolescents (aged 16-21) were interviewed by email. A letter of invitation was distributed. Potential participants emailed the researcher to convey interest in participating. If the inclusion criteria were met, email interviews were initiated. Participants controlled the interviews through their rate of response to interview questions. A grounded theory methodology was employed. Initial contact with participants reiterated confidentiality and the ability to withdraw from the study at any time. Interviews began with the collection of demographic information and a broad opening based on a semi-structured interview guide. All data were permissible, including text, photos, music, videos or outside media, for example YouTube. The participant was allowed to give direction to the interview after initial questions were posed. Email interviews continued until saturation was reached in the data. Participants were enthusiastic about email interviewing. Attrition did not occur. Email interviewing gave participants more control over the research, decreased power differentials between the adolescent and researcher, allowed the study to be adapted to cultural, linguistic and developmental needs, and maintained confidentiality. As participants said that email communication was slow and they preferred instant messaging, replication in faster-paced media is recommended. Repetition in face-to-face settings is warranted to evaluate how technology may have influenced the findings. Implications for

Identifying unintended consequences of quality indicators: a qualitative study.

PubMed

Lester, Helen E; Hannon, Kerin L; Campbell, Stephen M

2011-12-01

For the first 5 years of the UK primary care pay for performance scheme, the Quality and Outcomes Framework (QOF), quality indicators were introduced without piloting. However, in 2009, potential new indicators were piloted in a nationally representative sample of practices. This paper describes an in-depth exploration of family physician, nurse and other primary-care practice staff views of the value of piloting with a particular focus on unintended consequences of 13 potential new QOF indicators. Fifty-seven family-practice professionals were interviewed in 24 representative practices across England. Almost all interviewees emphasised the value of piloting in terms of an opportunity to identify unintended consequences of potential QOF indicators in 'real world' settings with staff who deliver day-to-day care to patients. Four particular types of unintended consequences were identified: measure fixation, tunnel vision, misinterpretation and potential gaming. 'Measure fixation,' an inappropriate attention on isolated aspects of care, appeared to be the key unintended consequence. In particular, if the palliative care indicator had been introduced without piloting, this might have incentivised poorer care in a minority of practices with potential harm to vulnerable patients. It is important to identify concerns and experiences about unintended consequences of indicators at an early stage when there is time to remove or adapt problem indicators. Since the UK government currently spends over £1 billion each year on QOF, the £150,000 spent on each piloting cohort (0.0005% of the total QOF budget) appears to be good value for money.

Effective International Medical Disaster Relief: A Qualitative Descriptive Study.

PubMed

Broby, Nicolette; Lassetter, Jane H; Williams, Mary; Winters, Blaine A

2018-04-01

Purpose The aim of this study was to assist organizations seeking to develop or improve their medical disaster relief effort by identifying fundamental elements and processes that permeate high-quality, international, medical disaster relief organizations and the teams they deploy. A qualitative descriptive design was used. Data were gathered from interviews with key personnel at five international medical response organizations, as well as during field observations conducted at multiple sites in Jordan and Greece, including three refugee camps. Data were then reviewed by the research team and coded to identify patterns, categories, and themes. The results from this qualitative, descriptive design identified three themes which were key characteristics of success found in effective, well-established, international medical disaster relief organizations. These characteristics were first, ensuring an official invitation had been extended and the need for assistance had been identified. Second, the response to that need was done in an effective and sustainable manner. Third, effective organizations strived to obtain high-quality volunteers. By following the three key characteristics outlined in this research, organizations are more likely to improve the efficiency and quality of their work. In addition, they will be less likely to impede the overall recovery process. Broby N , Lassetter JH , Williams M , Winters BA . Effective international medical disaster relief: a qualitative descriptive study. Prehosp Disaster Med. 2018;33(2):119-126.

Learners' decisions for attending Pediatric Grand Rounds: a qualitative and quantitative study.

PubMed

Dolcourt, Jack L; Zuckerman, Grace; Warner, Keith

2006-04-27

Although grand rounds plays a major educational role at academic medical centers, there has been little investigation into the factors influencing the learners' decision to attend. Greater awareness of attendees' expectations may allow grand rounds planners to better accommodate the learners' perspective, potentially making continuing education activities more attractive and inviting. We used both qualitative (part A) and quantitative (part B) techniques to investigate the motivators and barriers to grand rounds attendance. Part A investigated contextual factors influencing attendance as expressed through attendee interviews. Transcripts of the interviews were analyzed using grounded theory techniques. We created a concept map linking key factors and their relationships. In part B we quantified the motivators and barriers identified during the initial interviews through a survey of the grand rounds audience. Sixteen persons voluntarily took part in the qualitative study (part A) by participating in one of seven group interview sessions. Of the 14 themes that emerged from these sessions, the most frequent factors motivating attendance involved competent practice and the need to know. All sessions discussed intellectual stimulation, social interaction, time constraints and convenience, licensure, content and format, and absence of cost for attending sessions. The 59 respondents to the survey (part B) identified clinically-useful topics (85%), continuing education credit (46%), cutting-edge research (27%), networking (22%), and refreshments (8%) as motivators and non-relevant topics (44%) and too busy to attend (56%) as barriers. Greater understanding of the consumers' perspective can allow planners to tailor the style, content, and logistics to make grand rounds more attractive and inviting.

Primary healthcare nurses' experiences with motivational interviewing in health promotion practice.

PubMed

Brobeck, Elisabeth; Bergh, Håkan; Odencrants, Sigrid; Hildingh, Cathrine

2011-12-01

The aim of the study was to describe primary healthcare nurses' experiences with motivational interviewing as a method for health promotion practice. A person's lifestyle has a major effect on his or her health. Motivational interviewing is one way of working with lifestyle changes in health promotion practice. The basic plan of motivational interviewing is to help people understand their lifestyle problems and make positive lifestyle changes. Motivational interviewing has been proven to be more effective than conventional methods in increasing patient motivation. This study has a descriptive design and uses a qualitative method. Twenty nurses who worked in primary health care and actively used motivational interviewing in their work were interviewed. Qualitative content analysis was used to process the data. The primary healthcare nurses' experiences with motivational interviewing as a method of health promotion practice demonstrate that motivational interviewing is a demanding, enriching and useful method that promotes awareness and guidance in the care relationship. The results also show that motivational interviewing is a valuable tool for primary healthcare nurses' health promotion practice. This study shows that motivational interviewing places several different demands on nurses who use this method. Those who work with motivational interviewing must make an effort to incorporate this new method to avoid falling back into the former practice of simply giving advice. Maintaining an open mind while implementing motivational interviewing in real healthcare settings is crucial for nurses to increase this method's effectiveness. The nurses in the study had a positive experience with motivational interviewing, which can contribute to the increased use, adaption and development of motivational interviewing among primary healthcare professionals. Increased motivational interviewing knowledge and skills would also contribute to promotion of health lifestyle practices

Understanding Experiences of Youth Growing Up with Anorectal Malformation or Hirschsprung's Disease to Inform Transition Care: A Qualitative In-Depth Interview Study.

PubMed

Nah, Shireen Anne; Ong, Caroline C P; Lie, Desiree; Marimuttu, Vicknesan Jeyan; Hong, Julian; Te-Lu, Yap; Low, Yee; Jacobsen, Anette Sundfor

2018-02-01

 The impact of anorectal malformation (ARM) or Hirschsprung's disease (HD) in children continues into adulthood despite early surgical correction. We aimed to explore the physical, social, and emotional impacts of these conditions on youth to inform best transition care strategies.  Eligible participants were those aged between 14 and 21 years who had undergone surgery for ARM/HD in our institution. We conducted one-on-one in-depth interviews to saturation using a question guide developed from literature review and clinician expertise. Deidentified transcripts were coded by four coders (two pediatric surgeons, one psychiatrist, and one qualitative expert) for major themes using a constant comparison approach. A theoretical model for understanding the transition experience was developed using grounded theory.  Out of 120 patients identified as eligible, 11 youth (6 males) participated in the study. Interviews lasted from 50 to 60 minutes. Four major themes emerged: (1) social support (subthemes: family as core, friends as outer support), (2) cognitive and emotional change (subthemes: realization/recognition of illness, matching emotional response), (3) impact of physical symptoms (subthemes: adverse effects of abnormal bowel habits, gaining bowel continence control leading to overall feeling of control, need to keep disease private), and (4) healthcare providers (viewed as important information sources). Themes did not differ by gender.  Our model suggests that participants' understanding of bowel disease evolved over time with a "lightbulb" moment in preteens or early teens accompanied by increasing disease ownership and self-management. Clinicians should independently engage with patients in late childhood to address evolving emotional and information needs and encourage increasing autonomy. Future studies should explore communication approaches to meet transition needs of patients. Georg Thieme Verlag KG Stuttgart · New York.

A qualitative study of younger men's experience of heart attack (myocardial infarction).

PubMed

Merritt, Christopher J; de Zoysa, Nicole; Hutton, Jane M

2017-09-01

The effects of heart attack, or myocardial infarction (MI), across psychosocial domains may be particularly acute in younger adults, for whom serious health events are non-normative. MI morbidity is declining in Western countries, but in England MI numbers have plateaued for the under-45 cohort, where approximately 90% of patients are male. Qualitative research on younger adults' experience of MI is limited, and no study has sampled exclusively under-45s. This study aimed to understand how a sample of men under 45 adjusted to and made sense of MI. Qualitative research design based on semi-structured in-depth interviews. Ten men aged under 45 who had experienced MI in the past 3-6 months were purposively recruited and interviewed. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis. Seven superordinate themes were identified. This article focuses in depth on the three most original themes: (1) 'I'm less of a man', which described experiences of losing 'maleness' (strength, independence, ability to provide) post-MI; (2) 'Shortened horizons', which covered participants' sense of foreshortened future and consequent reprioritization; and (3) 'Life loses its colour', describing the loss of pleasure from lifestyle-related changes. Themes broadly overlapped with the qualitative literature on younger adult MI. However, some themes (e.g., loss of 'maleness' post-MI, and ambivalence towards MI risk factors) appeared unique to this study. Themes were also discussed in relation to risk factors for anxiety and depression and how this might inform clinical care for a younger, male population. Statement of contribution What is already known on this subject? Myocardial infarction (MI) morbidity is not declining in England for under-45s. Adjustment to MI is particularly challenging for younger adults, perhaps because it is non-normative. However, little is known about the experience of MI in younger adults. What does this study add? This

Use of Economic Compensation to Increase Demand for Voluntary Medical Male Circumcision in Kenya: Qualitative Interviews With Male Participants in a Randomized Controlled Trial and Their Partners.

PubMed

Evens, Emily; Lanham, Michele; Murray, Kate; Rao, Samwel; Agot, Kawango; Omanga, Eunice; Thirumurthy, Harsha

2016-08-15

Interventions to increase demand for medical male circumcision are urgently needed in eastern and southern Africa. Following promising evidence that providing economic compensation can increase male circumcision uptake in Kenya, there is a need to understand the role of this intervention in individuals' decision-making regarding circumcision and explore perceptions of the intervention and concerns such as coercion. As part of a randomized controlled trial in Kenya that found compensation in the form of food vouchers worth US $8.75-US $15.00 to be effective in increasing male circumcision uptake, we conducted qualitative in-depth interviews with 45 circumcised and uncircumcised male participants and 19 female partners to explore how compensation provision influenced the decision to get circumcised. Interview transcripts were coded and an inductive thematic analysis was conducted to identify patterns in decision-making. Interviews revealed that compensation promoted circumcision uptake by addressing a major barrier to male circumcision uptake: lost wages during and after the circumcision procedure. Participants who did not get circumcised perceived the compensation amounts to be insufficient for offsetting their costs associated with getting circumcised or reported having nonfinancial barriers that were not addressed by the intervention, such as fear of pain. Participants also reported that they did not feel compelled to get circumcised for financial gain. Female partners of circumcised participants felt that the intervention helped to motivate their partners to get circumcised. The results suggest that the provision of economic compensation is an acceptable intervention that can address an important barrier to male circumcision uptake. Providing compensation to circumcision clients in the form of food vouchers warrants further consideration in voluntary medical male circumcision demand creation efforts.

Identifying the Ethical Challenges Encountered by Information Technology Professionals Working within the Nevada Casino Industry

ERIC Educational Resources Information Center

Essig, Michael R.

2014-01-01

A thematic analysis qualitative study was used to identify the unethical challenges encountered by Information Technology (IT) professionals working within the Nevada casino industry. Fourteen current and former IT leaders working or who worked in the Nevada casino industry were interviewed. Using thematic analysis, nine themes regarding ethical…

Pilot study: evaluation of the use of the convergent interview technique in understanding the perception of surgical design and simulation.

PubMed

Logan, Heather; Wolfaardt, Johan; Boulanger, Pierre; Hodgetts, Bill; Seikaly, Hadi

2013-06-19

It is important to understand the perceived value of surgical design and simulation (SDS) amongst surgeons, as this will influence its implementation in clinical settings. The purpose of the present study was to examine the application of the convergent interview technique in the field of surgical design and simulation and evaluate whether the technique would uncover new perceptions of virtual surgical planning (VSP) and medical models not discovered by other qualitative case-based techniques. Five surgeons were asked to participate in the study. Each participant was interviewed following the convergent interview technique. After each interview, the interviewer interpreted the information by seeking agreements and disagreements among the interviewees in order to understand the key concepts in the field of SDS. Fifteen important issues were extracted from the convergent interviews. In general, the convergent interview was an effective technique in collecting information about the perception of clinicians. The study identified three areas where the technique could be improved upon for future studies in the SDS field.