BACKGROUND Interviews are among the most familiar strategies for collecting qualitative data. The different qualitative interviewing strategies in common use emerged from diverse disciplinary perspectives resulting in a wide variation among interviewing approaches. Unlike the highly structured survey interviews and questionnaires used in epidemiology and most health services research, we examine less structured interview strategies in which the person interviewed is more a participant in meaning making than a conduit from which information is retrieved. PURPOSE In this article we briefly review the more common qualitative interview methods and then focus on the widely used individual face-to-face in-depth interview, which seeks to foster learning about individual experiences and perspectives on a given set of issues. We discuss methods for conducting in-depth interviews and consider relevant ethical issues with particular regard to the rights and protection of the participants.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2929.2006.02418.x

The qualitative research interview

THINKING Young children understand the relation between objects and events in a functional manner, such that the first object is seen to go with or to operate on the second object. Complementarity criteria are an integral component of their thinking. Older children and young adults, by contrast, tend to use similarity criteria. In old age, however, the use of complementarity criteria has been found to increase once again (Reese & Rodeheaver, 1985). The reversal to complementarity in old age is thought to be caused by environmental factors rather than being attributable to changes in competence. Young children as well as the elderly are rarely required to state their thoughts in a specifically prescribed way, and complementary categorization therefore seems more natural, since such categorization groups occur naturally in time and space. Older adults do not neces-

The encyclopedia of aging

Objectives
To examine how practice constraints contribute to barriers in the health care of persons with dementia and their families, particularly with respect to behavioral aspects of care.

/pdf/practice-constraints-behavioral-problems-and-dementia-care-3en3xu8tcb.pdf

Practice constraints, behavioral problems, and dementia care: primary care physicians' perspectives.

Sharing qualitative research findings with participants: study experiences of methodological and ethical dilemmas.

Methods: We searched the electronic data- bases MEDLINE, Embase, PsychINFO and CINAHL to identify relevant articles. We extracted key study characteristics and meth- ods from the included studies. We also extracted direct quotes from the primary stud- ies, along with the interpretations provided by authors of the studies. We used meta- ethnography to synthesize the extracted information into an overall framework. We evaluated the quality of the primary studies using the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Results: In total, 46 studies met our inclusion criteria; these involved 1866 people with dementia and their caregivers. We identified 5 major themes: seeking a diagnosis; accessing supports and services; addressing information needs; disease management; and communica- tion and attitudes of health care providers. We conceptualized the health care experience as progressing through phases of seeking understanding and information, identifying the problem, role transitions following diag- nosis and living with change. Interpretation: The health care experience of people with dementia and their caregivers is a complex and dynamic process, which could be improved for many people. Understanding these experiences provides insight into poten- tial gaps in existing health services. Modifying existing services or implementing new models of care to address these gaps may lead to improved outcomes for people with dementia and their caregivers.

/pdf/health-care-experiences-of-people-with-dementia-and-their-2zm9qlii85.pdf

Health care experiences of people with dementia and their caregivers: a meta-ethnographic analysis of qualitative studies

Purpose: Many primary care physicians find caring for elderly patients difficult. The goal of this study was to develop a detailed understanding of why physicians find primary care with elderly patients difficult. Design and Methods: We conducted in-depth interviews with 20 primary care physicians. Using an iterative approach based on grounded theory techniques, a multidisciplinary team analyzed the content of the interviews and developed a conceptual model of the difficulty. Results: Three major domains of difficulty emerged: (i) medical complexity and chronicity, (ii) personal and interpersonal challenges, and (iii) administrative burden. The greatest challenge occurred when difficulty in more than one area was present. Contextual conditions, such as the practice environment and the physician’s training and personal values, shaped the experience of providing care and how difficult it seemed. Implications: Much of the difficulty participants experienced could be facilitated by changes in the health care delivery system and in medical education. The voices of these physicians and the model resulting from our analysis can inform such change.

/pdf/primary-care-for-elderly-people-why-do-doctors-find-it-so-asauzntd56.pdf

Primary Care for Elderly People Why Do Doctors Find It So Hard

Purpose: This study aims to develop an in-depth understanding of the issues important to primary care physicians in providing care to cognitively impaired elders. Design and Methods: In-depth interviews were conducted with 20 primary care physicians. Text coded as ‘‘cognitive impairment’’ was retrieved and analyzed by use of grounded theory analysis techniques. Results: A patient’s impaired ability to provide an accurate history and to participate in selfcare hindered the usual process of care, often resulting in greater medical uncertainty and feelings of inadequacy and frustration for the physician. Shifting the goal of care from ‘‘curing’’ the patient’s illness to ‘‘caring’’ for the patient’s quality of life was also problematic. The doctor–patient relationship changed dramatically as others became involved in care, often with attendant ethical dilemmas related to patient autonomy and the locus of decision making. Many physicians described a deep sense of loss and grief as the personhood of patients faded. The increased complexity and prominent social and emotional issues were difficult to manage in the context of the current model of practice. Implications: Profound changes occur in the process of care with cognitively impaired patients. The increased complexity mandates an expanded model of care that addresses the prominent psychosocial and ethical aspects of care as well as the medical ones.

/pdf/physicians-perspectives-on-caring-for-cognitively-impaired-74ezqqgegi.pdf

Physicians' Perspectives on Caring for Cognitively Impaired Elders

Alcohol and the health of aging men.

Injuries are a common cause of morbidity and mortality among elderly people. Falls are the most common type of accident, accounting for around 40% of injuries. There is substantial evidence that heavy alcohol use is an important risk factor for injuries in younger people, but results of the few studies of alcohol and injuries among elderly people have been inconsistent. In this paper, we review the literature on the effects of alcohol on gait and balance and present reasons that a causal relationship between alcohol and injuries is biologically plausible. We review the epidemiological studies of the relationship between alcohol and falls, hip fractures and other injuries in the elderly population and discuss sources of error in these studies. Selection bias, small sample sizes, measurement error and potential confounders such as age, gender, health status and medications may have played a substantial role in negative results from several studies. Further research that will help clarify the relationship between alcohol and injuries in elderly people is sorely needed.

Wendy L. Adams

Papers

Primary Care for Elderly People Why Do Doctors Find It So Hard

Physicians' Perspectives on Caring for Cognitively Impaired Elders

Alcohol and the health of aging men.

Alcohol and injuries in elderly people