Showing papers in "International Journal of Qualitative Studies on Health and Well-being in 2014"
TL;DR: The field of health and wellbeing scholarship has a strong tradition of qualitative research* and rightly so, and rich and compelling insights into the real worlds, experiences, and perspectives of patients and health care professionals can be found through quantitative methods.
Abstract: The field of health and wellbeing scholarship has a strong tradition of qualitative research*and rightly so. Qualitative research offers rich and compelling insights into the real worlds, experiences, and perspectives of patients and health care professionals in ways that are completely different to, but also sometimes complimentary to, the knowledge we can obtain through quantitative methods. (Published: 16 October 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 26152 - http://dx.doi.org/10.3402/qhw.v9.26152
1,590 citations
TL;DR: Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners.
Abstract: Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners.
449 citations
TL;DR: This commentary presents the characteristics of the Skype interview as an alternative or supplemental choice to investigators who want to change their conventional approach of interviewing.
Abstract: The most commonly used method for data collection in qualitative research is interviewing. With technology changes over the last few decades, the online interview has overcome time and financial constraints, geographical dispersion, and physical mobility boundaries, which have adversely affected onsite interviews. Skype as a synchronous online service offers researchers the possibility of conducting individual interviews as well as small focus groups, comparable to onsite types. This commentary presents the characteristics of the Skype interview as an alternative or supplemental choice to investigators who want to change their conventional approach of interviewing.
359 citations
TL;DR: Drawing on existing phenomenological studies of marginal caring situations at the limits of caring capability, and through a process of phenomenologically oriented reflection, some existential themes implicit in these publications are interrogated that could lead to deeper insights for both theoretical and applied purposes.
Abstract: Understanding the ‘‘insider’’ perspective has been a pivotal strength of qualitative research. Further than this, within the more applied fields in which the human activity of ‘‘caring’’ takes place, such understanding of ‘‘what it is like’’ for people from within their lifeworlds has also been acknowledged as the foundational starting point in order for ‘‘care’’ to be caring. But we believe that more attention needs to be paid to this foundational generic phenomenon: what it means to understand the ‘‘insiderness’’ of another, but more importantly, how to act on this in caring ways. We call this human phenomenon ‘‘caring for insiderness.’’ Drawing on existing phenomenological studies of marginal caring situations at the limits of caring capability, and through a process of phenomenologically oriented reflection, we interrogated some existential themes implicit in these publications that could lead to deeper insights for both theoretical and applied purposes. The paper provides direction for practices of caring by highlighting some dangers as well as some remedies along this path. Key words: Caring, person centred, phenomenology, lifeworld, humanization, individualized care, reflective analysis (Published: 21 January 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 21421 - http://dx.doi.org/10.3402/qhw.v9.21421
97 citations
TL;DR: Using an analytic data analysis, three main themes associated with the benefits of serious engagement in leisure activities are identified: the experience of psychological benefits, the creation of social support, and the enhancement of physical health.
Abstract: The existing literature suggests that serious engagement in leisure activities leads to happiness, life satisfaction, and successful aging among older adults. This qualitative study was used to examine the benefits of serious involvement in leisure activities among older Korean adults who were members of a sports club. Using an analytic data analysis, we identified three main themes associated with the benefits of serious engagement in leisure activities: 1) the experience of psychological benefits, 2) the creation of social support, and 3) the enhancement of physical health. These themes indicate that, through serious involvement in certain physical activities, participants gain various health benefits, which may contribute to successful aging.
69 citations
TL;DR: A holistic model of rehabilitation that helps individuals regain the capacity for everyday activities related to work, family life, and leisure can begin to address the emotional ramifications of diseases such as stroke, restore wellness, and work towards minimizing the burden felt by family caregivers and children.
Abstract: Stroke is a leading cause of disability across the developed world, affecting an increasing number of younger people. In this article, we seek to understand the experience of stroke as a disabling life situation among young people and the strategies that they use to recover and cope. Directed content analysis was conducted from interviews with 17 community-dwelling stroke survivors aged 55 years and younger across the United Kingdom. The sample was drawn from a larger maximum variation sample of stroke survivors. Using the sociological concepts of biographical disruption and biographical repair as a guide, excerpts from the interviews pertaining to aspects of the patients' life that were interrupted, in addition to how they coped with the changes, were selected and analysed. All individuals described an "altered sense of self," a theme that included loss of identity, family disruption, and/or loss of valued activities. Individuals sought to adapt their sense of self by seeking external support, by restoring normality, and/or through positive reflection. Despite the adapted self that emerged, most individuals continued to experience impairments. While young stroke survivors adapt to their illness over time, they continue to experience impairments and disruptions in their personal and work lives. A holistic model of rehabilitation that helps individuals regain the capacity for everyday activities related to work, family life, and leisure can begin to address the emotional ramifications of diseases such as stroke, restore wellness, and work towards minimizing the burden felt by family caregivers and children.
55 citations
TL;DR: This review has added scientific and systematic knowledge about parental experiences of providing SSC, and two themes that characterized the provision of SSC emerged: a restoring experience and an energy-draining experience.
Abstract: Aim : To describe parental experiences of providing skin-to-skin care (SSC) to their newborn infants. Background : SSC care for newborn infants has been reported to have positive physiological and psychological benefits to the infants and their parents. No systematic review regarding parental experiences has been identified. Design : In this first part of a meta-study, the findings of a systematic literature review on parental experience of SSC care are presented. Data sources : Four databases were searched, without year or language limitations, up until December 2013. Manual searches were performed in reference lists and in a bibliography of the topic. Review methods : After a quality-appraisal process, data from the original articles were extracted and analysed using qualitative content analysis. Results : The systematic and manual searches led to the inclusion of 29 original qualitative papers from nine countries, reporting experiences from 401 mothers and 94 fathers. Two themes that characterized the provision of SSC emerged: a restoring experience and an energy-draining experience. Conclusion : This review has added scientific and systematic knowledge about parental experiences of providing SSC. Further research about fathers’ experiences is recommended. Key words: Kangaroo mother care, meta-study, newborn infant, skin-to-skin care, qualitative systematic review (Published: 13 October 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 24906 - http://dx.doi.org/10.3402/qhw.v9.24906 Responsible Editor: Carina Bertero, Linkoping University, Sweden.
54 citations
TL;DR: SSC can be interpreted not only as a family-including and important health care intervention but also in terms of actually becoming a parent, and a theoretical model of Becoming a parent under unfamiliar circumstances emerged.
Abstract: Aim : To synthesize and interpret qualitative research findings focusing on parental experiences of skin-to-skin care (SSC) for newborn infants. Background : SSC induces many benefits for newborn infants and their parents. Three meta-analyses have been conducted on physiological outcomes, but no previous qualitative meta-synthesis on parental experiences of SSC has been identified. Design : The present meta-synthesis was guided by the methodology described by Paterson and co-workers. Data sources : Four databases were searched, without year or language limitations, up until December 2013. Manual searches were also performed. The searches and subsequent quality appraisal resulted in the inclusion of 29 original qualitative papers from 9 countries, reporting experiences from 401 mothers and 94 fathers. Review methods : The meta-synthesis entails a meta-data analysis, analysis of meta-method, and meta-theory in the included primary studies. Based on the three analyses, the meta-synthesis represents a new interpretation of a phenomenon. The results of the meta-data analysis have been presented as a qualitative systematic review in a separate paper. Results : When synthesizing and interpreting the findings from the included analyses, a theoretical model of Becoming a parent under unfamiliar circumstances emerged. Providing SSC seems to be a restorative as well as an energy-draining experience. A supportive environment has been described as facilitating the restorative experience, whereas obstacles in the environment seem to make the provision of SSC energy-draining for parents. When the process is experienced as positive, it facilitates the growth of parental self-esteem and makes the parents ready to assume full responsibility for their child. Conclusion : The results show that SSC can be interpreted not only as a family-including and important health care intervention but also in terms of actually becoming a parent. The process of becoming a parent in this specific situation is influenced by external factors in three different levels; family and friends, community, and society at large. The descriptions of providing SSC are similar to what has previously been described as the natural process of becoming a mother or a father. Key words: Kangaroo mother care, meta-study, meta-synthesis, newborn infant, skin-to-skin care, qualitative research (Published: 13 October 2014) Responsible Editor: Carina Bertero, Linkoping University, Sweden.
46 citations
TL;DR: A meaning structure—the ambivalence of losing weight after obesity surgery—was identified across the women's processes of change and consisted of five core themes: movement and activity—freedom but new demands and old restraints; eating habits and digestion—the complexity of change; appearance—smaller, but looser; social relations—stability and change; and being oneself—vulnerability and self-assurance.
Abstract: This study is grounded in a phenomenological lifeworld perspective. It aims at providing rich descriptions of lived experience of the process of losing weight after obesity surgery. Two women participated in in-depth interviews four times each during the first postoperative year. Based on the women’s experiences, a meaning structure*the ambivalence of losing weight after obesity surgery*was identified across the women’s processes of change. This consisted of five core themes: movement and activity*freedom but new demands and old restraints; eating habits and digestion*the complexity of change; appearance*smaller, but looser; social relations*stability and change; and being oneself*vulnerability and self-assurance. These core themes changed over time in terms of dominance. The experience of ambivalence is discussed according to a phenomenological perspective of the body as lived experience. Key words: Obesity surgery, weight loss, women, lived body, lived experience, phenomenology (Published: 29 January 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 22876 - http://dx.doi.org/10.3402/qhw.v9.22876
46 citations
TL;DR: The result shows that supporting children during NRMP is characterized by a desire to meet the child in his/her own world and by an effort to reach the child's horizon of understanding regarding these actions, based on the given conditions.
Abstract: Children state that among their worst fears during hospitalization are those related to various nursing procedures and to injections and needles. Nurses thus have a responsibility to help children cope with needle-related medical procedures (NRMP) and the potentially negative effects of these. The aim of the study is to describe the lived experience of supporting children during NRMP, from the perspective of nurses. Fourteen nurses took part in the study, six of whom participated on two occasions thus resulting in 20 interviews. A reflective lifeworld research approach was used, and phenomenological analysis was applied. The result shows that supporting children during NRMP is characterized by a desire to meet the child in his/her own world and by an effort to reach the child’s horizon of understanding regarding these actions, based on the given conditions. The essential meaning of the phenomenon is founded on the following constituents: developing relationships through conversation, being sensitive to embodied responses, balancing between tact and use of restraint, being the child’s advocate, adjusting time, and maintaining belief. The discussion focuses on how nurses can support children through various types of conversation and by receiving help from the parents’ ability to be supportive, and on whether restraint can be supportive or not for children during NRMP. Our conclusion is that nurses have to see each individual child, meet him/her in their own world, and decide on supportive actions while at the same time balancing their responsibility for the completion of the NRMP. This work can be described as ‘‘balancing on a tightrope’’ in an unpredictable situation. Key words: Lived experience, caring science, younger children, phenomenology, reflective lifeworld research (Published: 12 March 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 23063 - http://dx.doi.org/10.3402/qhw.v9.23063
43 citations
TL;DR: Investigation of how the staff experienced the interaction with patients suffering from behavioral and psychological symptoms of dementia before, under, and after introduction of sensory stimulation methods in clinical practice revealed a gradual emergence of person-centered care.
Abstract: The overall aim of this 2-year Norwegian action research study was to improve the interaction between care workers and patients with dementia in a nursing home by means of sensory stimulation. Furthermore, the aim was to investigate how the staff experienced the interaction with patients suffering from behavioral and psychological symptoms of dementia before, under, and after introduction of sensory stimulation methods in clinical practice. An intervention program consisting of lectures and practical guiding in sensory stimulation was implemented. The care workers participated in group meetings to reflect on the progress. Focus group interviews and participant observations were conducted initially to map exciting practice, and at the end to evaluate potential changes in attitude and skills. Observation notes and interview transcripts were analyzed by means of thematic analysis which revealed a gradual emergence of person-centered care. A phenomenological life-world perspective may serve as a theoretical b...
TL;DR: The study revealed that the women experienced retraumatization, uncaring behaviors, and unendurable suffering during their encounter with healthcare professionals, and they were disappointed, dismayed, and saddened by the lack of support, care, and empathy.
Abstract: In recent years there has been increased intimate partner violence (IPV) toward women. Research on the care provided to victims of IPV is limited. The purpose of the study was to gain a deeper understanding of women's lived experience of IPV and their encounters with healthcare professionals, social workers, and the police following IPV. A phenomenological hermeneutic method inspired by the philosophy of Paul Ricoeur was used. The method is based on text interpretation and gives voice to women's lived experience. Twelve women living at a women's shelter in Sweden narrated their IPV experiences. The study revealed that the women experienced retraumatization, uncaring behaviors, and unendurable suffering during their encounter with healthcare professionals. They were disappointed, dismayed, and saddened by the lack of support, care, and empathy. Nurses and other healthcare professionals must understand and detect signs of IPV as well as provide adequate care, as these women are vulnerable. IPV victims need to feel that they can trust healthcare professionals. Lack of trust can lead to less women reporting IPV and seeking help.
TL;DR: “At-homeness” was found to be a contextually related meaning of wellness despite illness and disease embedded in the continuum of being metaphorically at-home and metaphorically homeless, and this conceptualization is to be regarded as a step in conceptual clarification.
Abstract: Only one empirical study, the one by Zingmark, Norberg and Sandman published in 1995, explicitly focuses on at-homeness, the feeling of being metaphorically at-home, as a particular aspect of wellness. However, other studies reveal aspects of at-homeness, but if or how such aspects of at-homeness are related to each other is unclear. For this reason, the aim was to review Scandinavian nursing research related to at-homeness in the context of wellness-illness in severe and long-term conditions in order to take a step towards conceptual clarification of "at-homeness." The review included interpretive studies related to severe and long-term illness conducted in Sweden: 10 original articles and 5 doctoral theses. "At-homeness" was found to be a contextually related meaning of wellness despite illness and disease embedded in the continuum of being metaphorically at-home and metaphorically homeless. This was characterized by three interrelated aspects and four processes: being safe through expanding-limiting experiences of illness and time, being connected through reunifying-detaching ways of relating, and being centred through recognition-non-recognition of oneself in the experience and others giving-withdrawing a place for oneself. This conceptualization is to be regarded as a step in conceptual clarification. Further empirical investigation and theoretical development of "at-homeness" are needed. The conceptualization will be a step of plausible significance for the evaluation of interventions aimed at enhancing wellness for people with severe long-term illness, such as the frail elderly, and people with chronic illness or palliative care needs.
TL;DR: In this paper, an empirical study of interviews on people living with different long-term illnesses has been carried out and the results have shown that the learning process is a complex phenomenon interwoven with life as a whole, and that the essential meaning of learning to live with longterm illness concerns a movement toward a change of understanding of access to the world.
Abstract: A long-term illness is an occurrence that changes one’s life and generates a need to learn how to live with it. This article is based on an empirical study of interviews on people living with different long-term illnesses. The results have shown that the learning process is a complex phenomenon interwoven with life as a whole. The essential meaning of learning to live with long-term illness concerns a movement toward a change of understanding of access to the world. In this movement, in which everyday lives as well as relationships with oneself and others are affected, a continual renegotiation is needed. Texts from existential/lifeworld philosopher, Heidegger and Gadamer, have been used to get a greater understanding of the empirical results. These texts have been analysed with particular focus on learning turning points and the importance of reflection. The results are highlighted under the following themes: Pursuit of balance*the aim of learning, The tense grip*the resistance to learning, To live more really*the possibilities of the learning, Distancing*the how of the learning, and The tense of the learning*the whole of the learning. In those learning turning points are present. Knowledge from this study has been used to make a didactic model designed to give caregivers a tool to support patients’ learning. The didactic model is called: The challenge to take charge of life with a long-term illness. Key words: Life-world philosophy, Gadamer, Heidegger, learning process, long-term illness (Published: 21 February 2014) Citation: Int J Qualitative Stud Health Well-Being 2014, 9 : 22842 - http://dx.doi.org/10.3402/qhw.v9.22842
TL;DR: Evaluators in the field of public health are encouraged to consider the use of QE as a complementary tool for program evaluation to be able to identify areas of opportunity to improve programs’ implementation processes from the perspective of intended beneficiaries.
Abstract: This short essay aims at commenting on the origin, development, rationale, and main characteristics of qualitative evaluation (QE), emphasizing the value of this methodological tool to evaluate health programs and services. During the past decades, different approaches have come to light proposing complementary alternatives to appraise the performance of public health programs, mainly focusing on the implementation process involved rather than on measuring the impact of such actions.QE is an alternative tool that can be used to illustrate and understand the process faced when executing health programs. It can also lead to useful suggestions to modify its implementation from the stakeholders’ perspectives, as it uses a qualitative approach that considers participants as reflective subjects, generators of meanings. This implies that beneficiaries become involved in an active manner in the evaluated phenomena with the aim of improving the health programs or services that they receive. With this work we want to encourage evaluators in the field of public health to consider the use of QE as a complementary tool for program evaluation to be able to identify areas of opportunity to improve programs’ implementation processes from the perspective of intended beneficiaries. Key words: Qualitative evaluation, qualitative research, health programs, health care services (Published: 22 August 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 24417 - http://dx.doi.org/10.3402/qhw.v9.24417
TL;DR: The two groups of physicians differed considerably in their views on the usefulness of the concept of depression and in their language and narrative styles when telling stories about depressed patients, providing fertile ground for organizational research into the actual implementation of cooperation between sectors to explore how differences are dealt with.
Abstract: The diagnosis of depression is defined by psychiatrists, and guidelines for treatment of patients with depression are created in psychiatry. However, most patients with depression are treated exclusively in general practice. Psychiatrists point out that general practitioners' (GPs') treatment of depression is insufficient and a collaborative care (CC) model between general practice and psychiatry has been proposed to overcome this. However, for successful implementation, a CC model demands shared agreement about the concept of depression and the diagnostic process in the two sectors. We aimed to explore how depression is understood by GPs and clinical psychiatrists. We carried out qualitative in-depth interviews with 11 psychiatrists and 12 GPs. Analysis was made by Interpretative Phenomenological Analysis. We found that the two groups of physicians differed considerably in their views on the usefulness of the concept of depression and in their language and narrative styles when telling stories about depressed patients. The differences were captured in three polarities which expressed the range of experiences in the two groups. Psychiatrists considered the diagnosis of depression as a pragmatic and agreed construct and they did not question its validity. GPs thought depression was a "gray area" and questioned the clinical utility in general practice. Nevertheless, GPs felt a demand from psychiatry to make their diagnosis based on instruments created in psychiatry, whereas psychiatrists based their diagnosis on clinical impression but used instruments to assess severity. GPs were wholly skeptical about instruments which they felt could be misleading. The different understandings could possibly lead to a clash of interests in any proposed CC model. The findings provide fertile ground for organizational research into the actual implementation of cooperation between sectors to explore how differences are dealt with.
TL;DR: The essence of Neonatal Intensive Care Unit (NICU) nurses’ attitudes in skin-to-skin care (SSC) practice for preterm infants and their parents is illuminated.
Abstract: This article illuminates the essence of Neonatal Intensive Care Unit (NICU) nurses' attitudes in skin-to-skin care (SSC) practice for preterm infants and their parents. Health care providers are in a unique position to influence the dynamic between infants and parents, and SSC affects both partners in the dyad. The design is descriptively phenomenological in terms of reflective lifeworld approach. Eighteen Swedish, Danish, and Norwegian nurses from NICUs offering varied possibilities and extents of SSC participated. NICU nurses' attitudes in SSC practice are ambivalent. The nurses consider the sensory, wellness, and mutuality experiences to be primary and vital and enact SSC as much as possible. But "as much as possible" is a broad and varied concept, and their attitudes are ambivalent in terms of not always facilitating what they consider to be the optimal caring conditions. The source of NICU nurses' ambivalent attitudes in SSC practice is a complex interplay of beliefs, norms, and evidence, which have a multidisciplinary basis. The ambivalent attitudes are, to a great extent, the result of the need to balance these multidisciplinary concerns. This needs to be acknowledged in considering SSC practice, as well as acknowledging that clinical judgments concerning optimal SSC depend on parents and infants unlimited access to each other, which NICU nurses can influence.
TL;DR: The results showed that the nurses gave threshold support with an openness and awareness of the patient's individual needs during the transition, except that there seemed to be a lack of knowledge and ability to provide emotional support.
Abstract: Chronic kidney disease is a major health problem due to the significant financial burden for the healthcare system and likewise for the patient who needs the treatment. The patient’s whole life situation is turned upside down with chronic kidney disease when they are confronted with the forced change to start treatment with hemodialysis. Patients with chronic kidney disease experience a lack of adequate emotional support from nurses during the transition to hemodialysis. The purpose of this study was to explore nurses’ experiences of giving support to patients during the transition to hospital-bound hemodialysis. The study had a qualitative descriptive design with a content analysis approach; eight nurses from four hospitals in the south of Sweden participated. The results showed that the nurses gave threshold support with an openness and awareness of the patient’s individual needs during the transition, except that there seemed to be a lack of knowledge and ability to provide emotional support. Patient support during the transition could therefore be absent. Education, at local and national levels, is needed for the nurse to be able to give professional emotional support. Further research is also desired in order to provide nurses with the tools they need to give emotional support, which is of utmost importance. Key words: Qualitative content analysis, support, transition, hemodialysis, chronic kidney disease (Published: 8 April 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 22952 - http://dx.doi.org/10.3402/qhw.v9.22952
TL;DR: A phenomenological hermeneutic study of experiences of women who were recently diagnosed with osteoporosis, finding three key themes emerged: being diagnosed, being prescribed medical treatment, and being on the path of learning to live with osteeporosis.
Abstract: This paper describes a phenomenological hermeneutic study of experiences of women who were recently diagnosed with osteoporosis. The research objective was to investigate women’s experiences of living with osteoporosis during the first 6 months after diagnosis when treatment was first prescribed. Fifteen women were included in the study. The inclusion criteria were a DXA scan at one of the two hospitals showing a T-score below 2.5 (lower back or hip), age 65 years or older; no previous known osteoporotic fracture; at least one of the known risk factors for osteoporosis; and prescription of anti-osteoporotic treatment. Exclusion criteria were previous diagnosis of osteoporosis or previous treatment with anti-osteoporotic medication. Data were collected through in-depth interviews shortly after diagnosis and 6 months later. The performed analyses were inspired by Paul Ricoeur’s theory of interpretation of texts comprising three levels: nai¨ve reading, structural analysis, and critical interpretation and discussion. Three key themes emerged: 1) being diagnosed, 2) being prescribed medical treatment, and 3) being on the path of learning to live with osteoporosis. The findings suggest a need for improved support for the patients to gain understanding of their diagnosis and the risk of osteoporotic fracture as well as to learn to live with osteoporosis. The study highlights new health promotion areas for targeting interventions at newly diagnosed patients, helping them accept and interpret the diagnosis, and the medical treatment. Key words: Interpretation, interview, nursing research, Ricoeur, qualitative research (Published: 21 February 2014) Citation: Int J Qualitative Stud Health Well-Being 2014, 9 : 22438 - http://dx.doi.org/10.3402/qhw.v9.22438
TL;DR: The findings of this study suggest that Korean immigrant participants gained various social, cultural, and psychological benefits by engaging in activities with other Korean immigrants.
Abstract: This qualitative study is designed to examine the benefits of physical activity involvement with members of the same ethnic group. For this study, Korean immigrants who were members of Korean physical activity clubs such as badminton and tennis were selected as participants. Using a constructive grounded theory methodology, three themes were identified as benefits of physical activity involvement: (1) the experience of psychological well-being, (2) the creation of a unique cultural world, and (3) the facilitation of physical activity involvement. The findings of this study suggest that Korean immigrant participants gained various social, cultural, and psychological benefits by engaging in activities with other Korean immigrants.
TL;DR: In this article, focus groups were conducted with female PhD students employed at a Swedish university to explore how they experience and perceive their well-being, and three main themes emerged from the analysis: being true to oneself, being in the sphere of influence, and performing a balancing act.
Abstract: The aim of this study was to explore how female PhD students experience and perceive their well-being. Focus groups were conducted with female PhD students employed at a Swedish university. The study was performed using a phenomenological hermeneutic approach based on the concept of the lifeworld, used as both a philosophical perspective and a methodology. Three main themes emerged from the analysis: being true to oneself, being in the sphere of influence, and performing a balancing act. By unfolding these themes, the study shows that perceptions and experiences of well-being in female PhD students are a multifaceted phenomenon and materialize through interaction of different aspects of “self” (agent) and “others” (structure). As well as illustrating these perceptions and experiences, the study also presents female PhD students’ conceptualization of their well-being, expressed in terms of a white-water rafting metaphor.
TL;DR: In this article, Carina Bertero et al. used a qualitative grounded theory design following the approach of Glaser (1978) to collect qualitative data from 33 Chinese elders who were aged between 60 and 84.
Abstract: The health of older people is a priority in many countries as the world’s population ages. Attitudes towards help seeking behaviours in older people remain a largely unexplored field of research. This is particularly true for older minority groups where the place that they have migrated to presents both cultural and structural challenges. The UK, like other countries, has an increasingly aging Chinese population about who relatively little is known. This study used a qualitative grounded theory design following the approach of Glaser (1978). Qualitative data were collected using semi-structured interviews with 33 Chinese elders who were aged between 60 and 84, using purposive and theoretical sampling approaches. Data were analysed using the constant comparative method until data saturation occurred and a substantive theory was generated. “Being healthy” (the core category) with four interrelated categories: self-management, normalizing/minimizing, access to health services, and being cured form the theory. The theory was generated around the core explanations provided by participants and Chinese elders’ concerns about health issues they face in their daily life. We also present data about how they direct their health-related activities towards meeting their physical and psychological goals of being healthy. Their differential understanding of diseases and a lack of information about health services were potent predictors of non–help seeking and “self” rather than medical management of their illnesses. This study highlights the need for intervention and health support for Chinese elders. Key words: help seeking, elderly Chinese, grounded theory (Published: 21 October 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 24820 - http://dx.doi.org/10.3402/qhw.v9.24820 Responsible Editor: Carina Bertero, Linkoping University, Sweden.
TL;DR: The comprehensive understanding suggested that being an oldest old man living alone in a rural area means a struggle between a dependent existence and a desire to be independent.
Abstract: The amount of older people receiving home nursing care is increasing; in rural areas, they are at additional risk because of the distance between people and health care facilities. No specific studies have been found about oldest old men living alone and receiving home nursing care and the meaning of living alone in one’s own home. The aim of this study was therefore to illuminate the meaning of being an oldest old man living alone in a rural area and receiving home nursing care. A sample of 12 oldest old men living in rural areas in the middle of Norway was chosen for this study. Narrative interviews were conducted, and data were analyzed using the phenomenological hermeneutical method. After a nai¨ve reading and a structural analysis of the text, we identified three themes: feelings of insufficiency in everyday life, finding hope in life, and feeling reconciliation with life. The comprehensive understanding suggested that being an oldest old man living alone in a rural area means a struggle between a dependent existence and a desire to be independent. Living in the tension between independence and dependency is a complex emotional situation where one is trying to accept the consequences of life and loss-reconciling the wish to live with the fact that life will come to an end. Key words: Oldest old, phenomenological hermeneutics, rural (Published: 13 February 2014) Citation: Int J Qualitative Stud Health Well-Being 2014, 9 : 23088 - http://dx.doi.org/10.3402/qhw.v9.23088
TL;DR: By using their inner strength in facing losses and declining health, the oldest old women managed to appreciate aloneness as solitude, and find new meaning in life.
Abstract: In Western countries, the number of older people receiving home nursing care is increasing, and in rural areas they are at additional risk because of the distance between people and health care facilities. The aim of this study was therefore to illuminate the meaning of being an oldest old woman living alone in a rural area and receiving home nursing care. A sample of 11 oldest old women living in rural areas in the middle of Norway was chosen for this study. Narrative interviews were conducted, and the data were analyzed using the phenomenological hermeneutic method. After a naive reading and a structural analysis of the text, we identified four themes: being satisfied with life , being thankful , feeling vulnerable , and feeling secure . The comprehensive understanding implied that being an oldest old woman living alone in a rural area meant living in the intersection between embracing the present in solitude and fearing the future with additional declining health. Living in this complex situation meant to enjoy the present, but still fear the future, as the oldest old women knew their present life situations were limited. This challenging emotional situation meant using their inner strength by trying to be optimistic and seeing opportunities in present life, even if losses were many and extensive. By using their inner strength in facing losses and declining health, the oldest old women managed to appreciate aloneness as solitude, and find new meaning in life. Key words: Home nursing care, oldest old, phenomenological hermeneutics, rural (Published: 29 October 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 25217 - http://dx.doi.org/10.3402/qhw.v9.25217
TL;DR: A critical finding was the negative role of the media in escalating fears for life prior to and during the cyclone, highlighting the need for government, community leaders, and health professionals to have a media plan in place to ensure that disaster warnings are taken seriously without inciting unnecessary panic.
Abstract: The aim of this study was to explore the experiences of people who lived through Cyclone Yasi on 3 February 2011. Data from two open-ended questions (Q1: n =344; and Q2: n =339) within a survey completed by 433 residents of cycloneaffected areas between Cairns and Townsville, Australia, were analysed using a qualitative, thematic approach. Experiences were portrayed in three main themes: (1) living in the mode of existential threat describes survivors’ sense of panic and feeling at the mercy of nature as they feared for their life; (2) unforgettable memories describe feelings of emotional helplessness and the unimaginable chaos that the cyclone wrought; and (3) centrality of others shows how community support and closeness helped alleviate losses and uncertainty. A critical finding from this study was the negative role of the media in escalating fears for life prior to and during the cyclone, highlighting the need for government, community leaders, and health professionals to have a media plan in place to ensure that disaster warnings are taken seriously without inciting unnecessary panic. Although survivors experienced extreme vulnerability and a threat to life, the disaster also brought communities closer together and connected family, friends, and neighbours through the caring, support, and help they offered each other. This highlights the central role of others during the recovery process and underlines the importance of promoting and facilitating social support to aid recovery post disaster. Key words: Australia, cyclone, mental health, disasters, emergency preparedness, qualitative research (Published: 15 January 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 19821 - http://dx.doi.org/10.3402/qhw.v9.19821
TL;DR: This manuscript provides a critique of traditional approaches to developing health interventions, and theoretically justifies what and why changes are warranted.
Abstract: An overemphasis on clinical trials and behavior change models has narrowed the knowledge base that can be used to design interventions. The overarching point is that the process of overanalyzing variables is impeding the process of gaining insight into the everyday experiences that shape how people define health and seek treatment. This claim is especially important to health decision-making and behavior change because subtle interpretations often influence the decisions that people make. This manuscript provides a critique of traditional approaches to developing health interventions, and theoretically justifies what and why changes are warranted. The limited scope of these models is also discussed, and an argument is made to adopt a strategy that includes the perceptions of people as necessary for understanding health and health-related decision-making. Three practical strategies are suggested to be used with the more standard approaches to assessing the effectiveness and relevance of health interventions.
TL;DR: Empirical original qualitative data collected in the third and final phase of this study are described and examined how individuals living with a neurological condition maintain continuity of their sense of self, with a particular focus on their strategies.
Abstract: The Living with a Neurological Condition (LINC) study was part of the National Population Health Study of Neurological Conditions conducted in Canada. This article describes empirical original qualitative data collected in the third and final phase of this study and examines how individuals living with a neurological condition maintain continuity of their sense of self, with a particular focus on their strategies. Fifteen interviews were analysed for this paper. Emerging strategies for maintaining sense of self include: (1) avoidance and denial, (2) cognitive reframing, (3) articulation of the self through imagined positive identity, (4) strategies that reconnect to identity in the past, (5) adjusting and altering goals, (6) spiritual activities, (7) humour, (8) comparison with others: identity as shaped through social constructs, and (9) creating communities: a reciprocal reflection of self.
TL;DR: Through better awareness of gender biases and the callers’ different resources for making themselves heard, the communication between telenurse and caller might become more equal and thereby better suitable for all callers.
Abstract: Background : Telenursing is an expanding service in most Western societies. Sweden is a front-line country, with all of its 21 counties connected to Swedish Healthcare Direct (SHD) 1177. The intention of the service is twofold: to make health care more efficient, while also making it more accessible and safe for patients. Previous research has shown, however, that the service is not used equitably. Gender, age, socio-economic, and ethnicity differences have been reported as determining factors for the use of the service and the advice given. Aim : The aim of the study was to explore the communication between telenurses and callers in authentic calls to SHD 1177. Methodology : A qualitative method, using critical discourse analysis (CDA), was chosen. The approach was deductive, that is, the analysis was made in view of a predetermined framework of theory. Twenty calls were strategically chosen and included in the study. Results : The CDA resulted in five types of calls, namely a gatekeeping call, a gendered call, a call marked by impersonal traits, a call with voices of the life world, and finally a counter discourse call. The dominating patterns in the calls were of gatekeeping and biomedical character. Patterns of the societal gender order were found, in that representations of the reluctant male caller and the ideal female caller were identified, but also a call representing a counter discourse. The service seemed difficult to use for patients with low language proficiency. Conclusion : Telenursing could potentially challenge inequalities in health care. However, the discourse of telenursing is dialectically related to neoliberal ideology and the ideology of medicine. It is also situated in a gendered context of ideal femininity and hegemonic masculinity. Through better awareness of gender biases and the callers’ different resources for making themselves heard, the communication between telenurse and caller might become more equal and thereby better suitable for all callers. Key words : Authentic calls, communication, discourse analysis, gender, telenursing, Sweden (Published: 24 June 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 24255 - http://dx.doi.org/10.3402/qhw.v9.24255
TL;DR: The provision of support and coaching over the Internet led to more in-depth knowledge about these young persons’ everyday lives and revealed their ability to use IBSC to express the complexity of everyday life for young persons with ADHD and ASD.
Abstract: This study focuses on the everyday life of young persons with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). There are follow-up studies describing ADHD, and ASD in adults, and residual impairments that affect life. Few qualitative studies have been conducted on the subject of their experiences of everyday life, and even fewer are from young persons' perspectives. This study's aim was to describe how young persons with ADHD and ASD function and how they manage their everyday life based on analyses of Internet-based chat logs. Twelve young persons (7 males and 5 females aged 15-26) diagnosed with ADHD and ASD were included consecutively and offered 8 weeks of Internet-based Support and Coaching (IBSC). Data were collected from 12 chat logs (445 pages of text) produced interactively by the participants and the coaches. Qualitative content analysis was applied. The text was coded and sorted into subthemes and further interpreted into themes. The findings revealed two themes: "fighting against an everyday life lived in vulnerability" with the following subthemes: "difficult things," "stress and rest," and "when feelings and thoughts are a concern"; and the theme "struggling to find a life of one's own" with the following subthemes: "decide and carry out," "making life choices," and "taking care of oneself." Dealing with the problematic situations that everyday encompasses requires personal strength and a desire to find adequate solutions, as well as to discover a role in society. This study, into the provision of support and coaching over the Internet, led to more in-depth knowledge about these young persons' everyday lives and revealed their ability to use IBSC to express the complexity of everyday life for young persons with ADHD and ASD. The implications of the findings are that using online coaching makes available new opportunities for healthcare professionals to acknowledge these young persons' problems.
TL;DR: A substantive theory explaining how the staff in a resource-limited neonatal intensive care unit of a developing nation manage to ensure adherence to behavioral modification components of a noise reduction protocol (NsRP) during nonemergency situations is generated.
Abstract: The aim of this study was to generate a substantive theory explaining how the staff in a resource-limited neonatal intensive care unit (NICU) of a developing nation manage to ensure adherence to behavioral modification components of a noise reduction protocol (NsRP) during nonemergency situations. The study was conducted after implementation of an NsRP in a level III NICU of south India. The normal routine of the NICU is highly dynamic because of various categories of staff conducting clinical rounds followed by care-giving activities. This is unpredictably interspersed with very noisy emergency management of neonates who suddenly fall sick. In-depth interviews were conducted with 36 staff members of the NICU (20 staff nurses, six nursing aides, and 10 physicians). Group discussions were conducted with 20 staff nurses and six nursing aides. Data analysis was done in line with the reformulated grounded theory approach, which was based on inductive examination of textual information. The results of the analysis showed that the main concern was to ensure adherence to behavioral modification components of the NsRP. This was addressed by using strategies to ‘‘sustain a culture of silence in NICU during nonemergency situations’’ (core category). The main strategies employed were building awareness momentum, causing awareness percolation, developing a sense of ownership, expansion of caring practices, evolution of adherence, and displaying performance indicators. The ‘‘culture of silence’’ reconditions the existing staff and conditions new staff members joining the NICU. During emergency situations, a ‘‘noisy culture’’ prevailed because of pragmatic neglect of behavioral modification when life support overrode all other concerns. In addition to this, the process of operant conditioning should be formally conducted once every 18 months. The results of this study may be adapted to create similar strategies and establish context specific NsRPs in NICUs with resource constraints. Key words: Grounded theory, noise, NICU, operant conditioning (Published: 18 March 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 22523 - http://dx.doi.org/10.3402/qhw.v9.22523