Showing papers in "International Journal of Qualitative Studies on Health and Well-being in 2015"
TL;DR: There is a need for more empirical-holistic research that applies interpretive qualitative methods and uses a social perspective of health, e.g., healthism, and examining the role of sports and exercise in relation to orthorexia that takes the problematizing of “orthorexic behaviours” within the sports context into account.
Abstract: Bratman first proposed orthorexia nervosa in the late 1990s, defining it an obsession with eating healthy food to achieve, for instance, improved health. Today, in the Swedish media, excessive exercising plays a central role in relation to orthorexia. A few review articles on orthorexia have been conducted; however, these have not focused on aspects of food and eating, sport, exercise, or a societal perspective. The overall aim of this study was to provide an overview and synthesis of what philosophies of science approaches form the current academic framework of orthorexia. Key questions were: What aspects of food and eating are related to orthorexia? What role do exercise and sports play in relation to orthorexia? In what ways are orthorexia contextualized? Consequently, the concept of healthism was used to discuss and contextualize orthorexia. The method used was an integrative literature review; the material covered 19 empirical and theoretical articles published in peer-reviewed journals. This review demonstrates a multifaceted nature of orthorexia research; this field has been examined from four different philosophies of science approaches (i.e., empirical-atomistic, empirical-atomistic with elements of empirical-holistic, empirical-holistic, and rational-holistic) on individual, social, and societal levels. The majority of the articles followed an empirical-atomistic approach that focused on orthorexia as an individual issue, which was discussed using healthism. Our analysis indicates a need for (a) more empirical-holistic research that applies interpretive qualitative methods and uses a social perspective of health, e.g., healthism and (b) examining the role of sports and exercise in relation to orthorexia that takes the problematizing of "orthorexic behaviours" within the sports context into account.
96 citations
TL;DR: Five salient patterns of meaning (themes) were found: finding an inner source of calm, sharing a human struggle, staying focused in learning situations, moving from fear to curiosity in academic learning, and feeling more self-acceptance when facing difficult situations.
Abstract: The aim of this qualitative study was to investigate the subjective experiences of 29 university students who participated in an 8-week mindfulness-based stress reduction (MBSR) program for academic evaluation anxiety. Participants who self-referred to the Student Counseling Service underwent individual semi-structured interviews about how they experienced the personal relevance and practical usefulness of taking the MBSR program. Interviews were transcribed and analyzed through a team-based explorative–reflective thematic approach based on a hermeneutic-phenomenological epistemology. Five salient patterns of meaning (themes) were found: (1) finding an inner source of calm, (2) sharing a human struggle, (3) staying focused in learning situations, (4) moving from fear to curiosity in academic learning, and (5) feeling more self-acceptance when facing difficult situations. We contextualize these findings in relation to existing research, discuss our own process of reflexivity, highlight important limitation...
76 citations
TL;DR: In this article, an exploratory qualitative study was conducted to examine both stressors and benefits resulting from technologies among practitioners in the advertising, public relations, and journalism industry in Hong Kong and Austria.
Abstract: Stress has become a mass phenomenon in the modern workplace. The use of information and communication technologies is beginning to receive greater attention in the context of occupational stress. An exploratory qualitative study was conducted to examine both stressors and benefits resulting from technologies among practitioners in the advertising, public relations, and journalism industry in Hong Kong and Austria. Results suggest that technologies allow instant availability, which facilitates communication processes as well as information exchange. Notably, modern technologies enable employees to organize their work with greater temporal and spatial flexibility, thus creating an opportunity for better balancing work and private life. However, evolving technologies have come with a cost; the pressure to be constantly available via technologies constitutes a major source of stress, increasing the risk of experiencing prolonged work stress and its adverse consequences on employee health and well-being, such as a burnout. Furthermore, findings suggest that availability pressure may be attributed to an inner obligation rather than to an organizational expectation. Hence, making employees aware of their connectivity behaviour may help to diminish the experience of technology-induced work stress and improve and maintain employees' health and well-being in the long term. Practical implications, limitations, and future research directions are provided.
73 citations
TL;DR: Several elements and stressors were affecting the well-being of the participants in daily life 1 week after discharge, and contact with the health care system created frustrations and worries, but also physical disability, loneliness, and inactivity were issues of concern.
Abstract: Introduction : Frail elderly are at higher risk of negative outcomes such as disability, low quality of life, and hospital admissions. Furthermore, a peak in readmission of acutely admitted elderly patients is seen shortly after discharge. An investigation into the daily life experiences of the frail elderly shortly after discharge seems important to address these issues. The aim of this study was to explore how frail elderly patients experience daily life 1 week after discharge from an acute admission. Methods : The qualitative methodological approach was interpretive description. Data were gathered using individual interviews. The participants were frail elderly patients over 65 years of age, who were interviewed at their home 1 week after discharge from an acute admission to a medical ward. Results : Four main categories were identified: “The system,” “Keeping a social life,” “Being in everyday life,” and “Handling everyday life.” These categories affected the way the frail elderly experienced daily life and these elements resulted in a general feeling of well-being or non-well-being. The transition to home was experienced as unsafe and troublesome especially for the more frail participants, whereas the less frail experienced this less. Conclusion and discussion : Several elements and stressors were affecting the well-being of the participants in daily life 1 week after discharge. In particular, contact with the health care system created frustrations and worries, but also physical disability, loneliness, and inactivity were issues of concern. These elements should be addressed by health professionals in relation to the transition phase. Future interventions should incorporate a multidimensional and bio-psycho-social perspective when acutely admitted frail elderly are discharged. Stakeholders should evaluate present practice to seek to improve care across health care sectors. Key words : Older people, hospital admission, transition, interviews, qualitative, care (Published: 1 June 2015) Citation: Int J Qualitative Stud Health Well-being 2015, 10: 27370 - http://dx.doi.org/10.3402/qhw.v10.27370
71 citations
TL;DR: The two main issues experienced by nurses while administering care to patients with dementia in acute care hospitals were the various problems and difficulties faced by nurses were interactive and caused a burdensome cycle and nurses do their best to adapt to these conditions despite feeling conflicted.
Abstract: Objective : Dementia is a major public health problem. More and more patients with dementia are being admitted to acute care hospitals for treatment of comorbidities. Issues associated with care of patients with dementia in acute care hospitals have not been adequately clarified. This study aimed to explore the challenges nurses face in providing care to patients with dementia in acute care hospitals in Japan. Methods : This was a qualitative study using focus group interviews (FGIs). The setting was six acute hospitals with surgical and medical wards in the western region of Japan. Participants were nurses in surgical and internal medicine wards, excluding intensive care units. Nurses with less than 3 years working experience, those without experience in dementia patient care in their currently assigned ward, and head nurses were excluded from participation. FGIs were used to collect data from February to December 2008. Interviews were scheduled for 1–1.5 h. The qualitative synthesis method was used for data analysis. Results : In total, 50 nurses with an average experience of 9.8 years participated. Eight focus groups were formed. Issues in administering care to patients with dementia at acute care hospitals were divided into seven groups. Three of these groups, that is, problematic patient behaviors, recurrent problem, and problems affecting many people equally, interact to result in a burdensome cycle. This cycle is exacerbated by lack of nursing experience and lack of organization in hospitals. In coping with this cycle, the nurses develop protection plans for themselves and for the hospital. Conclusions : The two main issues experienced by nurses while administering care to patients with dementia in acute care hospitals were as follows: (a) the various problems and difficulties faced by nurses were interactive and caused a burdensome cycle, and (b) nurses do their best to adapt to these conditions despite feeling conflicted. Key words : Difficulties in administering care, elderly, focus groups, geriatric nursing, KJ method, patient care management (Published: 24 February 2015) Citation: Int J Qualitative Stud Health Well-being 2015, 10 : 25828 - http://dx.doi.org/10.3402/qhw.v10.25828
54 citations
TL;DR: It is concluded that the identified narratives types may be constitutive, as well as reflective, of physical activity experiences and therefore may be a useful tool on which to base physical activity promotion initiatives.
Abstract: The aim of this study was to identity the types of physical activity narratives drawn upon by active spinal injured people. More than 50 h of semi-structured life-story interview data, collected as part of larger interdisciplinary program of disability lifestyle research, was analysed for 30 physically active male and female spinal cord injury (SCI) participants. A structural narrative analysis of data identified three narrative types which people with SCI draw on: (1) exercise is restitution, (2) exercise is medicine, and (3) exercise is progressive redemption. These insights contribute new knowledge by adding a unique narrative perspective to existing cognitive understanding of physical activity behaviour in the spinal cord injured population. The implications of this narrative typology for developing effective positive behavioural change interventions are critically discussed. It is concluded that the identified narratives types may be constitutive, as well as reflective, of physical activity experiences and therefore may be a useful tool on which to base physical activity promotion initiatives.
53 citations
TL;DR: Gadamerian philosophical hermeneutics is identified as a methodology that could provide a supportive framework and principles that may be useful in health and well-being studies utilizing the Delphi method.
Abstract: In this article we aim to demonstrate how Gadamerian philosophical hermeneutics may provide a sound methodological framework for researchers using the Delphi Technique (Delphi) in studies exploring health and well-being. Reporting of the use of Delphi in health and well-being research is increasing, but less attention has been given to covering its methodological underpinnings. In Delphi, a structured anonymous conversation between participants is facilitated, via an iterative survey process. Participants are specifically selected for their knowledge and experience with the topic of interest. The purpose of structuring conversation in this manner is to cultivate collective opinion and highlight areas of disagreement, using a process that minimizes the influence of group dynamics. The underlying premise is that the opinion of a collective is more useful than that of an individual. In designing our study into health literacy, Delphi aligned well with our research focus and would enable us to capture collective views. However, we were interested in the methodology that would inform our study. As researchers, we believe that methodology provides the framework and principles for a study and is integral to research integrity. In assessing the suitability of Delphi for our research purpose, we found little information about underpinning methodology. The absence of a universally recognized or consistent methodology associated with Delphi was highlighted through a scoping review we undertook to assist us in our methodological thinking. This led us to consider alternative methodologies, which might be congruent with the key principles of Delphi. We identified Gadamerian philosophical hermeneutics as a methodology that could provide a supportive framework and principles. We suggest that this methodology may be useful in health and well-being studies utilizing the Delphi method. Key words: Health and well-being methods, dialogue, collective opinion, democratic group method (Published: 5 May 2015) Citation: Int J Qualitative Stud Health Well-being 2015, 10: 26291 - http://dx.doi.org/10.3402/qhw.v10.26291
51 citations
TL;DR: Qualitative content analysis was used to analyse the pattern of 44 media reports of adolescent suicide in Ghana from January 2001 through September 2014 and showed that hanging was the dominant method used.
Abstract: Adolescent suicide is now a major health concern for many countries. However, there is paucity of systematic studies and lack of official statistics on adolescent suicide in Ghana. Mass media coverage of adolescent suicide (even though crude), at least, may reflect the reality of the phenomenon. With an ecological orientation, this study used qualitative content analysis to analyse the pattern of 44 media reports of adolescent suicide in Ghana from January 2001 through September 2014. Results showed that hanging was the dominant method used. The behaviour usually takes place within or near the adolescent's home environment. The act was often attributed to precursors within the microsystem (family and school) of the deceased. This study serves a seminal function for future empirical studies aimed at deeper examination of the phenomenon in order to inform prevention programmes.
50 citations
TL;DR: Inspired by a phenomenological framework, the results of this study illuminate novel clinical and theoretical insight into the meaning of BBAT as an adjunctive approach in the treatment of depression.
Abstract: Although there is a vast amount of research on different strategies to alleviate depression, knowledge of movement-based treatments focusing on body awareness is sparse. This study explores the experiences of basic body awareness therapy (BBAT) in 15 persons diagnosed with major depression who participated in the treatment in a randomized clinical trial. Hermeneutic phenomenological methodology inspired the approach to interviews and data analysis. The participants’ experiences were essentially grasped as a process of enhanced existential openness, opening toward life , exceeding the tangible corporeal dimension to also involve emotional, temporal, and relational aspects of life. Five constituents of this meaning were described: vitality springing forth , grounding oneself , recognizing patterns in one's body , being acknowledged and allowed to be oneself , and grasping the vagueness . The process of enhanced perceptual openness challenges the numbness experienced in depression, which can provide hope for change, but it is connected to hard work and can be emotionally difficult to bear. Inspired by a phenomenological framework, the results of this study illuminate novel clinical and theoretical insight into the meaning of BBAT as an adjunctive approach in the treatment of depression. Key words: Embodiment, lived body, physical therapy, person-centred care, movement-based therapies
45 citations
TL;DR: It is suggested that effective communication, mutual respect, and support from significant others, in the midst of stressful life events, contribute substantially to a holistic construction and meaning of health and wellbeing by Ghanaian adolescents.
Abstract: There is presently no internationally agreed upon set of indicators for assessing adolescent health and what “health and wellbeing” means to adolescents. The psychosocial context of family, friends, and school plays a crucial role in the construction of health and wellbeing by adolescents. In spite of this, not much is known about the meaning Ghanaian adolescents attach to their health and wellbeing and the role of stress and social support in the construction of this meaning. This study explores how perceived social support and stress influence the construction of the meaning of health and wellbeing to Ghanaian adolescents. Eleven respondents purposively selected from 770 males and females participated in semi-structured interviews, which were transcribed verbatim and analysed with thematic analysis. Findings pointed to the fact that health and wellbeing was largely construed as “ability to perform daily functions,” such as ability to take critical decisions and a general sense of vitality and mental strength. These were influenced by perceived social support (“encouragement and advice” and “religiosity or spirituality”) and stress (“teasing, strictness, quarrels, and arguments”). These findings suggest that effective communication, mutual respect, and support from significant others, in the midst of stressful life events, contribute substantially to a holistic construction and meaning of health and wellbeing by Ghanaian adolescents. Key words: Social support, stress, health and wellbeing, social constructionism, qualitative method, thematic analysis, adolescents, Ghana (Published: 7 April 2015) Citation: Int J Qualitative Stud Health Well-being 2015, 10 : 26370 - http://dx.doi.org/10.3402/qhw.v10.26370
39 citations
TL;DR: A need for contextual life-world knowledge and an understanding of fall prevention as a piece in a larger puzzle within a broader framework of culture, health, and well-being is indicated.
Abstract: Fall related injuries in nursing homes have a major impact on the quality of life in later adulthood and there is a dearth of studies on falling and fall prevention from the older person's perspective. The aim of the study was to identify how older persons perceive falling, fall prevention, and fall accidents. Six in-depth interviews were carried out and a hermeneutic phenomenological method was used to describe and interpret the older persons’ accounts. Interpretations of Levinasian and Heidegarian philosophy related to dwelling and mobility helped cultivate important insights. Symbolic and physical environments are important for the participants’ well-being. The older persons in the study did not wish to dwell on the subject of falling and spoke of past and present coping strategies and the importance of staying on their feet. The women spoke about endurance in their daily lives. The men's narrations were more dramatic; they became animated when they spoke of their active past lives. As the scope of the study is small, these gender differences require further investigation. However, their stories give specific knowledge about the individual and their symbolic environmental circumstances and universal knowledge about the importance of integrating cultural environmental knowledge in health promotion and care work. Traditional fall prevention interventions are often risk oriented and based on generalized knowledge applied to particular cases. The findings indicate a need for contextual life-world knowledge and an understanding of fall prevention as a piece in a larger puzzle within a broader framework of culture, health, and well-being. Showing an interest in the older persons’ stories can help safeguard their integrity and promote their well-being. This can ignite a spark that kindles their desire to participate in meaningful exercises and activities. Key words: Fall prevention, Heidegger, Levinas, older persons, narratives, well-being, nursing care, health promotion (Published: 8 January 2015) Citation: Int J Qualitative Stud Health Well-being 2015, 10 : 26123 - http://dx.doi.org/10.3402/qhw.v10.26123 Responsible Editor: Carina Bertero, Linkoping University, Sweden.
TL;DR: SB is perceived, motivated, and performed differently in patients with RA, and an individually tailored approach may be essential in understanding and encouraging patients’ motivation towards sustainable change in SB and activity patterns.
Abstract: Background : Despite increasing interest in investigating sedentary behaviour (SB) in the general population and in patients with rheumatoid arthritis (RA), there is little documentation of the subjective experiences of SB in patients with RA. This study aimed to examine how patients with RA describe their daily SB. Methods : Fifteen patients with RA (10 women and 5 men) from 23 to 73 years of age and with a disease duration ranging from 4 to 27 years were interviewed following a semi-structured interview guide. Data were analysed using the content analysis method described by Graneheim. Results : SB appeared in three categories covering: 1) A constant battle between good and bad days ; SB could be a consequence of RA in terms of days with pronounced pain and fatigue resulting in many hours of SB. 2) Adaptation to everyday life ; living with the unpredictability of RA included constant modification of physical activity level causing increase in SB, especially during periods of disease flare. Prioritizing and planning of SB also functioned as part of self-management strategies. 3) It has nothing to do with my arthritis ; for some patients, SB was not related to RA, but simply reflected a way of living independent of the disease. Conclusions : SB is perceived, motivated, and performed differently in patients with RA. An individually tailored approach may be essential in understanding and encouraging patients’ motivation towards sustainable change in SB and activity patterns. Key words: Sitting time, fatigue, pain, everyday life, chronic disease, adaptation, lifestyle (Published: 12 October 2015) Citation: Int J Qualitative Stud Health Well-being 2015, 10: 28578 - http://dx.doi.org/10.3402/qhw.v10.28578
TL;DR: A more relaxed focus on overweight issues and especially on appearance is necessary when addressing weight-balance issues and lifestyle changes in young adult women.
Abstract: With the increasing number of overweight and obese people, there is a growing public health concern and focus on body size and lifestyle issues, especially in the media. Young adult women comprise a vulnerable group regarding issues of weight balance and appearance. The aim of the study was to examine the experiences of young women on how this focus influences their attitudes concerning weight changes, appearance, and health. We conducted 12 interviews with young women from two different weight groups about the attention on overweight issues. The results from the in-depth interviews were scrutinized through content analyses. The main findings indicate that young women experience a considerable focus on overweight issues with a trend towards appearance rather than health. Overweight and obesity are sensitive topics, and participants expressed strong views on the cultural definitions of normal body size and appearance. The squeeze between cultural norms and young women's perceptions of their own body and health was described as a possible negative factor influencing well-being as well as motivation for lifestyle changes. A more relaxed focus on overweight issues and especially on appearance is necessary when addressing weight-balance issues and lifestyle changes in young adult women.
TL;DR: By engaging in various culturally meaningful activities, older Korean immigrants gain a sense of social, cultural, and psychological significance in life, and evidence is provided that they maintain and develop their cultural identity through cultural meaningful activities.
Abstract: Research indicates that participation in culturally meaningful activity is beneficial for immigrants’ health and well-being, yet older Korean immigrants struggle with accepting new cultural perspectives, which can negatively affect their health and well-being. Using in-depth interviews, this study was designed to capture the value of culturally meaningful activities for health among older Korean immigrants. Three themes were identified: (a) improved psychological well-being, (b) enhanced positive emotions and feelings, and (c) social connections developed with others. The findings suggest that by engaging in various culturally meaningful activities, older Korean immigrants gain a sense of social, cultural, and psychological significance in life. This study also provided evidence that older Korean immigrants maintain and develop their cultural identity through culturally meaningful activities.
TL;DR: The experiences of either suffering or well-being during PA affected the identity of adults with morbid obesity either by challenging or motivating them, and a change in identity may be needed to feel a sense of “homecoming” when active.
Abstract: The aim is to identify facilitators and barriers for physical activity (PA) experienced by morbidly obese adults in the Western world. Inactivity and a sedentary lifestyle have become a major challenge for health and well-being, particularly among persons with morbid obesity. Lifestyle changes may lead to long-term changes in activity level, if facilitators and barriers are approached in a holistic way by professionals. To develop lifestyle interventions, the perspective and experiences of this group of patients are essential for success. The methodology of the systematic review followed the seven-step procedure of the Joanna Briggs Institute and was published in a protocol. Six databases were searched using keywords and index terms. Manual searches were performed in reference lists and in cited citations up until March 2015. The selected studies underwent quality appraisal in the Joanna Briggs-Qualitative Assessment and Review Instrument. Data from primary studies were extracted and were subjected to a hermeneutic text interpretation and a data-driven coding in a five-step procedure focusing on meaning and constant targeted comparison through which they were categorized and subjected into a meta-synthesis. Eight papers were included for the systematic review, representing the experiences of PA among 212 participants. One main theme developed from the meta-data analysis: "Identity" with the three subthemes: "considering weight," "being able to," and "belonging with others." The theme and subthemes were merged into a meta-synthesis: "Homecoming: a change in identity." The experiences of either suffering or well-being during PA affected the identity of adults with morbid obesity either by challenging or motivating them. A change in identity may be needed to feel a sense of "homecoming" when active.
TL;DR: The experiences of learning to live with MUS as narrated by patients in primary health-care settings revealed a learning process that is presented in two themes, feeling that the symptoms overwhelm life and losing the sense of self.
Abstract: Background : Although research about medically unexplained symptoms (MUS) is extensive, problems still affect a large group of primary care patients. Most research seems to address the topic from a problem-oriented, medical perspective, and there is a lack of research addressing the topic from a perspective viewing the patient as a capable person with potential and resources to manage daily life. The aim of the present study is to describe and interpret the experiences of learning to live with MUS as narrated by patients in primary health-care settings. Methods : A phenomenological–hermeneutic method was used. Narrative interviews were performed with ten patients suffering from MUS aged 24–61 years. Data were analysed in three steps: naive reading, structural analysis, and comprehensive understanding. Findings : The findings revealed a learning process that is presented in two themes. The first, feeling that the symptoms overwhelm life , involved becoming restricted and dependent in daily life and losing the sense of self. The second, gaining insights and moving on , was based on subthemes describing the patients’ search for explanations, learning to take care of oneself , as well as learning to accept and becoming mindful . The findings were reflected against Antonovsky’s theory of sense of coherence and Kelly’s personal construct theory. Possibilities and obstacles, on an individual as well as a structural level, for promoting patients’ capacity and learning were illuminated. Conclusions : Patients suffering from MUS constantly engage in a reflective process involving reasoning about and interpretation of their symptoms. Their efforts to describe their symptoms to healthcare professionals are part of this reflection and search for meaning. The role of healthcare professionals in the interpretative process should be acknowledged as a conventional and necessary care activity. Key words : MUS, primary care, person centred care, phenomenological-hermeneutics (Published: 16 April 2015) Citation: Int J Qualitative Stud Health Well-being 2015, 10: 27191 - http://dx.doi.org/10.3402/qhw.v10.27191
TL;DR: Findings suggest that participation in self-advocacy groups opens up members for increasing health and well-being through new roles and identities, and it strengthens their control over everyday life.
Abstract: A growing number of young people in Sweden with intellectual disability have organized themselves during the last 15 years in self-advocacy groups for socializing, empowerment, and expressing opposition to the norms and attitudes in a society that labels them as disabled. At the same time, the Swedish welfare system has transformed dramatically with processes of far-reaching individualization, closure of the major institutions, decentralization of responsibility from the state to local governments, and an emerging welfare market where service users are turned into customers. The aim of this article is to analyse and discuss the significance of self-advocacy in the new welfare context. Data were collected over a period of more than 10 years using repeated interviews with members of two self-advocacy groups and participation observations. Findings suggest that participation in self-advocacy groups opens up members for increasing health and well-being through new roles and identities, and it strengthens their control over everyday life. Support is still needed, however, but in new ways; otherwise, the restrictions of the institutions will simply be reconstructed in the new welfare system.
TL;DR: How younger women in Norway construct their embodiment and sense of self after hysterectomy is explored, including feelings of suffering due to the loss of the uterus as well as profound side-effects, such as menopause.
Abstract: In this paper, we explore how younger women in Norway construct their embodiment and sense of self after hysterectomy. To do this, we conducted in-depth interviews with eight ethnic Norwegian women aged between 25 and 43 who had undergone hysterectomy. In line with a broad phenomenological approach to illness, the study was designed to explore the trajectories of the women’s illness with a specific focus on concrete human experience and identity claims from a subjective point of view. In analysing the stories, we encountered feelings of suffering due to the loss of the uterus as well as profound side-effects, such as menopause. However, we also found evidence of relief from being treated for heavy bleeding and serious illness. In order to accentuate the individual voices in these illness stories, we chose a case-oriented analysis in line with Radley and Chamberlain (2001) and Riessman (2008). From this, two main seemingly contradictory storylines stood out: They have removed what made me a woman versus Without a uterus, I feel more like a woman . We also identified heteronormativity as an unstated issue in both these storylines and in the research data as a whole. Acknowledging diversity in the way women experience hysterectomy is important for a better understanding of the ways in which hysterectomy may affect women as humans as well as for developing more cultural competent healthcare services for this group. Key words: Hysterectomy, gender identity, illness narratives, suffering, heteronormativity, cultural competent healthcare (Published: 30 April 2015) Citation: Int J Qualitative Stud Health Well-being 2015, 10 : 26720 - http://dx.doi.org/10.3402/qhw.v10.26720
TL;DR: Interpretive description, an alternative to the conventional qualitative approaches, can help in this regard by providing a better understanding of complex experiential clinical/ practical phenomena.
Abstract: An ongoing process in qualitative research aims at contributing to a deeper understanding of human experiences and behaviour, and the behavioural world of applied practice This process also aims to improve the usefulness of the findings by giving evidence for practical action Interpretive description, an alternative to the conventional qualitative approaches, can help in this regard by providing a better understanding of complex experiential clinical/ practical phenomena (Thorne, 2008) (Published: 13 May 2015) Citation: Int J Qualitative Stud Health Well-being 2015, 10: 27679 - http://dxdoiorg/103402/qhwv1027679
TL;DR: Critical thematic analysis was used to explore beliefs and attitudes towards herbal medicines in adults experiencing anxiety, and three major themes were found: Herbal medicines being different from pharmaceuticals, evidence and effectiveness, and barriers to herbal medicine use.
Abstract: Herbal medicine use is widespread and has been reported to be as high as 21% in people with anxiety disorders. Critical thematic analysis was used to explore beliefs and attitudes towards herbal medicines in adults experiencing anxiety. In-depth interviews were conducted with eight adults who experienced anxiety and used herbal medicines. Three major themes were found: Herbal medicines being different from pharmaceuticals, evidence and effectiveness, and barriers to herbal medicine use. Within these themes people held beliefs about the safety of natural treatments, valued anecdotes from friends and family as a form of evidence for self-prescribing, and described confusion about herbal medicines and their cost as barriers to using them as a treatment option. The findings will inform future research and provide guidance for health practitioners.
TL;DR: Findings from the TOPS study show that the potential recipients of eHealth are open to the use of such technologies and that although they cannot be expected to replace existing models of care, eHealth may provide opportunities to sustain and enhance these interactions.
Abstract: New and existing information communication technologies (ICT) are playing an increasingly important role in the delivery of health and social care services. eHealth has the potential to supplement in-person home visits for older, rural adults with chronic pain. The Technology to support Older Adults' Personal and Social Interaction project-TOPS-examines interactions between older people and their health/social care providers and considers how eHealth could play a part in enhancing the life experiences of older people with chronic pain, who live in remote/rural areas. This paper reports findings from the TOPS study, drawing upon observations of health/social care home visits to chronic pain patients and interviews with patients and health/social care providers in rural Scotland. Patients and care professionals believe in-person care promotes the general well-being of older people with pain. However, our findings show that the potential recipients of eHealth are open to the use of such technologies and that although they cannot be expected to replace existing models of care, eHealth may provide opportunities to sustain and enhance these interactions.
TL;DR: It is suggested that the next of kin in striving to maintain continuity and safety in the older person’s transition process are both vulnerable individuals and significant agents and it is urgent that health care providers accommodate both their vulnerability and their abilities to act.
Abstract: Next of kin represent significant resources in the care for older patients. The aim of this study was to describe and illuminate the meaning of the next of kin’s experiences during the transition of an older person with continuing care needs from hospital to home. The study has a phenomenological hermeneutic design. Individual, narrative interviews were conducted, and the data analysis was conducted in accordance with Lindseth and Norberg’s phenomenological hermeneutic method. Two themes and four subthemes were identified and formulated. The first theme: “Balancing vulnerability and strength,” encompassed the subthemes “enduring emotional stress” and “striving to maintain security and continuity.” The second theme: “Coping with an altered everyday life,” encompassed “dealing with changes” and “being in readiness.” Our findings suggest that the next of kin in striving to maintain continuity and safety in the older person’s transition process are both vulnerable individuals and significant agents. Thus, it is urgent that health care providers accommodate both their vulnerability and their abilities to act, and thereby make them feel valued as respected agents and human beings in the transition process. Key words: Relatives, adult, alteration, hospital care, home care, phenomenological hermeneutic study (Published: 5 March 2015) Citation: Int J Qualitative Stud Health Well-being 2015, 10 : 26554 - http://dx.doi.org/10.3402/qhw.v10.26554
TL;DR: Parents’ experiences of being a part of their adolescents’ empowerment-inspired PA intervention were described, demonstrating that parents are one important part of a successful PA intervention.
Abstract: Although physical activity (PA) is an important and modifiable determinant of health, in Sweden only 15% of boys and 10% of girls aged 15 years old achieve the recommended levels of PA 7 days per week. Adolescents' PA levels are associated with social influence exerted by parents, friends, and teachers. The purpose of this study was to describe parents' experiences of being a part of their adolescents' empowerment-inspired PA intervention. A qualitative interview study was performed at a school in the northern part of Sweden. A total of 10 parents were interviewed, and the collected data were analyzed with qualitative content analysis. Three subthemes were combined into one main theme, demonstrating that parents are one important part of a successful PA intervention. The life of an adolescent has many options and demands that make it difficult to prioritize PA. Although parents felt that they were important in supporting their adolescent, a successful PA intervention must have multiple components. Moreover, the parents noted that the intervention had a positive effect upon not only their adolescents', but also their own PA. Interventions aimed at promoting PA among adolescents should include measures to stimulate parent participation, have an empowerment approach, and preferably be school-based.
TL;DR: Health care providers and student counsellors need to understand the negative psychosocial consequences for adolescents living with a visible disfigurement and provide appropriate psychological and social support.
Abstract: The study explored experiences of adolescents aged 15–19 with alopecia areata (AA) and investigated their accounts of coping behaviours. Interpretative Phenomenological Analysis was used to provide an in-depth and holistic perspective of their accounts. Semi-structured interviews were undertaken with a volunteer sample of eight respondents diagnosed with AA. Four key themes were identified: loss (self/social), concerns (physical/future), negative (emotions/thoughts), and coping styles (adaptive/maladaptive). Females experienced greater feelings of loss, were more concerned about their looks and their future, and reported more negative thoughts and emotions. Females felt angry and blamed God for their fate; males blamed both their fate and luck. Action-oriented and practical coping styles were adopted by all of them. After the realization that initial coping behaviours were ineffective, self-distraction, acceptance, and humour were used. Psychological relief followed with the practice of religion and planning for treatments to be undertaken in the future. The findings here are similar to research conducted in the West, though with more emphasis on religion. Health care providers and student counsellors need to understand the negative psychosocial consequences for adolescents living with a visible disfigurement and provide appropriate psychological and social support. Key words: Adolescents, semi-structured interviews, interpretative phenomenological analysis, coping behaviour, alopecia areata (Published: 29 January 2015) Citation: Int J Qualitative Stud Health Well-being 2015, 10 : 26039 - http://dx.doi.org/10.3402/qhw.v10.26039
TL;DR: The experience of well-being in old cancer patients during hospital admission was absent or challenged when staff did not acknowledge their individual vulnerability and needs.
Abstract: Today, hospitals offer surgical treatment within a short hospital admission. This brief interaction may challenge the well-being of old patients. The aim of this study was to explore how the well-being of old hospitalized patients was affected by the interaction with staff during a fast-track surgical treatment and hospital admission for colon cancer. We used an ethnographic methodology with field observations and unstructured interviews focusing on one patient at a time (n=9) during a full day; the hours ranging from 7:45 a.m. to 8 p.m. Participants were between 74 and 85 years of age and of both sexes. The study was reported to the Danish Data Protection Agency with reference number (2007-58-0010). The encounter between old patients and the staff was a main theme in our findings elucidating a number of care challenges. The identified care challenges illustrated "well-being as a matter of different perspectives," "vulnerability in contrast to well-being," and "staff mix influencing the care encounter." The experience of well-being in old cancer patients during hospital admission was absent or challenged when staff did not acknowledge their individual vulnerability and needs.
TL;DR: The findings show that troublesome family relationships, including intimate partner violence and violence in the family, influenced the mothers’ mental well-being and it is important to focus on the depressive symptoms among new mothers and offer counselling to those showing depressive symptoms, as the cultural traditions do not always alleviate these symptoms in the changing Bangladeshi society today.
Abstract: Over recent years, researchers have found evidence which indicates that postpartum depression (PPD) crosses cultural boundaries and the prevalence of PPD is reported to be at least as high in non-Western countries as in Western-countries. However, qualitative studies about new mothers’ experiences from non-Western countries, such as Bangladesh, are rare, particularly in rural areas. This study aims to describe the experiences and concerns of rural Bangladeshi mothers with postpartum depressive symptoms. In-depth interviews were conducted with 21 mothers with depressive symptoms 2-3 months postpartum, consecutively selected from a longitudinal study about prevalence and risk factors of perinatal depressive symptoms. Inductive content analysis was used to analyse data and three themes emerged, based on six categories and 12 sub-categories. The findings have shown that troublesome family relationships, including intimate partner violence and violence in the family, influenced the mothers’ mental well-being. They and their families lived at the limit of survival and the mothers expressed worries about their insecure situation regarding economic difficulties and health problems. They felt sorry for being unable to give their infants a good start in life and sad because they could not always follow the traditional norms related to childbirth. Thus, it is important to focus on the depressive symptoms among new mothers and offer counselling to those showing depressive symptoms, as the cultural traditions do not always alleviate these symptoms in the changing Bangladeshi society today.
TL;DR: The aim of this study was to explore nurses’ experiences related to the challenges of implementing CRM in the organizational context and the emergence of “rocky milieu” as the main theme.
Abstract: Healthcare risks and clinical risks have been recognized as a major challenge in healthcare. Clinical risks can never be eliminated and can have serious adverse effects on patient safety. Thus, a clinical risk management (CRM) system has been introduced in the healthcare system to improve quality services. The aim of this study was to explore nurses’ experiences related to the challenges of implementing CRM in the organizational context. This qualitative study was based on the conventional content analysis of the Lundman and Graneheim approach, and it consisted of 22 interview sessions with 20 nurses. The purposive sampling method was used to choose the participants from three hospitals affiliated with the Kerman University of Medical Sciences. We used semi-structured interviews and review of relevant documents to collect data. The analysis of the data led to the emergence of “rocky milieu” as the main theme, and it consisted of three categories that, along with their subcategories, explain the challenges of implementing CRM. The three categories and their subcategories were (1) organizational culture and leadership challenges (decision and performance of leadership and cultural resistance to change), (2) limitation of resources (financial, human, and physical and equipment resources), and (3) variations and complexities in working conditions (the emotional, psychological, and social atmosphere and the heaviness of workload). Attempts have been made to establish CRM through clinical governance and accreditation, but organizational challenges have created a rocky milieu for implementing CRM. However, from an organizational context concerning the suitability of healthcare in Iran, there are obvious needs to move toward quality improvement and safe practices through the effective implementation of CRM. Key words: Clinical risk, healthcare risk, clinical risk management, patient safety, quality improvement, clinical governance (Published: 11 May 2015) Citation: Int J Qualitative Stud Health Well-being 2015, 10: 27040 - http://dx.doi.org/10.3402/qhw.v10.27040
TL;DR: The study shows that district nurses play an essential role in the provision of palliative care for older rural patients, and the therapeutic value of being in one's familiar landscape seems to depend on how homecare nurses manage to locate it and use it in a more or less person-centred manner.
Abstract: Rural home nursing care is a neglected area in the research of palliative care offered to older cancer patients. Because access to specialized services is hampered by long distances and fragmented ...
TL;DR: The aim of this study is to describe the experience of learning to live with diabetes, and shows that when the afflicted realize that their bodies undergo changes and that blood sugar levels are not always balanced as earlier in life, they can adjust to their new conditions early.
Abstract: Research shows that people with diabetes want their lives to proceed as normally as possible, but some patients experience difficulty in reaching their desired goals with treatment. The learning pr ...
TL;DR: The philosophical examination of the empirical results from two lifeworld phenomenological studies from the perspective of patients and carers using the French philosopher Michel Foucault's historical–philosophical work reveals embedded difficulties in forensic psychiatric care and highlights a need to revisit the aim of such care.
Abstract: The aim of this article is to shed light on contemporary forensic psychiatric care through a philosophical examination of the empirical results from two lifeworld phenomenological studies from the perspective of patients and carers, by using the French philosopher Michel Foucault’s historical–philosophical work. Both empirical studies were conducted in a forensic psychiatric setting. The essential results of the two empirical studies were reexamined in a phenomenological meaning analysis to form a new general structure in accordance with the methodological principles of Reflective Lifeworld Research. This general structure shows how the caring on the forensic psychiatric wards appears to be contradictory, in that it is characterized by an unreflective (non-)caring attitude and contributes to an inconsistent and insecure existence. The caring appears to have a corrective approach and thus lacks a clear caring structure, a basic caring approach that patients in forensic psychiatric services have a great need of. To gain a greater understanding of forensic psychiatric caring, the new empirical results were further examined in the light of Foucault’s historical–philosophical work. The philosophical examination is presented in terms of the three meaning constituents: Caring as correction and discipline, The existence of power, and Structures and culture in care. The philosophical examination illustrates new meaning nuances of the corrective and disciplinary nature of forensic psychiatric care, its power, and how this is materialized in caring, and what this does to the patients. The examination reveals embedded difficulties in forensic psychiatric care and highlights a need to revisit the aim of such care. Key words: Caring science, forensic psychiatric care, Foucault, philosophical examination (Published: 27 August 2015) Citation: Int J Qualitative Stud Health Well-being 2015, 10: 28703 - http://dx.doi.org/10.3402/qhw.v10.28703