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Qualitative Health Research

Markus A Feufel
Forty years of statistical database analyses have demonstrated the existence of unwarranted practice variation in care delivery, that is, variations independent of medical need, evidence, or patient preference. Alas, little is known about the underlying mechanisms and thus finding interventions to reduce unwarranted variations remains difficult, hampering quality, equity, and efficiency of care. Whereas statistical analyses describe deviations from ideal patterns, ethnographically inspired analyses aim at understanding when, how, and why variations occur in practice...
May 1, 2018: Qualitative Health Research
Charlotte L Clarke, Heather Wilkinson, Julie Watson, Jane Wilcockson, Lindsay Kinnaird, Toby Williamson
The involvement of "people with experience" in research has developed considerably in the last decade. However, involvement as co-analysts at the point of data analysis and synthesis has received very little attention-in particular, there is very little work that involves people living with dementia as co-analysts. In this qualitative secondary data analysis project, we (a) analyzed data through two theoretical lenses: Douglas's cultural theory of risk and Tronto's Ethic of Care, and (b) analyzed data in workshops with people living with dementia...
May 1, 2018: Qualitative Health Research
Melvina Brandau, Tracy A Evanson
Cyberbullying is a pervasive public health issue, affecting 10% to 50% of adolescents and resulting in significant negative health outcomes. Due to the relative newness of cyberbullying, there are many elements of the phenomenon that are not understood. Fifteen adolescents and young adults who had experienced cyberbullying as adolescents, participated in one-on-one, semi-structured interviews. A grounded theory and model, Emerging From Cyberbullying, was constructed to describe the process of being a victim of cyberbullying...
May 1, 2018: Qualitative Health Research
Ximena Briceño Morales, Laura Victoria Enciso Chaves, Carlos Enrique Yepes Delgado
This study sought to understand the meaning that women place on the health care practices carried out during labor. We used techniques from Grounded Theory such as coding, categorization, and constant comparison. A total of 18 interviews were conducted with 16 women who had given birth at least once in Colombia. Based on our results, we argue that obstetric violence is an expression of violence during the provision of health care, which occurs in a social environment favoring the development of power relationships between patients and health care staff...
May 1, 2018: Qualitative Health Research
Stephanie Saunders, Chad Hammond, Roanne Thomas
Negative health consequences of cancer and its treatments are multifaceted. Research suggests numerous psychosocial benefits may be gained by cancer survivors who engage in arts-based practices. To grasp the breadth of this literature, we undertook a scoping review exploring the intersection between arts-based practices, gender, and cancer. Three databases were searched according to the following criteria: (a) participants older than 18 years, (b) use of arts-based practices, (c) explore cancer survivorship, and (d) gender-based analysis component...
May 1, 2018: Qualitative Health Research
Chiwoneso B Tinago, Lucy Annang Ingram, Edward A Frongillo, Christine E Blake, Barbara Engelsmann, David Simmons
Zimbabwe has one of the highest rates of maternal mortality, yet little is understood about adolescent girls' and young women's perspectives on pregnancy or planning for pregnancy. The research study took an emic approach to understand and describe how adolescent girls and young women (14-24 years) in Harare, Zimbabwe, conceptualize pregnancy and planning for pregnancy and how these conceptualizations inform pregnancy decisions. Semi-structured, in-depth, qualitative interviews were conducted with adolescent girls and young women ( N = 48) and data were analyzed thematically using NVivo 10...
April 1, 2018: Qualitative Health Research
Kristín Thórarinsdóttir, Kristján Kristjánsson, Thóra Jenný Gunnarsdóttir, Kristín Björnsdóttir
A phenomenologically derived assessment tool, Hermes, was developed in a rehabilitation setting for adopting the central ideals of person-centered care and patient participation into health-assessment practices in nursing. This focused ethnographic study aimed at exploring the feasibility of using Hermes for enabling the application of these ideals into assessment of patients with chronic pain upon admission to a rehabilitation center. Participants were patients with chronic pain, enrolled in rehabilitation, and their nurses...
April 1, 2018: Qualitative Health Research
John L Oliffe, Alex Broom, Mary T Kelly, Joan L Bottorff, Genevieve M Creighton, Olivier Ferlatte
Although male suicide has received research attention, the gendered experiences of men bereaved by male suicide are poorly understood. Addressing this knowledge gap, we share findings drawn from a photovoice study of Canadian-based men who had lost a male friend, partner, or family member to suicide. Two categories depicting the men's overall account of the suicide were inductively derived: (a) unforeseen suicide and (b) rationalized suicide. The "unforeseen suicides" referred to deaths that occurred without warning wherein participants spoke to tensions between having no idea that the deceased was at risk while reflecting on what they might have done to prevent the suicide...
April 1, 2018: Qualitative Health Research
Eva Pila, Catherine M Sabiston, Valerie H Taylor, Kelly Arbour-Nicitopoulos
Cancer-related changes in body weight are problematic given that excess weight is associated with an increased risk of cancer reoccurrence and mortality. The purpose of this qualitative study was to explore the experiences of weight-concerned women treated for early-stage breast cancer. A purposeful sample of women were selected based on criteria for high weight and body image concerns ( n = 11; Mage = 65.31 ± 10.96 years). Each participant engaged in a one-on-one semi-structured interview. Five themes were identified: weight concerns contributed to psychological distress, prevalent history of weight cycling and ongoing quest to manage weight, shifting psychological impact of cancer versus weight, perceptions of failure around goal-oriented weight management behaviors, and internalized and explicit social pressures for weight loss in the context of risk reduction...
April 1, 2018: Qualitative Health Research
Y Fu, E McNichol, K Marczewski, S José Closs
Supporting patients in forming partnerships with health professionals is the key of effective self-management. This study aimed to explore the nature of patient-professional partnerships and its related factors that create facilitators and barriers to patients' self-management ability. A constructivist grounded theory approach was undertaken. Three main themes emerged: interaction and communication, integrated care, and service and system. A theoretical model was generated that posits effective communication, individualized integrated care, and high-quality service as key influences on the successful development of patient-professional partnerships and patients' ability to self-manage...
April 1, 2018: Qualitative Health Research
Yang Yang, David R Perkins, A Elizabeth Stearns
There is a call for drawing on client voice to provide a rich, nuanced understanding of factors influencing substance treatment engagement as to maximizing treatment benefits. We interviewed 60 clients in a short-term inpatient substance treatment program and examined facilitators and barriers to treatment engagement. Thematic analysis yielded four themes, including perceived treatment needs, trust and counselor rapport, peer inspiration, and organizational factors. Perceived treatment needs serve as both a facilitator and a barrier wherein the acknowledgment of needs led to greater treatment engagement whereas a lack of perceived needs hindered treatment engagement...
April 1, 2018: Qualitative Health Research
Alexandra Greenberg, Georgia J Michlig, Elizabeth Larson, Ilona Varallyay, Karen Chang, Blessing Enobun, Ellen Schenk, Benjamin Whong, Pamela Surkan, Caitlin E Kennedy, Steven A Harvey
The 2014 West African Ebola outbreak was unprecedented in scale and required significant international assistance. Many U.S.-based health professionals traveled to West Africa to participate in the response, whereas others considered participation, but ultimately decided against it. This study explores motivators, facilitators, and barriers to international health care worker mobilization. We conducted 24 semistructured in-depth interviews and one focus group discussion with clinical and nonclinical responders and nonresponders...
April 1, 2018: Qualitative Health Research
Sarah Brown, Monique Lhussier, Sonia M Dalkin, Simon Eaton
Care planning has been described as a "better conversation" that helps people with long-term conditions to be in control of planning their care. Each person with long-term conditions faces individual challenges and each health care setting is fundamentally different, so there is a need for empirical testing of the specific mechanisms through which care planning may lead to health improvements. A rapid realist review was conducted to unearth underpinning mechanisms leading to outcomes in particular contexts...
April 1, 2018: Qualitative Health Research
Keith Adamson, Sonia Sengsavang, Sakeena Myers-Halbig, Nancy Searl
Schwartz Rounds™ offers an interprofessional forum for staff to openly engage in discussions about social-emotional aspects of care. We aimed to assess the perceived impact of Rounds in the health care context of pediatric rehabilitation, as well as a comparative analysis of how Rounds affected clinical versus nonclinical staff. Does effect on perceived outcomes was also investigated. Data were collected from 29 hospital staff (15 clinicians, 14 nonclinicians) who attended one, two, or three+ Rounds via semistructured interviews...
April 1, 2018: Qualitative Health Research
Andrew R Hatala, Kelley Bird-Naytowhow, Tamara Pearl, Jen Peterson, Sugandhi Del Canto, Eddie Rooke, Stryker Calvez, Ryan Meili, Michael Schwandt, Jason Mercredi, Patti Tait
Saskatoon has nearly half of the diagnoses of HIV in Saskatchewan, Canada, with an incidence rate among Indigenous populations within inner-city contexts that is 3 times higher than national rates. Previous research does not adequately explore the relations between HIV vulnerabilities within these contexts and the experiences of illness disclosure that are informed by identity transformations, experiences of stigma, and social support. From an intersectionality framework and a constructivist grounded theory approach, this research involved in-depth, semistructured interviews with 21 Indigenous people living with HIV and/or AIDS in Saskatoon, both male and female...
April 1, 2018: Qualitative Health Research
Blythe E Rhodes, Nisha C Gottfredson, Lauren M Hill
Addiction rates are rising faster among women than men. However, women with substance use disorders are less likely to enter treatment than males. This study seeks to understand how turning-point events and other maturational processes affect "life course persistent" women's motivations for seeking treatment for their disorder. We conducted semi-structured in-depth interviews with 30 women who were receiving treatment for addiction using thematic analysis. Recurring themes were as follows: experiences of rock-bottom events prior to entering treatment, feeling "sick and tired" in regard to both their physical and mental health, and shifting identities or perceptions of themselves...
April 1, 2018: Qualitative Health Research
Michelle R Brear, Pinky N Shabangu, Jane R Fisher, Karin Hammarberg, Helen M Keleher, Charles Livingstone
Comprehensive theories of health justice can supplement rights-based approaches like primary health care, by conceptualizing key terms, and systematizing knowledge about structural factors that influence health. Our aim was to use "health capability" as a theoretical lens for understanding how primary health care approaches might address structural factors impeding health in a rural Swazi community. We conducted abductive, interpretive, analysis of a mixed-method (QUAL+quan) data set about "health capability deprivations," generated through participatory action research...
April 1, 2018: Qualitative Health Research
Debra Kramlich, Rebecca Kronk, Lenora Marcellus, Alison Colbert, Karen Jakub
The incidence of perinatal opioid use and neonatal withdrawal continues to rise rapidly in the face of the growing opioid addiction epidemic in the United States, with rural areas more severely affected. Despite decades of research and development of practice guidelines, maternal and neonatal outcomes have not improved substantially. This focused ethnography sought to understand the experience of accessing care necessary for substance use disorder recovery, pregnancy, and parenting. Personal accounts of 13 rural women, supplemented by participant observation and media artifacts, uncovered three domains with underlying themes: challenges of getting treatment and care (service availability, distance/geographic location, transportation, provider collaboration/coordination, physical and emotional safety), opportunities to bond (proximity, information), and importance of relationships (respect, empathy, familiarity, inclusion, interactions with care providers)...
April 1, 2018: Qualitative Health Research
Stacey Crane, Joan E Haase, Susan E Hickman
Children with cancer are only eligible for phase I clinical trials (P1Ts) when no known curative therapy remains. However, the primary aims of P1Ts are not focused on directly benefiting participants. This raises ethical concerns that can be best evaluated by exploring the experiences of participants. An empirical phenomenology study, using an adapted Colaizzi method, was conducted of 11 parents' lived experiences of their child's participation in a pediatric oncology P1T. Study findings were that parents' experiences reflected what it meant to have a child fighting to survive high-risk cancer...
April 1, 2018: Qualitative Health Research
Sharlene Hesse-Biber, Bailey Flynn, Keeva Farrelly
The growth of the Internet since the millennium has opened up a myriad of opportunities for education, particularly in medicine. Although those looking for health care information used to have to turn to a face-to-face doctor's visit, an immense library of medical advice is now available at their fingertips. The BRCA genetic predispositions (mutations of the BRCA1 and BRCA2 breast cancer genes) which expose men and women to greater risk of breast, ovarian, and other cancers can be researched extensively online...
April 1, 2018: Qualitative Health Research
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