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Qualitative Health Research

Alex Broom, Emma Kirby, Alexandra F Gibson, Jeffrey J Post, Jennifer Broom
Given the global crisis of antimicrobial resistance, the continued misuse of antibiotics is perplexing, particularly despite persistent attempts to curb usage. This issue extends beyond traditional "wastage" areas, of livestock and community medicine, to hospitals, raising questions regarding the current principles of hospital practice. Drawing on five focus group discussions, we explore why doctors act in the ways they do regarding antibiotics, revealing how practices are done, justified, and perpetuated. We posit that antibiotic misuse is better understood in terms of social relations of fear, survival and a desire for autonomy; everyday rituals, performances, and forms of professional etiquette; and the mixed obligations evident in the health sector...
July 1, 2017: Qualitative Health Research
Rhiannon Edge, Dawn Goodwin, Rachel Isba, Thomas Keegan
The Chief Medical Officer recommends that all health care workers receive an influenza vaccination annually. High vaccination coverage is believed to be the best protection against the spread of influenza within a hospital, although uptake by health care workers remains low. We conducted semistructured interviews with seven medical students and nine early career doctors, to explore the factors informing their influenza vaccination decision making. Data collection and analysis took place iteratively, until theoretical saturation was achieved, and a thematic analysis was performed...
July 1, 2017: Qualitative Health Research
Jill M Olausson, Lauren Clark, Janice M Morse, Marilyn Hammer, Nancy Allen, Marcia Grant
Currently, little information is available to guide health care practitioners on how to facilitate positive outcomes in individuals who develop new-onset diabetes after allogeneic hematopoietic stem cell transplantation (allo HSCT) for treatment of hematological cancers. Results from this constructivist grounded theory study provide a theoretical framework explaining the psychosocial process of change that middle-age and older adults experience when developing new-onset diabetes in this context. Two predominant factors influenced this change: treatment burden and perception of diabetes...
July 1, 2017: Qualitative Health Research
Marta Röing, Inger K Holmström, Jan Larsson
Phenomenography is a qualitative research method based on the assumption that almost any phenomenon will be understood by a group of people in a limited number of ways. Our aim in this article was to identify the different ways work can be understood by healthcare professionals. In a world where the delivery of healthcare is continually changing, a metasynthesis of phenomenographic articles on healthcare professionals' understandings can provide knowledge about the focus and meaning of work for these individuals today...
July 1, 2017: Qualitative Health Research
Carey DeMichelis
The refusal of blood products by Jehovah's Witness patients has provoked court proceedings, social science research, and contemporary fiction, all of which emphasize a seemingly intractable conflict between religious and secular ways of being. This article takes a different approach, focusing instead on the space that Witness patients have carved out for their accommodation in a major pediatric research hospital. Using discourse analysis and interview data, I map the way moralizing discourses surrounding Witness families have shifted over the past 70 years alongside advancements in bloodless medicine...
July 1, 2017: Qualitative Health Research
Lilian Teddy Mselle, Megan Aston, Thecla W Kohi, Columba Mbekenga, Danielle Macdonald, Maureen White, Sheri Price, Gail Tomblin Murphy, Shawna O'Hearn, Keisha Jefferies
Postpartum education can save lives of mothers and babies in developing countries, and the World Health Organization recommends all mothers receive three postpartum consultations. More information is needed to better understand how postpartum education is delivered and ultimately improves postpartum health outcomes. The purpose of this qualitative study was to examine how postpartum care was delivered in three postnatal hospital clinics in Dar es Salaam, Tanzania. Semistructured interviews with 10 nurse-midwives and three obstetricians were conducted...
July 1, 2017: Qualitative Health Research
Mélisa Audet, Alex Dumas, Rachelle Binette, Isabelle J Dionne
Excess weight and menopause are two major factors increasing aging women's vulnerability to chronic diseases. However, social position and socioeconomic status have also been identified as major determinants influencing both health behaviors and the development of such diseases. This study focuses on the socioeconomic variations of behavioral risk factors of chronic diseases in aging women. By drawing on Bourdieu's sociocultural theory of practice, 40 semistructured interviews were conducted to investigate preventive health practices of clinically overweight, postmenopausal women from contrasting socioeconomic classes living in Canada...
August 2017: Qualitative Health Research
Jonna Arousell, Aje Carlbom, Sara Johnsdotter, Elin C Larsson, Birgitta Essén
In this article, we explore how reproductive health care providers in Sweden, a country often described as one of the most gender-equal countries in the world, incorporate gender equality ideals in multicultural contraceptive counseling. In the tension between gender equality promotion on one hand and respect for cultural diversity and individualized care on the other, we will demonstrate that values of gender equality were often given priority. This is not necessarily undesirable. Nevertheless, our proposal is that the gender equality ideology may inhibit providers' ability to think differently about issues at stake in contraceptive counseling, which may negatively influence women's possibilities to obtain adequate support...
August 2017: Qualitative Health Research
Katie Broekema, Kirsten M Weber
In this article, we offer insights into how individuals with cystic fibrosis (CF) share information about their disease with a romantic partner. Using communication privacy management as a sensitizing theoretical construct, four themes emerged following 13 qualitative interviews with persons with CF. Themes about sharing CF-related information with a romantic partner include weighing the risks and benefits of sharing information, the role of health-related triggered rules, the motivations for disclosures, and the reactions from outsiders...
August 2017: Qualitative Health Research
Sonja Goedeke, Ken Daniels, Mark Thorpe, Elizabeth du Preez
Although in vitro fertilization (IVF) has offered hope to those struggling with infertility, it has also had some unintended consequences, including the fate of embryos that may be "surplus" to requirement following IVF treatment. The number of embryos in storage across the world is high, creating a dilemma for patients who need to make disposal decisions, as well as presenting an administrative and practical dilemma for clinics. Research has suggested that patients' views of the status of their embryo/s may affect their disposal decisions, and yet the nature of the links between views of the embryo and decisions to either donate or discard remain unclear...
August 2017: Qualitative Health Research
Stacey A Shaw, Tara McCrimmon, Gaukhar Mergenova, Alma Sultangaliyeva, Nabila El-Bassel
HIV incidence is increasing in Central Asia, where migrant workers experience risks for acquiring sexually transmitted HIV. As a social and structural factor that may influence perceptions and behavior, we examine how Islam shapes HIV risk and protection. Phenomenological qualitative interviews examine religion and contexts of HIV risk among 48 male Central Asian migrant workers residing in Almaty, Kazakhstan. Men described nonvaginal sex, alcohol use, premarital sex, and extramarital sex as forbidden or frowned upon...
August 2017: Qualitative Health Research
Limor Meoded Danon, Anike Krämer
Parents of intersex children are perceived in many studies as hopeless, highly dependent on the medical system, and as gate keepers of normative gendered bodies. In this article, we challenge these perceptions and argue that parents of intersex children are problematically positioned between their children's needs for care and well-being and the socialmedical forces that aim to "normalize" them. Their in-between position leads them to establish different parental strategies within and outside of traditional sex/gender norms...
August 2017: Qualitative Health Research
Heather E Canary, Victoria Wilkins
Hospital discharge processes are complex and confusing, and can detrimentally affect patients, families, and providers. This qualitative study investigated pediatric hospital discharge experiences from the perspectives of parents of children with acute and chronic health conditions, primary care providers, and hospitalists. Focus groups and interviews with parents, primary care providers, and hospitalists were used to explore discharge experiences and ideas for improvement offered by participants. Using an iterative approach to analyze data resulted in five major themes for discharge experiences: (a) discharge problems, (b) teamwork, (c) ideal discharge, (d) care chasm, and (e) discharge paradox...
July 2017: Qualitative Health Research
Venkatesan Chakrapani, Peter A Newman, Murali Shunmugam, Shruta Mengle, Ruban Nelson, Clara Rubincam, Pushpesh Kumar
Topical rectal microbicides (RMs) are a new prevention technology in development that aims to reduce the risk of HIV acquisition from anal sex. We examined RM acceptability among men who have sex with men (MSM) in India. We conducted a qualitative exploratory study guided by a modified Technology Acceptance Model, with 10 focus groups ( n = 61) of MSM and 10 key informant interviews. Data were explored using framework analysis. RM acceptability was influenced by technological contexts: perceived usefulness of RMs, perceived ease of use of RM and applicator, and habits around condom and lubricant use; individual and interpersonal contexts: perceived relevance and preferences for product formulation and dosing frequency; and MSM community/social contexts: perceived social approval, RM-related stigma, social support...
July 2017: Qualitative Health Research
Caroline Huyard, Luc Derijks, Harm Haak, Louis Lieverse
Medication adherence is a major issue for patients with a chronic illness, who sometimes rationally choose temporary nonadherence. This study aims at better understanding intentional nonadherence and especially why it seems to fluctuate over time. It is based on 48 semi-structured interviews conducted in a hospital in the Netherlands with patients who had been prescribed a medication for a chronic disease for at least 1 year, and who had either type 2 diabetes, hypertension, Parkinson's disease, inflammatory bowel disease, or chronic myeloid leukemia...
July 2017: Qualitative Health Research
Mel Hall, Pat Sikes
In the U.K. context where the emphasis is (quite rightly) on living well with dementia, on positivity and enabling approaches, it can be difficult for researchers to investigate and report negative experiences. Failing to re-present perceptions and experiences as they are lived, however, does a serious disservice to the research endeavor and can prevent policy and service development and positive change. In this article, we present some stories told by participants in an Alzheimer's Society (United Kingdom) Funded project uniquely investigating the perceptions and experiences of children and young people who have a parent with dementia...
July 2017: Qualitative Health Research
Errol L Fields, Laura M Bogart, Idia B Thurston, Caroline H Hu, Margie R Skeer, Steven A Safren, Matthew J Mimiaga
Medication adherence among youth living with HIV (28%-69%) is often insufficient for viral suppression. The psychosocial context of adherence barriers is complex. We sought to qualitatively understand adherence barriers among behaviorally infected and perinatally infected youth and develop an intervention specific to their needs. We conducted in-depth interviews with 30 youth living with HIV (aged 14-24 years) and analyzed transcripts using the constant comparative method. Barriers were influenced by clinical and psychosocial factors...
July 2017: Qualitative Health Research
Sally Thorne
Continuing the dialogue and debate on the relevance and value of qualitative metasynthesis research for the health fields, Thorne comments on some of the ideas raised by Britten and colleagues in response to her January 2017 Qualitative Health Research editorial on Metasynthetic Madness. Here she extends the debate on the terminology with which we refer to this kind of scholarly work and the kinds of research synthesis that hold potential for adding value to existing knowledge about matters of health and illness...
July 2017: Qualitative Health Research
Nicky Britten, Ruth Garside, Catherine Pope, Julia Frost, Chris Cooper
We continue the conversation initiated by Sally Thorne's observations about "metasynthetic madness." We note that the variety of labels used to describe qualitative syntheses often reflect authors' disciplines and geographical locations. The purpose of systematic literature searching is to redress authors' lack of citation of relevant earlier work and to reassure policy makers that qualitative syntheses are systematic and transparent. There is clearly a need to develop other methods of searching to supplement electronic searches...
July 2017: Qualitative Health Research
Kerrie Doyle, Michelle Cleary, Denise Blanchard, Catherine Hungerford
In this article, we discuss indigenist approaches to health research, including indigenist knowledges, cultural proficiency, and core values. We also highlight the importance of conducting Indigenous research in ways that are congruent with the needs and interests of Indigenous peoples. The discussion includes consideration of how indigenist approaches can be utilized to generate new Indigenous knowledges, in culturally appropriate ways. We then introduce the Yerin Dilly Bag Model for indigenist health research, an approach that allows for indigenist knowledges to be employed and created by the research/er/ed within an Indigenous framework...
July 2017: Qualitative Health Research
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