Medicine and Health Sciences Commons^™

Exploring The Experience Of Healthcare-Related Epistemic Injustice Among People With Myalgic Encephalomyelitis / Chronic Fatigue Syndrome, Joanne Hunt, Jessica Runacres, Daniel Herron, David Sheffield

The Qualitative Report

Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) is a chronic, disabling yet clinically “contested” condition, previously theorised through a lens of epistemic injustice. Phenomena conceptually close to epistemic injustice, including stigma, are known to have deleterious consequences on a person’s health and life-world. Yet, no known primary studies have explored how people with ME/CFS experience healthcare through a lens of epistemic injustice, whilst a dearth of research explicitly exploring healthcare-related injustice from a patient perspective has been noted. This qualitative study seeks to address this gap. Semi-structured interviews and interpretative phenomenological analysis (IPA) were used to explore the experiences of …

How To Develop A Qualitative Evaluation Plan For A Complex National Intervention: Key Steps And Reflections From The Radx-Up Program, Shelly A. Maras, Josephine Mckelvy, Kelley Milligan, Allyson Kelley, Valerie A. Lucas, Tara Carr, Abisola Osinuga, Leah Frerichs, Gaurav Dave

The Qualitative Report

This article describes the formative process of developing and implementing a Qualitative Evaluation Plan (QEP) for a large-scale, National Institute of Health (NIH) supported program: Rapid Acceleration of Diagnostics — Underserved Populations (RADx-UP). RADx-UP includes over 137 projects in the United States that aim to ensure that all Americans have access to timely, accurate diagnostics for COVID-19, with a specific focus on populations the pandemic disproportionately affects. As part of a comprehensive, mixed-methods strategic evaluation plan, our team developed the QEP. We employed qualitative methods to understand RADx-UP academic and community partners’ experiences implementing community-engaged research strategies, and to understand …

Pastoral Leaders’ Perception Of Obesity And Their Role Within Faith-Based Organizations, Darren D. Moore, Clinton E. Cooper, Charles Williams

The Qualitative Report

The purpose of this study was to explore the perspectives of pastoral leaders regarding obesity and health within faith-based organizations (FBOs). In this study, the authors focused on gaining additional insight regarding how pastoral leaders conceptualize and make sense of their roles in terms of health promotion within FBOs. Utilizing a qualitative research methodological approach, specifically Qualitative Description, authors administered a qualitative survey to 12 participants which yielded three emerging themes: (1) perceived scope, (2) understanding and use of resources, and (3) defining obesity through pastoral leaders’ perspectives. In the study, investigators discuss clinical implications and provide recommendations.

Sources Of Stress, Burnout, And Career Decisions Of Male Health And Nursing Professionals: A Qualitative Inquiry Of The Challenges During The Covid-19 Pandemic, Luis Miguel Dos Santos

The Qualitative Report

The human resources and workforce shortage of registered health and nursing professionals has been a long-term problem in health systems internationally, particularly during the COVID-19 pandemic. Many health and nursing professionals face stress and burnout, which may influence their career decisions and long-term human resources development. The purpose of this study is to investigate and understand the relationship(s) between sources of stress and the reasons why male health and nursing professionals decide to leave the profession within the next six months. With the employment of the social cognitive career and motivation theory and general inductive approach with 40 male health …

Family Caregivers Of Older Adults With Physical Disabilities In Rural Thailand, Denis Tuttle, Jiranan Griffiths, Anuchart Kaunnil

The Qualitative Report

Thailand is one of many countries experiencing changes in the demographics of its population. People are living longer and having fewer children resulting in an increasing percentage of older adults in the general population. This presents a challenge in providing care for older adults, especially in countries where there is a culture of family caregiving. This study aims to investigate the experience of family caregivers, exploring the problems of caring for older people with physical disabilities and the needs of family caregivers. This is done to better understand ways to support caregivers. Using a descriptive qualitative approach, 15 family caregivers …

Experiences And Concerns Of Female Hotel Housekeepers In The First Stages Of The Covid-19 Lockdown In The Balearic Islands (Spain): A Qualitative Study, Xenia Chela-Alvarez, Cristian Sanchez-Rodriguez, Oana Bulilete, Mclara Vidal-Thomàs, Joan Llobera

The Qualitative Report

Strongly enforced mobility restrictions to deter the spread of COVID-19 severely impacted tourism, a pivotal economic sector of the Balearic Islands. Little is known about the experiences of the most economically affected groups, such as hotel housekeepers. This study aimed to explore the experiences and concerns of hotel housekeepers (approximately 13,000 worked in the Balearic Islands before the pandemic) during the first stages of the COVID-19 lockdown. Semi-structured interviews were conducted by telephone in April of 2020. Thematic analysis was used for interpretation. Eighteen hotel housekeepers were interviewed. Main experiences and concerns identified were: (a) distress due to employment status …

A Qualitative Analysis Of Personal Health Care Challenges Experienced By Iranian Divorcees, Farzaneh Golboni, Zainab Alimoradi, Bengt Fridlund, Liselott Årestedt, Mark Griffiths, Anders Broström, Amir Hajiagha Pakpour Ahp

The Qualitative Report

Divorce, nowadays an increasingly more prevalent life event in Iran, can create poor general health among Iranian women, possibly due to bigger challenges for health-related behaviors. The aim was to explore challenges to achieve health-related behaviors as experienced by divorced Iranian women acting as household-heads. An inductive exploratory design based on qualitative content analysis was utilized. Twenty strategically selected divorced women acting as household-heads in Tehran were interviewed between September 2019 and January 2020. The divorced women experienced individual-centered and social and environmental-centered challenges concerning their health-related behaviors. Lack of competence, lack of personal control, and lack of emotional support …

“We Live On An Island:” Perspectives On Rural Family Caregiving For Adults With Alzheimer’S Disease And Related Dementias In The United States, Heather J. Williamson, Andria B. Begay, Dorothy J. Dunn, Rachel Bacon, Mark Remiker, Yolanda E. Garcia, Michael J. Mccarthy, Julie A. Baldwin

The Qualitative Report

As the United States’ aging population grows, there will be increased prevalence of individuals living with Alzheimer’s Disease and related dementias (ADRD), who largely rely on the support of their family caregivers. Family caregivers residing in rural areas face additional challenges with managing caregiving responsibilities and navigating support services. The purpose of this multilevel phenomenological qualitative study was to explore the assets, unique needs, and resources of rural-residing ADRD caregivers from the caregiver, provider, and policy influencers’ perspectives. The study took place between 2019 through 2021 in northern Arizona, a largely rural and geographically vast area home to caregivers from …

Access To Health Care By Foreign Children With Special Needs In An International Border Municipality, Gabriela Dominicci De Melo Casacio, Adriana Zilly, Rosane Meire Munhak Da Silva

The Qualitative Report

This qualitative study aimed to analyze access to health by foreign children with special needs in an international border municipality. Grounded on hermeneutics-dialectics, this research was conducted through in-depth interviews with 26 professionals who treat foreign children with special health care needs and thematic analysis for data analysis was adopted. One central theme emerged: Vulnerability of foreign children and the health access in a border area Brazil-Argentina-Paraguay, organized by six sub-themes. High demand of children, overload in the health services, problems with documentation and language, insufficient articulation between the countries, and lack of funding represent restrictions for the access, especially …

Attempting To Close The Evidence-Practice Gap In Physical Activity Intervention Research: Strategies And Outcomes Of A Co-Creative Qualitative Study, Andrew Powell, Charlotte Coward

The Qualitative Report

It is argued that a gap exists between research evidence and “real-world” physical activity (PA) intervention practice. One potential way to aid the translatability of evidence in this field is for researchers to work actively with the public health practitioners and organisations that run PA interventions to engage in co-creative research. This paper reports the process and strategies used to underpin research co-creation during a recent qualitative PA intervention study, and the outcomes of the co-creative approach from the perspective of the public health organisation involved in the research in terms of providing them with translatable evidence. A range of …

The Lived Experience Of Postpartum Anxiety During Covid-19: A Hermeneutic Phenomenological Study, Walker Ladd Phd, Jenny De Decker

The Qualitative Report

The experience of pregnancy and postpartum anxiety disorders results in adverse birth outcomes and the disrupted development of infants and children. Since the COVID-19 Pandemic, the Centers for Disease Control and Prevention (CDC) has designated pregnant and postpartum women as more vulnerable to COVID-19 (CDC, 2021), and perinatal mood and anxiety disorders rates have increased. However, research regarding the lived experience of women with postpartum anxiety (PPA) during a global pandemic remains lacking. Using van Manen’s hermeneutic phenomenological research method, we interviewed eight women self-identifying as having had PPA during the COVID-19 pandemic. Analysis revealed five themes describing the lived …

Arab Health Promoters’ Perspectives On Religious/Cultural Challenges To Adopt Healthy Lifestyle Behaviours Among Arab Immigrants In Canada, Hussein Baharoon, Judy King

The Qualitative Report

Despite the importance of faith and cultural background in Arab immigrants’ lives, little is known about their role in preventing cardiovascular diseases. To understand the challenges among Arab immigrants related to acculturation and religiosity in adopting healthy lifestyle behaviours and managing stress, we conducted three face-to-face focus groups with 17 Arab health promoters who were members of the Canadian Arab Health Coalition. Averaging 80 minutes in length, the focus groups were conducted in Ottawa, Canada, in February and March 2018. Data were analyzed with an inductive thematic analysis approach; we identified four themes: “Culture first!”: dominant influence of home country …

The Headaches Of Case Study Research: A Discussion Of Emerging Challenges And Possible Ways Out Of The Pain, Malin Knutsen Glette, Siri Wiig

The Qualitative Report

Case study research is a widely-used approach in qualitative research. The advantages of case study research include its ability to investigate complex social phenomena and to handle dense data. However, it has several drawbacks, such as defining the case and ensuring rigour. The large variety in descriptions of case study implementation makes the application of case study research a challenge for novice and experienced researchers alike. The aim of this paper is to describe a novice’s foray into case study research, illustrating advantages, drawbacks, and applications of case study research through examples from a previously conducted case study. By mapping …

Self-Portraits For Social Change: Audience Response To A Photovoice Exhibition By Women With Disability, Diane Macdonald, Angela Dew, Karen Fisher Assoc Prof, Katherine Boydell

The Qualitative Report

Negative attitudes about and behaviours towards women with disability are harmful and exclusionary, contributing to poorer health, income, educational, and employment outcomes. Our study focused on what audiences learnt, felt, and did (what changed) after viewing self-portraits and stories by women with disability. We questioned whether a public exhibition of their artworks, created through photovoice methodology, could be an effective platform to provoke social change and increase inclusion for people with disability. We collected audience response to our exhibition to address a research gap and to provide an example for other photovoice researchers. We employed interpretive thematic analysis through a …

Examining Newcomer Women’S Experiences With Perinatal Care In Ontario, Canada: An Application Of Carspecken’S Critical Ethnographic Method, Jessica Pimienta, Oona St-Amant, Sepali Guruge, Corinne Hart, Cristina Catallo

The Qualitative Report

This article provides a practical description of Carspecken’s (1996) five-stage critical ethnographic approach entitled “Critical Qualitative Research (CQR).” Situated epistemologically and ontologically in the critical paradigm, this article is an exploration of critical ethnography as an important methodology for shedding light on the discursive culture of perinatal care for newcomer women during the three-month health insurance waiting period in Ontario, Canada. We argue that Carspecken’s approach to critical ethnography is especially instrumental in illuminating the social structures that contribute to health inequities.

Developing A Sexual Health Consent Strategy For Refugees: A Qualitative Approach, Amita Tuteja, Elisha Riggs, Lena Sanci, Lester Mascarenhas, Anna Power, Di Vanvliet, Katrina Sangster, Kimberley Mcguinness, Meredith Temple-Smith

The Qualitative Report

We report the development of a strategy for obtaining a truly voluntary and informed consent for sexual and reproductive health (SRH) research with Burma-born refugees settled in Australia. Using a qualitative descriptive research design, we interviewed 29 providers of refugee services (PRS) including health care professionals (doctors, nurses, midwives), bilingual supporting staff (interpreters, social workers, settlement workers, community liaison officers) and administrative staff (practice managers, reception staff) who provide primary care services to refugees. Interviews were audio recorded, transcribed, and subjected to thematic analysis. Four themes emerged: (a) unique values of Burma-born people, (b) unfamiliarity with Western concepts of research, …

African-American Lay Pastoral Care Facilitators’ Perspectives On Dementia Caregiver Education And Training, Nik M. Lampe, Nidhi Desai, Tomeka Norton-Brown, Alexandra C. H. Nowakowski, Robert L. Glueckauf

The Qualitative Report

The African-American Alzheimer’s Caregiver Training and Support Project 2 (ACTS 2) is a faith-integrated, skills-training and support program for distressed African American family caregivers of persons living with dementia across Florida. Caregivers participate in a 12-week, telephone-based, skills-building and support program led by faith community workers (i.e., lay pastoral care facilitators) who provide volunteer services to their denominations. In this case study, we examined facilitators’ perspectives and recommendations for supplementary audiovisual and written training materials to optimize group process and goal-setting skills. Utilizing a qualitative approach, we explored facilitators’ needs, experiences in using current training materials, and recommendations for supplementary …

“If I Were To Suffer A Stroke Right Now, The First Place That I Should Be Taken To Is The Traditional Healer”: Community Beliefs And Health-Seeking Practices For Noncommunicable Diseases In Rural Kwazulu-Natal, South Africa, Herbert Chikafu, Innocent Tinashe Mutero Dr., Moses John Chimbari Prof.

The Qualitative Report

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The burden of chronic noncommunicable diseases in rural South Africa is exacerbated by delayed health-seeking. This study explored awareness, beliefs and health-seeking behaviour relating to diabetes, hypertension and cardiovascular diseases in Ingwavuma, a poor rural community in the uMkhanyakude district of KwaZulu-Natal, South Africa. Eight gender and age-stratified Focus Group Discussions (FGD) were conducted in isiZulu using a pre-tested FGD guide with seventy-six participants. Thematic analysis was done to discern views on access to care for noncommunicable diseases. Findings revealed limited awareness of hypertension, diabetes, and cardiovascular-related disease burden. The community practices medical plurality, and consultation with traditional healers …

Applying The Nominal Group Technique For Specifying The Interacting Dimensions Affecting Adherence To Post–Sharps Injury Follow-Up Services, Abdullah Aliff Abdul Wahab, Rosnah Ismail, Asnarulkhadi Abu Samah, Noor Dalila Inche Zainal Abidin, Nurul Asyikin Mustaffa, Halim Ismail

The Qualitative Report

Scale of adherence to post–sharps injury follow-up services among healthcare workers is uncommon compared to medication adherence scale. To develop a novel and culturally adapted scale, stakeholders should be consulted to specify dimensions by deducing it from the existing framework. This study was to demonstrate how health stakeholders were consulted to specify the dimensions.

This study employed two sessions of Nominal Group Technique. Each session consisted of 12 purposive-sampled mixed participants i.e., healthcare managers and providers. A four-step sequential protocol was used for collecting participants’ key ideas on what adherence factors in post–sharps injury follow-up services: silent idea generation, round-robin …

Challenges In Conducting Online Videoconferencing Qualitative Interviews With Adolescents On Sensitive Topics, Salima Moez Meherali, Samantha Louie-Poon

The Qualitative Report

In the wake of COVID-19, researchers are seeking innovative data-collection methods. Computer-mediated communication platforms have played a pivotal role among these pursuits. However, conducting online interviews present challenges to both researchers and participants. Online data-collection forces researchers to give up control over the study environment due to the varying location participants partake in interviews. Consequently, researchers can no longer fully guarantee the confidentiality and privacy of the researcher-participant conversations. Participants may face difficulties if being asked to disclose private information in the presence of family members. These challenges are heightened when conducting online interviews with adolescents on sensitive topics. Thus, …

The Importance Of Explicit And Timely Knowledge Exchange Practices Stemming From Research With Indigenous Families, Elizabeth J. Cooper, S Michelle Driedger

The Qualitative Report

Ethical research practice within community-based research involves many dimensions, including a commitment to return results to participants in a timely and accessible fashion. Often, current Indigenous community-based research is driven by a partnership model; however, dissemination of findings may not always follow this approach. As a result, products may not be as useful to participants who were motivated to be involved in the research process. We conducted a seven-week workshop on three occasions with different First Nations and Metis women and girls (age 8-12) in Winnipeg, Manitoba. The workshop explored participants’ perspectives around health, safety, and family wellbeing using a …

The Lived Experience Of Syrian Refugees In Canada: A Phenomenological Study, Khaldoun Aldiabat, Enam Alsrayheen, Catherine Aquino-Russell, Michael Clinton, Roger Russell

The Qualitative Report

Health care providers in Canada are expected to take care of people from a variety of cultural backgrounds, and it is difficult for health care providers to deeply understand the lived experiences of some individuals to provide them with culturally sensitive care. Syrian refugees comprise one such group of newcomers to Canada. This phenomenological study aimed to uncover the meaning of the lived experiences of Syrian refugees using Giorgi’s (2009) method. Seven participants’ descriptions were viewed through the lens of the social determinants of health model. Seven essences of the general structural description or the meaning Syrian refugees gave to …

Innovating The Study Of Context: Using A Qualitative Study On Subjugation And Resistance To Explore The Utility Of Foucauldian Governmentality As A Framework For Enriching Situational Analyses, Hannah Kia, Carol Strike, Daniel Grace, Lori E. Ross

The Qualitative Report

Situational analysis has, as an emerging poststructuralist approach to grounded theory, recently grown in use across a diverse range of disciplines and substantive areas. In this paper, we consider the complementarity of Foucauldian governmentality as a theoretical framework for supporting and enriching situational analyses. Our work is based on the findings of a recent study, informed by situational analysis, in which we interviewed 27 HIV-positive (n=16) and HIV-negative (n=11) gay men ages 50 and over about their health care experiences, and used these data to examine processes of subjugation and resistance reflected in their accounts. Drawing on our analytical process, …

How Do They Feel About It? Testing A New Mixed Methods Survey Tool To Assess Collective Emotional Status, Michael G. Schwab, Vasileios Margaritis

The Qualitative Report

Emotions are now widely accepted as important elements of qualitative research, in studies of individuals and communities. However, collective emotional status—what a community feels about a given situation or proposition—can be challenging to assess. In this study, we examined the validity and acceptability of a new mixed methods survey tool, primarily qualitative, to address this challenge—the Assessment of Collective Emotional Status (ACES). The tool begins with an adjustable set of questions about emotion, to draw respondents’ attention to their own feelings. These are followed by an emotional self-assessment, in which respondents select and prioritize five emotional responses to a standardized …

Tuberculosis Medication Nonadherence—A Qualitative Case Study, Karthick Swaminathan, Lalitha Ramakrishnan, C. S. G. Krishnamacharyulu

The Qualitative Report

India is grappling with the problem of controlling tuberculosis nearly for the past 50 years. The problem of nonadherence to treatment regimen has also worsened the situation of multidrug resistant tuberculosis (MDR-TB) in India. This article explores the factors behind nonadherence among erstwhile TB defaulters in a rural district in India. In-depth interviews with seven chronic defaulters and with healthcare professionals were conducted at a government-run Chest Clinic. In addition to in-depth interviews with defaulters and healthcare professionals, medical records and government orders related to TB control were examined extensively. Participants were also observed to understand their interaction with healthcare …

Use Of Mobile Health In Infant And Young Child Nutrition: A Formative Study In Rural Maharashtra, Samreen Sadaf Khan Dr., Archana Patel Dr., Amrita Puranik Ms., Priyanka Kuhite Dr., Yamini Pusdekar Dr., Michael J. Dibley Dr., Ashraful Alam Dr.

The Qualitative Report

Undernutrition is a major public health problem for under 5 years of age children in India. Approximately 41% and 21% of under 5 years of age children are stunted and wasted respectively. Despite the known importance of age appropriate infant and young child feeding practices for child nutrition, the rates of these practices remain poor in India. The major determinants for inappropriate IYCF practices are beliefs and knowledge of parents and caregivers. These can be effectively addressed through counselling by mobile Health technology as mobile phones are widely available and have a high penetration across the country. This formative research …

Access To Eye Care Before And After Vision Loss: A Qualitative Study Investigating Eye Care Among Persons Who Have Become Blind, Tosha Zaback, Stephanie Lam, Joan Randall, Teresa Field, Mitchell V. Brinks

The Qualitative Report

Navigating access to eye care requires that patients recognize the need for screening and care, employ limited financial and social resources, manage complex health insurance policies, and access specialty clinical care. We investigated the experience of patients through the progression of vision loss to blindness, utilizing qualitative methods. We conducted structured telephone interviews with 28 persons with blindness throughout Oregon. Utilizing closed and open-ended questions, we explored patient experience on the events preceding avoidable blindness. Coding for emergent themes was conducted independently by two researchers using a constant comparative method. Participants described important barriers to accessing eye care: at the …

Understanding Etiologies Of Road Traffic Crashes, Injuries, And Death For Patients At National Hospital Abuja: A Qualitative Content Analysis Using Haddon’S Matrix, Benjamin D. Holmes, Kristin Haglund, Emmanuel A. Ameh, Oluwole O. Olaomi, Uthman Uthman, Laura D. Cassidy

The Qualitative Report

Road traffic crashes and sequelae are reaching pandemic proportions globally and have currently achieved disproportionately high levels in Nigeria. Quantitative studies are accumulating in the peer-reviewed literature, but there is a paucity of qualitative research in Nigeria. Data for this study of structural and behavioral factors of road traffic crashes and injuries in Federal Capital Territory were collected in semi-structured interviews with crash survivors at National Hospital Abuja. Interviews were analyzed via qualitative content analysis, revealing crash location and participant beliefs about crash etiologies. Units of analysis were developed from participant statements and were structured within four a priori etiologic …

Application Of Rigour And Credibility In Qualitative Document Analysis: Lessons Learnt From A Case Study, Leanne M. Wood, Bernadette Sebar, Nerina Vecchio

The Qualitative Report

This paper probes functions and processes of qualitative document analysis (QDA), a method widely used in case study research. It firstly demonstrates the application of a QDA framework to inform a case study of women entrepreneurs in rural Australia; and provides insights into the lessons learnt, including strengths and limitations of QDA. Secondly, the paper provides guidelines for novice researchers seeking to use thematic analysis in a QDA process, arguing for rigour in naming assumptions and explicitness about the procedures employed. The paper contributes to discussion in the literature that positions QDA not only as a convenient tool, but as …

Healthy Older Adults’ Motivation And Knowledge Related To Food And Meals, Kai Victor Hansen

The Qualitative Report

The population over 60 years old is growing rapidly in Norway and in many other countries, and researchers often focus on elderly people and various diseases. This article examines the healthy elderly who are active in their daily lives to understand their motivation and knowledge about food and meals. The method used was CurroCus® group interviews, or fast focus groups. Nine CurroCus® groups were conducted, lasting for 37 to 56 minutes (average = 45 minutes). Altogether, 76 persons participated, ranging in age from 60 to 87 years; participants were predominantly female (>80%). The article discusses two areas: motivation and …