bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric Lung Transplantation: Families’ Need for Understanding
Authors: Stubblefield Carol , Murray Ruth L.
Published: May 2004

Fifteen parents of 12 children who had undergone lung transplantation described their relationships with others, such as members of their extended family, coworkers, and friends prior to, during, and following the transplantation. We conducted a content analysis to formulate a narrative description of the parents’ relationships with others. The parents described their relationships in terms of the support they received from them. Some parents described diminishing support in the posttransplantation period, which they attributed, in part, to a lack of understanding. This finding may reflect the influence that living with a physical condition with long-term consequences, such as lung transplantation, may have on some interpersonal relationships. Pediatric lung transplantation is an increasingly common treatment regimen for children with end-stage lung or pulmonary vascular disease. Promoting understanding of what it is like to live with a lung transplantation may help to maintain support for these families.
Engaging with Phenomenology: Is it more of a Challenge than it Needs to be?
Authors: Caelli Kate
Published: May 2004

When seeking to understand the human condition, with all the problems this enterprise poses for traditional scientific research approaches, qualitative research is held to be in some ways superior to rigidly quantitative research. As a result, many beginning health researchers plan to employ a qualitative approach to explore topics that were previously inaccessible via traditional scientific means. However, implementing a qualitative approach is not an easy process and, in many cases, researchers must look long and hard to find material to assist them in developing their research plans. This may be particularly so in phenomenological research. This article examines some of the problems and pitfalls faced by phenomenological researchers new to the approach. Through accounts of personal experience, it high-lights some of the areas where phenomenological researchers could be helpful by being less reticent about the process of implementing a phenomenological study.
Moving them on and in: The Process of Searching for and Selecting an Aged Care Facility
Authors: Cheek Julianne , Ballantyne Alison
Published: May 2004

This exploratory, descriptive study examined the search and selection process for an aged care facility following discharge of a family member from an acute setting. Few studies have examined this process and its effects on families. Individuals from 25 families where a family member had been recently admitted to an aged care facility following discharge from an acute setting were interviewed. This article reports participants’ perceptions of the search and selection process and its effect on the family. Five major themes emerged from the data: good fortune, wear and tear on the sponsor, dealing with the system, urgency, and adjusting. The results can be used to inform and assist families and health professionals working with families in this situation.
Jake’s Story: A Middle-Aged, Working-Class Man’s Physical and Spiritual Journey toward Death
Authors: Black Helen K.
Published: May 2004

In this article, the author explores a middle-aged, working-class man’s, Jake’s, reaction to his life-threatening illnesses and to his impending death. The experiences of illness and dying demand the “thick description” of narrative. Just as the medical model of illness breaks down the person into symptoms and parts, the relational model of illness and death in narrative “puts him back together again” by embedding him in a personal and social history. This article finds that the experience of illness and dying are rooted in the tacit ethos of an individual’s family and society. The cultural paradigms of gender and class, religious tradition, and the reaction of others to the dying person shape the individual’s response to his approaching death.
Can we Research Suffering?
Authors: Frank Arthur W.
Published: May 2004

Illness troubles us because it is an occasion of suffering, but research on illness has difficulty conceptualizing suffering—and naturally so because suffering is not a concept but a lived reality that resists articulation. Based on the work of Dorothy Smith, the author argues that the rhetoric of social science inadvertently increases suffering because it attempts to organize local experience within extralocal categories. He concludes with suggestions for changing research practices.
Understanding and Supporting African Americans’ Perspectives of End-of-Life Care Planning and Decision Making
Authors: Waters Catherine M.
Published: May 2004

Ethnicity has been found to explain some differences across ethnic groups regarding end-of-life care choices. African Americans appear to be less likely to know about advance directives and to complete them. Five community-based focus groups, consisting of 27 African Americans, were convened to explore their perspectives of end-of-life care planning and decision making. Content analysis revealed six themes: death is not an option, religiosity and end-of-life care planning is a paradox, the health care system is a microcosm of societal and historical events, a “trusted” family member or friend is the contract for life-and-death options, ethnically relevant initiatives are essential to increase advance directives participation, and people are people. These themes serve to guide health care professionals in minimizing actions that increase African Americans’ mistrust of the health care system not only in end-of-life situations but also in all of health care-related interactions.
From Meaning to Meaning: The Influence of Translation Techniques on Non-English Focus Group Research
Authors: Esposito Noreen
Published: May 2004

Language translation techniques are at the core of many cross-cultural qualitative research projects. The purpose of this article is to examine the impact of translation techniques on the collection and interpretation of non-English to English qualitative data and, in particular, on focus-group data collection and analysis. The goal is to offer suggestions that will minimize potential threats to validity. This article includes a working definition of translation, a discussion of issues related to translation in quantitative research, a discussion of how translation issues differ in focus group research, evaluation criteria for translators and interpreters, and an example of translation techniques used in a research study of perimenopausal Hispanic women.
How can Action Research Apply to Health Services?
Authors: Morrison Brian , Lilford Richard
Published: May 2004

The authors ask whether and how action research can apply to health services research, given action research’s claim to be radically different from mainstream research. They analyze the key tenets of an idealized version of action research, comparing them with those of the approach characteristic of mainstream research. The authors conclude, firstly, that action research deserves all credit for pioneering flexible and imaginative ways of working. Yet, there is nothing in the fundamental logic of the mainstream approach to preclude it from adopting some of these. Action researchers therefore need to reconsider their critical stance toward mainstream research. Conversely, mainstream researchers need to reconsider their critical stance toward the ways of working pioneered by action research and to adopt them as appropriate.
The Challenge of Adversity: Three Narratives of Alcohol Dependence, Recovery, and Adult Development
Authors: Paris Ruth , Bradley Cheryl L.
Published: May 2004

Turning points have been known to reverse the downward spiral of alcoholism and its concomitant associations with divorce, depression, and work-related difficulties. In this study, the authors present the stories of 3 women from the Mills Longitudinal Study who were alcoholic. Using a narrative approach, the authors tracked the women’s developmental gains during recovery using Erik Erikson’s theory of psychosocial development, specifically focusing on the tasks of identity, intimacy, and generativity. Results show that despite similar personal problems and turning points that moved them to stop drinking, each woman followed a different path to self-reconstruction and psychological growth. These accounts offer important information about individual differences in recovery from alcoholism, which are often lost in larger aggregate accounts of personal change.
Through the Haze of Cigarettes: Teenage Girls’ Stories about Cigarette Addiction
Authors: Moffat Barbara M. , Johnson Joy L.
Published: May 2004

Narrative inquiry was used to explore the meaning of nicotine addiction among teenage girls, age 14 to 17 years, who had recent experience with smoking. The following three narratives emerged: invincibility, giving in, and unanticipated addiction. Those who told a story of invincibility depicted how they were in control of their smoking and not addicted. Participants who gave accounts of giving in to smoking described yielding to external forces. In the narrative of unanticipated addiction, participants recounted their surprise at realizing that they were addicted. Two subnarratives, needing to quit and repeating history, were also uncovered. The study findings reveal the importance of semantics and identity issues as teenage girls talked about nicotine addiction. Listening to their stories is paramount in continued efforts in the reduction of tobacco consumption.
Feeling Healthy: So Why Should Mexican-Descent Women Screen for Breast Cancer?
Authors: Borrayo Evelinn A. , Jenkins Sharon Rae
Published: May 2004

Mexican-descent women are at particular risk of late-stage breast cancer diagnosis by being the least likely of the major U.S. Hispanic subgroups to undergo breast cancer screening. This grounded theory study investigated how cultural health beliefs regarding the causes and nature of breast cancer influence women’s decision to participate in screening. Thirty-four women (age 49 to 81) were interviewed in five focus groups using theoretical sampling across levels of acculturation and socioeconomic status. Analysis of the most prevalent cultural health beliefs led to a discovery that the core problem Mexican-descent women face is that they perceive there is no reason to participate in breast cancer screening when they are “feeling healthy.” In addition, women who subjectively and cognitively feel healthy and otherwise have no evidence of illness according to their cultural health beliefs are unlikely to risk feeling ill rather than healthy by seeking to discover breast cancer through screening.
Nerves in Northern Norway: The Communication of Emotions, Illness Experiences, and Health-Seeking Behaviors
Authors: Foss Nina
Published: May 2004

The nature of nerves is the subject of a growing and dynamic body of anthropological research. The term nerves is often conceptualized as hard to define. Its meaning carries ambiguities, inconsistencies, and variation, although it is connected to reactions to the hardships of life. In the West, it is often associated with psychiatric problems. In this study, the researcher unveiled peoples’ pragmatic use of the term nerves through diverse social settings in a coastal community in Northern Norway. The term was connected to psychological or psychiatric problems, privacy, and stigma, but had the capacity to communicate a continuum from normal emotional problems to severe mental illness. This study also showed the effect of the term in encounters between patients and professional health workers.
Talk that Talk: Storytelling and Analysis Rooted in African American Oral Tradition
Authors: Banks-Wallace JoAnne
Published: May 2004

Stories are the foundation of qualitative research. However, the development of qualitative methods rooted in oral traditions remains largely unexplored by researchers. The contextual and historical influences on storytelling and storytaking are critical features of the African American oral tradition that are often ignored or minimized in qualitative research. Despite the complex and often contentious history of African Americans, their oral traditions have not been explored to reveal the depth of their lived experiences and the way those experiences inform their health concerns. The purpose of this article is twofold. First, dialogues about storytelling and storytaking are revisited and critiqued. Second, a comprehensive analytic process for gathering and interpreting stories rooted in African American oral tradition is outlined.
The Social Construction of Disability in Schizophrenia
Authors: Williams Charmaine C. , Collins April A.
Published: May 2004

Chronicity and disability can accompany a diagnosis of schizophrenia, but long-term follow-up studies are demonstrating that these outcomes are not inevitable. There is growing awareness that characteristics of long-term illness previously understood to be part of the disorder can be partially constructed through a convergence of physical, psychological, and social processes. In this study, the potential for social construction of disability was explored through secondary analysis of qualitative data. Findings suggest that family, consumers, professionals, and society each have a role in shaping a person with schizophrenia’s perceptions of his or her worth, competence, and place in society but that the individuals are not passive recipients of this input.
What is this Thing Called Hormone Replacement Therapy? Discursive Construction of Medication in Situated Practice
Authors: Stephens Christine , Budge R. Claire , Carryer Jenny
Published: May 2004

The use of hormone replacement therapy (HRT) involves complex decisions for mid-aged women owing to controversy about the meaning of menopause and uncertainty regarding risks and benefits. Qualitative studies show that women can hold apparently contradictory beliefs, for example, both resisting and relying on medicalization. Focus group data (48 participants) and discourse analysis theorizing were used to investigate the complex discursive field available to women to construct HRT and to explain apparent contradictions. Interpretative repertoires identified in this study (threatening change, natural, biomedical, and drug) support previous findings. It is not contradictory to use different repertoires to achieve different discursive acts. The application of these findings to the development of decision tools that help women to arrive at individually appropriate decisions is discussed.
Redefining Life While Forestalling Death: Living with an Implantable Cardioverter Defibrillator after a Sudden Cardiac Death Experience
Authors: Dickerson Suzanne Steffan
Published: May 2004

Secondary analysis is a resourceful approach for making further use of existing data sets to answer questions not previously addressed or to expand on content not specifically examined in the original study. Using Heideggerian hermeneutics, the author analyzed transcripts of the stories of individuals with implantable cardioverter defibrillators (ICD) from three of her earlier phenomenological studies to obtain a description of the experience of living with an ICD after a sudden cardiac death experience. Three related themes emerged: (a) losing control: technology as lifesaving yet changing everything; (b) getting on with living: regaining control or conditional acceptance; and (c) creating a new vision: transformation or tenuous truce. The constitutive pattern was redefining life while forestalling death.
Postpartum Depression: A Metasynthesis
Authors: Beck Cheryl Tatano
Published: May 2004

Postpartum depression has been described as a dangerous thief that robs mothers of the love and happiness they expected to feel toward their newborn babies. Even though the number of qualitative studies on postpartum depression is increasing, knowledge development will be impeded unless the rich understandings gleaned from these studies are synthesized. Using Noblit and Hare’s 1988 approach, the author conducted a metasynthesis of 18 qualitative studies on postpartum depression. Four overarching themes emerged that reflected four perspectives involved in postpartum depression: (a) incongruity between expectations and the reality of motherhood, (b) spiraling downward, (c) pervasive loss, and (d) making gains. Implications for clinical practice and theory development are addressed.
Trust and Transparency in Human Encounters in Tuberculosis Control: Lessons Learned from Vietnam
Authors: Johansson Eva , Winkvist Anna
Published: May 2004

The purpose of this study was to elucidate understanding of mechanisms of the tuberculosis sickness trajectory in Vietnam. In-depth interviews with 24 TB patients and 16 health care providers involved in TB care were concurrently conducted, coded, and analyzed according to the grounded theory method. A need for quality interaction based on transparency and trust among patient, family, society, and provider was observed. Providers lacked an awareness of differences between male and female patients with regard to social situation and support. In particular, female patients needed social support, as they received less support from their families than men did. A need for active intervention to decrease social isolation and increase social support was more pronounced in families with a female TB patient.
Doing a Doctorate Using a Participatory Action Research Framework in the Context of Community Health
Authors: Gibbon Marion
Published: May 2004

The use of participatory action research (PAR) for doctoral research in a health setting is still a fairly rare phenomenon. The author explores what is meant by PAR and examines some of the obstacles to undertaking PAR for doctoral research so that these constraints can be overcome. The barriers are seen in terms of methodological conflicting interests, timing, and the information generated. There are also institutional obstacles. The author expresses the view-point that it is essential for academic institutions to consider how to minimize such obstacles for students to be able to engage in PAR in a meaningful way.
Conducting Research with Visually Impaired Older Adults
Authors: Moore Linda Weaver
Published: May 2004

Due to the frequency of eye disorders among older adults, qualitative researchers who involve older individuals in their work must be sensitive to the multiple ways in which visual deficits can influence the research process. The author addresses some of the difficulties encountered, insights gained, and strategies developed while conducting a phenomenological study in which all the participants were severely visually impaired. The author’s insights, drawn from personal experiences, reflections, and log entries kept throughout the study, are shared to help other researchers design and implement studies in which the voices of individuals with severe visual impairments can be skillfully tapped.
The Benefits of Being a Nurse in Critical Social Research Practice
Authors: Leslie Helen , McAllister Margaret
Published: May 2004

In critical social research, or research that evokes feminist or critical epistemological positions, researchers must examine their own situatedness vis-à-vis their research participants and work toward methods that break down the hierarchies inherent in the research relationship and empower research participants. Such aspects of research practices necessitate strong interpersonal skills, characteristic of many nurses. Drawing on their experiences, the authors critically appraise the benefits of nursing in critical social research practice. Nurses can move beyond their own discipline to use their skills, identity, and intersubjective way of relating with others to gain access to participants and data. Through a unique process of building meaning and interpreting data, nurse researchers are well placed to take effective actions for change.
Self-Resolution of Alcohol Problems in Young Adulthood: A Process of Securing Solid Ground
Authors: Finfgeld Deborah L. , Lewis Lisa M.
Published: May 2004

Quantitative research findings suggest that young adults resolve alcohol problems without participating in support groups or formal treatment programs. However, researchers have failed to fully explain the self-resolution process among this age group. Thus, the authors used grounded theory to better explicate why and how young adults self-resolve alcohol problems. The findings suggest that self-resolving alcohol problems in young adulthood involves a temporal process of seeking and securing solid ground. This process is precipitated by situations in which individuals experience precarious footing and eventually begin to lose their balance. These culminating events lead young adults to pursue personal visions and find safe footing on solid ground, despite some rugged terrain along the way.
Long-Term Dialysis Survivors: A Transformational Experience
Authors: Curtin Roberta Braun , Mapes Donna , Petillo Marty , Oberley Edith
Published: May 2004

In this exploratory/descriptive study, the authors examined processes involved in some kidney patients’ability to survive on dialysis. Through long semistructured interviews with 18 dialysis survivors, they identified four self-affirmations that characterized participants’ restructuring of self and four sets of illness experiences that required restructuring within the context of their extant worlds. The denouement involved the participants’ transformation into comprehensive, active self-managers of their disease, its treatment, and its manifestations. The authors describe the participants’affirmations and adaptations leading to transformation. Understanding this process paves the way for research into the timing and sequence entailed in transformation and lays the groundwork for the development of interventions to guide kidney failure patients to the positive outcome of transformation: comprehensive, active self-management.
Evolving Routines: Preventing Fatigue Associated with Lung and Colorectal Cancer
Authors: Olson Karin , Tom Barbara , Hewitt Joanne , Whittingham Joan , Buchanan Lisa , Ganton Gail
Published: May 2004

Some individuals with cancer develop fatigue whereas others do not. To begin the development of a biobehavioral model that could explain this phenomenon, the authors interviewed 29 individuals with lung and colorectal cancer before, during, and after treatment and obtained evaluable data for 18. Blood samples and body weight were obtained at the time of each interview. A three-stage process, evolving routines, and an adaptive behavioral mode labeled gliding characterized those who reported little or no fatigue, even when hemoglobin levels were low. Three other nonadaptive behavioral modes (inertia, disorganization, and overexertion) characterized those who reported fatigue. Individuals with similar disease and treatment profiles seldom demonstrated the same behavioral or biological response patterns.
A Discourse Analysis of Nursing Diagnosis
Authors: Powers Penny
Published: May 2004

The author presents a discourse analysis in three sections: a genealogy, a structural discourse analysis, and a power analytic. She concludes that the discourse of nursing diagnosis sustains conditions of social domination, limits autonomy and responsibility, and oppresses individuals and groups. The discourse of nursing diagnosis restricts what counts as evidence and limits acceptable input of voices, thus excluding, for example, the voices of the patient and his or her family. The discourse of nursing diagnosis appeals to the dominance of empirical analytic science and equates this dominance with professional social status. The author discusses potential discourses of resistance that provide speaking positions from which to articulate specific practices that resist oppressive effects of nursing diagnosis.
Navigating the Storm of Mental Illness: Phases in the Family’s Journey
Authors: Muhlbauer Susan A.
Published: May 2004

About 1.25 million American families live with persistently mentally ill members. Costs, personal and public, are substantial. Research providing holistic understanding of the processes these families experience is needed. This qualitative study’s objectives were to (a) examine the process holistically and (b) search for patterns in families’ experiences. The author used a framework of symbolic interaction and dramaturgical interviewing. Twenty-six respondents participated in a semistructured interview. Results indicated that families typically experienced six phases: development of awareness, crisis, instability and recurrent crises, movement toward stability, continuum of stability, and growth and advocacy. Needs characteristic of each phase were evident. Additional research is needed to determine if phases are consistent in other groups and to develop interventions appropriate for each phase.
Involvement and Detachment in Researching Sexuality: Reflections on the Process of Semistructured Interviewing
Authors: Perry Catherine , Thurston Miranda , Green Ken
Published: May 2004

In this article, the authors reflect on the utility of the concept of involvement-detachment for researchers involved in a study of the lifeworlds of gay, lesbian, and bisexual young people where one of the researchers was lesbian. They focus in particular on the process of semistructured interviewing in qualitative research and the analysis of material generated by the interviews, noting that complete detachment from the subject of study is neither achievable nor desirable. They discuss the benefit of teamwork in supporting researchers and enhancing the integrity of the research, particularly when the subject is sensitive, the importance of researchers’ active management of their own ideological leanings, and the understanding of project management as a conceptual and cognitive process that is fundamental to enhancing research rigor.
Surgical Body Modification and Altruistic Individualism: A Case for Cyborg Ethics and Methods
Authors: Frank Arthur W.
Published: May 2004

Three cases of pediatric surgical body modification—limb lengthening, normalization of genitalia, and craniofacial surgery—are considered through the moral language used by those who experience these surgeries. This language has been described as altruistic individualism. Decision making remains individualist, but it also shows considerable concern for others; egoism is complementary with altruism. The altruistic individualist is one of many incompatible identities that are predicted and described by the figure of the cyborg. Cyborgs suggest both ethics and qualitative methods appropriate to surgically shaped children.
Intersections of Gender and Age in Health Care: Adapting Autonomy and Confidentiality for the Adolescent Girl
Authors: Pinto Kristina C.
Published: May 2004

Autonomy and confidentiality are central topics in adolescent health care, both pertaining to findings that nonparent adults often benefit adolescent girls’psychological resilience. Traditionally, autonomy captures a patient’s right to self-determine a course of treatment, whereas confidentiality is understood as privacy between doctor and patient. The author proposes a revision of these constructs to accommodate the psychology of adolescent girls in health care contexts through a case study of a 17-year-old girl’s hospitalization. In particular, the importance of voice and trust in girls’psychology calls for understanding autonomy as self in relationship and confidentiality as mutual confidence. Suggestions for practice are guided by the premise that girls’ health care can foster psychological risk or resilience, depending on the doctor-patient relationship.
Patient Power and Control: A Study of Women with Uncertain Illness Trajectories
Authors: Åsbring Pia , Närvänen Anna-Liisa
Published: May 2004

The authors interviewed 12 women diagnosed with chronic fatigue syndrome and 13 with fibromyalgia with the aim of determining the strategies they perceive themselves as using to gain control over their situation during the health care process. The results highlight various strategies that the women report applying to find a way of managing the illness and to influence caregivers. They describe, for example, how they try to gain control over their situation by acquiring knowledge about the illness. The women also describe various power strategies they use in their interaction with the caregivers to take command of their situation, namely exiting, noncompliance, confrontation, persuasion/insistence, making demands, and demonstrative distancing.
Communication Between People With Schizophrenia and Their Medical Professionals: A Participatory Research Project
Authors: Schneider Barbara , Scissons Hannah , Arney Laurie , Benson George , Derry Jeff , Lucas Ken , Misurelli Michele , Nickerson Dana , Sunderland Mark
Published: May 2004

The authors describe a participatory research project undertaken by a group of people with schizophrenia under the guidance of a university researcher. Participatory research involves members of the research group in meaningful participation in all stages of the research process. In this study, group members chose the topic—experiences with medical professionals—and method of data collection—in-depth interviews that they conducted with each other. They developed and performed a readers’ theater presentation of the results and their recommendations for how they would like to be treated by medical professionals. The results indicate that good communication with medical professionals is essential to people with schizophrenia; it helps them accept the fact that they are ill and learn to live with the illness. The research offered a transformative experience to group members and is contributing to change in the practice of health care for people with severe mental illnesses.
Managing the Care Needs of Low-Income Board-and-Care Home Residents: A Process of Negotiating Risks
Authors: Perkins Molly M. , Ball Mary M. , Whittington Frank J. , Combs Bess L.
Published: May 2004

Small, low-income board-and-care homes play a critical role in the long-term care system, serving a variety of at-risk groups, including chronically mentally ill individuals, frail elders, and developmentally disabled adults. Unfortunately, the supply of homes available to serve these populations is decreasing. The purpose of this study, based on an in-depth ethnographic case study of one small (13-bed) African American-owned and -operated home in metropolitan Atlanta, was to understand how and why some homes continue to operate despite significant challenges. Grounded theory analysis showed that the survival of this home and residents’ ability to remain in it involved a basic social process conceptualized as Negotiating Risks. This survival process often put participants at risk of losing their means of subsistence. Community support emerged as an important protective factor. Findings have implications for community interventions to increase these homes’ survival and improve resident care.
Involving Homeless Persons in the Leadership of a Health Care Organization
Authors: Buck David S. , Rochon Donna , Davidson Harriett , McCurdy Sheryl
Published: May 2004

Consumer advisory boards (CABs) are a way of involving patients in their health care. To engage the homeless in the administration of a health care organization for the homeless, a service agency formed such a board comprising homeless and formerly homeless individuals. The purpose was to integrate experiences of homelessness into programmatic design and research efforts of the organization, and to promote participatory research among the homeless. A content analysis and member checking revealed four distinct themes relating to committee goals, identity definition, power, and issues and needs of the homeless. Findings indicate that participatory research provided a useful structure in which the CAB could improve self-sufficiency and self-efficacy, and contribute to the direction of the health care agency.
Clinical, Technical, and Social Contingencies and the Decisions of Adults with HIV/AIDS to Enroll in Clinical Trials
Authors: Mueller Mary-Rose
Published: May 2004

In this article, the author draws on interview data collected during an ethnographic field study of the informed consent process and HIV/AIDS clinical trial work. She held interviews to explore how individuals decide to enroll in a clinical trial and uses the concept of contingency to illustrate how individuals interpret and act on the uncertainties of clinical research. Findings show that people with HIV/AIDS consider three kinds of contingencies— clinical, social, and technical—before enrolling in a clinical trial. The author offers suggestions for how the concept of contingency might be used in future studies on informed consent and for how the concept might be used in discussions between research professionals and patients on human subject research.
Interviewing the Moderator: An Ancillary Method to Focus Groups
Authors: Traulsen Janine Morgall , Almarsdóttir Anna Birna , Björnsdóttir Ingunn
Published: May 2004

There has been an upsurge of academic interest in using focus groups (FGs) as a main or stand-alone qualitative method. In this article, the authors introduce a recently developed ancillary method to FGs called interviewing the moderator. The method is employed immediately after an FG and consists of a one-on-one interview with the FG moderator by another member of the research team. The authors argue, with reference to a specific study, that interviewing the moderator adds a new and valuable dimension to group interviews used in research. They describe how this method came about and provide a concrete example of its use in a recently completed research project. They discuss several advantages of the interview, among them that it provides information about group interaction and participant behavior, and furnishes additional data on what is discussed when the tape recorder is turned off.
Using Reflexivity to Optimize Teamwork in Qualitative Research
Authors: Barry Christine A. , Britten Nicky , Barber Nick , Bradley Colin , Stevenson Fiona
Published: May 2004

Reflexivity is often described as an individual activity. The authors propose that reflexivity employed as a team activity, through the sharing of reflexive writing (accounts of personal agendas, hidden assumptions, and theoretical definitions) and group discussions about arising issues, can improve the productivity and functioning of qualitative teams and the rigor and quality of the research. The authors review the literature on teamwork, highlighting benefits and pitfalls, and define and discuss the role for reflexivity. They describe their own team and detail how they work together on a project investigating doctor-patient communication about prescribing. The authors present two reflexive tools they have used and show through examples how they have influenced the effectiveness of their team in terms of process, quality, and outcome.
Community Formation and Community Roles among Persons with Alzheimer’s Disease: A Comparative Study of Experiences in a Residential Alzheimer’s Facility and a Traditional Nursing Home
Authors: McAllister Carol L. , Silverman Myrna A.
Published: May 2004

Based on an ethnographic study in a residential Alzheimer’s facility and a traditional nursing home, this article discusses the process of community formation and the maintenance of community roles among individuals suffering from dementia in institutional settings. These include: therapeutic programming that promotes resident independence and choice; flexible and person-centered staff roles; and a physical environment that facilitates social interaction, autonomy, and participation in the activities of daily living. In contrast, institutional programs that are regimented, that follow a medical rather than a social model of care, and that take place in physical environments that have limited options may discourage resident interaction and social bonding, thus inhibiting community formation. Although Alzheimer’s disease and other forms of dementia may create difficulties for the realization of community and community roles among institutionalized people, more significant are the environmental conditions in which such individuals live and the programs designed for their care.
The Physical Environment of Special Care Units: Needs of Residents with Dementia from the Perspective of Staff and Family Caregivers
Authors: Morgan Debra G. , Stewart Norma J.
Published: May 2004

To manage the care of increasing numbers of residents with dementia, many long-term care facilities have created special care units (SCUs) designed to meet the unique needs of this group. This article describes results of the qualitative component of a larger research project examining environment-behavior relationships in dementia care settings. Eighteen in-depth interviews were conducted with 9 staff and 9 family members of SCU residents. Thematic analysis was conducted using grounded theory techniques. Participants described residents’ needs in relation to both the physical and social environments. This article focuses on the five areas of need identified by participants in relation to the physical environment: safety, homelike setting, optimal stimulation, cues, and options for privacy and social interaction.
Phenomenography: A Qualitative Research Approach for Exploring Understanding in Health Care
Authors: Barnard Alan , McCosker Heather , Gerber Rod
Published: May 2004

Phenomenography is a little-known qualitative research approach that has potential for health care research, particularly when people’s understanding of their experience is the goal. Phenomenography is explained as a qualitative, nondualistic research approach that identifies and retains the discourse of research participants. This article seeks to present the major assumptions associated with phenomenographic research. An example of the way in which research outcomes are presented is included to emphasize its distinctiveness. It is noted that phenomenography has potential in the area of qualitative health research and will benefit from ongoing development and application.
A Protocol for Researcher Safety
Authors: Paterson Barbara L. , Gregory David , Thorne Sally
Published: May 2004

Although there is an abundance of literature about how to conduct qualitative research and some consideration of possible threats to researchers’ psychological well-being, there is little mention of the personal safety issues that researchers face while in the field. Few researchers have attempted to address the issue of researcher safety as a methodological concern. Consequently, there are minimal guidelines available to researchers to prevent and avoid dangerous incidents in the course of their research. The following is a discussion of the general guidelines for developing a protocol to address the issue of researcher safety in the field. These guidelines have been extrapolated from safety guidelines and policies written for students and clinicians who enter a client’s home in their role as health care practitioners, relevant literature in the area of safety for researchers in violent settings, resources such as safety guidelines for employees, and the personal experiences of several researchers.
Modeling a Dynamic Decision Process: Supporting the Decisions of Caregivers of Family Members with Dementia
Authors: Wackerbarth Sarah
Published: May 2004

One contributor to caregiving burden is the stress of making decisions. Family caregivers need support to consider and implement decisions. Support is likely to result in informed decisions and decreased guilt. The purpose of the study described in this article was to understand the decision processes of family caregivers of people with dementia using a multiple case study approach that would result in a model of their decision processes, with emphasis on support needs. The proposed model, based on control theory, charts the caregiving experiences over time and documents decisions made to maintain tolerable situations. This model is the first step toward developing interventions to provide the support needed to take on the role of decision maker, plan for the future, and make informed decisions.
Qualitative Methods: The State of the Art
Authors: Morse Janice M.
Published: May 2004

Qualitative methods offer the researcher different approaches to a research problem. They offer alternatives in analytic approaches; cater to different disciplinary perspectives, assumptions, and agendas; provide a means to explore various levels of analysis, from micro-analytic to complex behaviors; and permit the development of the necessary level of conceptualization of results. Depending on the researcher’s question(s), any one or combinations of qualitative approaches offer the researcher the means to obtain optimal research results. In this article, the example of the experience of traumatic injury is used to explore research possibilities and to convey an appreciation for methodological diversity.
Piths, Pearls, and Provocation
Authors: Peck Edward , Secker Jenny
Published: May 2004

Although qualitative research has considerable strengths both in assessing the effectiveness of organizational models of health care provision and in contributing to their development, its impact on local and national decision making in the United Kingdom appears to be negligible. This article examines three obstacles to the acceptance of qualitative research, illustrating some ways around them drawn from recent research at the Centre for Mental Health Services Development. However, our illustrations throw into relief the potential for tensions between the pragmatic world of health care management and the quality and integrity of qualitative research. The authors, therefore, examine these tensions with reference to recent work on the development of quality criteria and discuss some of the solutions they have attempted.
Mutual Intentionality: A Theory of Support Processes in Pregnant African American Women
Authors: Coffman Sherrilyn , Ray Marilyn A.
Published: May 2004

The grounded theory study described in this article explored social support processes in low-income African American women during high-risk pregnancy and early parenthood. Participants included 10 pregnant African American women, 3 close support providers, and 11 health care providers. Investigators served as participant observers and conducted audiotaped interviews. The substantive theory of support that emerged from the data was labeled “mutual intentionality.” This term described the active role that both pregnant woman and support givers played in the helping process. The phrase “being there” summarized the women’s definition of support, implying that the support giver was available and willing to provide help when needed. Support was further described as “caring,”“respecting,”“sharing information” with, “knowing,”“believing in,” and “doing for” the other. For support to happen, mutuality must be established within the relationship, and both support giver and recipient intentionally aim to meet the recipient’s identified needs.
Negotiating Activity Restriction: A Grounded Theory of Home Management of Preterm Labor
Authors: Durham Roberta F.
Published: May 2004

Preterm birth, preceded by preterm labor, is a significant perinatal problem. This article describes a qualitative, grounded theory study in which 25 women treated at home for preterm labor were interviewed. The purpose was to investigate how women managed this treatment, specifically bed rest, within the context of their day-to-day life. Three management phases were identified: Phase 1, the diagnostic phase, encompassed the circumstances around the diagnosis and subsequent realization that one was at risk to deliver preterm; in Phase 2, the negotiation phase, the women confronted their multisituated reality and negotiated their needs and wants that conflicted with it; and in Phase 3, the preparation phase, the women shift their focus from prevention of preterm delivery to preparation for parenthood. The proposed theory that women manage their activity restriction through negotiations in which they attempt to balance their perceived risk against a calculus of salient variables represents a new perspective in preterm birth prevention.
Complicating Mourning: The Social Economy of Perinatal Death
Authors: Malacrida Claudia
Published: May 2004

In this article, the social economic practices related to perinatal death, based on Rando’s model of complicated mourning and on an analysis of interactions with social institutions identified in the literature as relevant to perinatal death, are examined. Data are reported from semistructured interviews with 22 individuals who lost children to perinatal death. Parents’ stories indicate that they were not provided with material social supports that normally would be provided to individuals in the case of a “real” birth or death. Family and community gestures, workplace measures, and medical and legal supports were either discouraged or actively withheld. This lack of financial and material support creates an informal social economy of perinatal death that conveys clear messages to parents regarding their rights and claims to support. It is evident that these practices contribute to feelings of non-legitimacy and to complicated mourning.
Physicians’ Perspectives on Communicating Prescription Drug Information
Authors: McGrath John M.
Published: May 2004

Physician-patient communication has been identified as one factor that influences prescription drug compliance rates, even though the nature of such communication has not been well described. This study used a qualitative approach (in-depth interviews with 20 physicians representing a variety of medical areas) to better understand the process by which physicians communicate prescription drug information to their patients. A content analysis of interview transcripts indicated that two-way interactions focusing on the specific needs of the patients should be encouraged over simply disseminating more and more information about prescriptions. Information regarding unlikely outcomes was suggested to cause patient anxiety, which might be tied to decreased compliance rates. Physicians stressed the importance of “patient-directed communication” and expressed their concern over what they considered to be inappropriate sources of drug information. Other specific reasons cited for non-compliance included forgetfulness, ignoring medication when feeling better, and apprehensions about side effects.
Describing Expert Practice in Physical Therapy
Authors: Shepard Katherine F. , Hack Laurita M. , Gwyer Jan , Jensen Gail M.
Published: May 2004

In this article, the authors demonstrate how grounded theory may be used to develop models for understanding clinical practice. Through a series of research studies involving novice, experienced, and expert physical therapy practitioners, conceptual frameworks were continually revised based on data obtained from returning to the field and relevant literature available at the time. As concepts and relationships moved to larger themes, a theoretical framework for expertise in clinical practice was proposed. Current work on verifying the theoretical framework continues. Grounded theory is an excellent research approach to bound and help guide a multistage research program involving multiple researchers working in multiple settings.
The Textualizing Functions of Writing for Organizational Change
Authors: Anderson Donald L.
Published: May 2004

This article examines the role of writing during an attempt at organizational change. Through the investigation of conversational and writing practices used by members of a project team at a high-tech corporation, the article argues that writing has a textualizing function. In the context of members’work toward organizational change, writing served as a textualizing practice that documented, fixed, and stabilized ideas developed in conversation. Written forms that create general truths out of individual experiences help both to define the organizational change to come and to create the change as an object to be distributed and consumed by organizational members. The results of the study describe how writing helps to stabilize organizational reality to enable change to occur.