MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Qualitative Health Research' source. Thu, 09 Feb 2012 07:36:04 +0100 http://www.medworm.com/index.php?rid=5662930&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F22%2F3%2F429%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5662930 Fri, 03 Feb 2012 05:00:00 +0100 5662930 http://www.medworm.com/index.php?rid=5662929&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F22%2F3%2F428%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5662929 Fri, 03 Feb 2012 05:00:00 +0100 5662929 http://www.medworm.com/index.php?rid=5662928&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F3%2F416%3Frss%3D1 Using a metasynthesis approach, our aim was to articulate new insights relating to the most efficient and effective means of helping homeless women with substance abuse problems to enhance their well-being and become more stably housed. Distorted perceptions of competency, which are shaped by dysfunctional relationships and mental health problems, make it challenging for women with substance abuse problems to resolve homelessness. Women with particularly low or high levels of perceived competency tend to grapple with challenges related to structure and control, trust, and hopelessness. Therapeutic strategies for approaching these women include careful assessment, caring, personalized structure and control, development of interpersonal trust, instillation of hope, and the targeted use of ps... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5662928 Fri, 03 Feb 2012 05:00:00 +0100 5662928 http://www.medworm.com/index.php?rid=5662927&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F3%2F409%3Frss%3D1 In this article I explore the relationship between symbolic interactionist theory and interpretive description methodology. The two are highly compatible, making symbolic interactionism an excellent theoretical framework for interpretive description studies. The pragmatism underlying interpretive description supports locating the methodology within this cross-disciplinary theory to make it more attractive to nonnursing researchers and expand its potential to address practice problems across the applied disciplines. The theory and method are so compatible that symbolic interactionism appears to be part of interpretive description’s epistemological foundations. Interpretive description’s theoretical roots have, to date, been identified only very generally in interpretivism and th... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5662927 Fri, 03 Feb 2012 05:00:00 +0100 5662927 http://www.medworm.com/index.php?rid=5662926&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F3%2F397%3Frss%3D1 Cancer is a disease that affects the entire family, with each member having unique psychological needs. To date, there has been limited research into the effect of parental cancer on adult children. Furthermore, existing research has largely overlooked the possibility of positive psychological growth in the adult offspring of cancer patients. To investigate the perceived benefits arising from parental cancer, 11 interviews were undertaken with adults whose parents had been diagnosed with cancer, to discuss their experiences of their parent’s illness, and their evaluation of both the positive and negative changes that had arisen. All participants were able to identify positive outcomes in direct response to their parent’s cancer. Frequently suggested changes included improved re... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5662926 Fri, 03 Feb 2012 05:00:00 +0100 5662926 http://www.medworm.com/index.php?rid=5662925&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F3%2F384%3Frss%3D1 Grounded theory was employed to elucidate how public health nurses (PHNs) develop therapeutic relationships with vulnerable and potentially stigmatized clients, specifically, single mothers living in low-income situations. We named the emerging theoretical model Targeting Essence: Pragmatic Variation of the Therapeutic Relationship, after discovering that although PHNs strove to achieve relational goals, their attention was primarily focused on the goal of ascertaining concerns foremost on the hearts and minds of mothers, and that PHNs had to accomplish these goals within short practice timeframes. The study’s focused context elicited a nuanced explanation of the dynamic relationship-building process derived from subjective relationship experiences of PHNs and single mothers living i... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5662925 Fri, 03 Feb 2012 05:00:00 +0100 5662925 http://www.medworm.com/index.php?rid=5662924&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F3%2F373%3Frss%3D1 We applied grounded theory methodology to generate a working relationship model that influences motivation for stable housing among homeless people with serious mental illness, to understand the role of a working relationship in critical service transitions. We focused on practitioners’ perspectives and practices in Critical Time Intervention (CTI), a community intervention aimed to reduce homelessness through providing support during the transition from institutional to community living. We found a working relationship that highlighted "nonauthoritative" and "humanistic" features. Workers respected client autonomy and maintained flexibility in the format of client contact and service activities. They used practice strategies including following client leads and informal relating app... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5662924 Fri, 03 Feb 2012 05:00:00 +0100 5662924 http://www.medworm.com/index.php?rid=5662923&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F3%2F360%3Frss%3D1 In this article, we explore how adults with arthritis use self-care strategies in their valued leisure activities, and variations in use based on their access to environmental resources. We conducted six focus groups (N = 34) with adults aged 55 and older with a diagnosis of arthritis. Adults living in residential communities were recruited, with 31% of the sample residing in subsidized housing. Focus group transcripts were analyzed using content analysis based on themes of selective optimization with compensation. We found some differences in strategy use between the resource-rich and resource-poor participants. Adults highlighted the value of their leisure activities and the importance of leisure in maintaining their health and well-being. Our findings point to the need to incorporate le... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5662923 Fri, 03 Feb 2012 05:00:00 +0100 5662923 http://www.medworm.com/index.php?rid=5662922&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F3%2F346%3Frss%3D1 Little is known about the experiences of parents caring for a child through long-term treatment for cleft lip and/or cleft palate. We conducted in-depth interviews with 35 parents with children between the ages of 20 weeks and 21 years to explore experiences across the treatment program. We analyzed the data using a constructivist grounded theory approach and present in detail in this article one subcategory from the analysis: managing emotions. Throughout childhood and adolescence, parents experienced conflicting emotions about their child’s impairment, uncertainty about cleft treatment, and stigmatizing attitudes. Although parents attempted to manage emotional tensions by pursuing cleft treatments, the interventions could themselves be a source of conflict for them. We suggest that... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5662922 Fri, 03 Feb 2012 05:00:00 +0100 5662922 http://www.medworm.com/index.php?rid=5662921&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F3%2F332%3Frss%3D1 Self-management is crucial for people living with chronic diseases, but the actual process of integrating self-management has not been explored in depth. In this article, we investigate the integration of self-management into the lives of people with chronic illness. In this longitudinal study, we used an interpretive description approach. Twenty-one individuals were interviewed regularly during the first 3 years after they were diagnosed with a chronic condition. We found self-management integration to be an ongoing process that included four phases: seeking effective self-management strategies, considering costs and benefits, creating routines and plans of action, and negotiating self-management that fits one’s life. The participants managed the phases according to their context, e... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5662921 Fri, 03 Feb 2012 05:00:00 +0100 5662921 http://www.medworm.com/index.php?rid=5662920&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F3%2F320%3Frss%3D1 Distant healing procedures consist of benevolent intentions, often taking the form of prayers for a patient. Despite inconclusive evidence regarding distant healing, prayers are a widespread health-related technique. We studied subjective concepts of distant healing in 17 patients suffering from chronic fatigue syndrome and multiple chemical sensitivity who were given distant healing during a randomized controlled trial. We applied reconstructive interview analysis when analyzing the results. The overall theme was the tension between mainstream medicine and the immaterial healing procedure. Several components highlighted this tension: (a) patterns of legitimizing the use of distant healing, (b) distant healing and the social setting, (c) integrating distant healing into their belief system... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5662920 Fri, 03 Feb 2012 05:00:00 +0100 5662920 http://www.medworm.com/index.php?rid=5662919&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F3%2F304%3Frss%3D1 Providing peer support to individuals with psychiatric disabilities has emerged as a promising modality of mental health services. These services are delivered by individuals who experience mental illnesses themselves. The purpose of this study was to explore how working as a peer provider can enhance personal recovery. The study was conducted with 31 peer providers employed in a variety of mental health agencies. Data were collected through face-to-face semistructured interviews and analyzed using a grounded theory approach. Qualitative analysis revealed a wide range of recovery benefits for the peer providers. The benefits span across five wellness domains: foundational, emotional, spiritual, social, and occupational. In addition, analysis revealed five role-related and five work-environ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5662919 Fri, 03 Feb 2012 05:00:00 +0100 5662919 http://www.medworm.com/index.php?rid=5662918&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F3%2F291%3Frss%3D1 Restorative justice alternatives to criminal justice are designed to balance the needs of victims, offenders, families, friends, and the community at large to achieve social justice, repair of victims, and deterrence of crime. In the model we evaluated from RESTORE (Responsibility and Equity for Sexual Transgressions Offering a Restorative Experience), each offender and victim received individual services and met in guided conferencing to mutually determine reparative actions for the offender. At the exit meeting, the offender, as the responsible person, read a written apology to the survivor/victim. In this article, we analyze the expression of empathy in the apology, in which the initial mitigation of responsibility in early documents was replaced by acknowledgment of harm to the survivo... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5662918 Fri, 03 Feb 2012 05:00:00 +0100 5662918 http://www.medworm.com/index.php?rid=5602264&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F22%2F2%2F285%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5602264 Mon, 09 Jan 2012 05:00:00 +0100 5602264 http://www.medworm.com/index.php?rid=5602263&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F2%2F274%3Frss%3D1 Stories about illness have proven invaluable in helping health professionals understand illness experiences. Such narratives have traditionally been solicited by researchers through interviews and the collection of personal writings, including diaries. These approaches are, however, researcher driven; the impetus for the creation of the story comes from the researcher and not the narrator. In recent years there has been exponential growth in illness narratives created by individuals, of their own volition, and made available for others to read in print or as Internet accounts. We sought to determine whether it was possible to identify such material for use as research data to explore the subject of living with the terminal illness amyotrophic lateral sclerosis/motor neuron disease—th... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5602263 Mon, 09 Jan 2012 05:00:00 +0100 5602263 http://www.medworm.com/index.php?rid=5602262&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F2%2F263%3Frss%3D1 People in the United States often consult registered nurses (nurses) for advice when they want to explore alternatives to Western medicine, such as traditional Chinese medicine (TCM). Nurses find themselves confronting dilemmas when they are caught between these radically different worlds of medical cultures and thinking. Twenty Minnesota nurses were interviewed to learn how they integrate TCM into their triage process. Symbolic interactionism was the research framework used, and mixed coding methods facilitated data analysis. Several sociological theories explain the findings. The major finding is that nurses use a four-step triage process that begins from the Western medical perspective and includes consideration of TCM use. Nurses’ recommendations are influenced by their situation... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5602262 Mon, 09 Jan 2012 05:00:00 +0100 5602262 http://www.medworm.com/index.php?rid=5602261&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F2%2F250%3Frss%3D1 Based on a study exploring the phenomenon of coping among Hong Kong Chinese women afflicted with breast cancer, from diagnosis to completion of treatment, we report the findings on meaning making by the informants. Using the grounded theory method, we conducted 35 interviews with 24 women suffering from breast cancer. Among them, we followed and interviewed 5 women thrice, from diagnosis to 3 months after completion of treatment. We noted the evolution of reframing as the key category in the adjustment process through which the women identified meaning at different points of time in the cancer experience, to achieve different outcomes. Chinese women identified a sustaining force from minimizing social disturbance during treatment. The integration of cancer into their lives after completion... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5602261 Mon, 09 Jan 2012 05:00:00 +0100 5602261 http://www.medworm.com/index.php?rid=5602260&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F2%2F238%3Frss%3D1 Models of patient–physician decision making are typically framed on a continuum of discourses and practices ranging from patient autonomy to physician paternalism, with the middle ground being occupied by terms such as shared decision making. Critiques of these models center on the gulf between these idealized models and actual practice and on how context influences decision-making practices. In this article I focus on how 11 Canadian family physicians talked about patient–physician decision making in interviews about their diagnostic and treatment practices for depression. I adopt a discursive approach to analyzing extracts from these interviews, and show how these physicians constructed themselves as engaging in acts of professional judgment and persuasion, and patients as ha... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5602260 Mon, 09 Jan 2012 05:00:00 +0100 5602260 http://www.medworm.com/index.php?rid=5602259&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F2%2F226%3Frss%3D1 Euthanasia/assisted dying, the desire to hasten death, and religious supportive care at the end of life are controversial issues that have been heavily debated within the academic and medical communities. Little research has been done on hospice patients’ views, despite hospices being political spaces, espousing a range of perspectives on assisted dying, religiosity, and "good deaths." In this article I document the presence, articulation, and significance of these issues as perceived and experienced by 20 hospice inpatients in the last 4 weeks of their lives. Key themes to emerge included polarization in desire for hastened death and assisted dying in the hospice; the hospice as a morally bound space situated within particular notions of "dying well"; and the divisive character of r... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5602259 Mon, 09 Jan 2012 05:00:00 +0100 5602259 http://www.medworm.com/index.php?rid=5602258&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F2%2F212%3Frss%3D1 Despite the important instrumental and emotional role that parents play in the lives of children with cystic fibrosis (CF) and congenital heart disease (CHD), qualitative researchers have not examined the similarities and differences between caregivers’ experiences. Informed by thematic analysis, in this qualitative study I explored what it is like to care for a child with a chronic illness from the perspective of CF and CHD parents at a children’s hospital in Canada. Pediatric caregiver stress was qualitatively different between CF and CHD parents, whereas temporal dilemmas were unique sources of stress for CF parents only. To alleviate stress, all parents drew on a three-way, interrelated process to comprehend their child’s illness and acquire perspective. By opening up... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5602258 Mon, 09 Jan 2012 05:00:00 +0100 5602258 http://www.medworm.com/index.php?rid=5602257&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F2%2F199%3Frss%3D1 Some hospital practices that are routine for hospital staff may carry unintended significance for patients and their families. The transfer of neonatal infants between hospitals and hospital environments is one such practice that may be covered by perfectly acceptable rules and regulations but that, at times, gives rise to unsuspected anxieties, pain, and worries in the parent. In this phenomenological study, I explored meaning aspects of the phenomenon transfer to reveal a lived experience of carrying—a carrying across from here to there; a carrying between changing places; a carrying contact of parent–child in-touchness that is enabled or compromised in this experience; a carrying with care; and a carrying as a search for place as home. The concluding recommendations speak to... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5602257 Mon, 09 Jan 2012 05:00:00 +0100 5602257 http://www.medworm.com/index.php?rid=5602256&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F2%2F189%3Frss%3D1 Breast cancer among Filipinas in the United States is a major but largely neglected cancer disparity. In 2004, a community– university partnership resulted in the first Filipina breast cancer support group in the San Francisco Bay Area. Building on this partnership, we explored the social and cultural contexts of Filipinas’ experiences with breast cancer to inform development of culturally appropriate and sustainable support services and outreach. We utilized multiple qualitative methods (participant observation, individual and small group in-depth qualitative interviews) to identify meanings of survivorship and support. Interviews and observations revealed the influences of social context and immigration experiences on women’s understandings of cancer, what "surviving" c... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5602256 Mon, 09 Jan 2012 05:00:00 +0100 5602256 http://www.medworm.com/index.php?rid=5602255&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F2%2F174%3Frss%3D1 Although a considerable body of research has described the implications of parental mental illness, the perspectives of children and adolescents have rarely been addressed. In this article, I explore adolescents’ experiences in everyday life, based on an action-oriented study of a Norwegian online self-help group for adolescents (aged 15 to 18) with mentally ill parents. The analysis was conducted through participant observation of the group for 2 years. The adolescents experienced a variety of difficult challenges related to their parent’s mental illness: lack of information and openness; unpredictability and instability; fear; loneliness; and loss and sorrow. However, they also discussed strategies for active management of the challenges arising from the family situation. I a... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5602255 Mon, 09 Jan 2012 05:00:00 +0100 5602255 http://www.medworm.com/index.php?rid=5602254&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F2%2F157%3Frss%3D1 This article contributes to the body of knowledge about symptom recognition and management in the ICU by providing a comprehensive model to guide future research and practice. (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5602254 Mon, 09 Jan 2012 05:00:00 +0100 5602254 http://www.medworm.com/index.php?rid=5602253&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F2%2F147%3Frss%3D1 In this plenary address, I introduce the Global Congress for Qualitative Health Research, its purpose, and its role internationally. Within this context, I explore the origins and development of qualitative health research, the content of qualitative health research, its components, and its contribution to health research. I argue that qualitative inquiry develops in levels, building from exploration and description of phenomena to the identification of concepts, the theoretical basis for quantitative inquiry, qualitative theory development, and to utilization, implementation, and evaluation. This incremental development is not purposefully planned, but occurs as a result of voluminous inquiry into similar topics using different qualitative approaches and designs. A single study rarely mak... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5602253 Mon, 09 Jan 2012 05:00:00 +0100 5602253 http://www.medworm.com/index.php?rid=5490853&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F1%2F134%3Frss%3D1 Empathy is a very familiar term in the helping and caring literature. What appears to link empathy in the helping literature to the aims and goals of qualitative research and, in particular, to the argument underpinning insider/outsider debates, is a discernible common quest. That quest is to be able to hear, feel, understand, and value the stories of others and to convey that felt empathy and understanding back to the client/storyteller/participant. When relevant, the quest also includes conveying that felt understanding to a broader audience. In this article, I highlight commonalities between empathy in professional practice and empathy in qualitative research processes, including the shared experiences and understanding informing research relationships that are discussed as "insider/out... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5490853 Fri, 09 Dec 2011 05:00:00 +0100 5490853 http://www.medworm.com/index.php?rid=5490852&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F1%2F119%3Frss%3D1 In this article, we discuss processes of recovery in bipolar disorder. We utilized a hermeneutical-phenomenological approach developed within a reflexive-collaborative framework to examine what individuals do to promote improvement and positive change in their own lives. The study was designed and carried out in collaboration with an expert-by-experience group of 12 coresearchers with firsthand experiences of mental distress and recovery. In-depth interviews were conducted with 13 participants who acknowledged having lived and dealt with a bipolar disorder. Four core themes were drawn from our analysis: (a) handling ambivalence about letting go of manic states; (b) finding something to hang on to when the world is spinning around; (c) becoming aware of signals from self and others; and (d)... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5490852 Fri, 09 Dec 2011 05:00:00 +0100 5490852 http://www.medworm.com/index.php?rid=5490851&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F1%2F103%3Frss%3D1 Although health professionals advocate empowerment in patient care, they often fail to realize it in practice. Through grounded theories we previously explained why barriers to empowerment were seldom overcome in diabetes care. Zoffmann used these theories as a basis for developing a decision-making and problem-solving method called guided self-determination (GSD). To realize empowerment, health professionals need detailed knowledge of the barriers, their own roles in these barriers, ways to overcome them, and recognizable evidence of having succeeded. Through theory-driven, qualitative evaluation, the previously developed grounded theories helped us recognize changes consistent with empowerment in dyads of nurses and patients with poorly controlled type 1 diabetes. By completing GSD refle... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5490851 Fri, 09 Dec 2011 05:00:00 +0100 5490851 http://www.medworm.com/index.php?rid=5490850&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F1%2F89%3Frss%3D1 The Dominican Republic has high rates of HIV infection and alcohol consumption. Unfortunately, little research has been focused on the broader sources of the synergy between these two health outcomes. We draw on syndemic theory to argue that alcohol consumption and sexual risk behavior are best analyzed within the context of culture and economy in Caribbean tourism spaces, which produce a synergy between apparently independent outcomes. We sampled 32 men and women working in the tourism industry at alcohol-serving establishments in Sosúa, Dominican Republic. Interviewees described alcohol consumption as an implicit requirement of tourism work, tourism industry business practices that foster alcohol consumption, and an intertwining relationship between alcohol and sexual commerce. Th... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5490850 Fri, 09 Dec 2011 05:00:00 +0100 5490850 http://www.medworm.com/index.php?rid=5490849&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F1%2F76%3Frss%3D1 Patients with chronic obstructive pulmonary disease are often referred to pulmonary rehabilitation programs to manage their symptoms and the consequences of the disease on their lives. Finding ways to target programs to a specific patient’s needs could help improve individual response to the program. The purpose of this study was to develop a conceptual model for the assessment of patients’ rehabilitation needs by using a grounded theory approach. Focus groups, consultations of medical charts, and a literature review helped us develop a conceptual model characterized by the following categories: need recognition, knowledge, motivation, expectations, goals, ability to fulfill needs, and the ability for personal adjustment. Based on a content matrix reflecting the conceptual mode... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5490849 Fri, 09 Dec 2011 05:00:00 +0100 5490849 http://www.medworm.com/index.php?rid=5490848&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F1%2F67%3Frss%3D1 The use of the telephone for providing health care is growing. A significant amount of social meaning is derived from visual information, and the absence of visual stimuli provides unique barriers to communication and increases the risks for misunderstandings and distractions. Understanding challenges to telephone communication can provide insight into training opportunities for overcoming these difficulties and improving patient care. The purpose of this research was to explore through focus groups the challenges of phone communication perceived by specialists in poison information. General types of challenges to effective phone communication included developing new communication skills to compensate for lack of visual information, difficulty assessing caller understanding, difficulty man... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5490848 Fri, 09 Dec 2011 05:00:00 +0100 5490848 http://www.medworm.com/index.php?rid=5490847&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F1%2F54%3Frss%3D1 Despite the high prevalence of hepatitis C virus (HCV) infection among injection drug users also infected with human immunodeficiency virus (HIV), and the synergistic adverse effect of the two diseases on patients’ health and survival, research on the clinical management of these patients and particularly the low uptake of HCV therapy is limited. We conducted qualitative interviews with 17 HIV providers from two urban public hospitals. We discovered that the limitations of the current state of medical knowledge, the severe side effects of HIV and HCV therapies, and the psychosocial vulnerability of HIV/HCV-coinfected patients combined with their resistance to becoming informed about HCV posed significant challenges for providers. To contend with these challenges, providers incorporat... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5490847 Fri, 09 Dec 2011 05:00:00 +0100 5490847 http://www.medworm.com/index.php?rid=5490846&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F1%2F43%3Frss%3D1 In this study, we conducted in-depth, semistructured interviews with 11 health care professionals working in a psychiatric ward in one Israeli psychiatric hospital. Through content analysis, we revealed two main themes: patients’ and providers’ controllability over patients’ aggression. From the intersection of these two themes, four prototypes of the aggressive encounter emerged: the power struggle, the therapeutic encounter, inverse power relations, and victim-to-victim encounters, each distinctively characterized by different emotional, cognitive, and behavioral responses. We discuss our findings in light of attribution theory, which carries important theoretical and practical implications for handling aggression. (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5490846 Fri, 09 Dec 2011 05:00:00 +0100 5490846 http://www.medworm.com/index.php?rid=5490845&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F1%2F31%3Frss%3D1 Hepatitis C virus (HCV) infection is a significant global public health problem. In developed countries, 90% of new infections occur among people who inject drugs (PWID), with seroprevalence increasing rapidly among new injectors. Staying Safe is an international, qualitative, social research project, the aim of which is to draw on the experiences of long-term PWID to inform a new generation of HCV prevention strategies. The Sydney project team employed life history interviews and computer-generated timelines to elicit detailed data about unexposed participants’ (n =13) injecting practices, circumstances, and social networks over time. The motivations and strategies that enabled participants to avoid risk situations, and which might have helped them to "stay safe," appeared not to be... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5490845 Fri, 09 Dec 2011 05:00:00 +0100 5490845 http://www.medworm.com/index.php?rid=5490844&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F1%2F17%3Frss%3D1 In this article we analyze qualitative data from a multiple-method, longitudinal study drawn from 15-year follow-up interviews with a subsample of 82 individuals arrested for driving while intoxicated in a southwestern state (1989–1995). We explore reactions to the arrest and court-mandated sanctions, including legal punishments, mandated interventions, and/or participation in programs aimed at reducing recidivism. Key findings include experiencing certain negative emotional reactions to the arrest, reactions to being jailed, experiencing other court-related sanctions as deterring driving-while-intoxicated behavior, and generally negative opinions regarding court-mandated interventions. We discuss interviewees’ complex perspectives on treatment and program participation and the... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5490844 Fri, 09 Dec 2011 05:00:00 +0100 5490844 http://www.medworm.com/index.php?rid=5490843&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F22%2F1%2F3%3Frss%3D1 In this article, we describe the depth of knowledge and skill nurses used in making decisions regarding the safe processes and practices of medication administration. Using grounded theory, we identified the essence of medication safety by nurses as the theme of clinical reasoning. Nurses used two medication safety processes within the clinical reasoning theme—maintaining medication safety and managing the environment—together with six categories of patient-focused medication safety practices in the first process and four categories of environmental-focused safety practices within the second process. These processes and practices present an emerging model of safe medication administration developed from the narratives of 50 medical-surgical nurses. This model provides researche... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5490843 Fri, 09 Dec 2011 05:00:00 +0100 5490843 http://www.medworm.com/index.php?rid=5463256&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F21%2F12%2F1739%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5463256 Tue, 29 Nov 2011 05:00:00 +0100 5463256 http://www.medworm.com/index.php?rid=5463255&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F12%2F1729%3Frss%3D1 The effects of cancer and its treatment on quality of life contribute to patient and clinician decisions. Health-related quality of life (HRQL) is a subjective concept, leading to variation in its definition. This presents challenges when measuring HRQL and evaluating interventions. The designers of the Patient Generated Index (PGI) addressed these challenges by having individuals identify areas of their lives affected by illness and treatment, then report on these self-defined areas. We used cognitive interviews to collect information about patient understanding of the PGI, the response processes used to complete the PGI, and how well the PGI reflected participant HRQL. Interview data support the content validity of the PGI in comprehensively defining and adequately sampling participant H... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5463255 Tue, 29 Nov 2011 05:00:00 +0100 5463255 http://www.medworm.com/index.php?rid=5463254&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F12%2F1719%3Frss%3D1 Evidence-based approaches to health care have been difficult to achieve in Indigenous populations across the world, a situation which has contributed to the significant health disparities found in this group. One reason for the inadequacy of evidence-based health interventions is that empirical knowledge tends to be organized around professional disciplines that are grounded in Western ways of knowing. In this article we describe events that have led to more appropriate research methods in Australia, and the resulting changes in the research community. The principles that have guided Australian research policy development might not yet be fully matured, but the improvements we have experienced over the last several decades have gone a long way toward acknowledging the significant dispariti... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5463254 Tue, 29 Nov 2011 05:00:00 +0100 5463254 http://www.medworm.com/index.php?rid=5463253&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F12%2F1705%3Frss%3D1 In conclusion, we advocate for multimodal recruitment strategies that facilitate ongoing investigator–clinician partnerships. (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5463253 Tue, 29 Nov 2011 05:00:00 +0100 5463253 http://www.medworm.com/index.php?rid=5463252&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F12%2F1692%3Frss%3D1 Osteoporosis (low bone density) is a potentially serious disease which mainly affects women older than 50 years. National screening programs for osteoporosis are being developed in the United Kingdom. It is important to assess the psychological experience of receiving a positive diagnosis from a population-based screening program so that psychological distress does not outweigh medical benefits. Little research has been conducted in this field. In our study, we explored the experience of being diagnosed with osteoporosis following screening. We interviewed 10 women aged 68 to 79 who were recruited from a population-based osteoporosis screening trial. Four themes emerged from our interpretative phenomenological analysis of the interviews: osteoporosis is a routine medical condition, lack of... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5463252 Tue, 29 Nov 2011 05:00:00 +0100 5463252 http://www.medworm.com/index.php?rid=5463251&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F12%2F1679%3Frss%3D1 Obese adults face pervasive and repeated weight-based stigma. Few researchers have explored how obese individuals proactively respond to stigma outside of a dominant weight-loss framework. Using a grounded theory approach, we explored the experiences of 44 bloggers within the Fatosphere—an online fat-acceptance community. We investigated participants’ pathways into the Fatosphere, how they responded to and interacted with stigma, and how they described the impact of fat acceptance on their health and well-being. The concepts and support associated with the fat-acceptance movement helped participants shift from reactive strategies in responding to stigma (conforming to dominant discourses through weight loss) to proactive responses to resist stigma (reframing "fat" and self-acce... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5463251 Tue, 29 Nov 2011 05:00:00 +0100 5463251 http://www.medworm.com/index.php?rid=5463250&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F12%2F1667%3Frss%3D1 To understand the normalization process in families with hemophiliac children, and to explore the impact of two different therapeutic regimes on it (on-demand therapy and prophylaxis), we conducted a two-phase study using semistructured interviews. In the course of the first phase, we interviewed 13 parents belonging to 10 families with hemophiliac children in on-demand therapy. In the second phase, 5 years later, we repeated the interviews with three families who began prophylaxis at different times. We analyzed the interviews using text analysis software. The results show very different representations of hemophilia and daily life. Normalization processes involve the overcoming of a divided conception of life, and encourage the integration of care practices within daily life. Moreover, i... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5463250 Tue, 29 Nov 2011 05:00:00 +0100 5463250 http://www.medworm.com/index.php?rid=5463249&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F12%2F1658%3Frss%3D1 The Internet has become a major health information source for many patients, and they might discuss the information they get from the Internet with their doctors. I explored how the Internet as an information source influences cancer patients’ communication with their doctors in Taiwan, where the doctor–patient relationship is traditionally doctor dominated. Forty-six cancer patients or families participated in seven focus group discussions. I conducted inductive analysis to examine themes emerging from discussions. Participants searched for information on the Internet to probe and verify their doctors’ competence. Participants took responsibility for understanding the doctors’ jargon, and the Internet helped them to do that. The Internet also helped participants sp... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5463249 Tue, 29 Nov 2011 05:00:00 +0100 5463249 http://www.medworm.com/index.php?rid=5463248&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F12%2F1643%3Frss%3D1 In this article we discuss the results of an ethnographic study of professionals’ and patients’ experiences within a specialist constipation clinic in England. Chronic constipation tends to be poorly understood and inadequately treated. Eleven patients were followed through their illness trajectory during a 5-month fieldwork period, involving 21 home interviews, clinic-based interviews, participant observation, and a focus group. Professionals were likewise observed and interviewed. The clinic could be broadly described as biopsychosocial in its approach. However, professionals expressed uncertainty about how best to provide biopsychosocial care and suggested that some patients were not "open" to psychosocial therapies or to discussing psychosocial aspects of their disease. Pat... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5463248 Tue, 29 Nov 2011 05:00:00 +0100 5463248 http://www.medworm.com/index.php?rid=5463247&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F12%2F1632%3Frss%3D1 Our aim in this narrative inquiry was to understand the roles of paid carers supporting adults with developmental disability and complex communication needs in hospital, from the perspectives of 15 paid carers, 15 adults with developmental disability, and 15 hospital nurses. Results demonstrated that paid carers have an important role in supporting the adult with disability, providing information, delivering basic care, and facilitating communication. Stories reflected paid carer volunteerism; lack of orientation of carers and hospital staff to the paid carers’ roles; blurred role boundaries between paid carers, family carers, and nurses; and paid carers being uncertain about their own responsibilities for staff and patient safety. New policies and practice guidelines are needed to g... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5463247 Tue, 29 Nov 2011 05:00:00 +0100 5463247 http://www.medworm.com/index.php?rid=5463246&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F12%2F1618%3Frss%3D1 The achievement of a death consistent with personal preferences is an elusive outcome for most people with cancer. Maintaining a sense of control is a core component of a dignified death; however, control might be a Western bioethical notion with questionable relevance to culturally diverse groups. Thus, the purpose of our study was to explore the meaning of control and control preferences in a group of racially and ethnically diverse patients with an advanced cancer diagnosis. Using a hermeneutic, phenomenological approach, we interviewed 20 patients with advanced cancer and uncovered two themes: (a) preferences for everyday control over treatment decisions, family issues, final days of life, and arrangements after death, vs. (b) awareness that cancer and death are controlled by a higher ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5463246 Tue, 29 Nov 2011 05:00:00 +0100 5463246 http://www.medworm.com/index.php?rid=5463245&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F12%2F1607%3Frss%3D1 Adults in the United States increasingly use the Internet for health information, and online discussions can provide insights into public perceptions of health issues. The purpose of this project was to investigate public perceptions of issues related to health literacy, within the context of a conversation about recommendations to the U.S. Food and Drug Administration, driven by concerns about acetaminophen-related liver injuries due in part to health literacy issues. The discussion took place July 2-8, 2009, on a technology/science blog and included 625 comments. Participants debated the risks and benefits of acetaminophen, and most believed responsibility for taking medication safely falls on consumers. Some were implicitly aware of issues related to health literacy and its relationship... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5463245 Tue, 29 Nov 2011 05:00:00 +0100 5463245 http://www.medworm.com/index.php?rid=5266332&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F11%2F1588%3Frss%3D1 Qualitative research provides important insights into the experiences and perspectives of older people on end-of-life issues, but such research is methodologically and ethically complex. We offer a set of reflections from six end-of-life care studies conducted with older people in four European countries: Belgium, Germany, the Netherlands, and the United Kingdom. The reflection process was informed by four full-day meetings between the authors and referral to sources including the study interview guides, summary "pen portraits" about key issues encountered in the interviews, and key sections of the interview transcripts. We identified as major challenges accessing people, the introduction of end-of-life issues in an interview, managing emotions, the presence of companions, and reciprocity.... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5266332 Mon, 26 Sep 2011 04:00:00 +0100 5266332 http://www.medworm.com/index.php?rid=5266331&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F11%2F1576%3Frss%3D1 We present the Heideggerian concepts of Dasein, authenticity and truth, and draw on extracts from our interview transcripts to exemplify the different effects of joint and one-to-one interviews. We also discuss ethical considerations regarding these different interview approaches. Heidegger’s philosophy does not preferentially support either method, but helps us to be clearer about the merits and limitations of each approach. Combining both approaches provides richer understanding of phenomena. (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5266331 Mon, 26 Sep 2011 04:00:00 +0100 5266331 http://www.medworm.com/index.php?rid=5266330&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F11%2F1567%3Frss%3D1 In this article we explore how young adults became members and sustained membership in an online self-harm support forum, SharpTalk. We take a discursive approach to consider resources young people used to establish themselves, how others responded to their attempts, and how membership categories were developed and applied. Participants displayed expectations about appropriate ways of discussing self-harm, and about responses and advice. New posters made reference to other self-harm sites, provided biomedicalized narratives of their "story," and asked for help in particular ways. Participants were active in shaping interactions on the forum, requesting input from site moderators, and challenging each other both on perceived infringements of posting content, and on style of posting pertinen... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5266330 Mon, 26 Sep 2011 04:00:00 +0100 5266330 http://www.medworm.com/index.php?rid=5266329&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F11%2F1554%3Frss%3D1 Positive social support has been associated with medication adherence and slowed disease progression among people living with HIV. The nature of support within the medical context itself has not been adequately investigated, however. The purpose of our study was to describe HIV health care providers’ perspectives on informal supporter-oriented health care and whether and how the involvement of patients’ adult informal supporters in health care and health care decision making is helpful or beneficial. We conducted in-depth qualitative interviews with 11 HIV specialists between March and September, 2005. Using directed qualitative content analysis, we first describe the frequency and course of others’ involvement and the type of support provided. We then situate these findi... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5266329 Mon, 26 Sep 2011 04:00:00 +0100 5266329 http://www.medworm.com/index.php?rid=5266328&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F11%2F1539%3Frss%3D1 We present themes of difficult experiences of second-generation Holocaust survivors, arguing that some of these aversive experiences might have disorganizing qualities even though they do not qualify as traumatic. Based on in-depth interviews with 196 second-generation parents and their adolescent children, three themes of disorganizing experiences carried across generations were identified: focus on survival issues, lack of emotional resources, and coercion to please the parents and satisfy their needs. These themes reflect the frustration of three basic needs: competence, relatedness, and autonomy, and this frustration becomes disorganizing when it involves stability, potency, incomprehensibility, and helplessness. The findings shed light on the effect of trauma over the generations and,... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5266328 Mon, 26 Sep 2011 04:00:00 +0100 5266328 http://www.medworm.com/index.php?rid=5266327&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F11%2F1527%3Frss%3D1 We examined the perceptions of clinical personnel on the physical design of new treatment units and the impact on service delivery and the work environment. The new physical design appeared to support client recovery and reduce stigma; however, it brought certain challenges. Participants reported a compromised ability to monitor clients, a lack of designated therapeutic spaces, and insufficient workspace for staff. They also thought that physical design positively facilitated communication and therapeutic relationships among clinicians and clients, and increased team cohesion. We suggest that, from these findings, new avenues for research on achieving the important balance between client and staff needs in health facility design can be explored. (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5266327 Mon, 26 Sep 2011 04:00:00 +0100 5266327 http://www.medworm.com/index.php?rid=5266326&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F11%2F1508%3Frss%3D1 The impact of HIV/AIDS on the lives of youth with this chronic illness suggests the need for additional support as youth develop. Summer camp can serve as a therapeutic intervention for youth with HIV/AIDS. Using a case study employing observations, focus groups, and interviews, we examined outcomes associated with participation in a camp for youth with HIV/AIDS, and program processes that influenced outcomes. Findings showed that camp played a major developmental role for youth. Three outcomes of camp emerged: (a) forming caring connections (awareness of commonalities, lack of isolation); (b) feeling reprieve and recreation (fun activities, anticipation of and reflection on camp, sense of freedom); and (c) increasing knowledge, attitudes, and skills (conflict management, disclosure, skill... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5266326 Mon, 26 Sep 2011 04:00:00 +0100 5266326 http://www.medworm.com/index.php?rid=5266325&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F11%2F1495%3Frss%3D1 Many people with depression recognize their symptoms as depression, but fail to seek treatment for a number of years. We aimed to explore the reasons for this. Thirty primary care patients who screened positive for depression participated in semistructured, face-to-face interviews. Transcripts were analyzed using grounded thematic analysis. Patients who sought depression treatment emphasized their understanding of depression, their belief that treatment would work, and the negative consequences that would ensue if they did not seek treatment. Patients who did not seek treatment emphasized that treatment would not be effective, thought that depression would not last very long, and believed that depression did not affect their everyday lives. Patients’ illness perceptions of depression... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5266325 Mon, 26 Sep 2011 04:00:00 +0100 5266325 http://www.medworm.com/index.php?rid=5266324&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F11%2F1484%3Frss%3D1 Suicide is a significant health problem, yet many questions regarding suicide remain unanswered. One of the most frequently asked questions is related to motive: "Why did that person complete suicide?" We explored motivations for completing suicide, especially with regard to cultural differences, by analyzing suicide notes written by Native Americans, Hispanics, and Anglos in New Mexico. Five categories emerged describing motivation: feelings of (a) alienation, (b) failure or inadequacy, (c) being psychologically overwhelmed; (d) the desire to leave problems behind, and (e) reunification in an afterlife. The largest difference to emerge between ethnic groups was in the alienation category, which included more Hispanics and Native Americans than Anglos. The overall lack of differences in mo... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5266324 Mon, 26 Sep 2011 04:00:00 +0100 5266324 http://www.medworm.com/index.php?rid=5266323&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F11%2F1469%3Frss%3D1 The symbolic framework guiding primary care physicians’ (PCPs) practice is crucial in shaping the quality of care for those with degenerative dementia. Examining the relationship between the cure and care models in primary care offers a unique opportunity for exploring change toward a more holistic approach to health care. The aims of this study were to (a) explore how PCPs approach the care of patients with Alzheimer’s disease (AD), and (b) describe how this care unfolds from the physicians’ perspectives. This was a cross-sectional study of 40 PCPs who completed semistructured interviews as part of a dementia caregiving study. Findings show that PCPs recognize the limits of the cure paradigm and articulate a caring, more holistic model that addresses the psychosocial nee... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5266323 Mon, 26 Sep 2011 04:00:00 +0100 5266323 http://www.medworm.com/index.php?rid=5266322&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F11%2F1455%3Frss%3D1 This study was a secondary analysis of qualitative data from a larger study. The findings revealed three levels at which disability was viewed and/or used positively by people with SCI: self, peers, and disability community. In addition, several aspects of the participants’ situations were found to facilitate this positive view and/or use of disability: personality, spirituality, support systems, and acceptance of one’s disability. The findings reveal that individuals with SCI are viewing and/or using their disabilities positively in many different ways. This study has significant implications for the direction of future research and for health care professionals who need to increase their advocacy and facilitating roles. (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5266322 Mon, 26 Sep 2011 04:00:00 +0100 5266322 http://www.medworm.com/index.php?rid=5201507&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F10%2F1441%3Frss%3D1 The medication administration stage of the medication-use process is especially vulnerable to error because errors are least likely to be caught before reaching the patient. Medication administration, however, remains poorly understood. In this article we describe medication administration as observed in an ethnographic study conducted on one medical unit and one surgical unit. A central finding was that medication administration entailed a complex mixture of varied and often competing demands that temporally structured the nurses’ entire workday. Articulation work was evident in time management strategies nurses used to handle demands from institutional policies, technical devices, patients, the physical environment, and the medications themselves. The average number of doses of med... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5201507 Wed, 07 Sep 2011 04:00:00 +0100 5201507 http://www.medworm.com/index.php?rid=5201506&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F10%2F1427%3Frss%3D1 The objective was to help product designers develop improved assistive devices that not only increase mobility for child prosthesis users but also support the sociocultural integration of these children and their families. A philosophical hermeneutics research approach was used to seek the views of three children. The findings are useful for nongovernmental organizations and product developers that focus on the needs of impoverished children in rural, predominantly Buddhist communities. (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5201506 Wed, 07 Sep 2011 04:00:00 +0100 5201506 http://www.medworm.com/index.php?rid=5201505&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F10%2F1413%3Frss%3D1 Little is understood about parents’ experiences following children’s moderate to severe traumatic brain injury (TBI). Using descriptive phenomenology, we explored common experiences of parents whose children were diagnosed with moderate to severe TBI. Parents from across the United States (N = 42, from 37 families) participated in two semistructured interviews (~ 90 minutes in length and 12 to 15 months apart) in the first 5 years following children’s TBI. First interviews were in person. Second interviews, done in person or by phone, facilitated updating parents’ experiences and garnering their critique of the descriptive model. Parent themes were (a) grateful to still have my child, (b) grieving for the child I knew, (c) running on nerves, and (d) grappling to get... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5201505 Wed, 07 Sep 2011 04:00:00 +0100 5201505 http://www.medworm.com/index.php?rid=5201504&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F10%2F1400%3Frss%3D1 In this article we examine the moral ambiguities expressed by New Zealand health professionals regarding their clients and patients who have occupational overuse syndrome (OOS). Workers with OOS were described as being hard working and dedicated, but also undisciplined in their work and personal lives. The goal of rehabilitation in such cases is a return to full work duties and to this end, health professionals represent the disciplinary and normalizing technologies of the neoliberal state which, in New Zealand, provides financial support and treatment for injured workers. According to the health professionals in this study, the disciplinary technologies exercised through rehabilitation require that clients and patients internalize key values associated with the rhetoric of healthism; prim... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5201504 Wed, 07 Sep 2011 04:00:00 +0100 5201504 http://www.medworm.com/index.php?rid=5201503&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F10%2F1388%3Frss%3D1 Poor social functioning is a prevalent complaint of unipolar depression, but subjective experiences of social interactions have not been systematically studied. A limited number of qualitative researchers have specifically addressed the social difficulties in depression. We conducted in-depth semistructured interviews with 11 depressed women. Thematic analysis was used to analyze the transcripts. Five themes emerged. The first two, diminished desire to socially interact and fear of social interactions, encompass perceptions that have not been previously reported. The third theme, the pressure to adhere to social norms, provided support for previous findings. The final two themes, the perceptions of others and isolation, elaborated on existing knowledge. We found that difficulties with soci... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5201503 Wed, 07 Sep 2011 04:00:00 +0100 5201503 http://www.medworm.com/index.php?rid=5201502&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F10%2F1371%3Frss%3D1 The purpose of this study was to develop a theoretical framework about caregivers’ experiences and the processes in which they engaged during their spouses’ transition from a geriatric rehabilitation unit to home. We used a constructivist grounded theory methodology approach. Forty-five interviews were conducted across three points in time with 18 older adult spousal caregivers. A theoretical framework was developed within which reconciling in response to fluctuating needs emerged as the basic social process. Reconciling included three subprocesses (i.e., navigating, safekeeping, and repositioning), and highlighted how caregivers responded to the fluctuating needs of their spouse, to their own needs, and to those of the marital dyad. Reconciling was situated within a context sh... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5201502 Wed, 07 Sep 2011 04:00:00 +0100 5201502 http://www.medworm.com/index.php?rid=5201501&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F10%2F1360%3Frss%3D1 In a longitudinal study we investigated how young people come to live with a chronic disease, and asked them to record an audio diary on a regular basis. We also interviewed each participant every 6 weeks. Our analysis focused within and across the diary sets of 6 young people diagnosed with inflammatory bowel disease. All were aged between 11 and 16 years, and their recordings provided an insight into the experience of living within and beyond disease, and of negotiating health in the context of adolescence. This data collection method, which became known as the unclosed diary, was well received by the young people, who made use of their diaries in different ways. Three key aspects of their diary use, immediacy and intimacy, conversation, and reflection, demonstrate the flexibility of the... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5201501 Wed, 07 Sep 2011 04:00:00 +0100 5201501 http://www.medworm.com/index.php?rid=5201500&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F10%2F1347%3Frss%3D1 In this article, I present the findings from an ethnographic study of 18 women college students living in the northeastern United States. I examine how ethnically diverse women dealt with the messages of the dominant White society’s obsession with thinness, and whether it affected their perceptions of an ideal body image. From the analysis of the interviews, I identified and extracted several themes related to ethnicity, aesthetic body ideals, body dissatisfaction, and disturbed eating. Grounded in the women’s narratives, I found that ethnically diverse women coming of age in American society experience anxieties and emotional stress as they related to others in their daily lives. Their stories shed light on how the body is a vehicle for social mobility and is used by women fro... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5201500 Wed, 07 Sep 2011 04:00:00 +0100 5201500 http://www.medworm.com/index.php?rid=5201499&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F10%2F1335%3Frss%3D1 Gaining an improved understanding of people diagnosed with schizophrenia has the potential to influence priorities for therapy. Psychosis is commonly understood through the perspective of the medical model. However, the experience of social context surrounding psychosis is not well understood. In this research project we used a phenomenological methodology with a longitudinal design to interview 7 participants across a 12-month period to understand the social experiences surrounding psychosis. Eleven themes were explicated and divided into two phases of the illness experience: (a) transition into emotional shutdown included the experiences of not being acknowledged, relational confusion, not being expressive, detachment, reliving the past, and having no sense of direction; and (b) recovery... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5201499 Wed, 07 Sep 2011 04:00:00 +0100 5201499 http://www.medworm.com/index.php?rid=5201498&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F10%2F1316%3Frss%3D1 Using grounded theory, a multidisciplinary study team compared the narratives of 30 women who had recently experienced a breast cancer scare. Even though 10 women received a benign diagnosis, all women reported a difficult time prediagnosis, characterized by an array of emotions and contemplation of the meaning of life. Diagnosis separated the two groups with emotional relief dominant for the benign group and intensification of emotions for the cancer group. For those diagnosed with cancer, three factors contributed to arriving at a point of acceptance about the diagnosis and treatment: (a) sustained coping mechanisms; (b) a belief system that shifted the meaning of the cancer experience; and (c) the ability to manage non-cancer-related stressful events. Implications include the need for t... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5201498 Wed, 07 Sep 2011 04:00:00 +0100 5201498 http://www.medworm.com/index.php?rid=5201497&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F10%2F1307%3Frss%3D1 In conclusion, I maintain that there is a certain hierarchy for both senses and knowledge and, in spite of the possible vagueness and fuzziness of the concept, unbeknown knowledge both enhances recovery and can be used for research purposes. (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5201497 Wed, 07 Sep 2011 04:00:00 +0100 5201497 http://www.medworm.com/index.php?rid=5101253&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F21%2F9%2F1302%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101253 Wed, 03 Aug 2011 23:00:00 +0100 5101253 http://www.medworm.com/index.php?rid=5101252&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F21%2F9%2F1300%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101252 Wed, 03 Aug 2011 23:00:00 +0100 5101252 http://www.medworm.com/index.php?rid=5101251&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F21%2F9%2F1298%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101251 Wed, 03 Aug 2011 23:00:00 +0100 5101251 http://www.medworm.com/index.php?rid=5101250&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F21%2F9%2F1297%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101250 Wed, 03 Aug 2011 23:00:00 +0100 5101250 http://www.medworm.com/index.php?rid=5101249&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F21%2F9%2F1295%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101249 Wed, 03 Aug 2011 23:00:00 +0100 5101249 http://www.medworm.com/index.php?rid=5101248&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F9%2F1283%3Frss%3D1 Being reflexive and providing these reflections for public scrutiny is often considered a key element of ethical, rigorous qualitative research. Prevalent conceptualizations of reflexivity, however, need interrogating and sharpening. We aim to contribute to this by examining reflexive practice, and in particular researchers’ reflexive accounts, through the lens of the narrative paradigm. Our aim is to demonstrate that acknowledging the role of narrative reconstruction in reflexivity creates more ethical research, and that it is therefore crucial for researchers to more explicitly recognize this. Both authors present an analysis of one particular exchange between interviewer and participant. This analysis highlights that despite our best efforts at "doing reflexivity," both immediatel... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101248 Wed, 03 Aug 2011 23:00:00 +0100 5101248 http://www.medworm.com/index.php?rid=5101247&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F9%2F1273%3Frss%3D1 With growing emphasis on the importance of scientific evidence through clinical trials, qualitative studies have been used to deepen our understanding of research from participants’ perspectives. For people with a chronic illness, research participation could represent an additional impost on lives already overwhelmed with medical and care issues, and little is known about participants’ motivations when the research requires them to think differently about their illness and participate over an extended period. We interviewed participants with chronic obstructive pulmonary disease participating in a trial of a chronic disease self-management (CDSM) program. Our finding that people participate in research for altruistic reasons has similarities with other studies. We then extend ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101247 Wed, 03 Aug 2011 23:00:00 +0100 5101247 http://www.medworm.com/index.php?rid=5101246&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F9%2F1260%3Frss%3D1 Researchers studying health care decision making generally focus on the interaction that unfolds between patients and health professionals. Using the example of allogeneic bone marrow transplant, in this article we identify decision making to be a relational process concurrently underpinned by patients’ engagement with health professionals, their families, and broader social networks. We argue that the person undergoing a transplant simultaneously reconciles numerous social roles throughout treatment decision making, each of which encompasses a system of mutuality, reciprocity, and obligation. As individuals enter through the doorway of the consultation room and become "patients," they do not leave their roles as parents, spouses, and citizens outside in the hallway. Rather, these ro... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101246 Wed, 03 Aug 2011 23:00:00 +0100 5101246 http://www.medworm.com/index.php?rid=5101245&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F9%2F1249%3Frss%3D1 The purpose of this grounded theory study was to investigate how Danish HIV-positive persons live with their disease, focusing on HIV-related stressors. Using the Glaserian method, we analyzed textual data from in-depth interviews with 16 HIV-positive persons. Decisions about disclosure appeared to be a major concern and a determining factor for HIV-related stress. Consequently, we developed a substantive theory about disclosure decisions in which three different strategies could be identified: (a) disclosing to everyone (being open); (b) restricting disclosure (being partly open); and (c) disclosing to no one (being closed). Disclosure was a continuum; none of the three strategies automatically relieved HIV-related stress. The theory describes the main determinants and consequences of eac... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101245 Wed, 03 Aug 2011 23:00:00 +0100 5101245 http://www.medworm.com/index.php?rid=5101244&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F9%2F1239%3Frss%3D1 Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that gives rise to symptoms of breathlessness, chronic fatigue, and cough. The impact of COPD on people’s activity has been widely acknowledged, yet it appears that we know little about how individuals experience activity. We employed a grounded theory study with 18 participants with COPD to explore their dimensions of activity. We identified two core concepts that captured participants’ experience of activity; these were stagnation and movement. We found fresh air to be the single most important aspect affecting participants’ experience of stagnation and movement; this was linked to a changed perception of symptoms. We identified the environment as an important context influencing the experienc... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101244 Wed, 03 Aug 2011 23:00:00 +0100 5101244 http://www.medworm.com/index.php?rid=5101243&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F9%2F1229%3Frss%3D1 We compared reports of symptom bother for the same urinary symptoms to understand why symptom severity and bother do not correspond in a straightforward manner. We used a grounded theory approach to analyze qualitative data from 123 individual interviews and developed a conceptual framework, identifying three symptom perceptions that might moderate symptom bother: causal, relative, and uncertainty. Symptom bother was lower for respondents who viewed symptoms causally (symptoms seemed explainable or "normal") or relatively (urinary symptoms were compared to other symptoms or conditions). Bother tended to be higher for respondents who viewed symptoms with uncertainty (when symptom etiology and course were unknown). A greater portion of respondents in the causal perception group had not sough... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101243 Wed, 03 Aug 2011 23:00:00 +0100 5101243 http://www.medworm.com/index.php?rid=5101242&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F9%2F1220%3Frss%3D1 The objectives of these focus groups were to determine how and to what extent hypoglycemia affected people, and what, if any, methods were used to prevent or treat the condition, to better target education in the future. Four focus groups were held using a tiered discussion script with a moderator and comoderator. Discussions were audiotaped, transcribed, and analyzed by content by independent researchers. Five themes emerged from the discussions: friends, family, and neighbors need hypoglycemia education as well as individuals themselves; leaving home is a concern if you experience hypoglycemia; overeating occurs when treating hypoglycemia; routine is important; and hypoglycemia is a limitation. We found that hypoglycemia had a significant impact on the participants’ quality of life... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101242 Wed, 03 Aug 2011 23:00:00 +0100 5101242 http://www.medworm.com/index.php?rid=5101241&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F9%2F1205%3Frss%3D1 The realization that many persons with HIV/AIDS are subjected to multiple layers of stigmatization because they belong to socially deviant and disenfranchised groups (e.g., injection drug users, racial/ethnic and sexual minorities) accounts for an increasing interest in the phenomenon of stigma layering. The stigma associated with hepatitis C virus (HCV) has also been conceptualized as layered. However, researchers have overlooked the fact that HCV adds a layer to the HIV stigma and vice versa. Qualitative interviews with 132 HIV/HCV-coinfected patients were analyzed to explore how they experience the two layers of stigma. Most participants hierarchically ordered the stigmas associated with each disease and regarded HIV as the more stigmatizing of the two. A small number perceived HIV and ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101241 Wed, 03 Aug 2011 23:00:00 +0100 5101241 http://www.medworm.com/index.php?rid=5101240&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F9%2F1191%3Frss%3D1 In this article, we explore an area little researched within the literature on body dissatisfaction: the content and functions of body talk. We interviewed 60 diverse, college-educated women aged 18 to 30 in the urban United States about how social contacts talked about their bodies. Half the women, and by their reports, half their contacts (N = 295) endorsed some ideal body, most often the thin model. The other half favored a "healthy," "average" range in body size, shape, and/or appearance. Excepting family members, contacts gave mostly positive comments about women’s bodies or appearance, or made no comments. Many critiqued their own bodies, however, as did nearly half the women participants. We suggest that these women exempted others, but not themselves, from critical body surve... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101240 Wed, 03 Aug 2011 23:00:00 +0100 5101240 http://www.medworm.com/index.php?rid=5101239&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F9%2F1182%3Frss%3D1 We examine the conditions for trust relationships between patients and physicians. A trust relationship is not normally negotiated explicitly, but we wanted to discuss it with both patients and physicians. We therefore relied on a combination of interviews and observations. Sixteen patients and 8 family physicians in Norway participated in the study. We found that trust relationships were negotiated implicitly. Physicians were authorized by patients to exercise their judgment as medical doctors to varying degrees. We called this phenomenon the patient’s mandate of trust to the physician. A mandate of trust limited to specific complaints was adequate for many medical procedures, but more open mandates of trust seemed necessary to ensure effective and humane treatment for patients with... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101239 Wed, 03 Aug 2011 23:00:00 +0100 5101239 http://www.medworm.com/index.php?rid=5101238&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F9%2F1165%3Frss%3D1 The results of this exploratory study reflect a shift from public health studies that aim to examine the risk and prevalence of burn injury, toward eliciting survivors’ subjective meaning-making processes beyond the injury event. We drew on a narrative framework to explore how young survivors’ experiences of burn injury led to reconstructions of self and shifts in thinking about others and the world. Although participants’ narratives revealed elements of heightened self-awareness, need for acceptance, and desire for recognition, these stood alongside counter narratives denoting positive, transformative, and resilient aspects of healing that reflected a rebirth of the self, life having purpose, and psychospiritual growth. A multidimensional and relational framework for res... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101238 Wed, 03 Aug 2011 23:00:00 +0100 5101238 http://www.medworm.com/index.php?rid=5101237&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F21%2F9%2F1163%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5101237 Wed, 03 Aug 2011 23:00:00 +0100 5101237 http://www.medworm.com/index.php?rid=5045987&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F8%2F1147%3Frss%3D1 In this article, I explore what happens when general practitioners (GPs) and specialists meet using videoconferencing to collaborate on a patient’s treatment. By using videoconferencing, GPs and specialists are offered opportunities to share and produce knowledge. The data corpus was 42 videotaped videoconferences. The treatment of one specific patient was selected.This patient was discussed over a period of 9 days, which constituted five videoconferences. I describe how GPs and specialists discuss treatment strategies and exemplify how knowledge sharing creates opportunities for learning in boundary zones across activity systems as a part of daily practice.The talk about the treatment occurs by information exchange and by consultation. Information exchange without any dilemmas prese... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5045987 Sun, 17 Jul 2011 23:00:00 +0100 5045987 http://www.medworm.com/index.php?rid=5045986&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F8%2F1136%3Frss%3D1 In this article I examine some issues involved in researching vulnerable populations and sensitive issues, and the challenges and risks of researching issues of a deeply personal nature. Participants might have complex needs and vulnerabilities, but they also have many resources to ensure their own well-being. I ask researchers to move beyond the minimum standards espoused by human ethics committees, and utilize participant strengths to further reduce the risk of harm. My reflections on a study of older people who were experiencing family estrangement highlight some of the actions that participants used to increase their personal safety. I discuss the usefulness of "strengths" questions in assessing risk and facilitating participant strengths to minimize harm. Finally, I propose a three-wa... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5045986 Sun, 17 Jul 2011 23:00:00 +0100 5045986 http://www.medworm.com/index.php?rid=5045985&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F8%2F1127%3Frss%3D1 Encouraging youth voice, visibility, and active participation in adolescent-related research is strongly advocated in the literature. In this article, we describe how participatory approaches informed by arts-based methods (e.g., reflective writing, dramatization) were used with adolescents to enhance the research process in an exploratory study designed to develop and evaluate prevention resources for sexual risk-taking behaviors.Youth aged 15 to 17 years participated in iterative focus groups conducted over a 1-year period in school settings in Prince Edward Island, Canada. Descriptions of our experiences, strategies, and insights provide evidence for guiding practice to optimize adolescent participation in research. (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5045985 Sun, 17 Jul 2011 23:00:00 +0100 5045985 http://www.medworm.com/index.php?rid=5045984&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F8%2F1115%3Frss%3D1 In this study, we explored how living with diabetes in everyday life was experienced following a self-management intervention program based on motivational interviewing. We conducted seven focus group interviews, each comprising 3 to 5 participants diagnosed with type 1 or type 2 diabetes. Data analysis based on a phenomenological method revealed three main themes concerning diabetes self-management: becoming a self-regulating practitioner, managing the rules of self-management, and creating a supportive social network. Narrative analysis revealed a divergence in patients’ self-perceived competence in handling diabetes. The study findings indicate that people with diabetes have specific needs for support in the daily responsibility of managing diet, exercise, medication, and blood gl... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5045984 Sun, 17 Jul 2011 23:00:00 +0100 5045984 http://www.medworm.com/index.php?rid=5045983&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F8%2F1101%3Frss%3D1 Men are becoming increasingly aware of and keen about the promises of involved fathering, and there is growing recognition of the need to support fathers, especially in the postnatal period. However, there is limited evidence of how best to offer this support. In this article, we investigate a new avenue of support that is gaining popularity in the public health sector: the Internet. Using qualitative methods, we examine messages in an asynchronous online chat room for new fathers to reveal how fathers themselves requested, offered, and received social support. Features of their communication style included humor and self-disclosure. An emergent, overarching purpose of their communications was to make fathering more "visible," and to encourage each other to engage confidently and wholehear... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5045983 Sun, 17 Jul 2011 23:00:00 +0100 5045983 http://www.medworm.com/index.php?rid=5045982&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F8%2F1086%3Frss%3D1 Findings from 35 qualitative interviews with drug users who were engaging in or who had engaged in sex work in Dublin, Ireland, illuminated how, because of a result of felt stigma and internalized shame, they tried to hide their drug use, thus endangering their own lives. This group carried multiple layers of stigma because of sex work, drug use (including injecting drug use), and having contracted human immunodeficiency virus (HIV) or hepatitis C virus (HCV). This stigma was powerfully reinforced by the language routinely used by health professionals. To improve the effectiveness of harm-reduction interventions, it is recommended that service providers change their language, in particular in recognition of the human dignity of these clients, but also to help attract and retain drug users ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5045982 Sun, 17 Jul 2011 23:00:00 +0100 5045982 http://www.medworm.com/index.php?rid=5045981&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F8%2F1075%3Frss%3D1 We sought to gain an empirical and practical understanding of the barriers experienced by residents of the Mississippi River Delta in Arkansas to using the free, proactive telephone counseling (quitline) for tobacco dependence. Barriers included a lack of appropriate telephone service, lack of knowledge about the quitline, and lack of trust in the providers, as well as multiple root causes to seeking and achieving abstinence from tobacco, including stress related to the poor socioeconomic context and concerns about negative health effects of quitting. A strong belief in the role of faith was expressed. Participants suggested strategies for increasing knowledge and trust levels, but were not hopeful about addressing root causes. Given the considerable resources being allocated to quitlines ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5045981 Sun, 17 Jul 2011 23:00:00 +0100 5045981 http://www.medworm.com/index.php?rid=5045980&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F8%2F1065%3Frss%3D1 Research findings suggest that older adults prefer counseling for depression treatment; however, few older adults use counseling services. In this article we present the results of our analysis of semistructured interviews with 102 older adults to explore conceptualizations of counseling and impediments to use among African American and White older adults. We found that older adults believe counseling is beneficial; however, use was hindered in multiple ways. Older adults were skeptical about establishing a caring relationship with a professional. African American older adults did not mention social relationships to facilitate depression care, whereas White older adults described using personal relationships to navigate counseling services. African American older men were least familiar wi... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5045980 Sun, 17 Jul 2011 23:00:00 +0100 5045980 http://www.medworm.com/index.php?rid=5045979&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F8%2F1051%3Frss%3D1 The data for this article are from a primary health care project on HIV and depression, in which the prevalence, nature, clinical management, and self-management of depression among homosexually active men attending high-HIV-caseload general practice clinics were investigated. One of the qualitative arms consisted of in-depth interviews with general practitioners (GPs) with high caseloads of gay men. The approach to discourse analysis was informed by Halliday’s systemic functional linguistics. GPs constructed three discourses of depression: engaging with psychiatric discourse, engaging with the patient’s world, and engaging with social structures. When GPs drew on the discourse of psychiatry, this discourse was positioned as only one possible construction of depression. This di... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5045979 Sun, 17 Jul 2011 23:00:00 +0100 5045979 http://www.medworm.com/index.php?rid=5045978&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F8%2F1041%3Frss%3D1 HIV-related stigma continues to be a significant barrier to HIV testing, treatment, and care. Understanding the factors that underlie this stigma could help remove barriers to HIV/AIDS intervention. We identified these factors among nurses as well as community leaders in Lui, Southern Sudan. Participants included health workers at a local hospital, a women’s group, local market traders, religious leaders, and teachers. We categorized the responses generated from group interaction forums as concerns, fears, and perceptions. We found that stigma persisted not only toward people with conspicuous signs of full-blown AIDS, but also toward community programs, like voluntary counseling and testing centers. Future interventions, including delabeling the counseling and testing centers and dem... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5045978 Sun, 17 Jul 2011 23:00:00 +0100 5045978 http://www.medworm.com/index.php?rid=5045977&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F8%2F1033%3Frss%3D1 Adolescent cancer survivors face psychological effects that can include isolation, poor peer relations, anxiety, depression, and fear of recurrence, which can increase their risk for psychological late effects and poor health posttreatment. The purpose of this exploratory analysis was to understand the experiences of adolescent cancer survivors, with a particular focus on identity, health promotion, and meaning making. In-depth interviews were conducted with 12 adolescent cancer survivors. Constant comparative analysis was used to identify core themes from the data. Findings revealed that adolescent survivors might experience an identity paradox when making the transition to "survivor," which can contribute to their sense of isolation and risk of health-detracting behaviors. Health promoti... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5045977 Sun, 17 Jul 2011 23:00:00 +0100 5045977 http://www.medworm.com/index.php?rid=5045976&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F8%2F1022%3Frss%3D1 We apply the Communication Theory of Identity to investigate how patients display their ethnic identities during intercultural patient—provider interactions. Ethnic identity displays play a large part in reflecting patients’ and providers’ assumptions about the other, as well as their communicative needs. We collected paper-and-pencil responses from a convenience sample of providers and their patients, and conducted a constant comparative analysis of their open-ended reports of a recent intercultural medical interview. The results revealed how both parties viewed their roles in intercultural medical encounters and how they looked for accommodative behaviors from the other party. We draw implications for new applications and future developments of the Communication Theory ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5045976 Sun, 17 Jul 2011 23:00:00 +0100 5045976 http://www.medworm.com/index.php?rid=5045975&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F21%2F8%2F1019%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=5045975 Sun, 17 Jul 2011 23:00:00 +0100 5045975 http://www.medworm.com/index.php?rid=4958278&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F21%2F7%2F1013%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4958278 Mon, 20 Jun 2011 23:00:00 +0100 4958278 http://www.medworm.com/index.php?rid=4958277&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F21%2F7%2F1012%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4958277 Mon, 20 Jun 2011 23:00:00 +0100 4958277 http://www.medworm.com/index.php?rid=4958276&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F7%2F1000%3Frss%3D1 Proponents of community-based research advocate for the active involvement and engagement of community members, citing improved construct validity, intervention efficacy, and accountability. However, to create the conditions in which expertise is mutually constructed and in which no one is the object of research, a reconsideration of the fundamental ethos of community involvement and engagement is required. In this article, we seek to accomplish two goals: (a) to briefly assess the definitions of community health, focus groups, and dissemination that are often used in community-based research; and (b) to introduce an application of dialogical action that goes beyond traditional focus group methodology to promote the creation of an evolving and dynamic dialogue among campus and community st... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4958276 Mon, 20 Jun 2011 23:00:00 +0100 4958276 http://www.medworm.com/index.php?rid=4958275&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F7%2F987%3Frss%3D1 We describe this methodology and use the development of the Relationship Context Scale to illustrate it. As a result of independent confirmatory analyses of qualitative passages corresponding to survey items, we demonstrated that items from the same subscales are frequently double coded within a particular textual passage, and thematically related, suggesting associations that resulted in a unique factor structure within the subscale. This integrated mixed method design was critical to the development of this psychometrically validated behavioral measure, and could serve as a model for future measure development. (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4958275 Mon, 20 Jun 2011 23:00:00 +0100 4958275 http://www.medworm.com/index.php?rid=4958274&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F7%2F976%3Frss%3D1 There is a paucity of literature on how to conduct research with migrants, particularly those who do not speak the host country language, those who are newly arrived, and those who have a precarious immigration status. In qualitative research, interviewing is a common method for obtaining rich data and participants’ points of view. Gathering and presenting all perspectives when interviewing vulnerable migrant women on health-seeking behaviors is challenging. In this article, we explore the process of developing and implementing a data collection plan and an interview guide for a study carried out with migrant women to explore the inhibitors/facilitators for following through on professional referrals for postbirth care. Adaptability and careful attention to multiple factors throughou... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4958274 Mon, 20 Jun 2011 23:00:00 +0100 4958274 http://www.medworm.com/index.php?rid=4958273&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F7%2F968%3Frss%3D1 This article, from a keynote address, is the result of some of the things which I learned about qualitative research during my many years of doing and teaching it. The main point I make is that qualitative researchers should present a good story which is based on evidence but focused on meaning rather than measurement. In qualitative inquiry, the researchers’ selves are involved, their experiences become a resource. Researchers cannot distance themselves from the other participants, although they cannot fully present their meaning and experience. I also discuss voice, paradigm, and innovation as potentially problematic issues in qualitative research. These are terms often used but not always examined for their meaning in qualitative inquiry. If researchers are aware and sensitive, ra... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4958273 Mon, 20 Jun 2011 23:00:00 +0100 4958273 http://www.medworm.com/index.php?rid=4958272&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F7%2F952%3Frss%3D1 Health care delivery must be transformed to manage spiraling costs and preserve quality care. Transforming complex health systems will require the engagement of physicians as leaders in their health care settings, in both formal and informal roles. In this article we explore the experience of physician leader engagement and identify factors operating at the individual, team, and organizational levels related to increased or decreased physician leader engagement. Using an inductive approach, our analysis of the transcribed interviews yielded a rich understanding of what motivates physicians to be engaged as leaders, how they experience engagement, the role of the physician leader, how physicians understand other physicians’ engagement, what encourages and discourages their engagement ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4958272 Mon, 20 Jun 2011 23:00:00 +0100 4958272 http://www.medworm.com/index.php?rid=4958271&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F7%2F936%3Frss%3D1 In this study, we explored clinician interactional style characteristics contributing to patient response to perinatal depression referral and treatment. Stratified purposeful sampling resulted in 23 participants selected by pregnancy, socioeconomic, and depression status. Participants completed semistructured interviews exploring their experiences with and preferences for clinician interactional style characteristics in the context of obstetrics-setting referral and delivery of depression treatment. Thematic analysis revealed a central theme related to interactional cues that influence women’s reactions to clinical encounters, summarized by the question, "Can this person help me?" Women evaluated this question in four domains: feeling heard, developing trust in the clinician, percei... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4958271 Mon, 20 Jun 2011 23:00:00 +0100 4958271 http://www.medworm.com/index.php?rid=4958270&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F7%2F927%3Frss%3D1 Reorienting the focus of health systems to incorporate a multifaceted approach that allows for comprehensive and humane health care is pending. Using the participatory paradigm approach, we describe a study of a partnership-based family nursing practice for people with breathing difficulties. We generated data through nine conversations with eight patients accompanied by a close family member (n = 6) and one wife, 15 conversations between the authors, and through a reflective journal. Narrative data analysis was conducted. Results that reveal the meaning and experience of the family nursing practice are presented in four interlacing descriptive statements: (a) surfacing and contextualizing health problems, (b) responsiveness of services, (c) security—stability—self-direction, a... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4958270 Mon, 20 Jun 2011 23:00:00 +0100 4958270 http://www.medworm.com/index.php?rid=4958269&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F7%2F900%3Frss%3D1 Patient decision making is an area of increasing inquiry. For older individuals experiencing cancer, variations in health and functional status, physiologic aspects of aging, and tension between quality and quantity of life present unique challenges to treatment-related decision making. We used the pragmatic utility method to analyze the concept of patient decision making in the context of older individuals with cancer. We first evaluated its maturity in existing literature and then posed analytical questions to clarify aspects found to be only partially mature. In this context, we found patient decision making to be an ongoing process, changing with time, reflecting individual and relational components, as well as analytical and emotional ones. Assumptions frequently associated with patie... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4958269 Mon, 20 Jun 2011 23:00:00 +0100 4958269 http://www.medworm.com/index.php?rid=4958268&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F7%2F884%3Frss%3D1 Associations between HIV/AIDS and several forms of violence have been demonstrated in recent research. We conducted qualitative interviews with 30 providers who offered services related to HIV/AIDS or violence to identify specific manifestations of HIV/AIDS—violence intersections, factors that explain why HIV/AIDS and violence intersect in client/patient populations, and the theoretical salience of providers’ narratives. Providers confirmed links between HIV/AIDS and violent victimization, and yielded new insights into crossover risk between HIV/AIDS and suicidality, nonsuicidal self-harm, and witnessing and perpetrating violence. We also isolated 20 explanatory factors, including substance use, poor mental health, sex work/trading sex, and sexual orientation/gender identity. N... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4958268 Mon, 20 Jun 2011 23:00:00 +0100 4958268 http://www.medworm.com/index.php?rid=4958267&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F7%2F875%3Frss%3D1 Almost two decades ago, Janice Morse launched this conference, and QHR as a venue for qualitative health research scholarship. The health research climate was then resistant to qualitative research methods. Qualitative scholars portrayed the rigor of their work in traditional scientific language and justified qualitative approaches in opposition to quantitative approaches. Emphasis on difference expanded as we embraced paradigm debates and argued about location of particular research approaches. Increasingly, I have been challenged to reconsider the boundaries between and among research methods and paradigms as I struggled to answer my most pressing emerging questions. The focus of this presentation is consideration of how the position of qualitative research has shifted over the past 20 y... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4958267 Mon, 20 Jun 2011 23:00:00 +0100 4958267 http://www.medworm.com/index.php?rid=4786729&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F6%2F853%3Frss%3D1 Type 2 diabetes is a metabolic disorder characterized by chronically elevated blood glucose and high risk of comorbidities. In this article we report a metasynthesis of the 21st-Century qualitative research concerning the self-management of type 2 diabetes. We identified 38 relevant articles (sample size range 6 to 175), which were synthesized through a process of iterative reading and theory development. In this literature, authors argued and assumed that diabetes management is influenced by multiple, complex, competing factors, including interpersonal relations, gender, and sociocultural context. Conversely, self-management was sometimes construed as a facet of individual agency and was accepted uncritically, placing accountability for health with patients themselves. We conclude that a ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4786729 Tue, 03 May 2011 23:00:00 +0100 4786729 http://www.medworm.com/index.php?rid=4786728&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F6%2F839%3Frss%3D1 Informed consent to treatment (ICT), designed to honor patient autonomy, has been an important subject of inquiry in many disciplines. To foreground the dynamic and dilemmatic tendencies of ICT practice implied by previous inquiries, I advanced relational dialectics theory into the realm of physicians’ experiences with ICT. On performing a dialectical analysis of transcripts from focus group discussions with radiologists, I found them experiencing four primary tensions: (a) between simple and complex ICT; (b) between radiologist and patient control; (c) between standardized and idiosyncratic practice (involving struggles between documentation and conversational process, and between vague and detailed language use); and (d) between withholding and disclosing alternatives. Moreover, I ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4786728 Tue, 03 May 2011 23:00:00 +0100 4786728 http://www.medworm.com/index.php?rid=4786727&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F6%2F830%3Frss%3D1 Qualitative researchers who explore the individual’s experience of health, illness, death, and dying often experience emotional stress in their work. In this article, we describe the emotional stress we experienced while coding semistructured, after-death interviews conducted with 38 next of kin of deceased veterans. Coding sensitive topic data required an unexpected level of emotional labor, the impact of which has not been addressed in the literature. In writing this discussion article, we stepped back from our roles as interviewers/coders and reflected on how our work affected us individually and as a team, and how a sequence of exposures could exert a cumulative effect for researchers in such a dual role. Through this article, we hope to generate an expanded discourse on how qual... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4786727 Tue, 03 May 2011 23:00:00 +0100 4786727 http://www.medworm.com/index.php?rid=4786726&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F6%2F818%3Frss%3D1 In this article, we have explored 5-year-old children’s expressions when they as actors took part in an immunization situation in the Primary Child Health Care (PCHC) service in Sweden. Although children’s health and development are the main concern in the PCHC service, their perspectives in such a setting have not been explored fully. To capture children’s perspectives we used a hermeneutic design and video observations. The findings revealed children as competent and active participants, contributing to the construction of the PCHC situation in mutuality with the nurse and the parent. The conceptualization of children’s expressions and actions revealed how they influenced and dealt with a PCHC situation by using strategies of tuning-in, affirmative negotiation, an... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4786726 Tue, 03 May 2011 23:00:00 +0100 4786726 http://www.medworm.com/index.php?rid=4786725&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F6%2F807%3Frss%3D1 Following the collapse of socialism and subsequent German reunification, cardiac mortality rose unexpectedly in the former East Germany; although rates improved by mid-decade, a West/East health gradient persisted. Psychosocial stress from regime change, postsocialism, was one hypothesis proposed to explain the health transition. Absent from the scholarly conversation were individuals’ own assessments of their illness experiences in this time of social upheaval. I hypothesized that such data might illuminate processes linking illness and social change. I analyzed illness narratives of East and West Berliners with heart disease, attending to subjective notions of causation. Both groups cited nonmodifiable and modifiable risk factors; half of the East Berliners incorporated additional ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4786725 Tue, 03 May 2011 23:00:00 +0100 4786725 http://www.medworm.com/index.php?rid=4786724&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F6%2F796%3Frss%3D1 In this study, 18- to 39-year-olds diagnosed with cancer during young adulthood were interviewed to identify the types of behavioral and psychosocial programs needed. These young adult cancer survivors were also asked to identify potential barriers to program utilization. Participants expressed interest in programs targeting physical activity, relaxation, emotional support, provision of cancer-related and other information, and nutrition/weight loss. Emergent themes included the importance of choice, flexibility, convenience, and similarity to other program participants. Barriers to participation included practical barriers (e.g., limited time), lack of awareness of programs, health issues (e.g., fatigue), and psychosocial barriers (e.g., low motivation). Results highlight a range of unmet... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4786724 Tue, 03 May 2011 23:00:00 +0100 4786724 http://www.medworm.com/index.php?rid=4786723&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F6%2F783%3Frss%3D1 In this study, we explored psychosocial components influencing older women’s breast cancer risk appraisal. To identify key psychosocial components of breast cancer risk appraisal, we conducted focus group interviews. Data saturation occurred with four groups (N = 36) of older Black (58%) and White (42%) women with no prior history of breast cancer. On analysis of the data, we found three themes representing psychosocial factors influencing breast cancer risk appraisal with this cohort. Our findings revealed that worry/fear/anxiety, self-regulating empowerment, and realistic optimism were psychosocial mechanisms older Black and White women in this sample used in appraising breast cancer risk. (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4786723 Tue, 03 May 2011 23:00:00 +0100 4786723 http://www.medworm.com/index.php?rid=4786722&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F6%2F771%3Frss%3D1 Epidermolysis bullosa (EB) is a disease in which the skin blisters in response to minimal friction, causing painful wounds. Despite the potentially severe nature of epidermolysis bullosa, research on the psychosocial issues is scarce. The aims of the study were to explore the psychosocial impact of epidermolysis bullosa on affected adults and to identify associated support needs. We collected data using semistructured interviews and employed inductive thematic analysis to organize and analyze them. Three main themes—beliefs about containing the impact of EB, understandings of the disease, and the disabling impact of EB—describe the ways in which living with EB influences the daily lives of participants at intraindividual, interindividual, and sociocultural levels. The associate... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4786722 Tue, 03 May 2011 23:00:00 +0100 4786722 http://www.medworm.com/index.php?rid=4786721&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F6%2F757%3Frss%3D1 This study supports the importance of context in shaping evidence-based practices by health care professionals in the management of pain in the NICU. (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4786721 Tue, 03 May 2011 23:00:00 +0100 4786721 http://www.medworm.com/index.php?rid=4786720&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F6%2F743%3Frss%3D1 North America’s first supervised injection facility (SIF) was established in Vancouver, Canada, in 2003. Although evaluation research has documented reductions in risk behavior among SIF users, there has been limited examination of the influence of operational features on injection drug users’ access to these facilities. We conducted an ethnographic study that included observational research within the SIF, 50 in-depth individual interviews with SIF users, and analysis of the regulatory frameworks governing the SIF. The government-granted exemption allowing the facility to operate legally imposes key operating regulations, as well as a cap on capacity, which results in significant wait times to enter the injecting room. Regulations that prohibit practices that are common in the... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4786720 Tue, 03 May 2011 23:00:00 +0100 4786720 http://www.medworm.com/index.php?rid=4786719&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F6%2F731%3Frss%3D1 Drawing on examples from in-depth interviews with 49 women, in this article we aim to open up a discursive space for women and health professionals to begin to explore the phenomenon of the interembodied experience of breastfeeding. Although acknowledging that social dimensions partially constitute the lived body, we further the view that the lived body’s understanding is embedded in contexts far more complex than those that can be represented by language. We argue that women’s narratives of their breastfeeding experience contained instances of the body "understanding" its emotional task at a prelogical, preverbal level. We identified three central, iterative dimensions of the phenomenon— calling, permission, and fulfillment—that occurred prereflexively in the prote... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4786719 Tue, 03 May 2011 23:00:00 +0100 4786719 http://www.medworm.com/index.php?rid=4680353&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F21%2F5%2F726%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4680353 Mon, 04 Apr 2011 23:00:00 +0100 4680353 http://www.medworm.com/index.php?rid=4680352&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F5%2F714%3Frss%3D1 In this article we explore the concept of balance in the context of health. We became interested in balance during a grounded theory study of lay conceptualizations of cancer risk in which participants were concerned with having a good life, which relied heavily on balancing processes. This led us to the qualitative literature about balance in the context of health, which was large and in need of synthesis. We identified 170 relevant studies and used Thomas and Harden’s technique of thematic synthesis to identify key balance-related themes and develop these into more abstract analytic categories. We found that balance and balancing were salient to people in three health-related contexts: health maintenance, disease or disability management, and lay or professional caregiving. In each... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4680352 Mon, 04 Apr 2011 23:00:00 +0100 4680352 http://www.medworm.com/index.php?rid=4680351&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F5%2F704%3Frss%3D1 In this article we explore the challenges to researchers intending to involve vulnerable populations in health and social care research, and provide evidence-based recommendations to support the proactive inclusion of these populations in the research process. We provide a rationale for the study, followed by the introduction and descriptions of our research experiences (presented as two case studies) to provide a contextual backcloth for the discussion.We highlight the inherent challenges in empowering vulnerable populations in research, based on the combination of our own and other people’s experiences. Collectively, these illustrate and underpin practice issues, relate theory to practice in a meaningful way, and facilitate the recognition of the realities in future development in ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4680351 Mon, 04 Apr 2011 23:00:00 +0100 4680351 http://www.medworm.com/index.php?rid=4680350&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F5%2F696%3Frss%3D1 This article is about some of these close encounters, what we might learn from them, and how we might use this to "survive" as qualitative inquirers in an evidence-based world of health care and health care delivery. (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4680350 Mon, 04 Apr 2011 23:00:00 +0100 4680350 http://www.medworm.com/index.php?rid=4680349&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F5%2F683%3Frss%3D1 We used interpretive description to describe how everyday life close to death was experienced and dealt with in families with one member who had a life-threatening illness. We performed 28 individual, couple, and group interviews with five families. We found two patterns, namely, "being me in a family living close to death" and "being us in a family living close to death." "Being me" meant that every individual in the family had to deal with the impending death, regardless of whether or not he or she was the person with the life-threatening illness. This was linked to ways of promoting the individual’s self-image, or "me-ness." This pattern was present at the same time as the pattern of "being us," or in other words, being a family, and dealing with impending death and a new "we-ness... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4680349 Mon, 04 Apr 2011 23:00:00 +0100 4680349 http://www.medworm.com/index.php?rid=4680348&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F5%2F673%3Frss%3D1 The purpose of this study was to explore early-career registered nurses’ perceptions of high-quality nursing care in hospitals. The study findings contribute to ongoing work intended to explore and define what quality nursing care is and how it ultimately impacts patients. The final sample analyzed for this article consisted of 171 narrative responses from hospital-based registered nurses. We used Krippendorff’s technique for qualitative content analysis to identify themes. Three themes emerged as integral to high quality nursing care: registered nurse presence, developing relationships, and facilitating the flow of knowledge and information. Development of nursing quality indicators should focus on nursing processes in addition to patient outcomes. Such a focus would better ca... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4680348 Mon, 04 Apr 2011 23:00:00 +0100 4680348 http://www.medworm.com/index.php?rid=4680347&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F5%2F662%3Frss%3D1 In this article we provide a reconceptualization of patient-centered health care practice through a collaborative person-centered model for enhanced patient safety. Twenty-one participants were selected and interviewed from the internationally diverse population of individuals attending the Chicago Patient Safety Workshop (CPSW) sponsored by Consumers Advancing Patient Safety (CAPS). Analysis of the participant transcripts revealed three findings related to patient experience: the impact and meaning of communication and relationship within the health care setting, trust and expectation for the patient and family with the health care provider, and the meaning and application of patient-centeredness. Researchers concluded that successful planning toward enhanced patient-centered care require... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4680347 Mon, 04 Apr 2011 23:00:00 +0100 4680347 http://www.medworm.com/index.php?rid=4680346&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F5%2F652%3Frss%3D1 Professionally led support groups can significantly reduce distress, trauma symptoms, and pain for women with breast cancer. Despite the known benefits, women with breast cancer from marginalized groups tend not to participate in support groups. It is important to address barriers that prevent their participation and to identify types of support groups that appeal to as wide a range of women as possible. For this study, we interviewed women with breast cancer from marginalized groups in the San Francisco Bay Area (United States). We asked them about social, cultural, and psychological barriers that prevent participation in support groups, and about the potential of art groups to overcome these barriers. Our qualitative analysis of the interviews yielded findings that suggest a model for a ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4680346 Mon, 04 Apr 2011 23:00:00 +0100 4680346 http://www.medworm.com/index.php?rid=4680345&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F5%2F642%3Frss%3D1 Research has shown elevated rates of diet-related health problems in Detroit, Michigan compared to state and national averages. Using 47 in-depth interviews of African American residents in two Detroit neighborhoods, I examine the interplay between agency and social structure in food acquisition. Participants discussed numerous difficulties obtaining food, including availability, cost, quality, and accessibility. Residents employed many strategies to address these issues, including carefully examining food before purchase, sharing transportation to leave the neighborhood, and using multiple sources. However, the potential to pursue food acquisition strategies varied, in part, according to community contextual factors, including resident concerns about safety, the availability of food banks... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4680345 Mon, 04 Apr 2011 23:00:00 +0100 4680345 http://www.medworm.com/index.php?rid=4680344&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F5%2F625%3Frss%3D1 Research on drug use among gay and bisexual men has primarily focused on examining the link between drug use— most notably, methamphetamine—sexual practices, and risk of HIV transmission. Drawing on in-depth qualitative data from 40 interviews with gay and bisexual Asian American men, we examine perceptions and meanings associated with cocaine use in the San Francisco Bay Area gay community. We found that the participants, in contrast to their negative perceptions of methamphetamine use, believed that cocaine enhanced sociability and was acceptable for use in most social situations. Furthermore, participants perceived little connection between cocaine use and risky sexual practices, emphasizing the drug’s safety relative to other illicit substances. Based on these finding... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4680344 Mon, 04 Apr 2011 23:00:00 +0100 4680344 http://www.medworm.com/index.php?rid=4680343&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F5%2F612%3Frss%3D1 Depression is common among young people. Gender differences in diagnosing depression appear during adolescence. The study aim was to explore the impact of gender on depression in young Swedish men and women. Grounded theory was used to analyze interviews with 23 young people aged 17 to 25 years who had been diagnosed with depression. Their narratives were marked by a striving to be normal and disclosed strong gender stereotypes, constructed in interaction with parents, friends, and the media. Gender norms were upheld by feelings of shame, and restricted the acting space of our informants. However, we also found transgressions of these gender norms. Primary health care workers could encourage young men to open up emotionally and communicate their personal distress, and young women to be dar... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4680343 Mon, 04 Apr 2011 23:00:00 +0100 4680343 http://www.medworm.com/index.php?rid=4680342&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F5%2F601%3Frss%3D1 Approximately three fourths of middle-aged and older adults have at least two simultaneously occurring chronic conditions ("multiple morbidity," or MM), a trend expected to increase dramatically throughout the world. Rural residents, who tend to have fewer personal and health resources, are more likely to experience MM. To improve our understanding of the ways in which vulnerable, rural residents in the United States experience and manage MM, we interviewed 20 rural Appalachian residents with MM. We identified the following themes: (a) MM has multifaceted challenges and is viewed as more than the sum of its parts; (b) numerous challenges exist to optimal MM self-management, particularly in a rural, underresourced context; however, (c) participants described strategic methods of managing MM... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4680342 Mon, 04 Apr 2011 23:00:00 +0100 4680342 http://www.medworm.com/index.php?rid=4680341&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F5%2F587%3Frss%3D1 High rates of empowerment, HIV-related knowledge, and condom use among sex workers in Sonagachi, India have been attributed to a community-led intervention called the Sonagachi HIV/AIDS Intervention Program (SHIP). In this research we examined the crucial role of brothels in the success of the intervention. In-depth, semistructured interviews were conducted with 55 participants of SHIP. The results indicate that brothels help sex workers reduce HIV risk by (a) serving as targeted sites for SHIP’s HIV intervention efforts, (b) being operated by madams (women managers of brothels) who participate in SHIP’s intervention efforts and promote healthy regimes, (c) structuring the economic transactions and sexual performances related to sex work, thus standardizing sex-related behavior... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4680341 Mon, 04 Apr 2011 23:00:00 +0100 4680341 http://www.medworm.com/index.php?rid=4620330&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Freprint%2F21%2F4%2F580%3Frss%3D1 (Source: Qualitative Health Research) Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4620330 Tue, 22 Mar 2011 00:00:00 +0100 4620330 http://www.medworm.com/index.php?rid=4620329&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F4%2F563%3Frss%3D1 Based on positive deviance (examining the practices of successful individuals), we identified five primary themes from 36 strategies that help to maintain long-term weight loss (weight control) in 61 people. We conducted in-depth interviews to determine what successful individuals did and/or thought about regularly to control their weight. The themes included weight-control practices related to (a) nutrition: increase water, fruit, and vegetable intake, and consistent meal timing and content; (b) physical activity: follow and track an exercise routine at least 3x/week; (c) restraint: practice restraint by limiting and/or avoiding unhealthy foods; (d) self-monitor: plan meals, and track calories/weight progress; and (e) motivation: participate in motivational programs and cognitive processe... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4620329 Tue, 22 Mar 2011 00:00:00 +0100 4620329 http://www.medworm.com/index.php?rid=4620328&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F4%2F549%3Frss%3D1 In this study we explored daughters’ perceptions of changes in their relationship with their mother who became aphasic as a result of stroke. Four daughters of aphasic women were each interviewed qualitatively at three different times over the course of a year, and their discourse was transcribed and analyzed. A conceptual model of dynamic relationship changes was drawn, showing how the daughters’ perceptions of maternal fragility, problems and/or abilities motivated protective and/or trusting behaviors that resulted in maternal reactions of satisfaction and/or dissatisfaction that, in turn, reinforced the daughters’ initial perceptions. Results also showed that daughter—mother relationship changes followed four distinct yet coexisting patterns. Aphasia and communic... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4620328 Tue, 22 Mar 2011 00:00:00 +0100 4620328 http://www.medworm.com/index.php?rid=4620327&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F4%2F534%3Frss%3D1 Canes and walkers are commonly characterized as assistive devices that serve the same purpose: as walking aides. These general views were reappraised and tempered in this descriptive phenomenological study with 40 older women (aged 85 to 98 years) who were unable to leave their homes without help. The purpose was to describe the phenomena of negotiating reliance on canes and walkers as walking devices and the lifeworld context underlying each phenomenon. Relative to lifeworld, there were differences between coming to terms with using a cane and coming to terms with using a walker. Data revealed similarities and distinctions between the basic intentions of relying on canes and walkers and the associated purposes served by canes and walkers. Participants did not view either device as consist... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4620327 Tue, 22 Mar 2011 00:00:00 +0100 4620327 http://www.medworm.com/index.php?rid=4620326&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F4%2F520%3Frss%3D1 Family members in the United States—especially mothers—are frequently caregivers, and provide housing for their adult relatives and children with mental illness. They often do so with little support from the mental health system. The purpose of this analysis was to explore mothers’ experiences related to housing options available to their adult children with a mental illness and a history of violence (MIHV) toward the mothers. The results of this study reveal a complex mixing of desires, feelings, internal factors, and external forces experienced by mothers of adult children with MIHV when considering whether or not these children can live in their homes. The findings from this study illuminate needs for greater familial involvement in mental health treatment decisions, r... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4620326 Tue, 22 Mar 2011 00:00:00 +0100 4620326 http://www.medworm.com/index.php?rid=4620325&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F4%2F502%3Frss%3D1 Women who carry BRCA1 or BRCA2 (BRCA1/2) gene mutations have up to an 88% lifetime risk of breast cancer and up to a 65% lifetime risk of ovarian cancer. Strategies to address these risks include cancer screening and risk-reducing surgery (i.e., mastectomy and salpingo-oophorectomy). We conducted a grounded theory study with 22 BRCA1/2 mutation-carrier women to understand how women make decisions about these risk-reducing strategies. Preserving the self was the overarching decision-making process evident in the participants’ descriptions. This process was shaped by contextual conditions including the characteristics of health services, the nature of hereditary breast and ovarian cancer risk-reduction decisions, gendered roles, and the women’s perceived proximity to cancer. The ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4620325 Tue, 22 Mar 2011 00:00:00 +0100 4620325 http://www.medworm.com/index.php?rid=4620324&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F4%2F489%3Frss%3D1 We explored how community responses to HIV contribute to distress in African Americans living with HIV in the rural South of the United States. We listened to the voices of community members through focus groups and African Americans with HIV through interviews. Community avoidance of HIV, negative views of HIV, and discriminatory behavior powerfully affected the distress of people living with HIV (PLWH). Ongoing distress, coupled with limited support, led to a life in which many PLWH endured their pain in silence and experienced profound loneliness. We conceptualized their experiences as socioemotional suffering—the hidden emotional burden and inner distress of not only living with HIV, a complex serious illness, but also with the societal attitudes and behaviors that are imposed on... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4620324 Tue, 22 Mar 2011 00:00:00 +0100 4620324 http://www.medworm.com/index.php?rid=4620323&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F4%2F477%3Frss%3D1 Sober living homes are group residences for people attempting to maintain abstinence from alcohol and drugs in a mutually supportive setting. Residents typically develop strong psychological and economic ties and have been referred to as "alternative families," thus evoking the anthropological concept of fictive kinship. We analyzed data from seven focus groups with sober living home residents to assess the prevalence and functions of fictive kinship in these settings. Results suggest that residents created kinship by exchanging various types of support, and by incorporating other residents into existing family relationships, particularly in homes where there were children. Residents perceived fictive kin as more supportive than actual kin, encouraging them toward greater individuation, in... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4620323 Tue, 22 Mar 2011 00:00:00 +0100 4620323 http://www.medworm.com/index.php?rid=4620322&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F4%2F465%3Frss%3D1 After the devastating 2008 earthquake in China, grass-roots government officials were the main local force in postquake relief and reconstruction. Like other survivors, many officials were severely bereaved. Their psychological well-being was at stake. We conducted 25 semistructured interviews to investigate sources of stress at work and their coping experiences. We coded interviews using the content analysis method. Misunderstandings and assaults from survivors, prolonged heavy workload, and grief and bereavement were major sources of stress at work. Finding meaning in the work, emotion regulation, and goal and time management were main coping strategies. The challenge and importance of the work, combined with support and recognition at work, fostered an empowering work environment. Few i... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4620322 Tue, 22 Mar 2011 00:00:00 +0100 4620322 http://www.medworm.com/index.php?rid=4620321&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F4%2F454%3Frss%3D1 Incarcerated women face a number of stressors apart from the actual incarceration. Nearly half of all women in prison experience the death of a loved one during their incarceration. Our purpose for this study was to explore the experience of grief and loss among incarcerated women using a phenomenological method. Our study approach followed van Manen’s method of phenomenology and Munhall’s description of existential lifeworlds. Our analysis revealed four existential lifeworlds: temporality: frozen in time; spatiality: no place, no space to grieve; corporeality: buried emotions; and relationality: never alone, yet feeling so lonely. The findings generated from this study can help mental health providers as well as correctional professionals develop policies and programs that fac... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4620321 Tue, 22 Mar 2011 00:00:00 +0100 4620321 http://www.medworm.com/index.php?rid=4620320&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F4%2F443%3Frss%3D1 In this article, I trace the historical groundings of what have become methodological conventions in the use of qualitative approaches to answer questions arising from the applied health disciplines and advocate an alternative logic more strategically grounded in the epistemological orientations of the professional health disciplines. I argue for an increasing emphasis on the modification of conventional qualitative approaches to the particular knowledge demands of the applied practice domain, challenging the merits of what may have become unwarranted attachment to theorizing. Reorienting our methodological toolkits toward the questions arising within an evidence-dominated policy agenda, I encourage my applied health disciplinary colleagues to make themselves useful to that larger project ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4620320 Tue, 22 Mar 2011 00:00:00 +0100 4620320 http://www.medworm.com/index.php?rid=4534718&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F3%2F429%3Frss%3D1 We compiled data from nonparticipant observations of clinician—patient communication in clinical interactions in a tertiary care eye hospital in India. Applying elements of the French philosopher Michel Foucault’s concept of power and knowledge, we deconstructed the structuring and moderating influences on the expert/nonexpert dyad. We found that clinicians enforce their "disciplining power" through varying degrees of communicativeness to bring about compliance in the patient. Clinicians appear to classify the patient as "participant" or "deviant" based on the patient’s "internalization" of instructions, and then communicate in predictable ways with the patient. Patients can also wield power, communicating it by understanding and following or not understanding and not cla... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4534718 Tue, 01 Mar 2011 00:00:00 +0100 4534718 http://www.medworm.com/index.php?rid=4534717&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F3%2F419%3Frss%3D1 This article consists of a qualitative analysis of discussion forums in online mental health communities whose members routinely write about diagnosis. The analysis concerns the function of diagnosis from the perspective of personal identity, with particular focus on the status of official diagnosis, as well as community members’ discussions of symptoms and psychiatric syndromes that amount to informal diagnosis or consultation. Self-diagnosis sometimes takes the form of recommended "quizzes" and other online quasi-diagnostic tools. Other-diagnosis, in which a third party is discussed by community members, is also considered. We discuss the implications of such online discourse for Internet users themselves as well the challenges for the health and medical professions. (Source: Quali... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4534717 Tue, 01 Mar 2011 00:00:00 +0100 4534717 http://www.medworm.com/index.php?rid=4534716&cid=s_31000_46_f&fid=31000&url=http%3A%2F%2Fqhr.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F21%2F3%2F410%3Frss%3D1 A life in balance is commonly related to health and well-being. However, our knowledge regarding the perceptions of life balance among the general population is limited. Our aim was to explore the perception of life balance among working people without recent long-term sick leave. Individual interviews were conducted with 7 men and 12 women and analyzed according to grounded theory, aiming at achieving a description. The results showed that life balance includes four interrelated dimensions: activity balance, balance in body and mind, balance in relation to others, and time balance. Life balance was regarded by the participants as health related, promoted by a sense of security, and affected by context and individual strategies. Life balance was also seen as being individually defined and ... Qualitative Health Research journals http://www.medworm.com/rss/comments.php?id=4534716 Tue, 01 Mar 2011 00:00:00 +0100 4534716