Qualitative Health Research

Cancer Patients' Fears Related to Clinical Trial Participation: A Qualitative Study

by Alexis Koskan

Patient-related barriers have hindered cancer
patients' abilities to participate in the decision-making... more Patient-related barriers have hindered cancer
patients' abilities to participate in the decision-making processes
to participate in clinical trials. However, little is known about patients' emotional barrier of fear and how physicians influence this barrier. We conducted 48 in-depth interviews with cancer patients to determine their knowledge and attitudes about participating in clinical trials, transcribed interviews verbatim, and qualitatively analyzed the transcripts using content analysis. For the purpose of this manuscript, we focused on findings related to the role of the emotional barrier of fear in cancer patients' perceptions of participating in clinical trials. The majority of cancer patients (n=40, 83.3%) discussed fears surrounding clinical trials, particularly as it related to cancer diagnosis, clinical trial participation, and fear of the unknown. In conclusion, providers might consider addressing the role of fear in patients' considering participating in a clinical trial.

Affecting Qualitative Health Psychology

by john cromby

Health Psychology Review 5,1, 79-96 (2011)

The ‘affective turn’ is a contemporary movement within the humanities, social science and psychology to investigate... more The ‘affective turn’ is a contemporary movement within the humanities, social science and psychology to investigate affect, emotion and feeling as hybrid phenomena jointly constituted from both biological and social influences. Health and illness are themselves jointly constituted in this way, and many of the topics, concerns and methods of health psychology are strongly permeated by affective phenomena. Qualitative research in health psychology might therefore benefit by engaging with this work. This paper describes some features of the affective turn, and suggests theories, terminology and methods that might be useful.

Social psychology and the empirical body: Rethinking the relationship

by john cromby

Although social science work on the body has demonstrated its thorough socialisation, social psychology has barely... more Although social science work on the body has demonstrated its thorough socialisation, social psychology has barely recognised the mutual interdependence of the physical body and the social world. Accordingly, we propose that social psychology might be enriched and extended by detailed investigation of changes in the activity of the empirical body alongside processes of meaning-making during social interaction. We illustrate our proposal with a case study of changes in blood pressure during conversation, explored in conjunction with analyses using four discursive frames: gaining voice; identity negotiation; joint action/knowing of the third kind; positioning theory. We argue that this approach challenges the artificial separation of social psychology from other sub-disciplines, might inform social psychological analyses of emotion and belief, and allows it to address substantive topics, such as psychopathology, which it typically largely excludes.

Chamberlain, K. (2011). Troubling methodology. Health Psychology Review, 5, 48-54.

by Kerry Chamberlain

DOI:10.1080/17437199.2010.520113

Sheridan, J., Chamberlain, K., & Dupuis, A. (2011). Timelining: Visualising experience. Qualitative Research, 11(5), 552-569.

by Kerry Chamberlain

doi: 10.1177/1468794111413235

This paper discusses the uses and benefits of an innovative method of graphic elicitation; timelining. The method was... more This paper discusses the uses and benefits of an innovative method of graphic elicitation; timelining. The method was developed in the context of a narrative-based research project on fatness and weight loss. Participants’ weight over time was plotted on a graph, informed and elaborated by a variety of material objects such as photographs, diaries, and medical records. The timeline provided a focus for participants and prompted their stories of weight loss experiences over time. While initially intended as a simple heuristic tool for eliciting talk, over the course of the research the process of timelining became a central feature of the project. Timelining is a subtle and malleable research method. While keeping time in view, timelining documents, records, extends and deepens understandings of participants’ past experiences. It encourages the construction of rich temporal narratives. It also provides opportunity for deeper researcher-participant relationship to develop. This form of graphic elicitation has particular value for narrative forms of research.

Sheridan, J., & Chamberlain, K. (2011). The power of things. Qualitative Research in Psychology, 8, 315-332

by Kerry Chamberlain

DOI:10.1080/14780880903490821

Qualitative research extensively utilises interviews to gain insight into the intricacy and texture of lived... more Qualitative research extensively utilises interviews to gain insight into the intricacy and texture of lived experience. However, there is growing recognition of the limitations of interviewing as a data-gathering method. Popular alternatives include a move to visual methods, such as photo-production, to enhance the interviewing process. In this paper we argue for the power of materiality in this process. We propose that material objects, such as photographs, items of clothing, personal journals, and such like, have power to simultaneously provide proof of the past, produce increased narrative depth, force change in narratives, and also change the interview process and the relationships caught up within it. We illustrate these issues by drawing on data from a research project about weight loss, We conclude by considering the implications and value of using material things in research.

Compte-rendu du colloque: "Contributions des approches anthroposociales au champ transdisciplinaire et intersectoriel de la recherche en santé mondiale"

by Marie-Jeanne Blain

Rapport sous la direction de Suárez-Herrera, JC. et MJ Blain. Rapporteurs J. Simard et L. Doyon - (2011). Compte-rendu du colloque « Contributions des approches anthroposociales au champ transdisciplinaire et intersectoriel de la recherche en santé mondiale », ayant eu lieu le 10 mai 2011 dans le cadre du congrès de l’ACFAS, Sherbrooke, 46 pages.

INTRODUCTION. Socio-anthropologie de la recherche en santé mondiale : discours, méthodes et pratiques

par... more INTRODUCTION. Socio-anthropologie de la recherche en santé mondiale : discours, méthodes et pratiques

par José Carlos SUÁREZ-HERRERA, Université de Montréal

La nature transdisciplinaire et intersectorielle de la recherche en santé mondiale fait appel à des théories, des méthodes et des pratiques procédant de plusieurs courants de pensée contemporains fort éloignés du point vue épistémologique, mais potentiellement complémentaires. Cette confluence d’approches favorise l’émergence d’interactions dynamiques entre de nombreux acteurs concernés par la recherche tout en permettant de mettre en oeuvre une démarche dialectique entre, d’une part, des perspectives plus universalistes, qui prônent l’unicité des critères et l’équivalence du sens, et d’autre part, des approches nettement culturalistes, qui préconisent la cohérence interne et la différenciation identitaire.

Afin de rendre compte de cette complexité et des enjeux qui lui sont attribués, nous avons organisé, dans le cadre du 79e congrès de l’Acfas, un colloque visant l’alignement d’un ensemble de considérations conceptuelles, de choix méthodologiques et de stratégies opérationnelles essentiels au développement de compétences clés pour les chercheurs, praticiens, étudiants et gestionnaires en santé mondiale. Pour ce faire, nous avons compté sur la participation de chercheurs et d’étudiants post-gradués reconnus dans le domaine de la santé par la qualité et les retombées de leur production scientifique. La diversité transdisciplinaire de ces participants, provenant de plusieurs milieux académiques du Québec, offre un regard original sur la recherche en santé mondiale, se caractérisant surtout par l’étendue globale de sa perspective épistémologique ainsi que par sa sensibilité aux particularités locales de la santé des populations. Tout en suivant la structure proposée au sein du colloque, les sections de ce compte-rendu illustrent les contenus qu’on a touchés au sein des trois sessions et de la table ronde de cet événement. Les deux premières sections sont consacrées respectivement aux considérations conceptuelles et aux choix méthodologiques associés à la recherche en santé mondiale. La troisième section est dédiée aux stratégies opérationnelles relatives à la pratique du chercheur en santé mondiale. Le compte-rendu se clôture par une dernière section axée sur les enjeux, les défis et les pistes de recherche et d’action pour la santé mondiale contemporaine.

Performance incentives and job motivation factors among mental health professionals: a qualitative study

by ILIAS GRAMMATIKOPOULOS

Presented as a poster at the "2nd International Congress on Neurobiology, Psychopharmacology and Treatment Guidance"

Background
In our era of resource shortages, the lack of explicit policies for human resource management has... more Background
In our era of resource shortages, the lack of explicit policies for human resource management has produced imbalances that threaten the capacity of health care systems to attain their objectives[1]. The aim of this study was to identify important motivational factors according to the views of mental health professionals in two Greek psychiatric hospitals and particularly to determine if these might differ among medical, nursing and administrative stuff in terms of improving work performance.

Methods
A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements) was used[2]. Three categories of health care professionals, doctors (N=28), nurses (N=224) and office workers (N=72) working in two psychiatric hospitals (Thessaloniki and Corfu) participated, and motivation was compared across socio-demographic and occupational variables.

Results
The survey revealed that achievements were ranked first for the entire sample and by professional subgroup (P < 0.001) among the four main motivators, followed by remuneration, co-workers, and job attributes. Interestingly, remuneration (and salary in particular) was reported as a significant incentive only for professionals in managerial positions (P = 0.032) for the entire sample. The range of reported motivational factors was mixed and within subgroups motivators were varied. The job-attributes and co-workers factor was a significant motivational predictor for nurses in managerial positions, while the most important determining variable in the achievements factor was education, which was positively associated with higher motivation for the entire sample (P = 0.034). 

Conclusion
In today's economically unstable environment, both monetary and non-monetary incentives are important to motivate health care professionals [3, 4] focusing the attention to management approaches that improve performance, while the economic downturn may present as a specific opportunity for radical innovation within the mental health system[5]. Mental health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation, particularly in the public sector.

Making a success of providing NHS Health Checks in community pharmacies across the Tees Valley: a qualitative study

by Rebekah McNaughton

Generating Best Evidence From Qualitative Research: the Role of Data Analysis

by Karen Willis

A hierarchy of evidence for assessing qualitative health research

by Karen Willis

Young men, sexual health and responsibility for contraception: a qualitative pilot study

by Sally Brown

Qualitative Research Ethics: Enhancing Evidence-Based Practice in Physical Therapy

by Anne Townsend

Go to website for podcast discussion on this paper
http://ptjournal.apta.org/content/90/4/615.full

Background. Increasing challenges to health care systems and the prominence of patient-centered care and... more Background. Increasing challenges to health care systems and the prominence of patient-centered care and evidence-based practice have fostered the application of qualitative approaches in health care settings, prompting discussions of associated ethical issues in a range of disciplines.
Objectives. The purposes of this work were to identify and describe the application and value of qualitative health research for physical therapy and to identify ethical considerations in a qualitative research study.
Design. This was a qualitative interview study with telephone follow-ups.
Methods. Forty-six participants were interviewed about their early experiences with rheumatoid arthritis. They also were asked what motivated them to volunteer for the study. To inform the discussion of ethics in qualitative health research, this study drew on the in-depth interviews, took a descriptive approach to the data, and applied the traditional ethical principles of autonomy, justice, and beneficence to the
study process.
Results. Ethical issues emerged in this qualitative health research study that were both similar to and different from those that exist in a positivist paradigm (eg, clinical
research). With flexibility and latitude, the traditional principle approach can be applied usefully to qualitative health research.
Conclusions. These findings build on previous research and discussion in physical therapy and other disciplines that urge a flexible approach to qualitative research ethics and recognize that ethics are embedded in an unfolding research process
involving the role of the subjective researcher and an active participant. We suggest reflexivity as a way to recognize ethical moments throughout qualitative research and
to help build methodological and ethical rigor in research relevant to physical therapist practice.

Using focus groups to develop health surveys: An example from research on social relationships and AIDS-preventive behavior

by Kerth O'Brien

Improving survey questionnaires through focus groups.

by Kerth O'Brien

Coping with the threat of AIDS: An approach to psychosocial assessment.

by Kerth O'Brien

How do we know when research from one setting can be useful in another? A review of external validity, applicability and transferability frameworks

by Muriah Umoquit

Co-authored with Helen Burchett PhD and Mark Dobrow PhD.
Published in the Journal of Health Services Reserach & Policy,
October 2011 16 (4):238—244

Objective To review published frameworks that included criteria for the assessment of external validity, applicability... more Objective To review published frameworks that included criteria for the assessment of external validity, applicability and transferability in their assessment of health research.

Methods Five databases were searched for articles relating to the assessment of external validity or applicability and transferability in health research. A coding framework was developed inductively and used to assess which types of criteria were included in the frameworks.

Results Thirty-eight articles describing 25 frameworks were identified. Eleven focused solely on the assessment of applicability and transferability; 14 presented more general decision-making or evidence appraisal frameworks. The criteria were synthesized into four main categories: setting, intervention, outcomes and evidence. None of the frameworks covered all the criteria identified. A major limitation was the lack of empirical data used to develop many frameworks and the apparent lack of assessment of their perceived utility.

Conclusion A validated framework of applicability and transferability would help those aiming to encourage research use, as well as those conducting research. Greater understanding of applicability and transferability could help to encourage the appropriate use of research and the development of research that is more useful.

Studying social power in textual data: Combining tools for analyzing meaning and positioning

by Alexandra Bogren

Published in Critical Discourse Studies 2010, Vol 7, No 1, 73-84.

Texts are language excerpts produced from specific points of view; they communicate specific worldviews and values.... more Texts are language excerpts produced from specific points of view; they communicate specific worldviews and values. This implies that social science research on power in texts can benefit from an analysis of the perspective from which a story is presented. Nevertheless, discussion of concrete tools for doing this at the level of practical analysis is less common. This article describes a set of tools for analyzing positioning at two different levels: the level of enunciation – which focuses on narrator and audience positions – and the level of utterance – which focuses on positions in stories. Moreover, addressing readers less familiar with discourse analysis and students new to discourse analysis, the article argues that combining tools for analyzing positioning with more general tools for analyzing meaning is advantageous because this allows for more detailed analysis of social power in texts and for more detailed description of the analytical process.

Providing the results of research to participants: a mixed-method study of the benefits and challenges of a consultative approach.

by Clare Jackson

Dixon-Woods M, Tarrant C, Jackson CJ, Jones DR, Kenyon S

Background How best to provide the findings of research to study participants remains poorly understood. more Background How best to provide the findings of research to study participants remains poorly understood.
Purpose We aimed to develop, deliver, and evaluate a consultative approach to inform provision of feedback about research findings to participants in the Oracle Children Study (OCS). The OCS had identified adverse outcomes for some children whose mothers had been prescribed antibiotics as part of a trial in pregnancy.
Methods An iterative process, including focus groups with OCS participants and consultation with other OCS stakeholders, was used to inform the development of a feedback package, including a results leaflet, for OCS participants. A questionnaire survey of participants’ reactions to receiving the results leaflet was conducted. The Kolmogorov–Smirnov two-sample test was used to compare responses between different groups of respondents. Analysis of open-ended comments on the questionnaire was based on the constant comparative method.
Results Three focus groups with study participants provided insight into the potential emotional impact of receiving the results and into how the results might most clearly be explained. Negotiations with other stakeholders identified other priorities, including the need for scientific credibility. These multiple needs had to be balanced. The results leaflet was posted to all 4676 UK OCS participants. Survey responses were received from 1124 (25%) of participants. They indicated that the feedback was mostly well received by participants. Those whose children were affected by conditions associated with increased risk from trial participation were more likely to experience emotional distress on receiving the trial results, but there was also evidence of some other unanticipated impacts.
Limitations This study is limited by the low response rate to the survey.
Conclusions Important lessons can be learned from using a consultative approach to developing feedback about research results for study participants. Especially where the findings are unwelcome, feedback development may involve methodological, ethical, emotional, and practical challenges, be resource-intensive, and need early planning.

Understanding the benefits of prosthetic prescription: exploring the experiences of practitioners and lower limb prosthetic users.

by Elisabeth Schaffalitzky

Purpose.While lower limb prosthetic prescription is reliant on many physical indicators, it is clear that psychosocial... more Purpose.While lower limb prosthetic prescription is reliant on many physical indicators, it is clear that psychosocial factors need to be emphasised to a greater extent within this field if the needs of users are to be appropriately addressed. The aim of this study is to explore and identify the outcomes of prosthetic prescription through qualitative inquiry. Method.Six focus groups with prosthetic service users and 10 semi-structured interviews with service providers were conducted and then analysed with inductive thematic analysis. Results.The outcomes identified were: independence, not being in a wheelchair, balance and safety, improved quality of life and reaching potential. Conclusions.These emergent themes challenge the predominating focus on physical functioning that many practitioners have. These findings are important for developing a user-based model of service provision and outcome evaluation.