JournalTOCs

Qualitative Health Research
Journal Prestige (SJR): 0.946

Citation Impact (citeScore): 2
Number of Followers: 33

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1049-7323 - ISSN (Online) 1552-7557
Published by Sage Publications

[1176 journals]

“There’s Something to Remind You that Everything Is Okay”:
Australian Trans Young People and the Presence of Animals in Interactions
With Healthcare Professionals
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  Authors: Damien W. Riggs, Shoshana Rosenberg, Heather Fraser, Nik Taylor
  Abstract: Qualitative Health Research, Ahead of Print.
  While animals have long been a focus in therapeutic spaces for young people via approaches such as animal-assisted therapies, there is a sense in which such approaches overlook the broader contribution that animals play by being present in young people’s lives. In this article, we explore how the presence of animals (both physical and psychological) in interactions with healthcare professionals may hold specific meaning for trans young people living in Australia. Participants were recruited through Parents of Gender Diverse Children. Interviews were conducted in November 2021 with 17 trans young people and one of each of their parents living in Australia. All interviews were audio recorded, transcribed, and analyzed using thematic analysis. Two main themes were developed: (1) how healthcare professionals respond to conversations about animals and (2) the beneficial role of the presence of animals. The article concludes by discussing the importance of thinking about the presence of animals beyond existing frameworks and recognizing the value placed on the presence of animals by trans young people.
  Citation: Qualitative Health Research
  PubDate: 2023-03-25T03:00:06Z
  DOI: 10.1177/10497323231163723
Culturally Safe Neonatal Care: Talking With Health Practitioners
Identified as Champions by Indigenous Families
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  Authors: Anna Adcock, Fiona Cram, Liza Edmonds, Beverley Lawton
  Abstract: Qualitative Health Research, Ahead of Print.
  The burden of health inequities borne by Indigenous peoples can be overwhelming, especially when mothers and newborns’ lives are at stake and health services seem slow to invest in responsiveness. In Aotearoa (New Zealand), urgent action is required to eliminate persistent systemic inequities for Māori (Indigenous) whānau (family collectives that extend beyond the household). This Kaupapa Māori (by Māori, for Māori) qualitative study aimed to explore the views of health practitioners identified as champions by whānau of preterm Māori infants. Ten health practitioners were interviewed and asked about their involvement with the whānau, their role in explanations and communication, and their thoughts on whānau coping. Interview data were analysed using interpretative phenomenological analysis. Three superordinate themes were identified: working together in partnership, a problem shared is a problem halved, and sacred space. Collaboration between health practitioners and with whānau was important to the champions and central to their goal of enabling whānau autonomy. This was built on a foundation of connectivity, relationships, and a full appreciation that childbirth is a sacred time that is potentially disrupted when an infant is born prematurely. The values- and relationship-based practices of these champions protected and uplifted whānau. They showed that health practitioners have important roles in both the elimination of inequities and the sustaining of Māori self-determination. This championship is an exemplar of what culturally safe care looks like in day-to-day practice with Māori and is a standard that other health practitioners should be held to.
  Citation: Qualitative Health Research
  PubDate: 2023-03-23T09:05:00Z
  DOI: 10.1177/10497323231164550
Pathways, Contexts, and Voices of Shame and Compassion: A Grounded Theory
of the Evolution of Perinatal Suicidality
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  Authors: Laura J. Biggs, Bonnie Jephcott, Kim Vanderwiel, Imogen Melgaard, Shannon Bott, Mitzi Paderes, Julie Borninkhof, Melanie Birks
  Abstract: Qualitative Health Research, Ahead of Print.
  There is an urgent need to generate deeper understandings of how suicidality manifests and evolves during pregnancy and the following year. Several perinatal studies have examined the incidence of suicidal thoughts and behaviours and associated social and obstetric risk factors; however, there is very limited research offering insights into women’s experiences of suicidality at this time in their lives. This study aimed to generate a theory to explain how suicidality evolves in the perinatal period. A grounded theory design was used with data generated using anonymous online surveys (119 participants) and in-depth interviews (20 participants) with women who received pregnancy care in the past 5 years in Australia. The developed theory holds shame as a core concept. Origins and contexts of shame reflect current epidemiological understandings of risk for perinatal suicide, including experiences of gender-based violence, adverse childhood experiences, and a history of mental health difficulties. When women feel that they are defective, are unworthy of love and belonging, and do not possess what it takes to be a good mother, they can conclude that their family is better off without them. Pathways beyond shame were facilitated by compassionate and rehumanising care from family, friends, and care providers. Findings demonstrate that perinatal suicidality is a complex multidimensional phenomenon, influenced by socio-cultural expectations of motherhood and interpersonal, systemic, and intergenerational experiences of trauma. Increasing the prominence of perinatal suicide prevention within health professional education and practice, and addressing systemic barriers to compassionate health care are critical first steps to addressing perinatal suicide.
  Citation: Qualitative Health Research
  PubDate: 2023-03-23T07:07:36Z
  DOI: 10.1177/10497323231164278
Becoming Experts in Their Own Treatment: Child and Caregiver Engagement
With Burn Scar Treatments
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  Authors: Jessica Killey, Megan Simons, Sarah Prescott, Roy Kimble, Zephanie Tyack
  Abstract: Qualitative Health Research, Ahead of Print.
  Children who experience a severe burn injury not only require acute medical care but may also need ongoing rehabilitation. To mitigate the potential long-term consequences of scarring and the impact of scarring on their everyday lives, children may be expected to use a variety of time-consuming and multi-component non-invasive scar treatments (such as pressure garments and silicone gels). These treatments may pose unique challenges for children and their caregivers. With limited research previously addressing how Australian children navigate the use of scar treatments at home, this study aimed to develop a grounded theory of children and their caregivers’ engagement with non-invasive burn scar treatments. Using a constructivist grounded theory approach, interviews were completed with 20 caregivers and 7 children, and a theory of children and their caregivers becoming experts in the use of non-invasive burn scar treatments was developed. Through persistence and flexibility, they continued to develop expertise. Engaging with scar treatments was an evolving process over time for children with burns and their caregivers. Theoretical categories identified included ‘making it work’, ‘finding the balance’ and ‘seeking reassurance’ and highlighted the remarkable strengths and adaptability of children and their caregivers. Through trial and error, children and their caregivers developed their own unique strategies for engaging with scar treatments. These insightful results may inform the development of interventions to support children and their caregivers’ day-to-day engagement with non-invasive burn scar treatments and guide health professionals recommending these treatments.
  Citation: Qualitative Health Research
  PubDate: 2023-03-21T07:26:15Z
  DOI: 10.1177/10497323231161997
Inclusion as Assimilation, Integration, or Co-optation' A
Post-Structural Analysis of Inclusion as Produced Through Mental Health
Research on Peer Support
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  Authors: Aimee Sinclair, Sue Gillieatt, Christina Fernandes, Lyn Mahboub
  Abstract: Qualitative Health Research, Ahead of Print.
  In the last 20 years, research on the inclusion of peer support within mental health settings has burgeoned, paralleling the broad adoption of service user inclusion within policy as a moral imperative and universally beneficial. Despite the seemingly progressive impetus behind inclusion, increasingly peer support workers talk of exhaustion working within mental health systems, the slow rate of change to oppressive values and practices, and ongoing experiences of workplace exclusion. Such experiences suggest differences in the way in which inclusion is produced across different stakeholder groups and contexts. In this article, we adopt Bacchi’s ‘what’s the problem represented to be'’ approach to identify how mental health research, often understood as an a-political activity, produces versions of inclusion. We argue current research predominantly produces inclusion as ‘assimilation’ and ‘integration’. We use critical inclusion, mental health, and survivor scholarship to evaluate the effects these productions have for peer support and peer support workers, finding that both problematise peer support workers and those seeking support. We consider possibilities for more liberatory productions of inclusion, building on the notion of inclusion as ‘co-optation’. Our analysis points to the need for researchers to engage with an uncomfortable reflexivity to enable more emancipatory possibilities regarding inclusion and peer support.
  Citation: Qualitative Health Research
  PubDate: 2023-03-20T08:35:28Z
  DOI: 10.1177/10497323231163735
Customizing Health Recommendations About Physical Activity During
Pregnancy: A Qualitative Study Among Practitioners in France
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  Authors: Laura Schuft, Priscille Sauvegrain, Jérôme Delotte
  Abstract: Qualitative Health Research, Ahead of Print.
  While studies have long shown the beneficial health effects of physical activity during pregnancy, such recommendations have been rarely analyzed in terms of how practitioners adapt such health messages to patients’ social profiles. The present study sought to apprehend the logics underlying practitioner (non)recommendations of physical activity and exercise during pregnancy, and how these were associated with social distinctions made between patients. Semi-directive interviews were conducted with 20 midwives and 17 gynaecologists and obstetricians in south-eastern France. Based on thematic analyses, the results show how recommendations draw from both medical and social knowledge, mobilizing social representations regarding physical activity, (non)normative bodies and othered social categories of class, ethnicity or obesity. The othering processes reiterate gendered social hierarchies as well as moral orders surrounding normative bodies and health-enhancing behaviours. The findings demonstrate how social hierarchies and beliefs intertwine with public health discourses about the body and health-enhancing practices, suggesting directions for reducing their impact in contexts of medicine and health.
  Citation: Qualitative Health Research
  PubDate: 2023-03-17T10:37:58Z
  DOI: 10.1177/10497323231159621
Depression as an Embodied Experience: Identifying the Central Role of the
Body in Meaning-Making and Identity Processes
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  Authors: Maria Orphanidou, Irini Kadianaki, Cliodhna O’Connor
  Abstract: Qualitative Health Research, Ahead of Print.
  Α significant part of the psychological research on mental health and illness is interested in how the body can impact one’s mental health. This impact is primarily explored using a biomedical framework, in studies that examine the body’s role in the emergence of a mental illness, the ways it can signify the presence of an illness (i.e. physical symptoms) and, finally, its role in the treatment process. Within this literature, the body is conceptualised as an object that can be diagnosed and treated. The current study approaches the body as a subject in the experience of depression. Specifically, it demonstrates that the experience of depression is embodied and that the body mediates meaning-making and identity processes. Using qualitative findings from eight interviews with Greek-Cypriot adults diagnosed with depression, we demonstrate that participants make sense of depression through their bodies, as a painful, uncomfortable and agonising experience. Further, we discuss how the struggle to regain control over the body, experienced as hijacked by depression, leads to a disrupted relation with the self and the world that expands beyond the idea of the loss of self, as described in the literature. Theoretical and clinical implications are examined.
  Citation: Qualitative Health Research
  PubDate: 2023-03-16T05:02:33Z
  DOI: 10.1177/10497323231154210
Workers’ Perspectives on Workplace Disclosure of Serious Mental Illness
and Their Employers’ Responses
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  Authors: Rebecca M. B. White, Marjorie L. Baldwin, Xuesong Cang
  Abstract: Qualitative Health Research, Ahead of Print.
  Persons with serious mental illness are often reluctant to disclose their disability to an employer because of the intense stigma associated with their illness. Yet, disclosure may be desirable to gain access to employer-provided job accommodations, or to achieve other goals. In this article, we aimed to (1) describe the contexts in which workers in regular employment disclose a mental illness to their employer and (2) describe employer responses to disclosure, as perceived by the workers themselves. Semi-structured interviews were conducted with 40 workers, who were currently or formerly employed in a mainstream, regular job, post-onset of mental illness. Workers were asked to describe the circumstances that led to disclosure, and to describe their employers’ responses to disclosure. Conventional content analysis was applied to identify common themes in the transcribed interviews. Analyses revealed five mutually exclusive disclosure contexts: seeking job accommodations, seeking protection, seeking understanding, responding to an employer’s symptom-based inquiries, or being exposed by a third party or event. Analyses also revealed a wider range of employer responses—positive, negative, and ambiguous—than has been suggested by studies in which employers described their reactions to worker disclosure. Some themes were more prevalent among current versus former workers. Overall, the disclosure process appeared to be more complex than has been described by extant frameworks to date, and the linkages between disclosure contexts and employer response themes suggested that many workers did not receive the responses they were seeking from their employers.
  Citation: Qualitative Health Research
  PubDate: 2023-03-14T09:02:52Z
  DOI: 10.1177/10497323231160108
Governing Oneself Through HIV Diagnosis to Antiretrovirals
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  Authors: Nkululeko Nkomo
  Abstract: Qualitative Health Research, Ahead of Print.
  The article focuses on the experience of reinventing oneself post HIV diagnosis when living on antiretrovirals. Six women and men enlisted for antiretrovirals in South African public health facilities were interviewed, and a qualitative analysis was conducted drawing on Foucault’s theory of governmentality. For the participants, the prevailing governing rationality of taking personal responsibility for their health is synonymous with self-recovery and restoration of self-determination. From the hopelessness and despair of HIV diagnosis, for all six participants, committing to antiretrovirals enhances their capacity to take back control of their transformation from victim to survivor, and with it, a sense of personal integrity. Yet, an unwavering resolve to use ARVs is not always possible for some of them, is not preferable or is not always desirable, which perhaps signals that for certain people living with HIV, their life-long journey of self-governance with ARVs is likely to be characterized by constant contradictions.
  Citation: Qualitative Health Research
  PubDate: 2023-03-08T06:23:50Z
  DOI: 10.1177/10497323231159804
Recovering the Lost Soul: Older Women’s Reflections on Past
Intrafamilial Child Sexual Abuse
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  Authors: Tova Band Winterstein, Hila Avieli, Mili Gichaz
  Abstract: Qualitative Health Research, Ahead of Print.
  Intrafamilial child sexual abuse (IFCSA) is a social problem with longstanding effects on victims’ lives. While scholarly literature has focused on the adverse aftermath of sexual abuse, only a few studies have acknowledged older women’s perspectives on their experience of IFCSA and their journey of healing and recovery. The aim of the present study was to explore how older survivors of IFCSA construct and shape their experience of healing in later life and the meaning they assign to this process. Narrative inquiry was selected to explore the narratives of 11 older women survivors of IFCSA. Participants were interviewed using a biographical narrative interviewing method. The narratives were then transcribed and analyzed using thematic, structural, and performance analyses. Four major themes emerged from the participants’ narratives: Achieving closure; Spiritual framing of IFCSA as a platform for self-growth; Becoming whole in old age; and Looking to the future after IFCSA. During the aging years, IFCSA survivors may redefine their identity and their place in the world. Using life review processes, older women in this study were striving to heal and reconcile with their past.
  Citation: Qualitative Health Research
  PubDate: 2023-03-08T02:03:56Z
  DOI: 10.1177/10497323231159802
Empowering Cancer Survivors in Managing Their Own Health: A Paradoxical
Dynamic Process of Taking and Letting Go of Control
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  Authors: Jonathan Avery, Roanne Thomas, Doris Howell, Claire-Jehanne Dubouloz Wilner
  Abstract: Qualitative Health Research, Ahead of Print.
  In cancer care, gaps in support to help patients manage and live with the side-effects from cancer treatments have increased the emphasis on empowering patients to be more active and involved in managing their own health. However, empowerment in relation to promoting self-management behaviors is not well understood. Using the social constructivist grounded theory approach, our goal was to develop a theoretical understanding of this phenomenon in relation to the self-management behaviors of post-treatment cancer patients. Twenty-two post-treatment cancer patients participated in a semi-structured focused interview to co-construct with us how empowerment is defined, described, and experienced in relation to their capacity to self-manage. Through this co-construction, we defined empowerment as a process of personal growth, a display of fortitude and strength when participants confronted the impact of their illness that emerged in two dynamic and paradoxical ways: 1) establishing control over the impact of the illness as a means to maintain normalcy and to circumvent change over an eroding and changing sense of self and 2) relinquishing control over aspects of the illness deemed irrepressible and acknowledging and accepting change. When successful at establishing and/or relinquishing control, participants no longer viewed cancer as a threat, but re-interpreted their illness as also having a beneficial “empowering” experience and more capable of managing. Findings will guide the development of self-management interventions that use empowerment as a core construct.
  Citation: Qualitative Health Research
  PubDate: 2023-02-24T01:46:20Z
  DOI: 10.1177/10497323231158629
Shifting Professional Identity Among Indonesian Medical Practitioners
During the COVID-19 Pandemic
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  Authors: Gianisa Adisaputri, Michael Ungar
  Abstract: Qualitative Health Research, Ahead of Print.
  The COVID-19 pandemic has had a significant impact on medical practitioners’ professional identities due to its novelty and intensity. Using constructivist grounded theory, we investigated how the COVID-19 pandemic shifted individuals’ identities as medical practitioners in Indonesia, where the pandemic caused high death rates among healthcare workers, particularly medical practitioners. By interviewing 24 medical practitioners and analyzing relevant documents and reports, we developed a grounded theory of professional identity shifts. We found two patterns: (1) identity growth, in which the medical practitioners thrive and claimed stronger professional identities, and (2) psychological and moral distress leading to attrition, facilitated adaptation, or professional identity collapse. We also found several primary protective factors including religious beliefs, good leadership, team cohesion, healthy work boundaries, connection to significant others, and public acknowledgment. Without adequate protective factors, medical practitioners experienced difficulties redefining their professional identities. To cope with the situation, they focused on different identities, took some time off, or sought mental health support, resulting in facilitated adaptation. Others resorted to attrition or experienced professional identity collapse. Our findings suggest that medical practitioners’ experience of professional identity shifts can be improved by providing medical practitioners with opportunities for knowledge updates, better organizational leadership and work boundaries, strategies to enhance team cohesion, and other improvements to medical systems.
  Citation: Qualitative Health Research
  PubDate: 2023-02-22T12:57:41Z
  DOI: 10.1177/10497323231159614
Narrative Inquiry as a Caring and Relational Research Approach: Adopting
an Evolving Paradigm
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  Authors: Charlotte R. Weiss, Rachel Johnson-Koenke
  Abstract: Qualitative Health Research, Ahead of Print.
  Humans are continuously storying and re-storying themselves through language and socially organizing language into narratives to create meaning through experiences. Storytelling through narrative inquiry can bridge world experiences and co-create new moments in time that honor human patterns as wholeness and illuminate the potential for evolving consciousness. This article aims to introduce narrative inquiry methodology as a caring and relational research approach aligned with the worldview grounding Unitary Caring Science. This article uses nursing as an exemplar to inform other human science disciplines interested in using narrative inquiry in research, while defining essential components of narrative inquiry through the theoretical lens of Unitary Caring Science. By exploring research questions through this renewed understanding of narrative inquiry informed by the ontological and ethical tenets of Unitary Caring Science, healthcare disciplines will be knowledgeable and prepared to facilitate knowledge development to contribute to the sustainment of humanity and healthcare beyond eliminating the cause of illness and into the experience of living well with illness. The co-creative process of narrative inquiry as a caring and healing inquiry can guide collective wisdom, moral force, and emancipatory actions by seeing and valuing human experiences through an evolved holistic and humanizing lens.
  Citation: Qualitative Health Research
  PubDate: 2023-02-21T10:55:41Z
  DOI: 10.1177/10497323231158619
A Meta-Ethnography on the Impact of Cancer for Lesbian and Queer Women and
Their Partners
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  Authors: Trisha L. Raque, Kaitlin V. Ross, Anna R. Hangge, Rebecca C. Gaines
  Abstract: Qualitative Health Research, Ahead of Print.
  Lesbian and queer women face unique experiences navigating cancer care, including challenges in accessing services that incorporate their relational supports. Given the importance of social support for survivorship, this study examines the impact of cancer on lesbian/queer women in romantic relationships. We conducted the seven stages of Noblit and Hare’s meta-ethnography. PubMed/MEDLINE, PsycINFO, SocINDEX, and Social Sciences databases were searched. Two hundred and ninety citations were initially identified, 179 abstracts were reviewed, and 20 articles were coded. Themes were (a) intersectionality of lesbian/queer identity in the cancer context; (b) institutional and systemic supports and barriers; (c) navigation of disclosure; (d) characteristics of affirmative cancer care; (e) survivors’ critical reliance on their partner(s); and (f) shifts in connection after cancer. Findings indicate the importance of accounting for intrapersonal, interpersonal, institutional, and socio-cultural–political factors for understanding the impact of cancer for lesbian and queer women and their romantic partners. Affirmative cancer care for sexual minorities fully validates and integrates partners in care, removes heteronormative assumptions in services provided, and offers LGB+ patient and partner support services.
  Citation: Qualitative Health Research
  PubDate: 2023-02-20T07:55:11Z
  DOI: 10.1177/10497323231155403
The Role of Latina Peer Mentors in the Implementation of the Alma Program
for Women With Perinatal Depression
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  Authors: Caitlin McKimmy, Joseph Levy, Anahi Collado, Kenia Pinela, Sona Dimidjian
  Abstract: Qualitative Health Research, Ahead of Print.
  This study examines the role that compañeras (peer mentors) play in the implementation of a program, Alma, which was designed to support Latina mothers who are experiencing depression during pregnancy or early parenting and implemented in the rural mountain West of the United States. Drawing from the fields of dissemination and implementation and Latina mujerista (feminist) scholarship, this ethnographic analysis demonstrates how the Alma compañeras facilitate the delivery of Alma by creating and inhabiting intimate mujerista spaces with other mothers and create relationships of mutual and collective healing in the context of relationships de confianza (of trust and confidence). We argue that these Latina women, in their capacity as compañeras, draw upon their cultural funds of knowledge to bring Alma to life in ways that prioritizes flexibility and responsiveness to the community. Shedding light on contextualized processes by which Latina women facilitate the implementation of Alma illustrates how the task-sharing model is well suited to the delivery of mental health services for Latina immigrant mothers and how lay mental health providers can be agents of healing.
  Citation: Qualitative Health Research
  PubDate: 2023-02-16T02:27:41Z
  DOI: 10.1177/10497323231154369
HIV Diagnosis as Both Biographical Disruption and Biographical
Reinforcement: Experiences of HIV Diagnoses Among Recently Diagnosed
People Living With HIV
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  Authors: Nathanael Wells, Dean Murphy, Jeanne Ellard, Steven P. Philpot, Garrett Prestage
  First page: 165
  Abstract: Qualitative Health Research, Ahead of Print.
  Despite the potential for HIV treatments to transform the health needs of people living with HIV, receiving a positive HIV diagnosis can be a difficult experience and feelings of shock, distress and concerns for the future are commonly reported. Drawing on Michael Bury’s conceptualisation of ‘biographical disruption’, we utilised semi-structured interviews to explore experiences of HIV diagnoses among 34 people diagnosed with HIV between 2016 and 2020 and living in Australia. Interviews were conducted between January 2018 and August 2021. Despite significant advances in biomedical HIV treatments and prevention, participants commonly experienced HIV diagnosis as emotionally challenging. For those with limited HIV awareness, HIV was commonly understood as a likely fatal condition. For some participants, receiving a positive diagnosis also engendered a degree of uncertainty as to their anticipated life trajectory, particularly its impact on future sexual and romantic relationships, options for starting a family and migration opportunities. For some gay and bisexual male participants, receiving a positive diagnosis almost confirmed a life trajectory that they had worked to avoid and their own sometimes-negative attitudes toward people living with HIV were internalised, making adjusting to diagnosis more complex. While all participants reported challenges in adjusting to an HIV diagnosis, some ultimately came to experience living with HIV as bringing about unexpected and welcome changes to their lives. Our findings highlight the complex and intersecting medical, social and emotional needs of people living with HIV when receiving and adjusting to a positive HIV diagnosis.
  Citation: Qualitative Health Research
  PubDate: 2023-01-12T05:54:27Z
  DOI: 10.1177/10497323221146467
‘Trials and Tribulations’: The Ambivalent Influence of Temporary
Accommodation on Mental Health Recovery in Chronically Homeless Adults
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  Authors: Dimitar Karadzhov
  First page: 176
  Abstract: Qualitative Health Research, Ahead of Print.
  Relatively few studies have explicitly examined whether and how shelter-type, temporary or emergency accommodation shapes homeless clients’ personal (mental health) recovery. A transatlantic phenomenological qualitative study was conducted to examine the influence of those services on personal recovery. Eighteen chronically homeless adults with a history of serious mental illness were recruited from several temporary accommodation services in New York City (NYC), U.S., and Glasgow, Scotland. Participants completed repeat in-depth interviews and a novel one-week multimedia mobile phone diary. The interpretative phenomenological analysis (IPA) produced three overarching group experiential themes: ‘everything was just starting to fall into place’; ‘caught in a trap’; and ‘trials and tribulations’. Collectively, the findings underscore the duality of influence of temporary accommodation on recovery. Those ambiguous spaces confronted participants with existential uncertainty, volatility and chronic boredom, but also proffered opportunities for envisioning and enacting recovery. Embarking on recovery while residing in temporary accommodation is possible, even for those enduring chronic life adversity. However, it is contingent upon enabling socio-material, affective and relational resources. Implications are discussed for theorising recovery as a contextually embedded, relational phenomenon, and for providing recovery-oriented support across the housing continuum.
  Citation: Qualitative Health Research
  PubDate: 2023-01-16T09:38:46Z
  DOI: 10.1177/10497323221147127
The Help-Seeking Experiences of Family and Friends Who Support Young
People With Mental Health Issues: A Qualitative Study
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  Authors: Christine Migliorini, Nicholas Barrington, Brendan O’Hanlon, Gretel O’Loughlin, Carol Harvey
  First page: 191
  Abstract: Qualitative Health Research, Ahead of Print.
  Little has been documented of the journey that family and friends (F&F) undertake when supporting a young person aged 12–25 years struggling with mental illness. The experiences of family and friends were explored using an online qualitative survey (N = 58) and semi-structured interviews (n = 15). Recruitment was through a national youth mental health service Facebook page and website. An experiential thematic analysis was conducted focusing on participants’ experiences and sense of their world.Strong feelings and challenging life circumstances made the context of help-seeking complicated. Despite following usual avenues for advice or support, F&F still came across professionals and a health/mental health system that compounded their distress. It was the simpler things that some professionals did that made their journey more bearable. Useful insights derived from the narratives allow service improvement recommendations such as reminding professionals of the multiplicity of stressors commonplace to families and the value of validation and acknowledgement.
  Citation: Qualitative Health Research
  PubDate: 2023-01-18T04:15:00Z
  DOI: 10.1177/10497323221147130
“What I Would Do to Take Away Your Pain”: A Photovoice Project
Conducted by Mothers of Children With Medical Complexity
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  Authors: Melanie Sonsteng-Person, Javier García-Pérez, Victoria Copeland, Laura Liévano-Karim, Darlene Abrams, Brittany Jarman, Rachel Marquardt, Sara Taitingfong, Jesse Van Leeuwen, Riahannon Valdez
  First page: 204
  Abstract: Qualitative Health Research, Ahead of Print.
  Research identifies that families of children with medical complexities in the United States have diverse and complex needs. Despite research emphasizing that families demonstrate higher needs that are not being met, limited research focuses solely on mothers of children with medical complexities. Specifically, how mothers understand and identify themselves, understand and define their role in coordinating care, and how they view their own mental and physical health. As such, this study provides a better understanding of how mothers in San Diego, CA, navigate the day-to-day psychological, social, and physical realities of having a child with medical complexities. Through the use of the participatory action research method photovoice, mothers conducted a critical analysis of their daily lives. Findings identify mothers’ main concerns about the conditions of their lives as well as the strengths they employ to care for themselves and their children successfully. Implications provide recommendations for hospitals working with mothers of children with medical complexities.
  Citation: Qualitative Health Research
  PubDate: 2023-01-27T08:57:03Z
  DOI: 10.1177/10497323221146047
Exploring the Complexity of Telehealth Privacy Through a Lens of
Adolescent Development
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  Authors: Samantha Rea, Lisa Mikesell, Catherine Cuddihy, Martha Perry, Bianca Allison
  First page: 220
  Abstract: Qualitative Health Research, Ahead of Print.
  Many challenges exist related to ensuring adolescent privacy with health care providers (HCPs), and the rapid integration of telehealth visits has created additional complexities in organizing privacy for adolescents. Through interviews with adolescent patients and their parents (n = 34), this qualitative analysis aimed to explore the complicated relationship and balance of adolescent alone time with HCPs, parental presence and support, and organization of privacy in order to consider how privacy during telehealth visits may contribute to adolescents’ healthy development. A framework by Blum et al. (2014) proposed four central goals of adolescent development: emotional security, engagement with learning, self-efficacy, and decision-making skills. This conceptual framework was used to outline the ways in which adolescent privacy during telehealth impacts adolescent development. Some adolescents reported that having their parents present during their telehealth visit afforded reassurance and comfort, and many parents explained that they served as a role-model during their adolescent’s telehealth visit. However, other adolescents felt higher emotional security when they could establish an independent relationship with their HCP, with many describing how privacy during their telehealth visit enabled them to have more sensitive discussions with their HCP. Adolescents and parents also reported that telehealth allowed increased experiential learning for adolescents, given their proficiency with technology and ability to access their health care visits autonomously. Furthermore, the organization of privacy was complicated by a lack of understanding whose responsibility it was to facilitate alone time between the adolescent and HCP, as well as external factors such as location and quality of technology and the proximity of family members in the home. By ensuring opportunities for private healthcare encounters, both in telehealth and in-person visits, HCPs and parents can help support adolescents in achieving successful and healthy development.
  Citation: Qualitative Health Research
  PubDate: 2023-01-19T12:14:30Z
  DOI: 10.1177/10497323231151596
What are the Challenges and Resilience Resources Identified by Informal
Carers During the First UK COVID-19 Lockdown' A Longitudinal
Qualitative Study Using Naturalistic Data
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  Authors: Warren J. Donnellan, Lily Sepulveda Garcia, Sarah M. Gibson, Paige Butcher, Matthew J. Lariviere
  First page: 236
  Abstract: Qualitative Health Research, Ahead of Print.
  COVID-19 has posed serious challenges for informal carers living in the UK. This article examines some of the specific challenges facing carers and the resources they used to manage them throughout the first UK lockdown. We used a framework approach to analyse naturalistic, longitudinal data from 30 carers taking part in 96 of Mobilise’s daily Virtual Cuppas between March and July 2020. We found that lack of information and social restrictions cumulatively impacted carers’ sense of certainty, control and motivation. This took an emotional toll on the carers, leading to exhaustion and burden. However, carers quickly established new routines and used humour and self-care to actively manage their wellbeing. Carers received support but also provided it to those in need, including fellow members of the caregiving community, supporting an ecological approach to carer resilience. Our findings may be used to anticipate challenges and promote protective resilience resources in future lockdowns.
  Citation: Qualitative Health Research
  PubDate: 2023-01-27T04:04:10Z
  DOI: 10.1177/10497323221150131
Does Hope Reverberate Between Generations'
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  Authors: Dorit Redlich-Amirav, Denise Larsen, Elizabeth Taylor
  First page: 247
  Abstract: Qualitative Health Research, Ahead of Print.
  Intergenerational transmission refers to the transmission of stories, traits, abilities, ideas, behaviors, and various outcomes from parents to their children. To date, there has been little research on the intergenerational transmission of positive behavior, traits, and actions. To determine whether hope may be transmitted from one generation to the next, a qualitative study was performed, using narrative inquiry and thematic analysis. Over 4 months, four mothers of children with mental illness were engaged in repeated conversations about stories of hope related to their past and how they envisioned hope in their children. Findings indicated that hope could be transmitted to the next generation, either explicitly (verbally) or implicitly (i.e., expressed through actions involving one’s children). We conclude that also positive patterns may be transmitted both explicitly and implicitly from one generation to the next. Transmitting hope between generations played a significant role in the mothers’ experiences of hope.
  Citation: Qualitative Health Research
  PubDate: 2023-01-27T01:28:32Z
  DOI: 10.1177/10497323231151614
Ethical Consequences of Technological Mediation on Parental
Decision-Making Experiences in the Neonatal Intensive Care Unit
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  Authors: Annie B. Friedrich
  First page: 259
  Abstract: Qualitative Health Research, Ahead of Print.
  The neonatal intensive care unit (NICU) is a morally charged space in which parents may be confronted with difficult decisions about the treatment of their newborns, decisions often complicated and created by the increasing use of technologies. This paper adopts a postphenomenological approach to explore the ethical consequences of technological mediation on parental treatment decision-making in the NICU. Semi-structured interviews were conducted with parents of children who received invasive technological support in the NICU to better understand how they made treatment decisions or decisions about specific interventions during their child’s hospitalization. The findings suggest that technological mediation—or the various ways in which humans can interact with their world via technologies—contributes to experiences of ambiguity, ambivalence, and alienation in parental decision-making. The ambiguity of invasive NICU technologies can create uncertainty in a decision, which can then lead to internal ambivalence about which decision to make. Ultimately, this ambiguity and ambivalence may lead to alienation from one’s child, as parents are disconnected physically and emotionally from the decision and thus their child. Articulating the effects of technological mediation on parental decision-making is a key step in addressing decisional conflict in neonatal intensive care settings and better supporting parents in their decision-making roles.
  Citation: Qualitative Health Research
  PubDate: 2023-01-27T08:40:07Z
  DOI: 10.1177/10497323231151816
A Tale of Childhood Loss, Conditional Acceptance and a Fear of
Abandonment: A Qualitative Study Taking a Narrative Approach to Eating
Disorders
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  Authors: Roma L. Watterson, Marie Crowe, Jennifer Jordan, Sarah Lovell, Janet D. Carter
  First page: 270
  Abstract: Qualitative Health Research, Ahead of Print.
  Eating disorders (EDs) are serious mental health illnesses, yet there is a need to better understand the illness experience to improve treatment outcomes. Qualitative research, and narrative approaches in particular, can elicit life stories that allow for the whole illness journey to be explored. This study aimed to explore the experiences of women with a history of an ED, identifying the life events they perceived were relevant to the onset of their ED through to recovery. Interviews were conducted with 18 women with lived experience of an ED. Through structural narrative analysis, an overarching storyline of childhood loss contributing to a belief of conditional acceptance, fear of abandonment and struggle to seek emotional support due to the fear of being a burden was identified. Negative experiences with the health sector were common. These findings have implications for the way medical professionals respond to help seeking and deliver treatment.
  Citation: Qualitative Health Research
  PubDate: 2023-01-19T07:30:02Z
  DOI: 10.1177/10497323231152142
Clinician–Patient Relationships in Virtual Care: A Dimensional Analysis
of the Symbolic World of Cancer Care
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  Authors: Jane Evered, Lucy Andersen, Anessa Foxwell, Christin Iroegbu, Clare Whitney
  First page: 284
  Abstract: Qualitative Health Research, Ahead of Print.
  Rapid uptake of telehealth technologies has shifted clinician–patient relationships, a well-studied topic of sociological inquiry. The purpose of this dimensional analysis study was to understand the symbolic interaction of clinicians and patients within virtual supportive cancer care. Seventeen clinicians, eighteen patients, and three care partners receiving or providing care at a multi-site cancer center in the United States participated in interviews. Our analysis of supportive cancer care experiences reveals a key tension: clinicians need to rely on patients in order to share clinical tasks in a virtual care setting but can be reluctant to do so. We posit that dimming the light on cancer is a process that enables clinicians to overcome their reluctance to engage in clinician–patient task sharing by strengthening the relationship. Taken together, these findings reconceptualize the symbolic interaction of the clinician–patient relationship and highlight opportunities to actualize models of relationship-centered virtual care. We discuss implications for clinical practice, ethical relational care, and the literature on clinician–patient relationships and trust.
  Citation: Qualitative Health Research
  PubDate: 2023-01-31T11:46:09Z
  DOI: 10.1177/10497323231153793
“You Measure Us and You Depress Us”: Healthism and the Subjective
Impact of Body Measurements on Secondary School Students
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  Authors: Vicente J. Beltrán-Carrillo, Alejandro Jiménez-Loaisa, David González-Cutre, Ana C. Sierra, Javier Valenciano-Valcárcel
  First page: 297
  Abstract: Qualitative Health Research, Ahead of Print.
  This study explores adolescents’ subjective experiences when facing body measurements at school, performed to evaluate the effects of a school-based intervention to promote physical activity. Three semi-structured interviews (n = 3) and two focus groups (n = 7 and 3) were conducted with adolescents after measuring some variables related to their weight and adiposity. Observational data (n = 88) collected by the two researchers in charge of the measurements were also obtained. Findings derived from our thematic analysis question the suitability of body measurements as social contexts where the core ideas of healthism emerge. Some adolescents lived body measurements as negative social experiences, promoting body dissatisfaction, social comparison, embarrassment, and simplistic associations between health and body shape, which could hinder their adherence to healthy habits. We emphasize the role of qualitative research when evaluating pre/posttests of school-based intervention studies, not just the interventions themselves, to generate knowledge to improve research protocols and prevent unwanted psychological outcomes in participants.
  Citation: Qualitative Health Research
  PubDate: 2023-01-30T10:32:32Z
  DOI: 10.1177/10497323231152155
‘It Makes Me Feel Old’: Understanding the Experience of Recovery From
Ankle Fracture at 6 Months in People Aged 50 Years and Over
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  Authors: Elizabeth Tutton, Jenny Gould, Sarah E. Lamb, Matthew L. Costa, David J. Keene
  First page: 308
  Abstract: Qualitative Health Research, Ahead of Print.
  Ankle fracture is a common injury, and depending on injury severity, treatment may be a support boot, cast or surgery. Older people, particularly those with severe injuries who are asked to restrict weight bearing, struggle with early recovery. To elicit older peoples’ experience of recovery 6 months after injury, we drew on a phenomenological approach using interviews. Findings revealed that getting on with life was a way of accepting what it feels like to ‘be vulnerable’, needing to ‘be safe’ while determinedly working hard to ‘be myself’. Being vulnerable identified endurance of inactivity, loneliness and dependency in the non-weight bearing period of recovery, followed by a struggle to weight bear while lacking confidence and being fearful of falling and causing further damage. Being safe conveyed fragility where sensations, pain and stiffness acted as bodily reminders of injury. Lack of function and awareness of danger led to carefulness where planning or curtailing of activities ensured their safety. Being myself showed a determination to push away from a disrupted self-identify of being older or disabled while being challenged by the continuous process of learning to be more mobile. A lack of readiness for old age created a drive to age well. Despite loss of ability, participants hoped to regain their pre-injury way of living. This study challenges practice that disregards the hard work required to recover from ankle fracture. As comorbidity increases with age, failure to consider this aspect may contribute to frailty in this group of older people.
  Citation: Qualitative Health Research
  PubDate: 2023-02-06T03:48:23Z
  DOI: 10.1177/10497323231153605
Uncertainty Management Strategies in Communication About Urinary Tract
Infections
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  Authors: Alaina Leverenz, Rachael A. Hernandez
  First page: 321
  Abstract: Qualitative Health Research, Ahead of Print.
  Urinary tract infections (UTIs) are the most common bacterial infection, and yet the etiology, treatment, and prevention of UTIs are often clouded by uncertainty. UTIs can cause severe pain and may lead to serious infection, but communication about UTIs can help individuals manage this condition and avoid recurring UTIs. Grounded in uncertainty management theory (UMT), this study explored how individuals with female anatomy manage uncertainty surrounding UTIs. Iterative analysis was employed using UMT to analyze 21 qualitative interviews. Participants used uncertainty management strategies of talking to health care providers, eliciting social support, and using the internet to gather information. Results indicated that talking to heath care providers was a dominant strategy intended to reduce uncertainty about the diagnosis and treatment of their symptoms. However, these interactions inadvertently increased uncertainty as well, as providers did not provide information about the causes and prevention of UTIs. Some participants also engaged in deception to reduce uncertainty about how their providers would respond to their pain and their illness. Finally, participants employed metaphors to interpret and neutralize uncertainty related to their experiences. Implications for these findings include guidelines and support for patient and provider communication, communication in social networks, as well as deeper nuances and development for UMT.
  Citation: Qualitative Health Research
  PubDate: 2023-02-10T06:50:58Z
  DOI: 10.1177/10497323231156370
Introducing SAMMSA, a Five-Step Method for Producing ‘Quality’
Qualitative Analysis
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  Authors: Mary Ellen Macdonald, Sophia Siedlikowski, Kevin Liu, Franco A. Carnevale
  First page: 334
  Abstract: Qualitative Health Research, Ahead of Print.
  Qualitative health research is ever growing in sophistication and complexity. While much has been written about many components (e.g. sampling and methods) of qualitative design, qualitative analysis remains an area still needing advanced reflection. Qualitative analysis often is the most daunting and intimidating component of the qualitative research endeavor for both teachers and learners alike. Working collaboratively with research trainees, our team has developed SAMMSA (Summary & Analysis coding, Micro themes, Meso themes, Syntheses, and Analysis), a 5-step analytic process committed to both clarity of process and rich ‘quality’ qualitative analysis. With roots in hermeneutics and ethnography, SAMMSA is attentive to data holism and guards against the data fragmentation common in some versions of thematic analysis. This article walks the reader through SAMMSA’s 5 steps using research data from a variety of studies to demonstrate our process. We have used SAMMSA with multiple qualitative methodologies. We invite readers to tailor SAMMSA to their own work and let us know about their processes and results.
  Citation: Qualitative Health Research
  PubDate: 2023-02-06T03:01:24Z
  DOI: 10.1177/10497323231154482
Qualitative Story Completion: Opportunities and Considerations for Health
Research
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  Authors: Kristi Urry, Sarah Hunter, Rebecca Feo, Brett Scholz
  First page: 345
  Abstract: Qualitative Health Research, Ahead of Print.
  Qualitative story completion (QSC) is an innovative research method that offers researchers a range of unique opportunities for generating and analysing data. Participants are asked to write a ‘story’ in response to a hypothetical ‘story stem’, often in the third-person and involving fictional characters, rather than reporting on their direct experiences. QSC is being developed and increasingly taken up by researchers working across a range of fields; but it has been little used in health research, especially in the fields of nursing, health services research, medicine, and allied health. This means that health researchers have few examples to draw on when considering what QSC can offer them and how to rigorously design, conduct, and report a QSC study within health-related fields. We aim to address this gap and contribute to existing QSC literature by promoting increased use of QSC by health researchers and supporting them to produce rigorous QSC research. We outline three case examples illustrating how we have used QSC to conduct multidisciplinary health research relevant to nursing, medicine and nutrition. Drawing on these case examples, we reflect on challenges that we encountered, describe decision-making processes, and offer recommendations for conducting rigorous health research using QSC.
  Citation: Qualitative Health Research
  PubDate: 2023-01-31T10:02:00Z
  DOI: 10.1177/10497323221150130
The Adolescent Concept of Social Participation—A Qualitative Study on
the Concept of Social Participation from Adolescents with and without
Physical Disabilities
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  Authors: Tim Bärwalde, Laura Hoffmann, Astrid Fink, Carina Völlm, Olaf Martin, Marie Bernard, Britta Gebhard, Matthias Richter
  First page: 143
  Abstract: Qualitative Health Research, Ahead of Print.
  PurposeThe construct of social participation is still not clearly defined. To reach a better understanding of social participation, the perspectives of adolescents must be taken into account. This study explores the adolescent concept of social participation and expands knowledge of the meaning of subjective components of the term.MethodsThirty-four semi-structured interviews were conducted with adolescents with and without physical disabilities or chronic diseases between the ages of 12 and 17 and analyzed according to grounded theory.ResultsAdolescents describe social participation as involving reflexive interaction with their social environment. Furthermore, forming a social environment plays an important role. All components of the concept are embedded in a context that influences the ways adolescents participate. Adolescents differentiate between active and passive forms of social participation. The concept of reflexive interaction is situated within an interdependent structure of components such as the “feeling of belonging” and the feeling of “well-being” among adolescents.ConclusionThe results expand the current state of knowledge regarding the theoretical differentiation of social participation by exploring subjective components of the term. This offers the possibility of supplementing the theoretical frameworks of social participation and supports the understanding of the critical importance of social participation for adolescents.
  Citation: Qualitative Health Research
  PubDate: 2022-12-17T07:30:45Z
  DOI: 10.1177/10497323221146414
The Gendered Work/Role of Program Directors in International Graduate
Medical Education
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  Authors: Debalina Dutta, Halah Ibrahim, Joseph Cofrancesco, Sophia Archuleta, Dora J. Stadler
  First page: 154
  Abstract: Qualitative Health Research, Ahead of Print.
  Healthcare organizations offer numerous clinical and academic leadership pathways for physicians, among which the position of program director (PD) is considered to be a prominent educational leadership role. As PDs are instrumental in the recruitment and training of the next generations of physicians, PD gender distribution can affect the present and future of a medical specialty. This study offers a dialectical perspective in understanding how international PDs negotiate gendered understanding of their work/role by using the framework of Relational Dialectics Theory 2.0. Thirty-three interviews of PDs from Qatar, Singapore, and the United Arab Emirates were conducted and, using contrapuntal analysis, the competing discourses of meanings of gender in the PD work/role were examined. Competing discourses where structural, cultural, and professional meanings of gender were interrogated revealed inherent multiple meanings of how gender is understood in PD work/roles. In making sense of these meanings of gender, PDs express dilemmas of traditional gender binaries of masculine/feminine work/role meanings to explain the term in different ways in their everyday organizational and cultural struggles. The findings have implications for PD recruitment and retention in teaching hospitals.
  Citation: Qualitative Health Research
  PubDate: 2022-12-17T05:23:55Z
  DOI: 10.1177/10497323221145832