Qualitative Research (Health Sciences)

Introduction: The presence of a child with a specific learning disability in the family who needs care and has special educational problems is a source of stress for mothers, affecting their mental health and adjustment. This study aimed to explore the lived experiences of mothers of children with specific learning disability (SLD). Methods: This qualitative study was conducted using a phenomenological approach. The participants were 14 mothers of children with specific learning disability (SLD) whose data were collected through semi-structured interviews. The participants were selected using purposive sampling and the collected data were analyzed via Colaizzi's method of data analysis. Results: Analysis of the data revealed 4 main themes including “impact on family”, “the mother’s life”, “the student’s problems”, “concerns”, and “needs”, and 14 subthemes. Conclusion: The present study showed that specific learning disability has diverse effects on the child, mother, and family,...

The aim of this study was to investigate how individuals;who had been victims of school bullying;perceived their bullying experiences and how these had affected them;and to generate a grounded theory of being a victim of bullying at school. Twenty-one individuals;who all had prior experiences of being bullied in school for more than one year;were interviewed. Qualitative analysis of data was performed by methods from grounded theory. The research identified a basic process of victimising in school bullying;which consisted of four phases: (a) initial attacks;(b) double victimising;(c) bullying exit and (d) after-effects of bullying. Double victimising refers to a process in which there was an interplay between external victimising and internal victimising. Acts of harassment were repeatedly directed at the victims from their social environment at school – a social process that constructed and repeatedly confirmed their victim role in the class or the group. This external victimising affected the victims and initiated an internal victimising;which meant that they internalised the socially constructed victim-image and acted upon this image;which in turn often supported the bullies’ agenda and confirmed the socially constructed victim-image. The findings also indicate the possible positive effect of changing the social environment.

There is a widespread idea that in grounded theory (GT) research, the researcher has to delay the literature review until the end of the analysis to avoid contamination – a dictum that might turn educational researchers away from GT. Nevertheless, in this article the author (a) problematizes the dictum of delaying a literature review in classic grounded theory, (b) presents arguments for using extant literature in the substantive field within a constructivist grounded theory, and (c) suggests data sensitizing principles in using literature, which are: theoretical agnosticism, theoretical pluralism, theoretical sampling of literature, staying grounded, theoretical playfulness, memoing extant knowledge associations, and constant reflexivity.

There is a widespread idea that in grounded theory (GT) research, the researcher has to delay the literature review until the end of the analysis to avoid contamination – a dictum that might turn educational researchers away from GT. Nevertheless, in this article the author (a) problematizes the dictum of delaying a literature review in classic grounded theory, (b) presents arguments for using extant literature in the substantive field within a constructivist grounded theory, and (c) suggests data sensitizing principles in using literature, which are: theoretical agnosticism, theoretical pluralism, theoretical sampling of literature, staying grounded, theoretical playfulness, memoing extant knowledge associations, and constant reflexivity.

Οι αιματολογικές κακοήθειες μολονότι αποτελούν το 8% των περιπτώσεων καρκίνου δεν έχουν μελετηθεί επαρκώς από ψυχοκοινωνική σκοπιά. Η παρούσα έρευνα επιχειρεί τη διερεύνηση των αφηγήσεων 8 Ελλήνων ασθενών με αιματολογικό καρκίνο. Στόχος ήταν η κατανόηση της υποκειμενικής εμπειρίας του αιματολογικού καρκίνου και της νοηματοδότηση της ασθένειας, αλλά και η μελέτη της αναπαράστασης της ασθένειας στη γενικότερη αυτοβιογραφία και της επιρροής ευρύτερων συστημάτων στο προσωπικό βίωμα. Η έρευνα βασίστηκε στην αφηγηματική μέθοδο για τη συλλογή των δεδομένων καθώς και την ανάλυση και την ερμηνεία των αποτελεσμάτων. Από τη διαδικασία της αφηγηματικής ανάλυσης προέκυψαν τρία σημαντικά ζητήματα. Πρώτον, με αφετηρία τη θεωρία του Bury (1982) για τη βιογραφική ρήξη, περιγράψαμε και επιχειρήσαμε να ερμηνεύσουμε το πώς και σε ποιους τομείς άλλαξαν (ή δεν άλλαξαν) οι ζωές των συμμετεχόντων μετά τη διάγνωση του αιματολογικού καρκίνου. Δεύτερον, με βάση τους αφηγηματικούς τύπους του Frank (1995) μελετήσαμε το πώς οι συμμετέχοντες αναπαριστούν και νοηματοδοτούν την εμπειρία της ασθένειας και πώς προσαρμόζονται σε αυτήν. Τέλος, περιγράφουμε την αβεβαιότητα που βιώνουν οι συμμετέχοντες ως ένα πυρηνικό χαρακτηριστικό των αφηγήσεων της εμπειρίας του αιματολογικού καρκίνου, την οποία συνδέουμε με τη ροή της πληροφορίας ανάμεσα στην οικογένεια, τον ασθενή και το ιατρικό προσωπικό, καθώς και με το μοντέλο της μεταιχμιακότητας για την υποκειμενική εμπειρία του καρκίνου.

Consultation is an important feature of research and, increasingly, researchers are required to work in partnership with stakeholders to increase the impact of their work. Our aim is to demonstrate what can be learned from the scholarship on, and practice of, member checking to facilitate productive knowledge exchange. Using dialogical analysis we explore three member check interactions from three different qualitative psychology projects focusing our analysis on difficult moments between researchers and participants conceptualised here as ‘sore spots’. We identify two major genres in these sequences: participant ambivalence and participant challenge. We then consider passages that allow us to explore a more theoretical understanding of these two genres in terms of the metaphor of portraits and mirrors. Overall, we outline how implicit epistemologies and theories of subjectivity (uncomplicated, blank, and complex) may be linked to the way in which stakeholders approach research. We also provide a map with regard to the theories within which member checks can be undertaken, associated research practices in terms of a range of researcher responses to stakeholder ambivalence and challenge, and implications of these moments for knowledge exchange for qualitative research but also for psychological science as a whole. We conclude that sore spots in knowledge exchange process can be productive opportunities of transformational validity.

Keywords: member check; knowledge exchange; research impact; dialogical analysis; participant validation

Background: Obstetric fistula is a hole between the vagina and bladder, and/or between the vagina and rectum,
triggered by prolonged obstructed labor. The World Health Organization has estimated that at least 50,000 to
100,000 cases of obstetric fistula occur every year, and that over two million women with obstetric fistula in
developing countries remain untreated. Research on women’s lived experiences of obstetric fistula is limited. This
study aimed to explore the lived experience of women with obstetric fistula at Bahir Dar Hamlin Fistula Center,
Amhara Regional State, Ethiopia.
Methods: A qualitative study design, drawing from a phenomenological approach, was employed to explore the
lived experience of purposively-selected sample of ten women with obstetric fistula. In-depth interviews were
conducted in the local language (Amharic) using an interview guide. Interviews were transcribed and translated
into English, and transcripts were entered as primary documents into Atlas.ti 7 software. Thematic categories were
identified, and transcripts were coded accordingly.
Results: Participants perceived that the contributing factors to obstetric fistula were: instrument-assisted delivery;
inappropriate physical examination and care; early marriage; and long duration of labour. As a result of obstetric
fistula, the patients suffered from uncontrolled dripping of urine and/or faeces (and associated offensive odours),
ostracization by their family and community members, and feeling hopeless and isolation from the community.
Patients used different coping mechanisms, including frequent washing of clothes and changing of underwear;
they also expressed that they preferred to be alone.
Conclusion: Women with obstetric fistula experienced urine incontinence and associated bad odour; social and
psychological problems like isolation, divorce and fears were commonly reported. Our findings from perspectives of
Ethiopian setting suggest that integrated services for women with obstetric fistula are warranted, including physical
therapy, psychological support and social reintegration.

Aim: Our aim is to offer and illustrates a novel meta-methodology to enhance the rigour of method selection and understanding of results in pluralist qualitative research (PQR).
Method: To do so, we make innovative use of Braun and Clarke’s (2006) articulation of four discrete dimensions characterising different forms of thematic analysis. We provide secondary analyses of an interview from the Social Media, Men who have Sex with Men and Sexual Health project using critical discursive psychology, dialogical analysis, interpretative phenomenological analysis, and psychosocial narrative analysis.
Results: All four methods identified aspects of three central foci: Compartmentalisation, Detachment, and Jouissance.
Conclusion: We discuss how our proposed meta-methodology provides a rationale for the selection of methods in a PQR, offer evidence that it can anticipate the relative similarity in focus of the methods employed, and argue that our meta-methodology reveals the possibility of identifying an ‘axial’ or ‘hub’ method’ of a PQR which might be particularly fruitful in exploring commonalities and differences in results. Finally, we examine the synergies and challenges of combining pairs of the methods we used.

Background: Knowledge of mental health service users views is important in service planning, to ensure access for everyone and in particular for those in minority groups. Depression is common in older people and it has been suggested that ethnic elders may be more vulnerable to mental illness. This study therefore explored and compared the views of White British (WB) and Black African–Caribbean (BC) older people on depression as an illness, avenues of help and the place of mental health services. Methods: A qualitative analysis of semi-structured interviews using vignettes describing an older man with depression and a woman with psychosis. The purposive sample consisted of 40 WB and BC older people half of who had been depressed. Results: 21 WB (10 depressed and 11 not depressed) and 19 BC (10 depressed and 9 not depressed) were interviewed. Most people irrespective of ethnicity or depression recognised that there was something wrong with the man with depression. Most did not consider it an illness. Ethnicity but not depression effected the interpretation of the aetiology of the symptoms. A minority thought that consulting the GP would help but some BC specified that it would be inappropriate. BC who had not been depressed thought that spiritual help was appropriate. Both ethnic groups suggested that mental health services were for care, incarceration or dealing with violence. None of those who had been depressed thought that the mental health services were for dealing with violence. Limitations: We interviewed established BC immigrants and our results might not apply to new BC immigrants or other immigrant groups. Descriptions within the vignettes of depression and psychosis were defined by us. Conclusions: Most older people do not view depression as a mental illness. Older people, particularly BC therefore often do not see psychiatric services as appropriate and believe they are primarily for psychosis and violence. These views are amenable to change. Doctors should be explicit that services are for people with depression.

Introduction: Near-death experience (NDE) is a phenomenon with paranormal elements which follows pervasive and deep personal and social changes for patients. The familiarity of medical staff with the components of this phenomenon, and their appropriate response to patients’ experiences could facilitate understanding and integration process of NDEs for patients. Due to the impact of medical staff reaction to patients’ experiences, and the lack of research on NDEs which described the elements, this study aimed to explain the elements of Iranian patients’ NDEs. Method: This qualitative study was performed using a descriptive phenomenological approach. The subjects of the study consisted of 10 people with NDE. They were selected through purposive sampling method. Data were collected via individual tape-recorded interviews, and simultaneously analyzed using Colaizzi’s seven-step analysis method. Results: Through data analysis, 113 codes were extracted which were classified under 11 seman...

Objectives: We aim to provide an understanding of the psychological sequela of androgen insensitivity syndrome (AIS) in phenotypic females in order to begin to inform psychosocial health care services.

Design: Eight adult women with AIS were recruited through the Androgen Insensitivity Syndrome Support Group-United Kingdom (AISSG-UK). Data was collected via two semi-structured interviews with each woman.

Methods: Transcripts were analysed using grounded theory and a conceptual model was developed which suggests a way of understanding the AIS distress experienced by the participants.

Results: The pivotal concept is a woman's fear of devaluation. This is connected to her level of adaptation and perception of having a compromised womanhood. These, in turn, are related to her medical management and involvement with others via a support group and in talking about AIS.

Conclusions: Participants showed a clear preference for open communication about their condition throughout the process of medical management. We recommend sensitive, pacing of information to allow young women and their families to make informed decisions about treatment and a realistic adaptation to life with AIS.

Arts-Based Educational Research and Qualitative Inquiry: Walking the Path

Thalia M. Mulvihill, Ball State University
and
Raji Swaminathan, University of Wisconsin, Milwaukee

This book introduces novice researchers to arts-based qualitative research methods. In the last decade, qualitative research has expanded to include new and emergent methods that has led to more novice
researchers seeking out arts-based expertise to support their work. Following primarily the strands of visual, narrative, and performative inquiry, the book is relevant for all novice qualitative researchers interested in arts based inquiry methods.

This article introduces grounded theory and places this method in its historical context when 1960s quantitative researchers wielded harsh criticisms of qualitative research. The originators of grounded theory, sociologists Glaser and Strauss, sought to defend the quality of qualitative research and argued that grounded theory increased its quality by providing a method of theory construction. Our major foci include: (1) introducing the logic of grounded theory, with emphasis on how researchers can use it to construct theory, (2) detailing criteria for quality in the major forms of grounded theory advocated by Glaser and Strauss and augmented by Glaser, Strauss and Corbin and refined by Corbin, and Charmaz and (3) providing an analysis of how constructivist grounded theorists Thornberg, Halldin, Bolmsjö and Petersson attended to the interviewing process, coding, and developing their theoretical concept of double victimizing. Students and researchers new to the method can use our concluding guidelines as a checklist to assess the quality of their constructivist grounded theory research.

Introduction: Clinical judgement as a tool for professionals allows the nurses to play their roles and explore their opinion. This necessitates clarification of the structure of clinical judgment. It is difficult to give a unanimous definition for clinical judgement therefore, exploration of the structure of the concept is necessary to understanding clinical judgment. The aim of this study is to explore the structure of clinical judgment of nurses. Method: This qualitative research was a grounded theory study based on purposed sampling. 18 clinical nurses from Kurdistan University of Medical Sciences were interviewed. The interviews were transcribed in Microsoft Word Office, and then the data were analyzed in MAXQDA2007. Constant comparison analyses were used simultaneously with data collection. Results: The participants in study include 9 men and 9 women, with at least 3 years of experience of nursing in variable clinical settings. Final research findings could be discussed in five...

La presente ricerca di dottorato è stata condotta in co-tutela tra l’Università degli Studi di Napoli Federico II e l’Universidad Nacional de Tucuman, Argentina, attraverso la conduzione di un’indagine empirica qualitativa dedicata all’analisi dell’esperienza vissuta in prima persona da parte di persone che presentano una condizione di Iperplasia Surrenale Congenita (ISC) con particolare riferimento agli interventi chirurgici, alle terapie sostitutive e allo stigma psicosociale.

Introduction: Patient safety is one of the main components of health services quality which is defined as the prevention of harm to patients during health care provision. Medical students as members of the treatment team play an important role in patient safety. This study aimed to identify the role of medical students in patient safety in medical centers in Semnan province. Methods: This applied-qualitative study was carried out using a content analysis approach via the framework analysis method. The participants were key informants and experts of patient safety friendly hospital program. They were selected using purposive sampling and the sampling process continued until the data saturation (n=14). The data were collected via semi-structured interviews and analyzed using MAXQDA software (version 10). Results: Of 468 primary codes, 6 main codes were extracted including the importance of student education, student participation in teamwork, interaction with patients, medical errors ...

Arts-Based Educational Research and Qualitative Inquiry: Walking the Path Thalia M. Mulvihill, Ball State University and Raji Swaminathan, University of Wisconsin, Milwaukee This book introduces novice researchers to arts-based qualitative research methods. In the last decade, qualitative research has expanded to include new and emergent methods that has led to more novice researchers seeking out arts-based expertise to support their work. Following primarily the strands of visual, narrative, and performative inquiry, the book is relevant for all novice qualitative researchers interested in arts based inquiry methods.

Introduction: Although it is an accepted fact that using coping strategies have an important role in the coping process and quality of life following spinal cord injury (SCI), there is still little information about this issue in the world and especially in Iran. The purpose of this study was to explore important coping strategies used by Iranian patients with spinal cord injuries. Method: 18 patients with SCI from The Brain and Spinal injury Repair Research Center of Tehran University of Medical Sciences, and the Protection Center of the disabled with spinal cord injury were interviewed deeply. Data were collected through recorded interviews, and concurrently analyzed using the conventional content analysis method. Results: Data analysis showed seeking help from religious beliefs (understanding the disease as a divine fate and test, appeal to Imams, and increasing worship), to be an important coping strategy. Conclusion: Understanding strategies that influence the patients’ coping ...

Introduction: Induced demand utilizes the advantage of higher information in respect to patients and too much care is presented with suspicious value. Therefore, the theory of induced demand is based on the assumption of asymmetric information between physician and patient. The patients do not have sufficient expertise to assess the level and quality of provided services. They rarely know what and how much medical care they need. In fact, due to some reasons, patients can influence the demand induction. They have unlimited wishes and desires in respect to the offered services. This article examines the role of the patient in the phenomenon of induced demand with the use of the experiences of experts of Isfahan University Medical Sciences, Isfahan, Iran. Method: The present research was a qualitative study. Semi-structured interview was used for data generation. Participants in this study were people who had been informed in this regard, were experienced, and were known as experts. P...

Spurred by the value it can add, the use of qualitative research methods has been steadily growing by social pharmacy researchers around the globe, either separately or as part of mixed methods research projects. Given this increase, it is important to provide guidance to assist researchers in ensuring quality when employing such methods. This commentary addresses both theoretical fundamentals as well as practical aspects of establishing quality in qualitative social pharmacy research. More specifically, it provides an explanation of each of the criteria of trustworthiness proposed by Lincoln and Guba (credibility, transferability, dependability and confirmability) and different techniques used in establishing them. It also provides a brief overview of authenticity, a more recent and less widely used set of criteria that involve demonstrating fairness, ontological authenticity, educative authenticity, catalytic authenticity, and tactical authenticity. For each of these terms, the commentary provides a definition, how it applies to social pharmacy research, and guidance on when and how to use them. These are accompanied by examples from the pharmacy literature where the criteria have been used. The commentary ends by providing a summary of competing viewpoints of establishing quality in the published literature while inviting the reader to reflect on how the presented criteria would apply to different qualitative research projects.

Introduction: Islam has always stressed the importance of health and wellness. For centuries, Muslims have recognized the value of a good, clean, and healthy life. The purpose of this study is to explain the health-oriented lifestyle in the Islamic culture based on opinions, experiences, and perceptions of clergies, teachers, and students. Method: A qualitative research method was conducted in this study by grounded theory approach. Data were gathered through semi-structured interviews with participants. Moreover, the existing resources, such as case studies, life stories, letters, diaries, and press interviews have been used. Results: This study's central variable was deviation from moderation of thought, belief and behavior. Seven main categories were gained by analysis of data. They were: "policy in the health system", "Islamic education"," Islamic movement in people's family centered lives", "work, effort, and money", "ethics ...

Introduction: Parents who have children with cerebral palsy are exposed to the complicated care procedures of the afflicted child. Thus, they need support in order to decrease problems in this respe ct. However, their needs are not sufficiently met. Ther efore, this study was conducted to explore barriers to support for parents of children with cerebral palsy . Method: This qualitative study was conducted in 2011-2012 using content analysis. Purposeful sampling was used to select the participants and continued u ntil data saturation was reached. As a result, 31 participants from among parents of children with ce rebral palsy referred to the rehabilitation centers in Tehran, Iran, and experts were selected. The data w ere collected by in-depth semi-structured interview s and from collected documents, and were analyzed by induction method. Results: Data analysis results revealed three main categori s f organizational barriers (poor institutional coordination and communication, and lac...

Introduction: Infidelity as one of the main causes for divorce has very deleterious effects on family, mental health, and feelings of the victims. The purpose of this study was to identify and explain emotional experiences and reactions of women victims of infidelity. Method: In this interpretative study with phenomenology method, study population consisted of women victims of infidelity in Shemiranat, Tehran City, Iran, in 2016. 18 women of 22-64 years who were victims of the infidelity were selected through purposive sampling and were investigated by a semi-structured interview. The data were analyzed using a thematic analysis method. Results: The data analysis resulted in two main themes, 12 subthemes, and 61 initial concepts. As the first theme, ‘maladaptive emotional reactions’ consisted of subthemes as the feelings of separation from life (including feelings of sadness, frustration, and desire for death), separation from oneself (including inadequacy, and sense of abandonment)...

Introduction: Death anxiety is one of the ultimate anxieties of humankind, which is caused by consciousness of mortality and inevitability of death. Considering the fact that knowledge of death and experience of death anxiety arise from childhood, the objective of this study was to explore the experiences of children with heart disease and cancer about death anxiety. Methods: This study was conducted qualitatively with a phenomenological approach. The participants were 15 children with cancer and congenital heart disease (CHD) at Ali Asghar (AS), Modarres, and Rasoul-e-Akram hospitals in Tehran in 2018, whose information was collected through semi-structured interviews. The participants were selected via purposive sampling and the data were analyzed by Colaizzi's method. Results: The analysis of the data led to the development of a main category called anxiety, which consists of six subcategories including imaginary manifestations of death, loneliness and nothingness, fear and a...