Developing and refining interventions in persons with health disparities: the use of qualitative description

"I Need Help With the Abortion, so I Won't Have to Ever See or Hear From Him Again": Relationship Barriers Faced by Abortion Fund Applicants in the Rocky Mountain West

To explore the factors impacting abortion access for abortion fund clients, data from 816 applicants was analyzed using a summative content analysis approach. Nine relationship themes emerged for applicants who cited their partner as a significant factor in their abortion decision-making, including (a) power and control, (b) fear and safety concerns, (c) leaving the relationship, (d) barriers to accessing care, (e) sexual violence, (f) perpetration and victimization, (g) having an unsupportive partner, (h) being partnerless, and (i) having a supportive partner. Abortion funds are a potential resource for those experiencing intimate partner violence and can support survivors through confidential care and referrals.

Barriers to Gambling Treatment Among American Military Personnel: A Qualitative Study

Gambling disorder (GD) poses a significant public health problem, with treatment access frequently hindered by barriers. This study sought to identify the unique internal and external barriers encountered by military personnel with GD using a qualitative descriptive method. Twenty-eight United States military veterans and service members (SMs) were recruited through purposeful sampling strategies and interviewed using a semi-structured interview format. Content analysis revealed two main themes: "Emotional Suppression in Military Culture" reflecting military cultural norms that emphasize strength, discipline, and emotional control, which were internalized by the participants and created significant internal barriers; "Structural Ignorance of Gambling Problems" uncovers external barriers such as the normalization of gambling, insufficient recognition of gambling's addictive nature within military and Veterans Affairs (VA) settings, and inadequate treatment options within the VA healthcare system. The study underscores the complex interplay between cultural norms and institutional practices and proposes policy recommendations to improve help-seeking behaviors for veterans and SMs.

Incentives for COVID-19 Vaccination: Implications for Public Health Preparedness in a New Pandemic

OBJECTIVE

To examine opinions about incentives for vaccination against COVID-19.

METHODS

A qualitative study was conducted in spring 2022. The study population consisted of pairs of university students and their parents throughout Serbia. The qualitative content analysis was applied.

RESULTS

A total of 18 participants (9 student-parent pairs) were included. The following themes were identified: 1) Attitudes about financial incentives for vaccination, 2) Non-financial incentives for vaccination, and 3) Suggestions to enhance vaccination coverage. Theme 1 comprised several subthemes: General response to money, Dissatisfaction with financial incentives, Satisfaction with financial incentives and Amount of money to change people's opinion. Most parents and some students expressed a clear dissatisfaction and disapproval of the concept of financial incentives for compliance with vaccination. Financial offers would not make our participants change their position on whether to receive the vaccine, as no major differences in attitude towards vaccinations between the vaccinated and the non-vaccinated study participants was observed. Non-financial incentives were more acceptable compared to financial ones, but they were also seen as beneficial for some and not others.

CONCLUSIONS

Financial incentive programs' potential for inefficiency and public mistrust make other methods to boost vaccine uptake better public health choices for now.

National team biathletes' experiences of the menstrual cycle: "it's something that needs to be heard"

Objectives

To describe national team biathletes' experiences of their menstrual cycle (MC) while training and competing, and to identify factors to be considered in the development of policy and practice to support these athletes.

Methods

Participants included 18 national team biathletes (ages 17-32 years) who experience the MC. Following a qualitative description design, athletes participated in one-on-one semistructured interviews that were audio-recorded, transcribed verbatim and analysed using a content analysis process.

Results

Four descriptive themes represent the findings: (a) 'A very under-rated part of performance and training': Critical impacts of the MC on sport; (b) 'It varies month to month': Fluctuation in occurrence and impact of MC symptoms; (c) 'Block out and get through it': Managing the MC for performance; and (d) 'For the next generation': Improving policy and practice around the MC. Findings from this research outline actionable steps to support athletes who experience a MC, including developing mandatory MC education, increasing knowledge about the management of MC symptoms (eg, MC tracking, leakproof suits), and creating a fair point system of the overall biathlon season ranking allowing elimination of two race results that may have been affected by a health issue, such as adverse MC symptoms.

Conclusions

This research outlines the critical need for 'macro' level policies and practices that reduce the perceived impact of MC symptoms on athletes' training and performance. Furthermore, individual variations described in this study highlight the importance of individualised approaches to supporting athletes as they navigate the MC alongside the demands of sport.

"I Worry About My Kids' Safety When They Visit": Mothers' Perceptions of Father/Child Post-Separation Contact in the Context of IPV

After separation because of intimate partner violence, fathers' contact with children can be problematic. This mixed methods secondary analysis focused on 280 Canadian separated/divorced mothers who were 48.4% White, 45.1% Indigenous, and 6.5% Visible Minority. Of 176 fathers, 105 (59.7%) had regular visits and, 71 (40.3%) visited sporadically; 104 had no contact. Comments from half the mothers (54.3%) with regular father-child visits indicated worry, and 41.9% of all mothers perceived their children as sad/upset and another 14.5% as angry/acting out in response to visitation. Recommendations to address mothers' and children's issues with respect to problematic father-child contact are provided.

Development and initial validation of a role strain scale for male nursing students

BACKGROUND

Male nursing students face numerous challenges in learning and clinical practice due to occupational gender segregation and societal gender stereotypes. Although there is a role strain scale for nursing students of both genders, it is not specifically designed to assess role strain in areas such as community, family, peers, and nursing education among male nursing students.

PURPOSE

To develop and initially validate a Role Strain Scale for male nursing students.

METHODS

This study employed a three-phase approach to develop and validate the scale, including item generation, theoretical analysis, and psychometric analysis for reliability and validity among 163 male nursing students.

RESULTS

A 12-item Role Strain Scale was developed to include four dimensions: "Family and Friend Role Strain," "Classmate and Teacher Role Strain," "Medical Personnel Role Strain," and "Patient Role Strain," explaining 63.47 % of the variance. The role strain from teachers and classmates is unique from that experienced by male nurses. Male nursing students with different intentions to enter the nursing profession showed significant differences in overall role strain; those experiencing higher role strain had lower intentions to engage in clinical nursing work (F = 4.81, p = 0.003), supporting the scale's discriminant validity. Additionally, the overall Cronbach's α was 0.733, and a two-week test-retest showed an intraclass correlation coefficient of 0.767, indicating good reliability.

CONCLUSION

The Role Strain Scale for male nursing students is the first developed with satisfactory reliability and validity. This scale helps understand the role strain experienced by male nursing students and supports future nursing education and policy-making initiatives. It is recommended to validate the applicability of this scale across different cultures and countries to gain a more comprehensive understanding of the role strain phenomenon among male nursing students.

Digital divide or digital exclusion? Do allied health professionals' assumptions drive use of telehealth?

IntroductionTelehealth use within allied health services currently lacks structure and consistency, ultimately affecting who can, and cannot, access services. This study aimed to investigate the factors influencing allied health professionals' (AHP) selection of consumers and appointments for telehealth.MethodsThis study was conducted across 16 allied health departments from four Australian hospitals. Semi-structured focus groups were conducted with 58 AHPs. Analysis was underpinned by Qualitative Description methodology with inductive coding guided by Braun and Clarke's thematic analysis approach.ResultsSix themes were identified that influenced AHPs' evaluation of telehealth suitability and selection of consumers. These included the following: (1) ease, efficiency and comfort of telehealth for clinicians; (2) clear benefits of telehealth for the consumer, yet the consumers were not always given the choice; (3) consumers' technology access and ability; (4) establishing and maintaining effective therapeutic relationships via telehealth; (5) delivering clinically appropriate and effective care via telehealth; and (6) external influences on telehealth service provision. A further theme of 'assumption versus reality' was noted to pervade all six themes.DiscussionClinicians remain the key decision makers for whether telehealth is offered within allied health services. Ease and efficiency of use is a major driver in AHP's willingness to use telehealth. Assumptions and pre-conceived frames-of-reference often underpin decisions to not offer telehealth and present major barriers to telehealth adoption. The development of evidence-based, decision-support frameworks that engage the consumer and clinician in determining when telehealth is used is required. Services need to actively pursue joint decision-making between the clinician and consumer about service delivery preferences.

Hope for the Future: Key Informants' Perspectives on HIV Prevention in Dominican Republic Batey Communities: A Qualitative Description Study

ABSTRACT

The purpose of our study was to understand the interlocking spheres of cultural identity and health behaviors related to HIV prevention within Haitian migrant batey communities in La Romana, Dominican Republic. A qualitative description design was employed using the PEN-3 model by Airhihenbuwa (1990) as a theoretical framework. Data were collected through semi-structured interviews with 12 key informants. Participants, primarily adults of Hispanic (10) and African descent (2), ranged from 33 to 53 years old, with a majority having high school or higher education. A central theme, "Hope for the Future," emerged, highlighting five subthemes: stigma/discrimination, religious beliefs, voodoo tenets, community nurturers, and HIV education. Findings emphasized the need for a multifaceted approach using community health workers and incorporating local cultural contexts, including religious beliefs and stigma, to enhance HIV prevention efforts. Cultural identity of Haitian migrant batey communities included religious beliefs, stigma, and cultural practices as considerations in HIV prevention interventions.

"It Just Rips My Heart Out": Child Custody Dispositions After Women Leave Abusive Partners

Family court child custody dispositions for women who have left violent partners can result in complications and difficulties. This secondary analysis of data from 2005 to 2009 describes the child custody dispositions of 369 Canadian women survivors of intimate partner violence (IPV) (48.5% Indigenous, 44.7% White, and 6.4% Visible Minority). Of these, the most common court disposition was mothers receiving sole custody (38.9%), then those who did not use formal custody (34.5%), joint custody (13.3%), fathers receiving sole custody (4.4%), and family court still in progress (8.8%). Mothers' perspectives about these dispositions were qualitatively analyzed. Implications for researchers and practitioners are presented.

Breaking the chain from the chair: a manager's perspective on reducing employees sedentary time in a home-office context

BACKGROUND

Office workers have the highest estimated daily sedentary time (ST). The Covid-19 pandemic resulted in a switch from office-based work to home-office work or a hybrid of both. Home-office work has been shown to increase ST compared to the office, which may have deleterious health consequences.

OBJECTIVE

This study explored managers perspectives on the factors influencing their employee's ability to reduce ST in a home-office context.

DESIGN

A descriptive qualitative study.

METHODS

Semi-structured interviews (n = 20), which were mapped to the COM-B model, were conducted with managers from Ireland, Spain and The Netherlands. Interviews were conducted through Zoom, recorded and transcribed verbatim. A reflexive thematic analysis approach was used.

RESULTS

Organisational support, management engaging in physical activity (PA) during work and a social element were seen as key to increasing engagement in interventions. Creating opportunities for employees to engage in PA during work was seen as another key element. Leveraging infrastructure put in place during the Covid-19 pandemic was identified as a feasible approach to providing education and encouragement to employees. Lastly, managers feared the impact reducing ST may have on the performance of both employees and the organisation, yet, managers felt an increase in employee well-being would benefit their company long-term.

CONCLUSION

These results highlight the need to include organisational support and leadership from management, ensuring a top-down approach. These changes may create opportunities for employees to reduce their ST while working from home, which may benefit both the employees' and organisations.

Adapting the Role of Doulas to Enhance Supports for Perinatal People with Substance Use Disorders

PURPOPSE

There is a gap in the current literature regarding how doula care may be implemented into existing systems in Montana to best address the needs of individuals with substance use disorders (SUDs) during the perinatal period. Doulas may be particularly well positioned to reach a diverse range of patients, allowing them to feel supported and advocated for within the medical system. This study aims to illustrate the perspectives and experiences of doulas, individuals who have experienced perinatal SUDs, and maternal and mental health providers.

MATERIALS AND METHODS

A qualitative descriptive research methodology was used to conduct qualitative semi-structured interviews with 29 participants.

RESULTS

Through these interviews, three overarching themes emerged: the necessity of doula workforce development to enhance sustainability when working with individuals with SUDs; reducing financial and structural barriers that prevent clients with SUDs from accessing doula care; and working to promote the acceptability of SUD-focused doulas in the healthcare system.

DISCUSSION AND CONCLUSION

These findings highlight areas of possible intervention to broaden the use of doulas for perinatal individuals with SUDs.

What Motivates Older Sedentary People Living With HIV in the United States to Participate in an Exercise Trial? A Qualitative Study

ABSTRACT

Although exercise supports the physical function and health of older people living with HIV (PLWH), less than half of PLWH globally achieve recommended levels of activity. A qualitative descriptive design was used to determine what motivates sedentary PLWH, 50 years and older, to participate in an exercise trial. Interviews were conducted with PLWH who participated in an exercise trial ( n = 30) and PLWH who declined enrollment in the same exercise trial ( n = 4). The theory of planned behavior (TPB) guided a directed content analysis of the interviews. Data analysis identified four themes: (a) intention or motivation (perceived benefits, maintaining the exercise behavior over time), (b) attitudes (goals and preferences), (c) perceived behavioral control (barriers, facilitators, and self-efficacy), and (d) subjective norms (pressure from health care providers and social networks). Findings from our study contribute to informing the development of future exercise interventions or trials and to planning care to encourage a physically active lifestyle.

"When We First Split up, He Took the Kids and Ran": Child Abductions in the Context of Intimate Partner Violence

After separation because of intimate partner violence (IPV), fathers may threaten to or abduct children. In these mixed methods secondary analysis of a data set from 2005 to 2009 with 370 Canadian mothers, 242 (65.4%) of fathers had not threatened abduction, 70 (18.9%) had threatened abduction, and 58 (15.7%) had abducted children. The women with abduction histories reported more serious IPV on several Composite Abuse Scales. Seventy-one women commented about abductions: 36 described actual but brief abductions, 17 described more serious abductions, and 18 noted their partners' direct threats to abduct. Recommendations to better address mothers' issues about abductions are provided.

Tough choices: the experience of family members of critically ill patients participating in ECMO treatment decision-making: a descriptive qualitative study

BACKGROUND

ECMO treatment for critically ill patients mostly requires family members to make surrogate decisions. However, the process and experience of family members' participation in decision making have not been well described.

PURPOSE

To explore the experience of family members of critically ill patients who were asked to consent to ECMO treatment and to gain insight into the factors that promote and hinder their decision-making.

METHODS

A descriptive qualitative study. Data were collected using a semi-structured interview method and analysed using traditional content analysis approaches. The cohort included nineteen family members of critically ill ICU patients from a general hospital in China.

RESULTS

Eleven family members consented to ECMO treatment, and 8 refused. 4 themes and 10 subthemes emerged: (1) tough choices: the dilemma in the emergency situation, the guilt and remorse after giving up; (2) rationalisation of decision-making: ethics and morality guide decision-making, expected efficacy influences decision making, and past experience promotes decision making; (3) decision-making methods: independent decision-making, group decision-making, decision making based on patient preferences; (4) influencing factors of decision making: information and communication, social support.

CONCLUSION

The findings provide insights and a basis for promoting efficient ECMO decision-making in clinical practice. It may be difficult to improve the time it takes to make the decision without sacrificing the quality of the decision. Healthcare professionals should provide timely emotional support, informational support, and comprehensive social support to assist them in making efficient decisions while respecting the treatment preferences of the decision-makers.

Experience of Acceptance and Commitment Therapy for those with mild traumatic brain injury (ACTion mTBI): A qualitative descriptive study

Psychological interventions may make a valuable contribution to recovery following a mild traumatic brain injury (mTBI) and have been advocated for in treatment consensus guidelines. Acceptance and Commitment Therapy (ACT) is a more recently developed therapeutic option that may offer an effective approach. Consequently, we developed ACTion mTBI, a 5-session ACT-informed intervention protocol. To establish the feasibility of this intervention, we wanted to understand participants' experiences of ACTion mTBI, determine acceptability and identify any refinements needed to inform a full-scale effectiveness trial. We recruited adults (≥16 years of age) diagnosed with mTBI who were engaged in community-based multidisciplinary rehabilitation. After completing the ACTion mTBI sessions, 23/27 (85.2%) participants (mean time post-injury: 28.0 weeks) completed a semi-structured interview about their experience of the intervention. Interviews were audio-recorded, transcribed verbatim and analysed using a qualitative description approach. There were two overarching themes 1) attacking the concussion from a different direction and 2) positive impact on recovery which depicted participants' overall experiences of the intervention. Within these overarching themes, our analysis also identified two subthemes: 1) helpful aspects of the intervention which included education and ACT processes (i.e., being present and being able to step back) and 2) "contextual factors that enabled intervention effectiveness" which included being equipped with tools, cultural and spiritual responsiveness, the therapeutic connection, and the intervention having a structured yet flexible approach to order of delivery to meet individual needs. Participants' experiences support acceptability, cultural and spiritual responsibility of ACTion mTBI. Suggested refinements included enabling access to intervention over time, not just at one point during recovery and the addition of a brief check-in follow-up.

A park-based group mobility program for older adults with difficulty walking outdoors: a qualitative process evaluation of the Getting Older Adults Outdoors (GO-OUT) randomized controlled trial

BACKGROUND

The Getting Older Adults Outdoors (GO-OUT) randomized controlled trial showed that a workshop and 10-week park-based outdoor walk group (OWG) was superior to the workshop and 10 weekly reminders (WR) with increasing walking capacity, but not outdoor walking activity, health-promoting behavior, or successful aging, among older adults with difficulty walking outdoors. The objective of this planned process evaluation was to explore participants' perceptions of mechanisms of impact of and contextual factors influencing experiences with the interventions to help explain the observed intervention effects on study outcomes.

METHODS

A qualitative descriptive study involving semi-structured interviews conducted at 6-months post-baseline was conducted. A directed content analysis was undertaken.

PARTICIPANTS

We interviewed 27 adults (52% male, 48% female, mean age 76 years) from the OWG (n = 13) and WR group (n = 14).

RESULTS

We identified two themes including: "Holding Me Accountable to Walk More Frequently", and "We Walked Farther, With More Ease and Confidence, and We Felt Better". Participants in both groups described how the OWG and WR programs provided some degree of structure and accountability to others that increased their motivation to walk outdoors. Participants described how the OWG led to improved walking capacity (e.g., increased walking distance) and confidence. Interacting with people during OWG sessions led to a sense of enjoyment, and well-being.

CONCLUSIONS

Community programs that incorporate structure, accountability, and opportunities for social interaction, can help improve motivation to increase outdoor walking activity and a sense of belonging for older adults with difficulty walking outdoors. Park-based OWG programs appear to convey additional important benefits related to improved physical function and well-being.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03292510 Date of registration: September 25, 2017.

Boosting hospital falls prevention using health assistant staff alongside usual care

OBJECTIVES

Patient education is crucial for preventing hospital falls, yet workforce constraints can hinder targeted delivery. Utilising supervised healthcare assistants can enhance standard care. This study sought to understand factors that impact the feasibility of supplementing usual care with patient falls education delivered by supervised allied health assistants.

METHODS

In a qualitative study nested within a randomised controlled trial, focus groups and interviews were conducted with twelve health assistants, seven allied health professionals and two managers from the participating hospital. This elicited insights on barriers and facilitators to implementing workforce redesign to deliver tailored patient falls education. An inductive approach was used to thematically analyse the data.

RESULTS

Three key themes emerged: (i) it was feasible for health assistants to deliver hospital patient education; (ii) patients engaged with hospital falls prevention education delivered by assistants; (iii) hospital workforce redesign can be successfully implemented provided there is system-wide buy-in.

CONCLUSIONS

Health assistants can be trained to successfully deliver hospital falls prevention education provided they have adequate supervision, training, and resources.

PRACTICE IMPLICATIONS

Sustained implementation requires dedicated staffing hours for service delivery and staff education.

Walking, talking, playing: Children with disabilities' outdoor play in French mainstream schools

BACKGROUND

Children's right to play remains underexplored in French mainstream schools. France's inclusive education policies aim to include children with disabilities in mainstream classrooms, but this transition can create challenges hindering meaningful play opportunities. This highlights the importance of gaining a deeper understanding of children's experiences of play in school playgrounds.

AIM

This study explores children with disabilities' experiences and perspectives on their outdoor play in French mainstream school playgrounds.

MATERIAL AND METHODS

Walking and Talking tour interviews were conducted with thirteen children with various disabilities across six mainstream schools in western France. Data were audio-recorded, transcribed verbatim and analysed using thematic analysis.

RESULTS

(1) 'I can(not) play': Environmental Barriers and Opportunities; (2) 'I have an idea': Children's Preferences for Enriching Play and Inclusion; (3) 'Learn to Hear Me Out': Strengthening Children's Participation in Everyday School Practices including Playground Redesign.

CONCLUSIONS AND SIGNIFICANCE

This study highlights the barriers children with disabilities face in French mainstream school playgrounds. It emphasises the need for collaborative co-design to create inclusive and playful environments. Findings have implications for occupational science, inclusive education, school-based occupational therapy, and urban design. Future participatory research should explore the co-design of school playgrounds, involving all relevant stakeholders.

Development and Validation of the Self-Management Questionnaire for Patients with Lower Extremity Arterial Disease Who Underwent Endovascular Revascularization

Introduction

To develop and psychometrically validate the Self-management Questionnaire for Patients with Lower Extremity Arterial Disease Patients Who Underwent Endovascular Revascularization (LESQ).

Methods

We developed the LESQ and validated it in a Chinese population. A three-round cross-sectional descriptive survey in six hospitals in China, involving samples of 271, 269, and 623 participants, respectively. The surveys were conducted between February 2021 to March 2022.

Results

The final version of the LESQ, with 22 items, was divided into three domains using exploratory factor analysis: medical management, rehabilitation exercise management, and daily life management. The questionnaire had good internal consistency reliability, with a Cronbach's α of 0.953 and good retest reliability, with the coefficients of 0.917, respectively. The content validity of the LESQ was 0.939. The three domains of the questionnaire were confirmed by confirmatory factor analysis. The optimal cut-off points were 52 and 70, respectively, using latent profile analysis.

Discussion

The LESQ is a new self-report questionnaire for measuring self-management ability with good reliability and validity through validation.

Acceptability and usability of the Planning Advance Care Together (PACT) website for improving patients' engagement in advance care planning

Objectives

Most prior advance care planning (ACP) interventions lack integration of the social context of patients' ACP process, which patients indicate is critically important. The current study developed the Planning Advance Care Together (PACT) website to foster inclusion of loved ones in the ACP process.

Methods

To provide feedback about the PACT website, patients with advanced cancer (N = 11), their caregivers (N = 11), and experts (N = 10) participated in semi-structured interviews. Patients and caregivers also completed standardized ratings of acceptability and usability.

Results

Overall, patient (n = 11) and caregiver (n = 11) ratings of acceptability and usability of the website exceeded benchmark cut-offs (≥24 on the Acceptability E-Scale and ≥ 68 on the System Usability Scale). Patients, caregivers, and experts liked the topic of ACP but felt that it could be emotionally challenging. They recommended focusing more on planning and less on end of life. They appreciated being able to include loved ones and recommended adding resources for caregivers.

Conclusions

Study findings support the preliminary usability and acceptability of the PACT website. Findings will be used to inform a modified prototype of the PACT website that is interactive and ready for field testing with patients with advanced cancer and their loved ones.

Innovation

We utilized a novel application of the shared mind framework to support patients with advanced cancer in engaging their loved ones in the ACP process.

"He Stole My Meds to Get High:" The Mental Health and Well-Being of Women Abused by Intimate Partners and Their Disability Status

While population-based research confirms that women with disabilities abused by their intimate partners experience significant mental health issues, few studies compare this in intimate partner violence (IPV)-specific samples of women with or without disabilities and none analyze possible impacts based on disability type. This secondary mixed methods analysis examined 660 Canadian women (50.6% Indigenous, 43.1% White, and 6.1% visible minority) with respect to whether they reported having a disability that impacted their employability or daily living (291 or 44% yes; 369 or 56% said no). In the 291 women with disabilities, about one-third (30.7%) had a physical disability-only, one-quarter had a mental health disability-only, and 44.1% reported both physical and mental health disabilities. Women with mental health and both physical and mental health disabilities reported significantly more Severe Combined IPV on the Composite Abuse Scale, depression (CES-D-10; Center for Epidemiological Studies-Depression), psychological distress (Symptom Checklist Shortform-10; SCL-10; in the clinical range), PTSD symptoms (PTSD Checklist), and lower quality of life (Quality of Life Questionnaire or QoL-9) than women without disabilities. Education about disabilities is needed for IPV advocates and disability practitioners need education about IPV. Developing services specific to survivors of IPV with disabilities is recommended.

Management of a Dual Low Sodium and Diabetic Diet by Patient-Caregiver Dyads: A Qualitative Descriptive Study

PURPOSE

The purpose of the study was to explore factors surrounding management of simultaneous dietary recommendations for heart failure and type 2 diabetes among patient-caregiver dyads.

METHODS

Qualitative description was used to explore dyad experiences managing a dual diet. Semi-structured interviews were conducted with patients with a concurrent diagnosis of type 2 diabetes and heart failure and their family caregiver. Each 60-minute interview was conducted virtually. Interviews were audio recorded and transcribed verbatim. Thematic analysis was conducted with coding used for themes at dyadic-and individual levels.

RESULTS

Twelve patient-caregiver dyads (N = 24) were interviewed. The mean age was 57 years (±15 years). Most participants were white (75%); patients were predominantly male, and caregivers were predominantly female (83.3% for both). Dyadic-level themes that emerged included factors that influence simultaneous management of dual diet recommendations. Themes included shared barriers, facilitators, motivators, and strategies for dual diet management. Individual-level themes discussed by patients were barriers and motivators to dual diet management, and caregivers discussed barriers to supporting dual diet management.

CONCLUSIONS

Findings from the study highlight that patients and caregivers often work together and share similar barriers, facilitators, motivators, and strategies for adhering to a dual diet. The results provide insight into chronic disease management at the family level and can guide health care providers' efforts to promote family involvement with dietary recommendations for patients with multiple comorbidities.

Factors influencing community intensive care unit research participation: a qualitative descriptive study

PURPOSE

Community hospitals account for 90% of hospitals in Canada, but clinical research is mainly conducted in academic hospitals. Increasing community hospital research participation can improve generalizability of study results, while also accelerating study recruitment and increasing staff engagement. We aimed to identify and describe the factors that influence community intensive care unit (ICU) research participation and the development, implementation, and sustainability of a community ICU research program.

METHODS

We conducted a qualitative descriptive study using semistructured interviews. Between April 2022 and May 2023, we interviewed a purposeful sample of individuals interested or involved in community hospital research in Canadian community ICUs. We analyzed qualitative data using both conventional content analysis and rapid qualitative analysis. Findings were deductively mapped out using the Ecological Model of Health Behavior. Quantitative survey data were analyzed using descriptive statistics.

RESULTS

Participants included 23 health care workers, ten research staff, and five hospital administrators (n = 38) from 20 community hospitals across six provinces in Canada. The main factors associated with community ICU research participation were 1) infrastructure, 2) personnel characteristics, 3) key relationships and connections, and 4) the COVID-19 pandemic.

CONCLUSION

In this qualitative descriptive study, participants identified the physical resources, skills, and relationships required to start and sustain a clinical research program in a Canadian community ICU. Our findings suggest that all levels of the Canadian health care system need to invest in strengthening community hospital research capacity to increase research participation.

People with type 2 diabetes experiences of using WhatsApp-based diabetes self-management education and support: The process evaluation

RATIONAL

Online Diabetes Self-Management Education and Support (DSMES) offers people with type 2 diabetes mellitus (T2DM) accessible and tailored education, utilising innovative and interactive tools such as social media to enhance engagement and outcomes. Despite the demonstrated effectiveness of social media-based DSMES in improving health outcomes, there remains a significant gap in qualitative insights regarding participants' experiences.

AIM

This study aims to explore the experiences of people with T2DM who are using a newly developed WhatsApp-based DSMES.

METHODS

A qualitative descriptive approach was adopted. Data consisted of 23 semi-structured phone interviews with people with T2DM who had received the WhatsApp-based DSMES. Interviews were analysed using qualitative content analysis. The present study adheres to the COREQ guidelines.

RESULTS

Four themes emerged from the data: (1) acceptability of the programme, (2) flexible accessibility of the programme, (3) promoting healthy lifestyle and (4) future preferences for the programme use.

CONCLUSION

This study explored the experiences of people with T2DM participating in a 6-week WhatsApp-based DSMES. The findings indicated that the programme was acceptable, accessible, effectively revealing necessary self-management knowledge and skills, and provided essential support from professional and peer. The study also indicated that WhatsApp-based programmes could be feasibly implemented in various populations, healthcare settings and communities to support people with T2DM globally.

A Bibliometric Analysis of the Top 100 Cited Qualitative Research Papers in Dentistry From Scopus (1998-2024)

This bibliometric analysis aimed to identify trends among the top 100 most cited qualitative research articles in dentistry. Articles were retrieved from the Scopus database and screened based on predefined inclusion and exclusion criteria. The final set of 100 articles was then analyzed in R Studio (RStudio Team, Boston, MA) to assess performance metrics, including publication and citation trends, citation-publication relationships, and science mapping. Science mapping offers insights into citation analysis, co-citation analysis, bibliographic coupling, co-word analysis, and co-authorship patterns. The top 100 articles had citation counts ranging from 11 to 606, with publication dates spanning from 1998 to 2021, and were coauthored by 351 individuals across 35 different journals. Most papers originated from Europe, followed by North America and Asia. The United Kingdom contributed the most articles (27), and BMC Oral Health was the most frequently cited journal. Among the 351 authors, Hallberg U. was the most cited. The predominant study design was descriptive quantitative. Keyword analysis revealed diverse thematic groupings, reflecting the broad scope of qualitative research in dentistry. Key trending topics included dental care, attitude to health, child, health behavior, dental caries, clinical competence, psychological aspects, and motivation. This bibliometric evaluation provides an overview of qualitative research trends in dentistry and offers valuable insights to guide future research, emphasizing the need for high-quality qualitative studies across various dental fields to strengthen evidence-based practice.

"Men Need Role Models": Exploring the Facilitators and Barriers for Yoga Participation Among Men

Yoga is a holistic form of physical activity taken up for various reasons, including physical and mental health, and sometimes spirituality. Despite the growing popularity of yoga as a form of health-enhancing physical activity, data show the uptake among men to be consistently low compared to women. To gain an understanding of barriers and facilitators for yoga uptake and adherence among men, four focus group discussions (three male groups, one female group) and three individual interviews were undertaken. Using thematic analysis, three themes were developed: (a) encouragement, advice, and support from trusted others, (b) confronting gender-related perceptions and issues, and (c) getting to the benefits. The findings suggest that men are more likely to take up yoga when encouraged by trusted others and male role models. Men face gender-related challenges that can be overcome by educating them about yoga, focusing on its physical benefits, and experiencing the benefits of yoga firsthand. To encourage more men into yoga, yoga teachers need to create an inclusive environment that welcomes men and caters to their needs. These findings provide valuable insight into the unique challenges experienced by men in pursuing and practicing yoga regularly. They may be used to develop targeted recruitment and marketing strategies to draw more men into yoga and encourage them to stay, which is essential for experiencing the many long-term health benefits of yoga.

Service-policy gaps in the settlement journey of Arabic-speaking immigrant newcomer and refugee older adults in Edmonton, Canada

Immigrant newcomers and refugees (INRs) are two migrant categories that experience consistent systemic barriers to settlement and integration in Canada as older adults. This paper explores the challenges experienced by Arabic-speaking INR older adults in Edmonton, Canada, during settlement and discusses policy and service implications. A qualitative description study using community-based participatory research principles was implemented to evaluate and support digital literacy in Arabic-speaking INR older adults. We included men and women aged 55 and older who identified as immigrants or refugees and spoke Arabic. Experiences of settlement challenges were consistently identified during data collection and engagement of INR older adult participants. A thematic sub-analysis of interviews with (10 individuals and one couple) of participants' narratives was completed in 2022 and was used to identify themes related to settlement barriers for this population. Two main themes were identified: (1) Limited English skills and digital literacy gaps create service barriers for INR older adults, and (2) Gaps in services and policies as basic needs remain unmet. We describe key challenges experienced by INR older adults, such as language barriers, precarious finances, poor access to health care services and lack of transportation and employment opportunities, which hinder successful integration into the new society. This study showcases the ongoing challenges with early settlement and integration that continue despite Canada's well-developed immigration settlement landscape. INR older adults often remain invisible in policy, and understanding their experiences is a first step to addressing their needs for resources that support healthy aging in the post-migration context.

Healthcare professionals' perceptions on providing support to informal carers within stroke care

BACKGROUND

The sudden nature of stroke onset does not provide carers with sufficient time to prepare for the demands associated with caring. Healthcare professionals can have a vital role in providing carers with support and training, which may reduce carer stress and strain, and allow for better health and rehabilitation outcomes for the stroke survivor. The experiences of healthcare professionals on supporting carers in stroke care, however, remain unclear.

OBJECTIVE

To understand the experiences and perceptions of healthcare professionals working in stroke care on implementing resources and support to informal stroke carers.

METHODS

Semi-structured interviews were conducted with 11 healthcare professionals (5 occupational therapists, 5 physiotherapists, 1 psychologist) with at least 12 months' experience in working with stroke survivors. Interviews ranged from 25-70 minutes in duration, and were recorded, transcribed, and analysed using thematic analysis.

RESULTS

Three overarching categories that were explored were: (1) Experiences of working in stroke care and supporting carers; (2) Recommendations for a program designed for carers; and (3) Future priorities in stroke care. Participants discussed a variety of strategies they utilised to support carers including collaborating with other healthcare professionals and utilising skills and experience. Healthcare professionals highlighted the need for additional resources that are designed specifically for carers and explored key topics including carer stress and fatigue, support services, stroke education, and how to look after oneself. Participants identified priorities for stroke care including additional professional training and resource availability.

CONCLUSION

This study provided a unique insight from the perspectives of healthcare professionals on supporting carers. Participants identified the need for additional training and resources to equip healthcare professionals to better support carers. Future programs designed for carers should be informed by the needs and experiences of both informal carers and healthcare professionals.

A Worked Example of Qualitative Descriptive Design: A Step-by-Step Guide for Novice and Early Career Researchers

AIM

To provide a worked example informed by relevant literature and related studies that novice and early career researchers may use to reflect on, prepare and conduct a thoughtful and rigorous qualitative descriptive study.

DESIGN

Methodological discussion of qualitative descriptive design.

METHODS

Seminal work and recent related literature were reviewed to situate the discussion and identify the concepts and steps to conduct a qualitative descriptive study.

RESULTS

Qualitative descriptive design is widely used in nursing and health science research. This design offers flexible use of qualitative methods, which presents a double-edged sword, posing challenges in preparing a well-developed study and achieving methodological rigour. The design often borrows methods from other qualitative traditions, which may need to be clarified for novice and early career researchers, wherein studies may be conducted using a mix and match of methods without giving justice to the heart of qualitative descriptive design. In this paper, we present a step-by-step guide, using a worked example, to demonstrate how to conduct a qualitative descriptive study.

CONCLUSION

Qualitative descriptive design may be confusing due to its flexibility, which may limit the scope of research and subsequently, the quality and impact of the findings. With the appropriate application of research methods producing high-quality and relevant findings, qualitative descriptive design is a valuable qualitative method in its own right.

IMPLICATIONS FOR THE PROFESSION

Novice and early career researchers may increase the impact of their findings through rigorously conducting their studies. Clarifying steps for thoughtful execution may inform novice and early career researchers, allowing for a rigorous application of the method, which, in turn, may contribute to impactful findings.

IMPACT

A clear presentation of steps, supported by a worked example and related studies, may support novice and early career researchers in conducting a qualitative descriptive study with methodological rigour.

REPORTING METHOD

Not applicable.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Improve disaster literacy in nurses: a qualitative descriptive study

BACKGROUND

The enhancement of nurses' disaster literacy is crucial for effective disaster emergency management, especially for clinical nurses with no prior experience in disaster rescue. This study aims to explore the perspectives of nurses who have been involved in disaster rescue operations on strategies to advance nurses' disaster literacy.

METHODS

A qualitative descriptive study, which follows unified qualitative study reporting guidelines. Thirty disaster rescue nurses were recruited to participate in this study, who came from 30 third-class hospitals in China. From October to December 2021, information was acquired by conducting semi-structured telephone interviews with participants. Qualitative content analysis was used to examine the data.

RESULTS

Six categories and eleven subcategories were created. Strengthening disaster education and training was the main focus, and its subcategories included continuing education, nursing curriculum development, and disaster rescue experience guide. The second focus, which included scene simulation, actual combat/military simulation, and virtual reality simulation, was strengthening disaster simulation and drill. The third focus was on providing psychosocial support, which included improving self-psychological adjustment, developing resilience, and engaging in active coping. The fourth category was to strengthen nurse/hospital managers roles and leadership, which included enhancing professional identity and policies/leadership support. The fifth category was disaster preparedness, and the sixth was enhancing knowledge transformation.

CONCLUSIONS

Government agencies or healthcare organizations should actively promote the formation of nurses' disaster literacy from multiple viewpoints. Disaster education and training, simulation exercises, and psychosocial support should be prioritized.

Partner and social support in childbearing and rearing in a Gulf Coast Native American community

Objective

This study sought to understand the roles of partners in pregnancy, childbirth, and childrearing in Indigenous communities. It explores supportive and unsupportive attitudes in the relationships mothers experienced, and how these relationships affected their lives.

Background

Settler colonialism has negatively impacted Indigenous communities. However, little research has explored how it has influenced partner and social support during the perinatal time period.

Methods

Through 31 semistructured interviews with women from a tribe in the southeastern United States, participants described their experiences with supportive and unsupportive partners and how that shaped their experiences during pregnancy, childbirth, and childrearing.

Results

Participants described themes of (a) supportive and unsupportive partner relationships, (b) importance of partner support in childbirth, and (c) mothers as primary caregivers.

Conclusion

Results suggest that women experienced a wide range of partner relationships, and they relied more on their female family members to provide support during this time, rather than counting on their male counterparts.

Implications

Health care providers may want to take these findings into consideration when approaching their patient's care. These findings indicate that the impacts of settler colonialism continue to impact family relationships for the participants in this study.

Needs of children with neurodevelopmental disorders and medical complexity: Caregiver perspectives

BACKGROUND

Caregivers of children with neurodevelopmental disorders and medical complexities (NDD-MC) coordinate care across complex multisectoral systems. Often NDD-MC children have complex behaviors, however there is limited information on coordination needs for families.

AIM

The objective of this mixed methods study was to understand the needs of families with NDD-MC children.

METHODS AND PROCEDURES

 This sequential exploratory study obtained the perspectives of 67 caregivers of NDD-MC children using semi-structured interviews and validated questionnaires to measure family quality of life, care integration, and resource use. An adapted model using Maslow's hierarchy of needs was integrated, to understand the impacts of caregiving on quality of life.

OUTCOMES AND RESULTS

Lack of support in caring for NDD-MC children negatively impacted family quality of life, resulting in various unmet needs, including caregiver burden, behavioural challenges, financial losses, and mental health issues. Caregivers dealt with a fragmented healthcare system that offered limited support to address coordination challenges.

CONCLUSIONS AND IMPLICATIONS

The implementation of a needs-based care coordination program is recommended to consider the health, educational, and social needs of NDD-MC children and their families. Effective care for children with complex needs should tailor support for families using Maslow's hierarchy to enhance quality of life.

Mobile breast screening services in Australia: A qualitative exploration of perceptions and experiences among rural and remote women aged ≥75 years

OBJECTIVE

This qualitative descriptive study draws on data collected from a sub-sample of 15 women participating in a national study (n = 60) exploring the breast cancer screening motivations and behaviours of women aged ≥75 years. The study aimed to understand why women living in rural and remote areas might continue accessing mobile breast cancer screening despite being outside the targeted age range.

SETTING

Settings ranged from large towns to very remote communities (according to Monash Modified Model (MMM) classification 3-7) where BreastScreen Australia mobile screening services were available.

PARTICIPANTS

Interview data from 15 women aged ≥75 years living in rural and remote locations who had used mobile screening services was utilised for this study.

DESIGN

In-depth individual interviews were conducted via telephone or online platform (Zoom). These were transcribed verbatim and imported into NVivo software to enable thematic analysis to identify key themes.

RESULTS

Many women aged ≥75 years in rural and remote areas expressed clear intentions to continue breast cancer screening, despite no longer being invited to do so. They perceived great value in the mobile service and were highly appreciative for it yet acknowledged limited sources of information about the process of ongoing screening.

CONCLUSION

Few women in rural and remote areas had discussed ongoing breast cancer screening with their general practitioner (GP). More information is required to inform women about the risks and benefits of ongoing screening. Without an invitation to attend screening rural women reported difficulty in knowing when the service would be available. Ongoing notification of the availability of mobile services for women aged ≥75 years in rural areas is recommended.

Seeking the aim - perspectives of asylum seekers, nurses, and authorities on the objectives of the asylum seekers' initial health assessment: a qualitative study

BACKGROUND

A voluntary and free initial health assessment is offered to all asylum seekers upon arrival in Finland. The central aim of this initial health assessment is early identification of service needs. There is, however, limited information on how effective the initial assessment is in fulfilling its aims. This study explores the viewpoints of asylum seekers, reception centre nurses, and health authorities regarding the objectives of the initial health assessment. It serves as a starting point for effectiveness research, where effectiveness is defined as the achievement of intended aims.

METHODS

This qualitative descriptive study is based on 31 semi-structured individual interviews (13 asylum seekers, 14 nurses, and four asylum health authorities) conducted in January and February 2019. Reflective thematic analysis was employed for data analysis, involving initial separate analyses for each group, followed by an assessment of differences and similarities between the groups.

RESULTS

The importance of a comprehensive initial health assessment and preventing infections was emphasized by all groups. The main differences were views on service needs assessment in relation to persons in vulnerable situation and information provision. All groups described both individual and public health perspectives.

CONCLUSIONS

This study provides valuable insights for developing a more effective assessment. Asylum seekers require comprehensive health assessment and details about their rights. To address these needs, it is crucial to update reception centre nurses' practices. Additionally, authorities responsible for planning and guiding services should refine their instructions concerning the information provided to asylum seekers and persons in vulnerable situations. The findings of this study can be used to enhance information provision and develop targeted training programs for nurses, as well as to evaluate the achievement of established aims.

Considerations for Voice and Communication Training Software for Transgender and Nonbinary People

Transgender and gender diverse people often experience voice-gender incongruence, which is inversely correlated with health and quality of life. Such incongruence could be reduced with voice and communication training, but expert-administered training is often inaccessible while self-guided training is difficult and potentially risky. Training could alternatively be provided through software (eg, smartphone apps), but such software is at an early stage. This qualitatively driven mixed-methods study thus includes surveys and interviews with 21 transfeminine, transmasculine and nonbinary people to identify general views of voice and communication training software as well as most desirable features of such software. Participants were positive about the general idea and described ways to effectively implement four critical features: feedback, accountability, automated goal setting, and training characteristics other than pitch. They also discussed optional or undesirable features. These findings may inform development of voice and communication training software, thus improving health and quality of life for gender minorities.

"Is It Realistic?": A Qualitative Study of the Experiences of Elite Women Athletes Considering Parenthood

BACKGROUND AND OBJECTIVE

As the visibility and acceptance of athlete-mothers increase, so does the number of women athletes considering parenthood. Yet, many athletes struggle with the decision to become a parent while competing at the elite level due to the significant changes and uncertainties that have been reported by pregnant and parenting athletes. The experiences of women athletes considering parenthood are under-represented in the vast sport literature but are necessary for developing evidenced-based policies and practices that can support women's equitable participation in high-performance sport contexts. Thus, the purpose of this qualitative study was to describe the experiences of elite women athletes that are considering parenthood.

METHODS

Participants were ten elite North American athletes (29-36 years) who are considering becoming parents in the next 5 years. Each participant self-identified as a woman and competed at the highest level in their respective sport. Data were generated via one-on-one semi-structured interviews that were audio-recorded, transcribed verbatim, and analyzed through a process of content analysis.

RESULTS

The experiences of elite women athletes considering parenthood are represented by five themes: (a) calls for essential mandates and leadership, (b) how do you support yourself?, (c) hesitation of body changes, (d) age inequities, and (e) being proactive about reproductive health. Such findings support an in-depth understanding of gender-specific stressors that limit women's equitable participation in high-performance contexts.

CONCLUSION

This research is grounded in the voices of elite women athletes and identifies actionable steps necessary for research and culture change. Findings provide necessary evidence to inform the development of sport policies to support those athletes that are considering becoming parents.

Intergenerational Influence of African American, Caribbean and Hispanic/Latino Adults Regarding Decision to Participate in Health-Related Research

Introduction: Identifying effective strategies to enroll African American, Caribbean, and Hispanic/Latino adults ≥65 years of age in health research is a public health priority. This study aimed to explore intergenerational influence (IGI) among these populations living throughout Florida. Methods: African American, Caribbean, and Hispanic/Latino adults ≥65 years of age and a trusted family member/friend between 25-64 years participated in virtual listening sessions (LS). Culturally matched facilitators used a semi-structured guide to lead LS that was recorded, transcribed, and uploaded into NVivo©. The constant comparative method was used for analysis. Results: 363 African American, Caribbean, and Hispanic/Latino participated in LS. Five (5) themes relate to IGI emerged: (1) parent-child relationships; (2) family caregiving/parental illness experiences; (3) historical research maltreatment; (4) transfer of cultural knowledge; and (5) future generations. Discussion: Our findings support that IGI can be leveraged to increase the participation of African American, Caribbean, and Hispanic/Latino older adults in health research.

"Diluting Its Value as a Word by Applying It to Everything": A Qualitative Study Exploring Perspectives and Practices of Mindfulness Practitioners

Objective

The aim of this research was to explore the perspective, language, description, and practices of practitioners who identify as using mindfulness techniques for a range of health and clinical conditions.

Methods

This study was guided by a qualitative descriptive methodology. Mindfulness practitioners from a variety of backgrounds that included medical, allied health, complementary and alternative medicine, and traditional Buddhism from across Australia were invited to share their perspectives. Semi-structured interviews were conducted via Zoom, telephone, and face-to-face which were audio-recorded and transcribed verbatim. The transcripts were thematically analysed.

Results

Sixteen mindfulness practitioners from Australia self-nominated to participate in this study. Overall, the interviews revealed similarities, differences and even disagreements between participants from the different modalities regarding mindfulness. Participants from similar disciplines also reported differing perspectives and nuanced opinions. Differences appeared to stem from both participant background, training, and the overall aims of their practice.

Conclusion

This research highlights the complexities of what constitutes mindfulness. This study has highlighted, across a broad cohort, that for mindfulness practitioners, their beliefs, aims, and practices are varied and influenced by a range of factors including their ideological perspectives. While the diversity and broad application of mindfulness may be one of its strengths, it may also be its weakness as its value may be diluted due to plurality of understanding and multiplicity in use. This requires careful and considered actions from mindfulness stakeholders.

Self-care challenges of patients with heart failure from the perspectives of patients and caregivers: A qualitative study

OBJECTIVE

self-care is critically important for the long-term management of heart failure (HF) patients, with caregivers playing an important role in promoting self-care. However, adherence to self-care is typically low among HF patients worldwide.

METHODS

In-depth qualitative interviews were conducted with individuals diagnosed with HF. To structure the interview guide and underpin the analysis, two established behavioral science frameworks, the Behavior Change Wheel (BCW) and the Theoretical Domains Framework (TDF), were used in this study.

RESULTS

A total of 32 participants were included (n = 16 patients, n = 16 caregivers), with themes involving: barriers included: "Self-care with Limited Capability," "Insufficient External Support," "Lack of Motivation for Self-Care." Facilitators included: "Striving to Adapt to Disease Demands," "Adequate External Support," "Positive Health Behaviors and Experiences."

CONCLUSIONS

Providing positive support to heart failure patients and their caregivers, along with cultivating intrinsic motivation for behavioral change, can enhance self-care ability.

Canadian Veterans' Experiences of Living with Chronic Pain: A Descriptive Qualitative Study

Background

An estimated 30% of veterans live with chronic pain, compared to 20% of Canadians in the general population. Veterans face health care challenges upon release from the military, increasing difficulties in obtaining chronic pain care.

Aims

We explored experiences of Canadian Armed Forces veterans living with chronic pain, their transition from military to civilian care, perceived barriers and facilitators to chronic pain care, and impacts of their pain on the domains of well-being.

Methods

We conducted a qualitative descriptive study using semistructured interviews. We used a deductive/inductive approach to derive themes and concepts from interview transcripts.

Results

Thirty-five veterans living with chronic pain participated. Participants reported that pain affected their lives in numerous ways, including negatively impacting relationships and limiting activities of daily living and leisure. They identified barriers to care, including lack of access to family doctors or health care services, reluctance to ask for help, and challenges in obtaining coverage for services from Veterans Affairs Canada. Facilitators included support from other veterans and online resources. Chronic pain had bidirectional effects on domains of well-being.

Conclusions

Experiences of pain varied among Canadian veterans, and military culture played a role in perceptions and management of pain. Barriers and facilitators to chronic pain care were highlighted from their time in the military into their transition to civilian care. Participants described the impact of chronic pain on their overall well-being. Determining whether these findings are relevant to a larger population of Canadian veterans will be important for future research and knowledge translation to improve chronic pain care for Canadian veterans.

Impact of Financial Costs on Patients' Fertility Preservation Decisions: An Examination of Qualitative Data from Female Young Adults with Cancer and Oncology Providers

Purpose: To examine the impact of financial costs on fertility preservation decisions among female young adults (YAs) with cancer. Methods: Female YAs (N = 18; aged 21-36) with a history of cancer and oncology providers (N = 12) were recruited from an National Cancer Institute-designated comprehensive cancer center in a state without insurance coverage for fertility preservation. YAs and providers completed individual interviews and a brief online assessment. Qualitative description using thematic analysis was used to identify, analyze, and report common themes. Descriptive statistics was used to characterize the sample. Results: Female YAs and oncology providers highlighted the critical role that high out-of-pocket costs play in YAs' fertility preservation decisions along with the value that enhanced insurance coverage for fertility preservation would have for increasing female YAs' access to and utilization of fertility preservation. Although providers were concerned about preservation costs for their patients, they reported that their concerns did not impact whether they referred interested female YAs to reproductive specialists. Oncology providers expressed concern about inequities in utilization of fertility preservation for female and racially/ethnically minoritized YAs that were exacerbated by the high out-of-pocket fertility preservation costs. Conclusion: Cost is a significant barrier to fertility preservation for female YA cancer patients. Female YAs of reproductive age may benefit from decision support tools to assist with balancing the cost of fertility preservation with their values and family building goals. Policy-relevant interventions may mitigate cost barriers and improve access to care.

Physical activity of children with visual impairments: intentions and behaviors of parents post intervention

PURPOSE

Physical activity (PA) can provide multiple benefits for children with visual impairments (VI). To date, little research has explored the retention effects of PA interventions for children with VI. Thus, the purpose of this study was to explore the PA experiences of parents of children with VI three months after completing a PA intervention.

METHOD

This descriptive-qualitative study was situated in the Theory of Planned Behavior. Five parents completed semi-structured interviews that were transcribed and analyzed using a thematic line-by-line analysis.

RESULTS

Four themes characterizing how parents created PA opportunities for their children with VI were constructed: (a) Teaching from Awareness (b) Advocating for Needs, (c) Engaging Family through Community, and (d) Seeking More PA Opportunities.

CONCLUSION

Parent's awareness of their child's abilities, parents' advocacy, and parents' teaching skills all helped to expose their children to new types of PA in the community. Parents reflected about a lack of consistently offered community-based PA for their children. Researchers must consider the importance of educating parents on how to teach skills, increase awareness, and advocate for more community-based PA programs.

"I am a survivor!": Violently Injured Black Men's Perceptions of Labeling After a Violent Firearm Injury

Self-appraisal after a life-altering event is a critical process for individuals, often comprised by assigned labels that may not align with an individuals' perceptions of themselves or of their situation. Existing research within this victim-survivor dichotomy largely rests in the interpersonal violence space, with a victim assuming legal recourse and wrongdoing, and a survivor associating with positive personal characteristics like grit and resilience. Much existing literature on self-appraisal after interpersonal injury is heavily concentrated within the sexual violence literature, and this study applies these concepts to a sample of Black men injured by firearms. Ten Black men enrolled in a hospital-based violence intervention program (HVIP) were interviewed to understand how they label their experience of firearm injury, and if their perceptions aligned with common labels seen among other populations and/or in other areas of study (e.g., cancer, domestic violence). Each participant assigned themselves their own label, with three labels emerging: survivor, victim and survivor, and neither victim nor survivor. The results illustrate the nuance of experiences beyond the victim-survivor dichotomy, and how labels and personal identities may shift following injury into new terms and considerations of resilience and trauma processing. More research is warranted to understand the factors that shape self-labeling within this population, including influences of masculine norms, racialized stereotypes, community context, and availability of services. Findings support public awareness campaigns to reframe surviving violence as a strength, and for community partners and practitioners to increase access to culturally competent and trauma-informed mental healthcare.

Exploring patients' and families' preferences for auditory stimulation in ICU delirium prevention: A qualitative study

OBJECTIVES

To explore the preferences of patients and families for delirium prevention by auditory stimulation in intensive care units.

RESEARCH METHODOLOGY

One-on-one, face-to-face, semistructured interviews with 17 participants (6 patients and 11 family members) were conducted at a step-down unit in a tertiary general hospital using a descriptive qualitative design. The data were analyzed via inductive thematic analysis.

RESULTS

Four major themes and ten subthemes emerged from the interviews: (1) reality orientation; (2) emotional support; (3) links to the outside; and (4) promising future.

CONCLUSIONS

The results in this qualitative study shed light on patients' and families' preferences for auditory stimulation in preventing ICU delirium. The participation of family members plays a crucial role in preventing ICU delirium. Family members can assist patients in reducing confusion about the situation by providing accurate and clear reality orientation. The emotional support and promising future provided by family members can help patients regain confidence and courage, which are often lacking in ICU patients. Linking patients to the outside world helps them stay connected, understand what is happening outside and reduce feelings of isolation.

IMPLICATIONS FOR CLINICAL PRACTICE

These findings can help health care staff gain insight into patients' and families' preferences and needs for auditory stimulation. Furthermore, these findings pave the way for crafting effective auditory interventions.

"It's a Valuable Service but a Hard Place to Be:" Women's Views About Violence Against Women Shelters

This mixed-methods secondary analysis examined VAW shelter use by 662 Canadian women abused by partners (50.5% Indigenous, 43.4% White, and 6.1% visible minority). Women who had never resided in shelters (n = 242) had less Severe Combined and Total IPV on the Composite Abuse Scale and fewer PTSD symptoms. More nonresidents worked full time and had higher incomes and no children. The 420 women residents mentioned strengths (70.4%) such as supportive staff and safety, and concerns (29.6%) about unsupportive staff and the shelter rules or facility. Some Indigenous women reported racist attitudes by shelter staff and child apprehensions. Practice implications are presented.

Exploring opportunities to strengthen rural tuberculosis health service delivery: a qualitative study with health workers in Tibet autonomous region, China

OBJECTIVES

This qualitative study aimed to explore opportunities to strengthen tuberculosis (TB) health service delivery from the perspectives of health workers providing TB care in Shigatse prefecture of Tibet Autonomous Region, China.

DESIGN

Qualitative research, semi-structured in-depth interviews.

SETTING

The TB care ecosystem in Shigatse, including primary and community care.

PARTICIPANTS

Participants: 37 semi-structured interviews were conducted with village doctors (14), township doctors and nurses (14), county hospital doctors (7) and Shigatse Centre for Disease Control staff (2).

RESULTS

The three main themes reported include (1) the importance of training primary and community health workers to identify people with symptoms of TB, ensure TB is diagnosed and link people with TB to further care; (2) the need to engage community health workers to ensure retention in care and adherence to TB medications; and (3) the opportunity for innovative technologies to support coordinated care, retention in care and adherence to medication in Shigatse.

CONCLUSIONS

The quality of TB care could be improved across the care cascade in Tibet and other high-burden, remote settings by strengthening primary care through ongoing training, greater support and inclusion of community health workers and by leveraging technology to create a circle of care. Future formative and implementation research should include the perspectives of health workers at all levels to improve care organisation and delivery.

"A shoulder to lean on during your first year"-An exploration into a Canadian post-secondary institution's peer mentor program for varsity student athletes

The transition period from high school to post-secondary can be particularly challenging for many, including varsity student-athletes (SAs). To better support SAs through this transitional experience, some institutions have created peer mentor programs. What is unclear, however, is the perceived value of these mentorship programs from the perspectives of multiple stakeholder positions. This paper contributes to the Scholarship of Teaching and Learning by presenting findings of a program evaluation that investigated the perceived value of a peer mentor program to its stakeholders. To accomplish this, semi-structured interviews were conducted with 30 participants to discuss SA's experiences with being a first year student, making the transition from high school to post-secondary studies, and also, to discuss their lived experiences with the peer mentor program developed for SAs. Using the findings from the inductive thematic analyses, the peer mentor program's effectiveness, areas of strengths, and areas of improvement are discussed to better align with the stakeholders' needs and experiences. Findings offer insights into a) the trials and tribulations of the first year SA experience, b) how peer mentor programs can better support SA's transition to post-secondary education, c) the benefits of conducting a program evaluation, and d) strategies to enhance the peer mentor program to better support students' needs.

Disaster literacy in disaster emergency response: a national qualitative study among nurses

BACKGROUND

As the largest group of healthcare professionals, nurses play an indispensable and crucial role in disaster response. The enhancement of nurses' disaster literacy is imperative for effective disaster emergency management. However, there is currently a lack of knowledge regarding nurses' disaster literacy. This study represents the first attempt to explore the key components and characteristics of disaster literacy among nurses.

METHODS

A qualitative descriptive design was employed, and the reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines (refer to File S1). The purposive sampling method was utilized. Thirty-one rescue nurses from 31 medical institutions across 25 provinces and regions in China were recruited to participate in the study. The respondents were requested to share their experiences and insights regarding disaster rescue operations. Inductive content analysis was employed for data examination.

RESULTS

The results indicated that rescue nurses universally recognized that there was a pressing need to enhance the level of disaster literacy among nurses. The disaster literacy of nurses encompasses nine dimensions: physical and mental quality, disaster rescue general knowledge, professional and technical competence, professional ethics, teamwork, emotional ability, information literacy, leadership, and knowledge transformation.

CONCLUSIONS

To ensure national sustainability, government departments, healthcare organizations, and hospital administrators can accurately evaluate the disaster literacy of individual clinical nurses, groups, and the workforce as a whole through nine dimensions, which also can provide evidence to support the development of precision strategies to strengthen the disaster literacy of nurses.

Combining the Antenatal Risk Questionnaire and the Edinburgh Postnatal Depression Scale in Early Pregnancy in Danish Antenatal Care-A Qualitative Descriptive Study

Pregnant women with a history of mental disorders, neglect, or low social support are at increased risk of mental health problems. It is crucial to identify psychosocial risk factors in early pregnancy to reduce the risk of short- and long-term health consequences for mother and child. The Antenatal Risk Questionnaire has been found acceptable as a psychosocial screening tool among pregnant women in Australia, but it has not been tested in a Scandinavian context. The aim of this study was to explore the experiences of pregnant women when using the Antenatal Risk Questionnaire and the Edinburgh Postnatal Depression Scale as part of a model to identify psychosocial vulnerabilities in pregnancy in Denmark. We conducted individual interviews (n = 18) and used thematic analysis. We identified two main themes: (1) Feeling heard and (2) An occasion for self-reflection. Overall, the pregnant women deemed the online ANRQ/EPDS acceptable as a screening tool. The screening model provided a feeling of being heard and provided an occasion for self-reflection about mental health challenges related to pregnancy and motherhood. However, some women expressed that the screening raised concerns and fear of the consequences of answering honestly. A non-judgmental, open, emphatic, and reassuring approach by clinicians may help reduce stigma.

Experiences of using the MINDSET Self-Management mobile health app among Hispanic Patients:Results of a qualitative study

BACKGROUND

Interventions focusing on epilepsy self-management (ESM) are vital for promoting the health of people living with epilepsy. E-technology and mobile health (mHealth) tools are becoming increasingly integrated into practice to promote self-management strategies for chronic diseases, enhance care delivery, and reduce health disparities. Management Information and Decision Support Epilepsy Tool (MINDSET), a bilingual decision support tool (available in English and Spanish), was found to be both feasible and effective in facilitating goal-based ESM in the clinic.

PURPOSE

To assess the experience of using MINDSET as an ESM intervention among Hispanic patients with epilepsy to inform future interventional studies.

METHODS

This study used a Qualitative Descriptive (QD) framework to provide a rich and straightforward description of patients' subjective experiences using MINDSET. Participants were enrolled in the intervention group of a larger parent study (RCT) to assess the efficacy of MINDSET among Hispanic People with Epilepsy (PWE). The purposive, convenient, criterion-based sample for this qualitative analysis comprised of 42 patients who agreed to participate in a semi-structured interview at the end of the larger RCT. This RCT was conducted between August 2017 and January 2019. Spanish and English-speaking Hispanic adult patients (n = 94) with epilepsy in Arizona (n = 53) and Texas (n = 41) were randomly assigned within 6 neurology clinics to treatment (MINDSET plus Usual Care, hereafter referred to as MINDSET; n = 46) and comparison (Usual Care Only; n = 48) conditions.

RESULTS

Patient demographics, epilepsy conditions, and ESM behavioral characteristics were representative of the intervention group. Study participants were Hispanic, mainly of Mexican descent (94 %), with a mean age of 39 years, mostly female (53 %), and most of the participants reported having had one or more seizures per month (54 %). The MINDSET intervention revealed five ESM themes: (1) Awareness and Realization of Epilepsy Self-Management, (2) Communication and Partnership with Health Care Providers HCP, (3) Epilepsy Self-Management and Quality of Life, (4) Seizure Control, and (5) Optimism and Agency.

CONCLUSION

The participants who used MINDSET as a self-management intervention reported an overall positive experience. Qualitative data in this study show that MINDSET is a valuable ESM tool for Hispanic patients with epilepsy. Findings from this qualitative study were consistent with results from a larger parent study that recognized MINDSET as an effective platform for improving epilepsy self-management adherence.