Using diaries to collect data in phenomenological research

Moving towards holistic rehabilitation - A qualitative study exploring how people diagnosed with cancer and cancer survivors experience a dance-like intervention

BACKGROUND

Rehabilitation that supports the individual on the journey back to their usual selves after cancer treatment becomes increasingly important. Studies have shown that a focus on the connection between body and mind might be beneficial. Consequently, Whole Person Care and initiatives that fall in line with this holistic approach to health care, such as a dance-like intervention needs further examination. The aim of this study was to explore the qualitative aspects of 5Rhythms® as experienced by people diagnosed with cancer.

METHOD

A total of 29 (17 in 2017) participants were recruited through purposeful sampling. Participants underwent one 5Rhythms® session per week for 2 months. This qualitative study with a phenomenological approach used diaries and individual interviews as its methods for data collection. Data were analysed using Giorgi's phenomenological framework and Maurice Merleau-Ponty's theoretical perspectives on phenomenological approaches to the body, perception and consciousness were applied.

RESULTS

Three main themes ('(now) I sense my entire body', 'Something liberating is happening inside my body' and 'We travel together') and five connecting sub-themes were identified through the analysis process.

CONCLUSION

Participating in 5Rhythms® contributed to reconnecting body and soul during or after battling cancer. It evoked thoughts and feelings of existential matter. Results suggest that participating in 5Rhythms® can assist in personal growth. The benefit of being among peers while on the path to recovery was also illuminated. In regard to rehabilitation, this study underlines the importance of being aware of the connection between body and mind.

A diarized journey: an interpretative phenomenological analysis of the older person's lived experience of a hip or knee replacement within a fast-track programme

BACKGROUND

For the older person living with end-stage hip or knee osteoarthritis, a hip or knee replacement can be a traumatic event, influencing the physical, physiological, psychological, social and economic facets of daily living. This interpretative phenomenological study aimed to reveal and interpret the daily lived experiences of the older person before, during and after a primary total hip or knee replacement surgery in a fast-track programme in South Africa.

METHODS

A qualitative interpretive phenomenological study, collecting data through solicited diaries and reflexive member validation interviews from seven participants aged 65-75 years, who underwent a primary elective hip or knee replacement surgery. The surgical fast-track process and data collection process happened simultaneously. Data collection from the solicited diary started before surgery, continued during the surgery process and finished six weeks after surgery and this was followed with reflexive member validation interviews. Interpretative phenomenological analysis was used throughout the three phases of the fast-track programme.

RESULTS

Three superordinate themes developed during the three phases of surgery: "The holistic impact of pain on daily quality of life", "Finding ways to cope", and "Transition between independence and dependence and back". Although former research confirms the physical impact of osteoarthritis on the older person and the success of fast-track programmes for subsequent hip and knee replacements, this study contributes to the holistic impact of the surgery on participants' daily lives. The diarized journey of individuals through the psychological, psychosocial, physical, professional, and spiritual experience are described and interpreted in this study.

CONCLUSIONS

Across the solicited diaries, it was clear that pain as catalyst impacted the daily activities of the individual physically, psychologically, and psychosocially. Pain was subjectively present at different intensities during all the phases of the replacement surgery, impairing mobilization and triggering roller-coaster emotions. In order to cope with physical and emotional difficulties while preparing and adjusting to the environment, participants reflected on social support, physical and professional support, and spirituality. Throughout the preparation, hospitalization and the recovery process, the transition between independence, dependence, and back to independence was significant, reinforcing the individual's determination to recover.

Reflective based learning for nursing ethical competency during clinical practices

BACKGROUND

A combination of theoretical and practical approaches is required to learn and acquire ethical competencies in caring. Occasionally, reflection on practical action differs from theoretical learning. In the context of reflective learning, issues such as ethical values can be discussed since they evoke conflict among nursing students.

AIM

To identify ethical conflicts encountered by nursing students during clinical placements and to determine their cooperation strategies.

RESEARCH DESIGN

Qualitative study with a content analysis according to Elo and Kinglas framework.

PARTICIPANTS AND RESEARCH CONTEXT

Students enrolled in a nursing program at a Spanish university aged between 22 and 35, mainly women.

METHODOLOGY

The study includes 134 ethical reflections from nursing students in the last year of the nursing program, written during their clinical practices in a variety of learning environments. The research team analyzed the reflections using an inductive content analysis method.

ETHICAL CONSIDERATIONS

Ethical permission was obtained by the management center according to Law 3/2028, and all the participants accepted to participate through the informed consent form.

FINDINGS

Three main categories emerged from the analysis of the ethical reflections: (1) evaluation of professional performance and patient care; (2) the student as the protagonist of the dilemma; (3) student coping. Student dilemmas and concerns are related to ignorance, student-patient communication, mistakes made and self-confidence. Some situations conflict with the autonomy of patients and their rights, and can contribute to stressful situations for patients. Stress factors include hospital routines, which the patient cannot modify, and asymmetric relationships with staff, which encourage passivity.

CONCLUSION

All ethical problems detected by the students begin with the professional-patient relationship, including issues related to bad news, errors or malpractice. Reflection on the ethical values of nursing, both in the classroom and in clinical practices, allows students to develop a greater ethical awareness of care, enhancing their decision-making skills in ethical dilemmas.

The meaning and experience of gratitude for people living with dementia

RATIONALE

Supporting people to live well with dementia is an international government priority. People living with dementia experience a range of positive emotions despite the challenges associated with dementia. Further research is needed to explore how these positive experiences can be fostered to support well-being. There is empirical evidence of the benefits of gratitude in other clinical groups, but no studies have explored how gratitude is experienced by people living with dementia.

METHODS

In this mixed-methods study, eight people living with dementia shared their experiences of gratitude through interviews and gratitude diaries. Qualitative data were analysed using interpretative phenomenological analysis. Quantitative data regarding diary use were analysed using descriptive statistics.

FINDINGS AND CONCLUSIONS

Gratitude holds interpersonal and transpersonal meanings for people living with dementia, balanced with challenges of dementia and ageing. This study offers insight into the existence and relevance of gratitude for people living with dementia, highlighting the importance of using multiple methods in dementia research. Positive psychology interventions informed by these findings may be effective in supporting well-being for people with dementia.

Medical students' experience of the hidden curriculum around primary care careers: a qualitative exploration of reflective diaries

OBJECTIVES

Primary healthcare internationally is facing a workforce crisis with fewer junior doctors choosing general practice (GP) as a career. In the UK, a national report on GP careers highlighted adverse influences during medical school on students' career choices. The authors explored these influences in two urban UK medical schools, both with relatively low numbers of students entering GP training.

DESIGN

Using a phenomenological approach, the authors thematically analysed the reflective diaries of four medical students who were recruited as 'participant researchers' over a period of 10 months. These students made regular reflexive notes about their experiences related to GP career perceptions in their academic and personal environments, aiming to capture both positive and negative perceptions of GP careers. The research team discussed emerging data and iteratively explored and developed themes.

SETTING

Two UK medical schools PARTICIPANTS: Undergraduate medical students RESULTS: Seven key themes were identified: the lack of visibility and physicality of GP work, the lack of aspirational GP role models, students' perceptions of a GP career as default, the performativity of student career choice with the perceptions of success linked to specialism, societal perceptions of GP careers, gender stereotyping of career choices and the student perception of life as a GP.

CONCLUSIONS

Students overwhelmingly reflected on negative cues to GP careers, particularly through their experience of the hidden curriculum. Three recommendations are made: the need for increased representation of GP role models in clinical curricula content delivery and senior leadership; ensuring GP clerkships involve an active and authentic student role with patients, enabling students to experience GP's 'work' including managing complexity, uncertainty and risk. Finally, institutions need to consider students' experiences of the hidden curriculum and the effect this can have on students' perception of careers, alongside the challenges of rankings and perceived hierarchical positioning of disciplines.

Perspectives of Victims of Gender Violence

The purpose of the current study was to explore the experiences of women who have been affected by violence and received mental health care. A qualitative phenomenological design was used with in-depth interviews and personal letters in a sample of 29 women from a public mental health center of Madrid, Spain, who were affected by physical, mental, and/or sexual abuse. The analysis revealed three themes: (1) Living With Fear; (2) Feeling Guilty; and (3) Experiencing the Imposition of So-Called "Womanly Duties" (i.e., being a maid, babysitter, and/or sexual slave). The current study highlights the importance of developing educational programs for the prevention of abuse. [Journal of Psychosocial Nursing and Mental Health Services, 58(6), 30-39.].

Female Family Caregivers' Experiences During Nursing Home Admission: A Phenomenological Qualitative Study

The experience of nursing home (NH) admission has a significant impact on older adults and their relatives. The aim of the current study is to describe the life experiences of female family caregivers (N = 20) after long-stay NH admission of their relative. A qualitative phenomenological approach was followed with purposeful sampling. Data were collected over 18 months using unstructured interviews, letters, and diaries and were analyzed using systematic text condensation analysis. Three themes emerged: The Value of Experience: Deciding on Admission and Defending One's Criteria; Living on Two Sides of the Same Coin; and Maintaining Contact. Results provide insight into female caregivers' experiences of NH admission, which may improve relationships established between female family caregivers and NH staff and help inform the decision-making process. [Journal of Gerontological Nursing, 45(6), 33-43.].

Living with Urinary Incontinence: Potential Risks of Women's Health? A Qualitative Study on the Perspectives of Female Patients Seeking Care for the First Time in a Specialized Center

Background: Urinary incontinence (UI) represents a complex problem which commonly affects women and influences their physical, mental, and social wellbeing. The objective of this study was to explore the experiences of a group of women with urinary incontinence. Methods: A qualitative exploratory study. Purposeful sampling was used. Recruited patients were females aged >18 years old with positive symptoms, signs of urinary incontinence, and attending a specialized urinary incontinence center for the first time. We collected data using interviews and participants’ personal letters. A thematic analysis was performed. Results: 18 women participated with a mean age of 47.32 years. Four themes emerged: (a) Experiencing uncontrolled urinary leakage, (b) Information based on beliefs and myths regarding UI, (c) Adapting to change and developing strategies, (d) The role of education. Women’s experiences were accompanied by feelings of stress and shame. A lack of information regarding UI was found, together with numerous misconceptions. Urinary incontinence triggers many changes in women. Some women may develop feelings of rejection towards their own body. Family involvement during these times is essential for education and promoting healthy sexual practices. Conclusions: This study highlights the importance of developing educational programs that focus on women’s information and education regarding triggering factors and coping strategies.

The voice of paediatric oncology nurses: A longitudinal diary study of professional development

PURPOSE

There is a limited amount of studies with results on professional development of paediatric oncology nurses. This study seeks to increase the understanding of the factors associated with the professional development of paediatric oncology nurses through the continuous education programme from the paediatric nurses' perspective.

METHOD

The descriptive, qualitative study used the text of participants' electronic diaries as data during a two-year continuing professional education programme in 2016-2018. The sample consisted of 17 paediatric oncology nurses who were working in three different university hospitals. The data were analysed with the inductive content analysis method.

RESULTS

Professional development is linked with a strong knowledge base in nursing, which involves the use of nursing methods and up-to-date nursing practices. Professional development is also linked with the use of medical knowledge, which manifests as a deep understanding of cancers and their treatment.

CONCLUSIONS

Research results show that a strong knowledge base in nursing alone is not sufficient for the professional development of paediatric oncology nurses. They also need to use their medical knowledge in order to gain an adequately deep understanding of children's cancers and their treatment. Nursing must be organised so that nurses have the opportunity to compare, share, question and argue for the methods they use with their colleagues in their own unit and other hospitals. Further research is needed on the professional development of paediatric oncology nurses and factors affecting it in order for a career development model to be created for this specific yet demanding area of nursing.