Researcher or nurse? Difficulties of undertaking semi-structured interviews on sensitive topics

"You nearly feel a little bit like you've less right to grieve": a qualitative study on the impact of cancer on adult siblings

PURPOSE

Family members of cancer patients experience a range of challenges and are impacted in various ways by cancer. To our knowledge, the impact of cancer on adult siblings has yet to be explored. Sibling relationships are one of the longest relationships individuals have across the lifespan. Thus, the current study sought to investigate the perspectives of siblings of those who previously had cancer.

METHODS

Ten participants were recruited using purposive sampling. A qualitative, cross-sectional design was implemented with both virtual and in-person semi-structured interviews. Interviews were audio-recorded, transcribed and analysed using thematic analysis.

RESULTS

The researchers identified five themes relating to both the impact of cancer on siblings and the supports they received: changes in family relationships, sibling's grief is forgotten, benefits of social support networks, supporting their sibling and caregiving and self-support.

CONCLUSIONS

Cancer organizations and support services should focus on signposting services for siblings in order to ensure they can access support. Further research is needed with siblings to gain greater insight into what supports siblings feel are available for them to access, whether there are any for them to access or how supports can be improved.

IMPLICATIONS FOR CANCER SURVIVORS

The provision of appropriate psychological support for siblings of cancer patients will ensure they can provide optimal support and care to their siblings. This will in turn benefit cancer patients along their cancer trajectory as adequate support from their caregivers will enhance their quality of life.

'Out of the frying pan into the fire': a qualitative study of the impact on masculinity for men living with advanced prostate cancer

Background

Studies have highlighted how advanced prostate cancer causes biographical disruption and presents challenges to masculine identities for men. This article draws on a wider study that focused on the experiences of men living with advanced prostate cancer and their caregivers. Although men's experience of advanced illness is not overlooked in the literature, only a small body of work has taken an in-depth look at men's experiences with advanced prostate cancer and their caregivers in a non-Westernised cultural and social context.

Objective

To explore how advanced prostate cancer impacts on men's masculine identity from the perspective of patients and their caregivers.

Methods

A qualitative study of men living with advanced prostate cancer (n = 23) and family caregivers (n = 23) in Ghana. We used the Consolidated Criteria for Reporting Qualitative Studies (COREQ) as the reporting guideline.

Results

The findings from this study highlight profound challenges for most men to their masculine identities, from both the treatment and the symptoms of advanced prostate cancer within a non-Westernised, patriarchal society. Four main themes were developed. These were the impact on masculinity in terms of: (1) physical changes, (2) sexual ability, (3) socio-economic roles and (4) expressing emotions. Changes in physical appearance, feeling belittled, having no active sexual life and the inability to continue acting as provider and protector of the family made some men describe their situation as one of moving out of the 'frying pan into the fire'.

Conclusion

This study revealed the impact of advanced prostate cancer on masculine identity. These narratives add a new dimension to what is already known about the impacts on men's masculine identities when dealing with advanced prostate cancer. This knowledge can help improve the care provided to men with advanced prostate cancer with emphasis on the cultures, beliefs and aspirations of these men and their caregivers.

Formal caregivers' perceptions of everyday interaction with Deaf people with dementia

OBJECTIVES

Deteriorating interactive ability of people with dementia challenges formal caregivers. In Finland, Deaf people with advanced dementia may live in a nursing home designed for their care where the staff use Finnish Sign Language (FiSL). This study describes the perceptions of formal caregivers, focusing on the challenges, how they solve the challenges, and what support they need to improve interaction with Deaf residents.

METHODS

Semi-structured interviews with 13 formal caregivers who work with Deaf people with dementia were conducted and analyzed using qualitative content analysis. A purposive sampling was used.

RESULTS

Three key themes were challenges in interaction, strategies in supporting interaction, and support for coping. Caregivers perceived challenges in interaction caused by linguistic changes, deteriorating physical mobility and memory, and Deaf residents' behavioral challenges. Caregivers supported Deaf residents by learning to know them and using personal and linguistic strategies. Support for coping comprised supporting family members and other caregivers.

CONCLUSIONS

Efficient skills in sign language (SL) and knowledge of dementia are essential in interacting with Deaf residents and to build interpersonal relationships for care.

CLINICAL IMPLICATIONS

Supporting Deaf residents requires learning the way they interact which can be achieved over time.

Dismissal, distrust, and dismay: A phenomenological exploration of young women's diagnostic experiences with endometriosis and subsequent support

Endometriosis is associated with extensive physical and emotional difficulties, yet there is little research investigating the impact of the diagnostic journey particularly for younger women. Using semi structured on-line interviews and an interpretative phenomenological analysis, this study explored nine young women's experiences of the diagnostic process and the significance of support during this period. Three main themes emerged: 'the pursuit of a diagnosis', 'adjusting to a new normality' and 'the importance of effective support'. These experiences revealed clinical shortcomings and potential improvements to current guidelines and practices to facilitate a more emboldening process for patients.

Trauma-informed qualitative research: Some methodological and practical considerations

Mental health nurses who engage in research are likely to undertake research on sensitive topics, related to experiences of illness, care delivery and treatment. With recognition of the high prevalence of trauma in the lives of people who interact with mental health services, it is likely that many research participants will have experienced trauma in their lives and that while this may not be the focus of the research, sensitivity and awareness are required. Reference to 'trauma-informed' approaches in research design and practice is emerging in fields such as trauma-focused research and social sciences; however, it has not yet been applied to nurses. Trauma-informed approaches can build upon existing ethical and methodological frameworks to inform how mental health nurses go about qualitative research and what they need to consider when doing so. This discursive paper explores some of the implications of awareness and sensitivity to trauma for research undertaken by mental health nurses, including practical and methodological considerations. Recommendations include training and structural supports for nurse researchers, collaborative research designs, consideration of the environments where research occurs, awareness of approaches to distress and inclusion of trauma sensitivity within research policies, frameworks and leadership, alongside vigilance to interpersonal approach and the establishment and protection of psychological safety throughout. Continuing to undertake research on topics, and with people, where trauma is present, is essential to ensure ongoing awareness. Many of the existing skills held by mental health nurses can also support research to be undertaken in trauma-informed ways.

Reporting Harassment and Stalking to the Police: A Qualitative Study of Victims' Experiences

To date, there have been few studies with victims of stalking in the United Kingdom, and this is the first to have been conducted following the clarification of stalking as a criminal offense in 2012. In 2016, Her Majesty's Inspectorate of Constabulary Fire and Rescue Services (HMICFRS) and Her Majesty's Crown Prosecution Inspectorate (HMCPSI) announced the first ever inspection into harassment and stalking in England and Wales. This article presents research commissioned by HMICFRS as part of the inspection. In particular, we explore how victims described the response of the police and situate this within the context of changing legislation and previous research in the field. In total, 35 people shared their experiences of reporting harassment and stalking, 14 people completed an online survey, and 21 participants were interviewed. Responses were analyzed thematically and a series of themes were identified. The analysis suggests that despite the clarification of stalking as a criminal office in 2012, the majority of participants described poor responses from the police-with many describing police inaction, or inappropriate action-in addition to feeling blamed and not being taken seriously. The article considers possible explanations for these issues and concludes by calling for harassment and stalking legislation in England and Wales to be clarified, and for police training to shift the focus of the investigation from the behavior of the offender, to the emotional impact on the victim.

Conducting household surveys on reproductive health in urban settings: lessons from Karachi, Pakistan

Background

Data collection is the most critical stage in any population health study and correctly implementing fieldwork enhances the quality of collected information. However, even the most carefully planned large-scale household surveys can encounter many context-specific issues. This paper reflected on our research team’s recent experience conducting surveys for a quasi-experimental evaluation of a reproductive health program in urban areas of Karachi, Pakistan. We aim to describe the issues encountered and lessons learned from this process, and present some potential solutions for conducting future household surveys in similar urban environments.

Methods

The study followed a three-stage random sampling design. Initially, a Geographical Information System (GIS) was used to construct the sampling frame with union council (UC) area mapping and cluster demarcation followed by random selection of clusters in the selected UCs within the intervention and control sites. The second stage involved a complete household listing in selected clusters and the final stage was a random sampling of households with eligible women.

Result

This paper describes the issues that were encountered including technical problems related to GIS demarcation of cluster boundaries and hand-held devices for computer assisted personal interviews (CAPI), household listing, interviewing respondents on sensitive topics and their expectations, and ensuring privacy during the survey.

Conclusion

This study identifies a number of unique barriers to conducting household surveys in Karachi and highlights some key lessons for survey research in urban settlements. GIS mapping technology is a cost-effective method for developing sampling frames in resource-constrained settings. Secondly, the strategy of interviewing women immediately after the cluster is listed may be applied to make it easier to re-locate selected respondents and to reduce loss-to-follow up. Understanding local norms and developing culturally appropriate strategies to build trust with communities may significantly improve survey participation. Researchers should hire experienced female enumerators and provide continuous training on best practices for interviewing women on sensitive reproductive health topics in urban communities.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12874-021-01216-x.

Self-care while undertaking qualitative nursing research

BACKGROUND

Nursing research is usually carried out by registered nurses with some experience of practice. However, nurses may find that the role of the nurse researcher is very different from that of the practising clinical nurse and has its own challenges.

AIM

To explore the differences between the two roles and offer some guidance to nurses carrying out qualitative research, particularly research into sensitive topics.

DISCUSSION

Nurses need to be aware of various issues that could affect their ability to carry out nursing research and be emotionally traumatic.

CONCLUSION

There is a general need for greater awareness about the potential risks of carrying out qualitative research into sensitive topics.

IMPLICATIONS FOR PRACTICE

Nurse researchers must consider self-care when planning a research project, assessing their role, personality, background, personal experiences and stress triggers, and ensuring peer and supervisory support, reflection and a healthy lifestyle.

Registered Nurses' Experiences of Medication Errors-An Original Research Protocol: Methodology, Methods, and Ethics

BACKGROUND

The investigation of medication errors in nursing includes both methodological and ethical considerations because it is a sensitive field of research.

PURPOSE

To present an original research protocol for the investigation of nurses' experiences of medication errors with interpretative phenomenological analysis and the relevant methodological and ethical considerations.

METHODS

A discursive paper which presents an original research protocol about nurses' experiences of medication errors with interpretative phenomenological analysis followed by a literature review and personal reflections about the relevant methodological and ethical considerations. The review included papers published in English from 1990 to February 2019 on PubMed, BNI (British Nursing Index), CINAHL (Cumulative Index to Allied Health Literature), ScienceDirect, and Wiley Online Library.

RESULTS

The following methodological considerations were identified: recruitment of participants, data collection, and data analysis, and the ethical considerations included researcher's morality, ethics committees, sensitivity, phrasing of sentences and words, recruitment of participants, location of interviews, type of interviews, emotionality management, medication error incidents' management, researcher, or nurse?

CONCLUSION

By facing as many as possible methodological and ethical considerations and establishing solutions for them, the study's validity, reliability, and rigor are enhanced, and the study is ethically robust. Finally, their understanding enables researchers to uncover nurses' experiences and interpret the meanings they generate in depth.

Narrative research methods with vulnerable people: sharing insights

BACKGROUND

Families with hereditary illnesses have complex and unique experiences that are important for nurses to understand. In New Zealand, a Maori family predisposed to an aggressive gastric cancer recently participated in research to explore their healthcare experiences. The family constituted a vulnerable group, so the methodology needed to be inclusive and respectful. The authors chose to use narrative research.

AIM

To share insights from conducting narrative research with a vulnerable family.

DISCUSSION

Narrative research aligns well with nursing values. Numerous aspects of the methodology help to reduce power imbalance, enhance openness and explore wide-ranging experiences. These include: cultural humility; use of conversational cues rather than scripted research questions; the adoption of an empathic, curious stance; and working in partnership. Each of these aspects helps to foster an environment conducive to full exploration of experiences. People's stories are their own, and so researchers need to exercise humility and meticulous safe-keeping of data so that the whole experience is collaborative. When stories are conveyed to others, effort needs to be applied so that lessons are compelling for others and have generative, change-making potential.

CONCLUSION

Narrative research is a fitting methodology for nurses researching the experiences of vulnerable populations. Illness can be disempowering, but recounting stories may help participants with healing, adaptation and coping.

IMPLICATIONS FOR PRACTICE

New knowledge about illness, recovery and nursing care can be generated using a critical approach to analysis. By gaining a deeper understanding of people's experiences of illness, nurse researchers can co-create and share compelling narratives that may create empathy and change.

Designing in-depth semi-structured interviews for revealing meaning reconstruction after loss

The recent upsurge in the use of qualitative empirical studies, aiming to provide a deeper understanding of human reactions to loss, requires a methodological account of how to conduct better qualitative research with regard to data collection. This paper offers six general interview guidelines aimed at assisting researchers to achieve quality interviews in qualitative bereavement studies, based on the theoretical framework of meaning (re)construction in loss.

Working together to learn new oral hygiene techniques: Pilot of a carepartner-assisted intervention for persons with cognitive impairment

We pilot tested a carepartner-assisted intervention to improve oral hygiene in persons with cognitive impairment (participants) and help carepartners become leaders who can adapt approaches that foster participants' ability to develop new skills for oral hygiene care. Following the intervention, we conducted interviews with participants and carepartners to understand their challenges in working together to learn new oral hygiene skills. Participants reported challenges such as frustration using the electric toothbrush correctly, lack of desire to change, uncertainty about correctness of technique, and difficulty sustaining two minutes of toothbrushing. Carepartners reported challenges such as learning a new way of toothbrushing, learning new communication techniques, switching from instructing to working together, learning to balance leading with being too bossy, and being mindful of word choices. Findings suggested that despite challenges, participants were able to learn adaptive strategies to support new oral hygiene behaviors with support of the carepartner as the adaptive leader.

Emotion work in qualitative research: interviewing parents about neonatal care

BACKGROUND

'Emotion work' is a term used to describe the emotional responses that may arise in qualitative research exploring difficult experiences. Parents' experiences of neonatal care can raise sensitive issues during interviews, which may lead to emotional responses.

AIM

To reflect on an interpretive study involving narrative interviews with parents of preterm neonates, to inform researchers about the potential emotive issues that may arise in such work.

DISCUSSION

Reflection on interviews with parents of preterm neonates revealed areas for discussion relating to emotion work, the role of the researcher, emotional connections and empathic interviewing. Consideration of these areas highlights the importance of reflexivity for researchers.

CONCLUSION

Qualitative researchers undertaking narrative interviews should be prepared for emotive issues that arise and recognise the need for emotional intelligence. Achieving a balance between being an empathic, emotionally aware interviewer and remaining objective can be challenging.

IMPLICATIONS FOR PRACTICE

Strategies that researchers can use to address this balance and to manage the emotion work involved in research of this nature are provided.

Ethical Case Study of the Researcher-Participant Relationship in End-of-Life Research

Nurse-researchers studying interventions for patients at the end-of-life may become close with participants due to the nature of interactions within the research protocol. In such studies, participants may request further interactions that would constitute clinical care beyond the scope of the protocol. Nurse-researchers may feel a conflict of values between their obligation to the research goals and their inclinations and obligations as nurses to care for their patients. Nurse-researchers in this situation aspire to honor the bonds developed through close contact and ensure participants receive standard of care while maintaining standards of research ethics. Analysis of a case and review of applicable concepts in research ethics, including ethical relationships, therapeutic misconception, equipoise, and population vulnerability, are used to develop recommendations regarding the decision parameters for similar cases.