'We're outside the norm again because of the thing that allowed us to be inside the norm': An interpretative phenomenological analysis of the experience of developing an alcohol use disorder after bariatric surgery

Studies indicate that bariatric surgery is associated with an increased risk of alcohol use disorder (AUD). It is considered some patients develop the disorder after surgery, without having antecedents of preoperative alcohol problems. This qualitative study aimed to explore the experiences of people who developed AUD postoperatively and understand how they make sense of the onset of this disorder. A semi-directed interview was carried out with eight adults who had undergone bariatric surgery and developed AUD de novo postoperatively. Data were analysed using interpretative phenomenological analysis. Four superordinate themes emerged: (1) 'losing control over drinking and self after surgery'; (2) 'feelings of guilt, shame and loss contrasted with perceptions of still being lucky'; (3) 'trying to make sense of the onset of AUD'; and (4) 'retrospective evaluation of bariatric surgery and preoperative information'. These themes indicated loss of control was a central aspect of participant's experiences of postoperative alcohol consumption. AUD was associated with negative emotions and cognitions, but several participants still considered themselves lucky. All tried to make sense of this disorder's onset; many felt they would not have developed AUD if they had not undergone surgery. The onset of AUD influenced their current perceptions and feelings about surgery and the preoperative information regarding AUD risks. Taken together, these results provide insight into the subjective experience of suffering from new-onset AUD post-surgery. However, more studies are necessary to gain a better understanding of the physical and psychological implications of postoperative AUD.

'They tried to evil me': An explanatory model for Black Africans' mental health challenges

This paper explores the explanatory models of mental challenges among Black Africans in England. It argues that understanding these models is critical for providing culturally appropriate care to this population. The study employed qualitative methodology, and interpretative phenomenological analysis (IPA). Twelve mental health service users who are living in England and self-identified as first or second-generation Black Africans were purposively selected. The data were gathered using face-to-face semistructured interviews. Data were manually analysed in accordance with IPA concepts of searching for common, unique and idiosyncratic themes across transcripts. The findings revealed three themes Black Africans associated to their explanatory model of mental health challenges: complexities of migration, African-centred worldview and negative life experiences. To help alleviate the Eurocentric nature of mental health practice in England, it is hoped that this explanatory model will become an integral part of mental health practice in England and around the world.

The experience of Thai adolescents with depression: A qualitative study

AIM

People who have depression experience a maelstrom of emotion as they attempt to understand what is happening to them. While the experience has been quite extensively documented in adults and older individuals, there is a great deal less information available about adolescent depression experiences and reactions. The purpose of this study was to investigate the experiences of Thai-adolescents suffering from depression.

DESIGN

Interpretative phenomenological analysis.

METHOD

Fourteen adolescents were recruited from a secondary school in Chiangrai province, Thailand. Semi-structured interviews were carried out. Interviews were analysed using interpretative phenomenological analysis.

RESULTS

The following four themes were identified: (1) struggling to make sense of their situation, (2) feeling down and withdrawing, (3) contemplating self-harm and (4) therapy as a last choice. The results point to the continuing significance of promoting psychoeducation for Thai-adolescents with depression as well as parents, school nurses and health providers while eliminating stigma.

Exploring healthcare workers' experiences of a simple intervention to reduce their intrusive memories of psychological trauma: an interpretative phenomenological analysis

ABSTRACTBackground: Many healthcare workers (HCWs) endured psychologically traumatic events at work during the coronavirus disease 2019 (COVID-19) pandemic. For some, these events are re-experienced as unwanted, recurrent, and distressing intrusive memories. Simple psychological support measures are needed to reduce such symptoms of post-traumatic stress in this population. A novel intervention to target intrusive memories, called an imagery-competing task intervention (ICTI), has been developed from the laboratory. The intervention includes a brief memory reminder cue, then a visuospatial task (Tetris® gameplay using mental rotation instructions for approximately 20 min) thought to interfere with the traumatic memory image and reduce its intrusiveness. The intervention has been adapted and evaluated in a randomized controlled trial (RCT) with Swedish HCWs (ClinicalTrials.gov identifier: NCT04460014).Objective: We aimed to explore how HCWs who worked during the COVID-19 pandemic experienced the use of a brief intervention to reduce their intrusive memories of work-related trauma.Method: Interpretative phenomenological analysis was used for in-depth understanding of the lived experiences of HCWs who used the intervention. Seven participants from the RCT were interviewed by an independent researcher without prior knowledge of the intervention. Interviews were conducted via telephone and transcribed verbatim.Results: Four general themes were generated: 'Triggers and troublesome images', 'Five Ws regarding support - what, when, why, by/with who, for whom', 'Receiving it, believing it, and doing it' and 'The intervention - a different kind of help'; the last two included two subthemes each. The results reflect participants' similarities and differences in their lived experiences of intrusive memories, support measures, and intervention impressions and effects.Conclusion: HCWs' experiences of the novel ICTI reflect a promising appraisal of the intervention as a potential help measure for reducing intrusive memories after trauma, and gives us a detailed understanding of HCWs' needs, with suggestions for its adaption for future implementation.Trial registration: ClinicalTrials.gov identifier: NCT04460014.

"I do my best to do right by her": Autistic motherhood and the experience of raising a non-autistic adolescent daughter

LAY ABSTRACT

Little is known about the parenting experiences of autistic mothers, especially those who have daughters who are not on the autism spectrum. In this study, we interviewed seven autistic mothers who have raised or are currently raising non-autistic teenage daughters. Mothers were asked to describe what parenting was/is like during their daughters' teenage years. We analyzed the transcripts of the interviews and found several common themes. Mothers described their relationships with their daughters to be loving, safe, and empathetic. Mothers described several strengths when it came to parenting, such as helping their daughters solve problems and using positive strategies to handle conflict with their daughters. Mothers also described challenges they faced when interacting with other non-autistic people and when trying to form relationships with them. Mothers tried to build their daughters' social skills so that they would not experience the same challenges. This study shows that autistic mothers have close, loving relationships with their non-autistic teenage daughters but have trouble forming relationships with other non-autistic people. It is, therefore, important that non-autistic parents are more understanding and welcoming of autistic mothers.

Issues of identity, perceptions and isolation: An interpretative phenomenological analysis of women's experience of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome

The objective of this study was to explore the personal experience of women with MRKH, a rare condition characterised by congenital abnormalities of the genital tract. There are very few qualitative studies into the lived experiences of women with MRKH. Interviews were conducted with 13 women with MRKH and analysed using interpretative phenomenological analysis. Four superordinate themes are discovered: maintaining a viable female identity; acceptance and coping; normality, secrecy and shame and the isolating impact of a lack of knowledge amongst the medical profession. This study also suggests that societal ideals of a 'normal woman' are influencing how MRKH impacts on the self-experienced psychological health. It is suggested that the psychological wellbeing of women with MRKH could be improved with continued multidisciplinary support beyond the initial diagnosis and alongside any vaginal correction.

Facilitating transformative endings: Therapists' experience of ending therapy with people with intellectual disabilities-An interpretative phenomenological analysis

BACKGROUND

Endings in therapy are discussed widely in mainstream literature, however, there is only a small amount of research that considers endings in therapy for people with intellectual disabilities.

METHODS

Eight therapists were interviewed about their experience of ending therapy with people with intellectual disabilities. Interviews were analysed using Interpretative Phenomenological Analysis (IPA).

RESULTS

Four superordinate themes associated with endings that go well were identified: 'recognising', 'readying', 'reframing' and reflecting', with a fifth theme reflecting endings that were less successful. Participants worked hard to offer transformative experiences of endings and an overarching 'super-superordinate' theme of 'facilitating transformative endings' encompassed the findings.

CONCLUSIONS

Endings are a multi-faceted component of psychological therapy with people with intellectual disabilities and are significant for both client and therapist. We discuss implications for therapy adaptations and future research.

An exploration of family dynamics in adults who self-harm

OBJECTIVES

The aim of the present study was to explore how adults who self-harm experience family relationships.

METHODS

A phenomenological design was employed to examine the dynamic relationship between self-harm and family systems. Semi-structured interviews were conducted with six female adults who attend a community mental health service and engage in self-harm. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA).

RESULTS

Four superordinate themes emerged from the data and two subordinate themes emerged within each superordinate theme: family interactive patterns (subordinate themes: enmeshed patterns and culture of 'getting on with it'), searching for meaning (subordinate themes: expressing emotional turmoil and engrained worthlessness), relating to others (subordinate themes: guilt and feeling misunderstood) and journey towards life without self-harm (subordinate themes: acceptance and family support).

CONCLUSIONS

Findings emphasise the role of family systems in understanding self-harm in adults. The study highlights the need for family-based interventions for family members who support adults that self-harm.

Care-experienced young people's views on what they want from mental health services

This study explores what care-experienced young people want from mental health services. Six care-experienced young people were interviewed, and an interpretative phenomenological analysis applied. Three key themes emerged demonstrating that the way support is delivered, the people who deliver it, and the environment of mental health services are all important to care-experienced young people. Along with these findings, this study demonstrates that engaging vulnerable young people in research and service design is beneficial.

In the shadow of dissidence: exploring the experiences of descendants of Czechoslovakian dissidents

Introduction

The Communist Party's reign in Czechoslovakia (1948-1989) saw the persecution of thousands of individuals. The State Security campaign "Asanace" (meaning "sanitation") was conducted to expel critics of the regime from the country using psychological and physical terror. Although stories of dissidents are frequently presented in public spaces, little is known about the experiences of their children.

Methods

To address this gap, we conducted interpretative phenomenological analyses of semi-structured in-depth interviews with five adult descendants of Czechoslovakian dissidents.

Results

Our analyses revealed that while participants appreciated and were inspired by their parents' dissident activities, they tend to distance themselves from it in order not to live in their parents' shadow. Furthermore, for them, the "Asanace" campaign primarily meant emigration, which in turn affected their sense of self and (national) identity dispersion. Consequently, they experienced feelings of being uprooted and different. Furthermore, they faced challenges acculturating. However, they also recognized their resilience as being rooted in their migration experience and the legacy of their parents' dissidence.

Discussion

By highlighting intergenerational differences and the impact of family legacy on individuals' strengths and weaknesses, this study contributes to our understanding of the psychological consequences of living in, escaping from and adjusting to life beyond oppressive regimes.

Perioperative care to patients living with HIV by theatre nurses at a South African tertiary hospital

Background

Human Immunodeficiency Virus (HIV) is one of the leading health challenges worldwide that influences the provision of quality patient care. Stigma and discrimination around this condition and the health care needs affect the health care provision. This study aimed to gain an in-depth understanding of theatre nurses' experiences in providing perioperative care to patients living with HIV at a tertiary hospital in South Africa.

Methods

This study was conducted at a tertiary hospital in Tshwane district, South Africa. The study was underpinned by an interpretative phenomenological analysis design. Data were collected from 10 criterion purposively selected theatre nurses using in-depth individual interviews. Data were thematically analyzed and guided by an interpretive phenomenological analysis framework for data analysis.

Results

The study revealed that theatre nurses work in an under-resourced environment. The resources highlighted are human, materials, including personal protective equipment and life support. The situation negatively affects the perioperative care of HIV-positive patients, who are always prone to perioperative complications, such as profuse bleeding, and even death. The situation increases the occupational risk to the nurses.

Conclusions

The researchers proposed several recommendations targeted at improving the resources needed by theatre nurses when caring for people living with HIV perioperatively at South African tertiary hospitals. Findings will add to the body of knowledge of the Nursing profession about offering perioperative care to persons living with HIV.

'Am I fixed, am I better now?': undergoing MR-guided focused ultrasound for essential tremor: an interpretative phenomenological analysis

Introduction

Essential tremor (ET) is characterised by postural and intentional tremor typically affecting the upper limbs, which can negatively impact functionality and quality of life. Magnetic Resonance-guided Focused Ultrasound (MRgFUS) is a novel and promising non-invasive treatment for ET which offers instantaneous results.

Methods

Using interpretative phenomenological analysis we explored the experience of undergoing MRgFUS in six ET patients as well as their experiences pre- and post-procedure.

Results

One-time, retrospective semi-structured interviews were conducted and six themes emerged: Life pre-treatment: "It's everyday tasks that get you down" and "Most people who understand, they are okay. Some people aren't"; MRgFUS: Treatment day: "Going into the unknown" and "There's no way I was going to press that button"; and Life post-treatment: "One is good. Two is better" and "Am I fixed, am I better now?."

Discussion

The findings point to a significant period of adjustment associated with living with ET and the effects of undergoing ET MRgFUS treatment. As ET progressed, participants struggled to cope with increasing symptoms and had to develop coping strategies to manage life with ET. The procedure itself was perceived as strange and extraordinary and despite some immediate adverse effects participants were determined to go through with it. Post procedure, all participants reported tremor suppression which was life changing. While some participants still felt burdened by ET, others expressed it took them a while to psychologically adjust to what essentially was their new body. This study has highlighted the need for patients to be supported at all stages of their ET journey.

The relationship at the heart of the experience of daughter caregivers of a parent with dementia: An interpretative phenomenological analysis

BACKGROUND

Parents with dementia require emotional, physical, psychological and financial support from their child caregivers to continue living at home. Daughter caregivers have been shown to be more involved in self-care and household tasks and to experience higher levels of distress than son caregivers.

OBJECTIVE

The aim of this study was to investigate the experience of daughter caregivers who provide informal care for a parent with dementia living in their own home.

METHOD

Semi-structured interviews were conducted with 11 daughter caregivers of a parent with Alzheimer's disease. Interviews were analysed using Interpretative Phenomenological Analysis.

RESULTS

Three axes emerged from the analyses: [1] the before conditions the after: the quality of the previous relationship with the parent with Alzheimer's disease is a determining factor and allows the identification of three profiles of daughter caregivers: 'the grateful', 'the resentful' and 'the ambivalent', [2] when the relationship protects against the sense of burden: the feeling of being invaded by the caregiving situation is influenced by the quality of the relationship with the parent with Alzheimer's disease, and [3] alone or almost: the support network is desired when it is absent but kept at arm's length when it is present.

DISCUSSION

The results underline the importance of assessing the quality of attachment and supporting the relationship with the parent (especially when the relationship prior to the disease was difficult). Daughter caregivers should also be encouraged to delegate tasks and refocus their actions related to their values. Family mediation sessions may be planned to improve the organisation of care and set up an efficient collaboration.

The Poetry of Recovery in Peer Support Workers with Mental Illness: An Interpretative Phenomenological Analysis

This study was conducted to investigate and understand various aspects related to participants' experiences in peer support activities, with a particular focus on their personal growth and the influence of these activities on their lives. In this qualitative study, peer support workers with mental illness were the main subjects, and they were recruited from G Metropolitan City, South Korea. The study used purposive sampling, guided by recommendations from peer support worker support organizations. A total of five participants were selected using purposive sampling to ensure maximum variability in the sample. Data collection involved semi-structured individual interviews, and data analysis was conducted using the interpretative phenomenological analysis (IPA) method. Following the IPA procedure for data analysis, the study revealed six themes that encapsulated the recovery experiences of peer support workers with mental illness: (1) Facing confusion and challenges, (2) Rising and refining myself, (3) Navigating the paths of relationships, (4) Gazing at the desired horizons, (5) Awakening the inner hero, and (6) Standing as a person who cherishes life. This research underscores the positive impact of peer support activities on individuals who have faced mental health challenges. It emphasizes the significance of self-discovery, the development of supportive relationships, and the aspiration for a brighter future. These findings contribute to the expanding body of knowledge regarding the benefits of peer support in the context of mental health recovery.

"I Mean Who Likes Pedophiles"; Psychological Assessments of Men Who Have Sexually Offended. The Assessees' Experiences

Pre-sentence psychological assessments of men who have sexually offended can provide useful information regarding an individual's pathway to offending, risk of recidivism, and treatment needs. The outcome of the assessment can be used in court and has implications for the assessee and society at large. This research sought to explore offenders' opinions regarding the clinicians' approach to the assessment, to identify facilitative aspects of the clinicians' style and to understand how accuracy and honesty can be enhanced in these interactions. Six interviews were conducted with sex offenders on completion of a pre-sentence forensic assessment at a private practice. Applying Interpretative Phenomenological Analysis, the findings highlighted the relational nature of the assessments, the assessees' feelings of powerlessness, and their perceptions that the interaction helped them personally. The findings and approach advocated for by the assessees are discussed in terms of the associated ethical considerations and practice implications.

Emily's struggle for dignity: An idiographic case study of a woman with multiple sclerosis

Dignity is one of the essential values and central concepts in nursing care. Dignity can be threatened due to radical life changes; therefore, this idiographic case study aimed to explore the sense of dignity experienced by a woman with multiple sclerosis. An interpretative phenomenological analysis was adopted, using data collected through a face-to-face semistructured interview with Emily, a 45-year-old woman. The study was approved by the local ethics committee. Six personal experiential themes were identified: To be ruled by a sick body; Silent progression; Loss of independence as a burden for the family; Will to fight for the meaning of life; Maintaining dignity-in-relation; Dignified care in a period of greater vulnerability. Emily's dignity is based on the effort to fight for a meaningful life, utilization of her full potential, maintain independence in activities of daily living and support in relationships. Continuous changes in functional ability, loss of self-control and an uncertain future have a negative impact on the experience of her dignity. In the context of dignified health care, she considers individual care and maintaining autonomy important. The idiographic case study can contribute to a better understanding of the experience of a woman suffering from multiple sclerosis. It is possible to carry out interventions that aim to support her dignity, improve her quality of life and contribute to individually oriented health care.

Meaning and lived experience of Iranian COVID-19 survivors: A phenomenological study

BACKGROUND

The Coronavirus (COVID-19) is among the most contagious diseases worldwide. During the first peak of the illness, COVID-19 was considered a considerable crisis for survivors. This qualitative study explored the meaning and lived experience of Iranian COVID-19 survivors. This qualitative study was conducted in Iran sometime after the onset of the coronavirus in 2020.

METHODS

This interpretative phenomenological analysis (IPA) was performed on twenty survivors of COVID-19 disease, recruited through the purposeful sampling method via in-depth semistructured interviews. The interviews were recorded and transcribed, and several codes were extracted. Data were analyzed using the MAXQDA software (v. 12).

RESULTS

The main themes and subthemes obtained from the data analysis included (1) Taboo and stigma: COVID-19 as a monster, feelings of social exclusion and loneliness, an obvious sign of shamelessness and maltreatment, (2) God's predestination: God's will and test, COVID-19 as a wake-up call to remind low human power, (3) Shadow of death: The fear of death after positive test results, death is closer than the jugular vein, the mourning of a loved one's death, and mourning for an untimely death, (4) Caregivers as an angel: Family as an unrepentant supportive, know the level of family love and attention, and (5) Rebirth and new life: understand the higher value of health and pay more attention to self-care behavior, and God gives us a golden chance to experience a better life.

CONCLUSIONS

According to the results of this study, COVID-19 survivors experience various issues regarding the nature of the disease, coping with the illness, and their social and psychological status affected by COVID-19. Considering the multidimensional supportive programs, increasing public awareness and changing negative attitudes toward the patients and survivors of the pandemic for better rehabilitation and adjustment is essential.

Becoming a Rare Disease Parent: An Interpretative Phenomenological Analysis of Parent-Caregivers' Postpartum Experiences

Rare diseases constitute a group of conditions that are individually rare, but in aggregate impact between 3 and 6% of the world population. Many of these conditions present during infancy and involve substantial caregiving responsibilities, often assessed via quantitative measurements. However, few qualitative analyses examine lived experiences of parent-caregivers during the early period of their child's life. The purpose of this study was to examine the meaning that rare disease parent-caregivers apply to the postpartum year using data collected from a semi-structured interview exploring significant experiences over the course of their affected child's life. We utilized an interpretative phenomenological analysis (IPA) approach to analyze 22 interview transcripts from caregivers to children with several inherited metabolic and mitochondrial disorders, as well as an undiagnosed disease. Our analysis yielded three superordinate themes: Reckoning With the Parent-Caregiver Role, Familial Transition, and Adaptation and Adjustment. Subordinate themes expanded upon these concepts and included distinctions between the parent and caregiving identity, communal coping and shifting of family dynamics, as well as meaning applied to child milestones, anticipatory grief, and parental perception of a new normal. Exploration of these themes in relation to existing literature, as well as future research directions for qualitative research on rare disease caregivers, is discussed. Overall, this work contributes to a growing body of literature exploring the parental experience of rare disease across several condition contexts.

Exploring the lived experiences of participants and facilitators of an online mindfulness program during COVID-19: a phenomenological study

The coronavirus pandemic (COVID-19) has placed incredible demands on healthcare workers (HCWs) and adversely impacted their well-being. Throughout the pandemic, organizations have sought to implement brief and flexible mental health interventions to better support employees. Few studies have explored HCWs' lived experiences of participating in brief, online mindfulness programming during the pandemic using qualitative methodologies. To address this gap, we conducted semi-structured interviews with HCWs and program facilitators (n = 13) who participated in an online, four-week, mindfulness-based intervention program. The goals of this study were to: (1) understand how participants experienced work during the pandemic; (2) understand how the rapid switch to online life impacted program delivery and how participants experienced the mindfulness program; and (3) describe the role of the mindfulness program in supporting participants' mental health and well-being. We utilized interpretive phenomenological analysis (IPA) to elucidate participants' and facilitators' rich and meaningful lived experiences and identified patterns of experiences through a cross-case analysis. This resulted in four main themes: (1) changing environments; (2) snowball of emotions; (3) connection and disconnection; and (4) striving for resilience. Findings from this study highlight strategies for organizations to create and support wellness programs for HCWs in times of public health crises. These include improving social connection in virtual care settings, providing professional development and technology training for HCWs to adapt to rapid environmental changes, and recognizing the difference between emotions and emotional states in HCWs involved in mindfulness-based programs.

"I will try anything" the experience of working age stroke survivors living with chronic post-stroke pain: an interpretative phenomenological analysis

PURPOSE

To investigate the experience of working age adults living with chronic post-stroke pain in the United Kingdom (UK).

METHODS

Semi-structured interviews were conducted with eight working age (46-64 years) UK-based stroke survivors who experience chronic post-stroke pain (≥3 months). The interviews were analysed using interpretative phenomenological analysis.

RESULTS

The analysis led to three Group Experiential Themes: "The Solitude of the Pain Experience," "Unsatisfactory Healthcare and the Need for Self-Care" and "The Development of Pain Acceptance." Findings suggest that individuals see their post-stroke pain as an invisible disability, which is overlooked and misunderstood by others. Furthermore, in the absence of a differential post-stroke pain diagnosis, clear, accurate information and alternatives to pharmacological treatments, individuals with post-stroke pain invest their own resources in finding answers and a way to live with the pain.

CONCLUSIONS

The findings suggest the need for further education on post-stroke pain for healthcare professionals, the consideration of pain in post-stroke assessments, the need for clear differential pain diagnoses and the provision of accurate information to patients. Research is needed to establish non-pharmacological evidence-based treatment approaches, such as pain management programmes, peer support and psychological interventions.

Long-term social restrictions and lack of work activities during the COVID-19 pandemic: impact on the daily lives of people with intellectual disabilities

PURPOSE

Lockdowns due to the Covid-19 pandemic may have had a disproportionate impact on the daily lives of people with intellectual disabilities. Many of them had to deal with limited social contacts for an extended period. This study explores in depth how people with intellectual disabilities in the Netherlands experienced their daily lives, in particular due to lack of access to regular work activities.

MATERIALS AND METHODS

Eight participants with intellectual disabilities were interviewed. Interpretative Phenomenological Analysis (IPA) was employed in conducting and analysing interviews.

RESULTS AND CONCLUSIONS

Analysis yielded three overarching themes that are conceptually linked. Participants experienced a prolonged lack of social connections that resulted in experiences of social isolation and feelings of loneliness. This led to different kinds of struggles: either internal struggles involving negative thoughts or depressive feelings, or a perceived threat to their autonomous position in society. Meanwhile participants had to sustain their sense of self-worth in the absence of work activities. The findings emphasise the importance of social opportunities through the access to work activities for people with intellectual disabilities. Interventions are suggested to help reverse the increased social inequalities and enhance rehabilitation via work activities for people with intellectual disabilities.IMPLICATIONS FOR REHABLITATIONMore awareness may be raised among authorities, employers and the general public about the significant value people with intellectual disabilities attribute to meaningful social connections, in particular through work activities.Also, more awareness may be raised about the potential adverse effects of the loss of work activities and social connections on the quality of life of people with intellectual disabilities.Providing social support to others may help people with intellectual disabilities to construct social valued roles, either in or outside the work situation.Professionals and employers can support people with intellectual disabilities to find opportunities to provide social support to others.It is important to invest in sustainable and innovative post-pandemic community participation initiatives and particularly in accessible post-pandemic employment support, for example by organising paid in-company training placements.It is essential that professionals support people with intellectual disabilities to enhance their sources of resilience and coping strategies, that may have diminished as a result of the pandemic.

An exploration of the relationship between voices, dissociation, and post-traumatic stress disorder symptoms

OBJECTIVES

Extensive research has shown voice hearing to be associated with symptoms of Post-Traumatic Stress Disorder (PTSD) and dissociation. However, most studies have adopted a quantitative design, using cross-sectional data sampling methods, precluding temporal relationships between variables from being defined.

DESIGN

Using a qualitative design, this study sought to identify potential symptom relationships by addressing the research question: what is the nature of the temporal relationship between voices, dissociation and PTSD symptoms?

METHODS

Seven voice hearers (aged 27 to 68 years) participated in a semi-structured interview exploring voice hearing, PTSD symptoms, and dissociation. The interviews were analysed using Interpretative Phenomenological Analysis.

RESULTS

One superordinate theme was identified in the data. Voices were observed to occur in dynamic interrelationship with PTSD symptoms and dissociation, and were frequently experienced before and after PTSD symptoms and dissociative episodes.

CONCLUSIONS

Implications for theoretical understandings of voice hearing and future research are discussed.

Lived experiences of musicians with pain: an interpretative phenomenological analysis of performance-related pain of professional violinists

The purpose of this interpretative phenomenological analysis (IPA) is to explore how five professional South African violinists make sense of their lived experiences of performance-related pain. The research problem this study investigates is multifaceted. It includes examining the career implications for violinists who play despite experiencing pain and are afraid to speak up because of the stigma associated with being injured. There is a lack of support and understanding from fellow musicians, doctors and other specialists when faced with diagnosing injuries and recommending treatment options. In South Africa, there is limited research on these aspects. In this IPA study, the data were collected through semi-structured interviews with five professional South African violinists with performance-related pain.The six subordinate themes that emerged from the data analysis were: (i) Playing through the pain; (ii) Lack of identity; (iii) Depression when unable to play because of pain; (iv) Growth through faith and spirituality; (v) Support and lack of support from family, friends, management, doctors and other experts; and (vi) Lack of awareness and understanding of performance-related injuries. Heightened awareness of musicians' lived experience of performance-related pain could bring about much-needed change and support advocacy for pain-prevention initiatives and assistance for violinists.

Exploring the experiences of self-determination of individuals with mild intellectual disabilities and epilepsy

BACKGROUND

While epilepsy can decrease quality of life and self-determination in individuals without intellectual disabilities, the impact of epilepsy on experienced self-determination in people with intellectual disabilities remains unclear.

METHOD

We conducted semi-structured interviews with six adults (four men, two women) aged 30-61 with mild intellectual disabilities and drug-resistant epilepsy to investigate their experiences of self-determination. The data were analysed using Interpretative Phenomenological Analysis.

RESULTS

Three main themes were identified: (A) I am a competent person with epilepsy; (B) My social needs: being accepted as I am and stability in relationships; and (C) Being in control.

CONCLUSIONS

In this study, the impact of epilepsy on experienced self-determination of people with mild intellectual disabilities outweighs the influence of intellectual disabilities. Identity formation, friendships with peers, and autonomy support in risk management are identified as important topics in supporting this group.

'I felt like my senses were under attack': An interpretative phenomenological analysis of experiences of hypersensitivity in autistic individuals

LAY ABSTRACT

Research shows that the way autistic individuals perceive and process sensory stimuli differs from those of non-autistic people. However, while current research often focuses on what sensory differences in autism are and which neurocognitive processes may explain these, it often does not explicitly address what it is like to experience the world through the senses of an autistic person. To explore this understudied dimension, we conducted 18 in-depth interviews with autistic individuals in order to better understand how they personally experienced hypersensitivity from a first-person perspective. Participants described hypersensitivity as a feeling of being bombarded by intrusive stimuli that seemed to invade their bodies and from which they had difficulties distancing themselves. They also indicated how due to hypersensitivity they often perceived their (social) environment as invasive, chaotic, unpredictable or threatening. Hypersensitivities were thus not only described as unsettling bodily experiences but also related to challenges in perceiving, understanding and interacting with the (social) world. By focussing on the subjective dimension of sensory processing in autism, our study thus highlights how sensory difficulties are not peripheral features of autism but play an essential part in the daily challenges faced by autistic individuals.

How do women at increased risk of breast cancer make sense of their risk? An interpretative phenomenological analysis

OBJECTIVES

Offering breast cancer risk prediction for all women of screening age is being considered globally. For women who have received a clinically derived estimate, risk appraisals are often inaccurate. This study aimed to gain an in-depth understanding of women's lived experiences of receiving an increased breast cancer risk.

DESIGN

One-to-one semi-structured telephone interviews.

METHODS

Eight women informed that they were at a 10-year above-average (moderate) or high risk in a breast cancer risk study (BC-Predict) were interviewed about their views on breast cancer, personal breast cancer risk and risk prevention. Interviews lasted between 40 and 70 min. Data were analysed using Interpretative Phenomenological Analysis.

RESULTS

Four themes were generated: (i) encounters with breast cancer and perceived personal significance, where the nature of women's lived experiences of others with breast cancer impacted their views on the significance of the disease, (ii) 'It's random really': difficulty in seeking causal attributions, where women encountered contradictions and confusion in attributing causes to breast cancer, (iii) believing versus identifying with a clinically-derived breast cancer risk, where personal risk appraisals and expectations influenced women's ability to internalize their clinically derived risk and pursue preventative action and (iv) perceived utility of breast cancer risk notification, where women reflected on the usefulness of knowing their risk.

CONCLUSIONS

Providing (numerical) risk estimates appear to have little impact on stable yet internally contradictory beliefs about breast cancer risk. Given this, discussions with healthcare professionals are needed to help women form more accurate appraisals and make informed decisions.

Trust in healthcare professionals of people with chronic cardiovascular disease

BACKGROUND

Trust is an essential phenomenon of relationship between patients and healthcare professionals and can be described as an accepted vulnerability to the power of another person over something that one cares about in virtue of goodwill toward the trustor. This characterization of interpersonal trust appears to be adequate for patients suffering from chronic illness. Trust is especially important in the context of chronic cardiovascular diseases as one of the main global health problems.

RESEARCH AIM

The purpose of the qualitative study was to gain a deeper understanding of how people with chronic cardiovascular disease experience and make sense of trust in healthcare professionals.

RESEARCH DESIGN

Eleven semi-structured interviews with participants analysed using interpretative phenomenological analysis to explore in detail their lived experience of trust as a relational phenomenon.

PARTICIPANTS AND RESEARCH CONTEXT

Participants with chronic cardiovascular disease were purposively recruited from inpatients on the cardiology ward of the university hospital located in central Slovakia.

ETHICAL CONSIDERATIONS

The study was approved by the faculty ethics committee. Participants gave their written informed consent.

FINDINGS FOUR INTERRELATED GROUP EXPERIENTIAL THEMES

Sense of co-existence; Belief in competence; Will to help; Ontological security with eight subthemes were identified. The findings describe the participants' experience with trust in healthcare professionals as a phenomenon of close co-existence, which is rooted in the participants' vulnerability and dependence on the goodwill and competence of health professionals to help with the consequence of (re)establishing a sense of ontological security in the situation of chronic illness.

CONCLUSION

Findings will contribute to an in-depth understanding of trust as an existential dimension of human co-existence and an ethical requirement of healthcare practice, inspire patient empowerment interventions, support adherence to treatment, and person-centred care.

Changes in Patient Discourse: A Qualitative Study Based on the Treatment Experience of Chinese Patients with Somatization Symptoms

This qualitative study examines the characteristics exhibited by Chinese patients with somatization symptoms during their treatment process, focusing on changes in illness interpretation and language use. A semi-structured in-depth interview was conducted with 10 patients receiving treatment in a clinical psychology department of a general hospital who reported somatic symptoms as their main complaint. The interview data were recorded and transcribed, and analyzed using interpretive phenomenological analysis. Two core themes emerged from the analysis: avoidance at the utterance level; and at the semantic level, power and contestation. Patients with somatization symptoms exhibit avoidance behaviors, and their experience of illness and the therapeutic process impact their discourse. Professionals should pay attention to patients' own interpretations, cultural background and acceptance of the illness.

The Interaction Between Asthma, Emotions, and Expectations in the Time of COVID-19

Introduction

The main aim was to gain insight into the experience of adult people with a diagnosis of at least 6-months of mild or moderate persistent asthma according to the Global Initiative for Asthma (GINA), and their emotions, beliefs, and expectations during the first wave of COVID-19.

Methods

Qualitative semi-structured interviews using the Interpretative Phenomenological Analysis (IPA) were carried out by phone involving 31 people (mean age=58.2; SD=16.2). Interviews were audio recording, transcribed verbatim and analysed through thematic analysis.

Results

Five superordinate themes and themes were dedicated to illness (symptoms of asthma; difficulties related to COVID-19), experienced emotions (lockdown period; medical changes; emotions COVID-19 related), beliefs (about asthma; about COVID-19), expectations (related to asthma; related to COVID-19) and behaviours (to protect; risk taken; adherence; contacts with General Practitioners; support). The prevalence of emotions such as fear, worry and anxiety emerged in the participants' narratives. All are accompanied by a preference for action and problem solving. A sense of protection, connection to self and other, and commitment to life were revealed as central concepts for enhancing well-being even at a time of deterring.

Discussion

The common threads of the presence of uncertainty and vulnerability open the outlook of a treatment that ensures greater continuity and ownership of care in the patient, preserving the sense of self-efficacy even in times of greater instability.

A qualitative exploration of the lived experiences of Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) is characterized by an intense preoccupation with one or more perceived "defects" in physical appearance. Despite the distress and impairment associated with BDD, the disorder remains understudied and poorly understood. In particular, there are limited studies available which give voice to those with firsthand experiences of the disorder. A qualitative approach was employed to study lived experience of BDD. In-depth semi-structured interviews were conducted with 12 participants with BDD, aiming to understand their subjective experiences of the disorder. Data was analyzed using Interpretative Phenomenological Analysis (IPA). The results identified three superordinate themes; (1) consumed by the disorder, (2) the flawed self, and (3) intolerance of uncertainty about appearance. The qualitative findings of this study are discussed in relation to current conceptual understandings of BDD, including the cognitive behavioral model.

Experiences of family-witnessed cardiopulmonary resuscitation in hospital and its impact on life: An interview study with cardiac arrest survivors and their family members

AIM

To explore experiences of cardiac arrest in-hospital and the impact on life for the patient who suffered the arrest and the family member who witnessed the resuscitation.

BACKGROUND

Guidelines advocate that the family should be offered the option to be present during resuscitation, but little is known about family-witnessed cardiopulmonary resuscitation in hospital and the impact on the patient and their family.

DESIGN

A qualitative design consisting of joint in-depth interviews with patients and family members.

METHODS

Family interviews were conducted with seven patients and their eight corresponding family members (aged 19-85 years) 4-10 months after a family-witnessed in-hospital cardiac arrest. Data were analysed using interpretative phenomenological analysis. The study followed the guidelines outlined in the consolidated criteria for reporting qualitative research (COREQ) checklist.

RESULTS

The participants felt insignificant and abandoned following the in-hospital cardiac arrest. Surviving patients and their close family members felt excluded, alone and abandoned throughout the care process; relationships, emotions and daily life were affected and gave rise to existential distress. Three themes and eight subordinate themes were identified: (1) the intrusion of death-powerless in the face of the fragility of life, highlights what it is like to suffer a cardiac arrest and to cope with an immediate threat to life; (2) being totally exposed-feeling vulnerable in the care relationship, describes how a lack of care from healthcare staff damaged trust; (3) learning to live again-making sense of an existential threat, pertaining to the family's reactions to a difficult event that impacts relationships but also leads to a greater appreciation of life and a positive view of the future.

CONCLUSION

Surviving and witnessing a cardiac arrest in-hospital is a critical event for everyone involved. Patients and family members are vulnerable in this situation and need to be seen and heard, both in the hospital and after hospital discharge. Consequently, healthcare staff need to show compassion and attend to the needs of the family, which involves continually assessing how family members are coping during the process, and providing support and information during and after resuscitation.

RELEVANCE TO CLINICAL PRACTICE

It is important to provide support to family members who witness the resuscitation of a loved one in-hospital. Structured follow-up care is crucial for cardiac arrest survivors and their families. To promote person-centred care, nurses need interprofessional training on how to support family members during resuscitation, and follow-up care focusing on providing resources for multiple challenges faced by survivors (emotional, cognitive, physical) and families (emotional) is needed.

PATIENT OR PUBLIC CONTRIBUTION

In-hospital cardiac arrest patients and family members were involved when designing the study.

"It is like a pet in a way": The self-management experiences of people with cystic fibrosis diabetes

BACKGROUND

Cystic fibrosis diabetes (CFD) is a very common co-morbidity affecting the lives of people with cystic fibrosis. Surprisingly, minimal research has been undertaken to understand the experiences of people with CFD and how they self-mange this condition.

METHODS

Using interpretative phenomenological analysis, the present study examined the self-management experiences of people with CFD. In-depth semi-structure interviews were conducted with eight people who had CFD.

RESULTS

The following three superordinate themes were identified: forming a relationship with CFD, balancing the CFD self-management triad, and the unmet need for information and support.

CONCLUSIONS

The findings suggest that the management of CFD is challenging and, although people with CFD experience many adaptation and management processes similar to people with type 1 diabetes, they struggle with the additional complexity of balancing CF and CFD. The provision of appropriate education, support and person-centred care needs to be addressed.

"Falling Through the Cracks": A Retrospective Exploration of the Barriers to Help-Seeking Among Men Convicted of Sexual Crimes

The prevalence and impact of sexual abuse is of global concern, and the alarming rates of victimization have inspired a focus on its prevention. Whilst research has begun to explore the experiences of non-offending individuals to inform prevention initiatives, there is limited exploration of those who have struggled with their sexual interests and go on to commit sexual crime. Arguably these individuals hold key information about gaps in service provision, which may inform approaches to crime prevention. This study aimed to provide a phenomenological exploration of the pre-offense experiences of convicted individuals' beliefs about help-seeking, their desires for support, and any barriers that might have prevented them from coming forward for help. Semi-structured interviews were conducted with 14 individuals convicted of sexual offenses (n = 13 against children; n = 1 sexually motivated violence), and interpretative phenomenological analysis elicited three superordinate themes: Desperation, Barriers to Help-seeking and A Way Forward. The findings shed light on the distressing experience of living with sexual interests that are so openly rejected by society and the many ways participants attempted to cope with this, including multiple failed attempts to seek help. Implications and limitations are discussed.

Staff experiences of a novel in-reach rehabilitation and recovery service for people with profound and enduring mental health needs

This organizational case study addresses the research question: What are the experiences of staff who work in a novel in-reach rehabilitation and recovery service for people with profound and enduring mental health needs? Fifteen purposefully sampled staff were recruited from across a novel mental health service that embeds the community sector within inpatient provision. The sample comprises twelve National Health Service and three community voluntary organization staff (four men and eleven women). Data were generated via photo-elicitation in which interviews focused on the photographs participants brought to help convey their experiences of the Service. Interpretative phenomenological analysis was used to analyse the transcripts. The analysis demonstrates that participants are oriented towards five 'meta-questions': What is recovery? Who is valued and how is it demonstrated? Why are you frustrated in doing the best job you can and what support do you need? How can change occur in staff practices and approaches in an environment embedded in history? and How do we make the Service work in the context of constraints? Eight paired themes were also identified regarding staff experience of the Service: hope and individuality; culture and power; communication and confidence; accountability and limitations. The conclusions of this organizational case study have wide relevance to clinical practice: staff (i) place importance on promoting and developing greater awareness of different approaches to care; (ii) aspire to develop better communication across multidisciplinary teams and (iii) desire greater awareness of the complexities of risk to improve staff confidence.

The role of the lived body during the integration of the traumatic experience of the sternotomy scar: A case study

BACKGROUND

Open heart surgery is a potentially traumatic experience for patients, thus posing a real risk to both the patient's physical and mental health as well as bodily integrity. All of these can greatly affect the emotional relationship to the sternotomy scar, the physical aspect of self-representation. Sternotomy scars mark patients for life, yet our knowledge of patients' subjective experiences is unknown.

METHOD

In our case study, we explore the embodied experiences of a woman (42) who underwent open heart surgery with the method of interpretative phenomenological analysis combined with drawings.

RESULTS

The body and the bodily experiences play a prominent role in the formation, healing process, and symbolism of a scar. The central core of the traumatic experience of open heart surgery is the attack against the patient's sensation of bodily integrity. The interviewee experiences the surgery as abuse committed on her body, a memory that is deeply etched both in the physical memory and in the form of a scar on the skin.

CONCLUSION

Based on our study, it seems that the corporeal dimension of posttraumatic growth may develop after the traumatic experience of heart surgery, in which bodily intimacy with oneself and Significant Others plays a major role. In this case study, the objective reality of the heart as "sick" flesh and the "broken, pierced" bone (Körper), as well as the dissociation-and then its integration-of the lived, living body experience (Leib) are outlined. Our case study was analysed in the theoretical framework of phenomenology and psychoanalysis.

Specific interests as a social boundary and bridge: A qualitative interview study with autistic individuals

LAY ABSTRACT

Growing evidence shows that specific interests can help autistic individuals cope with difficulties in social communication and interaction. However, it is unclear which specific characteristics of these interests make them suitable for this coping role. Therefore, this study explored how specific interests can help autistic individuals navigate social communication and interaction. We conducted semi-structured interviews with nine autistic individuals to inquire about their perspectives on the meanings and functions of their specific interest in their (social) life. We found that specific interests served two important social functions. First, the interests provided a way to disconnect from the challenging outside world, through a shift in the attentional focus of participants. Second, the interests served as a "social compass," providing structure and meaning to social situations and helping the participants feel more connected to others. Based on these findings, we propose a conceptual model suggesting that specific interests create the experience of a "protective boundary" between oneself and others, which helps autistic individuals feel safe during social interactions. Namely, engaging in specific interests not only creates a space where autistic individuals can retreat when they feel overwhelmed, but also provides a framework with delineations in time and space, as well as explicit rules for social interactions, which make them more predictable and regulated. The study suggests that incorporating specific interests into therapy can help improve social communication and interaction for autistic individuals while still prioritizing their personal well-being.

Parents who experience psychosis: A qualitative exploration

OBJECTIVES

Psychosis can present parents with complex parenting challenges and significant adverse outcomes for parents and their children have been reported. However, remarkably little is known about how parenting is experienced by these parents. Therefore, this qualitative study aimed to understand the lived experiences of parents with psychosis, including how parenting support was experienced.

DESIGN AND METHODS

Using interpretative phenomenological analysis (IPA), eight biological parents (five mothers and three fathers) with psychosis were recruited and interviewed from early intervention in psychosis services in the Northwest of England.

RESULTS

Three superordinate themes and seven subordinate themes were identified. Theme 1 'Living with the Struggle: Painfully Disconnected' captured a persistent parenting struggle that distanced parents from their children and support due to all-consuming experiences of psychosis, fear and risk-focused service support. Theme 2 'Desired and Vulnerable Position: Comfortably Connected' captured parental experiences of symptom relief through connection with their children, alongside parental need to be integrated with the systems around them. Theme 3 'Exposed: Parenting Under a Spotlight' represented parental experiences of inescapable observation and judgement from the systems around them.

CONCLUSIONS

Novel insights into the role of misaligned parent and service priorities in parental perceptions of powerlessness, shame and disconnection from their children, valued parenting identities, and system supports are presented. Systemic interventions that target stigma, provide system-wide psychoeducation and promote person-centred, compassionate and meaningful connections between parents and the systems they live within are needed to promote better parenting outcomes.

'I Had It. I Don't Think I Have It…But I Do Feel It Will Come Back Somewhere': A Qualitative Investigation of the Experience of People With Non-Muscle Invasive Bladder Cancer

Very little is known about the impact of living with non-muscle invasive bladder cancer (NMIBC). NMIBC patients' experiences of their illness-in terms of their perceptions, coping strategies and psychological wellbeing-were explored. This study describes an interpretative phenomenological analysis (IPA) of individuals' accounts of living with NMIBC while on routine surveillance for cancer recurrence. Ten individuals took part in face-to-face semi-structured interviews. Three superordinate themes were derived from the data. The first theme, Being Diagnosed and Treated for NMIBC, concerned the observation that participants considered the physical implications, timeline and practicalities of their illness of primary importance and focused less on its psychological aspects. The second theme, Grappling with the Illness, outlined the impact of the doctor-patient relationship. The final theme, 'I don't treat it as a problem. I treat it as an issue', delineated how participants managed difficult emotions in the context of the illness. Findings from this study demonstrated that participants generally found effective ways to cope with their illness and experience of ongoing surveillance, though delay of emotional responses was common. Clinical implications for healthcare professionals are outlined including the importance of high-quality communication with the urology team.

The psychosocial adjustment of kidney recipients across donation contexts

The objective of this study was to investigate kidney recipients' experiences within deceased and living donation contexts and, in the latter, by donor relationship type, to identify differences by context and mechanisms by which the relationship with the donor may impact recipients' psychosocial well-being. Individual interviews were conducted with 12 participants and analyzed using Interpretative Phenomenological Analysis. Three themes emerged: (a) salience of and sensitivity toward sacrifice and loss, (b) honoring the sacrifice by honoring the gift, and (c) relational imbalance mirroring perceived burden of donation. Findings were contextualized in relation to the transplantation literature, and their clinical implications discussed.

Exploring the experience of a cognitive rehabilitation intervention for cancer-related cognitive change in people living with cancer: An interpretative phenomenological analysis

OBJECTIVES

Some cancer patients experience cancer-related cognitive change (CRCC). Cognitive rehabilitation interventions (CRIs) have recently been developed to help mitigate the impact of CRCC, which, untreated, can impact resumption of daily life post-cancer treatment. The experience of participants is important to understand but largely absent within research literature. This study aimed to explore how those with CRCC experience the phenomenon following completion of a CRI.

METHODS

This study comprised a qualitative phenomenological approach. This involved conducting in-depth, semi-structured interviews with 6 self-referred participants from one CRI. Participants were invited to discuss their experience of CRCC and what the CRI therefore meant to them. Interviews were analyzed using interpretative phenomenological analysis.

RESULTS

Analysis of the findings revealed 4 key themes. (1) "Experiencing and addressing isolation" comprises reflections on posttreatment perceived abandonment and consequent feelings of belonging through CRI participation. (2) "Identity" explores participants' reflections around perceived loss-of-self and feelings of empowerment from the intervention. (3) "Cognitive and physical balance" comprises the planning and choices participants make, supported by both their own and CRI coping strategies as they seek acceptance of cognitive change. (4) "Course reflections" explore reflections on intervention structure, format, and delivery, focusing on 2 subthemes of accessibility, flexibility and inclusivity, and communication. All participants reflected positively on their experience.

SIGNIFICANCE OF RESULTS

Results support further dissemination among health professionals and implementation of this CRI to better support self-reported CRCC concerns within this population. Future qualitative research should explore the long-term impact of CRI interventions.

How my life is unique: Sibling perspectives of autism

LAY ABSTRACT

The impact of autism on the family is an important area of study. Much of the existing literature has focused on the parent perspective, with less emphasis on the experiences of other family members, especially non-autistic siblings. This study aimed to explore the lived experiences of a sample of nine 8- to 17-year-old non-autistic siblings of children and youth on the autism spectrum. We interviewed non-autistic siblings and analysed the written transcripts. Our results revealed the following themes: (1) Role disparities, different expectations; (2) Connection and disconnection; and (3) Our family is (extra)ordinary. Our study findings highlight siblings' unique and collective perspectives regarding their brother or sister on the spectrum within the broader family unit. We discuss the implications of these results on siblings of autistic children and youth.

Anorexia nervosa through the lens of primary health care practitioners in the Kyrgyz Republic

BACKGROUND

Anorexia nervosa was investigated in a large number of studies. Several of the studies in our review highlighted how important it is to factor in the opinion of health care practitioners if we want to improve the quality of the medical care provided to patients with anorexia nervosa. Additionally, the dominance of studies focused on anorexia nervosa within the Western culture raised the need for cultural diversity in such research.

AIM

The present study endeavored to explore how primary healthcare practitioners in Bishkek, Kyrgyz Republic, perceive anorexia nervosa and people who suffer from it.

METHODS

The study used the qualitative approach of Interpretative Phenomenological Analysis. Six semi-structured interviews with six primary health care practitioners from Bishkek were conducted.

RESULTS

The analysis of the collected data pointed towards four themes: (1) Anorexia nervosa as a reaction to distressing events in the form of loss of appetite; (2) Attributing blame for developing anorexia nervosa by a patient to family members; (3) Local versus Western socio-cultural standards in the development of anorexia nervosa and seeking treatment; and (4) Denial of mental health disorders by patients.

CONCLUSION

The discussion of the interpreted results led us to the conclusion that the perceptions of the health care providers in Bishkek represent the common prism through which anorexia nervosa is viewed in the larger population, which is constructed out of information received from the physical and virtual environments.

Being the supporter: an interpretative phenomenological analysis of the role of caregivers in the self-management of type 2 diabetes

Objective: Social support is key in improving the care and self-management of people living with Type 2 Diabetes (T2DM). Despite the benefits of social support, limited research has explored the experiences of family members acting as caregivers for those living with T2DM.Design: This qualitative study explored the pressures, attitudes, and views of immediate family caregivers supporting a relative's self-management of T2DM.Methods: Five online semi-structured interviews were conducted with caregivers and analyzed using Interpretative Phenomenological Analysis. Results: This analysis presents two superordinate themes: Values within caregivers and Support for the Supporters. Participants shared stories of coping and resilience in adopting a duty of care to support their family members. However, they also highlighted a lack of support from healthcare professionals, increasing feelings of personal responsibility and loneliness when caring for their family, including further pressures during the UK COVID-19 lockdown periods. Although caregivers do not have T2DM themselves, the burdens of supporting can have detrimental effects on the psychological health of these individuals.Conclusion: Healthcare professionals should consider the needs of caregivers, specifically improving psychological health and increasing understanding of T2DM, which may also improve health-related outcomes for the person living with T2DM.

First-generation Nigerian mothers living in the UK and their experience of postnatal depression: an interpretative phenomenological analysis

OBJECTIVE

Previous studies emphasise the negative psychological and physical consequences of Postnatal Depression (PND) on mothers and children's health. In the UK, around 10-20% of women can be affected by perinatal mental health problems. Minority ethnic groups such as Black African mothers are considered to be at greater risk of developing PND and data estimates that immigrant mothers are twice more likely to develop PND than native mothers. The unique experiences and needs of this culturally diverse group remain little explored in the UK. To address this gap in the literature, this study aimed to explore the lived experiences of First-Generation Nigerian Mothers (FGNMs) who suffered PND, their coping behaviours and treatment experiences in the UK.

DESIGN

Six FGNMs with a previous diagnosis of PND and treatment experiences were purposefully recruited from GP practices and social groups attended by Nigerian mothers in the UK. Semi-structured interviews were analysed using Interpretative Phenomenological Analysis.

RESULTS

Three master and seven subordinate themes were identified: (i) Socio-cultural factors (Inter-generational transmission; cultural perceptions: shame and stigma; transitions: adjusting to a new culture); (ii) What about me? The neglected nurturer (experiences of treatment; pretending to be OK); and (iii) Loneliness and coping (lack of support from partner; self-reliance).

CONCLUSIONS

The study provides evidence about the difficulties encountered by FGNMs in relation to PND, including socio-cultural factors, neglect from family and healthcare professionals, and self-reliance as a coping strategy. Contrary to reports suggesting that Black ethnic groups do not seek help for their mental health needs, participants' accounts indicated that their attempts to engage with professionals were met with unsatisfactory responses. The findings highlight the need to address barriers affecting access to services by fostering a patient-centred and culturally sensitive approach in healthcare teams to effectively engage mothers at an early stage in the detection pathway.

The Impact of COVID-19 and Remote Learning on Education: Perspectives From University Students With Disabilities

The purpose of this study was to examine the impact of COVID-19 and remote learning on education for college students with disabilities. A qualitative research method, interpretative phenomenological analysis (IPA), was used to investigate participants’ learning experiences during the pandemic. A total of 10 participants were divided into three focus groups for data collection. Data were analyzed using the standard IPA process, and four themes were identified. Discussion of and implications for online instruction and related policies are presented.

Men's Experiences of Self-Conscious Emotions Following Childhood Sexual Abuse

Rates of detection and disclosure of childhood sexual abuse (CSA) are believed to be lower in males due to gender socialization fears. The experience of CSA is thought to increase negative self-conscious emotions (shame, guilt, embarrassment, anger, and fear). Such self-conscious emotions have been associated with a range of mental and public health issues. As there has been no research to date that has explored the experience of shame and guilt within the wider context of self-conscious emotional states for males, this research aimed to explore men's experiences of self-conscious emotions following CSA. Nine semi-structured interviews with males were completed. Interpretative Phenomenological Analysis identified three themes: "Invisible In This World" captures participants' isolating circumstances surrounding their CSA, and how this impacted their perception of not being protected or able to speak out; "The Emotional Fallout" describes the overwhelming emotions experienced as a result of the CSA and how such emotions have impacted participants lives, and "Learning To Live With The Wound That May Never Heal" addresses how participants have spent their lives living with the abuse and how it's a process to learn how to adapt and live with the abuse. Findings suggest there is a clear need to recognize the role and power of self-conscious emotions in male CSA, especially for healthcare professionals and services supporting males with CSA. Without addressing such self-conscious emotions, males who have experienced CSA are at risk of enduring the emotional fallout throughout their lives.

Autistic women's experiences of self-compassion after receiving their diagnosis in adulthood

Knowledge of autistic individuals' experiences of self-compassion is very limited. This study investigated autistic women's experiences of self-compassion after receiving their diagnosis in adulthood. Eleven autistic women were interviewed about their experiences of receiving their diagnosis in adulthood and their experiences of self-compassion. Systematic analysis of the interview transcripts revealed common themes in the participants' experiences. Participants reported that their autism diagnosis helped them to better understand themselves, particularly when reflecting on problematic past experiences. After receiving an autism diagnosis, participants described being able to relate to themselves with greater self-kindness compared to previous self-criticism; this included allowing themselves to assert their needs and engage in self-care activities. Participants spoke about having difficult social experiences, including feeling pressure to conform to expectations in society and often feeling misunderstood. The findings highlight the barriers autistic women face obtaining their diagnoses and demonstrate the need for autism training for professionals to support early identification. Findings from this study suggest that interventions aimed at developing self-compassion could support and enhance autistic women's well-being.

The psychosocial experience of traumatic birth in couples: an interpretative phenomenological study

BACKGROUND

One-third of women report a psychologically traumatic event during birth; limited research exists on how couples experience and process self-reported traumatic birth.

AIMS AND OBJECTIVES

This study aimed to examine the lived experience and psychosocial impact of traumatic birth in couples.

METHODS

Interpretative Phenomenological Analysis was used to explore in-depth participants' lived experience during and after traumatic childbirth. Four couples were recruited, from women experiencing vaginal deliveries in the public hospital system in Australia during the past 5 years. Women and men were interviewed individually.

RESULTS

Three superordinate themes were identified: 'Compassionless care' (experiences of being dismissed, devalued and degraded by care providers), 'Violation and subjugation' (women's bodies and birthing experiences being violated) and 'Parenting after birth trauma' (challenges in caring for a newborn following trauma and recovery from trauma).

DISCUSSION

Couples described care providers' actions as a major contributing factor to trauma experiences. Couples contextualised care in terms of under-resourced wards and perceived women were treated as a means to an end. Women and men both described feeling fearful, distressed and devalued. Following birth trauma, individual cognitive factors, such as negative self-evaluations and avoidance of the trauma memory interacted with family system to shape trauma-related distress.

CONCLUSIONS

Future research would benefit from highlighting the systemic context in which compassionless care occurs, and the family system in which trauma is experienced and processed. Findings reinforce that psychosocial safety must be considered in addition to physical safety for both women and men in maternity care practices.

Self-Help Groups within Nursing Homes: The Experiences of Family Caregivers in Northeastern Italy

Older adults and their family caregivers experience nursing home placement as a particularly critical time of life. The present study explored the experiences of family caregivers of nursing home residents taking part in a self-help group for caregivers. The sample was composed of six caregivers of older adults residing in a nursing home in the northeast of Italy. The respondents, aged 57 to 71, were part of a self-help group set up by the facility between 2017 and 2019. In this qualitative methodological design, we applied the principles of interpretative phenomenological analysis. Two main themes emerged from the interviews: (a) challenges in constructing experience as caregivers; and (b) shared experiences as stabilizing tools. The findings highlight the importance of self-help groups in fostering the well-being of caregivers of older adults living in nursing homes. The self-help group enabled caregivers to deal with nursing home placement and the sense of guilt deriving from it; understand and accept the disabilities affecting their loved one; comprehend the experience of ambiguous loss; and learn to listen to their own needs, thus avoiding physical and emotional exhaustion.

Working With the Terminally Ill: An Exploration of the Experiences of Psychotherapists in Greece

The present study explored mental health professionals' experiences of working with terminally ill patients in Greece, how they make sense of their lived experiences of working with the dying, and investigated how they relate to their personal and professional growth. Semi-structured interviews were conducted with five mental health professionals who work or have worked with terminally ill patients in Greece. Their responses were analyzed using Interpretative Phenomenological Analysis (IPA). The main themes that emerged were (1) Emergence of opportunities for growth and transformation; (2) Finding satisfaction and fulfillment; (3) Openly addressing the negative side of challenges; and (4) Tuning into the spiritual side. Overall, the participants emphasized the importance of the different types of relationships these experiences touched upon, and highlighted the effect of their line on work on the relationship with their patients, their relationships with significant others and coworkers, and their relationship with their own selves.