The experience of visual art for people living with mild-to-moderate vision loss

BACKGROUND

Visual art can enhance wellbeing and quality-of-life; however, the experience of visual art for people with mild-to-moderate vision loss has not been examined.

METHODS

Eight participants (6 females, 2 males; Mean age = 81 years, SD = 7.9, range 70-91 years; 4 with mild vision loss and 4 with moderate vision loss based on binocular visual acuity) completed a mixed-methods study comprising: a semi-structured interview on visual art experience; an eye examination; and questionnaires about visual functioning and quality-of-life.

RESULTS

Various themes were identified: visual perception of art (e.g. altered colours, visual distortions, etc.), viewing conditions, elements of art, personal preference, deriving meaning, appreciation of art, impact of impaired visual perception, and social aspects of art.

CONCLUSIONS

The overall experience of art is influenced by how an individual sees, perceives, and makes meaning from art. Even mild vision loss can impair this experience and impact emotional and social wellbeing.

Creating a difference - a role for the arts in addressing child wellbeing in conflict-affected areas

BACKGROUND

Details findings from a project on the potential for arts activities and art therapy to support the mental health and wellbeing of children living in Kashmir.

METHODS

The intervention engaged 30 school children over the course of one year who produced various forms of artwork and performances. In this paper, we report on project impacts, drawing on some of our qualitative measures including observations and interviews.

RESULTS

Our research details impacts and improvements in areas of emotional expression, belonging, and agency. We also found an important role for schools to create safe, secure, and caring spaces to allow students to express themselves and work through traumatic feelings in a non-judgemental way.

CONCLUSIONS

School-based arts interventions can play an important role in the mental health and wellbeing of children. Critical here, however, are dedicated space, time, and resources to provide a supportive environment and to sustain activity in long-term.

'I feel like this will never end': mental health during the COVID-19 pandemic among older adults with chronic conditions

OBJECTIVES

The COVID-19 pandemic may have a negative impact on mental health, especially among older adults with chronic conditions who are more vulnerable to severe illness. In this qualitative study, we evaluated how the pandemic has impacted the ways that adults aged 50 and older with chronic conditions managed their mental health.

METHODS

A total of 492 adults (M = 64.95 years, SD = 8.91, range = 50-94) who lived in Michigan (82.1%) and 33 other U.S. states completed one anonymous online survey between 14 May 14 and 9 July 2020. Open-ended responses were coded to ascertain relevant concepts and were reduced to develop major themes.

RESULTS

We determined four main themes. The COVID-19 pandemic impacted how participants took care of their mental health through: (1) pandemic-related barriers to social interaction; (2) pandemic-related routine changes; (3) pandemic-related stress; and (4) pandemic-related changes to mental health service use.

CONCLUSION

This study indicates that older adults with chronic conditions experienced various challenges to managing their mental health in the early months of the COVID-19 pandemic, but also showed considerable resilience. The findings identify potential targets of personalized interventions to preserve their well-being during this pandemic and in future public health crises.

Health Needs for Suicide Prevention and Acceptance of e-Mental Health Interventions in Adolescents and Young Adults: Qualitative Study

BACKGROUND

Adolescence is a phase of higher vulnerability for suicidal behavior. In Germany, almost 500 adolescents and young adults aged 15-25 years commit suicide each year. Youths in rural areas are characterized by a higher likelihood of poorer mental health. In rural areas, appropriate support for adolescents and young adults in mental health crises is difficult to access. The general acceptability of digital communication in youths can make the provision of an eHealth tool a promising strategy.

OBJECTIVE

The aim of this study was to explore the health needs regarding suicide prevention for adolescents and young adults in rural areas of Germany and Switzerland and to identify characteristics of suitable e-mental health interventions.

METHODS

This study reports on a qualitative secondary analysis of archived data, which had been collected through formative participatory research. Using 32 semistructured interviews (individually or in groups of 2) with 13 adolescents and young adults (aged 18-25 years) and 23 experts from relevant fields, we applied a deductive-inductive methodological approach and used qualitative content analyses according to Kuckartz (2016).

RESULTS

Experts as well as adolescents and young adults have reported health needs in digital suicide prevention. The health needs for rural adolescents and young adults in crises were characterized by several categories. First, the need for suicide prevention in general was highlighted. Additionally, the need for a peer concept and web-based suicide prevention were stressed. The factors influencing the acceptability of a peer-driven, web-based support were related to low-threshold access, lifelike intervention, anonymity, and trustworthiness.

CONCLUSIONS

The results suggest a need for suicide prevention services for adolescents and young adults in this rural setting. Peer-driven and web-based suicide prevention services may add an important element of support during crises. By establishing such a service, an improvement in mental health support and well-being could be enabled. These services should be developed with the participation of the target group, taking anonymity, trustworthiness, and low-threshold access into account.

In Search of a Value Proposition for COVID-19 Testing in the Work Environment: A Social Marketing Analysis

BACKGROUND

This study examined employer experience with SARS-CoV-2 (COVID-19) asymptomatic testing through a social marketing lens. Social marketing uses commercial marketing principles to achieve socially beneficial ends including improved health and safety behavior.

METHOD

Twenty employers across 11 occupational sectors were interviewed about implementation of COVID-19 testing from January through April 2021. Recorded transcripts were coded and analyzed using marketing's "Four P's": "product," "price," "place," "promotion."

RESULTS

COVID-19 tests (product) were uncomfortable, were easily confused, and didn't solve problems articulated by employers. Testing was not widely available or didn't line up with shifts or locations (place). The perceived price, which included direct and associated costs (e.g., laboratory fees, productivity loss, logistical challenges) was high. Most crucially, the time to receive (PCR) results negated the major benefit of less time spent in quarantine and challenged employer trust. A potential audience segmentation strategy based on perceptions of exposure risk also emerged.

CONCLUSIONS

This social marketing analysis suggests ways to improve the value proposition for asymptomatic testing through changes in product, price, and placement features in line with employers' expressed needs. Study findings can also inform creation of employee communication materials that balance perceived rewards of testing against perceived risks of exposure.

Embodied storytelling and meaning-making at the end of life: VoicingHan avatar life-review for palliative care in cancer patients

This article presents VoicingHan project as a new form of life-review mediated by digital avatars promoting the reconstruction of self and identity through performativity. Whereas traditional life-review uses interview as primary means of the therapeutic process, VoicingHan is mediated by virtual bodies with self-guided participation in one's own life stories through embodied storytelling performance. VoicingHan enrolled 12-patients receiving outpatient palliative care at VCU Massey cancer center. The storytelling performances were recorded via avatar video format and distributed to participants for review and/or sharing. The present study considered the avatar videos as qualitative data emerging from these individually constructed life review narratives. In this article, the benefits of VoicngHan life-review were demonstrated by analyzing the avatar video narratives, based on theoretical and developmental frameworks. Through the lens of Social Constructivism, this qualitative study deepens our understanding of human-avatar interactions to engage life review process, within the liminal space of life-threatening illnesses.

The role of social capital in participatory arts for wellbeing: findings from a qualitative systematic review

BACKGROUND

Social capital is often cited as shaping impacts of participatory arts, although the concept has not been systematically mapped in arts, health and wellbeing contexts. In wider health inequalities research, complex, differential, and sometimes negative impacts of social capital have been recognised.

METHODS

This paper maps of social capital concepts in qualitative research as part of the UK What Works for Wellbeing evidence review programme on culture, sport and wellbeing.

RESULTS

Studies often cite positive impacts of bonding and, to a lesser extent, bridging social capital. However, reported challenges suggest the need for a critical approach. Forms of linking social capital, such as reframing and political engagement to address social divisions, are less often cited but may be important in participatory arts and wellbeing.

CONCLUSIONS

Future research should further specify dimensions of social capital as well as their nuanced effects in arts, and wellbeing contexts.

Demystifying Content Analysis

Objective. In the course of daily teaching responsibilities, pharmacy educators collect rich data that can provide valuable insight into student learning. This article describes the qualitative data analysis method of content analysis, which can be useful to pharmacy educators because of its application in the investigation of a wide variety of data sources, including textual, visual, and audio files. Findings. Both manifest and latent content analysis approaches are described, with several examples used to illustrate the processes. This article also offers insights into the variety of relevant terms and visualizations found in the content analysis literature. Finally, common threats to the reliability and validity of content analysis are discussed, along with suitable strategies to mitigate these risks during analysis. Summary. This review of content analysis as a qualitative data analysis method will provide clarity and actionable instruction for both novice and experienced pharmacy education researchers.

Strategic Storytelling: An Exploration of the Professional Practices of Mental Health Peer Providers

Peer providers of mental health services use their personal illness and recovery narratives to help other mental health service users. Despite a substantial body of evidence supporting the effectiveness of these providers, little is known about the underlying strategies they employ in their professional practice. In this study, I used in-depth interviews with 23 peers to explore the most important practices they used in their day-to-day work with others. Results indicated that peers engaged in a reflexive process to strategically use their personal illness and recovery stories to help others re-story their life narratives. Peers also used communication strategies from motivational and cognitive-behavioral treatment approaches to engage, inspire, and mentor other service users. Findings suggest the need for research that further explores the rhetorical strategies used by peers using narrative methods. The development and testing of professional development opportunities to assist peers in maximizing their therapeutic potential are also warranted.

Challenges associated with parenting youth with neurofibromatosis: A qualitative investigation

Parents of children with the neurofibromatoses (NF; neurofibromatosis 1, neurofibromatosis 2, and schwannomatosis) are at an increased risk for emotional and physical health problems. This study aimed to determine parents' perceptions of stressors associated with parenting a child with NF in order to inform the development of a resiliency intervention. We conducted three live video semi structured focus groups with parents of youth with NF (N = 30), which were subsequently transcribed and coded using qualitative content analysis. Parents reported heightened stress associated with the child's educational, medical, and social needs, as well as concerns about their child's physical and mental health. They also reported stress associated with managing finances, multiple medical appointments, role challenges (i.e., being a parent or partner), and managing the uncertainty/unpredictability of their child's NF diagnosis. These stressors reportedly affected employment status (i.e., work scale backs), relationships (i.e., social, familial, with partner, other children), and the parents' physical and mental health. All participants expressed interest in a mind body program aimed at improving resiliency by teaching coping skills (e.g., mindfulness, adaptive thinking, positive psychology skills) and enhancing social support. Results show parents' enthusiasm for a resiliency intervention targeting stress associated with parenting a child with NF, and provide valuable information for the content of the intervention and its delivery modality.

Exploring educational and social inequality through the polyphonic voices of the poor: A habitus listening guide for the analysis of family-schooling relations

The aim of this methodological article is to contribute a new form of qualitative data analysis that is relevant for the comparative study of family cultures and schooling. We describe the development of our Habitus Listening Guide linking Bourdieu's theory of social reproduction to critical narrative theory. The interpretative tool outlines (a) social-structural (b) horizontal intergenerational (c) vertical gender and (d) mythic-ritual listenings which can be used to explore the engagement of youth and their families with schooling. Such listenings reveal the dispositional positioning of schooling in family values and the complex structural and human relational effects of schooling on family members' livelihood and wellbeing. It offers the possibility of comparing families in terms of their gendered and generational relations and the ways in which religious and mythic-ritual discourses legitimate their aspirations in the context of changing communities. The Guide offers a way of accessing and comparing subjective micro level experiences of social inequality and the contribution that schooling plays, or is expected to play, in relation to individual and/or family social mobility.

Online Communication Settings and the Qualitative Research Process: Acclimating Students and Novice Researchers

In the last 20 years, qualitative research scholars have begun to interrogate methodological and analytic issues concerning online research settings as both data sources and instruments for digital methods. This article examines the adaptation of parts of a qualitative research curriculum for understanding online communication settings. I propose methodological best practices for researchers and educators that I developed while teaching research methods to undergraduate and graduate students across disciplinary departments and discuss obstacles faced during my own research while gathering data from online sources. This article confronts issues concerning the disembodied aspects of applying what in practice should be rooted in a humanistic inquiry. Furthermore, as some approaches to online qualitative research as a digital method grow increasingly problematic with the development of new data mining technologies, I will also briefly touch upon borderline ethical practices involving data-scraping-based qualitative research.

"The Filter is Kind of Broken": Family Caregivers' Attributions About Behavioral and Psychological Symptoms of Dementia

OBJECTIVES

Behavioral and psychological symptoms of dementia (BPSD) are common, often challenging to manage, and may erode caregivers' well-being. Few studies have explored caregivers' perspectives of what causes these behaviors, but such attributions may be important-particularly if they negatively impact the care dyad. This study examined causal attributions about BPSD among individuals caring for a family member with dementia.

DESIGN

In-depth qualitative data were obtained from family caregivers of older adults with dementia.

SETTING

As part of a larger study (NINR R01NR014200), four focus groups were conducted with caregivers by an experienced facilitator.

PARTICIPANTS

A total of 26 family caregivers participated in the four focus groups.

MEASUREMENTS

Caregivers reported their own attributions about the causes of their care recipient's BPSD. Sessions were audio-recorded. Data were transcribed, coded to determine relevant concepts, and reduced to identify major categories.

RESULTS

Five categories were determined. Caregivers attributed BPSD to: 1) neurobiological disease factors; 2) physical symptoms or comorbid health conditions; 3) psychological reactions to dementia; 4) shifting social roles and relationships following dementia onset; and 5) environmental changes such as lack of routine and medical transitions (e.g., hospitalization). Despite this seemingly multifactorial attribution to BPSD etiology, a number of respondents also indicated that BPSD were at least partly within the care recipient's control.

CONCLUSIONS

Family caregivers attribute BPSD to a range of care recipient and environmental factors. Caregivers' own causal beliefs about BPSD may reflect unmet educational needs that should be considered in the development of targeted interventions to minimize caregiving stress.

What Is Qualitative Research?

The article is an in-depth explanation of qualitative research, an approach increasingly prevalent among today's research communities. After discussing its present spread within the health sciences, the author addresses: 1. Its definition. 2. Its characteristics, as well as its theoretical and procedural background. 3. Its procedures. 4. Differences between qualitative and quantitative approaches. 5. Mixed methods incorporating quantitative research. And in conclusion: 6. The importance of establishing an epistemological perspective in qualitative research.

Iterative categorization (IC): a systematic technique for analysing qualitative data

The processes of analysing qualitative data, particularly the stage between coding and publication, are often vague and/or poorly explained within addiction science and research more broadly. A simple but rigorous and transparent technique for analysing qualitative textual data, developed within the field of addiction, is described. The technique, iterative categorization (IC), is suitable for use with inductive and deductive codes and can support a range of common analytical approaches, e.g. thematic analysis, Framework, constant comparison, analytical induction, content analysis, conversational analysis, discourse analysis, interpretative phenomenological analysis and narrative analysis. Once the data have been coded, the only software required is a standard word processing package. Worked examples are provided.

Torn between dual roles: the experiences of nurse-family members when a loved one is hospitalised in a critical condition

AIMS AND OBJECTIVES

To understand and interpret the experiences of nurse-family members when a family member or loved one is hospitalised in a critical condition.

BACKGROUND

Having a family member hospitalised with a critical illness is a traumatic stressor, often with long-term sequelae. Providing holistic care for family members who are also nurses makes the provision of care more complex because of their professional expertise; yet few studies have explored this issue.

DESIGN

In this descriptive study, qualitative data were collected using a questionnaire and analysed using van Manen's (Researching Lived Experience: Human Science for an Action Sensitive Pedagogy, 1990, State University of New York Press, London, ON) six-step approach.

METHODS

Twenty nurse-family members completed an online questionnaire in June 2013. Qualitative findings from 19 participants were included in the analysis. The phenomenological analysis approach described by van Manen (Researching Lived Experience: Human Science for an Action Sensitive Pedagogy, 1990, State University of New York Press, London, ON) was used to describe and interpret nurse-family member experiences.

RESULTS

Nurse-family members experience significant dual role conflicts between their personal and professional personas due to their specialised knowledge, need for watchfulness and competing expectations. Our findings describe how dual role conflicts developed and were managed, and reveal the resultant emotional toll and psychological distress as nurse-family members struggled to resolve these conflicts.

CONCLUSIONS

Nurse-family members require a different type of care than general public family members, yet their unique needs are often unmet, leading to increased anxiety and distress that could potentially be minimised. An increased awareness and emphasis on the nurse-family member experience can ensure health care professionals are better placed to provide appropriate and targeted care to minimise distressing dual role conflicts.

RELEVANCE TO CLINICAL PRACTICE

There is a need for targeted and specialised communication appropriate to each nurse-family members' needs and level of understanding, and to clarify expectations to ensure nurse-family members' professional knowledge and skills are recognised and respected without being exploited.

Qualitative case study data analysis: an example from practice

AIM

To illustrate an approach to data analysis in qualitative case study methodology.

BACKGROUND

There is often little detail in case study research about how data were analysed. However, it is important that comprehensive analysis procedures are used because there are often large sets of data from multiple sources of evidence. Furthermore, the ability to describe in detail how the analysis was conducted ensures rigour in reporting qualitative research.

DATA SOURCES

The research example used is a multiple case study that explored the role of the clinical skills laboratory in preparing students for the real world of practice. Data analysis was conducted using a framework guided by the four stages of analysis outlined by Morse ( 1994 ): comprehending, synthesising, theorising and recontextualising. The specific strategies for analysis in these stages centred on the work of Miles and Huberman ( 1994 ), which has been successfully used in case study research. The data were managed using NVivo software.

REVIEW METHODS

Literature examining qualitative data analysis was reviewed and strategies illustrated by the case study example provided. Discussion Each stage of the analysis framework is described with illustration from the research example for the purpose of highlighting the benefits of a systematic approach to handling large data sets from multiple sources.

CONCLUSION

By providing an example of how each stage of the analysis was conducted, it is hoped that researchers will be able to consider the benefits of such an approach to their own case study analysis.

IMPLICATIONS FOR RESEARCH/PRACTICE

This paper illustrates specific strategies that can be employed when conducting data analysis in case study research and other qualitative research designs.

Computer-assisted qualitative data analysis software

Advances in technology have provided new approaches for data collection methods and analysis for researchers. Data collection is no longer limited to paper-and-pencil format, and numerous methods are now available through Internet and electronic resources. With these techniques, researchers are not burdened with entering data manually and data analysis is facilitated by software programs. Quantitative research is supported by the use of computer software and provides ease in the management of large data sets and rapid analysis of numeric statistical methods. New technologies are emerging to support qualitative research with the availability of computer-assisted qualitative data analysis software (CAQDAS).CAQDAS will be presented with a discussion of advantages, limitations, controversial issues, and recommendations for this type of software use.

Hearing the voices of service user researchers in collaborative qualitative data analysis: the case for multiple coding

BACKGROUND

Health research is frequently conducted in multi-disciplinary teams, with these teams increasingly including service user researchers. Whilst it is common for service user researchers to be involved in data collection--most typically interviewing other service users--it is less common for service user researchers to be involved in data analysis and interpretation. This means that a unique and significant perspective on the data is absent.

AIM

This study aims to use an empirical report of a study on Cognitive Behavioural Therapy for psychosis (CBTp) to demonstrate the value of multiple coding in enabling service users voices to be heard in team-based qualitative data analysis.

DESIGN

The CBTp study employed multiple coding to analyse service users' discussions of CBT for psychosis (CBTp) from the perspectives of a service user researcher, clinical researcher and psychology assistant. Multiple coding was selected to enable multiple perspectives to analyse and interpret data, to understand and explore differences and to build multi-disciplinary consensus.

RESULTS

Multiple coding enabled the team to understand where our views were commensurate and incommensurate and to discuss and debate differences. Through the process of multiple coding, we were able to build strong consensus about the data from multiple perspectives, including that of the service user researcher.

DISCUSSION

Multiple coding is an important method for understanding and exploring multiple perspectives on data and building team consensus. This can be contrasted with inter-rater reliability which is only appropriate in limited circumstances.

CONCLUSION

We conclude that multiple coding is an appropriate and important means of hearing service users' voices in qualitative data analysis.

Using Framework Analysis in nursing research: a worked example

AIMS

To demonstrate Framework Analysis using a worked example and to illustrate how criticisms of qualitative data analysis including issues of clarity and transparency can be addressed.

BACKGROUND

Critics of the analysis of qualitative data sometimes cite lack of clarity and transparency about analytical procedures; this can deter nurse researchers from undertaking qualitative studies. Framework Analysis is flexible, systematic, and rigorous, offering clarity, transparency, an audit trail, an option for theme-based and case-based analysis and for readily retrievable data. This paper offers further explanation of the process undertaken which is illustrated with a worked example.

DATA SOURCE AND RESEARCH DESIGN

Data were collected from 31 nursing students in 2009 using semi-structured interviews.

DISCUSSION

The data collected are not reported directly here but used as a worked example for the five steps of Framework Analysis. Suggestions are provided to guide researchers through essential steps in undertaking Framework Analysis. The benefits and limitations of Framework Analysis are discussed.

IMPLICATIONS FOR NURSING

Nurses increasingly use qualitative research methods and need to use an analysis approach that offers transparency and rigour which Framework Analysis can provide. Nurse researchers may find the detailed critique of Framework Analysis presented in this paper a useful resource when designing and conducting qualitative studies.

CONCLUSION

Qualitative data analysis presents challenges in relation to the volume and complexity of data obtained and the need to present an 'audit trail' for those using the research findings. Framework Analysis is an appropriate, rigorous and systematic method for undertaking qualitative analysis.