A Deeper Look into Bipositivity: Examining Bipositive Experiences and Internal Bipositivity Among U.S. Plurisexual Women

Background: Reflexive thematic analysis is widely used in qualitative research published in Palliative Medicine, and in the broader field of health research. However, this approach is often not used well. Common problems in published reflexive thematic analysis in general include assuming thematic analysis is a singular approach, rather than a family of methods, confusing themes and topics, and treating and reporting reflexive thematic analysis as if it is atheoretical. Purpose: We reviewed 20 papers published in Palliative Medicine between 2014 and 2022 that cited Braun and Clarke, identified using the search term ‘thematic analysis’ and the default ‘relevance’ setting on the journal webpage. The aim of the review was to identify common problems and instances of good practice. Problems centred around a lack of methodological coherence, and a lack of reflexive openness, clarity and detail in reporting. We considered contributors to these common problems, including the use of reporting checklists that are not coherent with the values of reflexive thematic analysis. To support qualitative researchers in producing coherent and reflexively open reports of reflexive thematic analysis we have developed the Reflexive Thematic Analysis Reporting Guidelines (the RTARG; in Supplemental Materials) informed by this review, other reviews we have done and our values and experience as qualitative researchers. The RTARG is also intended for use by peer reviewers to encourage methodologically coherent reviewing. Key learning points: Methodological incoherence and a lack of transparency are common problems in reflexive thematic analysis research published in Palliative Medicine. Coherence can be facilitated by researchers and reviewers striving to be knowing – thoughtful, deliberative, reflexive and theoretically aware – practitioners and appraisers of reflexive thematic analysis and developing an understanding of the diversity within the thematic analysis family of methods.

A transparent analytical process contributes to the methodological rigor of reflexive thematic analysis. To enhance such transparency in reflexive thematic analysis, novice researchers need to document and present the analytical processes of theme development. In this article, we showcase how qualitative comparative analysis can be integrated into reflexive thematic analysis as a strategy for novice researchers. We demonstrate how novice researchers can develop codes and categories, use qualitative comparative analysis to facilitate the exploration of the complex causal relationships between categories, and construct candidate themes based on these analyses. We then show how novice researchers can continue developing these themes by creating relationships between codes and categories on the basis of qualitative data and existing literature. Such integration of methods not only facilitates theme development, but also assists researchers in justifying the decisions made in a reflexive thematic analysis process. The analytical procedures presented in this article may thus help novice researchers engaged in reflexive thematic analysis to enhance the transparency of their analytical process.

Thematic analysis is a widely cited method for analyzing qualitative data. As a team of graduate students, we sought to explore methods of data analysis that were grounded in qualitative philosophies and aligned with our orientation as applied health researchers. We identified reflexive thematic analysis, developed by Braun and Clarke, as an interpretive method firmly situated within a qualitative paradigm that would also have broad applicability within a range of qualitative health research designs. In this approach to analysis, the subjectivity of the researcher is recognized and viewed not as problematic but instead valued as integral to the analysis process. We therefore elected to explore reflexive thematic analysis, advance and apply our analytic skills in applied qualitative health research, and provide direction and technique for researchers interested in this method of analysis. In this paper, we describe how a multidisciplinary graduate student group of applied health researchers utilized Braun and Clarke’s approach to reflexive thematic analysis. Specifically, we explore and describe our team’s process of data analysis used to analyze focus group data from a study exploring postnatal care referral behavior by traditional birth attendants in Nigeria. This paper illustrates our experience in applying the six phases of reflexive thematic analysis as described by Braun and Clarke: (1) familiarizing oneself with the data, (2) generating codes, (3) constructing themes, (4) reviewing potential themes, (5) defining and naming themes, and (6) producing the report. We highlight our experiences through each phase, outline strategies to support analytic quality, and share practical activities to guide the use of reflexive thematic analysis within an applied health research context and when working within research teams.

BackgroundPsychodynamic therapy (PDT), has an empirical evidence base, and a rich literature of therapist perspectives, but a dearth of patient perspectives. People with functional neurological disorder (FND), are often or...

Family, Friend, and Neighbour care is one of the oldest and most widespread forms of childcare used by families, yet there is far less research on this type of childcare compared to others. This study focused on Latinx immigrant FFN providers to learn about their motivations, needs, and facilitators and barriers to accessing services. Qualitative data come from a subsample of a larger study and include 5 focus groups with 41 Latinx immigrant FFN providers; these data were analysed using reflexive thematic analysis [Braun & Clarke, 2020. One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology, 1–25]. The themes, ‘They Need Us’; ‘We’re Not Babysitters, We’re Providers’; and ‘To Face the Job at 100%’ along with their subthemes capture Latinx immigrant FFN providers’ strong commitment and sense of duty to the families that they serve. Research and practice implications are discussed.

BackgroundAs the SARS-CoV-2 virus created a global pandemic and rapidly became an imminent threat to the health and lives of people worldwide, the need for a vaccine and its quick distribution among the population was evident. Due to the urgency, and on the back of international collaboration, vaccines were developed rapidly. However, vaccination rollouts showed different success rates in different countries and some also led to increased vaccine hesitancy.ObjectiveThe aim of this study was to identify the role of information sharing and context sensitivity in various vaccination programs throughout the initial COVID-19 vaccination rollout in different countries. Moreover, we aimed to identify factors in national vaccination programs related to COVID-19 vaccine hesitancy, safety, and effectiveness. Toward this end, multidisciplinary and multinational opinions from members of the Navigating Knowledge Landscape (NKL) network were analyzed.MethodsFrom May to July 2021, 25 completed questionnaires from 27 NKL network members were collected. These contributors were from 17 different countries. The responses reflected the contributors’ subjective viewpoints on the status and details of the COVID-19 vaccination rollout in their countries. Contributors were asked to identify strengths, weaknesses, opportunities, and threats (ie, SWOT) of the respective vaccination programs. The responses were analyzed using reflexive thematic analysis, followed by frequency analysis of identified themes according to the represented countries.ResultsThe perspectives of NKL network members showed a link between organizational elements of the vaccination rollout and the accompanying societal response, both of which were related to strengths and weaknesses of the process. External sociocultural variables, improved public communication around vaccination-related issues, ethical controversies, and the spread of disinformation were the dominant themes related to opportunities and challenges. In the SWOT 2×2 matrix, Availability and Barriers emerged as internal categories, whereas Transparent communication and promotion and Societal divide emerged as key external categories.ConclusionsInventory of themes and categories inspired by elements of the SWOT framework provides an informative multidisciplinary perspective for effective implementation of public health strategies in the battle against COVID-19 or any future pandemics of a similar nature.

This paper reflects on reflexive thematic analyses with Pacific peoples from different cultural and language backgrounds. This paper will briefly describe reflexive thematic analysis according to Braun et al. (2019) and reflect upon issues concerning thematic analysis and Pacific cultures and languages. As academics, researchers, and practitioners, “we engage in a co-construction of knowledge” with our communities while adhering to cross-cultural notions of respect (Enari & Rangiwai, 2021, p. 2). We draw upon our collective cultural knowledge to offer a unique insider perspective (Enari & Rangiwai, 2021) concerning our current understandings of reflexive thematic analysis as it applies to research with Pacific peoples.

Reflexive thematic analysis (reflexive TA) originated within psychology and the social sciences and has become an increasingly popular qualitative analytic method across a range of disciplines. In this article, we offer a brief methodological guide for researchers hoping to use the method, suitable for beginners through to those experienced in qualitative research. Reflexive TA can be used to analyze data generated via a range of methods. Reflexive TA is highly flexible, and we outline the choices that researchers need to address when conducting their research. These choices relate to the theoretical approach (realist through to relativist/experiential to critical), their orientation to analyzing the data (inductive to deductive), and the depth in which they analyze their dataset (semantic to latent). We offer an accessible but comprehensive discussion of the six phases of reflexive thematic analysis and how best to produce a rigorous analysis. Starting with familiarization of the dataset as a foundation for analysis, data are then coded, before using these codes to generate initial themes. These early themes are then reviewed and developed, before the researcher moves to defining and naming them. The final phase of analysis is the writing up of the research, at which point final changes may still be made to the results. Written from the basis of our experience of using, teaching, and training reflexive thematic analysis within psychology and the social sciences, we see it as useful for those working across a range of disciplines.

Learning from authentic patient narratives in nursing education using Gibbs' Reflective Cycle: A qualitative study using reflexive thematic analysis.

While numerous therapeutic approaches have been developed to assist people who stutter (PWS) in managing their condition, these interventions have been shaped by researchers' and speech-language pathologists' perspectives, showing limited effectiveness and long-term impact. Moreover, they often overlook PWS' lived realities, including their challenges, priorities, and values. This study explores the lived experiences of adults who stutter, providing insights into their priorities, needs, challenges, and perspectives to inform person-centred therapeutic practices. Nineteen adults who stutter, from diverse countries and cultural backgrounds, and with varying experiences with stuttering management, participated in this study. Using convenience and purposive sampling, in-depth semi-structured interviews were conducted. The collected data were analysed through reflexive thematic analysis. The findings revealed the self-perpetuating cycle of fear and avoidance as the core disabling experience of stuttering, restricting meaningful engagement across emotional, cognitive, social, and professional domains. Participants emphasised that breaking this cycle requires proactive self-acceptance, integrating stuttering modification, desensitisation, and non-verbal communication strategies to foster effective communication. However, sustaining progress was hindered by time limitations, inadequate support, and the misalignment of therapy models with real-world needs-particularly those that overlook the fluency trap. Many participants viewed avoidance, rather than stuttering disfluency, as their main concern, thereby highlighting the need for therapeutic approaches that prioritise psychological resilience over fluency. These findings underscore the need for a person-centred approach in stuttering research and therapy, ensuring tailored interventions that are holistic yet structured, goal-oriented, and coherent, where different therapeutic goals complement rather than contradict each other, aligning with PWS' lived realities.

Introduction Migration is at the core of today’s professional sport. In football, since 2020, the rate of migrant players has increased by 20% (Poli et al., 2024). Transnational mobility has become a highly valuable commodity making transnational football career an inescapable pathway to either professional level or world-class level. Therefore, understanding cross-borders sports mobility processes is crucial for both players and stakeholders to effectively prepare and negotiate cultural transitions. Transnational career and pathway research in sport psychology is recent, limited, and suggests that maintaining a career as a migratory athlete remains challenging (Book et al., 2021; Ryba & et al., 2016; Storm et al., 2022). By identifying challenges faced, and psychological process involved, those researches highlight at what extent culture frames athletes’ sport and non-sport life experiences. However, no studies focused on neither the first cultural transition nor African athletes. From analysis of some previous studies, it seems that the experience of the first cultural transition shapes the willingness to initiate and the experience of the following migrations (Book et al., 2021; Ryba et al., 2016). On the other hand, African countries are deeply distinct from the most other countries worldwide regarding relevant features shaping people’s life experience: social security, gross domestic product, facilities, governance, and race. Furthermore, African countries are among those displaying the highest growth of expatriate footballers (Poli et al., 2024). Additionally, most of athletic migrations from Africa correspond to forced migration (United Nations Humans Rights Council, 2022), with the difference that it is triggered by a contract. Thus, what characterize the experience of the first cultural transition of African footballers? This study aimed to explore the athletic transnational career of Cameroonian footballers to characterize their experience of the first cultural transition. Methods This study is grounded within Critical Realism philosophy. It is useful to engage causal analysis and explanation of social problems and suggest practical recommendations for social change (Fletcher, 2017). Fourteen Cameroonian former footballers were purposively sampled following three criteria: having spent at least the formative years in Cameroon, did the first cultural transition for athletic career development, and having played professionally for a football club abroad at least one season. The participants’ position in the pitch included all the main positions acknowledged in football (goalkeeper, defender, midfielder, and striker), and the country of their first cultural transition included the four continents (Kingdom of Saudi Arabia, Germany, France, Indonesia, Greece, Côte d’Ivoire, Paraguay, Italy, Switzerland, and Turkey). The semi-structured interviews based on life story and timeline interviews approaches were conducted, focusing on the participants’ experience of athletic transnational mobilities. This included a series of two interview sessions which lasted between 25 and 121 minutes. A total of 26 interviews were audio recorded, transcribed, and reflexively thematically analyzed (Braun & Clarke, 2021). The study applied the four rigorous criteria to ensure qualitative study trustworthiness: credibility, dependability, confirmability, and transferability (Lincoln & Guba, 1985). Results Nine themes (with their sub-themes) and their relationship were identified: Mental Health Issues (MHI), Context of athletic migration and seven challenges related to: Club and Contract, Team, Pitch, Way of life, Geography, Home country, and High Level Athlete status. MHI emerged as output of the context and challenges. MHI were characterized by players’ psychological distress and inability to understand that condition, and inability of the club leading team to understand what they were going through. The context of athletic migration was characterized by unplanned transition, adolescence, club’s facilities, and perception of moving abroad as having succeed their football career and life (satisfaction of achieving the dream). Challenges characterized tough situations players went through like contract disruption (club and team), broken In-group (team), injury (pitch), new mentality (way of life), winter (geography), long-distance relationship (home country), and experience of professionalism (High Level Athlete status). Discussion/Conclusion This research is the first to study the first cultural transition of athletes and to use a sample of athletes from Africa. The results depict main features characterizing the experience of the first athletic migration of young talented Cameroonian footballers. Applying critical realism philosophy, MHI was identified as the effect of the migration context and challenges faced. Those findings are consistent with the holistic developmental and ecological perspectives to talent development (Wylleman & Rosier, 2016), Intersectionality (Book et al., 2021), cultural sport psychology (Schinke & Hanrahan, 2009), and challenges underscored in previous transnational athletic career studies (Book et al., 2021; Ryba et al., 2016; Storm et al., 2022). Most importantly, this study highlights new result patterns enriching literature and providing critical information for African athletes and sport stakeholders: MHI (explicitly underscored), context of athletic migration, challenges related to winter, new mentality, broken In-group, etc. As successful talented footballers, they anticipated migration with professional contract as the guarantee of happiness. Actually, those young talented footballers navigated through the satisfaction of achieving professional level and distress. They struggled with psychological distress by shouldering the acculturation load and some professional football’s drifts in an environment which was not supportive enough, because it does not understand them. They could not seek for help because the lack means to understand their condition. Thus, this study is directly related to two Sustainable Development Goals (the third and eighth) by addressing mental health and decent work (United Nations Humans Rights Council, 2022). The results suggest several practical implications: informed football stakeholders’ action, strengthen coaches’ training, adjust sport psychologists’ intervention, and build solid preparatory foundation for next transnational African footballers. References Book, R. T., Jr., Henriksen, K., & Stambulova, N. (2021). Oatmeal is better than no meal: The career pathways of African American male professional athletes from underserved communities in the United States. International Journal of Sport and Exercise Psychology, 19(4), 504–523. https://doi.org/10.1080/1612197X.2020.1735258 Braun, V., & Clarke, V. (2021). One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology, 18(3), 328–352. https://doi.org/10.1080/14780887.2020.1769238 Fletcher, A. J. (2017). Applying critical realism in qualitative research: Methodology meets method. International Journal of Social Research Methodology: Theory & Practice, 20(2), 181–194. https://doi.org/10.1080/13645579.2016.1144401 Lincoln, Y., & Guba, E. G. (1985). Naturalistic inquiry. Sage. Poli, R., Ravenel, L., & Besson, R. (2024, May). Origins and destinations of football expatriates (2020–2024). CIES Football Observatory [Monthly Report n°95]. https://football-observatory.com/MonthlyReport95 Ryba, T. V., Stambulova, N. B., & Ronkainen, N. J. (2016). The work of cultural transition: An emerging model. Frontiers in Psychology, 7, Article 427. https://doi.org/10.3389/fpsyg.2016.00427 Schinke, R. J., & Hanrahan, S. J. (Eds.). (2009). Cultural sport psychology. Human Kinetics. https://doi.org/10.5040/9781492595366 Storm, L. K., Book, R. T., Jr., Hoyer, S. S., Henriksen, K., Küttel, A., & Larsen, C. H. (2022). Every boy’s dream: A mixed method study of young professional Danish football players’ transnational migration. Psychology of Sport and Exercise, 59, 1–11. https://doi.org/10.1016/j.psychsport.2021.102125 United Nations Human Rights Council. (2022). Mid-year trends 2022. https://www.unhcr.org/mid-year-trends Wylleman, P., & Rosier, N. (2016). Holistic perspective on the development of elite athletes. In M. Raab, P. Wylleman, R. Seiler, A.-M. Elbe, & A. Hatzigeorgiadis (Eds.), Sport and exercise psychology research: From theory to practice (pp. 270–282). Elsevier Inc.

BackgroundRecent advances in digital health technology offer the potential to overcome established access barriers to mental health support, such as stigma and geographical location. The World Health Organization recommends integrating digital technologies into mental health care, underscoring the need for countries to develop national digital mental health (DMH) strategies to guide efforts. The rate of development and availability of DMH tools currently outpaces the existing policy or regulatory guidance required to guide their use. In Ireland, a key requirement of the national mental health strategy, Sharing the Vision, was the development of a national DMH strategy. Key stakeholders in DMH research, policy, practice, and lived experience were brought together as part of a focused stakeholder engagement event to develop a shared vision for digital mental health in Ireland.ObjectiveThis study aimed to explore the views of DMH stakeholders to set priorities for the development of a national DMH strategy.MethodsForty-seven stakeholders were each assigned to 1 of 6 focused strategy discussion groups. Invited stakeholders included experts in DMH research, clinical practice, and mental health advocacy and policy, together with those with lived experience of accessing mental health services. Qualitative data were analyzed using a reflexive thematic analysis approach. Researchers followed the 6-step framework proposed by Braun and Clarke. Reflexive thematic analysis emphasizes intentionality and critical thought, highlighting researchers’ deliberate interpretation of data while being aware of how their perspectives shape the conclusions.ResultsA total of 5 major themes were identified: inclusive access, being user-led, trust, education and training, and connectedness. These major themes were related to 15 subthemes. The inclusive access theme comprised inclusivity, accessibility, and early intervention subthemes. The user-led theme encompassed coproduction, choice, and needs-led subthemes. Compelling narrative; regulation, policy, and governance; and evidence base subthemes were identified within the theme of trust. The subthemes of digital literacy, mental health literacy, and transformation were identified within the education and training theme. Finally, the connectedness theme incorporated the subthemes of integration, relationships, and stigma.ConclusionsOverall, delegates viewed digital technology as a potential enabler of accessible and inclusive mental health support. However, it was also seen as a potential barrier to access and inclusion if concerns regarding data privacy, education and training needs, regulation, and the need for a more a robust evidence base were not addressed. Coproduction at all stages was identified as key to reducing access barriers, enhancing inclusion, and maintaining trust. Themes identified informed a follow-on consensus-seeking process to further refine and prioritize the proposed actions of the first national DMH strategy.

Purpose: This study explored the experiences of young adults using the Youth Mental Health Center (YMHC) in South Korea to assess effectiveness and enhance comprehensive mental health services for this population. Methods: Ten participants were recruited through purposive sampling from a YMHC. Data were collected via in-depth interviews conducted between July and October 2024, and analyzed using Braun and Clarke's reflexive thematic analysis. Results: The analysis yielded 210 codes, 10 sub-themes, and four main themes: "Reconnecting with the World and Seeking Change," "A Journey of Recovery Begun Together," "Obstacles Still to Overcome," and "Emerging New Hope." Findings revealed that YMHCs serve as bridges connecting young adults with mental health issues to the community, providing refuge and opportunities for peer engagement that help restore broken social relationships. Professional assistance enabled participants to gain an accurate understanding of their challenges and initiate their recovery journeys. Conclusion: This study provides a comprehensive understanding of young adults' experiences with YMHCs. The findings can inform the development of effective programs tailored to the mental health needs of young adults, enhance service accessibility, and support policies aimed at improving mental health literacy and accessibility for this vulnerable population.

ObjectivesTo understand factors that influence the intention of workers to remain in or leave employment in National Health Service (NHS) mental health crisis services and to use findings to formulate recommendations for NHS trusts to achieve improved worker stability in mental health crisis services.DesignA reflexive thematic analysis was conducted to explore the retention-related experiences of crisis workers. Secondary data was obtained from interviews conducted with crisis workers. This was collected by The University of Sheffield as part of the Retention of Mental Health Staff (RoMHS) study.SettingSix NHS Trusts in England.ParticipantsAll crisis worker interviews from the RoMHS study were included, totalling 10 participants: 70% female, 30% male, exclusively White British, and mostly occupying leadership roles.ResultsFive themes were identified as influencing the retention of crisis workers: resource limitations, organisational culture and leadership, fairness and consistency, personal agency and team working. These themes are comparable to factors known to affect retention of the mental health workforce more widely. However, this study found a greater emphasis on the emotional burden of crisis work, including the challenges of complex risk management, and a perceived vulnerability of crisis service workers to increased workload and fewer development opportunities compared with other specialist mental health services.ConclusionThis study identifies that crisis workers face similar retention-related issues compared with the mental health workforce more widely, but with additional challenges related to the emotional intensity of the work and susceptibility of crisis services to resource constraints compared with other specialist mental health services. Further research should focus on employees who left crisis services, under-represented groups within the crisis workforce and the impact of retention-related policy.

Despite its importance, recruiting a sufficient sample size for randomised controlled trials (RCTs) can pose a significant challenge, which has real-world impact on reliability of evidence, trial completion and ultimately, patient care. Technology has potential to enhance the recruitment process, but there is a lack of evidence regarding its current use and effectiveness. Consistent with findings from the PRioRiTy I study, the current research aims to explore the advantages and disadvantages to using technology during the recruitment process for RCTs. Semi-structured interviews (n=7) were conducted with researchers involved in RCT recruitment in Ireland. Subsequently, a Public & Patient Involvement (PPI) panel focus group (n=3) was conducted to add further depth to these findings. The data were qualitatively analysed through 'Reflexive Thematic Analysis' to extract prominent themes. A superordinate theme arose: 'Tech is just a medium so that you can reach more people', along with two themes, which were corroborated by the PPI focus group: 'Technology is used if and when the benefits outweigh the costs' and 'Success of recruitment through technology depends on the nature of the study.' This study provided a deeper understanding of the factors which influence researchers to employ technology in recruitment for RCTs. Implications suggest that future researchers should aim to adapt their recruitment approaches to meet digital tool preferences of their target cohort; and engage with patient groups in the community to allow networking opportunities for future studies. This research may contribute towards maximising efficiency in RCT recruitment.