Descriptive Phenomenology Research Articles

Equitable Access of Naloxone Programs in Durham Region, Ontario, Canada

Abstract Background In 2019 there were over 1500 opioid-related deaths in the province of Ontario, Canada. While the opioid crisis is affecting many socioeconomic groups and communities across Canada not all are being affected equally despite the presence of naloxone distribution programs in Ontario. This qualitative exploratory study seeks to understand facilitators and barriers that influence equitable access of naloxone programs in Durham Region, Ontario, Canada. Methods An environmental scan will be conducted to examine the availability and distribution of naloxone across community pharmacies and organizations in Durham Region. A qualitative descriptive phenomenology will be the methodological approach where key informant interviews will explore experiences of users and providers of naloxone programs. Key informants will include service providers and clients of both Ontario Naloxone Program and Ontario Naloxone Program for Pharmacies in Durham Region. The harm reduction framework will be used to guide data analysis where thematic analysis will be conducted to generate overarching themes about the phenomenon. Results The environmental scan will result in the creation of a map outlining availability and distribution of naloxone programs to examine possible gaps that exist in Durham Region. It is expected that key informant interview findings will help understand where inequity exists in accessing Ontario's naloxone programs in Durham Region by highlighting its barriers and facilitators. Conclusions Findings generated will be used for larger scale studies in the future examining equitable access of naloxone distribution programs in Canada. This study will have implications to provide recommendations to policymakers for developing new policies to facilitate timely access of naloxone to mitigate risk of opioid-related harms. Key messages This research will help to better understand the inequities that exist in Ontario's naloxone distribution programs. This research will help to inform recommendations to improve policies surrounding Ontario's naloxone distribution programs.

From the carer's mouth: A phenomenological exploration of carer experiences with head and neck cancer patients.

Receiving a diagnosis of head and neck cancer is devastating for patients and family carers and causes high levels of distress. Previous studies report that carer distress levels exceed that of patients, but go largely unnoticed by health professionals. To date, there is a paucity of studies that have described carers' perspectives of the lived experience of caring for a loved one diagnosed with head and neck cancer. The aim of this study was to explore the lived experiences of carers of patients diagnosed with head and neck cancer. This qualitative study was informed by descriptive phenomenology. Carers of patients who had been diagnosed with head and neck cancer within the last 6 years were recruited from participating hospitals in Perth, Western Australia. Semi-structured interviews were conducted with 20 carers of patients diagnosed with head and neck cancer. Thematic analysis was conducted to gain an understanding of participants lived experiences. Key themes identified were: Silent Suffering, Gamut of Emotions, Causal Attribution, Changing Priorities, Gaining Support, and Coping. The changing priorities themes highlights that carers prioritised (a) being available for their loved one and (b) taking an active role in managing head and neck cancer symptoms and side effects. Carers of patients diagnosed with head and neck cancer experience distress. Instead of seeking support, carers often elected to suffer in silence. Implications for practice include screening for carer distress and providing specific interventions focused on caring for someone diagnosed with head and neck cancer.

Qualitative study on working experience of COVID-19 care nurses

To study the working experience of COVID-19 care nurses. Twenty two nurses taking care of COVID-19 patients were interviewed by means of descriptive phenomenology. All the data were transcribed and recorded, and then processed into WORD documents. The Colaizzi 7 footwork was used to classify, encode, establish nodes and extract themes based on Nvivo11.0 software. Two main themes were extracted: one is the positive feelings of nurses, including the sense of professional mission and pride, the sense of achievement and happiness, the improvement of self-worth and ability, the powerful support system and the power of role models; the other is the negative experience of nurses, including the worry and anxiety at work, the lack of experience and trust, the difficulty of work, and the inconvenience of isolating life. s While fully affirming the work value of nurses, it is necessary for the society, hospitals and patients to give extensive and continuous support, care and respect to nurses, so as to stimulate their working enthusiasm and sense of professional achievement. Hospital managers need to implement all kinds of security work, meet the safety needs of nurses, pay attention to the physical and mental health of nurses, strengthen the training of nursing talents for critical and severe diseases and infectious diseases, improve the allocation of human resources, and enhance the ability of material allocation and reserve for major health events, so as to make adequate preparations for coping with public health events in the future.

Experience of Registered Nurses of Postoperative Pain Assessment Using Objective Measures among Children at Effia Nkwanta Regional Hospital in Ghana

Introduction: People undergoing surgical operations experience some level of pain. Assessing pain intensity is one of the duties of the nurse and it involves subjective measures (self-report), and objective measures (behavioural and physiological). It has been observed by the researcher that nurses in clinical practice do not assess pain before management more so among children. Also, there is limited research in the area of pain assessment in children who cannot communicate. This study aimed to describe the experiences of registered nurses in assessing postoperative pain among children (0-3 years) using objective measures. Methods: Descriptive phenomenology was the chosen design. Maximum variation sampling was used to recruit nine registered nurses with experience in nursing children after surgery at Effia Nkwanta Regional Hospital (ENRH) in Ghana. The researchers conducted audio-recorded in-depth interviews, transcribed verbatim and qualitatively analyzed following Colaizzi’s approach to descriptive phenomenology analysis. Results: The study revealed that the nurses have more experience with using behavioural measures with limited experience with the use of physiological measures. The behavioural measures mostly reported from their experience were changes in facial expression and unusual crying of the child. In general, the nurses do not formally use consistent approaches to assess pain among children. Conclusion: Given these results, opportunities should be made available for nurses to enhance their skills and utilize evidence-based approaches to formally assess pain among post-operative children.

The Lived Experience of Nurses Caring for Patients with COVID-19 in Iran: A Phenomenological Study.

ObjectiveThis study aimed to explore the lived experiences of nurses caring for patients with COVID-19 in Iran.MethodsThis study was a descriptive phenomenology. Sampling was purposefully performed, and participants were selected in terms of the inclusion criteria. Data were collected through semi-structured interviews using the WhatsApp mobile messaging application. Colaizzi’s method was used to analyse the data. The criteria introduced by Lincoln and Guba were used for the study rigour.ResultsThe data were obtained from 12 nurses caring for patients with COVID-19. The mean age of the participants was 29.41 years (SD = 2.72) with a mean work experience of 6.75 years (SD = 2.52). Three main themes and six subthemes were identified: mental condition (subthemes included “anxiety and stress” and “fear”), emotional condition (subthemes included “suffering and affliction” and “waiting for death”), and care context (subthemes included “turmoil” and “lack of support and equipment”).ConclusionThe results of this study show that nurses working in the wards and care centres designated for patients with COVID-19 are experiencing mental and emotional distress and are working in inadequate professional conditions.

Navigating Life with HIV as an Older Adult in South African Communities: A Phenomenological Study.

The study explored how older adults experience an HIV diagnosis, deal with issues of stigma and disclosure, and navigate the healthcare system. Descriptive phenomenology was used to collect data from 20 older adults receiving antiretroviral treatment in health facilities in Gauteng Province, South Africa. Data analysis was inductive and followed the thematic approach. After diagnosis with HIV, the older adults experienced shock and disbelief, internalized their new reality of being HIV-positive, and found it difficult to disclose their HIV status. Stigma was embedded in their patterns of disclosure, and they chose not to disclose in order to manage stigma, protect their status, and maintain their privacy. Moreover, nondisclosure allowed them to achieve some normality in their lives without the fear of rejection. The older adults adopted various survival skills that aided them to accept their HIV status. Self-acceptance was important for the older adults who did not want to feel cheated out of life by the HIV diagnosis. The positive supportive attitudes of the healthcare professionals provided the much-needed support network for the older adults immediately after they had received their HIV test results. This was instrumental in their acceptance of their HIV status, their adherence to clinic visits, and their ability to live a healthy, positive life.

Experience of Truth-Telling From the Viewpoints of Family in the Intensive Care Units

Truth-telling is an important step toward reducing the cognitive gap between physicians and patients as well as reducing the psychological pressures applied to physicians by family members. There is a lack of research on the truth-telling experience and needs in the intensive care unit from the perspective of patient family members. This study is designed to explore the experiences and needs of families in the intensive care unit. A descriptive phenomenology method was used in this study. In-depth interviews were conducted with five participants who had family members assessed with acute physiology and chronic health evaluation II scores ≥ 20. Data were analyzed using Giorgi's phenomenological methods and Nvivo 11. Four experience themes were examined, including (1) nothing is clear, requires explanation; (2) helpless to find answers, need a nurse to resolve this issue; (3) professional conduct makes us feel helpless, longing for love from the medical team; (4) decisions are very difficult, hoping to get more help. The family members expressed that they were unable to understand the underlying causes of the progression in patient condition because the medical team only presented outcomes to the family and did not discuss related causes. Thus, it is recommended that medical teams learn to recognize the cognitive processes of patient family members and consider their emotions, including their needs and expectations, in order to provide individualized explanations based on a patient's status and progress.

The Meaning of Love and Love Orientation of Widows Based on Erich from Perspective (A Study at St. Petrus Paulus Church, Wlingi, East Java, Indonesia)

This study aims to explore the meaning of love and love orientation of Catholic widows based on Erich Fromm’s theory. The research model used qualitative research with descriptive phenomenology, based on interviews among four widow members of St Peter Paulus church. This interview data was analysed using thematic analysis techniques. The results showed the participants interpreted love as an effort to give what they have. Participant’s love orientation tends to be stronger towards children and God. Meanwhile, other orientations were also found namely grandchildren, nieces, neighbours, deceased spouses, friends and themselves. Productive love is experienced primarily in relationships with children, God, and people in their extended social spheres. Relationships with partners and themselves become the least dominant relationships in the life of a widow and less interpreted with productive love. Based on the results of this study it is advisable to the church to add a counselling for their member who has loss their partner (spouse) so that they regain a sense of self-worth.
 Keywords: meaning, orientation, love, Erich Fromm, phenomenological, widow, Santo Petrus Paulus Church Wlingi.

Potential of Hospital Fraud in the Indonesia National Health Insurance Era (A Descriptive Phenomenological Research)

Results of the Public Research Anti Corruption Clearing House The Corruption Eradication Commission submitted on December 2, 2016 that until mid-2015 there was a potential of 175,774 hospital claims of fraud that had been detected with a value of Rp. 440 M. In 2016 found an indication of 1 million fictitious claims from the hospital with a value of Rp. 2 trillion. The potential for fraud in hospitals in the era of National Health Insurance (NHI) in Indonesia will have an impact on health financing inefficiencies and at the same time a threat to the sustainability of the NHI program which is expected to reach Universal Health Coverage in 2019. This phenomenological study aims to explore understanding and meaning of the concept of fraud for parties who has had the potential to commit fraud at the hospital. The research method used qualitative research with a Descriptive Phenomenology Research approach. The informants were officers who served patients in administrative and medical matters and the hospital management was selected by purposive sampling. The focus of the study was the experience felt by informants in running the NHI program and how knowledge and attitudes of informants towards the phenomenon of fraud in hospitals. The results achieved in this phenomenological research were in the form of a reflection of the implementation of NHI in hospitals, especially relating to the phenomenon of potential fraud reflected in the knowledge and attitudes of the hospital about fraud and a description of the occurrence of fraud in the hospital. This is the basis for researchers to formulate indicators of potential fraud that still needs to be tested in a larger population.

Family Caregiver Phenomenon that Treats Persons with Disabilities Since Birth

Background: Disability is a disturbance or limitation of physical activity involving participation restrictions. The disturbance is a problem in the body’s function and its structure. Restrictions on physical activity are the difficulties faced in performing tasks or actions, while limiting participation is a problem experienced by individuals in engagement in life situations. Objective: This study aimed to provide an in-depth description of the feelings, explain the obstacles or difficulties experienced and explain the caregiver’s expectations of mothers/fathers/brothers in caring for children with disabilities from birth. Method: This study was a qualitative research with a descriptive phenomenology approach. Data collection was conducted through in-depth interviews of family caregivers of persons with disabilities since birth with inclusion and exclusion criteria. The data were analyzed by Colaizzi’s method and data triangulation was performed by a coder to maintain data validation. The sample selection was done by purposive sampling. The sample of the study amounted to 17 persons who were family caregivers. Result: The results showed that caregiver phenomenon in caring for persons with disabilities since birth is a burden. Psychological burdens include sadness, disappointment, anger, guilt, depression and ultimately acceptance. Additionally, there are financial burdens, time constraints and social stigma. Conclusions: Caregivers for persons with disabilities since birth experience several burdens, including psychological, physical, financial and social burdens. There is the psychological burden of anger, disappointment, fear, worry, and guilt which many finally can accept. The physical burden of fatigue, lack of sleep, lack of appetite may result in diseases such as gastritis, hypertension, along with muscle and joint disorders. Financial burdens are related to medical expenses, transportation, and daily necessities. The social burden involves stigma, negative labeling and lack of time with other families and communities. It is hoped all caregivers with family and community support can accept and overcome these challenges.

An exploration of why qualified mental health nurse prescribers do not prescribe

This article is an exploratory study of perceptions in mental health nurses who are qualified to prescribe yet choose not to do so. In-depth semi-structured face-to-face interviews, field notes and analysis of documents were used to investigate the perceptions of the non–prescribing nurse prescriber. A mapping exercise was conducted to identify potential participants. Interview data analysis was based on the principles of descriptive phenomenology and the research was theoretically framed within concepts of power, structure/agency and culture. This study has contributed to understanding the views of non-prescribing mental health nurse prescribers on why they do not use their prescribing qualification. The findings from this study suggest that there are complex, interlocking factors: power and knowledge; culture; and structure and agency, which may enable or prevent mental health nurse prescribers from independently prescribing.

Perceptions and experiences of frontline health managers and providers on accountability in a South African health district

ObjectivePublic primary health care and district health systems play important roles in expanding healthcare access and promoting equity. This study explored and described accountability for this mandate as perceived and experienced by frontline health managers and providers involved in delivering maternal, newborn and child health (MNCH) services in a rural South African health district.MethodsThis was a qualitative study involving in-depth interviews with a purposive sample of 58 frontline public sector health managers and providers in the district office and two sub-districts, examining the meanings of accountability and related lived experiences. A thematic analysis approach grounded in descriptive phenomenology was used to identify the main themes and organise the findings.ResultsAccountability was described by respondents as both an organisational mechanism of answerability and responsibility and an intrinsic professional virtue. Accountability relationships were understood to be multidirectional - upwards and downwards in hierarchies, outwards to patients and communities, and inwards to the ‘self’. The practice of accountability was seen as constrained by organisational environments where impunity and unfair punishment existed alongside each other, where political connections limited the ability to sanction and by climates of fear and blame. Accountability was seen as enabled by open management styles, teamwork, good relationships between primary health care, hospital services and communities, investment in knowledge and skills development and responsive support systems. The interplay of these constraints and enablers varied across the facilities and sub-districts studied.ConclusionsProviders and managers have well-established ideas about, and a language of, accountability. The lived reality of accountability by frontline managers and providers varies and is shaped by micro-configurations of enablers and constraints in local accountability ecosystems. A ‘just culture’, teamwork and collaboration between primary health care and hospitals and community participation were seen as promoting accountability, enabling collective responsibility, a culture of learning rather than blame, and ultimately, access to and quality of care.

The Self-Management Experiences of Adolescents with Type 1 Diabetes: A Descriptive Phenomenology Study.

Many adolescents with type 1 diabetes experience challenges in achieving good glycemic control and have insufficient understanding in executing interventions for glycemic control. This study aimed to understand self-management experiences of adolescents with type 1 diabetes in Taiwan. In this descriptive phenomenological study, we conducted in-depth interviews with 18 adolescents with type 1 diabetes from the pediatric outpatient clinic of a medical center. Data were analyzed using the Colaizzi’s method. Four themes were identified: (1) misconception regarding self-management of blood glucose; (2) conflict between depending on and breaking away from parental assistance for glycemic control; (3) encounter with disruptions in glycemic control regimen due to the presence of schedule changes; and (4) lack of motivation to achieve good glycemic control. The findings indicated that the misconceptions of adolescents with type 1 diabetes about managing glycemic levels resulted from an insufficient understanding of self-management of diabetes. In Taiwan, the heavy emphasis of academic achievement and changes of schedules during breaks tended to disrupt the regimen for glycemic control. Healthcare professionals are encouraged to provide individualized education focusing on the adolescents’ misconceptions regarding self-management of diabetes.

Parental presence in the implementation of atraumatic care during children's hospitalization.

Hospitalization requires children to adapt to various difficult conditions, such as treatments, health personnel, and separation from their families, especially their parents. Separation from parents often causes significant emotional changes in children like anxiety, which could trigger the trauma of hospitalization in both the short and long terms. The study used a qualitative research method with a descriptive phenomenology study approach. It was conducted in the Child Care Room with 11 participants. Data analysis was performed using Creswell thematic analysis. The study produced three themes: i) nurses support the presence of parents during children’s hospitalization; ii) parental presence is the main source of coping for children during hospitalization; iii) Parents have a role in fulfilling the children’s psychological needs during hospitalization.

Posttraumatic growth in adolescent survivors of earthquake, tsunami, and liquefaction in Palu Indonesia: a phenomenological study.

Exploration of posttraumatic growth (PTG) experiences in adolescent survivors of earthquakes, tsunamis, or liquefaction are needed by nurses to maximize the potential for recovery and growth of adolescents from trauma after natural disasters. The study used a qualitative method with a descriptive phenomenology approach. Data were collected through in-depth interviews with 16 adolescent survivors and were analyzed using the Colaizzi method. The results of this study have two main themes: trauma becoming the basis for realizing the meaning of life and escaping from disaster as a second chance to live better. PTG is a positive change that needs to be pursued. Escaping from disaster and realizing the meaning of life are the key points to get success in pursuing PTG to live a better life. In addition, support from mental health nurses through cognitive therapy (CT) and acceptance commitment therapy (ACT) are needed to increase the PTG.

The importance of shepherd leadership practices on easing the text book burden on South African university students

Herein the argument advanced is that excellent shepherd leadership practices serve as a condition necessary for affording South African university students easy access to the required book chapters instead of enduring the burden of having to buy the full books. In order to embellish this viewpoint, relevant data were collected through focus group interview discussion sessions (FGIDs) with a sample of 40 purposefully sampled participants from a target population of university students, lecturers and local text books sales personnel. These participants were first categorised into 4 focus groups of 10 members each and were interviewed for a duration of between 40 minutes and one hour per focus group. By adopting an interpretivist paradigm, utilising a qualitative research approach and descriptive phenomenology as strategy of enquiry (design genre) the study was able to explore the lived experiences of the participants. The two key research questions guiding the study were; how can the key university lecturers as curriculum leaders and shepherd leaders easy the text book burden on South African university students? And what role can text book publishing companies play towards easing the text book burdens on university students? Deploying shepherd leadership as the theoretical framework or lenses for viewing and analysing the data through inductive and or thematic approach, the study’s main finding was that since the biggest cost that university students have is books and given that most of the books are only used for one semester, their exorbitant prices more often than not, lead students to resort to photocopying while publishers lose out. The study concluded that using such new platforms as E-llumin 8, can help students alleviate their text book burden since it allows them access to specifically prescribed book chapters at a time instead of buying the full books. The chief recommendation from the study was that university lecturers need to work in liaison with the key book publishing companies to embrace any new and innovative ways to ease the text book burden on students whilst also ensuring that publishers do not lose out.

Midwives perceptions: Birth unit environment and the implementation of best intrapartum care practices

ProblemMidwives related avoidable factors causing maternal morbidity and mortality rates continue to occur despite the existing intrapartum care-related evidence-based practice guidelines and continuing staff development initiatives. Research questionWhat are your perceptions regarding a birth unit environment that supports the implementation of best intrapartum care practices. ObjectiveTo explore and describe midwives’ perceptions about the birth environment that supports the implementation of best intrapartum care practices. MethodA qualitative design that is explorative, descriptive, and contextual in nature using a descriptive phenomenology approach. SettingA public hospital birth unit in the Gauteng Province in South Africa. Population and sampleThe population comprised of 56 permanently employed female registered midwives. A purposive sampling method was used to select 26 participants who met the selection criteria, these participants were willing to participate in the study and to sign the consent form. Data collection process involved three focus group interviews using semi-structured interviews. A qualitative data analysis method was used to analyse data. Trustworthiness was ensured and ethical considerations were adhered to. FindingsThree main themes emerged namely, interpersonal skills, improved staff development, and adequate resources. DiscussionConducive birth environment is crucial to childbirth outcomes. Midwives’ constant introspection is essential in fulfilling their obligation to render competent and ethical intrapartum care. ConclusionMidwives identified perceived birth environment barriers affecting their implementation of best intrapartum care practices. Adoption of a comprehensive approach to address the birth unit environment-related factors is suggested to support midwives in their endeavour to provide the best care to women during childbirth.

Transcultural Nurses' Caring for Pilgrims for the First Time During Hajj Season in Saudi Arabia.

The Kingdom of Saudi Arabia invests tremendous governmental resources to support the annual Hajj season, including providing free world-class healthcare for all visiting pilgrims. Nurses from around the Kingdom are encouraged to work at Makkah during this period. These nurses come from different cultural backgrounds and provide care for pilgrims from around the world. The study utlized descriptive phenomenology design. A total of 11 transcultural nurses were interviewed. A thematic analysis was performed to understand the lived experience of the transcultural nurses participating in the Hajj for the first time. Five themes emerged. These included serving with satisfaction; a supportive and fair system; professional and personal values; difference, and difficulties and problems. This is the first study of transcultural nurses' experiences of providing nursing care to pilgrims during the Hajj. The results highlight transcultural nurses' perceptions of the benefits and challenges of providing care during the Hajj and potential strategies to improve preparation and care quality.

Gönüllü Çocuksuzluğu Tercih Eden Kadınlar Üzerine Fenomenolojik Bir Araştırma

The way in which women decide to have children is affected by many processes, including personal, social, historical, and political. Maternity is seen as an inevitable part of women’s happiness and a complement to their femininity. In traditional Turkish family structure, femininity is sanctified through maternity, and the status of women in the family and society is shaped by whether they have children or not. The status of women began to change with urbanization and also by virtue of women’s increasing participation in the workforce. The idea began to be expressed that maternity is not necessarily the fate of women, and given that it is a preference, which includes not only satisfaction but also difficulty, childlessness might be preferred. This study aims to examine the voluntary childlessness preferences of women. For this purpose, the study group consisted of four married women, who currently do not have children and who prefer not to have children. The age of the participants varies between 30 and 40 years and they are all voluntary. The study is designed according to descriptive phenomenology design of qualitative research methodology. The data were collected through semi-structured in-depth interviews. In the analysis of the data, Colaizzi’s (1978) phenomenological analysis steps were followed. During the interviews, it was seen that participants emphasized the concepts of responsibility and care giving. As a result of the analysis, it appears that the data are combined under the following themes: the meaning of maternity, the meaning of the concept of maternity in social circles, the meaning of not wanting a child, effects of voluntary childlessness, the decision of voluntary childlessness, social reactions to voluntary childlessness, and dilemmas experienced in the face of voluntary childlessness. It was observed that instinctive attitudes about maternity and perceptions on child bearing are still ongoing, that the pressure of being a mother has been preserved in the social environment, and that voluntarily childfree women define childlessness as freedom in many areas of life. With this study we make a contribution to the literature by attending to the voice of voluntarily childless women in the context of a woman’s right to decide on her own body.

Experience and Challenges of Objective Structured Clinical Examination (OSCE): Perspective of Students and Examiners in a Clinical Department of Ethiopian University.

Invented nearly half a century ago, Objective Structured Clinical Examination (OSCE) is overwhelmingly accepted clinical skills assessment tool and has been used worldwide for evaluating and teaching learners' competences in health care disciplines. Regardless of factors affecting the attributes, OSCE is considered as reliable and powerful tool with certain validity evidences. In spite of its advantages and various promotion efforts, the progress of OSCE implementation in Ethiopian public universities has not been satisfactory. Therefore, the objective of this study was to explore the experience and challenges of OSCE implementation from the perspective of clinical year-II medical students and their examiners in Ob-Gyn Department of Jimma University. Forty-nine students and seven examiners voluntarily participated in Ob-Gyn Department where OSCE has been used as one of summative assessment methods. Qualitative study design using structured open-ended questionnaire as a tool and descriptive phenomenology as underpinning method were employed. Collaizzi's descriptive analysis was used as phenomenological analysis approach. Poor organization, inadequate student preparation time, and inadequate number and duration of stations were thematically emerged as umbrellas of factors negatively affecting OSCE implementation. Satisfaction with OSCE was the only theme with findings that encourage OSCE implementation. There should be team approach, shared responsibility and proper planning among faculty to minimize hindering factors of OSCE implementation. Besides faculty development on OSCE, the department should improve skill lab utilization arranging schedule for both students and faculty members to increase guided students' exposure to simulation-based learning and ultimately enhance OSCE implementation.