Individual In-depth Interviews Research Articles

“Voices unheard: exploring the perception and attitude toward reporting elder mistreatment within Pakistani communities in the UK”

Purpose Elder mistreatment (EM) is a complex, universal health and social problem predominantly studied in the indigenous (white) populations of Western countries. This has led to consideration of dominant explanations as universal, potentially masking crucial cultural and ethnic differences. This study aims to fill the gap in elder mistreatment literature for the Pakistani community, offering unique perspectives to inform culturally sensitive policy recommendations. Design/methodology/approach A qualitative approach, anchored in the philosophical basis of constructivist grounded theory, was used to investigate understandings of EM among Pakistanis in Sheffield, UK. This involved two gender-based focus groups (male = 1; female = 1) and 22 in-depth individual interviews, engaging a diverse participant pool, including older people, family caregivers and community stakeholders. Findings This study reveals diverse understandings of elder mistreatment (EM) among Pakistani adults, varying across age and gender groups, with distinguished key forms identified. Reporting EM is crucial, but victims face complex decision-making, hindered by societal and individual barriers, including moral and cultural dilemmas. Access to formal support is limited, emphasising the need for targeted interventions. Originality/value To the best of the authors’ knowledge, this study is the first to delve into the perspectives of Pakistanis on elder mistreatment. It emphasises the importance of policymakers and service providers integrating considerations of race, ethnicity, culture and gender to develop inclusive services, as indicated by the study’s findings.

Exploring views on praxis possibilities of multilingualism in university literacy pedagogies

Background: South African literacy-as-social-practice theoreticians, language-in-education experts, educational linguists, and language policies advocate multilingual pedagogies to acknowledge and cater to diverse multilingual learners’ literacy development. Universities purport multilingualism to provide for the multilingual norm, students’ literacy, and educational development, as scholarship shows that multilingualism benefits academia and literacy education. Yet, these universities remain locations for monolingual and epistemological biases. Concerns about such praxis pretensions in pluralistic literacy education and the failures in literacy-as-social-practice strategies have been raised. However, the perceptions of lecturers and students on their role in implementing desirable praxis in multilingual literacy education are under-researched.Objectives: This qualitative study explores lecturers’ and students’ perceptions and their impact on practising linguistic plurality in literacy for educational development schemes.Method: The research uses in-depth individual and focus-group interviews with four lecturers and four first-year undergraduate students at a selected linguistically diverse university. An interpretivist paradigm was applied consisting of participants’ subjective experiences as members of a higher education institution (HEI).Results: Findings reveal that lecturers have difficulty coping with multiple languages due to inadequate training and misconceptions about multilingualism, and monolingual pedagogy perceptions carried over from their institutions whose culture denies students’ linguistic plurality.Conclusion: The study demonstrates the importance of shifts in epistemological orientation and adequate training, focused on multilingualism, to develop versatile and agile lecturers equipped for multilingual universities.Contribution: This research contributes to understanding the complex implementation problems regarding multilingual literacy education and possible solutions. It postulates new ways of forging multilingual literacy practices to erase praxis morbidity.

Field testing of user-friendly perennial malaria chemoprevention packaging in Benin, Côte d’Ivoire and Mozambique

BackgroundPerennial malaria chemoprevention (PMC) aims to protect children at risk from severe malaria by the administration of anti-malarial drugs to children of defined ages throughout the year. Sulfadoxine-pyrimethamine (SP) has been widely used for chemoprevention in Africa and a child-friendly dispersible tablet formulation has recently become available.MethodsThis qualitative non-interventional observational study was conducted in Benin, Côte d’Ivoire, and Mozambique between February and June 2022. Prototype blister packs, dispensing boxes and job aids designed to support dispersible SP deployment for PMC were evaluated using focus group discussions (FGD) and semi-structured in-depth individual interviews (IDI) with health authorities, health personnel, community health workers (CHWs) and caregivers. The aim was to evaluate knowledge and perceptions of malaria and chemoprevention, test understanding of the tools and identify gaps in understanding, satisfaction, user-friendliness and acceptability, and assess the potential role of CHWs in PMC implementation. Interviews were transcribed and imported to ATLAS.ti for encoding and categorization. Thematic content analysis used deductive and inductive coding with cross-referencing of findings between countries and participants to enrich data interpretation. Continuous comparison across the IDI and FGD permitted iterative, collaborative development of materials.ResultsOverall, 106 participants completed IDIs and 70 contributed to FGDs. Malaria was widely recognised as the most common disease affecting children, and PMC was viewed as a positive intervention to support child health. The role of CHWs was perceived differently by the target groups, with caregivers appreciating their trusted status in the community, whereas health authorities preferred clinic-based deployment of PMC by health professionals. Empirical testing of the prototype blister packs, dispensing boxes and job aids highlighted the context-specific expectations of respondents, such as familiar situations and equipment, and identified areas of confusion or low acceptance. A key finding was the need for a clear product identity reflecting malaria.ConclusionSimple modifications profoundly affected the perception of PMC and influenced acceptability. Iterative quantitative investigation resulted in PMC-specific materials suited to the local context and socio-cultural norms of the target population with the aim of increasing access to chemoprevention in children most at risk of severe malaria.

The effects of inpatient suicide on nurses at Weskoppies Hospital: A qualitative study

Background: Inpatient suicide is a serious adverse event in psychiatric wards. Suicide can cause severe trauma to both patients and health professionals, who may develop maladaptation with poor coping skills. Healthcare practitioners are the second victims and historically, this concept has been overlooked. The psychological effects and lack of support have not been sufficiently explored.Aim: The emotional well-being and clinical practice of nurses who experienced inpatient suicide at Weskoppies Psychiatric Hospital was explored.Setting: Weskoppies Psychiatric Hospital, South Africa.Methods: In this qualitative case study, 12 nurses who had lost a patient to inpatient suicide some time during their employment were purposefully selected. Data were collected through individual in-depth interviews, which were audio recorded and transcribed. The data were thematically analysed.Results: Nurses were negatively affected by inpatient suicide resulting in a range of emotional and psychological effects, including fear, anger, sadness, flashbacks, guilt, and difficulty in coping. Clinical practice factors included being doubtful and extra vigilant. Although nurses received psychological support from the institution, they recommended in-service training with periodic reviews to prevent and manage inpatient suicide.Conclusion: Inpatient suicide is a serious adverse event, and mental health practitioners become second victims. These events do not only impact the psychological well-being of nurses but also influence the clinical practice. Mental health practitioners should receive adequate training and support in preventing and handling inpatient suicide.Contribution: This study provided insights into nurse’s perspectives on the effects of inpatient suicide and how they can be supported.

“A roller coaster, both emotionally and work-wise…”: teachers in Swedish certified sport-oriented upper secondary schools experiences of the COVID-19 pandemic

This study aimed to explore how teachers at certified sports-oriented upper secondary schools (CSUSS) in Sweden experienced how the COVID-19 pandemic impacted their everyday practice and well-being. Individual in-depth interviews were conducted with 13 teachers (mean age: 44 years) from three CSUSS in southern Sweden. The interviews were analysed using abductive qualitative content analysis. The analysis resulted in one overreaching theme, ‘Making sense of changes in everyday practice and dealing with a changing world’, illuminating how the COVID-19 pandemic has impacted teachers. The teachers described the first lockdown as an initial shock that brought about changes in their workload and daily routines. The second lockdown was generally easier to handle, but they spent more time on planning and preparations, and had a greater focus on conveying theoretical knowledge and physical training. Throughout the pandemic, they experienced a lack of social interactions; nonetheless, supportive colleagues and schools provided some relief. The teachers also experienced uncertainty regarding constantly changing restrictions; they learned, however, the importance of being flexible and creative in coping with these changes. Thus, the COVID-19 pandemic significantly impacted their everyday practice and well-being.

Challenges faced by older people with dementia during the COVID-19 pandemic as perceived by professionals: a qualitative study with interviews.

Previous studies have highlighted a decline in the mental health of older adults over the course of the coronavirus disease 2019 (COVID-19) pandemic. Few studies have determined the possible causes of behavioural and psychological symptoms of dementia during COVID-19 in a comprehensive manner. We aimed to identify the challenges faced by older adults with dementia during the COVID-19 pandemic. This study adopted a qualitative approach to understanding the perceptions of healthcare professionals, such as regarding the negative effects of COVID-19 on the mental health of people with dementia. Between January and March 2022, the authors conducted individual in-depth interviews on how COVID-19 affected the stress levels, care, and self-determination of people with dementia. Qualitative data from the individual interviews were data cleansed to ensure the clarity and readability of the transcripts. The qualitative data were then analyzed by inductive manual coding using a qualitative content analysis approach. The grouping process involved reading and comparing individual labels to cluster similar labels into categories and inductively formulate themes. Qualitative analysis extracted 61 different semantic units that were duplicated. Seven categories were inductively extracted using a grouping process. These were further integrated to extract the following four themes: fear of personal protective equipment (PPE), loneliness, dissatisfaction with behavioural restrictions and limitations of video calls, and family interference with service use. People with dementia often faced mental distress during the pandemic owing to preventive measures against COVID-19, and a lack of awareness and understanding of such preventive measures worsened their distress. They experienced a severe sense of social isolation and loneliness. Findings also indicated that families tended to ignore the needs of people with dementia and their decisions and opinions regarding healthcare service use.

Monitoring and evaluation system for revitalization programmes in Germany

Monitoring and evaluation should form the foundation of revitalisation programme management. The literature on the subject points to a general reluctance of municipalities to assess the effects of implemented revitalisation programmes, as well as the difficulties that municipalities encounter during this process. In Germany, in 2013, the federal and state governments, along with municipal associations, adopted an inter-programme concept for the evaluation of revitalisation programmes. This concept represents the first systematic structure for monitoring and evaluation of revitalisation programmes. The aim of the article is to present the assumptions of this concept and provide an overview of the experiences gained so far in its implementation. The study was based on desk research, an in-depth individual interview, the case study method, and an email interview.

Approaches for prevention of mother-to-child transmission of HIV services during coronavirus disease 2019

Background: During the coronavirus disease 2019 (COVID-19) pandemic, there was a reduction in access to prevention of mother-to-child transmission (PMTCT) of human Immunodeficiency virus (HIV) services globally, yet this programme is critical for reducing paediatric HIV incidence. To minimise the impact of COVID-19 and prevent disruptions to the PMTCT service provision, innovative strategies had to be developed and implemented.Aim: The study aimed to describe the approaches that were developed and utilised during the COVID-19 pandemic in enhancing PMTCT services in Tshwane primary healthcare facilities.Settings: Three primary healthcare facilities that were providing PMTCT services during the COVID-19 pandemic located in the Tshwane district, Gauteng province, South Africa.Methods: The study is part of a larger study that focused on the experiences of healthcare workers who were rendering PMTCT services during the COVID-19 pandemic. An interpretative phenomenological analysis (IPA) design was employed to gain insight into the experiences of 16 purposively sampled healthcare workers who were providing PMTCT services during the pandemic in Tshwane district facilities. In-depth individual audio-recorded interviews were conducted with study participants, following a semi-structured interview guide. Data analysis was performed using an IPA framework.Results: Three superordinate themes emerged: strategies utilised for providing care, community-based initiatives, and support systems to enhance the PMTCT service access.Conclusion: Strengthening community-based initiatives and support systems is important for the enhancement of the PMTCT programme during and beyond the pandemic.Contribution: Community-based initiatives are critical in continuity of PMTCT services, reducing HIV incidence, under-five child morbidity and mortality particularly during emergency situations.

‘Getting addicted to it and losing a lot of money… it’s just like a hole.’ A grounded theory model of how social determinants shape adolescents’ choices to not gamble

BackgroundGambling abstinence when underage lowers the risk of harmful gambling in later life. However, little research has examined why many young people refrain from gambling, even though this knowledge can inform protective strategies and lower risk factors to reduce underage gambling and subsequent harm. This study draws on the lived experience of adolescent non-gamblers to explore how social determinants while growing up have shaped their reasons and choices to not gamble.MethodsFourteen Australian non-gamblers, aged 12–17 years, participated in an in-depth individual interview (4 girls, 3 boys) or online community (4 girls, 3 boys). Questions in each condition differed, but both explored participants’ gambling-related experiences while growing up, including exposure, attitudes and behaviours of parents and peers, advertising, simulated gambling and motivations for not gambling. The analysis used adaptive grounded theory methods.ResultsThe grounded theory model identifies several reasons for not gambling, including not being interested, being below the legal gambling age, discouragement from parent and peers, concern about gambling addiction and harm, not wanting to risk money on a low chance of winning, and moral objections. These reasons were underpinned by several social determinants, including individual, parental, peer and environmental factors that can interact to deter young people from underage gambling. Key protective factors were parental role modelling and guidance, friendship groups who avoided gambling, critical thinking, rational gambling beliefs, financial literacy and having other hobbies and interests.ConclusionsChoices to not gamble emanated from multiple layers of influence, implying that multi-layered interventions, aligned with a public health response, are needed to deter underage gambling. At the environmental level, better age-gating for monetary and simulated gambling, countering cultural pressures, and less exposure to promotional gambling messages, may assist young people to resist these influences. Interventions that support parents to provide appropriate role modelling and guidance for their children are also important. Youth education could include cautionary tales from people with lived experience of gambling harm, and education to increase young people’s financial literacy, ability to recognise marketing tactics, awareness of the risks and harms of gambling, and how to resist peer and other normalising gambling influences.

Dynamic capabilities for digital transformation in an enterprise business

PurposeDigital transformation is a process in which organizations use technology as an essential resource to improve performance and increase market reach and results.Design/methodology/approachThis research aims to verify how dynamic capabilities are configured for the development of strategies and processes necessary for digital transformation. To this end, qualitative research of an exploratory nature was carried out, operationalized through in-depth individual interviews with a semi-structured approach with managers who occupy leadership positions, in addition to a documentary survey of the internal records of the analyzed organization. In data analysis, the content analysis technique was used.FindingsThe main results of the research showed that the dynamic capabilities configured in sensing, seizing and reconfiguring contribute to leveraging digital transformation in the business studied through the reformulation of strategies to integrate and coordinate the implementation of new routines, investments in technological and human resources and actions to change culture with a focus on digital transformation considering the company’s stakeholders.Originality/valueThis transformation affects business models, products, services and processes, as well as the review of strategies, organizational structures and management concepts.

Upholding Informed Consent: Experiences of Note –Taking without Audio Recording of in-Depth Individual Interviews in a Qualitative Study on the Implementation of the Pregnancy Re-Entry Policy in Zambia

The context of the research study needs to determine the data recording method to be used in order to ensure that no harm is done to the participants. In-depth individual Interviews (IDIs) is one of the main data collecting strategy used in qualitative research on sensitive topics such as teenage pregnancy. Audio recording in capturing data during IDIs is a common practice. However, audio recording of IDIs should be done in the context of informed consent. The objective of this paper is to elaborate on how note-taking was used to capture data within the context of informed consent. The research design was multiple cohort Case studies involving Chongwe district plus national stakeholders of the Pregnancy Re-entry policy in Zambia. Semi-structured interviews were conducted with hundred (100) participants from different cohorts of stakeholders using note-taking to capture the data. Ninety percent (90%) of the interviews involved physical note-taking with 10 % being electronic notes. The results are that note-taking increased the interview time but it afforded the interviewer the opportunity to probe further as the data was being collected. The major disadvantage with note –taking is that it reduces the pace of data collection as time has to be dedicated to consolidating the notes and memory recall of information shared. The conclusion drawn is that upholding informed consent in research is key, therefore the capturing of data during IDIs should be guided by what best upholds the rights of the participants. Therefore, note-taking offers an alternative to audio recording.

Challenges of nurse managers in creating an environment conducive to empowerment of nurses in mining primary healthcare clinics in South Africa

BackgroundNurse managers are expected to create an environment conducive to empowerment of nurses in mining primary healthcare clinics to improve patients’ outcomes. However, in a specific mining primary healthcare clinics there are seldom staff trainings and nurses has overwhelming working schedules. PurposeThe aim of the study was to explore and describe the challenges of nurse managers in creating environment conducive to empowerment of nurses in mining primary healthcare clinics in South Africa. Design and MethodsThis study was underpinned by Winkler’s theoretical framework of leadership roles to create an environment conducive to empowerment. A qualitative, exploratory, descriptive and contextual research design was used to conduct this study in specific mining primary healthcare clinics in South Africa. Individual in-depth interviews were conducted to collect data from ten nurse managers, and Giorgi’s thematic analysis method was employed to analyse data. An independent qualitative coder confirmed the study’s findings. Trustworthiness was maintained, and ethical principles were also applied throughout the study. FindingsThree themes emerged from the analysed data: (1) training budget challenges; (2) training needs in mining primary healthcare clinics; (3) Legislation, training and development. Discussion and conclusionsThere are training budget challenges in mining primary healthcare clinics but nurse managers are not hindered by these challenges in creating an environment conducive to empowerment of nurses.

개념도 분석을 통해 본 초등학생 학부모의 선행학습에 관한 인식

This study aimed to investigate parent's perceptions of pre-learning among primary school parents using the concept mapping methodology, which is useful for understanding and structuring group perceptions. Sixteen parents participated in individual in-depth interviews. Based on the data obtained, a total of 58 final statements were derived through a statement integration process, with 14 participants contributing to similarity classification. Multidimensional scaling and cluster analysis were conducted based on similarity classification of participants. Subsequently, a survey on the degree of empathy for statements was conducted using a 5-point Likert scale with 76 parents, including statement generators and similarity classification participants, to calculate the degree of empathy for statements and clusters. The results revealed that parent's perceptions were divided into two dimensions: 'children's motivation-social pressure' and 'parent’s conviction- experience and external influence'. They were further classified into four clusters and two sub-clusters. Specifically, the clusters included 'enhancing children's motivation and abilities for pre-learning', 'realities and surrounding circumstances inducing pre-learning', 'value system and conviction towards pre-learning', and 'awareness and coping with the current state of pre-learning'. Among these, the cluster 'enhancing children's motivation and abilities for pre-learning' was further divided into sub-clusters of 'children's motivation for pre-learning' and 'enhancing children's abilities through pre-learning', while the cluster 'realities and surrounding circumstances inducing pre-learning' was divided into sub-clusters of 'experiential realities necessitating pre-learning' and 'surrounding environments prompting pre-learning'. Parents showed the highest empathy towards the cluster 'value system and conviction towards pre-learning'. In conclusion, parents have evolved considering the choice regarding pre-learning to strategizing for the success of their children's pre-learning. Parents have taken an active lead in their children's pre-learning situations, armed with their own educational value system and convictions, considering factors such as their children's motivation, timing, methods, surrounding circumstances, and experiences. The study is significant in suggesting the necessity of observing changes in societal perceptions of pre-learning and improving educational policies and entrance examination systems based on parent's perceptions.

Unveiling perspectives on the psychosocial impacts of childhood cancer survival on young adult survivors' reassimilation journey: A qualitative exploration.

Approximately 82% of children with childhood cancer survive more than five years after diagnosis. Living as a cancer survivor elicits a new reality that can include psychosocial impacts. These psychosocial impacts interact collectively, especially regarding reassimilation, and are rarely explored. To explore the psychosocial impacts of surviving childhood cancer and reassimilation back into society in young adult survivors of childhood cancer. Individual in-depth semi-structured interviews were conducted with childhood cancer survivors and explored psychosocial aspects associated with returning to work, school, and social environments after remission. Interpretive phenomenological analysis was conducted once interviews were manually transcribed. A group interview with survivors was held to discuss the study's findings and interpretation. Individual interviews and the group interview revealed three major themes: outlook on reassimilating, outlook on coping, and outlook on cancer. This work is a first step to understanding how survivors' personal outlook on coping and healthcare system barriers play influential roles in reassimilation following cancer treatment. Survivors expressed the need for reliable survivorship information and improved communication with healthcare providers regarding what to expect, so they could feel prepared for life post-cancer. These aspects need to be explored more deeply through other qualitative studies.

Understanding "The Athletic Labour of Femininity" Through the Experiences of Turkish Female Personal Trainers

The momentum of social media in the world of sports has created a wide range of opportunities for women in sports. One of the most obvious of these opportunities is undoubtedly related to economic visibility. The current research aims to examine how female trainers in the health and fitness sector, who actively participate in the creation and consumption of sports, represent themselves on Instagram through the concept of the athletic labour of femininity in the light of Turkey's gender regime and neoliberal feminism. In this study, which applied quantitative content analysis to a total of 1100 photographs of eleven individual coaches (11), eight in-depth individual interviews were conducted, and these qualitative data were analyzed by thematic analysis method. The quantitative and qualitative findings of the research show that women trainers in the health and fitness sector construct coaching that is in line with neoliberal femininity. On the other hand, power relations based on Turkey's neoconservative, religious patriarchal norms influence the market-based decisions trainers make about their sharing. As a result, Turkey-specific dynamics are at the forefront of trainers' athletic endeavours, which they focus on building a brand image. This study offers a perspective on how personal trainers serving in the healthy living and fitness industry use Instagram as a marketing tool, what economic opportunities they get, and what they negotiate while improving their visibility on Instagram, in the context of neoliberal femininity and Turkey's gender regime.

The deteriorating legislative role of the legislature in multilevel democracies. Case of Poland

ABSTRACT Poland is a case of a state in which the role of legislative bodies in the political system has been gradually reduced at the various levels – national, regional, and local. Recently, this process has been related to executive aggrandisement observed in Poland, but the roots of this phenomenon can be traced back to the political transformation of this country observed after 1989. At the national level, the deteriorating legislative role of parliament manifests itself in four general processes: (1) The executive power treats the Sejm (lower chamber) as a subordinate institution. This involves formally introducing laws forced by the government in the form of proposals written by members of parliament (MPs) (as a way to shorten the legislative process and limit public consultations required by law); (2) Speeding up of parliamentary works – the Sejm is treated as a voting machine and not as a forum where debates and discussion take place; (3) Public consultations are superficial and the regulatory assessment impact is minimal; (4) The influence of the opposition on legislative processes is reduced to almost zero. Similar processes can be observed at the regional and local levels. The subnational legislative bodies are often under the control of executives. Instances of voting with no or limited discussions (favouring the governing majority) can be sometimes observed during the sessions of local and regional councils. This paper analyses the weakening of the legislative function in Poland at different levels, using a qualitative approach and data from desk research, media analysis, in-depth individual interviews and focus group interviews.

Managing “Who I Am”: An Exploration of Chinese Employees’ Identity Tension Management Strategies in MNCs

ABSTRACT This exploratory qualitative study aims to examine Chinese employees’ identity tensions in multinational companies (MNCs) in China, more specifically, how Chinese business professionals communicate to organize various identities while managing identity tensions from a cultural insider’s perspective. Guided by a grounded theory approach, 20 in-depth individual interviews with Chinese employees in MNCs revealed four identity tensions: work-life identity tensions, task-relational interrole tensions, friend-professional interrole tensions, and cultural-professional tensions. It was through defining, communicating, and organizing these identity tensions that Chinese participants displayed one of two identity structuring models: holistic (interdependent) and kaleidoscope (independent) models. This study contributes to identity and communication literature with its cross-level examination of identity tensions and the identity structuring models in multicultural organizational communication. The findings suggest that MNCs and global teams should focus more on navigating identity clashes in global collaborations with institutional communication training moving beyond cultural awareness exercises.

Patients' Representations of Perceived Distance and Proximity to Telehealth in France: Qualitative Study.

In the last 2 decades, new technologies have emerged in health care. The COVID-19 pandemic further accelerated the adoption of technology by both health care professionals and patients. These technologies create remote care practices that bring several benefits to the health care system: easier access to care, improved communication with physicians, and greater continuity of care. However, disparities in the acceptance and use of telehealth tools still exist among patients. These tools also disrupt conventional medical practices and prompt a new reassessment of the perceptions of distance and proximity as physical (ie, time and space dimensions) and nonphysical (ie, behavioral dimensions) concepts. The reasons why patients do or do not adopt telehealth tools for their care and therefore their perspectives on telehealth remain unanswered questions. We explored the barriers as well as the motivations for patients to adopt telehealth tools. We specifically focused on the social representations of telehealth to establish a comprehensive conceptual framework to get a better understanding of how telehealth is perceived by patients. This study uses a qualitative design through in-depth individual interviews. Participants were recruited using a convenience sampling method with balanced consideration of gender, age, location (urban/rural), and socioeconomic background. After collecting informed consent, interviews were transcribed and analyzed using the thematic analysis methodology. We conducted 14 interviews, with which data saturation was reached. The 2 main opposed dimensions, perceived proximity and distance, emerged as an essential structure for understanding the social representations of telehealth. A logic of engagement versus hostility emerged as the main tension in adopting telehealth, almost ideological. Interestingly, practical issues emerged regarding the adoption of telehealth: A logic of integration was opposed to a logic of constraints. Altogether, those dimensions enabled us to conceptualize a semiotic square, providing 4 categories with a coherent body of social representations. Due to the dynamic nature of these representations, we proposed 2 "paths" through which adherence to telehealth may improve. Our semiotic square illustrating patients' adherence to telehealth differentiates socially beneficial versus socially dangerous considerations and pragmatic from ideological postures. It shows how crucial it is to consider perceived distance and proximity to better understand barriers and motivations to adopting telehealth. These representations can also be considered as leverage that could be modified to encourage the step-by-step adhesion process. Even if reducing the perceived temporal distance to in-person meeting and enhancing the perceived proximity of access to care may be seen as efficient ways to adopt telehealth tools, telehealth can also be perceived as a care practice that threatens the patient-physician relationship. The patient-oriented perceived value turns out to be critical in the future development of and adherence to telehealth tools.

Weight management personas of breast cancer patients undergoing chemotherapy in China: a multi-method study

BackgroundMobile health (mHealth) may be an ideal solution for breast cancer (BC) patients in China to access weight management interventions. User retention and engagement are the main challenges faced by mHealth applications. A user persona, which is a user-centered design process, can lead to the development of mHealth that is more acceptable to the needs of target users. This study aimed to investigate the variety of experiences in weight management and the behavioral preferences of BC patients receiving chemotherapy to develop users’ personal information and persona development for the design and implementation of mHealth interventions.MethodsSixteen individual semi-structured in-depth interviews were conducted with BC patients receiving chemotherapy. We employed the thematic analysis method to analyze the interview transcripts in NVivo 11 software. The themes obtained from the analysis were used as the subdomains of personas. A proforma was designed to extract each participant’s experience in each subdomain. Patients who exhibited similar experience in subdomains were grouped into a persona using affinity diagrams. The personas were named according to their prominent features. A questionnaire survey was conducted to validate the personas and to test whether the personas that were generated from the qualitative interview data were applicable to the Chinese population with BC.ResultsFour themes were identified as subdomains of weight management personas: the perception of weight management while undergoing chemotherapy, symptoms and emotional disturbance, changes in diet and exercise, and health literacy and information seeking. Five personas were ultimately obtained: (1) positive weight controllers, (2) patients who were inactive due to fatigue, (3) young patients who avoided communication, (4) overweight patients with treatment priority, and (5) patients who engaged in irregular exercise. Finally, the quantitative study showed that 51.58% of patients chose one of these five personas to represent themselves in weight management. None of the patient reported selecting options that were not explicitly outlined in the questionnaire and provided personalized descriptions of their weight management characteristics.ConclusionsThe selected personas were developed from in-depth interviews on biopsychosocial areas. They highlight different weight management patterns in Chinese BC patients and provide implications for both the design of mHealth systems and traditional interventions.

Facilitators, barriers, and strategies of communication in Malaysian school-age children with non-syndromic cleft lip and palate: Results of in-depth online qualitative interviews

ABSTRACT This study explores the perceptions of facilitators, barriers to communication and strategies in Malaysian school-aged children with non-syndromic cleft lip and palate (CL/P), parents, and teachers. Fourteen children with non-syndromic CL/P aged 7 to 12 years, their parents (n = 16), and their teachers (n = 10) were recruited via purposive sampling. Participants were selected based on resilience scores (RS-10; (Wagnild, 2015) distinguishing low (<34) from high resilience (35–40) (Wagnild, 2015). Individual in-depth interviews were conducted online and evaluated qualitatively. The analyses were conducted utilising the guidelines by Braun and Clarke (2006). Inductive thematic analysis was performed. Facilitators for communication identified by children, parents and teachers were the child’s personal attributes, common interests, and helping others. Barriers that were identified were unfamiliar conversation partners, and insensitive comments or questions. Children used passive (e.g. ignored) and active (e.g. retorted, explained the condition) strategies to address social communication issues. Children with high resilience responded more actively than children with low resilience. Strategies that were described by the parents included accepting the child, empowering themselves, following the cleft management plan, and empowering the child. Teachers adopted general approaches such as giving encouragement, increasing confidence, and teaching empathy. The presence of face masks was perceived as both a facilitator and a barrier to communication. The study provides information on challenges encountered and coping mechanisms used by children with non-syndromic CL/P, their parents and their teachers. This knowledge may help the development of targeted interventions to support the communication of children with non-syndromic CL/P in school.