Longitudinal Qualitative Data Research Articles

A longitudinal qualitative study on physician experience in managing multimorbidity across the COVID-19 pandemic in Odisha, India

While many studies have documented adverse impact of multiple chronic conditions or multimorbidity on COVID-19 outcomes in patients, there is scarcity of report on how physicians managed these patients. We investigated the experiences and challenges of clinicians in managing patients with multimorbidity throughout the COVID-19 pandemic in Odisha state, India. To understand the factors influencing illness management and the adaptive responses of physicians alongside the evolving pandemic, we followed a longitudinal qualitative study design. Twenty-three physicians comprising general practitioners, specialists, and intensivists, were telephonically interviewed in-depth. Saldana’s longitudinal qualitative data analysis method was employed for data analysis. COVID-19 pandemic initially diverted the attention of health systems, resulting in reduced care. With time, the physicians overcame fear, anxiety, and feelings of vulnerability to COVID-19 and started prioritising patients with multimorbidity for treatment and vaccination. All physicians recommended teleconsultation and digital health records to benefit chronic illness care during future public health crises. The findings underscore the transformative potential of physician resilience and adaptation during the COVID-19 pandemic, emphasizing the importance of prioritizing patients with multimorbidity, incorporating teleconsultation, and implementing digital health records in healthcare systems to enhance chronic illness care and preparedness for future public health crises.

Evaluating a nurse-led narrative interview intervention with cancer patients with a first diagnosis: A feasibility study

Narrative Medicine and Nursing are clinical-supporting intervention methodologies that aim to enhance professionals’ communication skills and place patients at the heart of their therapeutic path. A narrative interview (NI) is a communication tool between practitioner and patient. The role of NI is debated extensively in the literature, but no studies focus on its use by nurses responsible for first-diagnosed cancer patients.This study aimed to evaluate the feasibility and utility of NI, carried out by Nurses, in managing people recently diagnosed with cancer.A pilot mixed-methods study with before-and-after-intervention evaluation, qualitative longitudinal data analysis, and concurrent data triangulation was conducted. The Mini-Mental Adjustment to Cancer assessed disease adaptation, while the Psychological Distress Inventory investigated psychological distress. The qualitative analysis of the narrative interviews assessed the usefulness of this intervention.13 out of 14 eligible patients took voluntary part in the study. Of those, 9 (69 %) completed T1 and T2 questionnaires and NI. The following five themes emerged from thematic analysis: reaction to the disease, feelings related to the new condition of life, changes, importance of relationships and perception of care. Patients reported being highly stressed and recognized the importance of a supporting social network for better coping with the condition.The adoption of an NI approach at the time of cancer diagnosis is feasible. Due to the limited sample size, it is unclear if NI may positively impact psychological distress in this patient population. Further studies would benefit from the integration of an additional investigation tool aiming to clarify whether NI promotes disease awareness in cancer patients. Furthermore, the recruitment of a larger sample is equally recommended.

Mental Health First Aid for Black Populations: Recommendations From the Neighborhood Healers Project

Community-based participatory action research can facilitate counseling psychologists’ engagement in social justice to benefit Black people’s mental health. One way to improve Black mental health is to equip credible and trustworthy community members with mental health knowledge and skills to support other community members experiencing mental health challenges. This study presents the Neighborhood Healers Project—a community-based participatory action research project that trains Black adults (Neighborhood Healers Fellows) in Mental Health First Aid (MHFA). During the inaugural 12-month fellowship year, we collected longitudinal qualitative data from N = 20 Fellows on the relevance of MHFA to Black people. In this paper, we examined their responses using reflexive thematic analysis. Findings included two themes with affiliated subthemes: (a) Liberatory Paradigm Shift and (b) For Us By Us: Culturally Relevant Curriculum. We conclude with implications for counseling psychologists.

Zooming into qualitative research: online adaptation of the action-project method research design

ABSTRACT The Action-Project Method (A-PM) is a comprehensive qualitative research method guided by Contextual Action Theory, which has been successfully employed to study the goal-directed actions of dyads (e.g. parent-child pairs; couples). In this article, we discuss how we adapted the A-PM to successfully collect rich longitudinal qualitative data using remote video-based data collection procedures. After describing the A-PM in detail, we draw upon an example from a recent study which successfully implemented this methodology over a video-conference platform. Data collection and analysis procedures are described, as well as the methodological integrity of the A-PM. To facilitate consideration of the appropriateness of the remote methodological adaption to the A-PM, we discuss several practical strengths and limitations. Ultimately, we maintain that it is possible and viable to complete this method online. We hope to inform a new generation of researchers about the adaptability of the A-PM research design to remote data collection procedures.

Sustainable community development through peer-to-peer learning in the online and in-person classroom

Purpose Prior research suggests that collaboration is key to sustainable community development and environmental management, and peer-to-peer learning (P2PL) may facilitate community building and collaborative learning skills. This study aims to examine the effect of P2PL on the enhancement of environmental management and sustainable development skills, community building and social capital (i.e. connectedness) and understanding of course learning objectives. Design/methodology/approach Quantitative and qualitative longitudinal survey data was collected in a sustainable development focused course offered at a large American public university that uses P2PL to explicitly facilitate community building and collaborative skills. Safety precautions and changing locational course offerings due to the COVID-19 pandemic in years 2020, 2021 and 2022 provided an opportunity to evaluate the impact of P2PL on these skills during both virtual and in-person formats. Additionally, this study compared in-course student evaluations with students taking other sustainable development-related courses with collaborative learning aspects to understand the wider effectiveness of this course structure. Findings This study finds that course format (virtual vs in-person) overall made no difference in either connectedness or conceptual understandings, and that students in both formats felt more connected to others than students taking other courses with P2PL. Scaffolding P2PL and supplemental peer support can yield improved connectedness and learning among students taking environmental coursework. Originality/value Sustainable development requires group collaboration and partnership building skills. Issues are consistently raised about the challenges to teaching these skills in higher education. The students and instructors in this research study identify P2PL strategies to address these challenges for in-person and virtual classroom settings.

Early Exit Decisions in Finland: Investigating the Limbo between Unemployment and Retirement

Despite efforts to extend careers, workers continue to withdraw from working life before reaching the old-age pension age. The complexities behind early exit decisions have been extensively studied to understand the individual factors influencing the decision-making processes. However, fewer studies have attempted to understand how underlying cultural notions of age shape these decisions. Using qualitative longitudinal interview data from Finland, this article examined how individuals in the Finnish unemployment pathway to retirement position themselves between unemployment and retirement by drawing on age-specific discourses. Findings show that early exit was framed as the least problematic career option, although colored with ambiguity and anxiety. Individuals did not view themselves as retirees, and some expressed interest in continuing work. Nevertheless, age norms together with experienced, internalized, and expected ageism pushed individuals toward exit, highlighting the need to better understand and support individuals experiencing late-life unemployment.

Conceptualising the (dis)abling marketplace through value creation and destruction

ABSTRACT Drawing upon value theory, this study investigates both the enabling and disabling features of marketplaces for consumers in the disability market. Analysis of longitudinal qualitative data collected before and after the introduction of a new disability service provision scheme in Australia offer empirical evidence of such marketplaces that are both creating and destroying value for people with disability and their carers. In some instances, value creation and destruction can co-occur for individual consumers. These empirical insights lead to a theoretical conceptualisation of the marketplace as not being wholly disabling, but rather consisting of disabling and enabling factors. Understanding these factors allows service providers and policy makers to make adjustments in view of maximising value creation and minimising value destruction.

Learning from user behavior: A survey-assist algorithm for longitudinal mobility data collection

GPS-based travel surveys are widely used in mobility studies to gather crucial qualitative data, like purpose, transportation mode and replaced mode. However, survey response still poses a burden to users, especially in long-term mobility studies, leading to response fatigue. We explore a survey-assist strategy to ease this burden by a novel, user-level modeling approach that leverages past responses from each user to predict responses for new trips, without relying on external data sources like GIS data.We investigate three main algorithms for predicting responses: (i) clustering trips and extrapolating responses for similar trips, (ii) using random forest classification, and (iii) clustering that uses a hybrid algorithm to determine spatial structure, which is then fed as input to a classic random forest classifier. The clustering approach can flexibly predict responses for even complex qualitative survey questions; it achieved F-scores of 65%. The random forest pipeline uses architecture that restricts it to predicting three predetermined survey questions: trip purpose, mode, and replaced mode. However, it achieved F-scores of 78%.While the survey-assist approach has been implemented by several proprietary systems, to our knowledge, this is the first exploration in the academic literature. It follows that this is also the first rigorous evaluation of multiple algorithms that can implement the approach. The evaluation uses a large scale, publicly available, longitudinal dataset consisting of ≈ 92 k trips from 235 users over a period of roughly one and a half years.With this approach, travel surveys can be pre-filled with the predicted responses for each trip, thus streamlining the survey process for users. Combined with an active learning system that requests user input on low-confidence predictions, models can be updated and improved over time to better support the long-term collection of longitudinal qualitative data.

Normalized Expendability: Navigating Immigrant Legal Status During A Global Pandemic

Using longitudinal qualitative data, we examine how undocumented immigrants in Florida navigated the first year of the COVID pandemic. Building on the concepts of compounded vulnerability and legal violence, we demonstrate how heightened exposure to COVID shaped immigrants’ well-being by virtue of being overrepresented among frontline workers, underserved by the healthcare industry, and excluded from government pandemic aid. We demonstrate how immigrants’ anxieties overlay onto existing vulnerabilities facing those without legal status; although undocumented immigrants were often at even greater risk for negative outcomes related to the pandemic, access to mitigation efforts was denied to them because of policies and laws that allow for—and normalize—the unequal treatment of noncitizens. Findings demonstrate that undocumented immigrants and their families experienced legal violence through the mechanisms of restricted government aid, for which they were ineligible, in addition to bureaucratic delays in immigration paperwork renewals that resulted in expiring work permits for some with Deferred Action for Childhood Arrivals. These experiences further compounded their economic and social marginalization, rendering immigrants an expendable social group. We identify coping strategies that allowed immigrants to persevere in the face of uncertainty and distress and discuss how policies can diminish some of these vulnerabilities and improve their well-being.

Expanding Access to Comprehensive Geriatric Evaluation via Telehealth: Development of Hybrid-Virtual Home Visits

BackgroundIn response to the aging population, the Department of Veterans Affairs (VA) seeks to expand access to evidence-based practices which support community-dwelling older persons such as the Geriatric Resources for Assessment and Care of Elders (GRACE) program. GRACE is a multidisciplinary care model which provides home-based geriatric evaluation and management for older Veterans residing within a 20-mile drive radius from the hospital. We sought to expand the geographic reach of VA-GRACE by developing a hybrid-virtual home visit (TeleGRACE).ObjectivesThe objectives were to: (1) describe challenges encountered and solutions implemented during the iterative, pre-implementation program development process; and (2) illustrate potential successes of the program with two case examples.DesignQuality improvement project with longitudinal qualitative data collection.Program DescriptionThe hybrid-virtual home visit involved a telehealth technician travelling to patients’ homes and connecting virtually to VA-GRACE team members who participated remotely.Approach & ParticipantsWe collected multiple data streams throughout program development: TeleGRACE staff periodic reflections, fieldnotes, and team meeting notes; and VA-GRACE team member interviews.Key ResultsThe five program domains that required attention and problem-solving were: telehealth connectivity and equipment, virtual physical examination, protocols and procedures, staff training, and team integration. For each domain, we describe several challenges and solutions. An example from the virtual physical examination domain: several iterations were required to identify the combination of telehealth stethoscope with dedicated headphones that allowed remote nurse practitioners to hear heart and lung sounds. The two cases illustrate how this hybrid-virtual home visit model provided care for patients who would not otherwise have received timely healthcare services.ConclusionsThese results provide a blueprint to translate an in-person home-based geriatrics program into a hybrid-virtual model and support the feasibility of using hybrid-virtual home visits to expand access to comprehensive geriatric evaluation and ongoing care for high-risk, community-dwelling older persons who reside geographically distant from the primary VA facility.Graphical

Settling into uncertainty and risk amidst the COVID-19 pandemic and the war in Ukraine

ABSTRACT This study explores the process of navigating instability arising from sudden, co-occurring crises in the 2020s. We focus on the combined impact of the COVID-19 pandemic and the war in Ukraine on growing material and relational uncertainty and risk among Polish citizens, accumulating in the loss of ontological security. To showcase the practical and narrative presence of risk at the micro-level, we operationalize the broad theorization of risk society using the categorization of material, relational and subjective dimensions within the ‘unsettling events’ model proposed by Kilkey and Ryan. We reconceptualize the third pillar, positioning subjectivity as a meta-category. Moreover, we extend the application of the framework of unsettling events, treating the Polish situation as a case study for examining societies facing compounding catastrophes.The analyzed qualitative longitudinal data comprised 70 in-depth interviews about the pandemic and conducted with Polish young adults (ages 18–35) and their parents in 2021; and asynchronous responses from 43 study participants collected shortly after the Russian attack on Ukraine in 2022. Considering intergenerational and temporal lens, we identify the dominant patterns of meaning that interviewees attributed to the pandemic and war, thereby revealing materialities of unsettlement, relational gains and losses, and the erosion of ontological security. .

Adapting a collective will and a way during a civil war: The persistence of an entrepreneurial ecosystem as an architecture of hope

Persistent war is an increasing reality for millions of people worldwide. War contexts create a wide range of problems, but paradoxically may fuel some entrepreneurial activities. This inductive, qualitative study explores how an entrepreneurial ecosystem was launched and sustained amid an ongoing civil war despite repeated setbacks, disruptions, and impediments to pursuing collective goals. Building on our longitudinal qualitative data, we show how the entrepreneurial ecosystem was repeatedly reshaped by altering collective goals as well as providing the pathways and sense of agency needed to make progress toward ever-shifting goals. Our research culminates in a grounded theoretical model of an entrepreneurial ecosystem of hope, which contributes to our comprehension of entrepreneurship within war-affected regions and provides valuable insights into the dynamics of collective hope. This study offers practical implications for policy makers and practitioners by illuminating the role of entrepreneurial phenomena in the challenging context of war.

Psychological Capital and Work Engagement: Moderating Role of Social Relationships

Background Employees are the real capital of any organisation, and to keep the employees productive and functional, employers need to focus on the psychological capital and social relationship of the employees to keep them engaged in their work. This study examined the emerging field of constructs of psychological and social capital to examine Indian employee’s behaviour. Purpose The purpose of this study is to examine a comprehensive model of the relationship between employees’ psychological capital and work engagement. Furthermore, it examines the moderating effect of social relationships between them. Methods This is a primary survey conducted mainly on the manufacturing industry. A sample of 375 mid- and senior-level executives of different age groups was considered in the study from India’s public and private manufacturing sectors administering a questionnaire survey. A random sampling technique was used for data collection. This study applied SPSS and Amos software to validate the measurement model. Results The results indicate a significant correlation among PsyCap, work engagement, and social relationships. PsyCap and social relationships are positively connected to work engagement. Thus, these results provide preliminary support for our hypotheses. The finding suggests that psychological capital and social relationships positively influence work engagement, and social relationships moderate the association between positive psychological capital and work engagement. It helps employees get better engaged at work. Conclusion Organisations must develop psychological capital to provide resources to employees and share a supportive relationship. Developing and maintaining a supportive relationship for employees and employers is important. In the future, both qualitative research methods and longitudinal data from other sectors can be used to understand the interplay between social and psychological capital for enhancing work engagement. Developing and cultivating positive social relations can help employees utilise their psychological strength to better engage in work.

Assembling places, technologies and young people – becoming rural youth with vehicles and digital technologies in Finland

ABSTRACT In this article, we explore the meanings of different technologies, especially vehicles and digital technologies, in the lives of young rural people. This article combines two different qualitative longitudinal data collections from rural areas of Finland. We employ a new materialist framework, especially the Deleuzo-Guattarian assemblage theory and the theoretical concept of becoming. We ask how rural places, youth, and technologies assemble in everyday life. We argue that rural youth becomings assemble not only with traditional technologies, such as mopeds, snowmobiles, and cars, but also with digital technologies, the internet, and social media. In this article, we suggest that rural youth research would benefit from theoretical and methodological reiterations of different rural materialities and human and non-human fluxes.

Use of dyadic longitudinal interviews in health services research: a case example

Abstract Introduction/background Pregnancy loss (PL) is common (∼25% of pregnancies). PL has a negative psychological impact on women and growing evidence that partners are impacted too. Thus PL is a unique public health issue - a “couple” problem that affects both partners. With millions of pregnancies each year, a significant number of pregnant women and their partners will have experienced prior PL and may be vulnerable in pregnancy given their reproductive history. But are their needs met by the standard pregnancy care? This study used dyadic, longitudinal interviews to examine: what are couples’ perceptions of the health care and support provided in a subsequent pregnancy after PL and do their needs change across a pregnancy? The combination of dyadic and longitudinal methods is rarely used in health services research, but seems especially well-placed to examine how needs for health care change across the pregnancy and the perception of both partners. Methods Semi-structured dyadic interviews were conducted with 15 couples over four time periods across a new pregnancy after PL (after pregnancy test and once in each trimester). Couples were recruited from a national cohort of couples with PL. Interviews were held in person or via Zoom in Denmark. Qualitative dyadic and longitudinal interview data were analyzed using thematic analysis with a focus on identification of common themes within and across couples and trimesters. Results and analysis Dyadic data showed that both partners experienced anxiety and worry about the safety of the fetus and possibility of miscarrying. Longitudinal data revealed that couples believed that standard pregnancy care in the first trimester of pregnancy was insufficient for their needs. They wished for ongoing access to regular scans and close monitoring to provide reassurance and detect problems early. They reported that their needs for care were met through antenatal care provided in the later stages of pregnancy. Key messages • Dyadic longitudinal interviews generate nuanced data about a shared experience of receiving health care across a pregnancy. • A better understanding of needs can inform development and provision of effective health care and support to fill identified gaps and promote overall family, maternal and infant health.

Teachers’ professional learning through mentor education: a longitudinal mixed-methods study

ABSTRACT Mentor education for practice teachers and mentors’ professional learning has been described as an underdeveloped area in research. Therefore, the aim of this study was to gain a deeper understanding and knowledge of teachers’ professional learning during and after completing mentor education in Norway. The research questions examine teachers’ experiences of learning through mentor education and the implementation of mentor education in practice. Using a longitudinal mixed-methods research design, quantitative and qualitative data were collected in different phases, providing an opportunity to explore teachers’ professional learning during and 1.5 years after completing a two-year university-based mentor education programme. Through its longitudinal mixed-methods design and collective and school-based participation in mentor education, this study offers new perspectives on teachers’ professional learning and mentor education. The results show that participants experience professional learning as mentors and as teachers because of the content focus, duration, and collective participation of the mentor education programme. Moreover, the results show that the knowledge and skills acquired through mentor education have been implemented into the participants’ own and collective mentoring, teaching, and collaborative practices.

“Like One Long Battle:” Employee Perspectives of the Simultaneous Impact of COVID-19 and an Electronic Health Record Transition

BackgroundHealthcare organizations regularly manage external stressors that threaten patient care, but experiences handling concurrent stressors are not well characterized.ObjectiveTo evaluate the experience of Veterans Affairs (VA) clinicians and staff navigating simultaneous organizational stressors—an electronic health record (EHR) transition and the COVID-19 pandemic—and identify potential strategies to optimize management of co-occurring stressors.DesignQualitative case study describing employee experiences at VA’s initial EHR transition site.ParticipantsClinicians, nurses, allied health professionals, and local leaders at VA’s initial EHR transition site.ApproachWe collected longitudinal qualitative interview data between July 2020 and November 2021 once before and 2–4 times after the date on which the health system transitioned; this timing corresponded with local surges of COVID-19 cases. Interviewers conducted coding and analysis of interview transcripts. For this study, we focused on quotes related to COVID-19 and performed content analysis to describe recurring themes describing the simultaneous impact of COVID-19 and an EHR transition.Key ResultsWe identified five themes related to participants’ experiences: (1) efforts to mitigate COVID-19 transmission led to insufficient access to EHR training and support, (2) clinical practice changes in response to the pandemic impacted EHR workflows in unexpected ways, (3) lack of clear communication and inconsistent enforcement of COVID-19 policies intensified pre-existing frustrations with the EHR, (4) managing concurrent organizational stressors increased work dissatisfaction and feelings of burnout, and (5) participants had limited bandwidth to manage competing demands that arose from concurrent organizational stressors.ConclusionThe expected challenges of an EHR transition were compounded by co-occurrence of the COVID-19 pandemic, which had negative impacts on clinician experience and patient care. During simultaneous organizational stressors, health care facilities should be prepared to address the complex interplay of two stressors on employee experience.

Cash transfers amid shocks: A large, one-time, unconditional cash transfer to refugees in Uganda has multidimensional benefits after 19 months

Refugees in protracted displacement are often limited in their opportunities for income-generating activities and investments, making them dependent on aid for meeting basic needs. In the context of stretched humanitarian aid budgets, it is a necessary policy question to determine ways to increase refugees’ self-reliance. In this study, we combine a randomized controlled trial with extensive longitudinal qualitative data to explore the multidimensional impacts of a large, one-time, unconditional transfer of 1,000 USD to households of predominantly South Sudanese refugees living in protracted displacement in Uganda. Estimated after 19 months, we find that the transfer significantly increased households’ consumption, asset values, business ownership, business revenue, psychological well-being, and self-reliance. We find positive but insignificant effects on food security, migration, employment, or female empowerment. Overall, a large one-time cash transfer given in the context of shocks has multidimensional improvements in refugees’ lives, providing meaningful movement towards self-reliance.

Fostering, Tailoring, Negotiating: The Complexities of Collaborative Coaching in Schools Under Pressure to Improve

Recent research has examined the influential role coaches may play in supporting teachers’ collective capacity building for instructional improvement. While emerging research is promising, much remains to be learned about collaborative approaches to coaching, particularly in schools with the greatest opportunity gaps. We draw on extensive longitudinal qualitative data to explore a collaborative approach to coaching in urban middle schools under pressure to improve math outcomes. Findings reveal key coaching strategies to promote teacher team capacity building, including fostering student-centered discussion and collaborative relationships, tailoring capacity-building opportunities to provide access for all teachers, and negotiating across teachers and leaders to support improvement efforts. This work was complicated by conflicting expectations between leaders and teachers as well as challenges with addressing teachers’ misconceptions about math content in group settings. These findings reflect the need for ongoing capacity building that supports coaches as they attend to group dynamics and accountability pressures.

In their own words: a qualitative study of coping mechanisms employed by patients with acute myeloid leukemia.

Positive coping mediates improved outcomes from integrated palliative care in acute myeloid leukemia (AML). We qualitatively explored patients' coping mechanisms to better understand this relationship. We enrolled patients with high-risk AML admitted to Duke Hospital's inpatient hematologic malignancy service for intensive chemotherapy. This study is a secondary analysis of previously collected longitudinal qualitative data, with interviews conducted between February 2014 and August 2015. Interviews were coded in NVivo to identify examples of approach-oriented and avoidant coping. Patients demonstrated approach-oriented coping in many forms including acceptance, positive reframing, active coping, religious coping, and social coping. Acceptance included accepting their prognosis, the uncertainty of AML, and lifestyle changes due to the disease. Patients exhibited positive reframing by speculating about how their situation could be worse, deriving meaning from their experience, and expressing newfound appreciation for activities previously taken for granted. Social coping involved patients receiving support from their community or care team; however, some expressed guilt for being a "burden" on family. Avoidant coping included denial, behavioral disengagement, and self-blame. Some denied their prognosis, but denial was more commonly demonstrated via patients cognitively distancing themselves from their disease. Much of the behavioral disengagement described by patients was attributed to their symptoms (i.e., lethargy) which prevented patients from maintaining relationships or participating in activities previously enjoyed. These results demonstrate the diverse and nuanced applications of coping mechanisms amid a recent AML diagnosis. Future research should examine coping in the context of novel low-intensity AML therapies.