Multiple Qualitative Interviews Research Articles

The social meanings of choice in living-with advanced breast cancer

Individual choice is valorised as a core social value; yet the necessity and desirability of making choices takes on new significance for people living with incurable cancer who are required to make often difficult decisions about treatment, care and family life, amidst considerable vulnerability and precariousness. There has been comparatively little exploration of how choice is negotiated and made meaningful under the spectre of incurability and a contracted future. In this paper, drawing on multiple qualitative interviews with 38 women with metastatic breast cancer, we explore how they experience and give meaning to choice in relation to their health (and beyond) in their daily lives. Our analysis highlights that while exercising choice was sometimes a concealed or silent pursuit, choice was always a socially negotiated and temporally unfolding process, nested within relational and interpersonal dynamics. Choices were also often constrained, even foreclosed, due to situational and relational dynamics. Yet even in the absence of choice, the idea of choice-as-control was discursively embraced by women. We argue that greater attention is needed to the affective, temporal and economic dimensions of choice, and how treatment decisions are asymmetrically structured when considered within the normative context of cancer.

Narrative inquiry on case studies of crisis in dementia

PurposeThis study aims to explore the coping styles that can be inferred from the discourse of dyads with dementia, and how these appear to impact on care management.Design/methodology/approachThis was a case study approach. Participants were recruited from two teams managing crisis in dementia in the UK. The authors conducted multiple qualitative interviews with people with dementia and their family carers over the course of one month. The analysis was first performed through thematic analysis. Data were further analysed through narrative inquiry to create a story line, or play in our case, for our findings.FindingsFive dyads were interviewed and a total of 16 interviews were conducted. Three dyads were husband–wife and two were daughter–mother relationships. The mean age was 67.4 years for carers and 79.8 years for people with dementia. In these cases, the carer assumed responsibility for managing the episode and was more likely to seek formal help if a pre-existing plan was in place. Otherwise, when a crisis arose, dyads preferred to avoid involving professionals.Practical implicationsPsychosocial interventions should aim to identify and replace unhelpful strategies used by dyads to manage crisis episodes.Originality/valueTo the best of the authors’ knowledge, this is the first study using qualitative interviews of dyads to inquire into their experience of mental health crisis.

Impact of a Multifaceted Educational Program to Improve Provider Skills for Lupus Pregnancy Planning and Management: A Mixed-Methods Approach.

ObjectiveTo bring recent advances in pregnancy management in lupus to women nationwide, this multidimensional educational intervention sought to equip community rheumatologists with the needed skills, attitudes, and confidence to manage contraceptive decisions and pregnancy planning for women with lupus.MethodsThe program included an in‐person didactic, training in use of a comprehensive handout to guide contraception and pregnancy conversations, a simulated clinical experience, and access to an innovative website (www.lupuspregnancy.org). The program was analyzed using mixed methods, which included a quantitative survey by e‐mail before and after program completion and multiple qualitative interviews about attendees’ experiences integrating created resources into practice.ResultsThe analysis included 68 preintervention surveys and 55 postintervention surveys. For qualitative analysis, eight interviews were completed until thematic saturation was achieved. After completion of the program, there was an increase in providers reporting a systematic approach to preparing a woman with lupus for pregnancy (from 45.6% to 94.6%; P < 0.0001). Confidence in choosing both appropriate contraception and pregnancy‐compatible medications improved significantly. As expected, change in knowledge about contraception was limited. Qualitative themes included the utility of the printable handouts, enthusiasm for the program, increased confidence and, importantly, increased empathy for the patients.ConclusionWe created a valuable implementation tool that improves self‐reported provider skills and confidence in managing women with lupus who desire pregnancy. Providers now have access to a unique curriculum and resources that encourage providers to have open and accurate conversations about pregnancy, thus creating lasting clinical change.

Room for caring: patients' experiences of well-being, relief and hope during serious illness.

This study explores how seriously ill hospitalized patients' experience and assign meaning to their patient room. Modern hospitals and the rational underlying care and treatment of today have their emphasis on diagnosis, cure and treatment. Consequently, aesthetics in the patient rooms such as a view of nature or natural light entering the room are often neglected in caring for these patients. A phenomenological-hermeneutic study design was applied and data was collected through multiple qualitative interviews combined with observations at a teaching hospital in Denmark. Twelve patients participated. The findings show that a view of nature and natural light in the form of sunlight or daylight in the patient room play a significant role in creating positive and supportive thoughts and emotions in the seriously ill patients. Three themes were identified: (i) Experiencing inner peace and an escape from negative thoughts, (ii) Experiencing a positive mood and hope and (iii) Experiencing good memories. Our findings highlight aesthetic sensory impressions in the form of nature sights and natural light in the patient room as a powerful source of well-being, relief and hope for the patients during serious illness. Therefore, these sensory impressions should be thought of as holding palliative potential and should be included as a part of caring for the seriously ill patients.

A palliative environment: Caring for seriously ill hospitalized patients

To explore how patients experience being in the hospital environment and the meaning they assign to the environment during serious illness. A qualitative study design was applied, and the data analysis was inspired by Ricoeur's phenomenological-hermeneutic theory of interpretation. Data were collected through multiple qualitative interviews combined with observations at a teaching hospital in Denmark from May to September 2011. A total of 12 patients participated. The findings showed that the hospital environment has a strong impact on patients' emotions and well-being. They reported that aesthetic decorations and small cozy spots for conversation or relaxation created a sense of homeliness that reinforced a positive mood and personal strength. Furthermore, being surrounded by some of their personal items or undertaking familiar tasks, patients were able to maintain a better sense of self. Maintaining at least some kind of familiar daily rhythm was important for their sense of well-being and positive emotions. The results stress the importance of an aesthetically pleasing and homelike hospital environment as part of palliative care, since the aesthetic practice and a sense of homeliness strengthened patients' experiences of well-being, relief, and positive emotions while in a vulnerable situation. Such knowledge could encourage the development of new policies regarding appropriate care settings, which in turn could result in overall improved care during serious illness.

The Meaning of Gender While Aging With Paralytic Polio

The purpose of this article is to report the influence of gender on aging with childhood onset paralytic polio. The hermeneutic phenomenological exploration of gender was done using multiple qualitative interviews with 25 women, age 55 to 75 years of age, who had polio since before 14 years of age. We noted three themes: (a) the movement of her body, (b) integrating body and gender, and (c) gender discrepancies. Findings are discussed in the context of gendered expectations and the women's bodies.

Cross-Cultural Adjustments and International Collegiate Athletes

Ridinger and Pastore (2000a) proposed a theoretical model to measure international student-athlete adjustment to college consisting of: (a) adjustment factors, (b) antecedent dimensions to those factors, and (c) outcomes. The purpose of this study was to examine whether the antecedent factors listed by Ridinger and Pastore were indeed the best indicators of successful adjustment to college for international migrant athletes and to determine if other antecedent factors were also relevant to adjustment. Multiple qualitative interviews with 13 international athletes from four NCAA Division I institutions were conducted. Data collected through those interviews supported all of the antecedent dimensions of the Ridinger and Pastore (2000a) model with the exception of the perception dimension subheading of faculty/staff. New dimension subheadings (a) sense of adventure, (b) previous international travel experience, and (c) family infuence emerged from the data and were added to a revised model of international athlete adjustment.

Personal-professional connections in palliative care occupational therapy.

This qualitative study examined the experiences of occupational therapists working in palliative care. Multiple qualitative interviews were conducted with each of eight occupational therapists working with people who are terminally ill. The interviews were transcribed verbatim and analyzed for recurring and unique themes. Five themes emerged: satisfaction, hardship, coping, spirituality, and growth. Common themes, while resonating through all participants' stories, were experienced in a uniquely personal way by each participant. The result was the discovery of an individualized "personal-professional connection" for each participant. The exploration of personal-professional connections can contribute to the understanding of occupational therapy practice in palliative care. Furthermore, these individual stories may resonate for other occupational therapists and inspire personal and professional reflection; validation of feelings and issues can arise from parallel comparisons. Therapists may in tum gain insight into the relationship between their own personal and professional experiences.