Phenomenological Analysis Approach Research Articles

Promoting Safe and Supportive Health Care Spaces for Youth Experiencing Racism

ObjectiveThis qualitative study applies a community-based participatory research approach to elicit formative data on pediatric patient experiences of racism in the health care setting and to explore clinic-based opportunities for supporting pediatric patients experiencing racism. MethodsThe study is situated within the outpatient practice of a large tertiary academic medical center in a midsize Midwestern city. Community partners were involved in all aspects of the research, including research protocol design, recruitment, data analysis, community dissemination, and manuscript preparation. Participants were youth between 11 and 18 years, in middle or high school, self-identifying as a person of color, Latinx or Indigenous who answered yes to the question “have you ever experienced race-related prejudice and discrimination?” Parent/guardians of youth meeting inclusion criteria participated in separate focus groups. Data were analyzed using an interpretative phenomenological analysis approach. ResultsMajor findings were divided into 2 categories: 1) racism-related experiences in the health care setting; and 2) patient and parent/guardian recommendations to support pediatric patients experiencing racism. Among health care setting experiences, primary emerging themes included racism experienced in the health care setting, patient-clinician communication around racism, patient-clinician concordance, and high-quality clinical care. Recommendations were presented within the 4 domains of racism: intrapersonal, interpersonal, structural, and institutional. ConclusionsRacism experiences worsen child biological, psychological, and behavioral functioning, yet research is lacking on how health care professionals may best support pediatric patients experiencing racism. Study findings suggest opportunities for providing safer and more supportive health care spaces for youth experiencing racism.

"There's a Lifestyle, an Appreciation, a Beauty": An Interpretative Phenomenological Analysis of Masters Rowers.

Masters rowing has seen a measurable increase in participation, with masters rowers engaged in the sport for competition, health, and recreation reasons. Unlike other masters sports, masters rowing has a unique high level of synchronous, cooperative, and interdependent elements. To better understand the benefits and challenges of participation in competitive masters rowing, the purpose of this study was to explore the lived experiences of competitive masters rowers. Twelve competitive masters rowers were recruited and interviewed. Utilizing an interpretative phenomenological analysis approach to guide data collection, analysis, and interpretation, the analysis revealed four major themes: navigating community relationships, finding a reason to row, growing opportunities, and seeking considerate coaches. Utilizing self-determination theory as a framework for interpreting the findings, the identified themes illustrate the varying motivations, needs, and preferences of competitive masters rowers, as well as how their experiences are influenced by their coaches and peers. Efforts should be made by masters rowing coaches and administrators to better understand the needs of their athletes to ensure the maximum benefits of participation, commitment, and enjoyment of the sport.

EXPLORING AI ELDERS’ CULTURAL PERCEPTIONS OF DISASTERS AND THE ROLE OF GENERATIVITY IN PREPARING FUTURE GENERATIONS

Abstract Natural and man-made disasters have a great impact on human health, especially for AI Elders. As keepers of cultural and community knowledge, AIAN Elders also serve as guides on how to best support their communities. This study focuses on a Midwestern Tribe’s cultural perceptions of disaster management, specifically being generative, or passing down disaster management knowledge and practices to future generations. In-person semi-structured interviews were conducted with eighteen Elders from the Midwestern Tribe. Recordings were transcribed, de-identified, and coded thematically using an interpretive phenomenological analysis approach. The study received approval from the Tribe’s Department of Emergency Management and the interview guide was reviewed and approved by a Community Advisory Board of six individuals. Elders described past experiences with natural and man-made disasters, including what they did before, during, and after disasters. Elders also explained how people cared for one another, including the importance of interconnectedness with all beings, caring for grandchildren, and the role of the Tribal Government in disaster management. Elders also described how culture shaped disaster management practices, such as traditional practices to follow during a storm, and the important role of Elders in teaching communities what to do when disasters happen. Exploring the role of generativity in passing on disaster-related information is one way to learn how Elders’ knowledge is valued by the community. Findings suggest that Elders can provide important guidance to Tribal governments and public health systems to determine effective disaster management strategies for AIAN communities.

EFFECTS OF BEING FORGOTTEN ON ADULT CHILDREN OF MOTHERS WITH DEMENTIA

Abstract Mothers with dementia sometimes do not recognize their adult children. Yet, research on the effects of being forgotten by a mother with dementia is scarce. Object relations theorists posit that healthy development of a child’s sense of self is linked to being remembered by a primary caretaker. Further, being held in mind by a primary caregiver allows the child to form a cohesive identity. It is unclear how adult children’s identities are impacted by being forgotten by their mothers. To investigate this phenomenon, this qualitative study explored the effects of being forgotten on adult children in the context of dementia. The aims were: 1) to develop an in-depth understanding of what it means for adults to be forgotten by their mothers with dementia, and 2) to gain insight on the effect of being forgotten on adults’ identities. Data were gathered through 12 interviews. Data was analyzed following an interpretative phenomenological analysis approach. Preliminary findings suggest adult children of mothers with dementia experience being forgotten as both a threat to their identity and forewarning of continued poor disease outcomes. The following themes illustrate this: 1) The sense that one’s existence was not important enough to be remembered, 2) Feelings of failure due to the inability to spark recognition of themselves in their mother’s mind, and 3) Dread for the disease progression. While research regarding adult children of parents with dementia largely focuses on practical aspects of caregiving, clinical implications of these findings suggest that this population suffers silently from being forgotten.

Preparedness for the transition to medical registrar from senior house officer-What's the problem?

Transitions in clinical training are a hallmark in medical trainee's careers. The transition from senior house officer (SHO) to the role of medical registrar is often viewed as one of the most challenging, but to date, there is little research exploring why the transition is proving problematic for so many learners. The aim of this study was to explore the experiences of trainees preparing to make this transition. Using an interpretative phenomenological analysis (IPA) approach, this qualitative study employed semi-structured interviews to explore the lived experiences of transition in a purposive sample of trainees on the cusp of transition from SHO to registrar or who were in their first year of being a medical registrar. Interviews were recorded, transcribed verbatim and analysed using an IPA approach. Six trainees participated in this study, four of whom were currently in SHO positions, with the remaining two in their first year of medical registrar. Two main themes emerged from data-perception of the medical registrar and barriers in transition. The role of the medical registrar was perceived to represent a strong leadership role, with barriers created due to increasing expectations, lack of support and uncertainties regarding the job. The role of the medical registrar is a challenging one, representing periods of uncertainty, increased expectations and reduced supports. Within this, there is potential to further support SHOs in transitioning to the role of medical registrar.

Social Entrepreneurship Education for Orphans Through Chicken Farming : A Case Study from Yogyakarta

This research aims to explore in depth the social entrepreneurship education activities of Omah Pak Cilik, the Gerakan Kebaikan community in livestock-based entrepreneurial activities for orphans, including constructing the meaning and reality behind the emergence of these programs and collaboration. The research method used was phenomenological with a qualitative approach. For collecting the data, this research used interviews, direct observation, and directed dialogue with the founder of Omah Pak Cilik, the Actor for the Good Movement, and Orphans. The validity of the research data was obtained through triangulation and then analyzed using the Interpretative Phenomenological Analysis (IPA) approach. This study found that 1) Omah Pak Cilik cooperated with the kindness movement community to organize a KUB Chicken Farm business to solve economic problems, starting with providing understanding related to entrepreneurship to orphans so that an entrepreneurial spirit grows, 2) Orphans were given education and training related to business management and sales skills. 3) The result changed the mindset of orphans for entrepreneurship, improving the economy, and establishing partnerships.

‘Sometimes I wonder if our best really is our best’: Tutor reflections on the challenges of shifting to online tutoring during the pandemic

Tutors play an important role in higher education, as they may facilitate learning, promote engagement, and assist with student success. Students also often feel more comfortable seeking assistance from them than from lecturers. Yet, tutors tend to be sidelined in the literature on teaching and learning, including during the COVID-19 pandemic. The paper is framed by an Interpretative Phenomenological Analysis (IPA) approach and seeks to understand how three tutors in an online academic literacy module experienced the shift to online learning. Data, in the form of personal reflections, were collected online and analysed thematically. It was found that the tutors experienced the shift negatively and they raised practical concerns, as well as interpersonal ones. Implications for tutor training are discussed.

Healthy School Meals for All in Utah.

The National School Lunch and School Breakfast programs reduce food insecurity and improve dietary intake. During the COVID-19 pandemic, school meals were provided to all children at no cost, regardless of income. This policy is known as Healthy School Meals For All (HSMFA). The purpose of the study was to examine the feasibility of a HSMFA policy in Utah. A mixed-methods approach was used, including qualitative interviews for policymakers, surveys for school foodservice directors, and financial modeling of Utah Child Nutrition Programs data. Analysis included a phenomenological analytic approach for qualitative data, descriptive statistics for surveys, and development of a cost model with 6 scenarios. Qualitative data revealed themes of (1) awareness; (2) responsibility; (3) perspectives on school meals; and (4) new opportunities. Most (81%) foodservice directors believed HSMFA should continue post-pandemic. HSMFA would cost $51,341,436 to $82,358,375 per year. HSMFA would result in the equitable treatment of all children regarding access to healthy school meals. Given the support of foodservice directors but the lack of political consensus, considering stepwise implementation and providing cost estimates may increase feasibility of a HSMFA policy in Utah.

Exploring Parental Experiences and Meaning of Involvement within Youth Sport: An Interpretative Phenomenological Analysis

By applying an interpretative phenomenological analysis approach, the purpose of the study was to explore the lived experience of parental involvement in youth sport and the meaning the involvement holds. Specifically, we examined how role identity theory provides a deeper understanding of how parents experience and provide meaning to their involvement in their children’s sport. The overarching themes interpreted from the data include Expectations of Involvement, Commitment, and Constructing Meaning-making of the Experience. These findings highlight the ways in which role identity salience defines the meaning involvement as a leisure pursuit holds to a parent. This study provides a deeper theoretical understanding of the experience of being a parent involved in youth sport, as well as highlights the usefulness of conducting research in this field with an interpretative phenomenological analysis approach to explore a complex and diverse topic.

The Perceived Impact of the Intergenerational Component of an Ageing Well Program

ABSTRACT This paper investigates the perceived impact of the intergenerational component of an Ageing Well Program from the perspectives of the older adult and university student participants. An interpretative phenomenological analysis approach was used, with data being collected via semi-structured interviews. Seven older adults and six students who participated in the most recent program were interviewed. “Forming Connections,” “Getting to Know the Older Adults” and “Assisting the Students Through the Learning Process” were the key themes that emerged from the data. Ultimately, it was perceived that the inclusion of an intergenerational component was of greater benefit to the university students.

The sound of education: Exploring Filipino students' perceptions of teachers' vocal quality in the classroom

Every teacher needs to develop their vocal skills through continual practice and voice quality improvement. Students will draw judgments and assumptions about the teacher's attitude toward them, as well as the knowledge and concepts that he or she is imparting, based on the tones of the teacher's voice. The purpose of this study was to explore students’ perception on teachers’ vocal quality in a classroom setting. With a qualitative research design, the current study employed an interpretative phenomenological analysis approach. The participants of the study are composed of 26 students (9 males) (17 females) under the College of Business and Entrepreneurship. The collection of data was done through a face-to-face, semi-structured interview with audio recording. With the help of thematic analysis, the researchers come up with these themes: (1) the instructional tone or manner and emotional expression of the teachers; (2) teachers’ emphasis and motivation on teaching; (3) engagement and voice characteristics of teachers; (4) teachers’ effectiveness and students’ engagement in the classroom; (5) challenges faced by students; (6) comprehensibility and academic performance of students; and (7) learning and knowledge acquisition of students. The findings revealed that the vocal quality of teachers have an impact on how engaged their students are in the learning process, which in turn helps them achieve academically.

Making sense of a myocardial infarction in relation to changing lifestyle in the five months following the event: An interpretative phenomenological analysis

ObjectivePrevious research has shown that experiencing an acute cardiac event, such as a myocardial infarction (MI), can lead to lifestyle changes. This study aimed to explore the potential of a MI as a ‘teachable moment’ (TM) for positive lifestyle changes and to identify psychosocial sensemaking processes that facilitate or hinder the presence of a TM. MethodWe conducted semi-structured interviews with 14 patients who suffered their first MI and were hospitalized in a larger Dutch city. Participants were interviewed twice, respectively one and five months after their hospitalization. They were encouraged to explain how they experienced their MI and how this had affected their lifestyle. We used an Interpretative Phenomenological Analysis approach to the data collection and analysis. FindingsThe participants varied in their willingness to adopt a healthy lifestyle due to their MI. Most participants experienced their event as a TM for changing specific health behaviors, for example facilitated by reflecting on self-concept or social roles and by constructing and comprehending a personal narrative of their MI. Some participants struggled to follow through on their intentions to change their behavior, for example because of a negative attitude towards a healthy behavior or because they perceived it as incongruent to their identity. Only three participants maintained most former health behaviors, for example because they failed to acknowledge their MI as severe or because of earlier life events that elicited more blunted cognitive responses. ConclusionCardiac patients may experience a TM, which is the consequence of interrelated processes of psychosocial sensemaking. As this does not occur at a singular time point, we suggest using the term ‘teachable window’ rather than ‘moment’. Given these findings, there is a window of opportunity to provide continuous psychosocial and lifestyle support during and after hospitalization for acute cardiac events.

Becoming a Rare Disease Parent: An Interpretative Phenomenological Analysis of Parent-Caregivers' Postpartum Experiences.

Rare diseases constitute a group of conditions that are individually rare, but in aggregate impact between 3 and 6% of the world population. Many of these conditions present during infancy and involve substantial caregiving responsibilities, often assessed via quantitative measurements. However, few qualitative analyses examine lived experiences of parent-caregivers during the early period of their child's life. The purpose of this study was to examine the meaning that rare disease parent-caregivers apply to the postpartum year using data collected from a semi-structured interview exploring significant experiences over the course of their affected child's life. We utilized an interpretative phenomenological analysis (IPA) approach to analyze 22 interview transcripts from caregivers to children with several inherited metabolic and mitochondrial disorders, as well as an undiagnosed disease. Our analysis yielded three superordinate themes: Reckoning With the Parent-Caregiver Role, Familial Transition, and Adaptation and Adjustment. Subordinate themes expanded upon these concepts and included distinctions between the parent and caregiving identity, communal coping and shifting of family dynamics, as well as meaning applied to child milestones, anticipatory grief, and parental perception of a new normal. Exploration of these themes in relation to existing literature, as well as future research directions for qualitative research on rare disease caregivers, is discussed. Overall, this work contributes to a growing body of literature exploring the parental experience of rare disease across several condition contexts.

Reflective practice in medicine: The hidden curriculum challenge.

Despite the known benefits of reflection in various health care professions, it is still not a thriving practice in medical education. The literature suggests that this may be due to tensions between epistemological tenets of reflection and biomedicine. Further research is needed into experiences of doctors as they implement reflection in medical education settings. We set out to explore how these experiences were influenced by hidden curricula to provide insights into personal and contextual features of medical settings influencing engagement in reflection. Using an interpretative phenomenological analysis (IPA) approach, four semi-structured qualitative interviews were conducted virtually. Participants were doctors who graduated from a postgraduate diploma in clinical education with core reflective practice components. Interviews were recorded, transcribed, coded and analysed using IPA. Opportunities to review and amend transcriptions were provided. Three superordinate themes were identified including epistemological divergence, fear of showing vulnerability and reflection volte-face. Challenges in engaging in practices epistemologically different to predominant discourses in medicine were compounded by fears of vulnerability and a common antipathy towards reflection. All developed more accommodating perspectives towards reflection with shared experiences of a programme incorporating reflective practice. The hidden curriculum can have positive and negative impacts on doctors' engagement in reflection. In facilitating reflective practice for this group, we recommend assisting with awareness of ways of thinking and being in medicine, offering reassurance that reflection may initially feel like running contrary to predominant discourses and finally, role modelling openness to vulnerability to better integrate and promote meaningful engagement in reflection.

El viaje del paciente con fibromialgia en Latinoamérica

ObjectivesTo explore the patient journey of people with fibromyalgia (FM) in Latin American countries in order to identify problems in health care and other areas that may be resolvable. MethodsQualitative study with phenomenological and content analysis approach through focus groups and patient journey (Ux; User Experience) methodology. Nine virtual focus groups were conducted with FM patients and healthcare professionals in Argentina, Mexico and Colombia recruited from key informants and social networks. ResultsForty-three people participated (33 were clinicians and 10 were patients). The agents interacting with the patient in their disease journey are found in three spheres: healthcare (multiple medical specialists and other professionals), support and work life (including patient associations) and socioeconomic context. The line of the journey presents two large sections, two loops and a thin dashed line. The two major sections represent the time from first symptoms to medical visit (characterized by self-medication and denial) and the time from diagnosis to follow-up (characterized by high expectations and multiple contacts to make life changes that are not realized). The two loop phases include (1) succession of misdiagnoses and mistreatments and referrals to specialists and (2) new symptoms every so often, visits to specialists, diagnostic doubts, and impatience. Very few patients manage to reach the final phase of autonomy. ConclusionThe journey of a person with FM in Latin America is full of obstacles and loops. The desired goal is for all the agents involved to understand that self-management by the patient with FM is an essential part of success, and this can only be achieved with early access to resources and guidance from professionals.

The operational experience of private owners of small-sized care homes in China: a qualitative study

BackgroundPrivate small-sized care homes (<50 beds) have proliferated across China, however, until recently little was known about the characteristics of such institutions, and the challenges and the problems faced by their owners. This study aimed to explore the characteristics of small-sized, privately-owned care homes in the People’s Republic of China; and to understand the motivation and challenges faced by their owners.MethodsThis study used an interpretative phenomenological analysis approach of qualitative research. Owners of eight small-sized private care homes located in two cities of Henan Province, China, were interviewed using semi-structured interviews.ResultsFour themes and eight subthemes were identified: 1. Motivation for establishing a care home business; 2. Certification and establishing a legal footing for the business; 3. Operational challenges; 4. Future business development. The study found that the development of privately owned small-sized care homes faced great challenges and critical survival problems due to policies, staffing, and management issues. There is a lack of regulations about the safety and quality of care provided for older people and a lack of legal protections for the owners of small-sized private care homes.ConclusionThe study suggests that formal regulations and provisions are needed to support these smaller-sized private care homes. Monitoring is also needed to ensure the quality of care. It also suggests that there needs more support by policymakers as well as provision monitoring services to improve quality of care in these care homes. Care regulations and standards are not unique to China so findings from this study can be applied to places where there are similar situations or if there are aged care services still developing.

The hidden pandemic: a qualitative study on how middle-aged women make sense of managing their long COVID symptoms.

A relapsing and remitting illness, long COVID can be challenging and debilitating. A person living with long COVID can feel like they are getting better and recovering only to relapse again. The aim of the research was to explore how non-hospitalized middle-aged women who contracted COVID in the first wave of the pandemic, from March 2020, are managing their long COVID symptoms. A qualitative research study with an interpretative phenomenological analysis approach was used to explore how the women made sense of managing their condition and health seeking behaviours. Participants were recruited from long COVID Facebook groups and semi-structured interviews were conducted remotely by Teams audio; these were digitally recorded and transcribed by hand with prior informed consent. Nine women were interviewed and four themes and eight sub-themes emerged from the data. The four emerging themes were: inequality and inconsistent medical treatment; uncertainty and ambiguity of managing long COVID symptoms; managing other people's expectations and perceptions of long COVID; and the changing identity. Overall, these results indicated a general mistrust in health care services to provide adequate support and individualized treatment plans leading women to self-advocacy and to seek alternative support and treatment. This study raised questions about the possible unfair treatment of women seeking medical attention for their long COVID symptoms; how ambiguous symptoms are misattributed to anxiety and discrimination from health care professionals contributes towards stigma. The study concludes with recommendations for service improvement such as the compassionate validation of patients' pain and the use of evidence-based therapeutic practices such as mindfulness.

Turnover intention and coping strategies among older nursing assistants in China: a qualitative study.

With the increasing aging population, older nursing assistants have made significant contributions to institutional eldercare. However, there is a high turnover rate among these workers, and it is crucial to address this issue and find ways to stabilize the workforce. This study aimed to explore the factors influencing turnover intention and coping strategies among older nursing assistants, in order to provide targeted assistance and guidance to reduce their intention to resign and ultimately lower the turnover rate. Qualitative research methods were employed to conduct semi-structured interviews with older nursing assistants in Changsha. The data obtained from these interviews were then analyzed using a phenomenological analysis approach and NVIVO (QSR International, Doncaster, Australia) software version 11.0. It is found that several factors influence turnover intention among older nursing assistants. Which include work pay, work environment, professional identity, external motivation, and work pressure. Additionally, the coping strategies employed by these individuals in relation to their intention to resign include self-regulation, seeking support, self-improvement, and exploring motivation. It is also evident from our study that reducing the turnover intention of older nursing assistants requires a collaborative effort from older adult care institutions, functional departments, and eldercare nursing assistants themselves. By addressing the factors influencing turnover intention and providing support and resources for coping strategies, we can work towards stabilizing the workforce and improving institutional eldercare.

You wouldn’t let your phone run out of battery: an interpretative phenomenological analysis of male professional football coaches’ well-being

ABSTRACT Little is known about how coaches make sense of and experience well-being within their given context as athletes have traditionally been at the forefront of well-being research, which is concerning given coaches are as susceptible to well-being challenges. Considering well-being and coaching comprise of many idiosyncratic and sociocultural interactions, the present study employed a combined bioecological and interpretative phenomenological analysis (IPA) approach to explore how six professional football coaches make sense of and experience well-being within the context of football clubs. Due to IPA’s contextualist position, commitment to the individual, and ability to empower and give voice, two group experiential themes were created: ‘The endeavour to comprehend coaches’ well-being’, and ‘Volatility of the football coaching profession: fragmented well-being’. Findings showed that football coaches made sense of their well-being by drawing on past playing experiences and sociocultural interactions, with some coaches comprehending well-being as a physical and mental battery. Additionally, several coaches experienced a fragmentation of self and subsequent well-being due to conflicts within and between their ecological niche. A combined bioecological and IPA approach facilitated and enriched how well-being was contextually made sense of and experienced.

Experiences of young people living with type 1 diabetes in transition to adulthood: The importance of care provider familiarity and support.

During the developmental transition from childhood to adulthood, young people living with type 1 diabetes (T1D) are more likely to take less care of their chronic disease. Alongside the developmental transition, young people with T1D also experience an organisational transition in which the care responsibility changes from a family-based approach in paediatric care to an individualised approach in adult care. Little is known from the perspective of the young people about what their interactions with the healthcare providers mean during these transitions. The aim of this study is to explore how young people living with T1D experience interactions with their care providers, and what it means for their developmental transition. Semi-structured interviews with 10 respondents aged 18-20 living with T1D who were recruited from a youth outpatient diabetes clinic in Denmark. Recorded audio data were transcribed and analysed using an interpretative phenomenological analysis approach. Young people experience continuity in the relationship with the diabetes nurse from the paediatric clinic and a personal patient-provider relationship with their well-known and new care providers. This creates a feeling of familiarity and contributes to a seamless transition. The young people express that becoming more involved in diabetes treatment increases their willingness to take more responsibility for their own health. They also express that care providers should support them in managing their diabetes and talk about sensitive topics. Continuity in the relationship with the diabetes nurse makes the transition from paediatric to adult care more satisfying and seamless. To support the developmental transition, care providers should gradually involve young people more in diabetes management and be supportive as they become more independent during the developmental transition.