Phenomenological Interview Study Research Articles

Exploring marital safety: three South African wives living with HIV in nonmutual monogamous marriage

For wives who have been sexually monogamous, their being infected with HIV disrupts the cultural assumption of sexual safety in marriage. This phenomenological interview study shows how three married South African women, who were diagnosed with HIV and had reported being monogamous, experienced gendered distress while contemplating the failures of married coupledom in offering safety and familial stability. Constructionist thematic analysis showed three themes to represent changes in the marital unit. The first theme, HIV as Demarcation of Enduring Disruption, pointed to infection as the harbinger of distressing relational dynamics. The second theme, Feeling Controlled, reflected domains in which the wives felt trapped: restricted freedoms and obligatory intimacy. The third theme, Relational Deterioration, showed meanings about infidelity, fights or arguments, and distress about partner disengagement. Highlighted in this analysis is that, for two women, male control and disempowerment after having been infected with HIV added to their experiences of feeling trapped because they felt pressured into regressing into subservient spousal roles. They were required to retreat into household, mothering, and child care duties. The study’s practice implication is that, to address the aftermath of the discovery of HIV infection in heterosexual married couples, wherein sexual monogamy remains the unquestioned norm, health psychology and clinical interventions should incorporate a gendered approach in counselling formulation.

What the textbooks don’t teach about the reality of running a digitally enabled health study: a phenomenological interview study

BackgroundMost studies do not produce their intended outcomes on time or within budget. However, it is challenging to identify the facilitators and barriers to successful study management when the “behind the scenes action” of especially digitally enabled health research studies are akin to a black box. Therefore, it is necessary to explore first-hand experience of the facilitators and barriers to managing digitally enabled health studies. The goal of such studies is to produce new knowledge and/or develop tools that can be translated to real-world benefits for the health and care sector, individuals, and other stakeholders. These studies now exist in a time that encourages collaborative research activities with interdisciplinary research partnerships, industry collaboration, end-user involvement and insights for policy. These expectations require teams with different work cultures, methodologies, technologies, and approaches to work together, resulting in significant benefits but also challenges.ObjectivesTo explore the relationship between the dynamics and needs of research teams and the technology used to manage digitally enabled studies through the experience of those who worked on such studies.MethodsWe used an interpretive phenomenological approach to explore research team members’ experiences and perceptions of study management in the field of digitally enabled health research. We interviewed 15 research team members from eight studies. A semi-structured interview guide was used to explore concepts related to study activity management, team dynamics, resources and technologies used to manage research activities, and reflections of personal experiences. An adductive thematic analysis was performed on the transcripts.ResultsFive main themes were identified: 1) Project Team, 2) Study management, which included management technologies, 3) Study plan, 4) Intervention, 5) Participants. This paper focuses on the first two main themes. Sub-themes included: Roles and responsibilities, Methods, Changes, Challenges and solutions and Expectations vs. reality. Sub-themes were applicable to all main themes. Therefore, results were presented as knowledge gained from the interaction between sub-themes within each theme, i.e. referred to as “comprehensive insights” in the results section of this paper.ConclusionThis interview study provides new knowledge about the realities of working in collaborative, digitally enabled health research studies and demonstrates several opportunities for improved understanding of study management. More realistic and thorough understanding of the complex system in which digitally enabled health research exists can be applied to better prepare experienced researchers and newly graduated students entering the field, as well as improve existing strategies for management.

'There is still a part of me that would love to be the old me again', how do adolescents and young adults (AYA) experience cancer-related bodily changes: a phenomenological interview study.

Due to the increase in both cancer incidence and overall survival rates, more adolescents and young adults (AYAs) have to live with the effects that their cancer diagnosis and following treatments have on their bodies. This qualitative phenomenological study aimed to gain more insight into the way AYAs experience these effects and how they respond to these effects. Semi-structured interviews with a sample of 11 AYAs with an age range of 25-41years at the time of the interview, who were diagnosed with different types of cancer, were conducted. Participants were recruited via social media and patient associations until data saturation was reached. A topic guide with open-ended questions about lived experiences was used. Interpretative phenomenological analysis (IPA) was performed to analyse the transcripts. We identified six Group Experiential Themes based on different ways AYAs experience their bodies: (1) self-conscious body, (2) vulnerable body, (3) adapting to the body, (4) uncontrollable body, (5) remembering the body and (6) shared bodies. This study offers in-depth insight into the bodily experiences of AYAs after cancer and how they respond to these changes from a phenomenological point of view. This knowledge could be beneficial to provide more guidance for AYAs during and after their illness, by focussing on personalised psychological (after)care.

A phenomenological interview study with patients being non-conveyed in the ambulance service

BackgroundNon-conveyed patients (i.e. patients who are not transported to a hospital after being assessed by ambulance clinicians) represent a significantly increasing proportion of all patients seeking ambulance care. Scientific knowledge about patients’ non-conveyance experiences is sparse. This study describes the lived experiences of non-conveyed patients in an ambulance care context.MethodsA reflective lifeworld research (RLR) approach founded on phenomenology is used. Data is derived from nine in-depth interviews with patients not conveyed by the ambulance service in a major Swedish region.ResultsPatients’ lived experiences of becoming acutely ill or injured and not conveyed by ambulance to a hospital are characterised by several dynamic movements: losing and regaining situational and bodily control, dependence and autonomy, external competence and inner knowledge, handing over and regaining responsibility, and fear and security.ConclusionsPatients’ lived experiences of non-conveyance are complex and versatile. Although non-conveyed patients initially experience strong fear and the loss of situational and bodily control, they gradually feel more secure when experiencing confirmation and trust, which evolves into insecurity and uncertainty. The non-conveyance situation’s complexity from a patient’s perspective implies the need for ambulance organisations to take measures to prevent further suffering. Non-conveyed patients must be taken seriously in their unique situations, requiring ambulance clinicians to reflect and act with a conscious ethical perspective before, during and after their visit.

A phenomenology of direct observation in residency: Is Miller's 'does' level observable?

Guidelines on direct observation (DO) present DO as an assessment of Miller's 'does' level, that is, the learner's ability to function independently in clinical situations. The literature, however, indicates that residents may behave 'inauthentically' when observed. To minimise this 'observer effect', learners are encouraged to 'do what they would normally do' so that they can receive feedback on their actual work behaviour. Recent phenomenological research on patients' experiences with DO challenges this approach; patients needed-and caused-some participation of the observing supervisor. Although guidelines advise supervisors to minimise their presence, we are poorly informed on how some deliberate supervisor participation affects residents' experience in DO situations. Therefore, we investigated what residents essentially experienced in DO situations. We performed an interpretive phenomenological interview study, including six general practice (GP) residents. We collected and analysed our data, using the four phenomenological lenses of lived body, lived space, lived time and lived relationship. We grouped our open codes by interpreting what they revealed about common structures of residents' pre-reflective experiences. Residents experienced the observing supervisor not just as an observer or assessor. They also experienced them as both a senior colleague and as the patient's familiar GP, which led to many additional interactions. When residents tried to act as if the supervisor was not there, they could feel insecure and handicapped because the supervisor was there, changing the situation. Our results indicate that the 'observer effect' is much more material than was previously understood. Consequently, observing residents' 'authentic' behaviour at Miller's 'does' level, as if the supervisor was not there, seems impossible and a misleading concept: misleading, because it may frustrate residents and cause supervisors to neglect patients' and residents' needs in DO situations. We suggest that one-way DO is better replaced by bi-directional DO in working-and-learning-together sessions.

Lived experiences of patients undergoing treatment for traumatic knee injury using integrated psychological training (MOTIFS) in the context of care-as-usual training: a phenomenological interview study

The objective was to increase understanding of how knee-injured people make sense of using the Motor Imagery to Facilitate Sensorimotor Re-Learning (MOTIFS) training intervention. This model integrates structured psychological skills...

Everyday life with childhood functional constipation: A qualitative phenomenological study of parents' experiences

Childhood functional constipation (FC) is a worldwide problem with treatment regiments affecting everyday life. AimTo explore parents´ experiences of living with a child with FC and its impact on everyday family life. MethodA qualitative phenomenological interview study using a reflective lifeworld research approach. Interviews with 15 parents of otherwise healthy children aged 1–14 years affected by FC. FindingsShame is the driving force making parents put everyday life on hold. The quest for control, self-imposed loneliness, guilt, inadequacy, and frustrating battles become essential parts of everyday life to protect it from FC-related shame. ConclusionFC has as great an impact on everyday life as any childhood illness. Every part of family life is affected by FC. Continuously family support and guidance are needed. Practice implicationsHealthcare professionals need to take FC more seriously, listen to the parents and try to understand their experiences of everyday life to enable custom made care plans with the family-unit in focus. Care with clinical sensitivity might help parents deal with the attendant shame and stigmatization that stem from illness beliefs about FC.

Living well (or not) with patellofemoral pain: A qualitative study

ObjectivePatellofemoral pain (PFP) is a common musculoskeletal condition, which has a negative effect on physical activity and function. Currently, it is unknown how and why individuals with PFP modify their physical activity. The purpose of this qualitative study was to explore the experience of knee pain on physical activity and everyday life in individuals experiencing PFP. DesignQualitative phenomenological interview study. SettingUniversity. ParticipantsSixteen patients experiencing PFP. Main outcome measuresSemi-structured interviews were used to explore the pain experience on physical activity and daily living. ResultsPatients with PFP attempted various strategies to remain physically active, such as identifying pain thresholds, activity modification, and pushing through their pain. Despite these various strategies to stay active, pain influenced their social life and patients demonstrated both fear avoidance beliefs and pain catastrophizing. Patients with PFP also reported barriers to seek care for their knee pain, such as negative past experiences with health care professionals and care not aligned with the best evidence available. ConclusionClinicians treating PFP should be aware of biologic, psychological, and social aspects when evaluating and intervening with patients.

How Family Members Experienced a Family-Focused Atrial Fibrillation Intervention in an Outpatient Setting-A Qualitative Study.

IntroductionFamily-focused nursing has gained ground worldwide, and a range of healthcare systems are now practicing family-focused nursing, which has been shown to increase the quality of care. Even so, a lack of research remains into family-focused nursing for various groups of patients in clinical practice.ObjectivesThe purpose of this study was to explore how family members (FMs) of patients with atrial fibrillation (AF) experienced a family-focused nursing intervention in a clinical outpatient setting.MethodsThis was a qualitative phenomenological interview study employing Reflective Lifeworld Research (RLR) to explore humans’ lived experiences. The data reported herein were derived from semi-structured interviews with seven FMs of patients with AF who participated in a clinical trial which tested a family-focused intervention in a Cardiology outpatient clinic treating patients with AF. The transcribed interviews were analyzed in four phases which is an iterative process as proposed by Dahlberg and Dahlberg.FindingsThe essence of the phenomenon was experiencing less panic and finding peace, which emerged from the following four patterns. (1) The FMs’ post-AF experience, (2) Enhanced understanding and knowledge of AF, (3) Personal interaction with a nurse specialist and (4) AF becomes manageable. A space facilitating reflection upon the disease and daily life with the disease was established through group sessions and family conversations.ConclusionA family-focused nursing intervention facilitated by specialized nurses with extensive communication skills filled a knowledge gap related to AF thereby reducing panic and increasing peace among FMs. Furthermore, the intervention facilitated family awareness of their resources to bring about change, regain balance, and enhance well-being in their everyday lives and initiated a healing process in the families. Future interventions for patients with AF should consider FMs as well as patients as an entity of care.

Administrative Leadership in Times of a Global Health Crisis: Voices and Images From the Field

The novel coronavirus (COVID-19) pandemic took the world into crisis. We saw the virus alter a multitude of spheres worldwide, including our healthcare, economies, politics, social processes, and education. In fact, the impact of COVID-19 on educational administration took our leaders into forced emergency measures. Our study aims to better understand the experiences of educational administrators under crisis to ascertain what might be learned on how educational institutions may better respond to the crisis in the future. These stories were collected from educational leaders, both from K-12 and higher education, throughout the United States. In brief, this article is framed in the theory and literature associated with the complexity of leading in times of crisis. We explore the resiliency of leadership forged in crisis and the rethinking of administrative as administration as a caring and trustful acts. Our research began as a hermeneutic phenomenological interview study, but transitions into a two-round project, where after the first interview, participants were invited to share some images that typify and speak to the experiences being educational administrators during this time. We are engaged in sensitive topics that are ongoing and changing. Moreover, throughout, we are asking for images that speak to their experiences. Across both K-12 and higher education, our results indicated varied responses, from immediate to delayed administrative action. However, albeit they looked contextually different, there are clear indications the participants valued continuous, transparent communication, authentic caring, trust, and agency. In our discussion, we elaborate on the distinction between what the institutional response was as compared to what was valued by our educational leaders. Finally, as a contribution to the field, we seek to provide guidance for future administrators in crisis based on our own experiences and the recommendations provided by our educational leaders.

A phenomenological investigation of patients\u2019 experiences during direct observation in residency: busting the myth of the fly on the wall

Direct observation (DO) of residents by supervisors is a highly recommended educational tool in postgraduate medical education, yet its uptake is poor. Residents and supervisors report various reasons for not engaging in DO. Some of these relate to their interaction with patients during DO. We do not know the patient perspectives on these interactions, nor, more broadly, what it is like to be a patient in a DO situation. Understanding the patient perspective may lead to a more complete understanding of the dynamics in DO situations, which may benefit patient wellbeing and improve the use of DO as an educational tool. We conducted a phenomenological interview study to investigate the experience of being a patient in a DO situation. Our analysis included multiple rounds of coding and identifying themes, and a final phase of phenomenological reduction to arrive at the essential elements of the experience. Constant reflexivity was at the heart of this process. Our results provide a new perspective on the role of the supervisor in DO situations. Patients were willing to address the resident, but sought moments of contact with, and some participation by, the supervisor. Consequently, conceptions of DO in which the supervisor thinks she is a fly on the wall rather than a part of the interaction, should be critically reviewed. To that end, we propose the concept of participative direct observation in workplace learning, which also acknowledges the observer’s role as participant. Embracing this concept may benefit both patients’ wellbeing and residents’ learning.

Life after falls prevention exercise \u2013 experiences of older people taking part in a clinical trial: a phenomenological study

BackgroundThere is little evidence about the lived experience of older people who have completed a falls prevention exercise programme and their life beyond their intervention.MethodA phenomenological interview study with 23 participants (12 females), mean age 81 years (range 74–93 years), residing in their own homes across England, who had participated in a falls prevention exercise intervention within the Prevention of Falls Injury Trial (PreFIT). The aims were to explore their experiences of:being in a clinical trial involving exercise.exercise once their falls prevention intervention had finished.Interpretative data analysis was informed by van Manen’s (1997) framework for phenomenological data.ResultsAnalysis of interviews about experiences of participating in PreFIT and what happened once the falls intervention ended identified five themes: Happy to help; Exercise behaviours; “It keeps me going”; “It wasn’t a real fall”; and Loss. Participants did not continue their specific exercises after they had completed the intervention. They preferred walking as their main exercise, and none reported preventing falls as a motivator to continue exercising. Participant experiences suggest that they have their own ideas about what constitutes a fall and there is disparity between their interpretation and the definition used by healthcare professionals and researchers.ConclusionDespite good intentions and perceived benefits, on-going participation in falls prevention exercises beyond a structured, supervised intervention was not a priority for these older people. Promoting continuation of falls prevention exercises post-intervention is just as challenging as promoting uptake to and adherence during exercise programmes.

Musical Fatherhood: A Phenomenological Study

ABSTRACT Although a number of studies have emerged in recent years on the role parents play in their children’s musical development, few have examined fatherhood. Through this phenomenological interview study, the author considers the lived experiences of musical fathers and their children, which are retrospectively recounted by three father-child pairs. The data are interpreted through the lens of children’s four psychological needs – competence, autonomy, relatedness, and purpose – and consider the extent to which these were met for each of the six participants throughout their childhood music experiences. Throughout the findings, the author suggests that although the degree to which the three fathers’ own psychological needs were met varies widely between participants, their shared value for music was most influential in fathers’ fostering of rich musical opportunities inside and outside of their homes. In highlighting the positive ways these three fathers contributed to their children’s musical lives, the author aims to depict empowered, musical fathers who engage in joyful music making with their children and support their children’s musical growth throughout their lives.

Reflections on Phenomenological Method in Depression

Reflections on Phenomenological Method in Depression Gareth Owen (bio) Heidegger as a Theorist of Melancholia For phenomenological psychopathologists an important methodological question is which philosopher, or philosophical corpus, one is going to draw on to help organize and illuminate raw psychopathological data. For the main phenomenological psychopathologists of the past this involved selecting from among phenomenological philosophers and keeping close to them to varying degrees (Broome, Harland, Owen, & Stringaris, 2009). For Minkowski it was Bergson, for von Gebsattel it was Scheler, and for Binswanger it was Heidegger and then Husserl. A question that arises is what makes the choice of philosopher non-arbitrary? A pragmatist, or pluralist, answer to this question which I tend to favor is that psychopathologists should be willing to select philosophies which are well fitted, or suited, to the area of psychopathology of interest. Hughes in her article on “Melancholia, Time, and Death” (Hughes, 2020) selects Heidegger (specifically, Division 2 of Being and Time and associated writings). I think she makes a good choice. Heidegger’s suitability is supported by his well-recognized phenomenological talent, his first personal experience of low mood/suicidality and his familiarity with the German Lutheran cultural tradition (which has strong interest in the phenomenon of Despair). Several psychiatrists (e.g., Kurt Schneider, Nassir Ghaemi, John Cutting) have considered Heidegger’s work highly illuminating when it comes to depression and there has been an interesting difference between those who think it illuminates only mild depression and those who think it illuminates severe depression. Hughes thinks it illuminates severe depression. This is an under-trodden and I think promising path despite the difficulties—which include problems in getting high quality phenomenological data in severe depression was well as the notorious obscurity of some of Heidegger’s writings. The Melancholic Experience of the Future Using Heideggerian categories, Hughes constructs a thesis that severe depression is a state of experiencing Dying (a collapse of one’s intelligible world in which, attuned by anxiety, the ability to project oneself into meaningful projects and possibilities is nullified or negated) together with the impossibility of experiencing Demise (the experience that one’s body, as a biological entity, will perish). The experience of severe depression that [End Page 219] is constructed by Hughes thus seems to be one whereby there is a collapse of the ability to project oneself into possible futures which is experienced as never ending because one experiences oneself as unable to perish as a biological being. In the article, Hughes also makes apposite but brief remarks on the temporal desynchronization that people with severe depression experience with others (and vice versa) and on the impact of depression on capacity to make decisions related to dying. These are important topics but, given space, I focus on the central thesis of Dying without Demise commenting on phenomenologically accuracy. First, Dying: Hughes’s Heideggerian characterization of severe depression as an experience of Dying seems right to me and consistent with a phenomenological interview study I have conducted in severe depression (Owen, Freyenhagen, Hotopf, & Martin, 2015; Owen, Martin, & Gergel, 2018). Across cases of severe depression one can discern a basic experience of the inability (painfully felt) to project oneself into meaningful projects and possibilities. I think it can be characterized as the collapse of a previously intelligible experiential world (Dying in Heidegger’s sense). But Hughes’s elaboration of Dying in depression as involving an experience of the future as blocked, closed off (p. 204) or that there is no intact future (204) I think is inaccurate. In severe depression interview evidence suggests there is an experience of the future. This can be lost in some self-reports due to the fact that it can be difficult for people to describe their experiences (a common sentence is “I don’t know”) and because expression is typically given in a negative form. For example, “I don’t feel anything at all” can be verbalized at the same time as clear non-verbal expressions of anxiety. I think it is more accurate to say that in severe depression there is an experience of the future (rather than no experience of the future at...

How is the emerging role of domiciliary physiotherapists who treat residents with dementia in nursing homes perceived by allied health professionals? A phenomenological interview study.

Dementia affects majority of older residents in nursing homes and physiotherapists are regularly involved with this population. However, little is known about the role of physiotherapists who treat residents with dementia in nursing homes. The aim of this paper was to report on an interpretivist qualitative exploration of the perceptions of both the providers of and referrers to domiciliary physiotherapy for residents with dementia in nursing homes in London. In 2015, we conducted semi-structured interviews with 10 purposively sampled participants - two were providers of physiotherapy for residents with dementia in nursing homes, five were referrers to these providers and three occupied dual roles. A thematic analysis of the verbatim transcripts identified three main themes. First were perceptions of a multifaceted but unclear role, focused on both conventional 'physical' physiotherapy interventions and specialist care, the latter being reliant on knowledge and confidence that physiotherapists did not always feel they possessed. Second were the stated challenges to the role, including the focus and organisation of the nursing home setting, with perceived lack of emphasis on rehabilitation; the progressive and demanding nature of dementia itself; a lack of continuity of nursing home and visiting health professional staff with associated need to entrust physiotherapy intervention to multiple others and the final challenge was the difficulty measuring impact. Third, despite the challenges, enablers of the role were experienced, namely collaborative working and positive previous experiences of referrers. Joining these themes were underpinning concepts of complexity and uncertainty in relation to the physiotherapy role in this setting. This paper highlights a need for enhanced collaborative working in clinical practice, enabled at organisational level, to help address some of the uncertainties expressed around the physiotherapists' role with residents with dementia in nursing homes and thereby enable improvements to processes and outcomes of their interventions.

Assessing non-conveyed patients in the ambulance service: a phenomenological interview study with Swedish ambulance clinicians

ObjectivesTo combat overcrowding in emergency departments, ambulance clinicians (ACs) are being encouraged to make on-site assessments regarding patients’ need for conveyance to hospital, and this is creating new and challenging...

Parents' journey caring for a preterm infant until discharge from hospital-based neonatal home care-A challenging process to cope with.

To present parents' lived experience of having a preterm infant cared for at the neonatal unit until discharge from hospital-based neonatal home care (HNHC). Becoming a parent to a preterm infant has been reported as an experience that may influence the parent's lifeworld also after discharge. Interventions have been implemented at the NICUs, for example introduction of family-centred care aiming to reduce parent-infant separation, increased integration of the parents, to support them in their altered parental role. A descriptive phenomenological interview study. Six parent couples at a NICU in Sweden were included and interviewed individually after discharge from HNHC. The interviews were analysed from the perspective of caring sciences using a descriptive phenomenological method. The study followed the consolidated criteria for reporting qualitative research (COREQ) checklist. The journey from birth to discharge from hospital-based neonatal home care affected the parents' lifeworld. The parents' experiences differed. Mothers experienced more physiological reactions that triggered feelings of existential loneliness and guilt and difficulties in combining the role of mother with partner. The fathers faced conflicts managing their partners' demands, family challenges and employers who claimed their time and energy, which negatively affected their transition into fatherhood. Both mothers and fathers experienced ambivalent feelings in the relationships with the professional staff, which was more strongly expressed by the mothers. It is important for healthcare providers to help parents clarify their individual needs and values in caring for a preterm infant to help them achieve parental and family well-being. These findings can guide healthcare providers to help parents improve care for their preterm infants in the NICU. Integrating a person-centred approach such as supportive person-centred dialogues focused on parents' individual needs might be one way to support parents.

Dancing Like a Girl: Physical Competence and Emotional Vulnerability in Professional Contemporary Dance

The analysis presented here is based on a phenomenological interview study conducted with sixteen professional contemporary dancers, and focuses on the differences between the accounts of male and female dancers with regard to notions of openness in dance and to associated feelings of emotional vulnerability and metaphorical nakedness or exposure. In a way that is reminiscent of Young’s (1980) description of “throwing like a girl,” such feelings of vulnerability and accompanying self-consciousness were considerably more noticeable in the accounts of the female dancers, tending to emerge when dancers were asked to express something of a personal or private nature through dance in the presence of others. This paper explores potential resonances between feminine throwing experience as conceptualized by Young (1980) and female dancing experience for my interviewees. Significantly, however, it moves beyond a direct parallel with Young’s (1980) work to explore this sense of vulnerability in a context where female dancers did not display the reduced physical competencies typical of “throwing like a girl.” The article further suggests that the dualist concepts of transcendence and immanence may not be appropriate for understanding the experience of dance, including its gendered dimensions, and that we should instead look to theorizing dancing body-subjectivity in ways that attend to the blurring of the boundaries of such binaries.

Understanding barriers to medication, dietary, and lifestyle treatments prescribed in polycystic kidney disease

BackgroundAutosomal dominant polycystic kidney disease (PKD) is the most common genetic renal disease and the fourth leading cause of end-stage renal disease in the United States. Although there is no cure for PKD, several treatments are considered to be beneficial, including blood pressure control, exercise, low-salt diet, and high volume water intake. However, levels of understanding of the importance of these treatments and adherence to these recommendations vary among patients. This study explores illness perception models of patients with PKD to reveal barriers in adherence to prescribed therapies; satisfaction with medical care; and sources of medical information.MethodsWe designed a phenomenological interview study to evaluate illness perception models of individuals with PKD. Patients were identified from the national PKD Foundation e-mail distribution list (N = 190) and responded voluntarily to an introductory survey (N = 50). Seventeen PKD patients in the Bay Area were scheduled for one-on-one in-depth interviews with one trained interviewer (W-CT). Open-ended questions administered with an interview guide were used to evaluate patients’ beliefs.ResultsMean age was 56.6 +/− 12 years (range 29–78); 65% were female. Many of the PKD patients in this study were highly motivated and willing to incorporate blood pressure, exercise, low-salt diet, and high volume water intake into their daily routines. Barriers to adherence to these therapies include personal beliefs and confusion due to unclear recommendations.ConclusionsThese findings suggest there is variability between what patients understand about their disease and treatments and what they believe their doctors have told them. Not all physicians focus on lifestyle-based treatments, but the majority of PKD patients in our study are motivated and willing to incorporate blood pressure control, exercise, low-salt diet, and high volume water intake into their daily routines and would like specific recommendations on how to implement these. These findings support a role for further exploring patient beliefs about the disease and its necessary treatments in order to design strategies to improve communication and meet the needs of these patients.

The Influence of Trust on Project Management Practice within the Construction Industry

Given that any construction project is inherently a human endeavour, it follows that issues of trust are significant in terms of the stakeholder interactions that deliver eventual project outcomes. Previous research indicates that the relational basis upon which projects are undertaken are intended to influence the likelihood of trusting relationships between stakeholders. Thus, experiences of trust in a construction project environment are likely to be influenced by the contextual specifics of respective transactional and relational contracting (RC) procurement mechanisms, given the divergent theoretical principles upon which they are founded. The influence of trust has therefore been examined through the lived experiences of construction practitioners. A phenomenological interview study consisting of thirty-five (35) participants was conducted with sensitivity to the procurement of experiences being recounted. Issues of trust were shown to be integral to stakeholder experiences in both procurement environments, with the benefits of trust acknowledged in many instances. However, little understanding was evident regarding methods for building and maintaining trust, nor for repairing trust when problems arose. Importantly, despite the differing principles that underpin transactional and relational procurement, and particularly the contention that relational procurement would increase trust between trading partners, this was not evident; with individual personalities and appropriate risk apportionment shown to be greater influences upon the likelihood of trusting relationships. It is reasonable to conjecture that relational contracts actually diminish the need for trust, given that the objective is to reduce uncertainty through formulaic approaches to risk distribution and reward; the absence of risk negates the need for trust. Ultimately, the potential to deliver improved project outcomes as a result of proactive approaches to developing and maintaining trust, as well as repairing trust after difficulties, was shown to apply under all procurement conditions.