Qualitative Experience Research Articles

Perception of Teachers about the Role of Parents in Developing Reading Habit of Basic Level Students

This study aimed to explore teachers’ perceptions about the role of parents in developing the reading habit of children to improve academic performance. In this qualitative study, semi-structured interviews were used for data collection, which enabled me in capturing qualitative experiences, opinions, beliefs, and perceptions of purposefully selected participants. The participants were three basic level English teachers from Rupandehi district, Lumbini Province, Nepal. Social constructivism of Vygotsky (1978) has been used as a theory in this study. The data were analyzed using a thematic analysis approach. The study confirmed that parents’ involvement is crucial in developing children’s reading habits. The parents’ continuous support in reading further enhances the academic performance of the children. The study helped me understand how children’s reading habits enable them to learn English from childhood, which thrives for further educational enhancement. It particularly appeals to and makes parents aware of their influential role in helping children begin reading habits at home.

LONELINESS ACROSS THE LIFE COURSE; LIFE STORY INTERVIEWS WITH MENTAL HEALTH SERVICES USERS

Abstract Introduction The complexity of loneliness and its negative impact on our health and wellbeing is well established. However, the qualitative experience of loneliness over the life course is poorly understood. Method: This presentation, based on 18 life story interviews, with a sample of older adults, who were attending a mental health service and objectively defined as lonely, provides an insight into the personal experiences of loneliness as well as the situations and factors associated with loneliness across the life course. Results The analysis identified three distinct typologies of loneliness; those who experienced (1) chronic loneliness across their life (2) those whose loneliness became chronic after a transition e.g. bereavement (3) those whose loneliness remained situational/transitional. Conclusions The insights are important to inform both general loneliness services and policy as well as specialist mental health services and training. The presentation demonstrates the importance of a life course approach to addressing and understanding loneliness.

Enhancing Patient Centricity of Real-World Data Research: An Exploratory Analysis Using the Patient Experience Mapping Toolbox

ObjectivesThere is an increasing expectation that medical product development and assessment be guided by patient input captured through patient engagement. Recently published consensus guidelines describe how qualitative patient experience data (PED) can guide the design, conduct, and translation of real-world research that reflects patients’ lived experience. The objective of this exploratory analysis is to examine how researchers could leverage PED captured through the Patient Experience Mapping Toolbox (PEMT) to guide real-world data (RWD) research designs. MethodsThis exploratory analysis included a thematic analysis of interview transcripts collected while pilot testing the PEMT followed by a qualitative analysis of the emerging themes aligned with stages listed in the patient-centered real-world evidence, Real-World Research Design Framework. ResultsPED collected using the PEMT include information about symptomology, interactions with the healthcare system, information-seeking behavior, misdiagnoses, lifestyle changes, treatments, side effects, and comorbidities. This information can be leveraged at key study design decisions, including (1) identifying study cohorts and subgroups, (2) identifying exposures, (3) informing covariates and potential confounders; and (4) refining study periods. Additionally, participants described where they seek information about treatments and diseases, which should inform dissemination strategies. ConclusionsWe identified opportunities for PED collected using the PEMT to inform RWD study designs. The PED described in this exploratory analysis stem from pilot testing of the PEMT across a variety of conditions. In the next phase of development in this area, researchers should evaluate how data collected using the PEMT can be applied to RWD research for a specific disease.

Mild Traumatic Brain Injury: What We Can Learn from a Qualitative Study of Patient Perceptions Following Emergency Department Discharge

Aims: This study investigated the experiences of patients with mild traumatic brain injury (mTBI) to identify barriers and suggest clinically relevant areas for improvement in the current system of care.
 Methods: 16 patients with a clinical diagnosis of mTBI were recruited from the Cork University Hospital Emergency Department (ED) for participation in this study. Semi-structured phone interviews were conducted at approximately 2.5-3 months post-discharge. Reflexive thematic analysis with an inductive and realist approach was used to code and inductively analyse the data. The most frequently occurring themes and their relationship to subthemes are reported.
 Results: A total of 16 mTBI adult patients were interviewed (mean age: 50.5 (18-85)). Major themes identified in the experience of mTBI patients were: lack of clarity in diagnosis and treatment, poor access to information, and ongoing symptoms. Notably, 87.5% of participants reported being uncertain about their diagnosis of mTBI and 93.8% of participants did not seek further information regarding their head injury. Nearly half (43.8%) of the participants reported prolonged recovery with two participants (12.5%) reporting ongoing symptoms. Headache, photophobia, and difficulty with thinking and memory were the predominant symptoms reported.
 Conclusion: Several overarching themes were identified in the qualitative self-reported experiences of mTBI patients following ED discharge. Participants reported persistent symptoms, lack of clarity, and a lack of access to information regarding their mTBI diagnosis and treatment. Suggested recommendations for future practice include adding psychoeducational resources and increasing awareness and training among staff to provide timely patient education.

Qualitatively exploring the impact of a relationship-centered communication skills training program in improving patient perceptions of care.

To explore qualitative patient experience comments before and after a relationship-centered communication skills training to understand patient experience, program impact, and opportunities for improvement. Qualitative patient experience evaluation data was captured from January 2016 to December 2018 for 483 health care clinicians who participated in the skills training. A random sampling of available open-ended patient comments (N = 33,223) were selected pre-training (n = 668) and post-training (n = 566). Comments were coded for valence (negative/neutral/positive), generality versus specificity, and based on 12 communication behaviors reflective of training objectives. No significant difference was found in the valence of comments, or generality versus specificity of comments before and after the training. A significant decrease was present in perceived clinician concern. "Confidence in care provider" was the communication skill most frequently identified in comments both pre- and post-training. Perceptions of interactions largely remained the same following training. Key relationship-centered communication skills require further attention in future training efforts. Measurements of patient satisfaction and engagement may not adequately represent patient experience. This study identified areas for improvement in the training program and offers a model for utilizing patient experience qualitative data in understanding communication training impact.

Novel approaches to communication skills development: The untapped potential of qualitative research immersion

Participation in qualitative research, particularly analysis of recorded medical dialogue, offers real-time, longitudinal immersion that can strengthen clinical trainee communication skills. The study objective was to explore how qualitative research participation impacts clinical trainees’ self-perceived communication skills development and practice. In this study, a 17-member multidisciplinary working group of child life specialists, advanced practice providers, undergraduate/medical students, residents, fellows, attending physicians, social scientists, and career researchers with recent qualitative and communication research experience assembled to discuss this topic using a structured discussion guide. Content analysis was used to identify concepts and themes. Three key themes characterizing the impact of qualitative research participation on aspiring clinicians’ communication skills development and practice arose – the 3Cs: (1) C onnection, therapeutic alliance, and accompaniment; (2) C larity and prognostic communication; (3) C ompassion, empathy, and understanding. Participants emphasized that qualitative research learning improved their understanding of patient/family lived experiences, preparing them for future clinical encounters, strengthening their emotional intelligence, and promoting self-care, resilience, and professional affirmation. Immersion in clinical communication through participation in qualitative research is an under-utilized resource for supporting clinical trainees in communication skills development. The process of collaborative knowledge production through the collective exploration of an a priori question related to group members’ collective experiences is methodologically innovative. Further, re-thinking qualitative research participation as an underutilized educational opportunity is pedagogically novel, and leaders in medical education and qualitative research should collaborate to realize the potential of this teaching tool. • Qualitative research participation offers immersion in clinical communication. • Participation impact characterized by the 3 C’s: 1) Connection, 2) Clarity, 3) Compassion. • This is an under-utilized medical education resource for communication skills development. • Medical education and qualitative research leaders should collaborate.

Qualitative Experiences of Trained Medical Student Coaches Delivering a Community-Outreach Telehealth Coaching Program

<h3>Research Objectives</h3> To describe medical student coaches' experiences leading the Community Outreach teleheAlth program for Covid education and Health promotion (COACH). <h3>Design</h3> Qualitative, descriptive study. <h3>Setting</h3> Online via Zoom video conferencing. <h3>Participants</h3> Trained medical student coaches (n = 19) were recruited from the University of British Columbia via convenience sampling. Seventy-four percent of participants were female and had an average age of 25.6. Most participants (57.9%) were from visible minority populations, and 42.1% administered COACH in suburban/rural areas. <h3>Interventions</h3> COACH included six 30-45-minute one-on-one sessions where student coaches promote positive health behaviours to adults ages 65 or older. <h3>Main Outcome Measures</h3> Participants engaged in a 45-to-60-minute semi-structured interview conducted via one-on-one Zoom video-conferencing calls. Interview questions focused on students' experiences delivering COACH, their understanding of various health-related topics (e.g., chronic care, virtual health, and health promotion), and possible impacts on their beliefs and future practice. Interviews were transcribed verbatim and analyzed thematically. <h3>Results</h3> Three main themes emerged from our thematic analysis, including: (1) exploring opportunities for knowledge and skill acquisition (i.e., learning virtual care, health promotion strategies for chronic care, and client-centered care), (2) developing clinical perspective and acumen (i.e., developing a chronic care perspective, overcoming challenges to health coaching, and developing interest in chronic care practice), and (3) learning to appreciate patient care (i.e., becoming a health motivator and appreciating the opportunity to build rapport). <h3>Conclusions</h3> Findings suggest that COACH supported development of knowledge, skill, and confidence in medical school students in areas of health promotion, virtual care, and chronic disease management. These findings also demonstrate promise for the use of health professional students and telehealth in advancing chronic care health services. <h3>Author(s) Disclosures</h3> We report no real or perceived conflicts of interest.

Social norms in digital spaces: Conflict reports and implications for technology design in the teleworking context

With the increase of telework during the COVID-19 pandemic, employees’ interactions with colleagues have shifted almost exclusively to digital channels. Hence, it is critical to understand the underpinnings of successful collaboration and individual wellbeing in digital working structures. Combining qualitative experience reports and quantitative surveys from 145 teleworkers, this study sheds light on teleworking from a psychological perspective, taking social norms as a conceptual frame. The qualitative reports revealed five types of typical conflicts related to communication in the telework context, including both (1) technical problems (e.g., a bad connection) and psychological aspects such as (2) uncertainty or a lack of social feedback, (3) norm violations, (4) a lack of rules or meta-communication about appropriate behavior, and (5) digital communication barriers. Respondents’ quantitative ratings of qualities of telework versus working on-site revealed benefits of telework regarding task fulfillment and efficiency, but lower levels of motivation, conflict management, leadership, team spirit, inspiration and creativity. Participants qualitative reports on perceived challenges in remote work conditions included feelings of loneliness and increased demands related to self-management, creating boundaries between private and working life, motivation and self-regulation. This paper connects these findings with theoretical concepts from psychology and human-computer interaction and discusses implications for leadership and technology design.Practical Relevance: This article discusses practical implications for leadership and technology design, e.g., interventions against conflicts in the context of digital work.

'What price do you put on your health?': Medical cannabis, financial toxicityand patient perspectives on medication access in advanced cancer.

Following 2016 legislation permitting limited access to cannabis for research and medicinal purposes, the number of randomized clinical trials (RCTs) investigating the effectiveness of medicinal cannabis (MC) on symptom burden relief in cancer contexts has increased in Australia. This study aimed to understand the perceptions, hopes and concerns of people with advanced cancer regarding the future availability and regulation of MC in Australia. This qualitative study draws on semistructured interviews conducted between February 2019 and October 2020 in Brisbane, Australia, as part of an MC RCT substudy. Interviews were undertaken on48 patients with advanced cancer in palliative care eligible to participate in an MC trial (n = 26 participated in an RCT; n = 2 participated in a pilot study; n = 20 declined). Interviews included a discussion of patients' decision-making regarding trial participation, concerns about MC and perceptions of future availability, including cost. Transcribed interviews were analysed inductively and abductively, informed by constructivist thematic analysis conventions. Overall, participants supported making MC legally accessible as a prescription-only medication. Fear of financial toxicity, however, compromised this pathway. Steep posttrial costs of accessing MC prompted several people to decline trial participation, and others to predict-if found effective-that many would either access MC through alternative pathways or reduce their prescribed dosage to enable affordable access. These findings suggest that-despite a relatively robust universal healthcare system-Australians are potentially vulnerable to and fearful of financial toxicity. Prevalent in the United States, financial toxicity occurs when disadvantaged cancer patients access necessary but expensive medications with lasting consequences: bankruptcy, ongoing anxietyand cancer worry. Interview transcripts indicate that financial fears-and the systems sustaining them-may pose a threat to RCT completion and to equitable access to legal MC. Such findings support calls for embedding qualitative substudies and community partnerships within RCTs, while also suggesting the importance of subsidisation to overcoming injustices. A patient advisory committee informed RCT design. This qualitative substudy foregrounds patients' decision-making, perceptions and experiences.

Show Must Go On: How Can Ballet Help Us Strengthen Ethnographic Practice?

This PechaKucha is drawn from research conducted as an organizational ethnography at The Dutch National Ballet (DNB), a renowned professional organization in the culture and arts sector in the Netherlands. However, just like most research trajectories, mine was also full of hurdles that I needed to overcome, the biggest being Coronavirus and the disruptions it created. While constantly adapting myself and my research to the circumstances of the day, I agree with Marcus and Fischer's description of ethnography being a “messy, qualitative experience” (1986, p.22). I have come to recognize how resilience is very much engraved in the ballet as a profession with opportunities to observe its manifestation even before (or during) adversities; and its learnings can be useful for other (cultural) settings and/or disciplines. In this PechaKucha, by proposing a new perspective to understand ethnographic practice, I suggest that what we learn from ballet can impact the resilience of researchers and the trajectories we take.

Jail-based reentry programming to support continued treatment with medications for opioid use disorder: Qualitative perspectives and experiences among jail staff in Massachusetts.

Individuals with opioid use disorder released to communities after incarceration experience an elevated risk for overdose death. Massachusetts is the first state to mandate county jails to deliver all FDA approved medications for opioid use disorder (MOUD). The present study considered perspectives around coordination of post-release care among jail staff engaged in MOUD programs focused on coordination of care to the community. Focus groups and semi-structured interviews were conducted with 61 jail staff involved in implementation of MOUD programs. Interview guide development, and coding and analysis of qualitative data were guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Deductive and inductive approaches were used for coding and themes were organized using the EPIS. Salient themes in the inner context focused on the elements of reentry planning that influence coordination of post-release care including timing of initiation, staff knowledge about availability of MOUD in community settings, and internal collaborations. Findings on bridging factors highlighted the importance of interagency communication to follow pre-scheduled release dates and use of bridge scripts to minimize the gap in treatment during the transition. Use of navigators was an additional factor that influenced MOUD initiation and engagement in community settings. Outer context findings indicated partnerships with community providers and timely reinstatement of health insurance coverage as critical factors that influence coordination of post-release care. Coordination of MOUD post-release continuity of care requires training supporting staff in reentry planning as well as resources to enhance internal collaborations and bridging partnerships between in-jail MOUD programs and community MOUD providers. In addition, efforts to reduce systemic barriers related to unanticipated timing of release and reinstatement of health insurance coverage are needed to optimize seamless post-release care.

Diagnosis and management of headache disorders in osteopathic practice: A qualitative study

BackgroundRecurring headache disorders are prevalent conditions that have a substantial impact on both individuals’ daily lives and national health systems. Despite being a treatable condition, they remain underdiagnosed and undertreated. Currently, there is little qualitative research that has explored practitioner experiences of diagnosing and managing these disorders. ObjectiveThe aim of this study is to provide novel insight into osteopathic practitioners' qualitative experiences of diagnosing and managing primary headache disorders. MethodsTen osteopathic clinicians participated in individual semi-structured interviews. These were transcribed and then underwent qualitative thematic analysis. ResultsThematic analysis of the data found five key themes: History Taking, Osteopathic Assessment, Diagnosis, Management and Interprofessional Care, with further sub-themes emerging. DiscussionParticipants primarily use history taking and osteopathic examination to develop a diagnosis and management plan. However, due to the multifactorial nature of headache disorders, an accurate diagnosis was reported to be difficult to achieve. Additionally, participants outlined numerous treatment interventions and other health professionals they work with to optimise patient outcomes. Lastly, patient compliance and lack of resources were challenges that practitioners commonly described, with more research and resources being specified as ways to overcome these challenges. ConclusionMany themes form the basis of the osteopathic diagnosis and management of primary headache disorders. The challenges faced by osteopaths in this clinical area can underpin further research to improve clinician experiences and patient outcomes alike.

Making visible the Chicagoland suburban healthcare landscape of latina women: a qualitative GIS approach

ABSTRACT How accessible is linguistically-appropriate health care to Latina women in demographically shifting suburban landscapes in the United States? Using data from a survey of Latina immigrant women and those from mixed-status households in the Chicago suburbs, this research examines barriers Latinas face in accessing healthcare for themselves and their families. This research also asks how those barriers vary among suburban contexts. Qualitative GIS mapping is used to situate women’s experiences in relation to the local availability of healthcare services. The findings show Latina women must make complex spatial, financial, and temporal trade-offs when seeking high quality, linguistically-appropriate healthcare in the Chicago suburbs, especially in exurban areas where services that meet their needs are in short supply. Latina women’s qualitative healthcare experiences in the suburbs are valuable for policy insights targeting this social group. Further, this paper demonstrates how qualitative GIS can be used in understanding spatial access to health services for vulnerable populations.

A Novel Mixed Methods Approach for Integrating Not-for-Profit Service Data via Qualitative Geographic Information System to Explore Authentic Experiences of Ill-Health: A Case Study of Rural Mental Health

Meeting the mental health needs of rural populations is challenging internationally, with few methods and scarce data available to inform site-specific planning. We developed a mixed methods approach that integrates Not-for-profit (NFP) organization data in a Geographic Information System (GIS) to explore interrelated understandings of mental health experiences in rural places. Integrating qualitative experience data from online forums with quantitative data from service search and emergency pickup locations via GIS demonstrates how NFP health service data can be ethically sourced, reused, integrated, analyzed, and ground-truthed to explore how mental health is experienced in rural places. This article contributes to the mixed methods literature an ethical approach that utilizes NFP health service datasets to inform research in contexts of data scarcity.

Motives of Student Teachers in Academic Teacher Education for Secondary Education: Research in Flanders (Belgium) on the Motivation to Become and to Remain a Teacher

The increasing shortage of teachers in secondary education, in Flanders (Belgium) as well as worldwide, is partly due to an insufficient inflow of new teachers. This stimulates research on the motivation of students to become and remain teachers. Our research focuses on the motives of student teachers in academic teacher education for secondary education to become a graduated teacher and how this evolves during teacher education, taking into account different profiles of students. Surveys, with closed and open questions based on our theoretical framework, were conducted at different points in time during teacher education as a basis for mixed method analyses. Compared to the period between the start and the end of the teacher education courses, it appeared that graduated student teachers attached more importance to the motives ‘subject orientation’ and ‘educational orientation’. The research shows a shift to a more realistic educational orientation among graduated students. ‘Work dynamic’ aspects as a motive to work in education were generally considered equally important by women and men but combination possibilities were more important for men. Specifically related to students with a ‘teacher in training’ [TiT] statute, graduated TiT-students considered the motive ‘idealism’ more important than non-TiT-students. Related to working students, ‘work perspective’ appeared to be more important compared to non-working students. These insights into the evolving motives of student teachers have a number of possible implications for the organization of teacher education, which can also contribute to reducing the teacher shortage. Teacher education can put extra emphasis on positive and qualitative hands-on experiences by performing a well-considered selection of internship schools and mentors. At the same time, teacher education can offer even more space and time for student teachers to dedicate to internships, by keeping other activities such as deadlines and teaching moments during internships to a minimum.

The South African social enterprises’ strategies to guard against mission drift when faced with tensions from the funders

Social enterprises utilize entrepreneurial activities to generate revenue and build sustainable business models for social impact. Because of their resource constraints, especially finance, social enterprises are forced to reach out to external funders. Although there are obvious benefits, the relationship with the funders also presents tensions that social enterprises must manage to guard against mission drift. Little is known about the strategies employed by social enterprises to protect their missions in pursuing a beneficial relationship with their funders. Drawing from the resource dependency theory, this paper analyzed the qualitative experiences of 13 South African social enterprises and presented the strategies to prevent mission drift. The findings show that social enterprises engage in multiple complementary strategies to manage the tensions between themselves and the funders. The most critical strategy is prioritizing the social impact-oriented projects that enrich their missions. Once in partnership with the funders, social enterprises employ social effectual logic to make decisions. At the same time, some manage the tensions by strengthening their hybrid social models, especially in commercial activities. Lastly, developing strong leadership and governance processes, supported by delivering on the contractual agreements, helped the social enterprises to maintain their missions. The study adds to the literature on collaborative relationships, tensions, and mission drift in the context of social enterprises.

Understanding the near-peer relationship: resident perspectives around a novel on-call workplace-based assessment.

Workplace-based assessment (WBA) is a critical component of competency-based medical education (CBME), though literature on WBA for overnight call is limited. We evaluated a WBA tool completed by supervising subspecialty trainees on paediatric residents during subspecialty overnight call, for usefulness facilitating feedback/coaching in this setting. Web-based surveys were sent to residents pre- and post-WBA tool implementation monthly for four months (August-December 2018), exploring feedback frequency, Likert-scaled opinions of tool feasibility/usefulness facilitating feedback, and qualitative experiences. Assessor comments were categorized as actionable/non-actionable. Quantitative data was summarized using descriptive statistics. Qualitative data was coded to identify themes. Total response rates averaged 41% (total 25 responses, average five respondents/12 residents on-call each month). Post-implementation (n = 16 responses), a non-sustained trend of increased Medical Expert feedback was observed. Residents were generally divided or disagreed on tool usefulness facilitating feedback and feasibility. Comments contained actionable feedback in < 10% of completed WBAs. Qualitative analysis revealed barriers to tool-facilitated coaching including: feedback quality and setting/environment, role of senior near-peer as assessor, interpersonal burden in encounters, and tool-specific issues. Increasing frequency of WBA tool completion is not sufficient to achieve CBME goals. Factors impacting feedback/coaching within the resident/near-peer dyad must be addressed.

A descriptive investigation of clinical practice models used by cardiovascular genetic counselors in North America.

Cardiovascular genetic counseling has expanded as an established genetic counseling specialty over the last 20 years. Despite guidelines recommending genetic counseling for heritable cardiac diseases, there have been limited descriptions of the practice model types used for different clinical indications seen in this genetic counseling subspecialty. We aimed to describe current clinical practice models used by cardiovascular genetic counselors and to document practice model strengths, challenges, and areas for improvement. Genetic counselor respondents (n=63) who self-reported seeing cardiovascular indications were recruited through the National Society of Genetic Counselors and Twitter. They completed a survey describing the types of healthcare professionals with whom they collaborate to see common cardiovascular indications, the nature of their collaboration, and their qualitative experiences with their practice models. Clinical indications addressed in this survey were hypertrophic cardiomyopathy, dilated cardiomyopathy, all other cardiomyopathies, arrhythmias, aortopathies, dyslipidemias, pulmonary arterial hypertension, and congenital heart defects. Data were analyzed using descriptive statistics and thematic analysis. We found that the composition of multidisciplinary provider practice models varies by indication, though general cardiologists were the most common collaborative provider reported. Practice models including geneticists were most common for aortopathy indications. Overall, the majority of respondents were satisfied with the practice models they reported. While a wide variety of successes, challenges, and areas for improvement of practice models were reported, collaboration, communication, and access to appropriate providers for patient care were consistent themes across these three questions. To our knowledge, this is the first description of practice models used by cardiovascular genetic counselors. The results of this study add to the knowledge of this specialty of genetic counseling and assist in understanding the needs and challenges for developing cardiovascular genetics programs and clinics.

Beyond Settler Time: Temporal Sovereignty and Indigenous Self-Determination

Beyond Settler Time: Temporal Sovereignty and Indigenous Self-Determination

Positive exchanges buffer negative exchanges: Associations with marital satisfaction among U.S. mixed-sex couples.

Perceived positive and negative exchanges in relationships contribute to marital satisfaction in qualitatively distinct manners. However, the nature of these associations is unclear with some studies demonstrating curvilinear relationships and some literature suggesting interaction effects of positive and negative exchanges on marital satisfaction. Extant work has not compared curvilinear and interactive models to address this discrepancy. The present study clarifies these associations by comparing multiple models. Based on cross-sectional data from 886 mixed-sex married couples from across the U.S., we found that marital satisfaction was associated with greater positive exchanges and lower negative exchanges. In addition, the data support interaction effects of positive and negative exchanges on marital satisfaction, but not curvilinear effects. Specifically, high positive exchanges may buffer the impact of negative exchanges on relational satisfaction. Gender differences in effects were not supported. These findings confirm that positive and negative exchanges are distinct constructs and demonstrate how relationship satisfaction scores suffer from issues of equifinality by failing to distinguish between very different qualitative relational experiences. We suggest that curvilinear, plateauing effects may be an artifact of data loss when analyzing individuals in relationships rather than whole dyads, and suggest that scholars study positive and negative exchanges with both members of a dyad moving forward. (PsycInfo Database Record (c) 2022 APA, all rights reserved).