Qualitative Exploration Research Articles

Where does physical activity fit into preschool postpandemic? A qualitative exploration with parents, teachers and administrators

ObjectivesDuring the preschool years, children depend on adult caregivers to provide opportunities for physical activity (PA). Research has focused on measuring PA in preschool, as well as barriers and facilitators...

Navigating social and academic isolation: a qualitative exploration of American university students’ perspectives and experiences early in the COVID-19 pandemic

Objective: To qualitatively explore the multifaceted impacts of the early months of the COVID-19 pandemic on the lives of American university students. Method: Undergraduate students in general education courses at a mid-sized public Western U.S. university were recruited to complete a Qualtrics survey that evaluated their perceptions, beliefs, and behaviours towards COVID-19. Thematic analysis identified prevailing themes regarding the positive and negative changes to students’ lives during the pandemic. Results: Participants included undergraduate students (N = 241) between the ages of 18 and 24 (74.7% women), with 49.4% identifying as White. Thematic analysis of the survey identified several codes encompassed by six key themes: (1) shifting social interactions; (2) wellness; (3) school; (4) financial changes; (5) loss of experiences; and (6) political turmoil. Conclusion: Some students identified positive consequences (e.g., more family time, more flexible schedule), while almost all students reported negative consequences (e.g., difficulty with time management and organisation, loss of job or income) of the COVID-19 pandemic. University communities should consider providing additional academic, financial, and mental health resources to students to further mitigate the lasting consequences of the pandemic.

A qualitative exploration of the experiences of pregnant women living with obesity and accessing antenatal care.

Women are advised to optimise weight before pregnancy. However, many are either already living with overweight or obesity prior to becoming pregnant, increasing the risks for adverse outcomes. Health care professionals (HCP) are responsible for advising women of risks throughout and following pregnancy. However, midwives often find broaching the conversation around maternal obesity difficult. This study explored the experiences of pregnant women living with obesity in accessing antenatal care. Seventeen women completed a semi-structured interview. Transcripts were analysed thematically. Four themes were developed: 1) antenatal care is inconsistent, 2) additional support is needed, 3) women feel judged about their weight, and 4) weight cycling is highly prevalent. Findings suggest that pregnant women living with obesity often experience weight bias from HCPs, feel judged because of their weight and are left feeling confused and overlooked. Women reported inconsistencies in advice and care offered and acknowledged a lack of continuity of care throughout pregnancy. We call for an urgent need for further multidisciplinary training to address the concerns, experiences and needs of pregnant women living with obesity.

Exploring Cultural Competence, Inclusivity, and Diversity in Ketamine Assisted Psychotherapy: A Phenomenological Study

ABSTRACT Black, Indigenous, and People of Color (BIPOC), and other minoritized populations are insufficiently represented in research on therapeutic psychedelics. This research was a phenomenological qualitative exploration of a culturally diverse (Hispanic, African American, Asian, Native American, biracial, or LGBTQIA+) and low-income sample of 15 individuals receiving ketamine-assisted psychotherapy (KAP) at a sliding-scale fee community clinic. Participants were interviewed after a ketamine session, after a ketamine integration session, and one month later. The interviews inquired about mental and emotional state prior to treatment and the treatment context (traditionally called set and setting), preparation for treatment, experiences during the ketamine and integration sessions, barriers to treatment, perceived stigma if any, reflections on KAPs’ impact, and relevance of culture to the treatment. The current analysis, which focuses on participant comments related to diversity, equity, and inclusion that are uniquely relevant to this sample and the research goals, yielded four major themes: Insufficient Financial Resources, Race, Ethnicity, and LGBTQIA+, Stigma, and Culture and Ritual. Themes and subthemes are presented accompanied by representative quotes. Results demonstrate the high salience of culture in the KAP experience and the need to incorporate issues of race, culture, stigma, ritual, and socioeconomic status into treatment planning and outcome research.

How adult children experience and cope after their parents’ diagnosis of multiple myeloma: A qualitative exploration

PurposeThe aim of this study was to understand and explore the caregiving experience of adult children of patients with multiple myeloma (MM) during diagnosis and initial treatment based in Chinese filial piety culture. MethodsA descriptive phenomenology study was conducted to investigate semi-structured interview responses from the adult children (N=22) of MM patients within three months after diagnosis. Colaizzi's descriptive analysis framework was employed to analyze data. This study was reported following the COREQ checklist. ResultsFour themes and twelve subthemes were identified from the interviews. (1) Commitment to filial piety. Participants subconsciously fulfilled their commitment to filial piety by supporting their parents, obeying their wishes, providing emotional comfort, and protecting them from harm. (2) Experiencing multiple dilemmas. They faced challenges such as difficult treatment decisions, insufficient caregiving preparation, emotional distress, and role conflict. (3) Benefiting from setbacks. The caregiving experience allowed participants to cherish the present more and to establish a new view of life. (4) Adaptive coping. Family supports and self-adaptation are effective coping strategies to achieve their good psychosocial adaptation. ConclusionsOur study provides a culturally sensitive perspective on the caregiving experience of adult children of patients with MM. This study found that Chinese culture, especially filial piety culture, influenced the experiences and coping strategies of MM caregivers. Healthcare providers should focus on the challenges faced by adult children and develop various strategies to help them cushion the burden and adjust to caregiving roles, such as supportive care programs, meaning-centered psychotherapy, and family-centered medical communication interventions.

"Too young to have this kind of diagnosis": A qualitative exploration of younger adults' experiences of colorectal cancer diagnosis.

Colorectal cancer (CRC) incidence is rising among adults under the age of 50 (early- or young-onset CRC). This population is more likely to have advanced-stage disease at diagnosis, suggesting their diagnostic pathway may be prolonged. To better understand factors influencing this pathway, this study explored patients' experiences of decision-making during a diagnosis of young-onset CRC. Semi-structured interviews were conducted with 17 participants with young-onset CRC diagnosed in 2021-2022 in Victoria, Australia. Interviews were conducted online or by phone an average 7months (range 1-13) after diagnosis. Analysis was approached from a critical realist perspective, with themes developed inductively using reflexive thematic analysis. Five themes were identified: Shifting Perception of Urgency, Multidimensional Perception of Role, Making the Most of Resources, Stage of Life, and COVID Adds Complexity. Participants' decision-making evolved over the diagnostic period. As participants perceived urgency to act, they took on a more active role in decision-making, utilising personal resources to access timely care. Their decisions were shaped by stage-of-life considerations, including employment and caring for a young family, with the COVID-19 pandemic adding "…a whole other layer of complexity" to the process. Younger adults with CRC make decisions in the context of unique considerations, adapting to reduce time to diagnosis, with decisions complicated by the COVID-19 pandemic. Greater support from health care providers/systems in the diagnostic period may improve timeliness of CRC diagnosis and outcomes in younger adults.

The health workforce conundrum for burn care in Uttar Pradesh, India: a qualitative exploration

ABSTRACT Delivering specialised care for major burns requires a multidisciplinary health workforce. While health systems ‘hardware’ issues, such as shortages of the healthcare workforce and training gaps in burn care are widely acknowledged, there is limited evidence around the systems ‘software’ aspects, such as interest, power dynamics, and relationships that impact the healthcare workforce performance. This study explored challenges faced by the health workforce in burn care to identify issues affecting their performance. Qualitative in-depth interviews were conducted with a purposively selected sample (n = 31, 18 women and 13 men) of various cadres of the burn care health workforce in Uttar Pradesh, India. Inductive coding and thematic analysis identified three major themes. First, the dynamics within the multidisciplinary team where complex relations, power and normative hierarchy hampered performance. Second, the dynamics between health workers and patients due to the clinical and emotional challenges of dealing with burn injuries and multitasking. Third, dynamics between specialised burn units and broader health systems are narrated in challenges due to inadequate first response and delayed referral from primary care facilities. These findings indicate that burn care health workers in India face multiple challenges that need systemic intervention with a multipronged human resource for health framework.

Unveiling perspectives on the psychosocial impacts of childhood cancer survival on young adult survivors' reassimilation journey: A qualitative exploration.

Approximately 82% of children with childhood cancer survive more than five years after diagnosis. Living as a cancer survivor elicits a new reality that can include psychosocial impacts. These psychosocial impacts interact collectively, especially regarding reassimilation, and are rarely explored. To explore the psychosocial impacts of surviving childhood cancer and reassimilation back into society in young adult survivors of childhood cancer. Individual in-depth semi-structured interviews were conducted with childhood cancer survivors and explored psychosocial aspects associated with returning to work, school, and social environments after remission. Interpretive phenomenological analysis was conducted once interviews were manually transcribed. A group interview with survivors was held to discuss the study's findings and interpretation. Individual interviews and the group interview revealed three major themes: outlook on reassimilating, outlook on coping, and outlook on cancer. This work is a first step to understanding how survivors' personal outlook on coping and healthcare system barriers play influential roles in reassimilation following cancer treatment. Survivors expressed the need for reliable survivorship information and improved communication with healthcare providers regarding what to expect, so they could feel prepared for life post-cancer. These aspects need to be explored more deeply through other qualitative studies.

Unveiling perspectives on the psychosocial impacts of childhood cancer survival on young adult survivors’ reassimilation journey: A qualitative exploration

Contexte : Environ 82 % des personnes atteintes d’un cancer pendant l’enfance survivent plus de 5 ans après le diagnostic. La survivance transforme leur quotidien et entraîne parfois des difficultés psycho­sociales. Les séquelles psychosociales – rarement étudiées – sont inter­reliées, surtout en ce qui concerne la réinsertion aux activités normales. Objectif : Examiner les effets psychosociaux de la survie au cancer pédiatrique et la réinsertion sociale des jeunes adultes. Méthodologie : Des entrevues individuelles semi-structurées détaillées ont été réalisées auprès de personnes ayant survécu à un cancer pédiatrique afin d’étudier les aspects psychologiques du retour au travail, à l’école et en société après la rémission. Après la transcription manuelle des entrevues, on a procédé à une analyse phénoménologique interprétative. Un groupe de discussion a été organisé pour permettre aux survivants de discuter des résultats de l’étude et de l’interprétation des données. Résultats : Les entrevues individuelles et le groupe de discussion ont fait ressortir trois grands thèmes : le regard porté sur la réinsertion, le regard porté sur l’adaptation et le regard porté sur le cancer. Conclusions : La présente recherche amorce une démarche visant à comprendre en quoi le regard que portent les survivants sur l’adaptation et les obstacles liés au système de santé influence la réintégration après le cancer. Les survivants ont exprimé le besoin d’obtenir des renseignements fiables sur la survivance au cancer et d’être mieux informés par leurs professionnels de la santé afin de se préparer à la vie après le cancer. Ces aspects devront faire l’objet d’autres études qualitatives détaillées. Mots-clés : cancer pédiatrique, survivance, réinsertion, transition, effet psychosocial, jeune adulte

“Once Again It Becomes a Friend in Times of Adversity”: A Qualitative Exploration of Interrelationships between Anorexia Nervosa and Trauma over Ten Years

Background: The majority of research on the relationship between anorexia nervosa (AN) and trauma has been cross-sectional and quantitative. This study aimed to qualitatively explore how this relationship may shift over time. Methods: A community sample of nine women with a lived experience of AN and trauma were interviewed three times over ten years (1997–2007). Thematic analysis and narrative emplotment were utilised to construct themes both within and across interview transcripts. Results: AN was found to function as a way of coping with trauma (Theme 1), and also became a traumatic experience in and of itself (Theme 2). Longitudinal shifts were identified where the women moved away from AN as a way of coping to loosen the stronghold it had over their lives. Conclusions: This study illuminated how the women’s relationship with AN shifted over time, including the functions and meanings ascribed to AN, and the resilience of women to exit critical stages of AN and achieve meaningful change in their lives over the long term. A further novel finding was that the coping function AN served in early years of life shifted over time as they navigated additional traumas in adulthood and new and diverse ways of coping.

A validation study of the Bolton Forgiveness Scale (BFS-15) in India

Purpose This study aims to validate the Bolton Forgiveness Scale (BFS) created by Amanze and Carson (2019) for the Indian population. Design/methodology/approach The data for the validation of the BFS was collected (Total N = 813) in two phases (Phase-I, N1 = 613 and Phase-II, N2 = 200) through online surveys. SPSS 26 and AMOS were used to establish the psychometric properties of the scale through internal consistency and confirmatory factor analysis. Findings The results indicated the validation of the BFS in the Indian context, with a high internal consistency (a = 0.847). Confirmatory factor analysis validated the factor structure and items, along with face validity. Research limitations/implications This study offers comprehensive suggestions on the approaches to forgiveness, addresses biases, advocates for qualitative exploration and emphasizes rigour for the future research on forgiveness. Originality/value The present study validates the BFS for future use for the Indian population. The authors offer comprehensive suggestions on the approaches to forgiveness, address biases, advocate for qualitative exploration and emphasize rigour for future research on forgiveness.

“I have to fight for them to investigate things”: a qualitative exploration of physical and mental healthcare for women diagnosed with mental illness

IntroductionWomen play a significant role in the management of their own healthcare and that of others, however women diagnosed with mental illness and physical health concerns experience significant health inequalities as compared to people living without mental health concerns.MethodsIn this paper, we reflect on the experiences of 20 cis women diagnosed with mental and physical health concerns who agreed to be a part of this research. This qualitative study is part of the larger Healthtalk Australia research project which was not gender specific. Female participants shared many experiences of mental and physical healthcare in interviews with researchers that pointed to the need for a gendered approach to addressing health inequalities. Consequently, we iteratively consolidated transcripts of interviews with participants into thematic categories facilitated by NVIVO 12.ResultsWe identified two broad themes and a set of subthemes: in the doctor’s office – experience of labelling; negotiating medications; and interactions with physical and mental health, and outside the doctor’s office – responses to trauma, financial concerns, and reliance on participant’s internal resources to get healthcare needs met.DiscussionWe conclude that participants in this study undertook significant work to manage their own healthcare needs, despite being challenged by clinicians and systems that failed to see them as whole people with expertise regarding their own health.

A qualitative exploration of community pharmacists’ experiences of dispensing oral anti-cancer medications

Abstract Introduction Oral anti-cancer medications (OAMs) have revolutionised cancer care. OAMs have a convenient route of administration, which avoid infection and extravasation risks, and injection site reactions associated with intravenous access. In Ireland, OAMs are dispensed from community pharmacies by community pharmacists who often have a lack of specialist training, insufficient access to patient notes, and prescriptions inadequate to clinically verify a patient’s treatment. No research has been conducted in Ireland on this topic since 2012.[1] The huge growth in OAMs since then means that the community pharmacy environment for dispensing OAMs have likely changed significantly. Aim To explore community pharmacists’ experiences of dispensing OAMs in Ireland and identify areas of improvement within the current system. Methods Semi-structured interviews were conducted with sixteen community pharmacists registered with the Pharmaceutical Society of Ireland who had dispensed OAMs in a community pharmacy setting. Participants were recruited through convenience (n=3), purposive (n=7), and snowball (n=6) sampling. Interview guides were developed from published literature. Interviews were conducted face-to-face or through Microsoft Teams and were recorded. Recordings were transcribed verbatim. The transcripts were analysed using an inductive thematic analysis approach using NVivo 12. Results The majority of participants were female (11/16), aged <40 years (11/16), and worked in a small pharmacy chain (2-9 pharmacies; 11/16). Only a quarter of participants had training in specific training about OAMs (4/16). There were three themes identified: ‘Patient Benefit’, ‘Communication’, and ‘Infrastructure’. Participants acknowledged that community pharmacists have strong relationships with their patients that facilitate an environment that aided counselling and eliciting patient queries. At the same time, it was noted that it is more difficult to monitor adherence of anti-cancer medications taken at home. Communication with hospitals was identified as a barrier. Discharge information is often inadequate to verify prescriptions due to insufficient details on the prescription or poor legibility. This is compounded by the difficulty in contacting OAM prescribers. On a systems’ level, community pharmacists feel that there is little support or training given to allow them to dispense OAMs. Participants found that only with time and experience in dispensing OAMs did they gain expertise and confidence. Conclusion Community pharmacists have an important role in the management of patients treating their cancer with OAMs; however, many feel that there are difficulties communicating with other healthcare professionals about potential OAM issues and that the infrastructure and resources are not in place to maximise the benefit to patients. Provision of OAM-specific training, provision of adequate discharge information, and ability to directly communicate with prescribers and/or oncology pharmacists would increase the competence and confidence of community pharmacists to dispense OAMs safely. This would reduce the risk of dispensing errors, missed supportive medications, and unrecognised adverse drug reactions.

Path to adventure: a qualitative exploration of provider training for adventure-based prevention practice

ABSTRACT Despite the utilization of adventure therapy techniques in behavioral health disorder prevention programming, little is known about how providers become trained in adventure-based prevention practice. Additionally, limited literature examines how adventure therapy providers are trained. This exploratory qualitative study provides a starting point for understanding the education and lived experiences that prepared providers of adventure-based prevention for professional practice. A purposive sample of 23 clinicians and administrators participated in semi-structured interviews with the first author. Interviews were transcribed and analyzed using thematic analysis with first-cycle coding, second-cycle coding, and in-vivo coding. Strategies to ensure the trustworthiness of the data were utilized including researcher reflexivity, memoing, intercoder reliability, triangulation, in-vivo coding, and member checking. Primary themes were providers’ lived experiences leading to adventure-based work, education & training, and mentorship. Discussion of new findings about preparation and education for adventure-based prevention are offered. Implications are described for practice, policy, research, and education.

Towards person-centred work-focused healthcare for people with cardiovascular disease: a qualitative exploration of patients’ experiences and needs

Purpose To explore the experiences and needs concerning work-focused healthcare of patients experiencing problems with work participation due to cardiovascular disease based on all facets of person-centred care. Methods Nineteen patients who experienced or continue to experience problems with work participation due to cardiovascular disease participated in semi-structured interviews preceded by preparatory written assignments. The transcripts were analysed by means of directed qualitative content analysis. Adapted principles of the Picker Institute for Person-Centred Care provided a template for the analysis. Results 28 experiences and needs emerged and were grouped into the eight principles for person-centred work-focused healthcare. Randomly presenting one theme for each of the eight principles, the themes included: (1) frequent encounters with occupational healthcare professionals; (2) substantive work-related advice; (3) transparency in communication; (4) support for family; (5) information provision on the work-focused healthcare process; (6) personal control during the process; (7) empathy for the personal situation; and (8) tailored work-focused support. Conclusions The identified experiences and needs for work-focused healthcare of patients experiencing problems with work participation due to cardiovascular disease clearly indicate the need to improve the delivery of person-centred work-focused healthcare to better meet the individual needs of patients.

Patient experience and decision-making process for laser photocoagulation for monochorionic twin pregnancy: A qualitative exploration.

To explore patients' perspectives on diagnosis and treatment options for complicated monochorionic multiple gestations, and experiences with fetoscopic laser photocoagulation. This is a prospective cohort study of patients undergoing laser photocoagulation. Participants were interviewed during pregnancy and the postpartum period. Qualitative analysis was performed. 27 patients who were candidates for laser photocoagulation were included. All elected to have laser photocoagulation. Patients chose surgery with goals of improving survival, decreasing the risk of preterm delivery, and improving the long-term health of their fetuses. They demonstrated accurate knowledge of the risks and benefits of treatment. Most (74%) felt that laser photocoagulation represented their only viable clinical option. Few seriously considered pregnancy termination or selective reduction (7% and 11% respectively). Postpartum, patients expressed no regrets about their decisions for surgery, but many felt unprepared for the challenges of preterm delivery. Participants weighed treatment options similarly to fetal specialists. They acknowledged but did not seriously consider treatments other than fetoscopic laser photocoagulation, and were highly motivated to do whatever they could to improve outcomes for their fetuses.

A Qualitative Descriptive Exploration of the Experiences of Burn Therapists.

Exposure to patients who have experienced major traumatic events places burn therapists at risk of developing high levels of anxiety and stress, directly impacting their quality of life. Poor professional quality of life has been associated with negative physical and emotional characteristics in healthcare professionals and may subsequently influence patient safety and satisfaction, job retention, and productivity. The purpose of this study was to understand and describe the experiences of occupational and physical therapists who provide acute therapy to people who have sustained burn injuries. Semistructured interviews were completed with 10 participants (8 females and 7 physical therapists) for this qualitative descriptive study. Conventional content analysis was used to analyze the data collected from semistructured interviews. Six themes emerged after content analysis: (1) the importance of therapeutic relationships to patient successes and therapists' retention; (2) the autonomy and flexibility of burn therapists; (3) the impact of career longevity on compassion; (4) the uniqueness of burn team relationships and camaraderie; (5) the challenges of operating within the business of a healthcare system; and (6) the physical, mental, and emotional challenges to the burn therapists' resiliency. This research brings to light the physical, mental, and emotional challenges that impact burn therapists' resiliency, and which should be considered when creating programs to increase retention and professional quality of life in this professional population.

Parents' Trigger Tool for Children with Medical Complexity - PAT-CMC: Development of a recognition tool for clinical deterioration at home.

To develop a trigger tool for parents and lay caregivers of children with medical complexity (CMC) at home and to validate its content. This was a multi-method study, using qualitative data, a Delphi method and a concept mapping approach. A three-round electronic Delphi was performed from December 2021 to April 2022 with a panel of 23 expert parents and 30 healthcare providers, supplemented by a preliminary qualitative exploration of children's signs of deterioration and three consensus meetings to develop the PArents' Trigger Tool for Children with Medical Complexity (PAT-CMC). Cognitive interviews with parents were performed to assess the comprehensiveness and comprehensibility of the tool. The COREQ checklist, the COSMIN guidelines and the CREDES guidelines guided the reporting respectively of the qualitative study, the development and content validity of the trigger tool and the Delphi study. The PAT-CMC was developed and its content validated to recognize clinical deterioration at home. The tool consists of 7 main clusters of items: Breathing, Heart, Devices, Behaviour, Neuro-Muscular, Nutrition/Hydration and Other Concerns. A total of 23 triggers of deterioration were included and related to two recommendations for escalation of care, using a traffic light coding system. Priority indicators of clinical deterioration of CMC were identified and integrated into a validated trigger tool designed for parents or other lay caregivers at home, to recognize signs of acute severe illness and initiate healthcare interventions. The PAT-CMC was developed to guide families in recognizing signs of deterioration in CMC and has potential for initiating an early escalation of care. This tool may also be useful to support education provided by healthcare providers to families before hospital discharge. Parents of CMC were directly involved in the selection of relevant indicators of children's clinical deterioration and the development of the trigger tool. They were not involved in the design, conducting, reporting or dissemination plans of this research.

Is it fear or politics? A qualitative exploration of stakeholders’ views on the failed Ebola vaccine trial in Southern Ghana

Background: The negative meaning and rumours associated with the conduct of clinical trials regarding their experimental nature adversely affect trust and their conduct. A typical example of the challenges in conducting clinical trial studies was where Ghana was selected to conduct the ebola vaccine trials, which was not successful. This study explored the social and political perspectives on the unsuccessful implementation of the ebola vaccine trial in Ghana. Methods: This was a cross-sectional exploratory study using qualitative research approach where 31 in-depth individual interviews and Key informant interviews were conducted with participants. The interviews were recorded, transcribed and coded into themes using Nvivo 12 software to aid thematic content analysis. Results: The views expressed by participants suggested that lack of stakeholder engagement to create awareness on the Ebola vaccine trial led to doubts on the purpose for the trial. Also, media propaganda, negative influence and the perception that conducting the vaccine trial in Ghana could introduce the Ebola virus into the country created panic and fear, which affected public trust and support for the Ebola vaccine trial conduct in Ghana. Furthermore, political influence linked with site selection and timing for the study in particular, led to mistrust and the subsequent suspension of the trial in Ghana. Conclusions: Based on the interpretation of our data, we conclude that the indefinite suspension of the Ebola vaccine trial in Ghana could largely be attributed to both fear and political influence as well as misinformation resulting from media propaganda leading to mistrust.

Hidden costs of providing care: a pilot study of Japanese migrant care workers’ experiences in Aotearoa New Zealand during the COVID-19 pandemic

ABSTRACT Recognising the increasingly vital yet precarious role that Asian migrant care workers (MCWs) play within Aotearoa New Zealand (Aotearoa) health system, this paper delves into the qualitative exploration of the experiences encountered by Japanese MCWs amidst everyday challenges and injustices during the COVID-19 pandemic in Aotearoa. Gaining in-depth understanding of their lived experiences, encompassing challenges inherent in their care roles and racial/social injustices outside their care roles, holds the potential to establish a sustainable care workforce capable of delivering quality health care while also attracting and retaining MCWs in Aotearoa. Employing the perspective of Critical Migration Studies (CMS), this pilot study explores the hidden costs of care provision, drawing insights from in-depth interviews conducted with 10 Japanese MCWs in late 2022 and early 2023, and presents mixed findings. The data indicates intersecting challenges in their work, including unfair treatment, linguicism, labour market inequality and various forms of social injustices. However, most Japanese MCW participants had developed robust resilience in dealing with these perceived challenges and injustices in Aotearoa, stemming from their previous experiences of gender, cultural and other forms of oppression in their workplace and everyday life in Japan.