Qualitative Health Research Articles

Qualitative Clinical Mental Health Program Evaluation: Models and Implications for Counseling Practitioners and Educators

Qualitative program evaluation is an effective tool allowing agencies and clinicians to provide holistic validation of innovation in clinical settings. Counselor educators can introduce models of qualitative program evaluation in both agency settings and counseling master's programs to enhance the development of clinical evaluation in the community and to integrate clinical and evaluative identities in clinical mental health practitioners and students. This article defines qualitative program evaluation and logic models and introduces methodologies that may be effective in clinical settings. Developing a logic model provides a structure that guides qualitative inquiry, and general categories of logic models are defined. Specific qualitative program evaluation models appropriate to clinical settings are also identified and defined. Recommendations for incorporating qualitative program evaluation into clinical practice and counselor education programs are discussed.

Young adults’ perspectives on living with kidney failure: a systematic review and thematic synthesis of qualitative studies

IntroductionYoung adults fare worse than younger adolescents or older adults on a broad range of health indicators. Those with a chronic illness such as renal failure are a particularly vulnerable...

A Novel Fractal Contact-Electromechanical Impedance Model for Quantitative Monitoring of Bolted Joint Looseness

Bolted joint are among the key components that enable the robust assembly of a wide variety of structures. However, due to wear and tear over time, bolted joint may loosen, and if not detected in its early stages, can lead to devastating results. A monitoring method that can detect bolted joint looseness prior to bolt failure will be essential for the continued operation of the host structure and depending on the situation, the safety of the occupants. Prior research has proven the electromechanical impedance method (EMI) to be an effective technique for detecting the loosening of bolted joints, however, EMI-based methods until now are focused on qualitative health monitoring, which can only provide limited information about the damage. Thus, this paper attempts to quantify EMI based methods through the integration of fractal contact theory, the result of which is a novel electromechanical impedance model for quantitative monitoring of bolted looseness. The method determines the effective impedance of the bolted joint and is applied to develop the relationship between the electrical impedance of a piezoceramic patch installed on the joint and the mechanical impedance of the bolted joint. The mechanical impedance of the bolted joint under various preloads is computed by using the fractal contact theory. Then, the bolted looseness can be monitored quantitatively. At last, a set of verification tests under different applied preload of bolted joint are conducted to verify the validity of the proposed model in this paper.

Teaching Qualitative Research Methods in Public Health and Medicine: a research oriented module

Objectives: Qualitative health research can contribute to knowledge building in public health and medicine, but there is a lack of research-oriented training of qualitative methods at universities with public health programs and in medical schools. The aim of this paper is to describe our experiences in conceptualising, implementing and evaluating an elective on qualitative methods in the Master of Public Health (MPH) programme at the Medical Faculty of the Ludwig-Maximilians-University (LMU) Munich. Methods: A new research-oriented elective (3 Credit Points) was developed and delivered to MPH and medical students in summer 2016. This elective consisted of three blocks that were complemented by two practice sessions. The students worked in small groups. These groups developed a research question and a qualitative study design addressing the thematic focus of vaccinations. Each student conducted two semi-structured interviews with a semi-structured interview grid. Students transcribed the interviews, analysed them according to content analysis and presented the results collaboratively. Results: In that semester, 16 students successfully completed the elective. Groups of two to three students worked on their respective research questions, presented, and reflected on their research results. The participants evaluated the module as very good, particularly with regard to the structure and consistency of the blocks. To facilitate individualised mentoring and guidance, a high student-lecturer ratio is required. Timeframe and workload should pay tribute to the module's credit points. Conclusions: We successfully implemented a research-oriented elective providing a first-hand experience with qualitative health research methods. Students were able to learn about the theory and practical application of qualitative research in the field of medicine and public health.

A qualitative health literacy study in fourth grade primary school children

A qualitative health literacy study in fourth grade primary school children

Photo-elicitation with adolescents in qualitative research: an example of its use in exploring family interactions in adolescent psychiatry

BackgroundPhoto-elicitation is a method used increasingly often in qualitative health research, and its positive effect on the research process is well established today. Photo-elicitation appears to facilitate verbalization and insight and to improve relationships between the researcher and participants, thereby enriching the quality of the data collected. Nonetheless, it is barely used at all in the field of adolescent psychiatry. With the aim of exploring the potential of these methods for research with adolescents receiving psychiatric care, we conducted a qualitative photo-elicitation data collection study with this population, asking them about family interactions around food.MethodsThe data were collected from 15 adolescents and 17 parents during semi-structured interviews in which a photo taken by the adolescent served as the focus of discussion. Data were explored through inductive thematic analysis.ResultsPhoto-elicitation played a threefold role in this study: (1) it induced the teens’ interest, thought, and pleasure, (2) it played a mediating function during the interviews, and (3) it enabled family interactions to be viewed from the adolescent’s perspective. Three themes concerning family interactions were found: (1) parent–child relationship patterns, (2) the functioning of the family group, and (3) the adolescent’s individual relation with food, that is, the issue of the adolescent’s autonomy.ConclusionsPhoto-elicitation proved to be an innovative technique in qualitative research in the area of adolescent psychiatry, one that enriched the data and enabled the emergence of new themes in this field, related in particular to the process by which adolescents develop autonomy.

Completeness of reporting in Indian qualitative public health research: a systematic review of 20 years of literature

Background This study reviewed the completeness of reporting in Indian qualitative public health research (QPHR) studies using the 'Consolidated Criteria for Reporting Qualitative Research' (COREQ) checklist. Methods Search results from five electronic databases were screened by two independent reviewers. We included English-language, primary QPHR studies from India, which were assessed for their compliance with the COREQ checklist. Each COREQ item was noted as either reported or unreported. Descriptive statistics for the number of COREQ items reported by each study, and the number of studies that reported each COREQ item were reported, as were the items reported in each year, and in pre- and post-COREQ time periods. Results Of 537 citations, 246 articles were included. Trends demonstrated an increasing number of Indian QPHR studies being published annually, and an overall increase in reporting completeness since 1997. Only two COREQ items were reported in all studies. 52.4% of articles reported between 16 and 21 items, corresponding to 43-57% of items being reported. Six items were reported in fewer than 10% of studies. COREQ domain 1 was least frequently reported. Conclusions Despite improving trends, the reporting of QPHR in India is incomplete. Authors and journals should ensure adherence to reporting guidelines.

Developing and Using Vignettes to Explore the Relationship Between Risk Management Practice and Recovery-Oriented Care in Mental Health Services.

There is a lack of literature evaluating the development and use of vignettes to explore contested constructs in qualitative health care research where a conventional interview schedule might impose assumptions on the data collected. We describe the development and validation of vignettes in a study exploring mental health worker and service user understandings of risk and recovery in U.K. mental health services. Focus groups with mental health workers and service users explored study questions from experiential perspectives. Themes identified in the groups were combined with existing empirical literature to develop a set of vignettes. Feedback focus groups were conducted to validate and amend the vignettes. Following use in research interviews, results suggested that the vignettes had successfully elicited data on issues of risk and recovery in mental health services. Further research using creative, comparative methods is needed to fully understand how vignettes can best be used in qualitative health care research.

A NOVEL HEALTHCARE MODEL TO EXPLORE CLOUD DATA SPACE DIGITALLY FOR HEALTH IMPROVEMENT IN RURAL AREAS

Qualitative health care services are considered as a basic need for every citizen irrespective of age, gender and culture. The Health Care system in developing countries still relies on paper medical records. Information that is digitized is usually not portable; preventing information sharing amongst the different health care resources. The Health Care system faces substantial challenges with growth inhibitors such as rapidly growing population, changing disease profile and re-emerging diseases, multilayered healthcare system or landscape, lack of absence of infrastructure, scarcity of manpower that is doctors, nurses and paramedics, extremely low public expenditure on health and its inefficiencies. The aim of this paper is to create an improvised public health care system for developing countries with efficient big data analytics to delve bioinformatics data taking into account from various resources including medical records, hospitals, research groups, insurance companies and public and private sector health organizations. The proposed Health Care model facilitates collaboration and to coordinate care between patients and physicians and amongst medical community possible. It also provides an infrastructure that allows hospitals, research groups, insurance companies and public and private sector health organizations to tap improved computing resources at lower initial investments. Also the cloud environment will reduce the obstacle for innovation and modernization of health information technology systems and applications. This paper also includes guidance and strategies that helps to build an autonomous, digital and efficient health care system to benefit the rural population utmost and nation as a whole.

Community based qualitative health research: negotiating ethics in India

In the last two decades, rise of community-based qualitative health research (CBQHR) has given impetus to deliberations on ethics, primarily on inequality between the researcher and the researched, and the principles of flexible and non-deductive field design adopted in CBQHR. The paper attempts to understand ethics as a process of negotiation at various stages in the field after the Research Ethical Board’s (REB’s) approval. The paper identifies three vulnerable stages of ethical negotiations: consent at commencement stage; data-collection stage (interview, observations, and ethnography); and data analysis at the collation stage in the context of a developing economy. Analysis suggests that REBs need to graduate from a product certification to ethical governance process to address the inherent flexibility and inequality that exists between the researcher and researched in developing countries like India.

Anticipatory Care Planning in Scotland

Background: Innovative work on Anticipatory Care Planning (ACP) is being undertaken across Scotland to ensure delivery of high quality, person-centred care. This aligns with the NHS Quality Strategy for Scotland, the 2020 vision and the Health and Wellbeing Outcomes supporting Health and Social Care integration. ACP has been prioritised nationally across Scotland and recognised as an exemplar by the International Foundation for Integrated Care (IFIC).Given the demographic and cultural similarities between Scotland and New Zealand we believe that there would be value in collaborating to share learning and best practice to take forward sustainable ways of working across our systems.ACP is a person-centred, proactive, “thinking ahead” approach, requiring services and professionals to work with individuals and their carers, have the right conversations and set personal goals to ensure that the right thing is done at the right time by the right person with the right outcome. It is about the individual’s situation and their conditions and helping people navigate the system and make informed choices about their care and place of care. Population stratification estimates 5-6% of the population could benefit from ACP. Initiation is prompted by a range of triggers and risk prediction tools based on situation, condition and assessment.Current work prioritises use of IT, including the Key Information Summary (KIS), to communicate between primary and acute services. A person-centred App “Let’s Think Ahead” has been developed to support ownership and improve health literacy. Two short educational films “Alice’s story” and “ACP matters” have been produced to increase public and professional awareness about ACP.A National Action Plan supports implementation of ACP principles across Scotland to deliver best-model, person-centred care close to home and consequently reduce avoidable hospital admissions. The aims are to build on good practice, mainstream ACP; focus services on sharing information appropriately, make decisions about the “whole” person and align ACP with work around carer support and Power of Attorney.ACP requires a cultural and resource shift to develop the right community infrastructure supporting early intervention about future health and care needs during the spectrum of care when complexity is recognised through to end of life care.Evidence suggests early intervention, at all ages, through ACP can optimise outcomes and improve quality of life and that appropriate access to community services, good anticipatory care supported by development of a Key Information Summary that contains the right information can reduce the risk of hospital admission by 30-50%.KIS, currently hosted on the GP IT system, enables electronic ACP access. 4.4% of the Scottish population now have a KIS accessible to unscheduled care services with 3.32m KIS accesses/annum outside general practice. Work is ongoing to enable greater accessibility to KIS.National role-out of a whole-system Scotland ACP model is co-ordinated through a series of national cross sector workshops overseen by a National ACP Programme Board and development of a learning and communication strategy.Impact will be assessed by quantitative and qualitative measurement, contribution analysis and health economic input.

Holding Firm: Power, Push-Back, and Opportunities in Navigating the Liminal Space of Critical Qualitative Health Research.

Critical qualitative health researchers typically occupy and navigate liminal academic spaces and statuses, with one foot planted in the arts and social sciences and the other in biomedical science. We are at once marginalized and empowered, and this liminality presents both challenges and opportunities. In this article, we draw on our experiences of being (often the lone) critical qualitative health scholars on thesis advisory committees and dissertation examinations, as well as our experiences of publishing and securing funding, to illuminate how power and knowledge relations create conditions that shape the nature of our roles. We share strategies we have developed for standing our theoretical and methodological ground. We discuss how we use the power of our liminality to hold firm, push back, and push forward, to ensure that critical qualitative research is not further relegated to the margins and its quality and integrity sustained.

Reclaiming the Potential of Transformative Scholarship to Enable Social Justice

Scholars within critical qualitative inquiry and health sciences are becoming increasingly interested in transformative scholarship as a means to pursue greater justice in society. However, transfo...

Advancing the Field of Synthesis Scholarship: A Response to Nicky Britten and Colleagues.

Continuing the dialogue and debate on the relevance and value of qualitative metasynthesis research for the health fields, Thorne comments on some of the ideas raised by Britten and colleagues in response to her January 2017 Qualitative Health Research editorial on Metasynthetic Madness. Here she extends the debate on the terminology with which we refer to this kind of scholarly work and the kinds of research synthesis that hold potential for adding value to existing knowledge about matters of health and illness. In the spirit of engaging an ongoing critical conversation, she proposes that the kinds of metasynthesis products that get published ought to be those capable of demonstrating actual relevance. She reminds us that the procedural steps that have come to be associated with metasynthesis in many of the recently published reports are merely the stage-setting one does in order to prepare the way for the actual intellectual work of synthesis. By whatever name it is known, if qualitative synthesis is to make a meaningful scholarly contribution in the health domain, Thorne argues that it must demonstrate the kind of thoughtfully critical and interpretive intellectual engagement that takes our understanding of phenomena significantly beyond what we could have known on the basis of an ordinary kind of literature review, offering us an original form of insight that would not have been otherwise accessible.

Implementing a Global Health Qualitative Research Study: Experiences of a Project Coordinator in Uganda

Qualitative research in global health requires substantial operational and logistical support during both the implementation phase and day-to-day operations. However, little to no published work shares the experiences of international qualitative research teams. Yet, without a strong project foundation and attention to everyday details, studies can begin without appropriate guidance and, as a result, poor quality data may be generated. This paper presents a detailed account of a project coordinator's experience implementing 4 qualitative HIV and reproductive health studies in Uganda between 2012 and 2014, reflecting on our research team's practices and lessons learnt, and provides recommendations for successful project implementation. The aim of this paper is to help new global health qualitative project coordinators, and international teams more generally, by detailing 6 coordination tasks: hiring, training, team communication, organization of study documents, data collection and storage, and research ethics. To avoid repeat learning of basic, yet important, logistical steps by each new qualitative research project coordinator, this paper can help coordinators think about how to organize their work in order to prepare for both planned and unplanned challenges that have been encountered by others. Sharing operational and logistical experiences and expertise can benefit the global health community and help future studies run more efficiently.

Group Discussions in Health Services Research - Part 1: Introduction and Deliberations on Selection of Method and Planning

Health services researchers focus on the players, structures and impact of health care in "real life". They investigate how social aspects, financing, organizational structures, technologies and personal attitudes affect the process and outcomes of health care. Qualitative research methods are used here, which address how people act according to their unique living conditions (outside the context of experimental studies). Different methods of debriefing groups are essential for qualitative health services research. In 2 subsequent articles, we aim to outline the diverse facets and possible range of implementation of the above-mentioned methods, in order to highlight the potential of debriefing groups in health services research (focus groups or group discussions) using these methods. In the current article, we would like to encourage researchers to reflect on relevant topics such as the selection of an appropriate method, the planning and undertaking of investigations including sampling methods, and questions regarding ethics and privacy. A follow-up article (in preparation) will deal with theoretical considerations of the term "group", as well as with the process of moderating discussions, methods of analyzing data and (qualitative) online research.

Where does good quality qualitative health care research get published?

This short report aims to give some insight into current publication patterns for high-quality qualitative health research, using the Research Excellence Framework (REF) 2014 database. We explored patterns of publication by range and type of journal, by date and by methodological focus. We also looked at variations between the publications submitted to different Units of Assessment, focussing particularly on the one most closely aligned with our own research area of primary care. Our brief analysis demonstrates that general medical/health journals with high impact factors are the dominant routes of publication, but there is variation according to the methodological approach adopted by articles. The number of qualitative health articles submitted to REF 2014 overall was small, and even more so for articles based on mixed methods research, qualitative methodology or reviews/syntheses that included qualitative articles.

A Study on Methods for Establishing Surrogate Safety Goals for Nuclear Power

Quantitative risk values for nuclear power plants (NPPs) can be obtained by conducting a probabilistic safety assessment (PSA). However, people cannot judge the risk level without comparing the risk values from PSA with the standards of acceptable risk in society. Acceptable risk standards are affected by many factors, and those factors are preferentially considered in specified applications. There are many methods used to establish acceptable risk, and a comparative method is easily understood and accepted by the public. In the United States, both qualitative safety goals and quantitative health objectives (QHOs) for the current generation of light water reactors are established by a comparative method and are described in the Safety Goals Policy Statement published by the U.S. Nuclear Regulatory Commission. The evaluations of Level 1 PSA or Level 2 PSA are enough for most regulatory decisions and engineering practices.In order to use PSA as a useful tool for regulation, establishing surrogate safety goals based on QHOs is necessary. But, there is no clear derivation process. First, this paper introduces the process of how to derive QHOs from qualitative safety goals and a model of quantitative health risk. Then, models using core damage frequency (CDF) and large early release frequency (LERF) based on the QHOs are introduced. The situations of nuclear power for each country—the number of plants, the types of reactors, the weather conditions, the population distribution, and the off-site emergency response plan—are different for each country. This paper considers two representative situations. The first situation is that a society has only a single NPP. The maximum consequence method is used to determine the surrogate safety goals for this situation. The second situation is that a society has multiple types of NPPs and the off-site environments of the plants are different from each other. The statistical tolerance intervals method is used to determine the surrogate safety goals for this situation. Data of individual early fatality and cancer fatality risk in China from 2004 to 2013 are collected and analyzed, and then, Chinese, U.S., Korean, and Japanese QHOs are compared. Chinese QHOs and some data from the reference are used to establish surrogate safety goals for the two situations, which are compared with existing surrogate safety goals CDF = 1E-04 per reactor and LERF = 1E-05/reactor-year.

A Ten-Year-Old’s Use of Creative Content to Construct an Alternative Future for Herself

A Ten-Year-Old’s Use of Creative Content to Construct an Alternative Future for Herself

Ethical Challenges in Community-Based Participatory Research: A Scoping Review.

Ethical challenges in community-based participatory research (CBPR) are of increasing interest to researchers; however, it is not known how widespread these challenges are or how extensively the topic has been explored. Using Arksey and O'Malley's scoping review method, studies on ethical challenges in CBPR were mapped. Findings indicate that researchers continue to raise questions about ethics associated with CBPR. Our purpose in this article is to present a thematic summary of international ethical challenges as a guide for researchers interested in community participatory approaches and to better prepare them for qualitative health research with communities.