Qualitative Research Expert Research Articles

Purpose: With the growing number of immigrants in Korea, immigrant health has become a significant public health concern. This study aimed to explore immigrant women's motivations for and experiences of participating in a community-based prenatal pilot program, with the goal of informing the future development and expansion of multicultural-friendly educational content and effective delivery systems to promote health.Methods: Among 19 participants in the program, six immigrant women who had lived in Korea for over three years were invited to participate in an exit group interview. The two-hour session was moderated by two qualitative research experts, digitally recorded, and transcribed verbatim. A content analysis was conducted using triangulation to ensure credibility and depth.Results: Participants were motivated to join the program both to receive help and to offer help to others. Their experiences included a sense of comfort and joy from receiving accurate health information and forming new relationships, as well as building trust through educational and emotional support. They also expressed unmet needs, such as expanding health education content and including their family members as part of the target audience. Furthermore, they wished to be acknowledged as active contributors to Korean society by serving as peer mentors.Conclusions: There is a need to develop culture-friendly health education programs for improving immigrant health. Bilingual and bicultural immigrant women can play vital roles as community health workers, promoting public health and health equity. This approach may also support their social reintegration and empowerment.

This study aimed to explore and understand the lived experiences of non-teaching personnel transitioning to teaching position in Carmen District, Division of Davao del Norte. A qualitative phenomenological research design was used in the study. Twelve teachers, who were non-teaching personnel s in their previous work, were chosen purposively had undergone in-depth interviews regarding their challenges, strategies and motivation, and insights on their transition to teaching roles. There were three research questions with five probing questions for each main question had been asked to the participants regarding their challenges, strategies and motivations, and insights. Data were collected through in-depth semi-structured interviews, guided by three main research questions with five probing sub-questions each. To ensure validity, the interview guide was reviewed by qualitative research experts and pilot-tested prior to actual data collection. Results on the responses of the participants on experiences include adjustment challenges, professional growth, and commitment and passion. For strategies and motivation, responses from participants include personal motivation and financial reasons, mentorship and peer support, and adaptation and skill application. For the insights, results from the participants include realization of teaching purpose, discovery of personal strengths, and adaptation to professional expectations. Future studies may concentrate on information regarding the transition experiences, challenges, and support mechanisms not only for non-teaching personnel but also for other career shifter s and other professionals entering the education sector.

Introduction: Although previous knowledge has proposed guidelines for promoting sexual health literacy in sexually transmitted disease (STD) prevention, there is a knowledge gap in studies about approaches to promote sexual health literacy for STD prevention among undergraduate students tailored to undergraduate students, who are influenced by specific personal, familial, and sociocultural factors. Methods: This critical ethnographic study explored the promotion of sexual health literacy in STD prevention among undergraduate students in Thailand. The total number of participants was 63 persons, including undergraduate students, health care providers, university department representatives, university administrators, advisors or lecturers, parents, and friends. Data were collected by in-depth interviews, participatory observation, non-participatory observations, field notes, and documented studies. Verify the accuracy of the data using multiple periods, multiple individuals, multiple university departments, member checking, reflexivity, and qualitative research experts. Data were analyzed by thematic analysis. Results: It consists of 2 parts: 1) Development of university mechanisms to prevent, deter, and support students, and 2) Providing health services to care and help for students. Conclusions: The results of this research provide practical knowledge. However, the limitations need to be addressed in the implementation process. Recommendations are that University administrators should increase the integration and promotion of all elements of sexual health literacy to students. Student health centers should develop their competencies in providing counseling services to LGBTQ students. Policymakers should develop specific policies with student participation, and for future research, should explore integration models of all stakeholders and cross-university comparison research.

IntroductionThe transition from paediatric to adult healthcare marks a pivotal period for chronically ill adolescents, as they transition from a highly supportive and family-oriented environment to an adult-oriented and a more individual-oriented healthcare system that places a greater emphasis on personal responsibility and independence. Parents, given their firsthand experience managing their child’s healthcare, play a central role in ensuring a smooth and successful transition, yet their perspectives on the barriers and facilitators of this complex process remain vastly underexplored. This scoping review aims to assess and provide comprehensive insights into parents’ perceptions of the successes and challenges during their adolescents’ transition from paediatric to adult healthcare.Methods and analysisThis scoping review is led by patient partners and will be guided by the Peters et al and the Joanna Briggs Institute guidelines for scoping reviews. The preliminary search strategy will be developed and calibrated in Ovid MEDLINE and will be subsequently replicated in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychInfo, Embase, Web of Science and Sociological s from inception through 18 December 2024, including all types of studies. Grey literature sources recommended by patient partners and clinical and qualitative research experts will also be included. Two reviewers will independently perform the title and abstract review of all studies against the predefined inclusion and exclusion criteria, followed by the full-text review of included studies. The reference list of all included studies will also be screened to maximise the retrieval of relevant sources. Data will be extracted and analysed quantitatively and qualitatively, with the study procedural and reporting format following Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.Ethics and disseminationThis scoping review, through the broad and systematic mapping of existing literature, aims to provide a foundation for developing targeted support systems, strategies and interventions to address the unique needs and barriers faced by parents and caregivers of chronically ill adolescents during this critical transition to adult care.

Abstract Aim Patients with abdominal wall hernia (AWH) face significant psychological, and emotional challenges that impact their quality of life (QoL). The lived experiences of patients reveal substantial psychosocial burdens, including issues related to body image, interpersonal relationships, and mental health (Smith et al 2022). This project aimed to develop an evidence-based, patient-centred educational leaflet to address these challenges. Method The leaflet was informed by a qualitative study conducted by York Abdominal Wall Unit, using Interpretative Phenomenological Analysis (IPA) to explore the lived experiences of patients with AWH. Themes included body image, mental health, interpersonal relationships, symptoms, and employment. A collaborative approach between surgeons and the hospital’s psychology team integrated psychological insights with surgical expertise. Patient representatives from the British Hernia Society reviewed drafts. Plain English guidelines were followed to ensure readability (Flesch-Reading-Ease Score: 60–70). Results The leaflet included the following sections:Body Image and Self-Esteem: Summarizes key challenges, such as changes in self-perception and fears about others’ judgments.Interpersonal Relationships: Explores difficulties with social connections and intimacy.Emotional Responses: Highlights common emotions such as anxiety and depression, with relatable examples.Guilt and Self-Blame: Addresses feelings of responsibility and their emotional impact, emphasizing normalization.Coping Strategies: Provides practical advice grounded in psychological theory, including reframing negative thoughts, mindfulness, and seeking support. Conclusions This leaflet represents a multidisciplinary approach to addressing the psychosocial aspects of AWH. By combining insights from qualitative research, patient-centred design, and psychological expertise, it offers a low-resource, yet comprehensive support for individuals living with AWH.

Stroke is a leading cause of disability among older adults, with long-term effects on their independence and quality of life. In Thailand, while previous studies have explored aspects of post-stroke rehabilitation, there remains a gap in understanding how to effectively integrate healthcare services, community resources, and cultural practices into a comprehensive, sustainable rehabilitation model. This study aimed to explore community-based rehabilitation for older adults post-stroke in Thailand. An ethnographic research design was employed to examine community-based rehabilitation practices. Participants included 88 key informants, comprising older adults post-stroke (n = 21), family members (n = 24), local administrative officials (n = 7), healthcare professionals, caregiver representatives, public health volunteers, village/sub-district headmen (n = 12), community organization members (n = 15) and general informants (neighbors and relatives) (n = 9). Data collection methods included participant observation, in-depth interviews, group discussions, and document reviews conducted from May 2023 to August 2024. Content analysis was applied, with triangulation ensuring data validity. Findings were further confirmed by informants and qualitative research experts. Community-based rehabilitation for older adults post-stroke consisted of three interconnected domains: 1) Support Systems and Infrastructure, including family caregiver involvement, healthcare services, emergency care, community rehabilitation programs, and public services; 2) Social and Economic Support, encompassing community welfare initiatives, volunteer networks, financial stability measures, and legal protections; and 3) Administrative and Management Systems, comprising integrated planning for older adults, data and information management, welfare accessibility, and culturally embedded care approaches. These elements created a comprehensive and sustainable rehabilitation framework. The study highlights the importance of an integrated rehabilitation system that combines healthcare, socioeconomic support, and administrative mechanisms. Findings emphasize the need for advanced training in case management and coordination for community nurses and call for culturally sensitive rehabilitation protocols that merge traditional Thai healing practices with contemporary medical care. These findings align with global recommendations for sustainable rehabilitation and highlight the importance of culturally sensitive approaches. Strengthening formal and informal care networks can enhance rehabilitation outcomes and improve the quality of life for older adults post-stroke.

The active involvement of end users may overcome socio-economic, cultural and context-related barriers that may reduce health promotion effectiveness in type 2 diabetes control and prevention. The "Cardio-metabolic diseases in immigrants and ethnic minorities: from epidemiology to new prevention strategies" (DIABETHIC) project funded by the European Union through the Italian Ministry of Health includes a multicentre randomised controlled trial (RCT) aimed to assess the effectiveness of a co-created health promotion intervention for immigrants affected by type 2 diabetes. This protocol describes the co-creation process and methodological challenges in evaluating co-created health promotion interventions. Between November 2023 and July 2024, four Italian primary care centres will recruit 200 immigrants with type 2 diabetes that will be randomised to usual health promotion practice or to the experimental health promotion intervention developed through a participatory process. Endpoints are changes in glycated haemoglobin, Body Mass Index, diet, physical activity and therapeutic adherence at 12 months after recruitment. Qualitative research experts supported the participatory process at local and national levels. According to available evidence and recommendations, the participatory process focused on the three pillars of type 2 diabetes control (diet, physical activity, and therapeutic adherence). To co-create the intervention, interviews, focus groups and role-plays were conducted with patients and immigrants, healthcare workers and representatives of social services. Identified barriers were ranked according to priority and actionability. Given different health promotion practice in the four centres, the intervention was standardised by function (dietary counselling, culturally tailored information materials, access to cultural mediation, training in effective and reflective communication, individual and group meetings) rather than by form (operators involved, protocols and timeframes), which was defined locally by feasibility and by contrasting usual health promotion. (Trial registration: ClinicalTrials.gov ID NCT06131411).

Hai Phong City, an important coastal economic center in Northern Vietnam, possesses rich tourism resources, including natural landscapes, historical relics and cultural heritages. However, rapid urbanization, environmental degradation and unsynchronized infrastructure pose challenges to sustainable tourism development. This study aims to analyze the current status of tourism in Hai Phong, identify issues related to sustainability and propose strategic solutions for long-term development. Through qualitative and quantitative research methods, including surveys, expert interviews and policy analysis, the paper provides assessments of the environmental, economic and social aspects of sustainable tourism. The research results show that promoting ecotourism, improving management mechanisms and enhancing community participation are important factors to ensure the sustainable development of Hai Phong's tourism industry.

Background. Hepatocellular carcinoma (HCC) treatment decisions are becoming increasingly complex as new treatment options emerge. Improved understanding of tradeoffs and patient preferences in treatment decisions will enhance patient–provider discussions, improve treatment development, and inform HCC treatment guidelines. We performed a qualitative study involving patients with HCC and medical providers to assess the role of patient preferences in HCC treatment choices. Methods. Patient participants included those with HCC seen within a single tertiary care center. Provider participants involved physicians and advanced practice providers who cared for patients with HCC from a single center. Baseline and posttreatment patient interviews were conducted by trained qualitative research experts, informed by semi-structured interview guides, and analyzed using thematic analysis with pilot-tested codebooks. Summaries included a narrative description of the themes and subthemes that emerged related to each code, and illustrative quotes were used to highlight each theme. Results. The baseline interview involved 30 patients with HCC (22 of whom participated in follow-up interviews) and 10 providers who cared for patients with HCC. Patients identified factors considered when making treatment decisions included provider confidence and experience, patient prior cancer experiences, other health issues, and faith. Providers primarily discussed the role of Barcelona Clinic Liver Cancer stage, liver function, performance status, and eligibility of liver transplantation in making treatment recommendations. There was general agreement among providers that there is a need to better understand the role of patient values to improve care for HCC. Limitations. Qualitative interviews were limited to patients and providers from a single center. Conclusions. This qualitative study provided information on the variety of values considered by both patients and providers in HCC treatment decisions and the importance of considering tradeoffs of efficacy, toxicity, and inconvenience/costs.HighlightsHepatocellular carcinoma (HCC) treatment decisions are often complex and may become increasingly so as new treatment options emerge.Improved understanding of tradeoffs and patient preferences in treatment decisions will enhance patient–provider discussions, facilitate patient-centered trials to develop new treatments, and inform HCC treatment guidelines.This qualitative study of patients and providers provided information on the values considered in HCC treatment decisions and the importance of considering the tradeoffs of efficacy, toxicity, and inconvenience/costs.These insights can be used to develop preference elicitation tools, perform large-scale preference elicitation surveys, and systematically assess and incorporate patient preferences into treatment decisions.

Low libido is a common and potentially distressing problem among midlife and older women. We recently reported results from a pilot randomized controlled trial of a mindfulness intervention for midlife and older cisgender women with low libido; the purpose of this qualitative investigation is to illustrate women's experiences with being recruited for, enrolling in, and participating in the trial. We conducted individual interviews with a subset of trial participants, some of whom attended a group-based mindfulness intervention and some attended an educational control group (N = 25). We also interviewed participants who were enrolled but did not attend any groups (N = 9). A semi-structured interview guide was developed by the study team. A co-investigator with qualitative research expertise and the primary investigator conducted interviews, which were audio recorded and transcribed. We used a thematic analysis approach to analysis, co-coding a subset of interviews to develop and refine a codebook, then assigning codes to all data. Codes were grouped into subthemes and themes and key insights were extracted. Three key themes emerged from women who attended groups. First, women were interested in the intersection of sexuality and mindfulness. Second, women in both groups valued the sense of community they gained from participating; the interactive nature of sessions contributed to this. Third, experiences with attending groups over videoconferencing software were largely positive. Suggestions for improvement included a better explanation of the randomization process and more didactic information about sexuality and aging in both groups. Non-attendees listed time conflicts as their top reason for not attending. We recommend researchers consider utilizing a group format when designing behavioral interventions for midlife and older women, as this design offers many benefits for participants, but ensuring that a qualified professional is present can ensure information exchanges is evidence-based. In addition, healthcare systems can consider building in opportunities for midlife women to gather and exchange information regarding health.

В статье проанализированы перспективы развития якутского языка с учетом результатов качественных и количественных социологических исследований в Республике Саха (Якутия), проведенных в 2022 и 2023 годах. Предпринято сравнение с идентичными исследованиями, осуществленными в республиках Поволжья и Приуралья. Отмечаются схожие проблемные зоны в части стандартов образования, где превалирует русский язык, а также влияния процесса цифровизации, ведущей к усилению русского языка в билингвальной среде. Представлены мнения эксперов, касающиеся использования эффективных инструментов по сохранению и развитию языков, в частности, дана оценка работе СМИ и медиа на якутском языке в цифровой среде. Сравнивая результаты количественных (мониторинговые опросы) и качественных (экспертное интервью и фокус-группы) исследований, проведенных в Республике Саха (Якутия), также выявлено влияние цифровизации на языковые процессы. Экспертное сообщество обозначает беспокойство языковой компетенцией подрастающего поколения, что подтверждается уровнем владения родным якутским языком детьми-саха. По результатам опроса, 20% родителей оценивают уровень знания якутского языка своими детьми на «удовлетворительно». При этом 10% детей-саха вообще «не знают» родного языка или владеют им «неудовлетворительно». Отмечается, что контент на национальных языках на данный момент не конкурентоспособен с преобладающими русским и английским языками в Интернете, объемы его недостаточны для влияния на языковой процесс. Авторы считают, что при достаточной государственной поддержке СМИ на национальных языках, использования этноблогеров возможно развивать национальные языки в цифровой среде. Отмечается, что стандарты общего образования снижают мотивацию к изучению родного языка. Авторы предлагают обеспечить эту мотивацию посредством сдачи экзаменов (ОГЭ и ЕГЭ) на родных языках. Кроме того, предлагается обеспечить выпуск учебников нового поколения для изучения якутского языка с учетом современных методологических требований. Экспертами отмечается отсутствие паритета между языками – русским и якутским – хотя законодательная база оценивается положительно. Вместе с тем, как показывают фокус-группы, ситуация с паритетностью развития двух государственных языков в РС (Я) в различных экономических зонах Якутии отличается специфичностью. Количественные и качественные социологические исследования выявили, что число саха-билингвов в якутском социуме достаточно велико (примерно 40-45% и, возможно, даже гораздо больше). Можно предположить, что эта группа будет в дальнейшем достаточно перспективной в плане установления паритетного функционирования языков. The article analyses the prospects of Yakut language development taking into account the results of qualitative and quantitative sociological research conducted in the Republic of Sakha (Yakutia) in 2022 and 2023. A comparison with identical studies carried out in the Volga and Urals republics is made The analysis highlights common problematic areas concerning educational standards, where the Russian language predominates, as well as the impact of digitalization processes that contribute to the strengthening of the Russian language within bilingual environments Expert opinions regarding effective tools for the preservation and development of languages are presented, particularly evaluating the role of media and journalism in the Yakut language within the digital landscape. Comparing the results of quantitative (monitoring surveys) and qualitative research (expert interviews and focus groups) conducted in the Republic of Sakha (Yakutia), the impact of digitalisation on language processes is also revealed. The expert community is concerned about the linguistic competence of the younger generation, as evidenced by the level of proficiency of Sakha children in their native Yakut language. According to survey results, 20% of parents rate their children’s knowledge of the Yakut language as ‘satisfactory’, while 10% of Sakha children ‘do not know’ their native language at all or have an ‘unsatisfactory’ command of it. It is noted that content in national languages is currently not competitive with the predominant Russian and English languages on the Internet, with insufficient volume to influence language processes. The authors believe that with sufficient state support for media in national languages and the engagement of ethno-bloggers, it is possible to promote national languages in the digital environment. It is noted that the standards of general education reduce the motivation to learn the native language. The authors propose to ensure this motivation through examinations (United State Exams – EGE and OGE) in native languages. In addition, it is suggested that a new generation of textbooks be produced for the study of the Yakut language, taking into account modern methodological requirements. Experts note the lack of parity between Russian and Yakut languages, although the legislative framework is positively assessed. However, focus groups reveal that the situation regarding the parity of development between the two state languages in the RS (Y) varies across different economic zones of Yakutia. Quantitative and qualitative sociological research has shown that the number of Sakha bilinguals within Yakut society is quite substantial (approximately 40-45%, and possibly even more). It can be hypothesized that this group will be promising for establishing a parity in language functioning in the future.

This study examined the phenomenon of prelicensure nursing students caring for culturally diverse patients. Individual interviews were conducted with undergraduate nursing students using a hermeneutic phenomenological approach. Qualitative research experts conducted the interviews, transcribed the data, and followed van Manen's methodology for analysis. Eleven nursing students participated in the study. Data were collected from April to August 2022. The average length of the student interviews was 32 minutes. Four themes were identified: (1) communication issues; (2) access to care; (3) nurse background; and (4) trust and respect. This study highlights the importance of caring for culturally diverse patients. Policymakers and health care leaders can use the findings to support legislative proposals for enhancing culturally diverse patient safety and health equity. Based on these findings, nurse educators and preceptors can adapt their clinical teaching approaches accordingly, and nurse managers can benefit from the results when hiring new graduate nurses. [J Nurs Educ. 2024;63(6):373-379.].

In this paper, I have used qualitative research methods, including interview and expert opinion, to analyse viewership patterns in young adults in India towards Cinema of the country and Hollywood. Factors such as visual aesthetics, sociability, relatibility, and marketing, among others are few that find description, and how they influence preferences of young adults today. With the listed results, I aim to comment on the debate whether Indian audiences are moving away from Indian cinema to Hollywood. If any leaning is found towards Hollywood, I attempt to explore a possible connection of the same with the idea neo-colonial lineage of viewership in India. In addition to the research question, this paper will also answer: Do people watch Hollywood because they see Indian cinema as a copy? Is there a charm of ‘westernization and progressive thought’? How does the narrative tie to parallel cinema? I have studied a group of undergraduate students in Sonipat for this paper, which are not necessarily representative of the mass young adults in India. The differences, in relevance with my research question, also find description in this paper.

BackgroundA specialty training program is crucial for shaping future specialist doctors, imparting clinical knowledge and skills, and fostering a robust professional identity. This study investigates how anesthesiologists develop their professional identity while navigating unique challenges specific to their specialty. The formation of professional identity in anesthesiology significantly influences doctors’ well-being, teamwork, and ultimately patient care, making it a crucial aspect of anesthesiology education. Utilizing a phenomenographic approach, the research explores the learners’ personal experiences and perspectives of professional identity formation in their specialty training programs, providing valuable insights for enhancing future anesthetic educational programs.MethodThe data for this phenomenographic study were collected through semi-structured interviews with anesthesiology trainees and specialists, guided by open-ended questions. The interviews were conducted at a Swedish university hospital, and participant selection used purposive sampling, providing rich and diverse data for analysis after 15 interviews. Iterative analysis followed the seven-step phenomenographic approach. The research team, comprising qualitative research and anesthesiology education experts, ensured result validity through regular review, discussion, and reflective practices.ResultsThe study reveals three fundamental dimensions: ‘Knowledge of Subject Matter,’ ‘Knowledge of Human Relations,’ and ‘Knowledge of Affect.’ These dimensions offer insights into how anesthesiologists comprehend anesthesiology as a profession, navigate interactions with colleagues and patients, and interpret emotional experiences in anesthesiology practice – all crucial elements in the formation of professional identity. The findings could be synthesized and further described by three conceptions: The Outcome-Driven Learner, the Emerging Collaborator, and the Self-Directed Caregiver.ConclusionThe study uncovers differing learner understandings in the development of anesthesiologists’ professional identity. Varying priorities, values, and role interpretations highlight the shortcomings of a generic, one-size-fits-all educational strategy. By acknowledging and integrating these nuanced learner perspectives, as elucidated in detail in this study, the future of anesthesia education can be improved. This will necessitate a holistic approach, intertwining both natural sciences and humanities studies, focus on tacit knowledge, and flexible teaching strategies, to guarantee thorough professional development, lifelong learning, and resilience.

Ethics committees ensure compliance with ethical principles in medical research. They are oriented towards clinical studies, but also review e. g., qualitative research. Using a semi-structured online survey, we collected data on experiences of qualitative researchers with the review by ethics committees and analysed them via content analysis. In July 2019, 73 researchers took part in the survey. Five main topics were derived from their statements regarding the ethics review of qualitative research: 1. relevance of qualitative research expertise; 2. cooperation between researchers and ethics committees; 3. transparency of review criteria; 4. dealing with formal review requirements; 5. evaluation of the review's significance for qualitative research. The results show the potential of ethics review for reflection on ethical questions in qualitative research. Prerequisites for this are the fit with the characteristics and quality criteria of qualitative research, the presence of qualitative research expertise in ethics committees, the transparency of the ethics review process as well as openness to different professional cultures and a constructive communication culture.

Through the use of a survey and statistical methods, this study explores the effects and interventions of handheld Tai Chi water resistance fitness balls on the elderly with Parkinson's disease. Firstly, a questionnaire on exercise compliance for patients with Parkinson's disease was developed, and its reliability and validity were tested. Then, a survey was conducted to investigate the current status of exercise compliance among Parkinson's disease patients, including general information, scoring status, and single and multiple factor analyses of influencing factors [1]. The results of the study show that through qualitative research, the dimensions and item pools of the questionnaire were initially constructed, and the reliability analysis of the questionnaire was conducted through Delphi expert consultation, with favorable results in terms of its reliability and validity [2]. Regarding the current status of exercise compliance among Parkinson's disease patients, the study found that the level of exercise compliance needs improvement, and there are significant differences in exercise compliance levels among patients under different circumstances. Finally, the research results were discussed and conclusions were drawn. The innovation of this study lies in the development of a questionnaire on exercise compliance for patients with Parkinson's disease and the preliminary qualitative research and Delphi expert consultation conducted on it, providing new ideas and methods for the study of exercise compliance. However, the study also has limitations as it did not examine the effects of other interventions on Parkinson's disease, therefore further research should be conducted [3].

To understand medical interpreters' perspectives on surgical informed consent discussions and provide feedback for surgeons on improving these conversations. Informed consent is a critical component of patient-centered surgical decision-making. For patients with limited English proficiency, this conversation may be less thorough, even with a medical interpreter, leaving patients with an inadequate understanding of their diagnosis or treatment options. A semistructured interview guide was developed with input from interpreters and a qualitative research expert. We purposively sampled medical interpreters representing multiple languages until thematic saturation was achieved. Participants discussed their experience with the surgical consent discussion and process. Interview transcripts were analyzed using emergent thematic analysis. Among 22 interpreters, there were 10 languages represented and an average experience of 15 years (range: 4-40 yr). Four major themes were identified. First, interpreters consistently described their roles as patient advocates and cultural brokers. Second, interpreters reported unique patient attributes that influence the discussion, often based on patients' cultural values/expectations, anticipated decisional autonomy, and family support. Third, interpreters emphasized the importance of surgeons demonstrating compassion and patience, using simple terminology, conversing around the consent, providing context about the form/process, and initiating a pre-encounter discussion. Finally, interpreters suggested reducing legal terminology on consent forms and translation into other languages. Experienced interpreters highlighted multiple factors associated with effective and culturally tailored informed consent discussions. Surgeons should recognize interpreters' critical and complex roles, be cognizant of cultural variations among patients with limited English proficiency, and improve interpersonal and communication skills to facilitate effective understanding.

BackgroundInjuries are a leading cause of death and disability for Alaska Native (AN) people. Alaska Native Tribal Health Consortium (ANTHC) is supporting the development of a burn care system that includes a partnership between Alaska Native Medical Center (ANMC) in Anchorage, AK and UW Medicine Regional Burn Center at Harborview Medical Center (HMC) in Seattle, WA. We aimed to better understand the experiences of AN people with burn injuries across the care continuum to aid development of culturally appropriate care regionalization.MethodsWe performed focus groups with twelve AN people with burn injury and their caregivers. A multidisciplinary team of burn care providers, qualitative research experts, AN care coordinator, and AN cultural liaison led focus groups to elicit experiences across the burn care continuum. Transcripts were analyzed using a phenomenological approach and inductive coding to understand how AN people and families navigated the medical and community systems for burn care and areas for improvement.ResultsThree themes were identified: 1-Challenges with local burn care in remote communities including limited first aid, triage, pain management, and wound care, as well as long-distance transport to definitive care; 2-Divergence between cultural values and medical practices that generated mistrust in the medical system, isolation from their support systems, and recovery goals that were not aligned with their needs; 3-Difficulty accessing emotional health support and a survivor community that could empower their resilience.ConclusionParticipants reported modifiable barriers to culturally competent treatment for burn injuries among AN people. The findings can inform initiatives that leverage existing resources, including expansion of the Extension for Community Healthcare Outcomes (ECHO) telementoring program, promulgation of the Phoenix Society Survivors Offering Assistance in Recovery (SOAR) to AK, coordination of regionalized care to reduce time away from AK and provide more comfortable community reintegration, and define rehabilitation goals in terms that align with personal goals and subsistence lifestyle skills. Long-distance transport times are non-modifiable, but better pre-hospital care could be achieved by harnessing existing telehealth services and adapting principles of prolonged field care to allow for triage, initial care, and resuscitation in remote environments.

Background: Talking about personal olfactory experiences is challenging because subjective, often latent reactions to odor are difficult to perceive and express. In qualitative empirical research on the effects of Aromatherapy (AT), this issue needs to be considered in data collection. Therefore, we developed a new data-collection method to support participants in perceiving and articulating their own olfactory experiences. The method development was embedded in the background study arth4WOMEN about AT for women with gynecological cancers. Method: The data-collection method was developed in five steps inspired by A rts-informed R esearch (AIR) and Creative Writing (CW). A workshop on scent and writing was conceptualized for an existing CW course ( n = 8) (step 1). The findings were condensed (step 2) into the new data-collection method called the Olfactory Journey (OLFJ), then pilot tested, discussed with qualitative research experts and adapted (step 3). The final version of the OLFJ was carried out with 15 participants of the background study arth4WOMEN as one part of a qualitative interview concept (step 4), then analyzed via qualitative content analysis (step 5). Results: The analysis of the workshop showed that pictures can be a useful tool to focus on olfactory experiences and find words to express them. Thus, in the OLFJ inner visuals were stimulated by an olfactory trigger and brought into focus through a guided instruction. The inner visuals were used as a tool to talk about the olfactory experiences. The resulting descriptions were characterized by many pictorial associations and marked by contrasts and comparisons. Discussion: The OLFJ as a data-collection method has potential to support participants in their verbal expressions of their olfactory experiences. The inclusion of creative art forms in the development process of the OLFJ was helpful and should be encouraged in future research. Further research is needed to test OLFJ validity and reliability.

Background The think-aloud (TA) approach is a qualitative research method that allows for gaining insight in thoughts and cognitive processes. It can be used to incorporate a respondent’s perspective when developing resource-use measurement (RUM) instruments. Currently, the application of TA methods in RUM research is limited, and so is the guidance on how to use them. Transparent publication of TA methods for RUM in health economics studies, which is the aim of this paper, can contribute to reducing the aforementioned gap. Methods Methods for conducting TA interviews were iteratively developed by a multi-national working group of health economists and additional qualitative research expertise was sought. TA interviews were conducted in four countries to support this process. A ten-step process was outlined in three parts: Part A ‘before the interview’ (including translation, recruitment, training), Part B ‘during the interview’ (including setting, opening, completing the instrument, open-ended questions, closing), and part C ‘after the interview’ (including transcription and data analysis, trustworthiness). Conclusions This manuscript describes the step-by-step approach for conducting multi-national TA interviews with potential respondents of the PECUNIA RUM instrument. It increases the methodological transparency in RUM development and reduces the knowledge gap of using qualitative research methods in health economics.