Data Saturation Research Articles

Data saturation in qualitative research: A literature review in entrepreneurship study from 2004–2024

This systematic literature review examines data saturation in qualitative research within the context of entrepreneurship studies from 2004 to 2024. Data saturation, a critical concept in ensuring the rigor of qualitative research, remains inadequately defined in terms of sample size and assessment criteria across various studies. This review synthesizes 11 empirical studies, focusing on strategies such as stopping criterion, code frequency counts, and comparative methods for determining saturation. It identifies sample sizes ranging from 7 to 39 interviews, with an average saturation occurring between 10 and 12 interviews. Furthermore, the study explores the influence of different sampling methods and homogeneity of study populations on saturation outcomes. Despite the reliability of existing methods, the findings underscore the need for greater transparency and consistency in reporting saturation criteria. The review offers valuable insights for entrepreneurial researchers aiming to design qualitative studies, emphasizing the importance of tailored saturation standards based on research objectives and methodologies. This research contributes to a clearer understanding of data saturation in entrepreneurial studies and highlights the necessity for further empirical investigation into saturation across diverse qualitative methods.

Self protective health care in childhood cancer survivors from the perspective of survivors, parents, and professionals: a qualitative study

IntroductionChildhood cancer survivors experience many health problems that they must protect themselves from their destructive physical and psychological effects. Understanding experiences of children about self-protective care will help health care providers manage long-term care plans. Therefore, this study was conducted with the aim of exploring self-protection care in childhood cancer survivors.MethodsThis is a phenomenological study that was conducted in the clinics and cancer care centers of Urmia and Khoy in Iran. 27 participants were selected by purposive sampling until data saturation. The data was collected using a semi-structured and in-depth face to face interview. Content analysis approach used for data analysis and MAXQUDA 10 software used for data management.ResultsData analysis led to the emergence of “self-protection health care” as a main category, two categories “maintaining physical health” and “keeping a strong mindset” and 9 sub-categories including “abstain activities that may cause harm”, “refusing contact with others for possible infection”, “monitoring symptoms and side-effects of cancer coming back”, “avoiding unhealthy diet”, “knowing about cancer from similar others”, “keep away negative thoughts and emotions”, “drawing on spiritual resources”, “creating a bridge to life again” and “being healthy for the sake of one’s family”.ConclusionAccording to the results of this study, self-protection is one of the most important cares for childhood cancer survivors. Over time, the influence of the clinical team and parents on children’s health care diminishes. Therefore, they should promote their health and well-being behaviors and use a variety of protective approaches to self-care.

Role of traditional healers in the management of microbial keratitis in eastern Nepal

Background Microbial Keratitis (MK) is a leading cause of corneal blindness due to infection and its consequences, with a higher incidence in resource-limited nations. Hospital-based patient records from different parts of Nepal suggest patients often use traditional eye medicine to treat MK. Traditional healers (TH) within the community are often the first point of care for MK management. Little is known of their practice, perceptions, and knowledge around MK management. We aimed to understand the role of traditional healers in the management of MK in south-eastern Nepal. Methods A cross-sectional, mixed method, descriptive study was conducted in the Siraha district of Nepal. A total of 109 traditional healers consented to participate in a survey of knowledge, attitude, and practices. Some participants were also invited to participate in in-depth interviews and focus group discussions. Interviews and focus groups were conducted and recorded in the Maithili language by a native speaking interviewer and transcribed into English. Descriptive analysis was performed for the survey. Data saturation was considered the endpoint for qualitative data collection, and a thematic was analysis applied. Results Traditional healers believe that infection of the eye can be caused by trauma, conjunctivitis, or evil spirits. They were unclear about differentiating MK from other eye conditions. They provided various types of treatment. Some were confident that they could treat severe ulcers that had not responded to medical therapy, while others thought treating larger diameter ulcers would be difficult. Although there were mixed responses in referring patients with MK, the majority of TH were willing to refer. Conclusion In a weak health system, traditional healers may help address barriers to healthcare access and reduce delays to definitive care, upon integration into the formal health system and referral pathway.

Validation of the Comprehensive and Brief International Classification of Functioning, Disability and Health Core Sets for Schizophrenia from the Perspective of Individuals Diagnosed with the Disorder: A Worldwide Study Using Focus Groups

The comprehensive and brief International Classification of Functioning, Disability and Health (ICF) core sets for schizophrenia, based on the World Health Organization (WHO) framework, aim to describe the functioning of individuals with schizophrenia. The objective of this study was to identify the most common problems faced by these individuals and validate the ICF core sets. Eight focus groups were conducted, recorded, and transcribed verbatim. The linking process involved two independent coders identifying meaningful units and linking agreed-upon concepts to the ICF categories. Data saturation was defined as the point at which no new categories emerged from additional focus groups. The 37 participants in this study represented the WHO regions of Africa, South-East Asia, the Western Pacific, and Europe. The focus groups confirmed the relevance of all ICF core set categories, with an additional 21 second-level categories being proposed in at least six of the eight focus groups. In this study, the ICF core sets for schizophrenia were validated from the perspective of individuals. However, several second-level categories not currently included in the ICF core sets also emerged. To ensure that the ICF core sets are truly international in scope, the potential relevance of these categories should be investigated further.

Organizational silence and hidden threats to patients' dignity with schizophrenia: A qualitative study.

Maintaining patients' dignity is a key ethical requirement in healthcare and is emphasized in nursing standards. This issue is particularly significant for patients with schizophrenia because they face unique challenges such as physical and psychological difficulties, dependence on others, and social isolation, making them more vulnerable. Organizational factors can either threaten or preserve their dignity. However, there is little knowledge in this domain within the sociocultural context of Iran. This study aimed to explore the role of the healthcare organization in the dignity of patients with schizophrenia, based on the opinions of patients, healthcare personnel, and family caregivers. This qualitative study was conducted with 26 participants (16 patients, 4 family caregivers, 2 nurses, 3 psychologists, and 1 service worker) who were selected using a purposeful sampling method. The data were collected through semi-structured, in-depth face-to-face interviews until data saturation was reached. The data were analyzed via Graneheim and Lundman's method. The study protocol was approved by the Research Ethics Committee of Urmia University of Medical Sciences (IR.UMSU.REC.1401.099). Based on data analysis, participants reported the three following challenges as organizational hidden threats to patients' dignity: "Lack of facilities," "premature management," and "ineffective communication." The study findings indicated that the healthcare organization does not support the dignity of patients. Management inefficiency and lack of facilities are evident in psychiatric hospitals, and healthcare centers are not monitored based on standard criteria. Limited interactions between healthcare personnel and patients were identified as the main reasons for the neglect of patients with schizophrenia and the violation of their dignity. The results of this study can help healthcare policymakers in designing and implementing effective programs to preserve the dignity of patients with schizophrenia.

Unsafe termination of pregnancy where abortion is illegal: A Botswana context-specific study

Unsafe pregnancy termination contributes to morbidity and mortality among women globally. Despite Botswana's restrictive abortion laws, women continue to use unsafe abortion methods. This study aimed to explore factors that contributes to unsafe termination of pregnancies in Ngami sub-district, Botswana. A qualitative descriptive and exploratory research approach, using a phenomenological design, was applied. Semi-structured in-depth interviews were conducted with women admitted to the gynecological ward from June to August 2021. Data saturation was reached with the 12th participant. Data was analyzed thematically. The study revealed two major themes: factors contributing to unsafe abortions, and interventions to reduce unsafe abortions. The study underscores the global issue of unsafe abortion that leads to high morbidity and mortality, and long-term complications. An overall recommendation is for Botswana to reconsider its abortion law and aim to prevent unsafe abortions and reduce healthcare costs.

Pengaruh Alam dan Budaya dalam Pembentukan Makanan Tradisional di Lembah Lenggong, Perak

Traditional food is a valuable asset inherited from one generation to another. The formation of this traditional food in a specific district or country is influenced by various factors such as natural environment, cultural intermingling, political boundaries and local genius. As a result, the background and characteristic of traditional food can reflect the community’s origin, culture and identity. Despite that, research on the formation of traditional food is seemingly limited, particularly in rural areas. This phenomenon is due to the lack of appreciation of traditional food among the community especially the young generation. Thus, this study aims to understand the formation of traditional food in Lenggong Valley based on the influence of nature and culture. A qualitative research design was used in this study. The data was collected through semi-structured interviews, and purposive sampling technique was employed by the researchers. A total of 10 informants were involved in this study comprising Lenggong traditional food experts and entrepreneurs. In addition, snowball sampling technique was used to achieve data saturation. To validate the findings from semi-structured interviews, participant observations were also executed by the researchers. Several places were visited such as traditional food restaurants, events and homestays to conduct the observations. Findings for this study have concluded into two themes namely, (1) Lenggong traditional food based on the availability of natural resources; and (2) the influence of culture diversity in the formation of Lenggong traditional food. This study explores the formation process of Lenggong traditional food that is influenced by the natural environment and cultural diversity, in which the influence of both explains the ingenuity of the past people in crafting various types of food which can still be tasted until today. Findings for this study encourage the current generation to preserve and sustain this intangible heritage for the next generations to come. Beside inheritance, the uniqueness and differences of Lenggong’s traditional food connote a potential that can also be benefited as a tourist attraction.

Nurses’ experiences in neonatal sepsis prevention and management: a qualitative cross-sectional study at selected hospitals in a metropolitan area

BackgroundNeonatal sepsis represents a significant cause of morbidity and mortality among infants in healthcare settings. This study explored nurses’ experiences in preventing and managing neonatal sepsis in the Tamale metropolis.MethodsAn exploratory, descriptive qualitative cross-sectional study design was used, and data was collected using semi-structured interviews. The sample size was determined at the point of data saturation of fifteen participants. Thematic analysis was employed to identify codes, subthemes, and themes within the interview transcripts.ResultsThree major challenges nurses face in preventing and managing neonatal sepsis, including (1) the absence of a protocol for handling newborns upon admission, (2) an excessive workload that made it difficult for staff to follow infection prevention protocols, and (3) inadequate, obsolete and/or lack of equipment that caused devices to be overused. The nurses also identified critical psychological and emotional difficulties they encounter as a result of working within such a stressful environment. Other activities nurses conducted were handwashing before and after every procedure, infection prevention, and separating the babies in the incubator. In managing babies with neonatal sepsis, nurses provided daily treatment, hygiene care, and supported activities of living. The nurses also assert that the availability of resources, appropriate staff, and critical skills are important for preventing and managing neonatal sepsis.ConclusionThe lack of basic working consumables like gloves, syringes, and needles, inadequate staff, and lack of defined protocol of care were identified as critical challenges that hamper the care provided in neonatal care units. Hospital authorities must focus attention on addressing the critical challenges faced by neonatal care units. Also, measures should be instituted to address the emotional and psychological concerns associated with nursing care. Future research must consider the level of influence of each of the challenges enumerated on nurses’ overall health.

Data dashboards in health inequalities monitoring - A qualitative study of subnational policy-makers

Abstract Background Despite sustained improvements in life expectancy and health during past decades, substantial health inequalities persist. Subnational jurisdictions are increasingly recognised for their pivotal role in addressing health inequalities. While data dashboards offer a promising solution for monitoring health inequalities, their utilisation in supporting local policies to reduce inequalities remains largely unexplored. This study examines the utilisation of health equity data and data dashboards (i.e. Sotkanet, Sotekuva, Tietotarjotin and Hyvinvointivajemittaristo) for health policy-making in Finnish wellbeing services counties, identifies barriers in using existing dashboards and determines the data needs for improved health inequalities monitoring. Methods A qualitative case study design with reflexive thematic analysis will be used. The study will be pre-registered in the OSF framework. Semi-structured interviews will be conducted with policy-makers involved in health policy development. Data analysis will involve open and axial coding to identify themes in participants’ responses. Themes will be organised into a coding framework, and the analysis will continue iteratively until data saturation is achieved. The study will include a pre-approved interview guide and peer debriefing sessions. Findings will be reported according to the Consolidated criteria for reporting qualitative research (COREQ) guidelines, with thematic diagrams illustrating key themes and sub-themes. The study is expected to reveal varying levels of utilisation of data and data dashboards among local policymakers, along with specific challenges and gaps in their current use. Policymakers may express needs for additional data or new features in dashboards to better monitor health inequalities. The study will conclude with recommendations for improvements in current data dashboards. Work is under development but by funders requirement the results will be ready by November 2024. Key messages • Data dashboards offer a promising solution for monitoring health inequalities, but their utilisation in supporting local policies to reduce inequalities remains largely unexplored. • This study examines the utilisation of data dashboards for health policy-making subnationally, identifies barriers for use and determines the data needs for improved health inequalities monitoring.

The potential of non-clinical guidance alongside e-mental Health to overcome non adherence

Abstract Background Mental health problems account worldwide for over an eighth of the global burden of disease and waiting lists nowadays are commonplace. E-Health has potential to reduce mental illness, whilst waiting for therapy or as a stand alone. A big problem with implementation of E-health in clinical practice is non adherence. Non-clinical guidance could make a difference as compared to the non guidance modus. Our research question is: what factors contribute to the potential of non-clinical guidance in overcoming non adherence for e-mental Health for patients with depressive, anxiety and stress symptoms? Methods We did a qualitative study in a Dutch general practice. The treatment consisted of several modules accompanied by non-clinical guidance by a healthcare assistant. Out of 190 invited patients, 31 patients participated. Eight weeks after being invited, 11 semi-structured interviews were conducted until data saturation. Thematic analysis was used with open, axial and selective coding. Results Three major themes emerged: 1) The patients were satisfied with the non-clinical guidance in almost all aspects: Negative comments arose from an urge for more contact or tailoring. 2) The form of the guidance (e.g. non-clinical; used interface) was subordinate to the amount and tailoring of it. 3) Adherence could further be improved through a more personal introduction, explaining the benefits of certain exercises and more time management. Conclusions The potential of non-clinical guidance in overcoming non adherence for e-mental Health can be improved by further tailoring and increasing the interactivity when needed. Further research is also needed, after the suggested improvements, whether the intervention is effective, compared to a therapist guided and a non guided version. This study needs to be repeated in other clinical settings. Key messages • Non-clinical guidance, alongside e-mental health has potential to help with non adherence, thereby decreasing the burden of waiting lists. • Non-clinical guidance was positively received by patients who received e-mental health, although further tailoring could make online treatment even a larger success.

The evaluation of an eHealth tool to prevent and alleviate migraine complaints in adults

Abstract Background Migraines attacks cause great suffering in individual patients. There is great unfulfilled potential to increase patients’ knowledge about various personal triggers and subsequent treatments. The objective of this study is to pilot test an e-Health tool that aims to increase migraine patients’ knowledge. It takes into account personal preferences and contributes to informed decision-making in choosing the appropriate method. Considering the shortage of primary care physicians and other health care providers, such an e-Health tool could be of great value. Methods lessmigraine.nl consists of a website with information plus an electronic decision aid. It was evaluated on its content, development process and effectiveness, and its contribution to the patients’ empowerment process. A first round of usability testing was done using semi-structured interviews and thematic analysis with 12 patients from a Dutch General Practice until data saturation. After minor improvements to the e-tool, in a first implementation step subsequently 85 patients used the e-tool. Results Patients’ expectations were exceeded in terms of the content of the e-Health tool, as all patients discovered new potential migraine triggers. Most patients found the tool effective in the sense that it provided enough information to decide on an appropriate treatment. The implementation was successful in the sense that all 85 participants completed the e-tool. Most important triggers were stress, sleeping problems, changes in weather and flickering or bright light. Conclusions The majority of the migraine patients were satisfied with the e-Health tool. It enlarged their knowledge of prevention and treatment options and therefore empowered them in their decision-making process and communication with their GP. Other aspects of implementation need to be studied. This study needs to be repeated in other clinical settings. Key messages • Migraines cause great suffering in individual patients: Considering the shortage of primary care physicians and other health care providers, an e-Health tool could be of great value. • The e-Health tool increases patients’ knowledge about migraine, including personal triggers and subsequent treatments.

Exploring the multiple dimensions of perceived food access in the local food environment

Abstract Persons in socioeconomically disadvantaged situations (PSEDs) are more susceptible and disproportionally exposed to unhealthy food environments, resulting in poorer dietary outcomes. Food access plays an important role within the wider food environment. This qualitative paper explores the context-specific relationships between the dimensions of perceived food access within the local food environment among PSEDS. 23 participants were recruited through purposeful convenience sampling until data saturation was achieved in two municipalities in Flanders, Belgium. Utilizing the photovoice and photo-elicitation method, participants expressed their perceptions of food access within their local food environment and its role in their eating behaviour, both individually (n = 16) and in group (n = 7). Applying the access framework to our analysis, the dimensions of perceived food access among PSEDS were divided into the personal (acceptability and convenience), perceived external (accommodation and desirability) or both personal and perceived external (awareness, availability, accessibility and affordability) domain. Our results suggest that awareness (e.g. of local opportunities available) precedes the other dimensions and that affordability is related to all dimensions among PSEDs. This study underscores the importance of perceived food access in healthy eating among PSEDS. The identified food access dimensions can inform policy, urban planning and community-based interventions to promote equitable access to healthy food. Key messages • Understanding perceived food access is essential to identify ways in which inequalities in food access can be addressed. • Perceived food access interacts between external and personal domains.

Development of a novel Patient-Reported Outcome Measure (PROM) for adults with an Inherited Cardiac Condition (ICC)

Abstract Background Research on the quality-of-life (QoL) among patients with inherited cardiac conditions (ICC) is limited. Existing evidence from a systematic review indicates that most studies rely on generic measures of health-related QoL, which may not adequately capture ICC-specific factors. The current study aims to develop a disease-specific patient-reported outcome measure to address this gap. Methods Using a qualitative study design, we first conducted focus groups until data saturation was achieved (n=15). Additionally, an expert panel of healthcare professionals was interviewed to ascertain their perspectives on patient-centered care and to evaluate face validity. Transcripts of all focus groups and interviews were analyzed thematically using Atlas.ti, qualitative analysis software, to identify concepts and formulate survey items for the initial instrument. We used the ‘Centre for Health Promotion’ QoL model, consisting of three domains- Being, Belonging, and Becoming- as the theoretical framework for our analysis. Results Our analysis revealed alignment with specific QoL domains of the overarching framework and identified a gap in genetic-specific domains. A novel overarching theme, genetic well-being, was identified, encompassing specific constructs related to future uncertainty, reproductive concerns, and the anticipation of disease development, thus enriching the conceptualization of QoL in the context of inherited cardiac conditions. The discussion will include an exploration of the face validity of the draft instrument. Conclusion Patients diagnosed with an inherited cardiac condition (ICC) face a spectrum of challenges originating from both disease-related stressors and hereditary factors alike. Recognizing that relying solely on objective clinical assessment may fail to capture the full impact of the disease, there has been an increasing focus on incorporating patient-reported measures into disease evaluation. This qualitative study contributes to developing a comprehensive patient-reported outcome measure tailored to individuals with ICC.PROM development study

Work context and drinking behavior in the French public service: a qualitative study

IntroductionAlcohol use disorders (AUD) are a major public health problem. Among the working population, alcohol is the most frequently used psychoactive substance, as well as the most inappropriately used. Alcohol consumption reduces the worker’s psychophysical integrity, leads to an increase in inappropriate behavior, accidents and injuries, and affects the safety and health of other workers. Thus, the workplace must play an essential role in prevention. Particularly in France, in the civil service, a specific professional sector made up of many professionals exposed to stress, the prevention of AUD must play an essential role. The objective of this study was to describe the framework of alcohol consumption in the French public service in order to understand the sources of alcohol consumption behaviors and to identify the prevention measures to be implemented, in order to reduce the risk of transition to an alcohol use disorder.MethodsThis descriptive qualitative study was based on focus groups. Sampling was purposive and data saturation was verified. Coding was “in vivo,” descriptive and pattern-oriented. Analysis was inductive thematic, and the COREQ guidelines were followed.ResultsFirstly, the presence of alcohol in the workplace has been characterized by a before-and-after a prohibition law, and by the revelation of mechanisms for avoiding the ban. Then, the three main determinants for alcohol use disorders were: society, work and personal factors. Lastly, the prevention initiatives identified must be based on both collective and individual approaches. They must be encouraged by the hierarchy, include screening, accompaniment to care, and take into account both work in the workplace and work at home. The fight against work-related alcohol use disorders must be part of the corporate culture.DiscussionPreventing alcohol-related disorders among civil servants will help fight the burden of non-communicable diseases.

Overcoming non-usage of e-mental health: A qualitative study in a Dutch general practice

Abstract Background Worldwide percentages of people with mental health problems are substantial and increased during the COVID pandemic (to about 25 % in the general population). E-mental health has potential to help with waiting lists, rising health care costs and work pressure. To reach the desired effects, participants need to use the technology as intended. Non-usage though is a common problem. Research question is: what elements obstruct the intention to use e-mental Health interventions, plus what are barriers to bridging the intention-behaviour gap? Methods In a qualitative study, semi-structured interviews were conducted (interview guide). We recruited patients who were invited for an e-mental health intervention in a Dutch general practice but did not start the intervention. Data saturation occurred with 11 patients. Open, axial and selective coding was done on the transcribed interviews using the software ATLAS.ti. Results Five main themes were associated with non-use: 1) ‘Expectations about the eHealth in general’ were neutral to positive. 2) ‘thresholds to start e-mental health’ were: negative expectations about the content, lacking mental capacity due to mental problems, missing personal contact, the therapy with the mental health professional in general did not fit their needs or aversion towards more screen time. 3) ‘lack of planning’. 4) lacking encouragement from mental health professional 5) ‘Expectations from therapy in general’. (a.o. face-to-face contact and tailoring) Conclusions Embedding the e-mental health more into regular therapy has potential to overcome non-usage. The mental health care professional has social influence to increase usage, by a clear and convincing introduction plus joint review of the exercises during consultations. This study needs to be repeated in other clinical settings. Future research should also include age (computer use) and disease prognosis to define when e-mental health is a suitable solution for patients. Key messages • E-mental health interventions have potential to help with waiting lists, rising health care costs and workload, but non usage is a problem. • Embedding the e-mental health more into regular therapy has potential to overcome non-usage.

Managing child abuse or suspected child abuse in primary care: Results from a qualitative study of general practitioners trained in detecting child abuse: Managing child abuse or suspected child abuse in primary care

IntroductionIdentifying and alerting suspected child abuse enables its investigation and management. In France, anyone can report the situation to child services when child abuse is suspected. However, the number of reports of concern received from physicians is low, and lack of knowledge is a frequent obstacle. This study aimed to explore the practices of trained general practitioners (GPs) regarding the identification and management of suspected child abuse. MethodWe led a qualitative study from February to November 2021 based on a grounded theory approach. We conducted semi-structured interviews with GPs working in the south of France who had received training in identifying child abuse. We performed an inductive analysis using NVivo software. ResultsWe interviewed 10 GPs (data saturation with seventh GP). Despite the training, obstacles seemed to persist, such as apprehension of the parents’ reaction, the technical difficulties of the process, and the lack of feedback after making a report. Being accompanied by a professional who can be directly contacted would facilitate the communication of worrying information. Without direct links to a single referent, doctors would prefer alternative ways of referring their patients to organizations they were familiar with. Discussion and conclusionGPs expressed a need for easy access to childcare professionals to support them in the decision to file a report of suspected child abuse. A multidisciplinary approach and a dedicated point of contact seemed to help the process. Nominating a child protection referent doctor per department and creating specific units in hospitals for children at risk would help GPs get effectual contacts for reporting worrying information and better care for children at risk of abuse.

The Experiences of Grief in Bereaved Women Following the Death of Their Husbands During the COVID-19 Pandemic in Qom, Iran: A Phenomenological Study

Background and Objectives: The death of a loved one is one of the most difficult and stressful life events in the world. The effects of death caused by COVID-19 on the mental health of individuals and families are of great importance. This study aims to elucidate the experience of grief in bereaved women following the death of their husbands due to COVID-19 in Qom, Iran. Methods: In this phenomenological study, 12 bereaved women were selected using a purposive sampling method. The information was collected using semi-structured interviews until reaching data saturation. Results: The data analysis led to the extraction of 3 main themes and 10 sub-themes: Complicated grief (ambiguous loss, farewell with no embrace, grieving alone), unconventional grief (strange death, deviation from religious burial customs, virtual mourning), and grief outcome (spiritual experiences, moral panic, social stigma, distrust in healthcare providers). Conclusion: The grief of bereaved women due to the death of their husbands by COVID-19 differs from their mourning for the death caused by other diseases in two aspects. Firstly, according to the majority of women, the cause of death was unclear. This situation intensified their grieving and mourning. Secondly, due to the specific nature of COVID-19 and the necessity of quarantine, they were restricted from having funeral and religious mourning rituals according to the prevalent culture, which resulted in an incomplete mourning process. Gaining spiritual experiences is one positive aspect of grief in women. It is recommended to provide support and care by the healthcare system during pandemics for families, especially bereaved women, to reduce the negative effects of grief.

Barriers and Facilitators of Management of Type-1 Diabetes in Children: A Socio-Cultural Enquiry of Caregivers’ Perspectives Living in Resource-Constrained Settings

Purpose Caregivers are key stakeholders in management of children with Type 1 Diabetes (T1D), but their perspectives have remained understudied, especially in the developing countries. This study explores their perspectives on the barriers and facilitators of management of a child with T1D in a resource-constrained setting. Methods This qualitative study, conducted in a tertiary level diabetes clinic in India, included parents of children with T1D, selected from subgroups varying in disease duration, education, habitat, and socioeconomic status, who participated in one of the five Focused Group Discussions (FGDs) of 60–90 min duration. The topic guide included questions like "What are the barriers you face related to diabetes care of your child at home or school?" and "What do you think helps you in managing a child with diabetes?" FGDs were audio-recorded, transcribed verbatim, and inductive coding was done independently by two authors. Results Twenty-eight parents (nineteen mothers and nine fathers, mean age: 35.1 years) of children aged between 2–13 years, were recruited till data saturation. Themes related to barriers of management were, ‘balancing nutrition and glycemic control is challenging’, ‘diabetes management involves psychological burden’ and ‘operational challenges’. Parents opined that family support, gaining decision-making and problem-solving attitude and optimal school-time management helped. Conclusion Parents living in resource-constrained circumstances perceive unique challenges during management of T1D in their children like social stigma, illiteracy, financial and logistic issues like procuring and storing essential supplies. A better understanding of these factors can aid healthcare professionals in managing them.

Stakeholder mapping of precision weeding commercialization ecosystem in California

CONTEXTPrecision weeding, a sector of agricultural technology in which drones and/or automated weeders use chemical, mechanical, or thermal means to eradicate weeds, has moved from academic research settings to commercialization. Because of labor shortage pressures, the push to gain competitive advantages, and the environmental impacts of excessive chemical inputs, many California growers have been interested in adopting precision weeding technologies in their operations. OBJECTIVEUsing semi-structured qualitative interviews, this study investigated the viewpoints of three key stakeholder groups involved in the diffusion and adoption of precision weeding technologies: California growers, precision weeding startups, and agricultural technology venture capital firms. With the supplemental viewpoints of large agricultural firms and their corporate venture capital arms and government agencies, this study seeks to understand the compatible motivations between stakeholders, current collaborative models between stakeholders and their limitations, and the user journey for growers adopting precision weeding technology. METHODSWe conducted 17 semi-structured qualitative interviews with diverse stakeholders in the precision weeding sector to gather textual data and gain high data saturation. Data collection balanced rigorous criteria for participant selection with adaptive interview questions to ensure depth and relevance. The analysis procedure involved coding and thematic framework development, complemented by grounded theory for iterative data examination and stakeholder map creation for distilling cross-organizational insights and stakeholder dynamics. RESULTS AND CONCLUSIONSThe results indicated that compatible motivations include addressing current labor issues, reducing costs, and the potential of precision weeding to transform agriculture. Less cited but still popular motivations included having more weeding options, meeting specific field needs, and environmental sustainability. The individual and stakeholder group cognitive maps demonstrated that concerns such as startup longevity, the high expenses of precision weeding machinery, and some startups lacking a direct connection to growers commonly limit the growers' adoption of precision weeding technologies. SIGNIFICANCEThe procedure and cognitive mapping presented in this study can be applied to other emerging agtech technologies and ecosystems.

Perceptions and experiences of a multi-domain preventive health programme: a qualitative study informing future community-based health interventions in singapore

BackgroundDespite global popularity, Community-based Health Intervention (CBHI) programmes have yet to be fully incorporated into Singapore’s public healthcare systems, with most initiatives focusing on specific diseases. This qualitative study aimed to evaluate older adults’ perceptions of the “Get Well, Live Well” multi-domain preventive health programme, explore the effectiveness of Community Health Workers (CHWs) in promoting health literacy and modifying health behaviours, and examine participants’ experiences in the CHW-delivered CBHI programme.MethodsPurposeful sampling was used to recruit study subjects from participants in the “Get Well, Live Well” programme until data saturation was achieved. In-depth, semi-structured, one-to-one telephone interviews were conducted in English or Chinese with participants aged ≥ 40 years. Audio recordings were translated into English as needed and transcribed in full. The collected data were anonymised, and thematic analysis was performed by three trained evaluators using a structured process.ResultsThe final study sample included 19 subjects (median age of 64 years; 84% women; and 95% Chinese). Three key themes emerged regarding the programme’s value, interactions with CHW, also known as Care Connectors, and their facilitation of health services/behaviours. Participants acknowledged that the “Get Well, Live Well” programme provided physical/emotional support, improved health literacy, and enhanced social interaction. The programme’s effectiveness may depend on Care Connector’s personal qualities, service quality beyond expectation, connection with participants, and their proactive and authoritative roles in facilitating health services/behaviours.ConclusionThe findings suggest that future Community-based Health Interventions could benefit from deploying CHWs with strong people skills to enhance the programme’s success.