Unstructured Qualitative Interviews Research Articles

OLDER LGBTQ+ PEOPLE’S PERSPECTIVES ON DISCRIMINATION AND AGEING IN THE UK: EMERGING FINDINGS FROM A TIMELINE STUDY

Abstract This paper presents emerging findings from a United Kingdom study of socially inclusive ageing, reporting on timeline interviews with a sample of 25 LGBTQ+ people aged forty years and above, carried out during summer and fall of 2023. The research interrogates older LGBTQ+ people’s understanding of the impact of minority sexuality and gender identity on their lived experience and the ways in which this impacts their approach to challenges and opportunities linked to ageing. We draw on an innovative methodological approach, adapting Adriansen’s (2012) timeline interview method to fit the needs of older participants. Timeline interviews provide an approach to life-story research that structures a conversation around a written timeline, produced on paper during unstructured qualitative interviews. During the paper presentation we share anonymised timeline and narrative data highlighting milestones in individual biographies. We focus on moments and periods where sexuality and gender identity may have been a positive factor in individual life stories (romantic relationships, community membership) or have been seen as more problematic (discrimination, stigma and marginalisation). The timelines and associated interview data also provide opportunities to ground the biographies of older LGBTQ+ people in the context of social, cultural, political and policy contexts. The timelines reveal compelling data about ageing and identity, belonging and exclusion. Our emerging findings reflect C. Wright Mills’s concept of the sociological imagination, placing personal troubles and histories in the context of public issues. We gratefully acknowledge the funding this study has received from the United Kingdom Economic and Social Research Council.

Exploring the Lived Experiences of Rural Hospice Social Workers in Navigating “Cracked” Systems

Social workers often encounter health and resource disparities and caregiver challenges in support of hospice patients and families. Social workers also play a critical role in navigating systems and confronting systemic barriers. Their input regarding macro practice is invaluable, though there is not much literature pertaining to end-of-life disparities as experienced from the social worker point of view. There is also limited research from the hospice social worker perspective, with little pertaining to those providing care in rural areas. To address these gaps, this phenomenological study explored the lived experiences of rural hospice social workers to better understand their role in these matters. Data collection occurred through in-depth unstructured qualitative interviews. A total of 19 rural hospice workers participated in the study. There were four main themes identified: systemic issues in hospice settings, resource and geographic barriers, tensions and benefits of interprofessional collaboration, and hospice work environment. Based on these findings, recommendations for hospice social work practice, research, and policy include support of and elevation of the voice of hospice social workers on the interprofessional team, assessment of resource barriers to improve hospice social work interventions and improve quality of life for dying persons, education of hospice administrators to understand best ways to support hospice social, and implementation of policy change to expedite access to caregiver resources at end of life.

Responsive Measures for Youth Development to Prevent Delinquent Behaviour Among Youths Not in Education, Employment or Training

In this article, I sought to explore the perspectives of young people who are no longer in the education system and who are not working or being trained for work (NEETs) of youth development interventions that can be used to prevent delinquent behaviour among youths residing in the Cape Flats, South Africa. In this regard, convenience and purposive sampling were used to sample 30 NEETs, aged 18 to 24 years. Unstructured qualitative interviews were used to collect the data, and a thematic analysis was used to analyse the data that were collected. The findings revealed that the institutionalisation of youth clubs in the Cape Flats could be the best type of intervention to prevent youth delinquent behaviour. In this article, I recommend a multisectoral approach that would involve joint efforts from civil society and the government with the already existing basic package of support for empowerment of NEETs to strengthen the Presidential Youth Service Programme.

Exploring the lived experiences of (un)employment among visually impaired persons in Nigeria: Implications for policy and practice

Blind people have been consistently underemployed in Nigeria. There have been recent policy initiatives, and programmes especially by the federal government and the Lagos state government, aimed at improving the unemployment situation of people with disabilities, but not much success has been recorded. This study explored the views of blind individuals about their (un)employment experiences to understand their challenges and proffer solutions. The study employed a qualitative approach, conducting one-to-one unstructured qualitative interviews with 22 blind and visually impaired adults aged between 18 and 55 years. Verbatim transcripts of the interviews were analysed using the thematic analysis approach. Four major themes emerged: describing participants’ views on discrimination and lack of inclusive processes in recruitment; perceived gaps with policy enforcement; inadequate support systems for vocational skills training and entrepreneurship; as well as general views on life, society, and hopes for future employment opportunities. The most common barrier to employment mentioned by participants was the misconception by employers that being blind meant being unable to work. There was a general lack of confidence and trust in recent policies seeking to address structural barriers to visually impaired people’s employment goals. Real solutions and specific policy changes were desired.

Chronic Health Crises and Emergency Medicine in War-torn Yemen, Exacerbated by the COVID-19 Pandemic.

IntroductionMuch of Yemen’s infrastructure and healthcare system has been destroyed by the ongoing civil war that began in late 2014. This has created a dire situation that has led to food insecurity, water shortages, uncontrolled outbreaks of infectious disease and further failings within the healthcare system. This has greatly impacted the practice of emergency medicine (EM), and is now compounded by the coronavirus disease 2019 (COVID-19) global pandemic.MethodsWe conducted a systematic review of the current state of emergency and disaster medicine in Yemen, followed by unstructured qualitative interviews with EM workers, performed by either direct discussion or via phone calls, to capture their lived experience, observations on and perceptions of the challenges facing EM in Yemen. We summarize and present our findings in this paper.ResultsEmergency medical services (EMS) in Yemen are severely depleted. Across the country as a whole, there are only 10 healthcare workers for every 10,000 people – less than half of the WHO benchmark for basic health coverage – and only five physicians, less than one third the world average; 18% of the country’s 333 districts have no qualified physicians at all. Ambulances and basic medical equipment are in short supply. As a result of the ongoing war, only 50% of the 5056 pre-war hospitals and health facilities are functional. In June 2020, Yemen recorded a 27% mortality rate of Yemenis who were confirmed to have COVID-19, more than five times the global average and among the highest in the world at that time.ConclusionIn recent years, serious efforts to develop an advanced EM presence in Yemen and cultivate improvements in EMS have been stymied or have failed outright due to the ongoing challenges. Yemen’s chronically under-resourced healthcare sector is ill-equipped to deal with the additional strain of COVID-19.

The experiences of facilitating foreign direct investment in a developing country: A comparative analysis of two local authorities

The experiences of local authorities (LAs) with facilitating foreign direct investment (FDI) in developing countries are reported in isolation. Resultantly, there is no consolidated and comparative analysis of the above. While the impact of neo-liberalism and capitalism on the experiences of investment facilitating agencies (IFAs) such as LAs is recognised in literature (Kuswanto, Hoen, & Holzhacker, 2017; Minh, 2019), an empirical gap exists in demonstrating this impact. Using a comparative multiple case study analysis research design, this study relies on the qualitative research method to empirically compare and contrast the experiences of two Namibian LAs, Windhoek and Walvis Bay, with facilitating Ramatex Textiles Namibia (RTN) and Namibian Press and Tools (NPT) as FDIs, respectively. It similarly draws insights from the impact of neo-liberalism and capitalism on these LA experiences with FDI. Unstructured qualitative interviews were conducted with 13 purposely-selected key respondents and data were interpreted, analysed, and presented in themes. This study found that while the developmental experience of the Windhoek LA with RTN was largely negative, the Walvis Bay LAs experience with NPT was neutral. These experiences are largely linked to the neoliberalist and capitalist orientation of Namibian legislation that fails to adequately embrace sustainable FDI for local development

Chronic Myeloid Leukemia Patients' Voice: Preliminary Results from the Italian Substudy of Enestpath (CAMN107AIC05), Exploring the Emotional Experience of Patients in the Context of Treatment-Free Remission

Introduction:ENESTPath, an ongoing phase 3 study in patients with chronic myeloid leukemia (CML) in chronic phase, was designed to determine the optimal duration of consolidation treatment with nilotinib 300 mg twice daily required to remain in treatment-free remission (TFR) without molecular relapse, 12 months after entering TFR. With TFR as a new goal of therapy in clinical practice, there is a need for individual approaches and counselling for patients when preparing for a possible treatment discontinuation.An ongoing Italian substudy of ENESTPath assesses patients' emotional experience during and after stopping nilotinib therapy. To have a comprehensive evaluation of patients' psycho-emotional outcomes, both quantitative (questionnaires) and qualitative (expressive writing and interviews) methods are used. Here, we present preliminary qualitative data on the emotional experience of patients who were either ineligible for randomization or relapsed during TFR phase.Methods:Patients in stable MR4 for >12 months (≥MR4 in 4 of 5 PCR assessments, including the last assessment, in the last 12 months) in the consolidation phase were randomized to stop nilotinib and enter TFR phase immediately or to continue on nilotinib for another year and then enter TFR phase. Patients with unstable MR4 in the consolidation phase had to discontinue the trial early without attempting randomization. Patients who were ineligible for randomization or those who relapsed during TFR phase (loss of MMR, or the confirmed loss of MR4) had qualitative interviews.In-depth unstructured qualitative interviews were conducted according to interpretative phenomenological analysis (IPA) to explore patients' emotional experience of “being ineligible for randomization” and “failing TFR.” Interviews were guided using open-ended questions and followed patients' narrative flow; the interviewer facilitated the narration. Patients were asked to describe the course of their disease and their involvement in the clinical trial, including the final moments before trial discontinuation. Interviews were audio recorded, transcribed verbatim, and analyzed according to IPA.Results:Of the 30 patients included in this substudy so far, 10 (male, n=8; mean disease duration, 9.5 years) were interviewed, including 7 ineligible for randomization and 3 relapsing in TFR. As the study is still ongoing, these numbers are not representative of the total study population. The remaining 20 patients were either in TFR, year 2 of consolidation, or yet to be interviewed. Enrollment for qualitative research respects the criterion of the most possible variety (eg, socio-demographic characteristics, duration of the disease).In total, four themes that describe patients' experience were identified: experience of early trial discontinuation for unstable response, linked to the view on stopping treatment; experience of the illness particularly focused on diagnosis; impossibility to talk about death and view on the drug as lifesaver; and impact of the disease and treatment on future plans (Table).Patients' experience of not being able to continue the trial due to unstable response reflected a slightly negative emotional experience, and they saw the idea of stopping treatment as something useful but demanding. Patients remembered the communication of the diagnosis as an unthinkable drama that is difficult to express and a shock. They perceived the disease as invisible and had difficulties in thinking or talking about death; however, they referred to the drug therapy as essential for life and survival. Finally, the disease was also perceived as something that undermines future plans (Table).Conclusions:These preliminary findings described how patients perceived early trial discontinuation, and the way they give sense to it appears to have a relationship with individual disease experience. This qualitative analysis helps in understanding patients' perspective, both in terms of getting access to the inner subjective experience of having CML and its strict relationship with the involvement in a trial or its cessation. The insights provided show that patients' perception of their disease, on TFR, and on failure to stop the therapy needs further analysis. There is a need to develop strategies to cope with patients' emotional experience and guarantee their psychoemotional wellbeing beyond the clinical setting. [Display omitted] DisclosuresCastagnetti:Bristol Myers Squibb: Consultancy, Honoraria; Incyte: Consultancy, Honoraria; Pfizer: Consultancy, Honoraria; Novartis: Consultancy, Honoraria. Bonifacio:Incyte: Membership on an entity's Board of Directors or advisory committees; Pfizer: Membership on an entity's Board of Directors or advisory committees; Bristol-Myers Squibb: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees, Research Funding. Cavazzini:Bristol-Meyers Squibb: Consultancy; Novartis: Consultancy; Pfizer: Consultancy; Incyte: Consultancy. Galimberti:Incyte: Speakers Bureau; Novartis: Speakers Bureau; Bristol-Myers Squibb: Speakers Bureau; Pfizer: Speakers Bureau. Orlandi:Incyte: Speakers Bureau; Bristol-Myers Squibb: Speakers Bureau; Novartis: Speakers Bureau. Galimberti:Novartis: Employment. Haenig:Novartis: Employment. Supekar:Novartis: Employment. Baccarani:Novartis: Consultancy, Honoraria, Speakers Bureau; Pfizer: Honoraria, Speakers Bureau; Bristol-Myers Squibb: Honoraria, Speakers Bureau; Incyte ARIAD: Consultancy, Honoraria, Speakers Bureau. Vegni:Novartis: Research Funding.

Situating the Religious Market Theory in Ghanaian Religious Context : Merits and Demerits

This study reviewed the religious market theory in relation to the religious economy of Neo-Prophetic Pentecostal-Charismatic churches in Ghana. Using unstructured qualitative interviews and focus group discussions, the study discovered that the theory in its present western context ignored Ghanaian religio-cultural sensibilities that affect decision-making in every aspect of the Ghanaian's life. It also ignored ethical and human rights cases such as flogging or at times stepping on pregnant women for alleged involvement in sinful acts. In other cases, prophets/pastors touch women's private parts for alleged claims of casting out demons. These missing links in the theory appear to produce a distorted view of the realities of religious actors in Ghana. Thus, the analysis implicates the widening of the theoretical framework to encompass the missing links that significantly influence the behavior of religious actors in Ghana.

Individuals, Structures, and Human Agency in Community Development

Community development, especially in developing societies, has focused on mobilizing community members for collective action. Little attention has been paid to creative efforts of individuals engaged in transformative activities that improve their lives and from which other members of a community can learn. This paper examines how individuals creatively engage in activities that improve their households. The research, done in a rural area of northern Malawi, Africa, involved in-depth unstructured qualitative interviews of a number of individuals and careful observations of what was going on in their households. The analysis reveals evidence that creative individuals improved their households’ well-being through meaning-making, learning, and acting while navigating structural imperatives. Some of their actions were counter to social and cultural expectations, others were behavioral outliers, but all were driven by choices each made. Community development facilitators ought to consider identifying creative individuals (could be Christians) in a community, enhancing their agency, and organizing communities of practice around these individuals for other members of a community to learn from or for them to engage in the spreading of the Good News. I term this constructivist community development / evangelism and argue that it is particularly relevant in subsistent, substantive, and allocentric communities where group norms are a significant factor in people’s behavior. These group norms are important for collective action but can stifle individuals’ creativity.

Development and initial psychometric validation of a patient-reported outcome measure for Crohn’s perianal fistula: the Crohn’s Anal Fistula Quality of Life (CAF-QoL) scale

IntroductionCrohn’s perianal fistulas are challenging for patients and clinicians. Many do not respond to available treatments and despite recommendations by a global consensus, there are currently no specific patient-derived quality...

What matters to you when the nursing home is your home: a qualitative study on the views of residents with dementia living in nursing homes

BackgroundDementia is recognised as one of the greatest global public health challenges. A central tenet of national health and social care policy is to ensure that services support people in achieving their personal well-being and outcomes, defined as the things important to people in their lives, also people with dementia. The aim of this study is to explore what matters to nursing home residents with dementia based on their perceptions of nursing homes as home.MethodsThere were conducted 35 interviews with people with dementia in nursing homes. We conducted the in-depth unstructured qualitative interviews. Thematic analysis was applied to analyse the data.ResultsThe analysis resulted in one over-arching theme “tension between the experiences of a nursing home being a home and an institution” and five themes; “myself and my relationships with fellow residents", “creation of individualised living spaces”, "single rooms with personal decor that enhances a sense of connectedness”, “transition between the old home and the new home” and “significant activities providing meaning”. The participants stated that the transition to the supported, structured living environment in nursing homes to be a clear need based on immediate, serious safety concerns. They went from being masters of their own lives to adhering to nursing home routines. Fellow residents could be both resources and burdens, creating feelings of security and insecurity. A home-like environment was created by allowing the participants to bring their important personal belongings into private spaces. The participants said they needed to be able to decorate their rooms to their own specifications. They wanted involvement in meaningful activities.ConclusionsThe findings showed that ‘home’ was an emotive word that awakened many associations. The participants reported mixed feelings and stated that they could thrive even if they missed their old homes. What mattered was that the participants felt safe, had single rooms where they could retire from the community, their own belongings and did activities. The participants wanted greater possibilities for meaningful relations. They appreciate that nursing home were similar to their previous homes. They desired opportunities to continue some activities they did in their former home.

Social Work Communication with Parents Who Are Practising Christians: An Empirical Study

Abstract Given Britain’s religious, spiritual and secular diversity, and national legislation and policy directives such as The Children Act 1989 and Working Together to Safeguard Children, this empirical study addressed the lack of specific research investigating social workers’ actual communication-in-action with Christian parents during statutory parenting assessment. The research deployed the two complementary theoretical frameworks of Critical Realism and Worldview studies to generate a deep understanding of communication. Thick descriptions of the communication act, social-worker-with-Christian-parent communication and the attendant meanings attributed to this event by study participants were generated from substantive data obtained from (i) a Forum Theatre performance delivered to thirty-one volunteering qualifying and qualified social workers and from (ii) unstructured qualitative interviews with twelve volunteering Christian parents. Analytic tactics from grounded theory were deployed to conduct the retroductive analysis. Key findings identified some shared social-worker-with-Christian-parent understandings. However, generally, Christian parents were so mistrustful about revealing ontological commitments to their Christian living/parenting praxis that they altered their language—a wariness worsened by the social workers’ absenting of Christian belief-talk through using formulaic strategies.

Improving Quality of Life in Hematopoietic Stem Cell Transplantation Survivors Through a Positive Psychology Intervention.

Despite advances in transplantation medicine, psychological distress and quality of life and functional deficits continue to compromise survivorship after hematopoietic stem cell transplantation (HSCT). With increasing numbers of HSCT survivors, supportive oncology interventions that target health-related outcomes in HSCT survivorship are needed. Here we aimed to test the feasibility and acceptability of a group format phone-delivered positive psychology (PP) intervention in HSCT survivors. This is a one-arm pilot study design that adapted and tested an individual PP intervention used in cardiac disease to a phone-delivered group-based program for HSCT survivors who were .4 to 39 years post-transplantation. All participants received an 8-session weekly PP intervention. We assessed feasibility by the enrollment and intervention completion rates. We examined acceptability on a 10-point Likert scale of ease and utility. Unstructured qualitative interviews were used to obtain participant feedback on the intervention for future application in a larger trial. Self-reported assessments on psychological, functional, and quality of life outcomes were administered at baseline and at follow-up (the end of the intervention). Of 64 eligible participants, 29 (45%) enrolled in the study. For the main aim of intervention feasibility and acceptability, participants completed 96% of all PP sessions and rated the ease (7.6 ± 1.7) and utility (8.1 ± 1.1) of sessions highly. Of the self-reported assessments obtained, the PP intervention resulted in improvements in the resilience scale (mean difference, 2.4 ± 5.4; P=.03). From unstructured qualitative interviews, participants reported the PP exercises and intervention helped them to focus on positive emotions and the group format fostered a sense of community and social support. An 8-week phone-delivered group format PP intervention is feasible and acceptable in HSCT survivors. The piloted intervention could be tested with minor modifications in a randomized study to definitively examine the impact of the group format PP intervention on health-related outcomes.

P487 Development and validation of a new patient-reported outcome measure for Crohn’s perianal fistula: Crohn’s anal fistula quality-of-life (CAF-QoL) scale

Abstract Background Crohn’s perianal fistulas are challenging for patients and clinicians. Many do not respond to available treatments, and despite recommendations by a recent global consensus, there are currently no specific patient-derived quality of life (QoL) tools to measure outcomes including response to treatment, in patients with Crohn’s perianal fistulas. Exploratory qualitative work has demonstrated that Crohn’s perianal fistulas reduce QoL far beyond restricting daily and sexual activities, and a patient-centred, patient-derived tool is needed. We present a patient-reported outcomes measure (PROM) for this complicated disease phenotype. Methods A 35 item draft questionnaire was generated using information from: (a) unstructured qualitative patient interviews, exploring the experience of living with Crohn’s perianal fistulas; (b) a consensus exercise analysing outcomes from a systematic review of studies assessing medical, surgical and combined (medical/surgical) treatment of Crohn’s perianal fistula; and (c) a patient and public involvement meeting. Psychometric properties were assessed including construct validity (by comparison with the Hospital Anxiety and Depression Scale, HADS and the United Kingdom version of the Inflammatory Bowel Disease Questionnaire, UK-IBDQ), and reliability and responsiveness assessed by test-retest analysis. Results Data from 211 patients contributed to the development of the CAF-QoL scale, following the collation of items including patient experience interviews, a systematic review and a consensus exercise involving 187 stakeholders (patients, gastroenterologists, surgeons, IBD specialist nurses, radiologists). Internal consistency was good with Cronbach’s α of 0.88. Analysis aided reduction of the questionnaire to 26 items that demonstrated good internal consistency, good stability (intra-class correlation 0.98) and good construct validity and responsiveness with positive correlation with the UK IBDQ and HADS. Conclusion A disease-specific PROM to assess clinical outcome (i.e. QoL) as baseline and following interventions in patients with Crohn’s anal fistula—the CAF-QoL—is ready for use. Translation and cross-cultural validation will aid wider international dissemination.

The Importance of Reflection: An Exploratory Analysis on How Prospective Psychotherapists Learn Self-Determination

Background: Learning to become a psychotherapist is a complicated process. Research on this topic has been limited and there is little consensus on how to assess therapeutic skills. SP/SR (Self-Reflection/Self-Practice) has emerged as a theory and method for learning psychotherapy. In this article students' reflections on how to become a psychotherapist has been studied from a phenomenological perspective. Objective: The aim of the present exploratory study was to generate preliminary hypotheses for future investigations in order to elucidate the complicated processes that occur during the therapist training programs. Methods: Five prospective psychotherapists were recruited to the present investigation, who all studied at the penultimate semester at Evidens University College, Gothenburg, Sweden. Unstructured qualitative in-depth interviews were used followed by phenomenological analysis. Results: Analysis yielded 252 meaning units and 12 categories which in turn led to four overarching themes: Learning as a visit to the dentist (when learning becomes painful because certain issues are not resolved); Learning as theatre (when the students just perform what is expected in order to pass); Learning as post-training soreness (when the learning process is challenging on a relevant level); Learning as reflections (when the students seek the intrinsic meaning). Conclusion: The study provided a basis for preliminary hypotheses for future investigations: reflections are helpful for managing the challenges described in the four themes. This, in turn, led to the formulation of some proposals for research questions for future investigations.

A qualitative study of the impact of plexiform neurofibromas on need fulfilment in adults with neurofibromatosis type 1.

Objective:To explore the impact of plexiform neurofibromas on the lives of adults with neurofibromatosis type 1.Background:Neurofibromatosis type 1 is a complex neurogenetic syndrome that affects many aspects of health and functioning. A common manifestation of neurofibromatosis type 1 is plexiform neurofibromas, non-cancerous tumours that can cause disfigurement, pain and neurologic disability. Patient-reported outcome measures used in this condition have addressed symptoms and functional ability but not how the condition affects patients’ lives, particularly, their ability to meet their human needs.Methods:Unstructured qualitative interviews were conducted with adults with neurofibromatosis type 1–associated plexiform neurofibromas in the United Kingdom and United States. Interviewees were encouraged to describe how plexiform neurofibromas affected their ability to meet their needs. Interviews were audio-recorded and transcribed verbatim. The UK and US transcripts were combined and theoretical thematic analysis was conducted.Results:In all, 42 interviews (United Kingdom = 20, United States = 22) were conducted. Transcripts revealed 696 statements on the impact of plexiform neurofibromas on need fulfilment. Five major themes emerged: appearance, relationships, independence, role fulfilment and pleasure.Conclusion:Neurofibromatosis type 1–associated plexiform neurofibromas have a major effect on individuals’ ability to meet their needs. An understanding of need fulfilment will complement information generated from traditional patient-reported outcome measures, particularly in a multi-faceted syndrome such as neurofibromatosis type 1.

The impact of Home Parenteral Nutrition on the lives of adults with Type 3 Intestinal Failure

Several studies have been published reporting on the impact of Home Parenteral Nutrition (HPN) on the lives of people with Type 3 Intestinal Failure. These studies focused on symptoms and functional limitations resulting from the treatment. The aim of this study was to determine how dependence on HPN affects individuals' ability to fulfil their human needs. Unstructured qualitative interviews were conducted with people dependent on HPN, who were asked to explain how their lives were affected by the treatment. Theoretical thematic analysis was conducted on the interview transcripts to identify statements describing aspects of human needs that were left unfulfilled. Care was taken to separate the impact of HPN from that of the underlying disease. Interviews were conducted with 30 patients (53% female; mean age, 55.9 (range 35-76) years). Most of the sample (87%) had short bowel syndrome. Major aspects of need affected by HPN were related to: autonomy, cognition, relationships, role fulfilment, socialisation, appearance and self-esteem, appetite and perceived vulnerability. The study illustrates how patients' lives are affected by HPN. Statements generated from this qualitative study were used to produce the Parenteral Nutrition Impact Questionnaire (PNIQ), a patient-centric measure of quality of life specific to people using HPN.

Navajo Nation Brain Drain: An Exploration of Returning College Graduates’ Perspectives

American Indian tribes face the phenomenon known across the world as the brain drain. They invest millions of dollars in educating their members only to have little return on their investment. Many nation members leave reservations to get postsecondary education but never return. Those who get education off the reservation and choose to return are the exception to this rule. Although there is an abundance of literature regarding brain drain across the world, there has been little research done with American Indians. In order to begin to understand the brain drain phenomenon, this study analyzed unstructured qualitative interviews with 17 Navajo Nation members who left their reservation, obtained a degree, and returned to work on the reservation. Themes resulting from the hermeneutic analysis of transcribed interviews were (a) Family Support, (b) Community, (c) Cultural Identity, (d) the Simple Life, (e) Reservation Economy, and (f) Commitment to the Reservation. The analysis found that constant, lengthy, and meaningful relationships were motivating factors in drawing participants back to contribute to their reservations. Further study is needed to understand how communities and tribes can ensure that these relationships are built and maintained.

Bracketing as a skill in conducting unstructured qualitative interviews

To provide an overview of bracketing as a skill in unstructured qualitative research interviews. Researchers affect the qualitative research process. Bracketing in descriptive phenomenology entails researchers setting aside their pre-understanding and acting non-judgementally. In interpretative phenomenology, previous knowledge is used intentionally to create new understanding. A literature search of bracketing in phenomenology and qualitative research. This is a methodology paper examining the researchers' impact in creating data in creating data in qualitative research. Self-knowledge, sensitivity and reflexivity of the researcher enable bracketing. Skilled and experienced researchers are needed to use bracketing in unstructured qualitative research interviews. Bracketing adds scientific rigour and validity to any qualitative study.

Indigenous Women College Students’ Perspectives on College, Work, and Family

Native American and First Nations (herein collectively referred to as Indigenous) women college students are faced with the challenge of balancing their cultural imperatives and the demands of the dominant Western culture in family, school, and work/employment roles. In order to explore these women’s experiences and perspectives, this study analyzed unstructured qualitative interviews of 11 Native American and 9 First Nations female college students. The themes that resulted from the hermeneutic analysis were (a) honoring Indigenous culture and community, (b) living in two worlds, (c) pursuing individual fulfillment and goals, and (d) acknowledging the importance and influence of family.