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Research Opportunities With Curanderos to Address Childhood Overweight in Latino Families

Clark, L., Bunik, M., Johnson, S. — Fri, 20 Nov 2009 08:19:19 PST

Curanderos are consulted as an adjunct or alternative to biomedical health care in the greater southwest, although the extent of their involvement in obesity prevention and treatment is poorly understood. Seven curanderos participated in audiotaped interviews about their work with families and beliefs about childhood feeding and overweight. Themes reflected curanderos’ beliefs about their practice and childhood obesity. Curanderos approach their work as a calling, emphasizing elements from nature in etiology and cure. From the curandero’s standpoint, essential elements of obesity management must acknowledge the socially marginalized experiences of Latinos. We encountered working with curanderos as problematic, and this likely reflected our differing personal characteristics and a tension between our healing professions. Curanderos could serve as collaborators in childhood obesity interventions if we craft health messages and delivery modes that resonate with Latino families and address ethical and communication issues on the research team.

The Role of Creative Expression in Diabetes: An Exploration Into the Meaning Making Process

Stuckey, H. L., Tisdell, E. — Thu, 19 Nov 2009 10:39:34 PST

In this narrative exploration of meaning making through the use of creative arts, we recorded the experiences of 8 women with type 1 diabetes. Through a conceptual framework of creative expression as a way of knowing, we designed this study to evoke affective and metaphorical connections to the meaning of diabetes. The initial narrative interview findings reflected the experience of the participants, with three primary themes emerging: experiencing negative emotions about diabetes, putting a positive "spin" on the negative as a way to make meaning, and resisting against diabetes and the medical approach. During the creative arts process, we encouraged further exploration into the meaning-making process using imagery and photographs created by the participants. Final interview findings addressed the need for moving beyond numbers, and attention to the meaning-making process in patient care.

The Critical Value of Focus Group Discussions in Research With Women Living With HIV in Malawi

Mkandawire-Valhmu, L., Stevens, P. E. — Thu, 19 Nov 2009 10:39:33 PST

This article is based on a critical ethnography about HIV and gender-based issues of power and violence conducted in Malawi in 2008. In all, 72 women living with HIV were recruited from four antiretroviral treatment clinics, three rural and one urban, to participate in 12 focus groups. Informed by a postcolonial feminist perspective, we analyze the process and products of these focus groups to interrogate their capacity to facilitate collective engagement with the social and structural realities confronting women in a resource-limited, highly AIDS-affected country. We present exemplars to show how women together created collective narratives to mobilize individuals to action. Findings indicate that focus groups can be used innovatively to benefit both the research and the participants, not only as a critical method of inquiry with marginalized groups but also as a forum in which validating dialogue, mutual support, and exchange of strategic information can generate transformative change to improve women’s lives.

Interaction Between Participants in Focus Groups With Older Patients and General Practitioners

Moen, J., Antonov, K., Nilsson, J. L. G., Ring, L. — Thu, 19 Nov 2009 10:39:34 PST

Group interaction is put forward as the principal advantage for focus group research, although rarely reported on. The aim of the article is to contribute to the methodological knowledge regarding focus group research by providing an empirical example of the application of the Lehoux, Poland, and Daudelin template suggested for analysis of the interaction in focus groups. The data source was 18 focus groups’ performance in Sweden: 12 with older patients and 6 with general practitioners (GPs). GPs found common ground in belonging to the same profession, whereas the older patients, instead of constituting a group in the word’s real sense, started just sharing a common focus. We found the template easy to understand and use, except for identifying participants’ explicit and implicit purposes for participating. Furthermore, adding an interaction analysis to the content analysis helped us appreciate and clarify the contexts from which these data were created.

Contributions of a Retreat Weekend to the Healing and Coping of Cancer Patient's Relatives

Arnaert, A., Gabos, T., Ballenas, V., Rutledge, R. — Fri, 06 Nov 2009 15:07:57 PST

Relatives play a key role in the daily support and care of cancer patients. This role, however, can negatively affect relatives physically, psychologically, emotionally, and spiritually, challenging their health and well-being. Consequently, this could inhibit relatives’ abilities to continue in their roles as caregivers. Although various studies have examined different interventions for the relatives of cancer patients, no formal research has been published on the role that retreat weekends play in their cancer journeys. In this qualitative study we used semistructured interviews to explore the experiences of 8 relatives who attended a "Skills for Healing Retreat Weekend" in Ontario, Canada. The findings indicate that the retreat, in bringing people together to partake in discussions and activities, fostered a sense of community among the participants. The retreat also had enduring effects, contributing to relatives’ ongoing processes of healing as well as providing them with strategies for coping in their roles as caregivers.

The Revolving Door: High ER Use Among Older Veterans

Claver, M. L., Levy-Storms, L. — Tue, 13 Oct 2009 11:22:35 PDT

Why do some older veterans visit the emergency room (ER) frequently? This study expands an existing decisionmaking model that describes how ER users recognize symptoms of a health problem, decide to seek medical care for the health problem, and decide to visit the ER specifically for the medical care. The focus of this inquiry is the role of older veterans’ social support networks in decisions to visit the ER. Data were collected through in-depth, semistructured, in-person interviews with 30 community-dwelling, high-functioning veterans aged 65 years and older who had visited the ER frequently (3 or more times) in the previous year. We found that the older veteran study participants, regardless of the availability of social support, preferred to make decisions independently, relied heavily on formal social support network members, and received various types of assistance to visit the ER from informal social support networks.

Dimensions of Trust: The Tensions and Challenges in Provider-Interpreter Trust

Hsieh, E., Ju, H., Kong, H. — Tue, 13 Oct 2009 11:22:35 PDT

In this study we examined the challenges to providers’ and interpreters’ collaboration in bilingual health care. We conducted in-depth interviews and focus groups with 26 medical interpreters (speaking 17 languages) and 32 providers (from four specialties) in the United States to provide an empirically based framework of provider–interpreter trust. Constant comparative analysis was used for data analysis. We identified four dimensions of trust, theoretical constructs that can strengthen or compromise provider–interpreter trust: interpreter competence, shared goals, professional boundaries, and established patterns of collaboration. In this article we describe how these dimensions highlight tensions and challenges that are unique in provider–interpreter relationships. We conclude with practical guidelines that can enhance provider–interpreter trust, and propose future research directions in bilingual health care.

In for the Long Haul: Knowledge Translation Between Academic and Non-Profit Organizations

Jansson, S. M., Benoit, C., Casey, L., Burns, D., Phillips, R. — Fri, 02 Oct 2009 09:13:31 PDT

Although scientists are continually refining existing knowledge and producing new evidence to improve health care and health care delivery, far too little scientific output finds its way into the tool kits of practitioners. Likewise, the questions that clinicians would like to be answered all too rarely get taken up by researchers. In this article we focus on knowledge translation challenges accompanying a longitudinal research program with nonprofit organizations providing direct and indirect health and social services to disadvantaged groups in one region of Canada. Three essential factors influencing authentic and reciprocal knowledge transfer and utilization between nonprofit service providers and researchers are discussed: strong institutional partnerships, the use of skilled knowledge brokers, and the meaningful involvement of frontline personnel.

Cooperation and Conflict in Qualitative Research: A Dialectical Approach to Knowledge Production

Enosh, G., Ben-Ari, A. — Wed, 23 Sep 2009 10:04:58 PDT

Our goal with this article is to present a dialectical approach to examining the interaction between researchers and research participants. A dialectical approach maintains that an apparent contradiction at one level might, in fact, be integrated as a synthesis of the two opposing poles at a higher level of conceptual analysis. We claim that a research approach advocating either pole might limit understanding of the complexity of the phenomenon in question. The interaction between researchers and research participants might be conceived of as creating a continuum ranging from cooperation to conflict. We adopt a dialectical perspective, and propose a whole spectrum of interactive styles between cooperation and conflict. Although some of these interactions might be perceived as a hindrance to knowledge production, we treat them as opportunities for the production of knowledge and the enhancement of interests of the study's target population.