Qualitative Health Research最新文献

Women who are giving birth need to be met with compassion and understanding from healthcare professionals. However, there are growing concerns about the perceived lack of compassion in the delivery of healthcare services in general and maternity care in particular. We conducted 15 qualitative interviews with women who had given birth in Norway within the previous year, asking them to describe their experiences of compassionate care. We aimed to explore what healthcare professionals "do" that is experienced as compassionate. The analysis was informed by Paul Gilbert's theory of compassion and a concept analysis of compassionate midwifery undertaken by Ménage and colleagues. The compassionate caring actions of healthcare professionals that were identified in the women's narratives generated five themes: attuning actions, validating actions, contextualizing actions, empowering actions, and small acts of kindness. The findings build on the prior theoretical concepts used for the study and provide a nuanced account of how women perceive compassionate care from healthcare professionals. They could contribute to understanding more of the meaning and nature of compassionate care during childbirth. The analysis indicates the importance of ensuring that compassionate care is at the very core of maternity care services.

People living with HIV (PLHIV) in Ecuador experience challenges including discrimination, violence, and limited access to healthcare, which impacts their mental health and well-being. However, research shows that PLHIV also rely on social resources to foster resilience. In the Ecuadorian context, there is no literature exploring these narratives, which results in a lack of qualitative data to improve the reality of PLHIV in the country. To gain a deeper understanding of these stories, 15 semi-structured interviews were undertaken (15 verbatim hours) within the context of a peer- and professional-led support group for PLHIV and were analyzed through a thematic approach based on Skovdal and Daniel's conceptual framework on resilience and adversity. Findings suggest that PLHIV face multifaceted challenges across the home, community, and political-economy spheres. Families and communities can elicit pain and fear, leading individuals to avoid discussing their diagnosis due to ongoing rejection. Further, discrimination perpetuated within the public health sector, as well as societal violence, exacerbates adversity. Nevertheless, participants stress the indispensable role of family support, community networks, and accessible healthcare in fostering resilience. Specifically, support, emotional reassurance, and willingness to learn enabled PLHIV to build resilience. These findings emphasize the need for approaches that counter discrimination, enhance well-being, ensure integral and intersectional healthcare access, and promote knowledge around HIV.

Fraudulent participation is defined in the following as participation in research by individuals who, for one reason or another, intentionally provide false responses. Qualitative studies are at an increased risk of fraudulent participation when online recruitment and participation are used, and monetary incentives offered. Fraudulent participation threatens data quality and subsequent evidence-based practice, yet validated guidance on how to tackle it is lacking. This paper offers a critical reflection thereon by three separate qualitative research groups that experienced fraudulent participation in collaboration with a patient representative, a bioethicist, a legal expert, a journal deputy editor, and a chief executive of a national charity. The Prevent FRaudulent Online STudy participation (P-FROST) recommendations provide advice on (1) Study set-up (including team members and study design), (2) Monetary incentives and recruitment, (3) Data collection (screening and interview considerations), and (4) Analysis, reporting, and support. The reflection which balances the diverse perspectives of patients, researchers, funders, ethics boards, and legal teams puts forward the P-FROST recommendations to identify and prevent fraudulent participation throughout the design, ethical approval, and implementation of online qualitative research.

Organizations that work with people who trade sex for compensation (including sex work and trafficking) and who are homeless employ lived experience experts to enhance the relevance and utility of services. We sought to understand how lived experience experts become social service leaders and the conditions that influence their pathways and well-being. Influenced by anti-capitalism and anti-white-supremacy, we used an intersectional, community-engaged, constructivist grounded theory approach to conduct semi-structured, in-depth interviews with 26 adults with lived experiences who were currently employed in an organizational leadership role. Participants were ages 22-43; 50% people of color; 26% trans and gender expansive; and 62% queer. We found that lived experience experts were mostly situated either within an individualist or collectivist organizational context. Participants in the individualist context typically began their trajectories through storytelling, which contrasted with those in the collectivist context who began by organizing around a cause or policy. A cycle of internal and external validation (e.g., mentor affirmation and increased self-worth) and invalidation (e.g., insufficient pay; exploitation of their stories; and identity-based exclusion) resulted. Emerging conflicts were perceived and addressed differently depending on participants' contexts, with some additional barriers for those advocating for sex work decriminalization. Findings suggest that there may be insufficient funding structures, mentorship, and leadership development practices and policies to support lived experience experts. Left unaddressed, lived experience experts, especially those who are multiply minoritized, may transition to other roles and/or out of advocacy movements. Anti-capitalist practice, policy, and research implications that counteract harms and support employees' mental health are discussed.

The objective of this research was to extend current knowledge on the psychological and emotional aspects around patients' preparation for amputation surgery. This research explored amputees' perspectives on their preparation for amputation surgery and how patients can be better supported for this procedure. Data was collected through semi-structured interviews and online qualitative questionnaires with 17 amputees who underwent upper- or lower-limb amputation within the United Kingdom. The interviews were analyzed using reflexive thematic analysis. The analysis generated three themes describing participants' experiences of being prepared for this surgery and their ideas on how this process could be improved: (1) Making sense of amputation surgery, (2) Patients' experiences of information and support from healthcare staff, and (3) Patients' views on approaches to preparation. This research highlighted the importance of information provision and support from healthcare staff, along with the potential benefits of utilizing experiential knowledge through peer support to enhance feelings of preparedness for amputation surgery.

During the last three decades, an increased amount of research on errors in health care has been conducted. Studies show that physicians find it challenging to handle errors because of the blame and guilt that errors cause. Communicating with colleagues has been identified as vital for coping with errors and for creating a just culture; however, many physicians do not usually discuss their errors. Knowledge about how junior doctors experience errors is vital to ensure that they both receive emotional support and learn from errors. To capture junior doctors' perceptions and experiences, we used a qualitative, exploratory design based on virtual focus groups. We conducted seven virtual focus groups with 22 junior doctors from 11 specialties. We defined three main themes: (1) how the junior doctors conceptualized medical errors, (2) how they experienced talk about errors among colleagues, and (3) the context in which this talk took place. The participants experienced errors as challenging elements in their working life; however, they struggled to define it. They described inconsistencies regarding the reasons for discussing errors within the learning environment, with some being experienced as constructive (providing education and support) and some as destructive (involving blame and shame). There was a discrepancy between the wish to normalize error and the lack of sharing between colleagues. Our study shows that error in health care is a complex phenomenon that challenges junior doctors' navigation in clinical practice. Despite efforts to implement an open and just culture, this has not yet been achieved.

Despite national efforts, gaps persist in Ethiopian perioperative care. This reflexive thematic analysis aimed to investigate the contextual challenges faced in delivering perioperative care. In-depth interviews were conducted with 20 healthcare professionals, including anesthetists, nurses, and surgeons, to gain a frontline perspective of perioperative practice realities. The analysis revealed eight interconnected themes: systemic infrastructure vulnerabilities, workforce expansion uncertainties, workforce demoralization, fragile perioperative safety culture, hierarchical structures and communication barriers, financial barriers to care, fragmented information systems, and fragile governance with sociopolitical instability. Local deficiencies in resources and equipment were amplified by global challenges, creating a precarious care environment. While workforce numbers increased, concerns persisted about competency and training quality. Systemic pressures and unmet professional needs contributed to staff demoralization. Inconsistent safety practices and top-down quality improvement initiatives hindered sustainable progress. Rigid hierarchies and departmental silos impeded effective teamwork and resource coordination. Financial constraints created significant barriers to care access and ethical dilemmas for providers. Incomplete digitalization and inconsistent documentation practices compromised continuity of care and data-driven improvements. Overarching sociopolitical instability and weak governance cascaded into healthcare system disruptions. The findings underscore the need for a multifaceted approach to strengthen perioperative care, including improving infrastructure, enhancing workforce development, fostering a culture of safety, breaking down hierarchical barriers, addressing financial accessibility, implementing robust information systems, and building resilient governance structures amidst adversity.

Globally, mental health problems in adolescents, alongside associated morbidity and mortality, have never been higher. Local living, working and environmental conditions, socio-economics, and intra-individual and inter-individual processes impact mental health. The risk of developing mental health problems is higher in certain areas, including East London. However, limited research explores East London adolescents' experiences of mental health. An in-depth and locally situated understanding of determinants shaping East London adolescents' happiness and sadness is needed. This study used Photovoice, a qualitative method within a community-based participatory research methodology, to generate photographic and textual data, which was analyzed using reflexive thematic analysis. This method allows participants to be part of knowledge production and authors to present the data. Our findings underscore the bidirectional interplay between environmental factors and adolescents' happiness and sadness. Gratitude for nature was described as increasing happiness: adolescents connected to nature to memories, appreciation, and leisure opportunities. Adolescents were concerned about the fragility of nature in response to urban development. The urban environment was perceived as imposing, inspiring, and offering therapeutic benefits blighted by pollution. Beautiful areas were described as paradisical and lacking, revealing urban development and economic productivity disparities. Our research documents the voices of an under-researched group, revealing novel insights while empowering adolescents as co-producers of mental health research. This study indicates participatory research is valuable for granting adolescents autonomy and addressing misrepresentation. The findings implicate multiple stakeholders, including "Health in All Policies." By deepening our understanding of adolescent mental health in East London, our study can be leveraged to bolster the effectiveness and relevance of interventions for East London adolescents.

Self-management is pivotal for effective chronic disease management. However, this concept remains unexplored among people with endometriosis, who often experience chronic pain and significant impacts on their quality of life. This research explored participants' experience managing endometriosis and their understanding and integration of self-management into their lives. Inductive reflexive thematic analysis was used to analyze transcripts from 15 semi-structured interviews among people with endometriosis. The themes captured many aspects of self-management and included (1) perceptions of control, (2) engaging in self-management behaviors, (3) active decision-makers versus recipients of care, (4) establishing a patient-provider partnership, and (5) support is vital. The extent to which participants engaged in self-management varied, however, is consistent with self-management literature for other chronic conditions suggesting that there is a role for self-management among people living with endometriosis.

Previous work has demonstrated that gay, bisexual men, and other men who have sex with men (GBM) living with HIV are likely to experience intersectional stigma. However, mainstream systems often fail to recognize how power and privilege shape this experience. Such a complex psychological phenomenon requires an in-depth reflective inquiry that acknowledges individuals as experts in their own experiences. To explicate this matter, this study aimed to develop an understanding of how intersectional stigma impacts the experiences of GBM living with HIV and to illuminate how contexts (un)fuel inequities. The semi-structured interviews with five Filipino GBM living with HIV were analyzed using interpretative phenomenological analysis (IPA). Exploration of their accounts elucidated how cultural elements fueled power dynamics and privilege, which in turn shaped intersectional stigma and their experiences. Narratives accentuated how Filipino GBM living with HIV situate themselves from victims to agents of change who empower and liberate others in the community. Insights from this study underscore the critical role of collective actions in bridging gaps in inequities and guiding the improvement of policies and interventions that are well-suited to the context and culturally appropriate for people living with HIV and other multiply marginalized populations.