Qualitative Health Research

Morse, Janice M.

doi: 10.1177/1049732310379116pmid: 20693515

Here, I compare the content, characteristics of participants, and the methods used in qualitative health research with qualitative inquiry in general. Special problems that occur when conducting research in an institution, with the emotional content when participants are ill, in pain, or dying, will be discussed. What concerns for the investigator, for the researcher as a person, and methodological quandaries occur? The bottom line is: Do we have a subdiscipline? Is there a need for a special forum for those practicing qualitative health/illness research?

Kuzel, Anton J.

doi: 10.1177/1049732310379117pmid: 20962318

Bowers, Barbara J.

doi: 10.1177/1049732310379118pmid: 20962319

Mayan, Maria

doi: 10.1177/1049732310379119pmid: 20962320

Mill, Judy E.; Edwards, Nancy; Jackson, Randy C.; MacLean, Lynne; Chaw-Kant, Jean

doi: 10.1177/1049732310375436pmid: 20663937

Stigmatization contributes to inequity by marginalizing persons living with HIV and AIDS (PHAs). In this study we examined the stigmatizing practices in health care settings from the perspectives of PHAs and health care providers (HCPs). A qualitative design, using a participatory action research approach, was used. Interviews and focus groups were completed with 16 aboriginal and 17 nonaboriginal individuals living with HIV (APHAs and PHAs) and 27 HCPs in Ottawa and Edmonton, Canada. We present findings to support the premise that stigmatization can be used as a social control mechanism with PHAs. Participants described both active and passive social control mechanisms: shunning and ostracizing, labeling, and disempowering health care practices. Forgiving behavior, balancing disclosure, practicing universal precautions, bending the rules, shifting services, and reducing labeling were strategies to manage, resist, and mitigate social control. The findings illustrate the urgent need for multilevel interventions to manage, resist, and mitigate stigma.

Dale, Helen E.; Polivka, Barbara J.; Chaudry, Rosemary V.; Simmonds, Gwenneth C.

doi: 10.1177/1049732310374043pmid: 20562249

The Institute of Medicine’s report on racial and ethnic disparities in health care encourages enhancing patient—provider relationships by building trust. We explored factors important to 19- to 24-year-old African American women (N = 40) in choosing a health care provider. Eight focus groups were held in seven Ohio counties. Discussion was aided by photographs of client—provider interactions: two African American and two White providers (man or woman in each); in similar settings, attire, and pose; with a young African American woman client. Participants commented on what was happening in the photographs, how the woman felt, and their perceptions of each provider. Fongwa’s Quality of Care model guided analysis. Women providers were favored; race was not of primary concern. Provider proximity, perceived interest, and understandability were persistent preferences. Trust, awareness of body language, interest in client, and conveying information clearly are critical for providers caring for young African American women.

Prieto-Flores, Maria-Eugenia; Fernandez-Mayoralas, Gloria; Rosenberg, Mark W.; Rojo-Perez, Fermina

doi: 10.1177/1049732310374062pmid: 20562252

The importance of qualitative methods in quality of life (QoL) studies is being increasingly recognized. Whereas attention has mainly focused on the exploration of relevant domains, subjective well-being, and representations of health in aging, less consideration has been given to relations among different QoL domains. We aimed in this research to identify connections between subjective health and other relevant domains from the perspective of older adults. We identified four central categories: adaptation to the limits of health in aging; seeking a balance in subjective health and QoL in aging; sense of place in centers for older people; and health and family interrelated dimensions of QoL in old age. According to the participants, the family domain positively impacts health as a consequence of contacts, support, and accomplishments. It might also have a negative impact as a result of a relatives’ death or severe disease. The qualitative QoL perspective contributes to capturing the multidimensionality of health, aging, and place.

James, Inger; Andershed, Birgitta; Gustavsson, Bernt; Ternestedt, Britt-Marie

doi: 10.1177/1049732310374042pmid: 20562250

In this combined ethnographic and hermeneutic study we examined which forms of knowledge nurses make use of and how they construct knowledge. We collected data using participant observations, informal conversations, and interviews. Nurses’ knowledge construction took the form of a hermeneutic spiral, a journey in which the nurses moved up and down and horizontally, and in which they created understanding. The nurses constructed knowledge from reading the patient’s record, the brief oral handover report, greeting the patient, and reading the patient. By being sensitive, using humor, and emotional involvement, they deepened their understanding. By being suspicious and self-critical, they sought interaction with nurse colleagues, the patient, doctor, and relatives, and obtained additional knowledge. They strove throughout the journey to be one step ahead in their efforts to attain an understanding of the patient’s situation. We can relate the knowledge nurses make use of to intertwined forms of episteme, techne, and phronesis.

Ponic, Pamela; Frisby, Wendy

doi: 10.1177/1049732310374303pmid: 20581075

Community-based health promoters often aim to facilitate “inclusion” when working with marginalized women to address their exclusion and related health issues. Yet the notion of inclusion has not been critically interrogated within this field, resulting in the perpetuation of assumptions that oversimplify it. We provide qualitative evidence on inclusion as a health-promotion strategy from the perspectives of women living in poverty. We collected data with women engaged in a 6-year community-based health promotion and feminist participatory action research project. Participants’ experiences illustrated that inclusion was a multidimensional process that involved a dynamic interplay between structural determinants and individual agency. The women named multiple elements of inclusion across psychosocial, relational, organizational, and participatory dimensions. This knowledge interrupts assumptions that inclusion is achievable and desirable for so-called recipients of such initiatives. We thus call for critical consideration of the complexities, limitations, and possibilities of facilitating inclusion as a health-promotion strategy.

Gaal, Barbara J.; Pinelli, Janet; Crooks, Dauna; Saigal, Saroj; Streiner, David L.; Boyle, Michael

doi: 10.1177/1049732310375248pmid: 20581076

Siblings have unique relationships; however, not all sibling relationships are typical. In North America, the preterm birth rate ranks second only to Africa in a global climate of rising preterm birth rates. A paucity of literature exists for sibling relationships when one sibling is born prematurely. In this hermeneutic phenomenological study, we explored the lived experience of adult siblings with prematurely born, young adult brothers and sisters who subsequently developed disabilities. The 28 siblings, interviewed with open-ended questions, represented 47 families with extremely-low-birth-weight young adults with neurodevelopmental disabilities born between 1977 and 1982. Existential reflection guided by van Manen’s human science approach assisted the analysis of tape-recorded conversations. A structure of meaning entitled “outside looking in” emerged to illustrate the extraordinary relationships forged by the adult siblings with their brothers and sisters throughout their years together.