Mixing qualitative methods versus methodologies: A critical reflection on communication and power in inpatient care

Father Involvement in Pregnancy and Postnatal Care: Combined Perspectives of Fathers, Mothers, and Service Providers

Involving fathers in pregnancy and postnatal healthcare services can enhance family wellbeing, yet father-inclusive practice remains limited. This study explored the perspectives of key stakeholders (fathers, mothers and service providers) regarding father-inclusive healthcare. Separate online focus groups were held with Australian fathers (n = 4) and mothers (n = 10) of infants up to 12 months old. Semi-structured interviews were held with postnatal service providers (n = 12). Each dataset was analyzed thematically; key findings were then synthesized into overarching themes. All participant groups acknowledged the benefits of father involvement. Barriers to father involvement included traditional role divisions, fathers' competing commitments, workplace inflexibilities, and healthcare systems focused on mothers. Enablers included partner support, positive healthcare experiences, and the provision of father-specific services. Consistent with the view that active fathering has benefits for all the family and to enhance family health, father inclusion is recommended. However, this may require changes at the service, workplace, and societal levels.

Extreme Weather Events and Linkages with HIV Vulnerabilities Among Young Sex Workers and Sexually Diverse Men in Nairobi, Kenya: Qualitative Multi-method Insights

There is growing attention to the impacts of climate change and related extreme weather events (EWE) on HIV vulnerabilities, yet this research largely overlooks key populations such as sex workers and gay, bisexual, and other men who have sex with men (gbMSM). This is a critical knowledge gap in contexts that are greatly affected by climate change, EWE, and HIV, such as Kenya. To address this gap, this study examined the lived experiences of sex workers and gbMSM aged 18-24 in Nairobi, Kenya, regarding the relationships between climate change and EWE, resource insecurities (e.g., food, water), and HIV vulnerabilities. In 2023, we conducted a multi-method qualitative study in Nairobi, Kenya, including individual interviews using the SenseMaker web-based data collection tool and group digital storytelling workshops among 36 participants, including 21 sex workers and 15 gbMSM. Participant narratives aligned with the following themes highlighting the interconnections between EWE and HIV vulnerabilities: (1) EWE, specifically droughts and flooding, led directly and indirectly to resource scarcities and infrastructure damage; (2) participants enacted strategies to navigate resource scarcities, some of which increased HIV vulnerabilities (e.g., reduced condom agency, transactional sex engagement); (3) EWE and resource scarcities increased sexual violence risks; and (4) LGBTQ stigma exacerbated resource scarcities. Participants provided recommendations for multi-level strategies for HIV prevention, sexual health, and wellbeing for young sex workers and gbMSM in Kenya. Learning from young sex worker and gbMSM experiences can advance climate-informed HIV programming that addresses stigma, resource scarcities, and violence to advance sexual health and rights.

Return to practice for allied health professionals with protected characteristics: a mixed-methods study

INTRODUCTION

Return to practice is one mechanism for recruiting and retaining allied health professionals (AHPs) within the health and care workforce in England. It is not known how this affects persons with protected characteristics.

AIM

To understand experiences of AHPs with protected characteristics of returning to the workforce through a return to practice programme.

METHOD

A QUAL (semistructured interviews) + qual (focus group interviews) mixed-methods study. 12 online semistructured interviews with return to practice AHPs, followed by 2 online focus groups.

RESULTS

Our research identifies a new type of returners who have to use the return to practice programme as a vehicle to step into health and social care as they have not been able to find employment. A main driver to return to practice was financial reason.

CONCLUSION

To date there, is little evidence of leaders understanding the complexities of AHPs in a return to practice programme, the considerable contribution they can make to the workplace and the current inequities that exist.

"I'm not alone": perinatal women's experiences in an online self-directed program for perinatal anxiety

BACKGROUND

Anxiety is highly prevalent during pregnancy and postpartum, and access to treatment can be difficult due to a range of barriers (e.g., time, distance, and service availability). Online treatments have the potential to circumvent these barriers and may, therefore, be beneficial for the perinatal population. The present study leveraged qualitative methods to understand participants' perspectives on their use of a six-module online self-directed Cognitive Behavioral Therapy (CBT) program for perinatal anxiety as part of a randomized controlled trial.

METHODS

A mixed qualitative method design was used for this study. A total of 95 perinatal women were randomized to an intervention or waitlist control condition for an online self-directed program (Overcoming Perinatal Anxiety; OPA). Both waitlist and intervention participants provided open-ended feedback on each module via online surveys. A subset of individuals (n = 20) assigned to the intervention condition completed a virtual qualitative interview about their experiences using the program. Data obtained from open-ended survey questions and qualitative interviews were analyzed using Conventional Content Analysis (open-ended survey) and Reflexive Thematic Analysis (interviews).

RESULTS

Open-ended survey data were categorized into three themes, with associated sub-themes: User experience (subthemes: accessibility and modality), Perceptions of content (sub-themes: validating, informative, hopeful, anxiety-inducing, emotionally "heavy", and helpful), and Barriers to program engagement (subthemes: lack of time and energy, technical difficulties, challenging and external factors). Qualitative interview data were categorized into the following main themes, with associated subthemes: Tensions in engaging with the self-directed program (subthemes: connecting and multi-tasking, "finding the time," module length and pacing, pen to paper, and "thanks for the reminder but don't rush me"), "I'm not alone," (subthemes: relating to the content, sharing anxiety with "inner circle," and voicing a desire to connect with other "moms feeling the same way"), and "I'm managing my anxiety" (subthemes: "understanding my anxiety," using "strategies to help with my anxiety," "taking time for myself," and moving forward).

CONCLUSION

Findings highlight that online self-directed treatment can be an acceptable and feasible option for perinatal anxiety. Findings show promise for the scalability of OPA to improve access to psychological treatment for perinatal people experiencing anxiety.

TRIAL REGISTRATION

Clinical Trial Identifier: NCT04844138 (clinicaltrials.gov). Trial registration submitted: [April 5, 2021] accepted: [April 14, 2021].

Nurse-Assisted Remote Patient Monitoring for Self-Management Support to Patients With Long-Term Illness-A Qualitative Multimethod Study

AIM

To explore patients and nurses' experiences of digital self-management support following participation in a remote patient monitoring intervention.

DESIGN

An exploratory qualitative multimethod study.

METHODS

The study was conducted at two Norwegian university hospitals between January 2022 and February 2023. Data were obtained through semistructured interviews of 17 patients with heart failure, 10 patients surgically treated for colorectal cancer and eight nurses. The data collection also included excerpts from chat messages between patients and nurses obtained from the digital platform during January and February 2024. Data were analysed using abductive thematic analysis.

RESULTS

The analysis revealed three themes: (1) raising illness awareness through RPM technology, (2) establishing a mutual collaboration in self-management challenges and (3) fostering a continued engagement in health behaviour change. The themes captured patients and nurses' experiences of receiving and providing digital self-management support. The analysis also identified a unifying key theme: 'bridging technology and self-management support through remote caring encounters', which firmly connected the three themes.

CONCLUSION

Remote patient monitoring appeared to benefit both patients and nurses by altering patients' self-management routines and the nurses' workflows. Furthermore, applying the theory of technological competency as caring in nursing to remote patient monitoring interventions may help ensure that the patient-nurse relationship is not weakened as technology advances.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE

Remote patient monitoring interventions have the potential to become a valuable tool in modern healthcare, enabling effective communication and collaboration between patients and nurses while also ensuring patient-centred care. However, future development of remote patient monitoring interventions should include nursing support.

IMPACT

This study addresses remote patient monitoring and digital self-management support from the perspectives of both patients and nurses. The findings may have an impact on remote nursing, patient satisfaction and strategies to improve digital follow-up care for patients with long-term illnesses.

REPORTING METHOD

The authors adhered to the EQUATOR guidelines through the SRQR reporting method.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

HPV vaccine misinformation on social media: A multi-method qualitative analysis of comments across three platforms

Objective The purpose of this study was to characterize similarities and differences in HPV vaccine misinformation narratives present in the comment sections of top-performing initial creator posts across three social media platforms. Methods A qualitative multi-method design was used to analyze comments collected from social media posts. A sample of 2996 comments were used for thematic analysis (identifying similar themes) and content analysis (identifying differences in comment type, opinion, and misinformation status). Results Misinformation was pervasive in comment sections. Cross-cutting misinformation themes included adverse reactions, unnecessary vaccine, conspiracy theories, and mistrust of authority. The proportion of comments related to these themes varied by platform. Initial creator posts crafted to be perceived as educational or with an anti-vaccine opinion had a higher proportion of misinformation in the comment sections. Facebook had the highest proportion of misinformation comments. Conclusion Differences in the proportion of cross-cutting themes in the comment sections across platforms suggests the need for targeted communication strategies to counter misinformation narratives and support vaccine uptake. Innovation This study is innovative due to its characterization of misinformation themes across three social media platforms using multiple qualitative methods to assess similarities and differences and focusing on conversations occurring within the comment sections.

Finding a path in a methodological jungle: a qualitative research of resilience

Qualitative research provides an in-depth understanding of lived experiences. However, these experiences can be hard to apprehend by using just one method of data analysis. A good example is the experience of resilience. In this paper, the authors describe the chain of the decision-making process in the research of the construct of "resilience". s The authors justify the implications of a multi-method, pluralistic approach, and show how the triangulation of two or more qualitative methods and integration of several qualitative data analysis methods can improve a deeper understanding of the resilience among people with chronic pain. By combining the thematic analysis, narrative analysis, and critical incident technique, lived experiences can be seen from different perspectives.Therefore, the thematic analysis describes the content and answers to "what" regarding resilience, the narrative analysis describes the dynamics of resilience, and answers to "how", while the critical incident technique clarifies the most significant experience and the answers to "why" changes happen. This integrative approach could be used in the analysis of other psychological constructs and can serve as an example of how the rigour of qualitative research could be provided.

The struggle is real-A mixed qualitative methods synthesis of challenges in nursing care in activities of daily living

INTRODUCTION

Supporting care receivers in Activities of Daily Living (ADL), irrespective of diagnosis, setting, or cultural background, lies at the heart of fundamental nursing care. The pursuit of quality ADL care becomes increasingly challenging with the changing complexity of care needs. ADL care delivery is often undervalued and is considered a low-status task despite its crucial importance to care receivers. This study aims to synthesize challenges in ADL care irrespective of the care setting.

METHODS

In the mixed qualitative methods study, we used expert panel consultations, world café sessions, and a rapid literature review. For data analysis, we simultaneously analyzed the three data sets using inductive and deductive inquiry.

RESULTS

We identified four challenges and their corresponding subthemes. They are (1) Undervalued common-sense work versus complex, high-skilled care provision; (2) Limitations in professional reflective clinical decision-making; (3) Missed opportunities for shared ADL decisions; and (4) Meeting ADL care needs in a high-throughput system.

CONCLUSION

These challenges reveal the complexity of ADL care and how its paradoxical narrative relates to the conditions in which nursing professionals struggle to create opportunities, for reflective clinical reasoning and shared ADL decisions, by facing organizational and environmental barriers.

CLINICAL RELEVANCE

This study is relevant to nursing professionals, care organizations, policymakers, and researchers aiming to improve ADL care and provide insights into challenges in ADL care. This study forms the starting point for a changing narrative on ADL nursing care and subsequent quality improvements in the form of, for example, guidelines for nursing professionals.