The lifeworld – enriching qualitative evidence

Lived experience of using assistive technology for sandy beach based leisure for Australian people with mobility limitations

PURPOSE

This study explores experiences of using beach assistive technology (AT), such as beach wheelchairs, powered wheelchairs, prosthetics and crutches, to participate in sandy beach-based leisure for people with mobility limitations.

METHODS

Online semi-structured interviews were conducted with 14 people, with mobility limitations and experience of using Beach AT. A phenomenological interpretative hermeneutic approach guided reflexive thematic analysis of verbatim transcripts.

FINDINGS

Three overarching themes were identified as: The meaning of using Beach AT, Practicalities of using Beach AT and Responses to using Beach AT. Each overarching theme was underpinned by subthemes. Meaning included: AT connects me, AT impacts my identity and AT attracts attention. Practicalities included: using AT requires other people, AT impacts spontaneity, AT limitations and AT use differs in water. Responses to using Beach AT included: I didn't think it was possible, adaptions to AT limitations and not everyone wants to own Beach AT.

CONCLUSION

This study illustrates the use of Beach AT as a facilitator for beach leisure, enabling connections to social groups and contributing to one's identity as a beachgoer. Access to Beach AT is meaningful and may be made possible through personal Beach AT ownership or access to loaned AT. The unique nature of sand, water, and salt environments requires users to identify how they plan to use the devices, with realistic expectations that the Beach AT may not enable full independence. The study acknowledges the challenges related to size, storage, and propulsion, but emphasizes that these can be overcome through ingenuity.

Picturing oneself over time: a multi-modal interpretative phenomenological analysis of pain management trajectories

BACKGROUND

Chronic pain (CP) can be a disabling condition with impacts that affect the sense of identity of those who live with it. This article idiographically describes the longitudinal evolution of the sense of self of participants following their referral to a pain management service and participation in a pain management programme (PMP).

METHODS

Participants were interviewed three times: before they attended a PMP, and 1 and 6 months after the PMP. Data included the drawings of themselves that participants created at each interview and the transcripts of the interviews guided by the drawings, analysed longitudinally using interpretative phenomenological analysis.

RESULTS

This paper describes in detail the cases of four participants: two who experienced a positive albeit troubled trajectory following their PMP and two who did not experience any positive change. The results provide a nuanced account of how the impacts of CP on identity can evolve, with different people engaging with different aspects of a PMP and some people not engaging at all, and how pain self-management strategies enable those that do engage to cope in times of difficulty.

CONCLUSIONS

Participant responses to PMP participation are idiosyncratic and interviews with drawings of self analysed longitudinally can help illustrate processes of change.

SIGNIFICANCE

Not enough is understood about why some people get limited benefits from pain services. This idiographic longitudinal study illustrates how the impact of CP on identity can evolve when people are introduced to pain self-management, with some embracing change and others resisting it. For clinicians, this study describes four detailed CP individual paths, showing the interaction between contextual and idiosyncratic aspects. This is also the first study to use multiple drawings of self to explore the impacts of illness on identity longitudinally. In a person-centred approach to treatment, the drawings of self could also be adopted as a tool in clinician-patient conversations to gain a deeper understanding of the impacts of living with CP.

"Finding a new normal: the lived experience of persons' journey towards coping with persistent low back pain"

INTRODUCTION

Persistent low back pain (PLBP) is the biggest global cause of disability. Persons with PLBP experience biographic disruption and existential crisis. Guidelines recommend a biopsychosocial approach to management, with the emphasis on coping strategies.

PURPOSE

However, there is a paucity of research exploring the lived experience of persons who self-identify as coping with PLBP.

METHOD

The study used an interpretive phenomenological approach, analyzing transcripts from 1:1 interviews with six persons who self-identify as coping with PLBP. Poetic language was used to elicit empathic, embodied relational understanding and convey a richer understanding of the phenomenon that authentic quotations might not able to reveal.

FINDINGS AND CONCLUSION

Participants' descriptions conveyed the sense of a journey, starting with the loss of a sense of self as they engaged in the pain battle, followed by a transition toward a new 'normal,' in which time, acceptance and trust in their own intuition were meaningful components. Although anxiety and fear were a continued presence, but they became more manageable. Society's role in the coping process was significantly meaningful and is something which requires reflections from therapists' and more widely.

Understanding physiotherapy and physiotherapy services: exploring the perspectives of adults living with cerebral palsy

PURPOSE

To understand physiotherapy and physiotherapy services from the perspectives of adults with cerebral palsy (CP).

METHODS

Twenty-two adults with CP (15 women, 7 men), from across the UK, aged between 23 and 51 years, Gross Motor Function Classification System I-V, were interviewed about their experiences of physiotherapy and physiotherapy services. Participants were recruited through advertisements placed with relevant national organisations. The interviews were transcribed and analysed according to principles of Reflective Lifeworld Research. A second analysis examined the findings in relation to Donabedian's structure-process-outcome framework for healthcare quality.

RESULTS

Specialist services for adults with CP were described as scarce, unknowable, complex and disconnected through the life course. Specific problems included; structural dimensions such as access to and organisation of services, signposting to services and access to expert advice; process dimensions including a lack of attention to patients' perspectives, needs, priorities, experience and expertise; and outcome dimensions for example the negative impact of physiotherapy service configurations on health, well-being and quality of life.

CONCLUSION

Study findings support grassroots calls to radically improve and increase physiotherapy services for adults with CP. Accessible and widely available specialist services, information and advice across the life course would do much to address unmet need. Implications for RehabilitationAdults with CP found it difficult to identify and access specialised physiotherapy services and to obtain information and advice to help them best manage their condition.Adults with CP need physiotherapy services throughout the different phases of their lives, to meet their present needs, and to anticipate and, where possible, to prevent future needs.Participants highly valued person-centred physiotherapy and we recommend this approach is adopted as the foundational philosophy guiding physiotherapy services and interventions for adults with CP.More specialist physiotherapy services are urgently needed to meet the needs of adults with CP in the UK.

Being an Elderly Person Living in Metropolitan Cities of Northwestern Ethiopia: A Descriptive Phenomenological Study

Background

As people grow old, they pass through various life courses. Thus, it is important to realize aging in the context of each of these stages, as aging is not only physiological and psychological processes. To understand the lifeworld experiences of the phenomenon "being an elderly person" from the individual perspective was important, in this study, within day-to-day life in Metropolitan cities of northwestern Ethiopia.

Objective

The aim of this study was to describe the lifeworld of elderly persons living in Bahir Dar and Gondar Cities, Northwest Ethiopia.

Methods

A community based qualitative study conducted from October 29, 2021 to November 6, 2021. A purposive sampling technique and in-depth interviews were used for sampling and data collection, respectively. To explore the life experience /life-world/ of the elderly, a descriptive phenomenological study was conducted among 15 elderly persons. The audio records were transcribed and the field notes incorporated. Transcribed texts were translated into the English language, and a descriptive phenomenological analysis was done.

Results

In this study, the essence of the phenomenon, being an elderly person, means, in an ebb and flow motion, balancing a life change characterized by changing perspective, ambiguity to body functions, and preparing for being released. The elderly experienced physical, mental, and psychosocial changes. They had encountered positive and negative situations throughout their life span. They also expressed that their time was over and wished to prepare for God's Kingdom.

Conclusion

The use of phenomenology for this research provided an opportunity for a deeper understanding of the experiences of elderly persons. With knowledge from this study, nurses and other health professionals can understand and support the elderly from an individual point of view.

Empirical Phenomenological Inquiry: Guidance in Choosing Between Different Methodologies

Empirical phenomenological inquiry and analyses are of high relevance and applicability for nursing and health care. Phenomenology has clear roots in philosophy, which needs to be brought into an empirical phenomenological inquiry. However, all study of phenomena and experience does not qualify as phenomenological inquiry. The aim of this article is to provide guidance for how to relate different empirical phenomenological methodologies that are in play in the broader field of healthcare research, and thus support healthcare researchers in navigating between these methodologies. For pedagogical purposes, we present commonalities and differences as related to descriptive and interpretive phenomenological inquiries throughout the research process. The merits and criticisms of empirical phenomenological inquiry are commented on.

Moving the needle on qualitative approaches to studying HRD

Purpose

The purpose of this paper is to conclude this special issue on innovation in qualitative research by addressing the preceding papers in relation to the work of Human Resource Development (HRD) scholars and scholar-practitioners, consider the implications to the field of HRD and point to additional directions for innovative qualitative approaches. The authors use the term “innovative” to mean either an approach (or technique) that is newly conceived or one that is new to HRD (or little used).

Design/methodology/approach

The authors reviewed the papers in the special issue, identified other innovative qualitative approaches from the HRD literature and described briefly additional innovative approaches from other fields to suggest future directions for HRD professionals.

Findings

In this review, the authors noted the relatively few approaches to qualitative research that have been used regularly in HRD literature and suggested further innovative approaches that could deepen the understanding of organizations, including narrative, visual and indigenous methods, among others.

Research limitations/implications

This paper provides for HRD scholars an overview of a few qualitative research methodologies that are new to HRD and identifies additional approaches and epistemological challenges that could be valuable for future inquiry into complex organizations by HRD scholars and practitioners.

Practical implications

The authors suggest various feasible approaches and tools for HRD professionals to inquire into their practice in organizations to identify needs, evaluate outcomes and inquire into socially complex issues.

Originality/value

This study’s intent is to encourage the use of various innovative qualitative inquiry approaches when appropriate to understand and transform organizations. In particular, this study encourages the approaches that center the voices and experiences of those being studied and emphasizes the ways of listening to voices from the margins that may have been ignored previously.

Self-Ascribed Paranormal Ability: Reflexive Thematic Analysis

This study investigated personal perceptions (involvements) and comprehensions (interpretations) of self-ascribed paranormal abilities. Twelve participants with supposed supernatural powers took part in semi-structured interviews exploring the origin, phenomenology, and nature of their powers. Interview transcripts were analysed using reflexive thematic analysis (RTA), a qualitative method that identifies patterns within data. Four major themes expressed meanings and representations held by participants: Formative Influences (sub-themes: Gifted Family Members and Anomalous Occurrence), (Inter) Subjective Paranormal Experience (sub-themes: Transcendental/Mystic and Extra-Sensory Perception), Embodied Processes (sub-theme: Control), and Perception of Reality (two sub-themes: Self-Awareness and Fantastic/Surreal Perceptions). Consideration of themes identified an inextricable link between perception, interpretation, and belief in ability. Within narratives, interviewees outlined, contextualised, and established the validity of their powers. They drew upon supporting autobiographical evidence from their life histories and obfuscated and/or discounted conventional explanations. Generally, accounts reflected individual attempts to comprehend and justify the nature and experience of professed abilities. The authors discuss these processes and suggest ways to extend and develop ensuing research.

"A Bed of Nails": Professional Musicians' Accounts of the Experience of Performance Anxiety From a Phenomenological Perspective

Most investigations of musical performance anxiety have employed quantitative methodologies. Whereas such methodologies can provide useful insights into the measurable aspects of the experience in a larger group of participants, the complexity, subtlety and individuality of the emotional experience and the importance of the individual’s interpretation of it are often overlooked. This study employed a phenomenological approach to investigate the lived, subjective experience of performance anxiety, as described in professional musicians’ narratives. Semi-structured interviews with four professional musicians (two males, two females) specializing in Western classical and jazz music genres were conducted and analyzed using Interpretative Phenomenological Analysis (IPA). The analysis revealed the presence of four overarching themes: (1) Intensity of performance anxiety experience, (2) perceived effects, (3) development of coping strategies, and (4) achieving release from anxiety. Findings suggest that the lived experience of performance anxiety is multifaceted, characterized by a physical and a psychological dimension. Interpretative Phenomenological Analysis is a useful research tool that can facilitate our understanding of the subjective experience of performance anxiety (how it is felt and understood at an individual level) and can thus be useful in the development of tailor-made intervention programs for musicians.

‘Urban biocultural diversity’ as a framework for human–nature interactions: reflections from a Brazilian favela

Biocultural diversity (BCD), denoting the ‘inextricable link’ between biological and cultural diversity, has traditionally highlighted the coevolution between highly biodiverse regions and the ethnic–linguistic diversity of indigenous communities. Recently, European researchers have relaunched BCD as a conceptual foundation for urban greenspace planning capable of overcoming challenges of the ecosystem services paradigm. However, the methodological foundation for this particular approach to ‘urban BCD’ is still in its infancy, obscuring precisely how the framework is an advancement for studying different urban residents’ experience of and connectedness to nature and biodiversity. In this paper, we further develop the urban BCD concept by using the culturally and biologically diverse city of Rio de Janeiro, Brazil as a ‘critical case’. First, we employ qualitative field methods to investigate manifestations of human–nature relationships in the favela (informal settlement) of Rocinha and the neighbouring Tijuca Forest. Second, we reflect on how the urban BCD framework and methodology emphasise i) interrelationships, ii) varied group values and iii) participation, and iv) are sensitising and reflexive. Our findings challenge the ‘usual’ narrative about favelas as places of environmental degradation and disaster risk, revealing BCD and nature connectedness that are as related to popular culture, fitness ideals and citizen-building, as to traditional livelihoods and spiritual beliefs. Departing from interrelationships, BCD can portray aspects that a narrow focus on ‘services’ and ‘disservices’ cannot, but attention should be paid to how operationalisation risks perpetuating ecosystem services thinking. Nevertheless, we identify promising avenues for its use in highly diverse cities with unequal access to natural areas.

The question of meaning-a momentous issue for qualitative research

In this article, we identify some worrying problems in the contemporary practice of qualitative research, such as the confusion regarding content and meaning in content analysis, the frequent use of standardized methods that avoids philosophy, as well as the description/interpretation dichotomy in empirical research. Since they all arise from a failure to understand the concept of meaning, we return to the question of meaning as the axis that qualitative research pivots around. We examine the meaning of meaning, and how meaning differs from content, and we then ask what consequences this has for research. Even though our analysis is rooted in phenomenological philosophy, we argue that that the ideas that we present are valid for any qualitative research approach. The question of understanding and relating to meaning, we argue, is a momentous issue for qualitative research, where we either continue safeguarding the very essence of qualitative research as dealing with human phenomena, or give it up in favor of more pragmatic and clear-cut methods that seemingly does away with the question of meaning.

Naked in the eyes of the public: A phenomenological study of the lived experience of suffering from burnout while waiting for recognition to be ill

Although there has been a focus on problematic issues related to health care services and complaints made by patients, individuals who suffer from medically unexplained syndromes continue to report being epistemically marginalized or excluded by health professionals. The aim of this article is to uncover a deeper understanding of the what-ness of experiencing being naked in the eyes of the public while waiting to be recognized as ill. Therefore, a phenomenological approach was chosen to inductively and holistically understand the human experience in this context-specific setting. Semi-structured interviews were conducted with two men and six women between 25 and 65 years of age, who had been on sick leave for more than 52 weeks. Their symptoms were consistent with Exhaustion Disorder (ICD-10, F43.8A). The meaning of the interviewees' lived experience was explored using a life-world approach to phenomenological reflection and writing. The participants described their experience of encountering the general practitioner as taking part in a battle. Feeling distrusted by others seemed to result in disconnection from their habitual lifeworld, which in turn triggered a shame reaction. Additionally, the study showed a possible distrust related to several communication levels within the health care system, which influenced the recovery process negatively. Lack of experienced support can lead to exacerbated feelings of distress. Accordingly, the psychosocial experience of being ill might be as important as its unknown aetiology. Therefore, in the context of these interpersonal relations, both norms, values, and attitudes, and issues of power need to be considered and addressed properly.

The acute stroke unit as a meaningful space: The lived experience of healthcare practitioners

This hermeneutic phenomenological study was undertaken in response to the recent re-organization of stroke unit provision in the United Kingdom. Through the analysis of four acute stroke unit practitioners' subjective accounts, the acute stroke unit emerged as a dynamic, meaningful space, where they experienced authenticity and belonging. The findings showed how these practitioners navigated their way through the space, thriving, and/or surviving its' associated vulnerabilities. They offer a different gaze on which to attend to the complexity and challenge that is interwoven with health professionals' flourishing, the spatiality of healthcare practice, and perhaps other demanding places of work.