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Meixner C, Spitzner DJ. Leveraging the Power of Online Qualitative Inquiry in Mixed Methods Research: Novel Prospects and Challenges Amidst COVID-19. JOURNAL OF MIXED METHODS RESEARCH 2023; 17:171-186. [PMID: 38603220 PMCID: PMC9016368 DOI: 10.1177/15586898221084504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
The rare circumstances of COVID-19 have transformed research toward increased dependence on online spaces. This article examines related challenges and opportunities, focusing on how philosophical and ethical implications are differentially manifest amid crisis. Anchored by a transformative perspective, our framework recognizes heightened vulnerabilities amid COVID-19; it seeks dexterous strategies for implementing qualitative strands that adapt well to a virtual context while remaining philosophically grounded and ethical. Our findings highlight issues of unequal access, disembodiment, safety and vulnerability, researcher positionality, anonymity, and the delineation between private and public spaces; we also showcase an array of virtual qualitative methods. We conclude that ethical practice in the use of online methods is likely to be broadly applicable and adaptable to the mixed methods research community.
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Affiliation(s)
- Cara Meixner
- Department of Graduate Psychology, James Madison
University, Harrisonburg, VA, USA
| | - Dan J. Spitzner
- Department of Statistics, University of Virginia, Charlottesville, VA, USA
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Wallace-Farquharson T, Rhee H, Duckworth L, Elder JH, Wilkie DJ. Children's and adolescents' descriptors of asthma symptoms: An integrative review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100063. [PMID: 38745641 PMCID: PMC11080484 DOI: 10.1016/j.ijnsa.2022.100063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/17/2022] [Accepted: 01/20/2022] [Indexed: 01/03/2023] Open
Abstract
Background Accurate assessment of asthma symptoms is central to appropriate treatment and management; however effective communication about symptoms-how it is perceived and reported-remain challenging in pediatric clinical and research settings. Objective To synthesize the existing pediatric literature on children's and adolescents' word descriptors of asthma symptoms. Methods In this integrative review, we systematically searched Cumulative Index of Nursing and Allied Health Literature and PubMed databases to identify original research studies from 1980 to 2021 on children and adolescents' word descriptors of asthma symptoms. Results The search yielded 2,232 articles, of which 21 studies met the eligibility criteria. Scientific literature focused on children and adolescents' descriptions of asthma symptoms are limited. In addition to standard asthma symptom terminology (e.g. cough, wheeze, chest tightness, shortness of breath), pediatric populations used nonstandard word choices to describe the asthma symptom experience. Children and adolescents used a variety of affective (e.g. 'helpless', 'afraid of dying') and sensory words (e.g. 'pressure in chest', 'tightness, lungs feel shut') to describe the phenomena. Literature examining race differences in word descriptors in pediatrics is limited; thus it is unclear if word descriptors vary by race or ethnicity. Evidence of relationships between descriptors and gender and age are also lacking. Conclusions Our review elucidates gaps in the literature regarding the full extent of the language common to racially and ethnically diverse samples of children and adolescents. Further research is warranted to help clinicians and researchers query children and adolescents' experience of asthma symptoms.
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Affiliation(s)
| | - Hyekyun Rhee
- School of Nursing, University of Texas at Austin, Austin, TX, United States of America
| | - Laurie Duckworth
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, United States of America
| | | | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, United States of America
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Rhee H, Batek L, Wallace-Farquharson T, Tumiel-Berhalter L. Are Mid to Late Adolescents with Asthma Ready for Transition of Care? A Qualitative Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1573. [PMID: 36291509 PMCID: PMC9600616 DOI: 10.3390/children9101573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/05/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
This qualitative descriptive study explores experiences and perspectives of mid-to-late adolescents about growing up with asthma, and the roles of parents and providers as they transition. Purposeful sampling was used to recruit and enroll adolescents aged 16-20 years with asthma. Forty-one adolescents participated in a focus group or individual interview, and content analysis was conducted to analyze the data. The mean age of participants was 17.7 years, the majority (56%) of whom were Black. Themes that emerged included concerns about becoming an adult with asthma and its self-management, parental involvement, and communication with providers. Adolescents felt burdened by asthma, few considered becoming adults with asthma, and their future outlook was pessimistic with concerns related to worsening symptoms, inadequacy in symptom self-management and limitations on career choices due to asthma. Deficiencies in self-management were noted, parents still played major roles in adolescents' asthma care, and transition of care was seldom discussed with the providers. Mid-to-late adolescents with asthma are inadequately prepared for transition of care, and parents and providers insufficiently engage adolescents in the preparation. Parent, provider, and adolescent partnership is critical to achieve adolescent readiness for independence in asthma management and to ensure proper asthma care continuity post transition.
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Affiliation(s)
- Hyekyun Rhee
- School of Nursing, University of Texas at Austin, 1710 Red River St., Austin, TX 78712, USA
| | - Lindsay Batek
- School of Nursing, University of Rochester, 601 Elmwood Ave., Box SON, Rochester, NY 14642, USA
| | | | - Laurene Tumiel-Berhalter
- Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, 77 Goodell St., Buffalo, NY 14203, USA
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Dowell JA, Arcoleo KA. Child's Illness Representation Instrument: Testing Reliability & Factor Structure Study. J Nurs Meas 2022; 31:JNM-2021-0052.R1. [PMID: 35882531 DOI: 10.1891/jnm-2021-0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Researchers have determined that illness representation, including identifying the illness, understanding the cause, and knowing the risk, may influence asthma symptom management. PURPOSE The purpose of study was to determine reliability and factor structure for child's version of illness representation. METHODS A Maximum Likelihood factor analysis was used to examine reliability and factor structure of the child version of illness representation (CIR) scale. The sample included teens ages 12 to 18 from United States (N=331) with asthma. RESULTS The reliability was 0.79. Eight factors loaded with the most percentage of variance. CONCLUSIONS The perceptions of teens on the health care provider's prescribing practices may shed light on medication adherence. More research is needed to examine CIRS function in a study on medication adherence.
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Dramburg S, Dellbrügger E, van Aalderen W, Matricardi PM. The impact of a digital wheeze detector on parental disease management of pre-school children suffering from wheezing-a pilot study. Pilot Feasibility Stud 2021; 7:185. [PMID: 34627391 PMCID: PMC8501322 DOI: 10.1186/s40814-021-00917-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/31/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Viral airway infections are a major reason for doctor's visits at pre-school age, especially when associated with wheezing. While proper treatment requires adequate recognition of airway obstruction, caretakers are often struggling with this judgment, consequently leading to insufficient or late treatment and an unnecessary discomfort of the patient. Digital technologies may serve to support parental decision taking. The aim of the present pilot study is to acquire data on the feasibility of recruitment and observation procedures for a randomized controlled trial on the impact of a digital wheeze detector in a home management setting of pre-school wheezing. METHODS This single-armed pilot study enrolled patients with a doctor's diagnosis of wheezing aged 9 to 72 months. Participants were asked to use a digital wheeze detector (WheezeScan, Omron Healthcare, Japan) 2×/day for 30 days and record the child's respiratory symptoms, detection of wheezing, and medication intake via an electronic diary (eDiary) app. Demographic and clinical data were collected at the recruitment visit. The asthma control test and the Parent Asthma Management Self-Efficacy Scale (PAMSES) were assessed both, at recruitment and follow-up. RESULTS Twenty families were recruited and completed the monitoring. All but one completed the follow-up after 30 days. The recruitment procedures were feasible, and adherence to daily monitoring reached an average of 81%. The use of the wheeze detector was rated as uncomplicated. Parents detected wheezing without digital support in only 22/708 (3.1%) of the recorded events. By contrast, the wheeze detector indicated an airway obstruction in 140/708 (19.8%) of the recordings. CONCLUSION In parallel to feasible recruitment procedures, we observed good usability of the wheeze detection device and high adherence to eDiary recording. The positive outcomes show that the WheezeScan may empower parents by increasing their capacity for wheeze detection. This deserves to be investigated in a larger randomized controlled trial.
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Affiliation(s)
- Stephanie Dramburg
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | | | - Wim van Aalderen
- Department of Pediatric Respiratory Medicine and Allergy, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Paolo Maria Matricardi
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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Mammen JR, Turgeon K, Philibert A, Schoonmaker JD, Java J, Halterman J, Berliant MN, Crowley A, Reznik M, Feldman JM, Fortuna RJ, Arcoleo K. A mixed-methods analysis of younger adults' perceptions of asthma, self-management, and preventive care: "This isn't helping me none". Clin Exp Allergy 2021; 51:63-77. [PMID: 33007115 PMCID: PMC7821137 DOI: 10.1111/cea.13751] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/18/2020] [Accepted: 09/24/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Young adults (ages 18-44) have increased emergency department use for asthma and poor adherence to medications. The objective of this mixed-methods study was to understand experiences with and approaches to managing asthma, of which little is known in this age group. METHODS Surveys (Asthma Control Questionnaire, Asthma Quality of Life Questionnaire) and 1:1 semi-structured interviews were used to explore experiences with asthma, symptoms, self-management behaviours, and relationship to asthma control and quality of life. Qualitative data were analysed using content analysis techniques. Descriptive statistics and bivariate correlations were used to examine distributive characteristics and associations between variables. RESULTS Forty urban adults participated (mean age 32.7 ± 6.2, 1σ). Coughing was reported nearly 46% more often than wheezing, with 42.5% (17/40) coughing until the point of vomiting most days. Most participants delayed using medication for symptoms due to misperceptions about inhalers. Higher symptom frequency and worse asthma control were associated with greater use of non-pharmacologic symptom management strategies (r = 0.645, P < .001; r = 0.360, P = .022, respectively). Five themes were identified regarding young adults experiences with asthma: (1) having asthma means being limited and missing out on life; (2) health care for asthma is burdensome, and other things are more important; (3) there is not enough personal benefit in medical interactions to make preventive care worthwhile; (4) there are insufficient support and education about asthma for adults; and (5) people normalize chronic symptoms over time and find ways of coping that fit with their lifestyle. CONCLUSIONS AND CLINICAL RELEVANCE Young adults may tolerate symptoms without using quick-relief medication or seeking preventive care. Increasing engagement with preventive services will require decreasing perceived burdens and increasing the personal benefits of care. Evaluating for non-pharmacologic approaches to managing symptoms and asthma-related coughing may identify uncontrolled asthma. Enhanced training for clinicians in patient-centric asthma care may be needed.
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Affiliation(s)
| | - Kelsey Turgeon
- College of NursingUniversity of Rhode IslandKingstonRIUSA
| | | | | | - James Java
- Department of Biostatistics and Computational BiologyUniversity of RochesterRochesterNYUSA
| | - Jill Halterman
- Department of PediatricsUniversity of Rochester School of MedicineRochesterNYUSA
| | - Marc N. Berliant
- Department of Internal MedicineUniversity of Rochester School of MedicineRochesterNYUSA
| | - Amber Crowley
- Department of Internal MedicineUniversity of Rochester School of MedicineRochesterNYUSA
| | - Marina Reznik
- Department of PediatricsDivision of Academic General PediatricsAlbert Einstein College of MedicineChildren’s Hospital at MontefioreBronxNYUSA
| | - Jonathan M. Feldman
- Department of PediatricsDivision of Academic General PediatricsAlbert Einstein College of MedicineChildren’s Hospital at MontefioreBronxNYUSA
- Ferkauf Graduate School of PsychologyYeshiva UniversityBronxNYUSA
| | - Robert J. Fortuna
- Department of PediatricsUniversity of Rochester School of MedicineRochesterNYUSA
- Department of Internal MedicineUniversity of Rochester School of MedicineRochesterNYUSA
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Camacho-Rivera M, Vo H, Huang X, Lau J, Lawal A, Kawaguchi A. Evaluating Asthma Mobile Apps to Improve Asthma Self-Management: User Ratings and Sentiment Analysis of Publicly Available Apps. JMIR Mhealth Uhealth 2020; 8:e15076. [PMID: 33118944 PMCID: PMC7661227 DOI: 10.2196/15076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/10/2020] [Accepted: 08/03/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The development and use of mobile health (mHealth) apps for asthma management have risen dramatically over the past two decades. Asthma apps vary widely in their content and features; however, prior research has rarely examined preferences of users of publicly available apps. OBJECTIVE The goals of this study were to provide a descriptive overview of asthma mobile apps that are publicly available and to assess the usability of asthma apps currently available on the market to identify content and features of apps associated with positive and negative user ratings. METHODS Reviews were collected on June 23, 2020, and included publicly posted reviews until June 21, 2020. To characterize features associated with high or low app ratings, we first dichotomized the average user rating of the asthma app into 2 categories: a high average rating and a low average rating. Asthma apps with average ratings of 4 and above were categorized as having a high average rating. Asthma apps with average ratings of less than 4 were categorized as having a low average rating. For the sentiment analysis, we modeled both 2-word (bi-gram) and 3-word (tri-gram) phrases which commonly appeared across highly rated and lowly rated apps. RESULTS Of the 10 apps that met the inclusion criteria, a total of 373 reviews were examined across all apps. Among apps reviewed, 53.4% (199/373) received high ratings (average ratings of 4 or 5) and 47.2% (176/373) received low ratings (average ratings of 3 or less). The number of ratings across all apps ranged from 188 (AsthmaMD) to 10 (My Asthma App); 30% (3/10) of apps were available on both Android and iOS. From the sentiment analysis, key features of asthma management that were common among highly rated apps included the tracking of peak flow readings (n=48), asthma symptom monitoring (n=11), and action plans (n=10). Key features related to functionality that were common among highly rated apps included ease of use (n=5). Users most commonly reported loss of data (n=14) and crashing of app (n=12) as functionality issues among poorly rated asthma apps. CONCLUSIONS Our study results demonstrate that asthma app quality, maintenance, and updates vary widely across apps and platforms. These findings may call into question the long-term engagement with asthma apps, a crucial factor for determining their potential to improve asthma self-management and asthma clinical outcomes.
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Affiliation(s)
- Marlene Camacho-Rivera
- Department of Community Health Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
| | - Huy Vo
- Department of Computer Science, Grove School of Engineering, City College of New York, New York, NY, United States
| | - Xueqi Huang
- Department of Computer Science, Grove School of Engineering, City College of New York, New York, NY, United States
| | - Julia Lau
- Department of Computer Science, Grove School of Engineering, City College of New York, New York, NY, United States
| | - Adeola Lawal
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY, United States
| | - Akira Kawaguchi
- Department of Computer Science, Grove School of Engineering, City College of New York, New York, NY, United States
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Roberts G. Sibs, low-level allergic sensitization and adolescents. Clin Exp Allergy 2020; 49:264-265. [PMID: 30811766 DOI: 10.1111/cea.13368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- G Roberts
- Faculty of Medicine, Clinical and Experimental Sciences and Human Development and Health, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
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Zunic A, Corcoran P, Spasic I. Sentiment Analysis in Health and Well-Being: Systematic Review. JMIR Med Inform 2020; 8:e16023. [PMID: 32012057 PMCID: PMC7013658 DOI: 10.2196/16023] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/26/2019] [Accepted: 10/27/2019] [Indexed: 12/22/2022] Open
Abstract
Background Sentiment analysis (SA) is a subfield of natural language processing whose aim is to automatically classify the sentiment expressed in a free text. It has found practical applications across a wide range of societal contexts including marketing, economy, and politics. This review focuses specifically on applications related to health, which is defined as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Objective This study aimed to establish the state of the art in SA related to health and well-being by conducting a systematic review of the recent literature. To capture the perspective of those individuals whose health and well-being are affected, we focused specifically on spontaneously generated content and not necessarily that of health care professionals. Methods Our methodology is based on the guidelines for performing systematic reviews. In January 2019, we used PubMed, a multifaceted interface, to perform a literature search against MEDLINE. We identified a total of 86 relevant studies and extracted data about the datasets analyzed, discourse topics, data creators, downstream applications, algorithms used, and their evaluation. Results The majority of data were collected from social networking and Web-based retailing platforms. The primary purpose of online conversations is to exchange information and provide social support online. These communities tend to form around health conditions with high severity and chronicity rates. Different treatments and services discussed include medications, vaccination, surgery, orthodontic services, individual physicians, and health care services in general. We identified 5 roles with respect to health and well-being among the authors of the types of spontaneously generated narratives considered in this review: a sufferer, an addict, a patient, a carer, and a suicide victim. Out of 86 studies considered, only 4 reported the demographic characteristics. A wide range of methods were used to perform SA. Most common choices included support vector machines, naïve Bayesian learning, decision trees, logistic regression, and adaptive boosting. In contrast with general trends in SA research, only 1 study used deep learning. The performance lags behind the state of the art achieved in other domains when measured by F-score, which was found to be below 60% on average. In the context of SA, the domain of health and well-being was found to be resource poor: few domain-specific corpora and lexica are shared publicly for research purposes. Conclusions SA results in the area of health and well-being lag behind those in other domains. It is yet unclear if this is because of the intrinsic differences between the domains and their respective sublanguages, the size of training datasets, the lack of domain-specific sentiment lexica, or the choice of algorithms.
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Affiliation(s)
- Anastazia Zunic
- School of Computer Science & Informatics, Cardiff University, Cardiff, United Kingdom
| | - Padraig Corcoran
- School of Computer Science & Informatics, Cardiff University, Cardiff, United Kingdom
| | - Irena Spasic
- School of Computer Science & Informatics, Cardiff University, Cardiff, United Kingdom
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eHealth only interventions and blended interventions to support self-management in adolescents with asthma: A systematic review. CLINICAL EHEALTH 2020. [DOI: 10.1016/j.ceh.2020.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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