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Chen L, Zhou Y. Symptom management experiences of Chinese individuals with Crohn's disease: A longitudinal descriptive qualitative study. Res Nurs Health 2024; 47:423-434. [PMID: 38564311 DOI: 10.1002/nur.22386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/13/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024]
Abstract
Individuals diagnosed with Crohn's disease, a chronic lifelong condition, experience a dynamic or fluctuating process of developing symptom management behavior. However, less clear is how these individuals respond to and manage their symptoms over time. The aim of this study was to longitudinally explore the symptom management experiences of individuals with Crohn's disease in China. A longitudinal qualitative design was used. Eighteen individuals with newly diagnosed Crohn's disease were purposely selected. Semi-structured interviews were conducted on four occasions over a 12-month period. Interviews at each time point were transcribed and coded using conventional content analysis. Afterward, data analyses of each time point were compared longitudinally to form a holistic understanding. Three themes and eight subthemes emerged from the analysis: (1) disclosing symptoms strategically: voluntary disclosure, reluctance to disclose, no need to disclose; (2) decreasing vigilance in symptom prevention: preventing symptoms stringently, preventing symptoms discriminatively, preventing symptoms with decreased diligence; and (3) increasing autonomy in symptom treatment: actively seeking medical advice, self-treatment and self-observation. The participants were inclined to keep symptoms hidden from relatives and friends and showed a downward trend in actively disclosing physical discomfort to medical staff within the course of 1 year. The participants' attention to symptom prevention declined, but the enthusiasm and independence to eliminate symptoms on their own increased over time. Nurses could implement targeted interventions according to the characteristics of different periods to assist individuals with Crohn's disease in managing symptoms effectively, reducing symptom burden and improving their quality of life.
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Affiliation(s)
- Lingxi Chen
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yunxian Zhou
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
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McCormick A, Pedmanson P, Jane B, Watson P. How do new runners maintain their running, and what leads to others stopping? A qualitative, longitudinal study. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 70:102515. [PMID: 37717492 DOI: 10.1016/j.psychsport.2023.102515] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/20/2023] [Accepted: 08/21/2023] [Indexed: 09/19/2023]
Abstract
Many people who start running do not maintain their behaviour change. We used qualitative, longitudinal methods to explore and interpret the experiences of new runners and answer the question, "What experiences explain how new runners maintain their running or explain why they stop?" We interviewed 20 new runners (all White British, 14 women, 6 men) about their experiences; we interviewed 10 until they stopped running and 10 until they maintained running for 6-12 months (65 interviews in total). We also conducted nine participant observations at a running club, invited external reflections at a running club, and analysed six sets of participant diaries. Four themes were constructed using a reflexive thematic analysis: (1) Identifying a meaningful "why"; (2) "Life gets in the way" of running; (3) Learning that I can run; and (4) Opportunities are unequal and experiences contrast. The runners' reasons for running helped us to interpret changes in their experiences through time. Meaningful reasons helped runners to learn that they can run, prioritise running, and prevent life getting in the way. These reasons tended to be reasons to run, as opposed to reasons to be physically active, and they related to their identity, values, special memories, relationships, enjoyment of running, or a personal goal. Nevertheless, social inequalities like gendered experiences, wealth, and health differences meant that opportunities and experiences of running differed, creating more barriers for some runners. When runners faced substantial barriers, having a meaningful reason was helpful but it was sometimes insufficient for maintenance. The analysis illustrates how people's reasons for exercise influence their experiences through time, the dynamic nature of people's exercise barriers and facilitators, and the unequal nature of opportunities and experiences.
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Affiliation(s)
- Alister McCormick
- School of Health & Wellbeing, Plymouth Marjon University, Plymouth, UK.
| | - Pille Pedmanson
- School of Health & Wellbeing, Plymouth Marjon University, Plymouth, UK
| | - Ben Jane
- School of Health & Wellbeing, Plymouth Marjon University, Plymouth, UK
| | - Paula Watson
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK; Made Up to Move Ltd, Liverpool, UK
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Chen L, Zhou Y. The symptom experience of newly diagnosed Chinese patients with Crohn's disease: A longitudinal qualitative study. J Adv Nurs 2023; 79:3824-3836. [PMID: 37243391 DOI: 10.1111/jan.15721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 04/05/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023]
Abstract
AIMS To longitudinally explore the symptom experience of Chinese patients with Crohn's disease within the first year following their diagnosis. DESIGN A longitudinal qualitative study. METHOD Eighteen newly diagnosed Chinese patients with Crohn's disease were recruited through purposive sampling. Semi-structured interviews were conducted at four time points: soon after diagnosis, 3, 6 and 12 months post-diagnosis. Data were collected between January 2021 and February 2022. Conventional content analysis was used for data analysis of each time point. Afterwards, the data of each time point were compared longitudinally. COREQ checklist was followed. RESULTS Three themes and eight sub-themes were formed through analysis: feelings towards symptoms (symptoms make me feel uneasy, symptoms make me feel inferior and symptoms make me feel helpless); acceptability of symptoms (difficult to accept, have to accept, be able to accept); functions of symptoms (assessing disease conditions and treatment effects, warning of disease management). CONCLUSIONS Overall, the negative emotions related to symptoms gradually decreased over time, and the patient's acceptance of symptoms increased within the first year following diagnosis. In addition, when the disease was in remission after treatment, the warning function of symptoms gradually weakened. IMPACT The process of how patients accept their symptoms found in this study provides a basis for nurses to improve patients' acceptance of symptoms and reduce their symptom-related negative emotions. This study also emphasizes the phenomenon that patients gradually ignore some symptoms with their increased acceptance level, which warrants additional health education to strengthen their awareness of self-management. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was required to design or undertake this study. Patients contributed only to the data collection and member checking.
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Affiliation(s)
- Lingxi Chen
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yunxian Zhou
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
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Houtsma C, Powers J, Raines AM, Bailey M, Barber C, True G. Engaging stakeholders to develop a suicide prevention learning module for Louisiana firearm training courses. Inj Epidemiol 2023; 10:3. [PMID: 36631823 PMCID: PMC9832758 DOI: 10.1186/s40621-023-00413-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/30/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Firearm suicide is a significant public health problem in the United States of America among the general and veteran populations. Broad-based preventive strategies, including lethal means safety, have been emphasized as a key approach to suicide prevention. Prior research has identified ways to improve the reach and uptake of lethal means safety messages. However, few resources have been created with these lessons in mind. METHODS Louisiana firearm owners and instructors were recruited through a larger project, Veteran-Informed Safety Intervention and Outreach Network, as well as a publicly available database of firearm instructors to participate in focus groups to provide feedback on an existing suicide prevention learning module (developed in Utah) for use by firearm instructors. Their feedback was used to adapt the module, which included a brief video and PowerPoint presentation. Firearm owners and instructors were then invited back for another round of focus groups to provide feedback on this adapted learning module. Team-based rapid qualitative analysis was conducted to identify themes across transcripts from these four focus groups. RESULTS Firearm owners and instructors agreed on several key themes, including the importance of messenger relatability and aligning the lethal means safety message with firearm owner values. Feedback suggested these themes were adequately addressed in the adapted learning module and contributed to overall module acceptability. The final theme, present across the original and adapted learning modules (i.e., Utah and Louisiana), was openness to further information and training on firearm suicide prevention. CONCLUSION Consistent with a public health approach to suicide prevention, the current study used stakeholder engagement to develop a suicide prevention learning module perceived as representative, accurate, and acceptable to Louisiana firearm owners and instructors. These findings can be used to inform firearm suicide prevention efforts in other states.
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Affiliation(s)
- Claire Houtsma
- Southeast Louisiana Veterans Health Care System, 2400 Canal Street, New Orleans, LA 70119 USA
- South Central Mental Illness Research, Education and Clinical Center, New Orleans, LA USA
- Louisiana State University Health Sciences Center, New Orleans, LA USA
| | - Jeffrey Powers
- Southeast Louisiana Veterans Health Care System, 2400 Canal Street, New Orleans, LA 70119 USA
- Louisiana State University, Baton Rouge, LA USA
| | - Amanda M. Raines
- Southeast Louisiana Veterans Health Care System, 2400 Canal Street, New Orleans, LA 70119 USA
- South Central Mental Illness Research, Education and Clinical Center, New Orleans, LA USA
- Louisiana State University Health Sciences Center, New Orleans, LA USA
| | - Matthew Bailey
- Southeast Louisiana Veterans Health Care System, 2400 Canal Street, New Orleans, LA 70119 USA
| | | | - Gala True
- Southeast Louisiana Veterans Health Care System, 2400 Canal Street, New Orleans, LA 70119 USA
- South Central Mental Illness Research, Education and Clinical Center, New Orleans, LA USA
- Louisiana State University Health Sciences Center, New Orleans, LA USA
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Töbelmann L, Hahne I, Schulze T, Bergmann N, Fuchs L, Zierhut M, Hahn E, Böge K. Mechanisms of action and processes of yoga-based group intervention for inpatients with schizophrenia spectrum disorders-A longitudinal qualitative study. Front Psychiatry 2023; 14:1086468. [PMID: 36824673 PMCID: PMC9941680 DOI: 10.3389/fpsyt.2023.1086468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/16/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Research exploring the effects of yoga therapy (YT) on individuals with schizophrenia spectrum disorders (SSD) is scarce. Therefore, the current study aimed to explore possible mechanisms of actions and processes, as well as adverse effects of a novel yoga-based group intervention (YoGI) for in-patients with SSD in a German university hospital setting. MATERIAL AND METHODS A longitudinal qualitative study was integrated into a rater-blinded randomized controlled trial, exploring the impact of a 4-week YoGI as add-on treatment. In-depth interviews were conducted with participants receiving YoGI (n = 19) in addition to treatment as usual (TAU) and a control group (n = 14) which only received TAU. Interviews were conducted at baseline (n = 33) and 4 weeks post-intervention (N = 28) to assess the participant's experiences and how they changed over time. The interviews (N = 61) were audio-taped, translated, coded, and analyzed by means of inductive thematic analysis. Separate case summaries were prepared for each participant to analyze longitudinal changes within subjects. The research team members collaboratively discussed the final list of themes and subcodes. Rater-based questionnaires, such as the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Personal and Social Performance Scale (PSP) were administered at baseline to assess clinical outcomes. RESULTS At baseline, participants reported a desire to improve their stress- and symptom management. A minority of participants expressed reservations toward yoga, and several psychosocial barriers were named, including worries about symptom exacerbation. At post-intervention, four mechanisms of change became evident from the interviews: (1) acquiring competence in relaxation, (2) increased interoceptive awareness, (3) feeling connected, and (4) a sense of spiritual wellbeing. A small number of participants reported difficulties with YoGI. CONCLUSION Generally, YoGI positively influenced participants' experiences of their inpatient stay, regarding distress, self- and body awareness, social connectedness, and spiritual wellbeing. However, participants also illuminated necessary adjustments to improve the intervention. YoGI will therefore be adapted and further developed in an iterative process based on a participant involvement approach. The efficacy regarding outcomes and processes needs to be investigated in a future larger-scaled randomized controlled trial.
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Affiliation(s)
- Laura Töbelmann
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Inge Hahne
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Theresa Schulze
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Niklas Bergmann
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Lukas Fuchs
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Marco Zierhut
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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Audulv Å, Hall EOC, Kneck Å, Westergren T, Fegran L, Pedersen MK, Aagaard H, Dam KL, Ludvigsen MS. Qualitative longitudinal research in health research: a method study. BMC Med Res Methodol 2022; 22:255. [PMID: 36182899 PMCID: PMC9526289 DOI: 10.1186/s12874-022-01732-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 09/22/2022] [Indexed: 12/04/2022] Open
Abstract
Background Qualitative longitudinal research (QLR) comprises qualitative studies, with repeated data collection, that focus on the temporality (e.g., time and change) of a phenomenon. The use of QLR is increasing in health research since many topics within health involve change (e.g., progressive illness, rehabilitation). A method study can provide an insightful understanding of the use, trends and variations within this approach. The aim of this study was to map how QLR articles within the existing health research literature are designed to capture aspects of time and/or change. Methods This method study used an adapted scoping review design. Articles were eligible if they were written in English, published between 2017 and 2019, and reported results from qualitative data collected at different time points/time waves with the same sample or in the same setting. Articles were identified using EBSCOhost. Two independent reviewers performed the screening, selection and charting. Results A total of 299 articles were included. There was great variation among the articles in the use of methodological traditions, type of data, length of data collection, and components of longitudinal data collection. However, the majority of articles represented large studies and were based on individual interview data. Approximately half of the articles self-identified as QLR studies or as following a QLR design, although slightly less than 20% of them included QLR method literature in their method sections. Conclusions QLR is often used in large complex studies. Some articles were thoroughly designed to capture time/change throughout the methodology, aim and data collection, while other articles included few elements of QLR. Longitudinal data collection includes several components, such as what entities are followed across time, the tempo of data collection, and to what extent the data collection is preplanned or adapted across time. Therefore, there are several practices and possibilities researchers should consider before starting a QLR project. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01732-4.
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Affiliation(s)
- Åsa Audulv
- Department of Nursing, Umeå University, Umeå, Sweden.
| | - Elisabeth O C Hall
- Faculty of Health, Aarhus University, Aarhus, Denmark.,Faculty of Health Sciences, University of Faroe Islands, Thorshavn, Faroe Islands, Denmark
| | - Åsa Kneck
- Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Thomas Westergren
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway.,Department of Public Health, University of Stavanger, Stavanger, Norway
| | - Liv Fegran
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Mona Kyndi Pedersen
- Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Hanne Aagaard
- Lovisenberg Diaconale Univeristy of College, Oslo, Norway
| | - Kristianna Lund Dam
- Faculty of Health Sciences, University of Faroe Islands, Thorshavn, Faroe Islands, Denmark
| | - Mette Spliid Ludvigsen
- Department of Clinical Medicine-Randers Regional Hospital, Aarhus University, Aarhus, Denmark.,Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
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Balmer DF, Richards BF. Conducting qualitative research through time: how might theory be useful in longitudinal qualitative research? ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022; 27:277-288. [PMID: 34460054 DOI: 10.1007/s10459-021-10068-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/22/2021] [Indexed: 06/13/2023]
Abstract
This paper explores the use of theory in longitudinal qualitative research, an approach to research which explores lived experiences as they unfold. The authors illustrate how the complexity of conducting qualitative research through time drives an understanding and use of theory that differs from other research approaches. Longitudinal qualitative research considers time as fluid, subjective, and unbounded-in contrast to the more common taken-for-granted understanding of time as fixed, objective, and linear. Furthermore, longitudinal qualitative research is predicated on a premise of trust in the context of enduring research relationships. Therefore, while subject-matter theories used to investigate topics of interest to health professions educators may be useful frameworks for other types of research, longitudinal qualitative research needs theories that accommodate the myriad of changes in lived experiences through time. The authors share their decade-long, longitudinal qualitative research story, highlighting their decision points and insights. In doing so, they foreground issues such as time as fluid as an important contribution to health professions education literature.
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Affiliation(s)
- Dorene F Balmer
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, 9NW 72, Philadelphia, PA, 19104, USA.
| | - Boyd F Richards
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
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Balmer DF, Varpio L, Bennett D, Teunissen PW. Longitudinal qualitative research in medical education: Time to conceptualise time. MEDICAL EDUCATION 2021; 55:1253-1260. [PMID: 33847408 PMCID: PMC8596518 DOI: 10.1111/medu.14542] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/26/2021] [Accepted: 04/09/2021] [Indexed: 05/14/2023]
Abstract
CONTEXT Longitudinal qualitative research is an approach to research that entails generating qualitative data with the same participants over extended periods of time to understand their lived experiences as those experiences unfold. Knowing about dynamic lived experiences in medical education, that is, learning journeys with stops and starts, detours, transitions and reversals, enriches understanding of events and accomplishments along the way. The purpose of this paper is to create access points to longitudinal qualitative research in support of increasing its use in medical education. METHODS The authors explore and argue for different conceptualisations of time: analysing lived experiences through time versus analysing lived experiences cross-sectional or via 2-point follow-up studies and considering time as subjective and fluid as well as objective and fixed. They introduce applications of longitudinal qualitative research from several academic domains: investigating development and formal education; building longitudinal research relationship; and exploring interconnections between individual journeys and social structures. They provide an illustrative overview of longitudinal qualitative research in medical education, and end with practical advice, or pearls, for medical education investigators interested in using this research approach: collecting data recursively; analysing longitudinal data in three strands; addressing mutual reflexivity; using theory to illuminate time; and making a long-term commitment to longitudinal qualitative research. CONCLUSIONS Longitudinal qualitative research stretches investigators to think differently about time and undertake more complex analyses to understand dynamic lived experiences. Research in medical education will likely be impoverished if the focus remains on time as fixed. Seeing things qualitatively through time, where time is fluid and the past, present and future interpenetrate, produces a rich understanding that can move the field forward.
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Affiliation(s)
- Dorene F. Balmer
- Department of PediatricsPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Lara Varpio
- Department of MedicineCenter for Health Professions EducationUniformed Services University of the Health SciencesBethesdaMDUSA
| | - Deirdre Bennett
- Medical Education UnitSchool of MedicineUniversity College CorkCorkIreland
| | - Pim W. Teunissen
- Faculty of Health, Medicine and Life SciencesMaastricht UniversityMaastrichtThe Netherlands
- Department of Obstetrics and GynecologyMaastricht University Medical CenterMaastrichtThe Netherlands
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