Looking at the 'field' through a Zoom lens: Methodological reflections on conducting online research during a global pandemic

Perspectives on managing innovation readiness in long-term care: a Q-methodology study

BACKGROUND

The scarcity of resources in long-term care demands more than ever that organizations in this sector are prepared for innovation to ensure affordable access to care for older adults. Organizations that are innovation ready are more capable of implementing innovations. Therefore, a better understanding of how stakeholders view innovation readiness in long-term care can provide actionable strategies to enhance their innovative capacities. 'Innovation readiness' indicates the level of maturity of an organization to succeed in any type of innovation. Our study explored perspectives among stakeholders on what they consider important for organizations in long-term care for older adults to be innovation ready.

METHODS

Q-methodology, a mixed-methods approach, was used to investigate the perspectives of 30 stakeholders connected to long-term care for older adults in the Netherlands: academics, (top)management, innovation managers, client representatives, staff, and consultants. Stakeholders were asked to rank 36 statements on innovation readiness on importance. Statements were extracted from literature research and qualitative interviews. Thereafter in the post-interviews stakeholders explained their ranking and reflected on the statements. By-person factor analysis was used to identify clusters in the ranking data. Together with the qualitative data from follow-up interviews, these clusters were interpreted and described as perspectives of the stakeholders.

RESULTS

Four distinct perspectives were identified on what they consider important for innovation readiness in long-term care: (1) 'supportive role of management' (2) 'participation of the client (system) and employees' (3) 'setting the course and creating conditions' and (4) 'structuring decision-making, roles and responsibilities'. The 36 statements represented a complete overview of innovation readiness factors. No additional innovation factors to those previously identified in the literature emerged from the interviews.

CONCLUSIONS

Stakeholders agree that all factors contributing to innovation readiness of long-term care organizations for older adults are accounted for. The variety of perspectives on what is most important shows there is no agreement among stakeholders about a fixed route toward innovation readiness. However, stakeholders suggested a temporal order of the innovation readiness factors, preferably starting with formulating the innovation ambition. This study's results could contribute to developing an assessment tool to deliver a structured approach for managers to assess the innovation readiness of their organization.

REGISTRATION

The study received ethical approval on April 13, 2022 from the Medical Ethics Board of Zuyderland Medical Center in the Netherlands with the number METCZ20220036.

"What's the fun in That?": Latinx Families' Facilitators and Barriers to Virtual Research Participation

Latinx youth face increased risk for behavioral health concerns and experience obstacles accessing behavioral health services yet remain underrepresented in behavioral health research. Since the COVID-19 pandemic, there has been a shift toward virtual research methods, but little is known about how virtual methods may affect research participation among Latinx youth and families. This study explored the facilitators and barriers to virtual research participation among Latinx families living in low-socioeconomic status (SES) contexts. Seven parents and six adolescents participated in qualitative interviews. The interviews were analyzed to identify codes, categories, and broader themes. Findings identified several facilitators to virtual research participation, including having a clear virtual protocol, using video to simulate in-person interactions, and participants' perceptions of virtual research as safe and convenient. Barriers to virtual participation included limited technology literacy and access, online safety concerns, and technical difficulties. To promote virtual research engagement for Latinx families living in low-SES contexts, researchers should ensure accessibility and security of virtual platforms, emphasize online safety procedures, and attend to participants' access and preferences when developing virtual protocols. Future studies should assess the effectiveness of implementing specific strategies to enhance Latinx participation in virtual behavioral health research.

From curriculum to clinic: a qualitative study of junior doctors' perceptions of global health and sustainable development

INTRODUCTION

The role of global health and sustainable development in medical education is often debated. However, research regarding medical doctors' views on the application of their global health knowledge in the clinical setting remains scarce. This study aimed to explore junior doctors' perceptions of global health and sustainable development, the education they have received on these issues and the relevance of this knowledge in their current and future work.

METHODS

This was a qualitative study based on individual interviews conducted between May and June 2022. 16 junior doctors, in mandatory clinical training after completing medical school, were purposively sampled from five Swedish hospitals. Transcripts were analysed using qualitative content analysis.

RESULTS

Three themes were identified. The first theme (1) 'medical doctors have a role in the transition to a sustainable society', shows that sustainable development is increasingly perceived as relevant for junior doctors' clinical work. The second theme (2) 'global health and sustainable development teaching is inconsistent and somewhat outdated', highlights that there is an assumption that global health and sustainable development can be self-taught. A discrepancy between what is being taught in medical school and the clinical reality is also recognised. This causes challenges in applying global health interest and knowledge in the clinical setting, which is described in the third theme (3) 'application of global health and sustainable development is difficult'. This theme also highlights opportunities for continued engagement, with the perceived benefit of becoming a more versatile doctor.

CONCLUSION

This study emphasises the need for conceptual clarity regarding global health in medical education and raises the need for clarification regarding the level of responsibility for integrating sustainable practices in Swedish healthcare settings.

Unveiling polish judges' views on empathy and impartiality

The exploration of empathy's significance in judicial decision-making has garnered attention in scholarly discourse, yet there is a noticeable gap in studies delving into judges' perceptions of empathy's role, advantages, and impediments. This neglect reflects an "anti-empathetic" discourse that overlooks the insights of those central to justice delivery. Consequently, there is an urgent need for empirical inquiries into judges' perspectives on empathy, its definition, and its integration into their work. Primarily concentrated in Anglo-Saxon jurisdictions, empathy research in judicial decision-making lacks diversity. This paper responds to two critical calls: understanding judges' views on empathy and expanding research beyond common-law systems. It presents empirical research investigating Polish judges' perspectives on empathy, with a focus on its relationship with impartiality. This inquiry is crucial given debates on whether empathy compromises impartiality, particularly evident in discussions surrounding judicial appointments. Based on in-depth interviews with Polish judges, this article identifies five strategies employed by judges to reconcile empathy with impartiality, termed as "paths": (1) claiming symmetry in distributing empathy between parties, (2) defining empathy as unemotional, (3) mitigating empathy's influence on judgments, (4) emphasizing control over empathy, and (5) deabsolutizing formal impartiality and making more room for empathy. The paper discusses these strategies and comments on them, shedding light on the nuanced ways in which judges navigate the intersection of empathy and impartiality in their decision-making processes.

Resilience for working in Ontario home and community care: registered practical nurses need the support of themselves, family and clients, and employers

BACKGROUND

The context of practice is often not explicit in the discourse around the personal and professional resilience of nurses. The unique factors related to providing nursing care in home and community care may provide novel insight into the resilience of this health workforce. Therefore, this research addressed how nurses build and maintain resilience working in the home and community care sector.

METHOD

A qualitative study was conducted between November 2022 to August 2023 using 36 in-depth interviews (29 registered practical nurses [RPNs], five supervisors of RPNs, two family/care partners (FCPs) of clients receiving home and community care services). Analysis was consistent with a grounded theory approach including coding and comparative methods.

RESULTS

The factors of personal and professional resilience were not distinct but rather mixed together in the experience of nurses having resilience working in the home and community care sector. The process of building and maintaining resilience as home and community care nurses was informed by three categories: (1) The conditions of working in HCC; (2) The rapport RPNs held with FCPs; and (3) The nurses' ability for supporting the 'self'. Multiple components to inform these categories were identified and illustrated by the words of the nurse participants.

CONCLUSION

The process of building and maintaining resilience by RPNs working in the home and community care sector was guided by the day-to-day experiences of providing care for clients and the conditions of being a mobile health care provider. However, nurses may sense when they need to support their 'self' and must be empowered to request and receive support to do so.

"Male athletes play well to feel good, and female athletes feel good to play well": Attitudes, beliefs, and practices pertaining to perceived sex-related differences in communication and interpersonal approach of strength and conditioning coaches in international women's rugby union

Effective communication and rapport building with athletes are key tenets of coaching. As the majority of empirical evidence to date has adopted an androcentric view of strength and conditioning, a potential knowledge gap exists regarding sex-related differences in physical preparation and coaching approaches. Therefore, this study explored the attitudes, beliefs and practices of strength and conditioning coaches (n = 8; M/F, 6/2) in elite level (international) women's rugby union using semi-structured interviews (mean ±standard deviation duration 59 ± 15 min). The interviews explored differences in coaching practices for elite female rugby players compared to males, with a specific focus on the interpersonal aspects of the athlete-coach relationship. Reflexive thematic analysis was used to generate a rich qualitative dataset. The analysis resulted in the identification of higher order themes: athlete engagement, and interpersonal approach. The coaches in this study consistently perceived important differences between male and female players in factors related to engagement and interpersonal approach. Coaches adopted differing coaching practices for male and female athletes. This study provides important contextual evidence for the understanding of differences in the interpersonal relationships of female rugby players compared to male athletes from the perspective of elite-level strength coaches.

How do parents frame their engagement experience in early intervention? A grounded theory study

PURPOSE

Parent and therapist engagement and partnership are critical in early intervention physiotherapy and occupational therapy for infants with cerebral palsy to improve outcomes. The main aim of this study was to understand how parents perceive their engagement experience in early intervention over time.

METHODS

Grounded theory methodology was used. Twenty parents of diverse backgrounds participated in 22 interviews (including some repeated longitudinally) to reflect on their engagement experience within the context of early intervention community services provided in the UK NHS.

RESULTS

The findings highlight how parents' perspectives of their engagement in EI change according to critical circumstances, including their preceding neonatal trauma, the at-risk CP label, firmer diagnosis of CP and their child's response to intervention. We theorise that this disrupted transition experience to parenthood becomes part of parental framing (or sense-making) of their engagement in EI. Overlapping frames of uncertainty, pursuit and transformation capture and explain nuances in parents' engagement patterns within EI over time.

CONCLUSION

This theorising has implications for early intervention therapists in how they engage in the lives of families and partner with parents to support healthier parental transition, wellbeing and subsequent improved infant outcomes.

A multi-method exploration of a cardiac rehabilitation service delivered by registered Clinical Exercise Physiologists in the UK: key learnings for current and new services

BACKGROUND

Cardiac rehabilitation has been identified as having the most homogenous clinical exercise service structure in the United Kingdom (UK), but inconsistencies are evident in staff roles and qualifications within and across services. The recognition of Clinical Exercise Physiologists (CEPs) as a registered health professional in 2021 in the UK, provides a potential solution to standardise the cardiac rehabilitation workforce. This case study examined, in a purposefully selected cardiac exercise service that employed registered CEPs, (i) how staff knowledge, skills and competencies contribute to the provision of the service, (ii) how these components assist in creating effective service teams, and (iii) the existing challenges from staff and patient perspectives.

METHODS

A multi-method qualitative approach (inc., semi-structured interviews, observations, field notes and researcher reflections) was employed with the researcher immersed for 12-weeks within the service. The Consolidated Framework for Implementation Research was used as an overarching guide for data collection. Data derived from registered CEPs (n = 5), clinical nurse specialists (n = 2), dietitians (n = 1), service managers/leads (n = 2) and patients (n = 7) were thematically analysed.

RESULTS

Registered CEPs delivered innovative exercise prescription based on their training, continued professional development (CPD), academic qualifications and involvement in research studies as part of the service. Exposure to a wide multidisciplinary team (MDT) allowed skill and competency transfer in areas such as clinical assessments. Developing an effective behaviour change strategy was challenging with delivery of lifestyle information more effective during less formal conversations compared to timetabled education sessions.

CONCLUSIONS

Registered CEPs have the specialist knowledge and skills to undertake and implement the latest evidence-based exercise prescription in a cardiac rehabilitation setting. An MDT service structure enables a more effective team upskilling through shared peer experiences, observations and collaborative working between healthcare professionals.

Insights and recommendations into service model structure, staff roles and qualifications in a UK cancer specific clinical exercise service: a multi-method qualitative study

PURPOSE

Clinical exercise delivery in the United Kingdom is disparate in terms of service structure, staff roles and qualifications, therefore it is difficult to evaluate and compare across services. Our aim was to explore, in a purposely selected cancer exercise service that was recognised as effective; (i) how staff knowledge, skills and competencies contribute to the provision of the service, (ii) how these components assist in creating effective services, and (iii) to identify existing challenges from staff and service user perspectives.

METHODS

The Consolidated Framework for Implementation Research was used as an overarching guide to review the Prehab4Cancer service. Exercise specialists and service user perspectives were explored using a multi-method approach (online semi-structured interviews, online focus group and in-person observation) and data triangulation.

RESULTS

Exercise specialists were educated to a minimum of undergraduate degree level with extensive cancer-specific knowledge and skills, equivalent to that of a Registration Council for Exercise Physiologist (RCCP) Clinical Exercise Physiologist. Workplace experience was essential for exercise specialist development in behaviour change and communications skills.

CONCLUSIONS

Staff should be educated to a level comparable with the standards for registered RCCP Clinical Exercise Physiologists, which includes workplace experience to develop knowledge, skills and competencies in real-world settings.

Digital storytelling online: a case report exploring virtual design, implementation opportunities and challenges

BACKGROUND

Digital storytelling is an arts-informed approach that engages short, first-person videos, typically three to five minutes in length, to communicate a personal narrative. Prior to the pandemic, digital storytelling initiatives in health services research were often conducted during face-to-face workshops scheduled over multiple days. However, throughout the COVID-19 lockdowns where social distancing requirements needed to be maintained, many digital storytelling projects were adapted to online platforms.

METHODS

As part of a research project aiming to explore the day surgery treatment and recovery experiences of women with breast cancer in Peel region, we decided to pivot our digital storytelling process to an online format. During the process, we observed that the online digital storytelling format had multiple opportunities and challenges to implementation.

RESULTS

This paper outlines our promising practices and lessons learned when designing and implementing an online digital storytelling project including pre-production, production and post-production considerations.

CONCLUSIONS

We provide lessons learned for future teams intending to conduct an online digital storytelling project.

"I would be so proud of you guys and myself:" Exploring guided play learning interactions among Black caregivers and their children within a Black history home learning intervention during the COVID-19 pandemic

Existing literature on Black caregiver's interactions with their children has overwhelmingly focused on parenting deficits and interventions designed to "fix" Black families. In utilizing the BlackCreate framework (2023), this study explores how Black caregivers intentionally crafted learning spaces for their children within the context of a six month intervention. Brilliant Joy in a Box was a six-month intervention developed in partnership with a Black woman entrepreneur that delivered caregiver-child Black history home learning boxes to families during the COVID-19 pandemic with the goal of addressing the impacts of persistent historical educational inequities for Black youth, the disproportionate impact of the pandemic Black families, and requests from community members seeking additional programming during the winter months. In the current study, we analyzed videos of 77 families interacting during a guided play activity. We found that the learning spaces created by Black families focused on four subject matters and their domains: literacy, scientific curiosity, math, and identity. We also found that Black caregivers organically utilized guided play to promote joyful interaction and learning. Findings underscore the importance of educators and school staff learning from families in order to reimagine learning and design community based interventions.

The divide so wide: Public perspectives on the role of human genome editing in the US healthcare system

We report findings from two open-framed focus groups eliciting informed public opinion about the rapidly developing technology of human genome editing in the context of the US healthcare system. Results reveal that participants take a dim view of the present healthcare system, articulating extensive concerns about the accessibility and affordability of care. They feel that, unless these problems are resolved, they stand little chance of benefiting from any eventual human genome editing treatments. They prioritize improvement in healthcare access well above human genome editing development, and human genome editing regulation and oversight above human genome editing research. These results reveal substantial divergence between public perspectives and expert discourse on human genome editing. The latter attends primarily to the moral permissibility of technical categories of human genome editing research and how to treat human genome editing within existing regulatory and oversight systems rather than broader political-economic and healthcare access concerns. This divergence illustrates the importance of openly framed public engagement around emerging technologies.

Exploring Nursing Research Culture in Clinical Practice: Qualitative Ethnographic Study

BACKGROUND

Cultivating a positive research culture is considered the key to facilitating the utilization of research findings. In the realm of clinical nursing research, nurses conducting research may find the utilization of findings challenging due to the lack of a positive research culture.

OBJECTIVE

This study aims to identify and describe the sociocultural context of nursing research in a clinical setting at a Korean tertiary hospital.

METHODS

We included participant observation and ethnographic interviews with 6 registered nurses working in a medical-surgical unit in a Korean tertiary hospital who had experience conducting nursing research in clinical settings in this qualitative ethnographic study. The study was conducted from April 2022 to May 2022. Data analysis was conducted using Spradley's ethnographic approach, which includes domain analysis, taxonomic analysis, componential analysis, and theme analysis, and occurred concurrently with data collection.

RESULTS

The overarching theme identified for nursing research culture in clinical practice was the development of a driving force for growth within the clinical environment. This theme encompasses (1) balancing positive and negative influences in the research process, (2) fostering transformational change for both nurses and patients, and (3) promoting complementary communication among nurses.

CONCLUSIONS

Clinical research plays a vital role in nursing practice that requires a balance of supportive elements, such as patient-driven research questions and hospital research support, with practical challenges such as shift work and high work intensity. This study found that a positive clinical nursing research culture can serve as a unifying bridge, connecting researchers, patients, who serve as both the origin and ultimate beneficiaries of research, and hospitals that facilitate research endeavors. Future research should explore whether the themes derived from this study fully reflect a clinical nursing research culture comprising patients, nurses, and the hospital environment and determine what requirements are needed to establish such a nursing research culture.

'Engaging on a slightly more human level': A qualitative study exploring the care of individuals with back pain in a multidisciplinary pain clinic

Chronic low back pain is characterised by multiple and overlapping biological, psychological, social and broader dimensions, affecting individuals' lives. Multidisciplinary pain services have been considered optimal settings to account for the multidimensionality of chronic low back pain but have largely focused on cognitive and behavioural aspects of individuals' pain. Social dimensions are usually underexplored, considered outside or beyond healthcare professionals' scope of practice. Employing Actor Network Theorist Mol's concept multiplicity, our aim in this paper is to explore how a pain service's practices bring to the fore the social dimensions of individuals living with low back pain. Drawing on 32 ethnographic observations and four group exchanges with the service's clinicians, findings suggest that practices produced multiple enactments of an individual with low back pain. Although individuals' social context was present and manifested during consultations at the pain service (first enactment: 'the person'), it was often disconnected from care and overlooked in 'treatment/management' (second enactment: 'the patient'). In contrast, certain practices at the pain service not only provided acknowledgement of, but actions towards enhancing, individuals' social contexts by adapting rules and habits, providing assistance outside the service and shifting power relations during consultations (third enactment: 'the patient-person'). We therefore argue that different practices enact different versions of an individual with low back pain in pain services, and that engagement with individuals' social contexts can be part of a service's agenda.

Research ethics and collaborative research in health and social care: Analysis of UK research ethics policies, scoping review of the literature, and focus group study

Current research ethics frameworks were developed on the footprint of biomedical, experimental research and present several pitfalls when applied to non-experimental social sciences. This work explores how the normative principles underpinning policy and regulatory frameworks of research ethics and the related operational processes work in practice in the context of collaborative health and social care research. The work was organised in three phases. First, UK research ethics policy documents were analysed thematically, with themes further organised under the categories of 'Principles' and 'Processes'. Next, we conducted a scoping review of articles about research ethics in the context of collaborative health and social care research, published in English between 2010 and 2022. We then held an exploratory focus group with ten academic researchers with relevant experience to gather their views on how the research ethics system works in practice in England (UK). The thematic framework developed in the first phase supported the analysis of the articles included in the scoping review and of focus group data. The analysis of policy documents identified twelve themes. All were associated to both a principle and a related operational process. The scoping review identified 31 articles. Across these, some themes were barely acknowledged (e.g., Compliance with legislation). Other themes were extensively covered (e.g., The working of Research Ethics Committees), often to discuss issues and limitations in how, in practice, the research ethics system and its processes deal with collaborative research and to suggest options for improvement. Focus group data were largely consistent with the findings of the scoping review. This work provides evidence of the poor alignment between how the research ethics system is normatively expected to work and how it works in practice and offers options that could make research ethics more fit for purpose when addressing collaborative research in health and social care.

Mental health among rural Latino immigrants during the COVID-19 pandemic

The mental health of the United States' Latino population significantly deteriorated during the SARS-CoV-2 (COVID-19) pandemic, and Latino immigrants living in rural areas faced unique vulnerabilities. However, few studies have specifically examined the mental health burden and experiences of rural Latino immigrants during the COVID pandemic. To understand the mental health experiences of first- and second-generation Latinos in rural areas, we conducted semi-structured interviews with 35 Latino residents of rural California counties during July 2020-February 2021 and screened all respondents for major depression and generalized anxiety symptoms using the Patient Health Questionnaire [PHQ]-2 and Generalized Anxiety Disorder [GAD]-2 screeners. We explored the prevalence of symptoms of depression and anxiety in our sample, iteratively analyzed participants' narratives regarding the mental health impact of the pandemic, and used their mental health screener status to contextualize these narratives. Results indicated that nearly all respondents viewed mental health as a major concern, and 34% (n ​= ​12) of respondents screened positive for major depression or generalized anxiety disorder. Respondents connected their mental health concerns to experiences of financial precarity, fear of contracting COVID-19, social isolation, and the challenges of remote schooling. Additional themes emerged around problems accessing the mental health care system, the utility of pre-pandemic mental health services, and using healthy coping mechanisms to alleviate psychological problems. Respondents' narratives tended to focus on the mental health challenges facing their family members, particularly their children. Our findings suggest that mental health intervention models that engage with multiple family members, policies that support infrastructure for encouraging exercise and outdoor activity, and ensuring access to culturally and linguistically appropriate mental health care for Latino communities may be important for protecting population mental health.

The politics of glyphosate regulation: lessons from Sri Lanka's short-lived ban

BACKGROUND

Glyphosate is the world's most used herbicide and a central component of modern industrial agriculture. It has also been linked to a variety of negative health and environmental effects. For instance, the International Agency for Research on Cancer classified glyphosate as "probably carcinogenic to humans" in 2015. This has motivated widespread political demands for stricter glyphosate regulation but so far few governments have followed through.

METHODS

We conduct a case study of Sri Lanka, which in 2015 became the first and so far only country in the world to adopt and implement a complete glyphosate ban. But this ban proved to be short-lived, as it was partially reversed in 2018 (and later fully revoked in 2022). To explain the political causes of Sri Lanka's pioneering glyphosate ban and its subsequent reversal, we employ process tracing methods drawing on publicly available documents. Our analysis is theoretically guided by the multiple streams framework and the concept of self-undermining policy feedback.

RESULTS

Glyphosate regulation rose to the top of the Sri Lankan political agenda in 2014 when a local scientist linked glyphosate exposure to an epidemic of Chronic Kidney Disease of Unknown Origin (CKDu). A glyphosate ban was eventually adopted in June 2015 by the newly elected government of Maithripala Sirisena. The ban was a political commitment made to the Buddhist monk Rathana Thero and his party, which had supported Sirisena during his presidential campaign. The ban's partial reversal in 2018, implemented through sectoral exceptions, was the result of continued lobbying by export-oriented plantation industries and increased political concerns about potential negative effects on the large and structurally powerful tea sector. The reversal was further aided by the scientific community's failure to corroborate the hypothesized link between glyphosate and CKDu.

CONCLUSIONS

The case of Sri Lanka suggests that strict glyphosate regulation becomes more likely when coupled with locally salient health risks and when decision-making authority is de-delegated from regulatory agencies back to the political executive. Meanwhile, the short-lived nature of the Sri Lankan ban suggests that strict glyphosate regulation faces political sustainability threats, as the apparent lack of cost-effective alternative herbicides motivates persistent business lobbying for regulatory reversal.

General practice nurse trainees' perspectives on general practice nursing as a career choice: qualitative findings from a vocational training scheme in the United Kingdom (UK)

BACKGROUND

There is a shortage of general practice nurses worldwide to deal with an ever-increasing workload, and the need to attract new staff into general practice nursing is therefore vital. As part of this, a one-year Vocational Training Scheme (VTS) for new to general practice nurses was developed in 2020 by the South Yorkshire Primary Care Workforce and Training Hub.

METHODS

The aim of the study was to examine the VTS trainees' views on general practice nursing as a career. A pragmatic, convenience sample of trainees was recruited. Of the 21 trainees, 17 agreed to take part in the study. Data were collected from the trainees using a series of four regular, timed, online focus groups designed to follow the trainees' trajectory on the programme over a 12-month period. The data were analysed using framework analysis.

RESULTS

The timed nature of the focus groups meant that the analysis of the data was linked to the trainees' trajectory over the course of the year. Three themes were generated from the data: 'pathways into general practice'; 'learning to be a GPN'; and 'the future GPN'. In theme one, the trainees talked of the difficulties in accessing general practice as a new graduate, specifically the need for prior experience and how to get it. In the second, the transition to being a general practice nurse was discussed, and the expectation of being able to 'hit the ground running' once in post. The new graduate participants were also concerned over the opportunities for clinical supervision and support in the role after the programme. Finally, the participant s expressed concern over future opportunities for professional development and the prospects for a long-term career in general practice.

CONCLUSION

To address the worldwide workforce 'crisis' in general practice nursing, sustainable career pathways are needed to encourage new graduate nurses to consider working in general practice. Starting at university, changing the culture and providing the necessary infrastructure to support ongoing professional development in general practice nursing are key to its success.

"You Can't Be Too Skinny. You Can't Be Too Fat. I Don't Know What You Are Supposed To Be.": A qualitative focus group study exploring body image experiences of South Asian women in the UK

British South Asian women may experience unique appearance pressures associated with their intersecting (racialised and gendered) identities; yet qualitative investigations of intersectional understandings of their body image are scarce. The aim of this study was to explore sociocultural factors influencing British South Asian women's body image using an intersectional framework. Seven focus groups were conducted with 22 women of South Asian heritage living in the UK between the age of 18 and 48 years old who were comfortable speaking in English. Data were analysed using reflexive thematic analysis. We generated four themes (1) navigating (often marriage-related) appearance pressures from South Asian elders and aunties (2) negotiating cultural and societal standards across different aspects of one's identity (3) representation of South Asian women in the wider context and (4) forms of healing from the pressures imposed on South Asian women. The findings have important implications for the body image experiences of South Asian women by acknowledging the need for tailored and nuanced responses to their complex needs in the sociocultural, political and relational context such as family, peers, education, health, media and the wider consumer landscape.

Multispecies Childcare: Child Veganism and the Reimagining of Health, Reproduction, and Gender in Switzerland

Influenced by nutritional science, feeding children is generally thought of in terms of children's health and well-being. Here, I ask whether child veganism, with its focus on animal welfare and environmental concerns, challenges this model. Drawing from reproductive studies, I focus on Swiss vegan parents' ideas about food to illuminate a "multispecies," less anthropocentric form of childcare. While their ethic opens up new perspectives on health and childcare, I discuss how "sustainable" reproductive practices can also solidify gender stereotypes and modes of ordering species.

What is the role of global health and sustainable development in Swedish medical education? A qualitative study of key stakeholders' perspectives

BACKGROUND

Global health and sustainable development have increasingly been recognised as important parts of medical education, yet education on these issues remains fragmented and scarce. In 2020, a bill to reform the national medical curricula across all Swedish medical schools was introduced, including a greater emphasis on global health and sustainable development. This study aimed to explore the perspectives of key stakeholders in medical education on the role of global health and sustainable development in Swedish medical education.

METHODS

This was a qualitative study based on semi-structured interviews with 11 key stakeholders in medical education, broadly defined as faculty board members (dean and/or vice-deans for medical education) and/or programme chairs representing six universities. Data were analysed using qualitative content analyis (QCA). The study was conducted according to the Consolidated Criteria for Reporting Qualitative research (COREQ) guidelines.

RESULTS

Stakeholders discussed the challenges and opportunities associated with the modification of medical education, which was seen as necessary modernisation to fit the changing societal perception of the role of medical doctors. The anchoring process of redesigning the curriculum and integrating global health and sustainable development was discussed, with emphasis on ownership and mandate and the role of teachers and students in the process. Finding a shared understanding of global health and sustainable development was perceived as a challenge, associated with resistance due to fear of curriculum overload. To overcome this, integrating global health and sustainable development with other topics and developing existing components of the curricula were seen as important. Additionally, it was stressed that fostering capacity building and developing infrastructure, including utilization of digital tools and collaborations, were essential to ensure successful implementation.

CONCLUSIONS

Medical institutions should prepare future doctors to respond to the needs of a globalised world, which include knowledge of global health and sustainable development. However, conceptual uncertainties and questions about ownership remain among key stakeholders in medical education. Yet, key stakeholders also highlight that the inclusion of global health and sustainable development in the new curricula represents multiple overarching educational opportunities that can bring about necessary improvement.

Through the Zoom window: How children use virtual technologies to navigate power dynamics in research

Virtual technologies gained popularity during the COVID-19 pandemic for use in research, including research with children. As scholarship from the field of science, technology and society (STS) suggests, technologies are never neutral, but embedded with social values and, as such, used by people to navigate identities and relationships. Building on childhood studies research that has shown how children appropriate and use research tools, this article asks: How do child research participants use this virtual "window" into their homes and their lives? Using observations from a virtual and in-person study in the United States, we show how children used virtual technologies to manage relationships, filter what researchers saw of their lives, and navigate issues of privacy and self-disclosure. We conclude that analysing children's interactions with research technologies offers important indicators to guide researchers attending to ethical issues of power for both in-person and virtual research with children.

COVID-19 and unintended steps towards further equity in global health research

There was, and possibly still is, potential for COVID-19 to disrupt power inequities and contribute to positive transformation in global health research that increases equity. While there is consensus about the need to decolonise by transforming global health, and a roadmap outlining how we could approach it, there are few examples of steps that could be taken to transform the mechanics of global health research. This paper contributes lessons learnt from experiences and reflections of our diverse multinational team of researchers involved in a multicountry research project. We demonstrate the positive impact on our research project of making further steps towards improving equity within our research practices. Some of the approaches adopted include redistributing power to researchers from the countries of interest at various stages in their career, by involving the whole team in decisions about the research; meaningfully involving the whole team in research data analysis; and providing opportunities for all researchers from the countries of interest to voice their perspectives as first authors in publications. Although this approach is consistent with how research guidance suggests research should be run, in reality it does not often happen in this way. The authors of this paper hope that by sharing our experience, we can contribute towards discussions about the processes required to continue developing a global health sector that is equitable and inclusive.

A critical assessment of a protected area conflict analysis based on secondary data in the age of datafication

Recently, a global trend towards a broader use of secondary data in social sciences has been reinforced by the COVID-19 pandemic. This evoked doubts about the validity of the results unless restrictive assessment procedures are implemented. To address this need in the field of protected area (PA) conflict analysis, we propose a three-fold approach (theory-, method-, and cross-scale simulation-driven) to assess the usefulness of the utilized state register dataset and the indicator analysis methodology for the multi-level recognition of PA conflict determinants. With the ultimate aim to inform case study selection, we processed 187 relevant indicators from the official Statistics Poland register for a Lesser Poland region. We distinguished five types of PA conflict determinants in Lesser Poland ('urbanity', 'agriculture', 'tourism', 'small-scale entrepreneurship', and 'sprawl') and respective groups of 15 clusters comprising local-level units. For one cluster, we juxtaposed the obtained results with secondary data from another source (Internet content) and for a specific PA (Tatra National Park). Although the reported conflict issues corresponded to the indicator-derived descriptors of the cluster, in the theory-driven phase of the assessment, the state register failed to address the key prerequisites of PA conflicts. We have demonstrated that, in crisis conditions such as COVID-19, the proposed method can serve as a proxy for a multi-level recognition of PA conflict potentials, provided that it synthesises the results of different methodological approaches, followed by in-person interviews in the selected case studies.

Prenatal Mental Representations in Italian First-Time Mothers Before and During the COVID-19 Pandemic: A Study with Interviews on Maternal Representations During Pregnancy

INTRODUCTION

Psychosocial risks increase the levels of not-integrated/ambivalent and restricted/disengaged representations during pregnancy, but no study has specifically analysed the impact of the COVID-19 pandemic on maternal representation styles.

OBJECTIVES

(1) to compare maternal representation styles in primiparous women who became pregnant before and during the COVID-19 pandemic and (2) to analyse the content of representation styles during the COVID-19 pandemic.

METHODS

A total of 37 Italian pregnant women were recruited from 2019 to 2021. The sample was divided into two groups: the pre-COVID-19 group (22 women, mean age = 33.14 years; SD = 3.78) and the COVID-19 group (15 women, mean age = 35.9 years; SD = 4.6). Interviews on maternal representations during pregnancy were administered and analysed for style and content.

RESULTS

Women during the COVID-19 pandemic reported more restricted/disengaged and less integrated/balanced representation styles than women pre-COVID-19. Content analysis showed that the COVID-19 pandemic led women to focus more on concrete aspects of pregnancy in lieu of emotional aspects, thus leading them to develop more restricted/disengaged representation styles.

CONCLUSIONS FOR PRACTICE

In future pandemics pregnant women should be supported in focusing their attention to emotions, sensations and fantasies about themselves as mothers and their children.

Goal-Based Private Sustainability Governance and Its Paradoxes in the Indonesian Palm Oil Sector

In response to stakeholder pressure, companies increasingly make ambitious forward-looking sustainability commitments. They then draw on corporate policies with varying degrees of alignment to disseminate and enforce corresponding behavioral rules among their suppliers and business partners. This goal-based turn in private sustainability governance has important implications for its likely environmental and social outcomes. Drawing on paradox theory, this article uses a case study of zero-deforestation commitments in the Indonesian palm oil sector to argue that goal-based private sustainability governance's characteristics set the stage for two types of paradoxes to emerge: performing paradoxes between environmental, social, and economic sustainability goals, and organizing paradoxes between cooperation and competition approaches. Companies' responses to these paradoxes, in turn, can explain the lack of full goal attainment and differential rates of progress between actors. These results draw our attention to the complexities hidden behind governance through goal setting in the corporate space, and raise important questions about the viability of similar strategies such as science-based targets and net-zero goals.

‘ZOOMing’ in on Consulting with Children and Parents Remotely to Co-Create Health Information Resources

The COVID-19 pandemic altered the way many people worked. Remote and creative ways were favoured and utilised for consultation activities. In this paper, we draw attention to how we have used creative methods over the teleconferencing platform ‘ZOOM’ to consult with children and their parents when we were unable to consult with them face-to-face. We document a clear timeline of how we have worked together to co-create an animation and information sheet about receiving outpatient parenteral antimicrobial therapy (OPAT). We identify the opportunities and challenges we faced.

Juneau, Alaska’s Successful Response to COVID-19: A Case Study of Adaptive Leadership in a Complex System

Juneau, Alaska, kept COVID-19 deaths lower than in other similar jurisdictions. We argue that adaptive leadership—the early decisions and actions of Juneau’s leaders, effective communications, and emergent new collaborative structures—in the context of municipal ownership of key assets enabled Juneau’s success. The result of 61 interviews and follow-up research, this case study contributes a better understanding of which institutional design, communication, and collaborative factors mattered in responding to the pandemic. Adaptive leadership provides a better explanation for Juneau’s success than alternatives that focus on its isolation, home-rule status, and socio-economic structure.

A call to action for more disability-inclusive health policy and systems research

To date, the exclusion of people with disability participating in research has limited the evidence base informing health system strengthening policy and practice more generally, and addressing disability-related inequalities in access to health services and better health outcomes more particularly. Given that more than 1 billion people, or 16% of the world's population, have a disability, we may fail to respond to the needs of a large proportion of the population unless we are purposeful with inclusion. Our research in this area indicates that online qualitative methods can be effective in engaging under-represented groups and are essential to ensure their input into health policy and systems research. This has important implications for researchers whose responsibility it is to make all health research disability inclusive, for ethical and methodological reasons, so they do not perpetuate the under-representation of people with disability in health policy and systems research. Our paper puts forward several recommendations to facilitate more people with disability participating in health policy and systems research. By critically reflecting on a health system strengthening research project, in which we purposefully aimed to support the participation of people with disability, we identify lessons learnt and issues to consider when planning and conducting accessible research. We also propose a set of actions for moving the agenda forward.

My Home Quarantine on an App: A Qualitative Visual Analysis of Changes in Family Routines During the COVID-19 Pandemic in Chile

This article presents original findings from a longitudinal qualitative study on changes in individual and family life associated with safety and health measures implemented during the COVID-19 pandemic in three regions of Chile. We developed a methodological approach based on multimodal diaries in a mobile application, in which participants submitted photographs and texts to express changes in their daily lives under residential confinement. Content and semiotic visual analyses show a significant loss in instances of collective recreation, partially compensated through new personal and productive activities performed at home. Our results suggest that modal diaries serve as potential tools to capture people's perceptions and meanings as their lives go through exceptional and traumatic times. We assert that using digital and mobile technologies in qualitative studies could allow subjects to actively participate in the co-construction of fieldwork and produce quality knowledge from their situated perspectives.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11133-023-09531-z.

Mesothelioma patient and carer experience research: A research prioritisation exercise

OBJECTIVES

Incidence of mesothelioma worldwide is growing and the UK reports the highest global incidence. Mesothelioma is an incurable cancer with a high symptom burden. However, it is under researched when compared to other cancers. The aim of this exercise was to identify unanswered questions about the mesothelioma patient and carer experience in the UK and to prioritise research areas of most importance through consultation with patients, carers and professionals.

MATERIALS AND METHODS

A virtual Research Prioritisation Exercise was conducted. This involved a review of mesothelioma patient and carer experience literature to identify research gaps and a national online survey to identify and rank research gaps. Following this, a modified consensus method with mesothelioma experts (patients, carers and professionals from healthcare, legal, academic and volunteer organisations) was undertaken to reach a consensus regarding mesothelioma patient and carer experience research priorities.

RESULTS

Survey responses were received from 150 patients, carers and professionals and 29 research priorities were identified. During consensus meetings, 16 experts refined these into a list of 11 key priorities. The five most urgent priorities were symptom management, receiving a mesothelioma diagnosis, palliative and end of life care, treatment experiences, barriers and facilitators to joined up service provision.

CONCLUSION

This novel priority setting exercise will shape the national research agenda, contribute knowledge to inform nursing and wider clinical practice and ultimately improve the experiences of mesothelioma patients and carers.

Feeling our way: methodological explorations on researching touch through uncertainty

This paper argues that methodological uncertainty, such as that experienced by the social research community through the COVID-19 pandemic (2020-2022) is, and has always been, a vital part of the research landscape. Whilst recognising the many damaging effects of the uncertainties of the pandemic on research and researchers, we home in on the potential of the challenges raised by uncertainty as a force for methodological innovation. We introduce three InTouch project research studies conducted during Lockdown and reflect on the methodological challenges raised by the change and uncertainty of the pandemic. We describe our use, adaptation and reorientation of creative, sensory, and speculative methods to overcome these challenges. We reflect on how we mobilised the uncertain methodological terrain of digital touch and social research in the pandemic as a resource for methodological innovation.

Introducing “navigating failure in ethnography”: a forum about failure in ethnographic research

Purpose

The authors introduce a recurrent section for the Journal of Organizational Ethnography which scrutinizes the various manifestations and roles of failure in ethnographic research.

Design/methodology/approach

The authors peruse a wide body of literature which tackles the role of failure in ethnographic research and draw on the experiences to argue for a more sustained and in-depth conversation on the topic.

Findings

“Failure” regularly occurs in ethnographic research, yet remains under-examined. Increased discussion on the topic will enrich debates on methodology and fieldwork in particular.

Originality/value

While various scholars have commented on the role of “failure” in ethnographic research, an in-depth and sustained examination of the topic is lacking.

From Easter Eggs to Anti-Police Sentiment: Maintaining a Balance in Policing during the Three Pandemic Lockdowns in England and Wales

The three lockdown periods across 2020–2021 due to COVID-19 had significant consequences for police. Pandemic lockdown experiences were explored based on online interviews with 25 officers of varied ranks and from across five regions in England and Wales. The analysis demonstrates the existence of two counter-prevailing dynamics in the working world of police in England and Wales across the three lockdown periods. Changing government directives, deteriorating relationships between the police and the public and senior officers’ sensitivity to the needs of the workforce, were foci of concern and discussion. On reflection, officers acknowledged that relationships between senior management and police improved over the three lockdowns. However, officers found it difficult to balance the demands of the profession and the claims of the state while seeking to retain policing by consent with an increasingly fractious public unsettled by restrictions to their freedom of movement and government activity.

Researching with Qualitative Methodologies in the Time of Coronavirus: Clues and Challenges

In late 2020 and the first semester of 2021, in Santiago de Chile, five women researchers who work with qualitative methodologies, based on their reflections on how the context of the COVID-19 pandemic has impacted on their doctoral research or their role as thesis advisors, conducted a reflective exploration of the conditions and challenges for qualitative research amid a global crisis. In this context, they convene once per week to explore how other researchers conduct and document their research processes, based on a purposive and thorough bibliographic exploration of qualitative studies on the pandemic and remote methods published in qualitative research journals. During these meetings, they reflect on and analyze the impacts and challenges of research in today's world, identifying possibilities and challenges in the methodological and ethical domains. Thus, they organize the present paper around two axes: one on the effects of the pandemic on academic and research practices, in general terms, and another on the specific methodological challenges facing qualitative research during the pandemic. These challenges are largely caused by difficulties in accessing and recruiting participants; the conditions of participation, influenced by vulnerabilities or barriers that constitute factors of inequality; the data production strategies and methodologies used in virtual contexts; ethical considerations; and the effects of the pandemic context on quality and rigor criteria. The article concludes with reflections and questions on the meanings, underlying logic, and practices of qualitative research, which are interrogated and re-signified in light of the COVID-19 pandemic while also illuminating research in post-pandemic settings.

Linguistic validation of the Spanish version of the Anal Cancer High-Grade squamous intraepithelial lesions outcomes Research Health-Related Symptom Index (A-HRSI): AMC-A04

OBJECTIVES

The Anal Cancer High-grade squamous intraepithelial lesions (HSIL) Outcomes Research (ANCHOR) Health-Related Symptom Index (A-HRSI) is a 25-item measure that assesses physical symptoms and impacts, and psychological symptoms. To promote generalizability and equity in the capture of these concepts in Spanish-speaking participants, we linguistically validated a Spanish version of A-HRSI.

METHODS

Following independent forward translation and reconciliation of A-HRSI from English to Spanish, two rounds of cognitive interviews were completed with ANCHOR participants who had been diagnosed with anal HSIL in the prior nine months and preferred delivery of their healthcare in Spanish. Interviews were coded to highlight any items and concepts that were reported as being difficult for any reason by ≥ 3 participants, with such items revised during a research team panel discussion and tested in a second round of interviews if applicable.

RESULTS

Seventeen participants representing 8 nationalities were enrolled (Round 1 n=10, Round 2 n=7); 7 participants reported not completing high school (41.2%). No difficulties were reported with respect to the theoretical concepts measured by A-HRSI. We made modifications to the Spanish translation of eight items and two response option terms in cases where participants had difficulty understanding a term, experienced problems in discriminating between terms, or preferred the use of an alternative term to represent the concept(s).

CONCLUSION

The Spanish version of A-HRSI is a linguistically valid tool that can be used to assess physical symptoms, impacts, and psychological symptoms related to anal HSIL. Language is a tremendous barrier to enrolling patients to clinical trials. The anal cancer high-grade squamous intraepithelial lesions (HSIL) outcomes research [ANCHOR] trial is a randomized clinical trial that recently established that the treatment of anal HSIL, versus active monitoring, is effective in reducing incidence of anal cancer in persons living with HIV (PLWH). The ANCHOR Health-Related Symptom Index (A-HRSI) is a 25-item patient-reported outcomes measure that was developed to assess physical symptoms, physical impacts, and psychological symptoms related to anal HSIL. As approximately 10% of ANCHOR participants preferred the delivery of their healthcare in Spanish, the purpose of the present study was to linguistically validate a Spanish version of A-HRSI. Based on feedback from interviews with 17 participants from the ANCHOR trial who had been diagnosed with anal HSIL in the prior nine months and preferred delivery of their healthcare in Spanish, we made modifications to the Spanish translation of eight items and two response option terms in cases where participants had difficulty understanding a term, experienced problems in discriminating between terms, or preferred the use of an alternative term to represent the concept(s). The Spanish version of A-HRSI is a linguistically valid tool that can be used to assess physical symptoms, impacts, and psychological symptoms related to anal HSIL as part of clinical trials or routine care.

Consequences of Nurse Presenteeism in Switzerland and Portugal and Strategies to Minimize It: A Qualitative Study

Nurses exhibit higher rates of presenteeism than other professionals, with consequences for the quality of care and patient safety. However, nurses’ perceptions of these issues have been poorly explored. This study investigated the perceptions and experiences of frontline nurses and nurse managers in Switzerland and Portugal about the consequences of presenteeism and strategies to minimize it in different healthcare settings. Our qualitative study design used video focus groups involving 55 participants from both countries. Thematic analysis of their transcribed discussions revealed six themes surrounding the consequences of presenteeism: the personal impact on nurses’ health and wellbeing, on their family relationships, and on professional frustration and dissatisfaction; the professional impact on work dynamics; the social impact on the quality of care and patient safety and on society’s impressions of the profession. At the individual, collective, and institutional levels, six strategies were evoked to minimize presenteeism: encouraging professionals’ self-knowledge; creating a positive work atmosphere; facilitating communication channels; developing a positive organizational culture; implementing preventive/curative institutional interventions; identifying and documenting situations linked to presenteeism. Nurses’ perceptions and experiences provided a deeper understanding of their presenteeism and revealed underused pathways toward preventing and minimizing presenteeism via bottom-up approaches.

'Today Was Probably One of the Most Challenging Workdays I've Ever Had': Doing Remote Qualitative Research with Hospital Doctors During the COVID-19 Pandemic

In this article we outline how a team of qualitative researchers responded to the challenging circumstances of the COVID-19 pandemic, describing how we successfully and speedily adopted remote/digital methods to research the experiences of hospital doctors. In 2020, we used Zoom to conduct qualitative interviews with 48 hospital doctors; in 2021, we used Zoom and WhatsApp to conduct a Mobile Instant Messaging Ethnography with 28 hospital doctors. We explain how we adapted to a virtual setting and provide clear insights (case study vignettes) into the additional demands on researchers and respondents, in particular, the impact on the research team. Finally, we analyse the positive and negatives of using remote qualitative methods and highlight the potential of hybrid data collection models that combine remote and face-to-face methods. We also highlight our success in communicating findings to a policy audience, important in time-critical situations, such as the COVID-19 pandemic.

Biographical research through the looking glass of social distancing: Reflections on biographical interviewing and online technologies in pandemic times

This paper asks critical questions about biographical interviewing during the coronavirus disease 2019 era and the age of social distancing. How do we ‘do’ biographical research when we are more physically distant from interview participants than ever before? What kinds of challenges and issues emerge when doing biographical research in online spaces? How do we form rapport and strong trusting bonds with interviewees in the current context? This paper provides a critical commentary on these questions, focusing on the limitations and possibilities of online interviewing during pandemic times.

'Internet is easy if you know how to use it': Doing online research with people with learning disabilities during the COVID-19 pandemic

Background

The coronavirus disease 2019 pandemic changed the way we live, work, interact and do research. Many activities moved online, and digital inclusion became an urgent issue for researchers working with people with learning disabilities and other groups at risk of exclusion. This has generated new questions about how we conduct research and what it means to go into 'the field'.

Methods

We discuss our experience working across four qualitative research projects involving 867 participants with learning disabilities, conducted during the coronavirus disease 2019 pandemic.

Findings

Moving research online resulted in often-swift adaptations to research designs and practice, bringing new insights and benefits to our studies. The changing circumstances fostered innovation and greater flexibility and contributed to research becoming more accessible to many. However, doing research online also posed new challenges as well as amplified existing ones.

Conclusions

The pandemic has made it easier for some people with learning disabilities to participate in research, but more needs to be done to improve the reach and quality of that participation. Researchers should make the process of participation as accessible as possible. It is also their job to question and challenge the conditions that create barriers to participation in research and to look for ways to change these. We make some recommendations on how this can be achieved.

Rural Household Food Insecurity among Latino Immigrants during the COVID-19 Pandemic

U.S. food insecurity rates rapidly increased during the COVID-19 pandemic, with disproportionate impacts on Latino immigrant households. We conducted a qualitative study to investigate how household food environments of rural Latino immigrants were affected during the COVID-19 pandemic. Thirty-one respondents (42% from low food security households) completed interviews (July 2020-April 2021) across four rural counties in California. A rural household food security conceptual framework was used to analyze the data. Early in the pandemic, food availability was impacted by school closures and the increased consumption of meals/snacks at home; food access was impacted by reduced incomes. Barriers to access included limited transportation, excess distance, and lack of convenience. Key resources for mitigating food insecurity were the Supplemental Nutrition Assistance Program (SNAP), the Pandemic Electronic Benefits Transfer (P-EBT), school meals, charitable food programs, and social capital, although the adequacy and acceptability of charitable food distributions were noted issues. Respondents expressed concern about legal status, stigma, and the public charge rule when discussing barriers to government nutrition assistance programs. They reported that food pantries and P-EBT had fewer access barriers. Positive coping strategies included health-promoting food substitutions and the reduced consumption of meals outside the home. Results can inform the development of policy and systems interventions to decrease food insecurity and nutrition-related health disparities among rural Latino immigrants.

Healthcare professionals’ experiences in telehabilitation: a qualitative study (Preprint)

BACKGROUND

The use of digital communication in Swedish health care has increased in an effort to make health care more accessible. At the organizational level, trust in digitalization has stabilized, but a certain degree of skepticism regarding technology appears to exist among health care employees.

OBJECTIVE

This study aimed to explore health care professionals' (HCPs) experiences of digital communication with patients and colleagues in a habilitation context.

METHODS

Qualitative content analysis was used to analyze data derived from individual interviews.

RESULTS

The results revealed that there were mixed feelings regarding the digital format used at the habilitation center. Although some skepticism remained regarding the digital format, there seemed to be a parallel understanding of the motives and benefits of digitalization. Hence, positive aspects, such as increased health care accessibility, were identified. However, emphasis was placed on the considerations required to make digital consultations appropriate for each patient.

CONCLUSIONS

Managing a workday influenced by the balance between digital and physical demands forces HCPs to adjust to the digital format and new ways of working. This requires HCPs to consider whether digital means are appropriate for communication in individual patient-specific cases.

Digital Transformation of Face-To-Face Focus Group Methodology: Engaging a Globally Dispersed Audience to Manage Institutional Change at the World Health Organization

Focus group discussions (FGDs) are widely used to obtain qualitative data from purposely selected groups of people. This paper describes how the Learning and Capacity Development (LCD) unit of the World Health Organization (WHO) Health Emergencies Programme (WHE) digitalized FGDs to engage with WHO staff from around the world, to listen, share, and collect their feedback in the development of a WHO learning framework. The impact of the COVID-19 pandemic and the introduction of local lockdowns and travel restrictions resulted in the wide use of digital platforms, such as Zoom, for employee communications and collaboration capable of reaching employees wherever they are working. The LCD/WHE team drew upon the experience of WHO colleagues from human resources, country, and regional offices to set up and hold FGDs in 6 languages with participants from all WHO regions. Building on the findings of a 2019 WHO staff survey, which was part of a comprehensive, organization-wide career development initiative, the digitalized FGDs allowed for the exchange of substantive feedback, novel ideas, and alignment, connecting across different geographies, disciplines, and levels of seniority. As a result, FGDs can be successfully conducted online, but it is essential to remove barriers to participation by adopting a multilingual and flexible approach in multinational and international organizations such as the WHO.

From texts to contexts: the relevance of digital ethnography in a Foucauldian discourse analysis of online gender talk in Kerala

Purpose

The purpose of this paper is to foreground the importance of context in discourse analysis by drawing on a study of online gender talk on Facebook in India.

Design/methodology/approach

Using Foucauldian discourse analysis (FDA), this study explored participants’ use of language to construct and perform various identities in online gender talk. This study discusses the methods used and challenges in analyzing digital spaces through FDA, focusing specifically on the importance of an ethnographic perspective to contextualize online talk.

Findings

Engagement with the larger socio-cultural context of the subject of study through various data collection methods enhanced our understanding of the contexts behind text. It helped the authors to explore the data from multiple directions from a Foucauldian framework. This study found that people constructed a “progressive” identity when talking about gender on Facebook.

Originality/value

There are very few studies combining discourse analysis and digital ethnography and this paper seeks to do that. Digital ethnography helps to look beyond the text and locate text in the larger socio-cultural context. To emphasize the importance of context in discourse analysis, this study engages with both online and offline data as online talk is connected with offline contexts in many significant ways. In this paper, the authors provide a description on various methodological steps used to collect and analyze online data using FDA.

Developing guideline-based key performance indicators for recurrent miscarriage care: lessons from a multi-stage consensus process with a diverse stakeholder group

BACKGROUND

Standardised care pathways tailored to women/couples who experience recurrent miscarriage are needed; however, clinical practice is inconsistent and poorly organised. In this paper, we outline our processes and experiences of developing guideline-based key performance indicators (KPIs) for recurrent miscarriage care with a diverse stakeholder group which will be used to evaluate national services. To date, such exercises have generally only involved clinicians, with the need for greater stakeholder involvement highlighted.

METHODS

Our study involved six stages: (i) identification and synthesis of recommendations for recurrent miscarriage care through a systematic review of clinical practice guidelines; (ii) a two-round modified e-Delphi survey with stakeholders to develop consensus on recommendations and outcomes; (iii) four virtual meetings to develop this consensus further; (iv) development of a list of candidate KPIs; (v) survey to achieve consensus on the final suite of KPIs and a (vi) virtual meeting to agree on the final set of KPIs. Through participatory methods, participants provided feedback on the process of KPI development.

RESULTS

From an initial list of 373 recommendations and 14 outcomes, 110 indicators were prioritised for inclusion in the final suite of KPIs: (i) structure of care (n = 20); (ii) counselling and supportive care (n = 7); (iii) investigations (n = 30); treatment (n = 34); outcomes (n = 19). Participants' feedback on the process comprised three main themes: accessibility, richness in diversity, streamlining the development process.

CONCLUSIONS

It is important and feasible to develop guideline-based KPIs with a diverse stakeholder group. One hundred and ten KPIs were prioritised for inclusion in a suite of guideline-based KPIs for recurrent miscarriage care. Insights into our experiences may help others undertaking similar projects, particularly those undertaken in the absence of a clinical guideline and/or involving a range of stakeholders.

'We can play tag with a stick'. Children's knowledge, experiences, feelings and creative thinking during the COVID-19 pandemic

Using a relational approach, we draw on repeated interviews with a group of 30 diverse children from Ontario to share and reflect on their knowledge, experiences and feelings early in the COVID-19 pandemic. Prioritising relational interdependence and relational agency, this paper illustrates our participants' embedded engagements with the pandemic and their contribution to the co-production of knowledge. We emphasise their thoughtful responses to the pandemic; their creative, self-reflexive strategies for managing a difficult time; and their advice to others. We thus prioritise children's viewpoints and emphasise their relational interconnections with others during a time that was marked by social isolation.

Measuring Racial Discrimination Remotely: A Contemporary Review of Unobtrusive Measures

Social-science researchers have increasingly moved from conducting their studies in a face-to-face format to an online format. Although new and innovative remote platforms afford researchers generalizability and scale, many of these platforms also tend to solicit socially desirable responses. This pattern of socially desirable responding is evident in examinations of racial discrimination, in which participants are particularly determined to present themselves as ethical and moral. In the current article, we rectify the concern between remote platforms and inauthentic participant responses by reviewing unobtrusive measures of racial discrimination. First, we conceptualize unobtrusive measures as measurements that assess a participant's discriminatory action without the participant's knowledge that the specific discriminatory action is under observation. Next, we review the landscape of unobtrusive studies conducted within three broad categories-audit, helping, and friendly interaction-and discuss how these measures have changed over time. Finally, we discuss how to adapt classic face-to-face measures to remote platforms and provide recommendations for implementing unobtrusive measures into remote examinations of discrimination.

Remote Fieldwork in Homes During the COVID-19 Pandemic: Video-Call Ethnography and Map Drawing Methods

Restrictions on physical movements and in-person encounters during the COVID-19 crisis confronted many qualitative researchers with challenges in conducting and completing projects requiring face-to-face fieldwork. An exploration of engaging in what we term 'agile research' in such circumstances can offer novel methodological insights for researching the social world. In this article, we discuss the changes we made to our ethnographic fieldwork in response to the introduction of a national lockdown to contain the spread of the novel coronavirus. The 'Living with Personal Data' project, based in Sydney, Australia, and designed well before the advent of COVID-19, explores a diverse range of people's feelings, practices and understandings concerning home-based digital devices and the personal digital data generated with their use. Using a video ethnography 'home tour' and an elicitation technique involving hand-drawn maps of people's homes, digital devices and the personal data generated with and through these devices, this approach was designed to elicit the sensory, affective and relational elements of people's digital device and personal data use at home. The fieldwork had just commenced when stay-at-home and physical distancing orders were suddenly introduced. Our article builds on and extends a growing body of literature on conducting fieldwork in the difficult conditions of the extended COVID-19 crisis by detailing our experiences of very quickly converting an ethnographic study that was planned to be in-person to a remote approach. We describe the adaptations we made to the project using video-call software and discuss the limits and opportunities presented by this significant modification.

Convivial Quarantines: Cultivating Co-presence at a Distance

Sociology's focus on sociality and co-presence has long oriented studies of commensality-the social dimension of eating together. This literature commonly prioritizes face-to-face interactions and takes physical proximity for granted. The onset of the COVID-19 pandemic in March 2020 largely halted in-person gatherings and altered everyday foodways. Consequently, many people turned to digital commensality, cooking and eating together through video-call technology such as Zoom and FaceTime. We explore the implications of these new foodways and ask: has digital commensality helped cultivate co-presence amidst pandemic-induced physical separation? If so, how? To address these questions, we analyze two forms of qualitative data collected by the first author: interviews with individuals who cooked and ate together at a distance since March 2020 and digital ethnography during different groups' online food events (e.g., happy hours, dinners, holiday gatherings, and birthday celebrations). Digital commensality helps foster a sense of co-presence and social connectedness at a distance. Specifically, participants use three temporally oriented strategies to create or maintain co-presence: they draw on pre-pandemic pasts and reinvent culinary traditions to meet new circumstances; they creatively adapt novel digital foodways through online dining; and they actively imagine post-pandemic futures where physically proximate commensality is again possible.