Interpreting Health Events in Big Data Using Qualitative Traditions

The training of artificial intelligence requires integrating real-world context and mathematical computations. To achieve efficacious smart health artificial intelligence, contextual clinical knowledge serving as ground truth is required. Qualitative methods are well-suited to lend consistent and valid ground truth. In this methods article, we illustrate the use of qualitative descriptive methods for providing ground truth when training an intelligent agent to detect Restless Leg Syndrome. We show how one interdisciplinary, inter-methodological research team used both sensor-based data and the participant's description of their experience with an episode of Restless Leg Syndrome for training the intelligent agent. We make the case for clinicians with qualitative research expertise to be included at the design table to ensure optimal efficacy of smart health artificial intelligence and a positive end-user experience.

Data Collection via In-Depth Email Interviewing: Lessons From the Field

This methods article is a reflection on the use of in-depth email interviewing in a qualitative descriptive study. The use of emailing to conduct interviews is thought to be an effective way to collect qualitative data. Building on current methodological literature in qualitative research regarding in-depth email interviewing, we move the conversation toward elicitation of quality data and management of multiple concurrent email interviews. Excerpts are shared from a field journal that was kept throughout one study, with commentary on developing insights. Valuable lessons learned include the importance of (a) logistics and timing related to the management of multiple concurrent email interviews, (b) language and eliciting the data, (c) constructing the email, and (d) processing text-based data and preparing transcripts. Qualitative researchers seeking deeply reflective answers and geographically diverse samples may wish to consider using in-depth email interviews.

Informed Strangers: Witnessing and Responding to Unethical Care as Student Nurses

Nursing students occupy a unique perspective in clinical settings because they are informed, through education, about how patient care ought to happen. Given the brevity of placements and their “visiting status” in clinical sites, students are less invested in the ethos of specific sites. Subsequently, their perspectives of quality care are informed by what should happen, which might differ from that of nurses and patients. The purpose of this study was to identify predominant themes in patient care, as experienced by students, and the influence that these observations have on the development of their ethical reasoning. Using a qualitative descriptive approach in which 27 nursing student papers and three follow-up in-depth interviews were analyzed, three main themes emerged: Good employee, poor nurse; damaged care; and negotiating the gap. The analysis of the ethical situations in these papers suggests that students sometimes observe care that lacks concern for the dignity, autonomy, and safety of patients. For these student nurses, this tension led to uncertainty about patient care and their eventual profession.

Sources of Social Capital for Malawi People Living With HIV

With one of the highest rates of poverty and HIV in the world, Malawi faith-based organizations (FBOs), non-governmental organizations (NGOs), and community-based organizations (CBOs) are expected to provide tangible and emotional support to people living with HIV (PLWH). Using Lin’s social capital theoretical approach, we examine the perspective of PLWH regarding the adequacy of support responses. Forty-six rural Malawi HIV+ adults provided interviews that were recorded digitally, translated, and transcribed by Malawi research assistants. Atlas.ti was used to organize the data and to aid in the analytic process. Participants expressed disappointment in the lack of resources that could be accessed through the FBOs although their expectations may have been unrealistic. Outcomes from accessing and mobilizing the FBO network were negative in terms of stigmatization by FBO leaders and members, whereas outcomes related to CBOs and NGOs were generally positive in terms of empowerment through HIV information and attendance at support groups.

Vaccine-Hesitant Justifications: "Too Many, Too Soon," Narrative Persuasion, and the Conflation of Expertise

Vaccine-preventable diseases have re-emerged as more individuals have strayed from the recommended inoculation schedule. Previous work on vaccine hesitancy is generally limited to content analyses. Using grounded theory, this project examines vaccine debates on a prominent discussion board over a period of five years. Individuals generally justified opposition or hesitancy toward vaccines through personal experience and/or research, and the concepts of narrative persuasion and the conflation of expertise help describe the most prominent characteristics of such discourse. A consideration of online comments regarding vaccinations allows practitioners to not only become better prepared for patient concerns they might encounter, and but also become more familiar with the types of anecdotes and narratives that may be influential but left unspoken in face-to-face conversations.

Perceptions of health professionals on pain in extremely low gestational age infants

Extremely low gestational age infants (<28 weeks at birth) experience significant pain from repeated therapeutic procedures while hospitalized in the neonatal intensive care unit. As part of a program of research examining pain in preterm infants, we conducted a qualitatively driven mixed-methods design, supplemented with a qualitative and quantitative component, to understand how health care professionals (HCPs) assess and manage procedural pain for tiny and underdeveloped preterm infants. Fifty-nine HCPs from different disciplines across four tertiary-level neonatal units in Canada participated in individual or focus group interviews and completed a brief questionnaire. Four themes from the content analysis were (a) subtlety and unpredictability of pain indicators, (b) infant and caregiver attributes and contextual factors that influence pain response and practices, (c) the complex nature of pain assessment, and (d) uncertainty in the management of pain. The information gleaned from this study can assist in identifying gaps in knowledge and informing unit-based and organizational knowledge translation strategies for this vulnerable population.

Strategies for Aging in Place: The Experience of Language-Minority Seniors With Loss of Independence

For healthy and independent older adults, aging in place can be seen as identical to any other adult living at home. Little is known about how frail seniors, particularly those who speak a minority language, manage the challenges of aging in place. The present qualitative descriptive study explores the strategies that Canadian French-speaking seniors have put in place to counter their loss of independence and promote their ability to stay in their home. Semistructured individual interviews were conducted with 39 older adults and transcribed, followed by content analysis to identify common themes related to study objectives. Six themes emerged in response to strategies described for aging in place. Findings reveal the limited extent to which language issues were perceived as a barrier by participants. In conclusion, the results of this study provide us with fruitful insights to guide community nursing practice, future research, and public policy.

Understanding the life experiences of older adults in Korea following a suicide attempt

The purpose of this article is to describe life experiences following suicide attempts from the perspective of older Korean adults. Both field notes and in-depth interviews with 35 elderly Koreans who had attempted suicide were analyzed through qualitative content analysis. With an underlying theme of "life with no way out for those who believe they do not even have any luck in dying," I classified the experiences of participants in the wake of a failed suicide attempt into four categories: (a) facing additional hardships including deteriorating physical health, (b) having more sadness and loneliness than before the suicide attempt, (c) deepening dependency on tranquilizers, and (d) seesawing between despair and faint hope. Based on these research findings, I make four recommendations regarding secondary preventive interventions for elderly suicide attempters.

A method of phenomenological interviewing

In this article I propose a method of interviewing for descriptive phenomenological research that offers an explicit, theoretically based approach for researchers. My approach enables application of descriptive phenomenology as a total method for research, and not one just focused on data analysis. This structured phenomenological approach to interviewing applies questions based on themes of experience contextualization, apprehending the phenomenon and its clarification. The method of questioning employs descriptive and structural questioning as well as novel use of imaginative variation to explore experience. The approach will help researchers understand how to undertake descriptive phenomenological research interviews.