After the fire: An ecological, phenomenological exploration of resilience-building following the Fuego volcanic eruption in Guatemala

Combining ecological resilience theory with a phenomenological epistemology, we explored experiential, social, and cultural factors mediating resilience-building with participants from a village destroyed by the 2018 Fuego volcanic eruption in Guatemala. The purpose of the study is to find out what strategies displaced families and communities employ for living through the aftermath of a volcano eruption and for building psychological resilience. We conducted semistructured interviews with nine survivors of the Fuego eruption, now relocated and coping with the loss of community and family members killed in the disaster. Interpretive phenomenological analysis was used to analyze transcripts. The analysis produced four main themes: (i) individual and collective challenges, (ii) social support and protection, (iii) faith and culturally endorsed belief, and (iv) looking to the future. As well as learning more about how a community faced challenges presented by a volcano eruption, the current study has a degree of transferability, with implications for understanding how other communities experience and cope with such events.

Exploring Patient Advisors' Perceptions of Virtual Care Across Canada: Qualitative Phenomenological Study

BACKGROUND

While virtual care services existed prior to the emergence of COVID-19, the pandemic catalyzed a rapid transition from in-person to virtual care service delivery across the Canadian health care system. Virtual care includes synchronous or asynchronous delivery of health care services through video visits, telephone visits, or secure messaging. Patient advisors are people with patient and caregiving experiences who collaborate within the health care system to share insights and experiences in order to improve health care.

OBJECTIVE

This study aimed to understand patient advisors' perceptions related to virtual care and potential impacts on health care quality.

METHODS

We adopted a phenomenological approach, whereby we interviewed 20 participants who were patient advisors across Canada using a semistructured interview protocol. The protocol was developed by content experts and medical education researchers. The interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Data collection stopped once thematic saturation was reached. The study was conducted at Queen's University, Kingston, Ontario. We recruited 20 participants from 5 Canadian provinces (17 female participants and 3 male participants).

RESULTS

Six themes were identified: (1) characteristics of effective health care, (2) experiences with virtual care, (3) modality preferences, (4) involvement of others, (5) risks associated with virtual care encounters, and (6) vulnerable populations. Participants reported that high-quality health care included building relationships and treating patients holistically. In general, participants described positive experiences with virtual care during the pandemic, including greater efficiency, increased accessibility, and that virtual care was less stressful and more patient centered. Participants comparing virtual care with in-person care reported that time, scheduling, and content of interactions were similar across modalities. However, participants also shared the perception that certain modalities were more appropriate for specific clinical encounters (eg, prescription renewals and follow-up appointments). Perspectives related to the involvement of family members and medical trainees were positive. Potential risks included miscommunication, privacy concerns, and inaccurate patient assessments. All participants agreed that stakeholders should be proactive in applying strategies to support vulnerable patients. Participants also recommended education for patients and providers to improve virtual care delivery.

CONCLUSIONS

Participant-reported experiences of virtual care encounters were relatively positive. Future work could focus on delivering training and resources for providers and patients. While initial experiences are positive, there is a need for ongoing stakeholder engagement and evaluation to improve patient and caregiver experiences with virtual care.

Simplified Phenomenological Model for Ferroelectric Micro-Actuator

As smart structures are becoming increasingly ubiquitous in our daily life, the need for efficient modeling electromechanical coupling devices is also rapidly advancing. Smart structures are often made of piezoelectric materials such as lead zirconate titanate (PZT), which exhibits strong nonlinear behavior known as hysteresis effect under a large applied electric field. There have been numerous modeling techniques that are able to capture such an effect; some techniques are suitable for obtaining physical insights into the micro-structure of the material, while other techniques are better-suited to practical structural analyses. In this paper, we aim to achieve the latter. We propose a simplified phenomenological macroscopic model of a nonlinear ferroelectric actuator. The assumption is based on the direct relation between the irreversible strain and irreversible electric field, and the consequently irreversible polarization. The proposed model is then implemented in a finite element framework, in which the main features such as local return mapping and the tangent moduli are derived. The outcomes of the model are compared and validated with experimental data. Therefore, the development presented in this paper can be a useful tool for the modeling of nonlinear ferroelectric actuators.

International Counseling Values: Recognizing Valued Approaches Identified by International Counseling Professionals Through Qualitative Inquiry

People may assume that the counseling profession functions with a shared set of values that promote well-being and mental health to individuals, families, and communities across the globe. Common values, such as described in training programs, ethical codes, and other areas, reflect the approach and direction for providing professional counseling services among counseling professionals throughout the world. The researchers designed this qualitative study using a phenomenological approach to explore how counseling values are experienced and implemented across various cultures. The 16 participants of the study include counseling professionals from different countries to increase representation from eight regions of the world. The researchers recognize valued approaches commonly identified among the participants implementing counseling services, including marital and family counseling, child and school counseling, faith integration, indigenous practices, and person-centered safe spaces. While each of these valued approaches is described in detail, final applications of the data offer proposed steps to improve the advancement of counseling on a global scale, including strategies for transcultural counseling training, resource adaptability, and bilateral development in the profession.

'It's like Taking a Sleeping Pill': Student Experience of Autonomous Sensory Meridian Response (ASMR) to Promote Health and Mental Wellbeing

Autonomous Sensory Meridian Response (ASMR) is purposely elicited by some individuals to promote health and mental wellbeing. The aim of the current study was to explore how ASMR is used and its perceived benefits in a student population. We employed semi-structured qualitative interviews, with eight female students who self-reported as ASMR-sensitive users. Inductive thematic analysis, underpinned by a phenomenological framework, was applied to the data. Two themes, each with three subthemes, were identified; these highlighted the journey from first discovering ASMR to present experience and the use of ASMR to promote health and mental wellbeing both directly and indirectly. For some, ASMR was used daily, whilst for others it was used in a relapsing-remitting fashion: usage increased when struggling with mental wellbeing and was most often used as a tool to induce sleep or distraction when feeling anxious. Participants also reported ASMR-eliciting content as intriguing, and that the phenomenon was regarded as taboo. ASMR appears to play an important role in promoting health and mental wellbeing; frequency of use, preferred triggers, and purpose of use varied, highlighting its flexible and subjective nature. It provides a potential cost-effective tool in populations such as students where mental health needs are burgeoning.

Nigerian and Ghanaian Young People's Experiences of Care for Common Mental Disorders in Inner London: Protocol for a Multimethod Investigation

BACKGROUND

The Care Quality Commission published a review in 2018 in England titled "Are We Listening," which revealed that child and adolescent mental health services are not responsive to the specific needs of young Black people and other ethnic minorities even in areas with ethnically diverse populations. It found that commissioners and service planners failed to engage with these young people and their families to understand their needs and expectations.

OBJECTIVE

The purpose of this study is to engage Nigerian and Ghanaian young people (NAGYP) with experiences of care for common mental disorders (CMDs) in London, to increase understanding of their needs, and to give voice to their views and preferences. Their parents', caregivers', and practitioners' views will also be sought for service improvement.

METHODS

Three combined contemporary complementary methodologies-thematic analysis, interpretative phenomenological analysis (IPA), and intersectionality-based policy analysis (IBPA)-will be used across 3 comprehensive phases. First, a scoping review where relevant themes will be critically analyzed will inform further phases of this study. Detailed mapping of community and mental health care services in 13 inner London boroughs to investigate what professionals actually do rather than what they say they do. Second, IBPA will be used to scrutinize improving access to psychological therapies and other legislations and policies relevant to NAGYP to undertake an intersectional multileveled analysis of power, models, and constraints. Third, IPA will "give voice" and "make sense" of NAGYP lived experiences of CMDs via a representative sample of NAGYP participants' (n=30) aged 16-25 years, parents or caregivers' (n=20), and practitioners' (n=20) perspectives will be captured.

RESULTS

The study has been approved by the UCL Institute of Education Research Ethics Committee (Z6364106/2022/02/28; health research) and University College London (Z6364106/2022/10/24; social research). Recruitment has begun in 13 inner boroughs of London. Data collection through observation, semistructured interviews, and focus groups are expected to be finalized by early 2024, and the study will be published by early 2025.

CONCLUSIONS

Combining multiple qualitative methodologies and methods will enable rigorous investigation into NAGYP's lived experiences of care received for CMDs in London. Findings from this study should enable a reduction in the negative connotations and harmful superstitions associated with mental health-related issues in this group, inform evidence-based interventions, and facilitate preventive or early access to interventions. There may also be an indirect impact on problems resulting from mental illness such as school dropout, antisocial behaviors, knife crimes, juvenile detention centers, and even death.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/42575.

Phoenix On Fire: A Phenomenological Study Of A Psychiatric Hospital Fire In Iran

Psychiatric hospitals and centers have more complex conditions than other hospitals in responding to emergencies, given the differences in the design of their buildings and in non-structural elements. This is a qualitative study aimed at reviewing and investigating the experiences and challenges faced by psychiatric hospital staff in response to different fire incidents. A phenomenological approach was employed to conduct the study, believing that human experiences and beliefs are substances in phenomena and can be understood and examined. The contents of interviews and focus group discussion (FGD) sessions were extracted and classified into five categories, 14 themes, and 49 sub-categories. Many psychiatric hospitals in Iran are not ready to respond properly to incidents like fires. The study revealed that in order to ensure appropriate management of incidents and disasters in the hospitals, it is necessary to focus on five areas called the 5s framework, which includes structures, staff, supplies (facilities, equipment etc.), sick persons and systems. This framework is proposed to enhance preparedness, reduce vulnerability, and provoke an effective response to incidents in psychiatric hospitals.

Parents' priorities and preferences for treatment of children with ADHD: Qualitative inquiry in the MADDY study

BACKGROUND

Parents' lived experiences of having a child with ADHD may shape their decision making regarding ADHD treatment options for their child. The aim of this study was to explore parents' experiences of living with a child with ADHD in the family and how their experiences influence their perspectives on treatment preferences and priorities.

METHODS

A phenomenological qualitative design was used. Semistructured interviews were conducted with parents of children with ADHD who were enrolled in a multisite randomized controlled trial. Interviews were transcribed verbatim, and transcripts at each site were double coded. Initial codes were derived directly from the text. Qualitative data were analysed with an inductive approach.

RESULTS

Twenty-three parents were interviewed: eight from Alberta, Canada; eight from Portland, Oregon, USA; and seven from Columbus, Ohio, USA. Among the parents, 69% were married, 86% completed college education and 52% reported household income over $80,000. Among the children, the mean age was 9.6 years (SD = 1.8 years), 78% were boys and 48% were never medicated for their ADHD. Two major themes emerged from the analysis. Theme 1 was 'impact of ADHD on families within and outside the home' with the following subthemes: 'reconfiguring the home life', 'trial-and-error of accommodations at school' and 'responding to social pressures to fit in'. Theme 2 was 'enabling appropriate and accessible treatments for families' with the following subthemes: 'finding the "right fit" with professionals and treatments' and 'factors influencing inequitable access to treatments'.

CONCLUSIONS

Parents described shared experiences and identified similar barriers, preferences and priorities for ADHD treatments regardless of demographic differences by site. Families desired access to family-centred, multimodal approaches to ADHD treatment. Further research is needed to identify the specific structural changes to healthcare, services and policies that will better support this approach.

Parents' experiences with public health nursing during the postnatal period: A reflective lifeworld research study

AIM

To describe mothers' and fathers' experiences with public health nursing and child and family health centre services in the postnatal period, both as a couple and as individuals.

METHOD

A phenomenological reflective lifeworld research approach with a descriptive design was chosen. A purposive sample of 10 mothers and 10 fathers were interviewed twice, 1-2 and 6-8 weeks postpartum, using joint and individual interviews. By focusing on being open and flexible, the data were analyzed to elucidate a meaningful structure of the phenomenon.

RESULTS

The findings revealed that parents' experiences with public health nurse (PHN) and Child and Family Health Centre (CFHC) services in the postnatal period are characterised by a longing to be seen and confirmed both as unique individuals and as a family by the PHN. Although an increased need for both lay and professional care is prominent during the postnatal period, the parents drew a varied picture of their experiences demonstrating that the CFHC services are focussing almost exclusively on mother and child.

CONCLUSION

A public health nurse can contribute to strengthen parenthood and promote the family's health when the focus is on the new baby. Being cared for while learning to care for the baby is pivotal in a phase that involves both joy and vulnerability. This study adds knowledge concerning the importance of both parents being seen and confirmed by the PHN as unique individuals and a family unit in the postnatal period.

"Doing it on my own terms": Transgender and nonbinary adults' experiences with HPV self-swabbing home testing kits

The human papillomavirus (HPV) carries a significant health risk for people with a cervix. Among transgender and nonbinary people, however, testing and treatment for HPV can pose difficulties, and even be traumatic at times. This current study is part of a larger mixed methods study conducted in Michigan in 2020, and it explores the experiences of transmasculine and nonbinary people with at-home self-swabbing HPV test kits and knowledge of HPV transmission/screenings. Phenomenological methods were used by conducting virtual qualitative interviews with ten transmasculine and nonbinary individuals with cervixes, ages 23-59. Interviews were independently coded by members of the research team and a tabletop theming method was used. Four themes were generated from the data: 1) Multilevel barriers; 2) "Get it done, so I know that I am safe"; 3) Contrasting preferences for care; and 4) Community calls for change. The discussion focuses on the implications of these findings for improving sexual health care for the transgender and nonbinary community, along with directions for further research.

Lived experiences of frontline nurses and physicians infected by COVID-19 during their activities: A phenomenological study

We analyzed the lived experiences of frontline nurses and physicians who were affected by COVID-19 through a phenomenological approach, using Cohen's methodology with interview data. The participants were enrolled in the study in May 2020 during the COVID-19 pandemic in Italy. The inclusion criteria were (i) being a nurse or physician employed full time caring for COVID-19 patients before falling ill; (ii) contracting SARS-CoV-2 between February 2020 to May 2020; (iii) having recovered before enrollment; and (iv) providing informed consent to participate. Sixteen participants (60% nurses) with an average age of 45 years were included. The following main themes were extrapolated from our data analysis: "fear of diagnosis," "loneliness (as isolation)," "touch of nurses," and "feeling guilty of abandonment." Several aspects emerging from our study highlight the strong emotional impact of COVID on nurses and physicians infected during their activities, such as feelings of fear and loneliness on the one hand, and of impotence and guilt for not being able to help on the other.

Nurses and Stigma at the Time of COVID-19: A Phenomenological Study

The COVID-19 pandemic is putting strain on every country in the world and their health systems. Healthcare professionals struggle on the frontline and they can experience stigma, which can create difficulties in controlling epidemic diseases, influencing the mental health of healthcare professionals, caregivers, families, communities, and the provided quality of care. The aim of this study is to explore the lived experience of Italian nurses about perceived stigma during COVID-19 pandemic with the phenomenological Cohen method. The principal themes that emerged from data analysis were “stigma in the working environment” and “stigma in everyday life”. Each of these themes had subthemes: “looks like gun sights”, “avoiding closeness to others”, “nobody wants to touch you”, and “the fault of being your family members”. Public health emergencies, such as the COVID-19 pandemic, are stressful events for individuals and communities. Stigma can be more dangerous than the disease, and a major obstacle to appropriate medical and mental health interventions. Understanding how healthcare professionals experience stigma is essential to design and implement specific educational, psychological, and organisational programmes.

Postpartum Women's Lived Experiences of Perinatal Intimate Partner Violence in Wolaita Zone, Southern Ethiopia: A Phenomenological Study Approach

Objective

Perinatal intimate partner violence affects the health and safety of postpartum women and their infants. However, it has not been well recognized and addressed in the study setting. Hence, this study aimed to explore postpartum women's lived experiences of perinatal intimate partner violence and its contributing factors in Wolaita Zone, Southern Ethiopia.

Methods

A phenomenological study approach was used to explore postpartum women's lived experiences of perinatal partner violence from January to March 2020. A total of twenty-two postnatal women and five health extension workers (HEWs) were interviewed. Interviews were audio-recorded, transcribed verbatim in local languages, and then translated into English. Data were analyzed thematically, using deductive and inductive coding. The consolidated criteria for reporting qualitative research (CORE-Q) checklist was followed to report the findings.

Results

Results indicated that postpartum women had experienced recurrent violence before, during, and after pregnancy from their husbands, with 16 out of 22 women being subjected to perinatal intimate partner violence. A majority of the participants delineated their exposure to perinatal physical violence next to perinatal psychological violence. Many of the interviewed women noted that violence during pregnancy was exacerbated and increased during postpartum. Moreover, the interviewees revealed that some partners were not only a serious threat to their wives, but also their infants during the postpartum period. Four of the participants stated that their newborns were hit and thrown by their father and became unconscious. Participants linked husbands' perinatal violence with suspicion about the newborn, male-child preference, partner infidelity and jealousy, contraceptives usage, alcohol consumptions, indifference to shortages on household necessities, improper parenting, and financial problems.

Conclusion

This study highlights that postpartum women are experiencing continuous and severe forms of perinatal IPV in the study setting. Thus, community-level interventions that minimize perinatal partner violence against postnatal women and their infants are needed.

Volunteers do the fun stuff -- Experiences from volunteer-professional caregiver cooperation in nursing homes

BACKGROUND

The number of volunteers in Danish nursing homes is increasing. Volunteers cooperate with professional caregivers to improve the residents' well-being and quality of life as part of their palliative care. The Danish government encourages this volunteer involvement, which is partly intended to alleviate the resource constraints in municipal healthcare. Although volunteer roles are defined as complementary to the professional caregiver role, volunteer-professional caregiver cooperation can be challenging.

AIM

This article explores the challenges experienced in volunteer-professional caregiver cooperation in the general palliative care provided in nursing homes.

METHOD

A qualitative design and a sociological phenomenological approach were adopted to answer the research question: What is experienced as challenging in the cooperation between volunteer and professional caregivers in the provision of care for elderly residents in everyday life in a nursing home? And what meanings and understandings are associated with these experiences? Data were collected by combining participant observations and interviews, and thematic analysis structured the analytical process.

FINDINGS

The analysis of 115 hours of participant observations in two Danish nursing homes with 50-60 volunteers involved and 16 interviews (eight with volunteers, eight with professional caregivers) identified two overall themes: 'Symbolic indications of them and us' (two sub-themes) and 'Meaning and action regarding the residents best interest' (three sub-themes).

CONCLUSIONS

An institutional distinction between volunteer versus professional caregiver domains contributed to a sense of 'them and us', which hindered common experiences and raised challenges concerning the mutual understanding of actions. The professional caregivers felt that they lacked the time to engage in social care activities with residents, for which volunteers otherwise had time. The coordinator role was a crucial link in coordinating the daily care activities for residents but marked by a sense of ambivalence among the professional caregivers.

A Resilient Care of the Patient With COVID-19: A Phenomenological Study

This study a utilized phenomenological hermeneutic design. Fourteen Iranian family caregivers of patients with COVID-19 who were isolated at home were included in the study using purposive sampling. In-depth unstructured interviews were conducted via WhatsApp. Sampling continued until data saturation. Interviews were transcribed and analyzed using Van Manen's approach. Three primary themes and eight subthemes emerged. The primary themes included: "captured in a whirlpool of time", "resilient care' and "feeling helpless". It seems that the families of patients with COVID-19 attempt to resist the pressures of this disease with religious practices and problem solving. However, due to the nature of the disease and its severity, they sometimes feel ashamed or lonely and are afraid of losing their loved ones. It is recommended that psychiatric nurses should develop programs in the form of comprehensive spiritual care packages or psychological support and utilize multiple media channels to deliver these.

Addressing Phantom Pain Through Occupational Participation: A Qualitative Study of Support Group Participants

The purpose of this qualitative phenomenological study was to explore the adaptation process of support group participants who are survivors of lower limb amputation (LLA) experiencing phantom limb pain (PLP). The study followed a qualitative, descriptive phenomenological design. Ten adult participants with LLA met inclusion criteria and through semi-structured interviews shared their lived experience. A qualitative descriptive methodology was used to analyze the data collected from interview transcriptions. Analysis involved coding and theme development. Three themes emerged: PLP interrupted but does not prevent participation, adapting to PLP allowed for continued participation in meaningful occupations, and education to promote self-management of PLP. Themes identified highlight the importance of social support and early education on PLP to facilitate the adaption process and promote occupational participation. The finding underscores the value of empowering survivors to self-manage pain through their own personal and unique ways.

Intergenerational Choir: A Qualitative Exploration of Lived Experiences of Older Adults and Student Music Therapists

The purpose of this phenomenological study was to explore the essence of an intergenerational choir experience for older adults and student music therapists. Data were gathered through a series of open-ended individual interviews with older adult participants (n = 10) and student participants (n = 5). Analysis of data revealed four emerging themes common to both older adults and students: mutual learning, social bonding and support, feelings of accomplishment, and appreciation and enjoyment. Emerging themes unique to the older adult community members were that (a) participation challenges came from differences in musical culture; (b) intergenerational choir promoted experience of emotional health and helped maintain an active lifestyle; and (c) community members were passionate about recruiting new members to expand the choir. Emerging themes unique to the student music therapists were that (a) intergenerational choir provided unique ensemble experiences and (b) students reported positive changes in perception of older adults. Implications of intergenerational music engagement for music therapy clinical practice, research, and education are discussed.

Sources of Happiness: A Mixed Methods Phenomenological Study of Factors Affecting Residents' Subjective Wellbeing in Shenzhen, China

Maintaining cultural sensitivity has been a challenge in subjective wellbeing (SWB) research involving nonwestern populations, which continues to primarily use a quantitative approach and Westernoriginating measurements. Accounting for culturally specific characteristics of the study area and sample, we employed a concurrent mixed-methods phenomenological approach to uncover factors contributing to urban Chinese residents' SWB in the context of their daily lives. Data from 65 semi-structured interviews in Shenzhen, China revealed five meta-themes, including harmony in interpersonal relationships, financial wellbeing and homeownership, health, physical and social environment, and intentional activities and mentality. Residents' background contextual information was cross-referenced with the meta-themes to enrich data interpretation, unveiling the profound imprint of age and life stages, the broad-scale structural inequities associated with China's household registration system, and the firm grip of traditional family core values and folk wisdom in the form of a transcendental mindset of inner peace and dignity. The results provide a contextualized understanding of the primary sources of SWB relevant to today's urban Chinese residents, and offer valuable insight about the social-cultural complexities involved in "ordinary" Chinese residents' pursuit of happiness that is co-shaped by individual effort, deep-rooted traditional values, and consequential social infrastructure and policies amidst the country's deepening, transformative urbanization. Keywords: China, Cultural Sensitivity, Happiness, Mixed Methods, Phenomenological Approach, Socio-Cultural Context, Sources of Happiness, Subjective Wellbeing, Urban Resident.

'Mammy's supposed to be strong and supportive - not sitting in a corner rocking and crying': an interpretative phenomenological analysis of British mothers' experiences of postnatal depression

OBJECTIVE

To gain an in-depth understanding of the lived experience of women with postnatal depression (PND).

BACKGROUND

Although there is a small body of existing research which explores subjective experience of this phenomenon, relatively little research has been carried out and is prior to the publication of the NICE guidelines for PND in 2007.

METHOD

Semi-structured interviews were carried out with six mothers (aged 23-40 years), who had taken part in a PND support group. Verbatim transcripts were analysed using Interpretative Phenomenological Analysis (IPA).

RESULTS

One broad superordinate theme of 'the conflicted mother' emerged from the data, with four corresponding sub-themes (own mother as absent and judgemental; internalised mother; pregnancy on the road to motherhood as an unpleasant stranger; the ideal mother).

CONCLUSION

It is argued that a broad umbrella construct of 'the conflicted mother' exists in PND experience. This study highlights the importance of the mother's own maternal relationship in living with depression. The authors discuss limitations of the study, make service recommendations to improve current clinical practice for women with PND, and provide future research directions.

The Lived Experiences, Perceptions, and Considerations of Patients After Operable Lung Cancer Concerning Nonparticipation in a Randomized Clinical Rehabilitation Trial

The purpose of this study was to explore the lived experiences, perceptions, and considerations of individuals who declined participation in a randomized clinical trial involving exercise rehabilitation after surgery for lung cancer. An interpretive phenomenological approach was applied comprising interviews with 15 individuals who did not wish to participate in the trial. The findings shed light on a discrepancy between their freedom to act and make decisions and the limitations of having to act in a certain way. The participants found themselves in a gray area between a healthy life and a good life, as influenced by societal norms and taking responsibility for one's own health and rehabilitation. When including patients in rehabilitation after lung cancer, having insight into the underlying narrative on values and the good life, priorities in daily life, social context and the norms embedded in people's self-understanding is crucial.

When the Hospital Is No Longer an Option: A Multiple Case Study of Defining Moments for Women Choosing Home Birth in High-Risk Pregnancies in The Netherlands

Some women in a high-risk pregnancy go against medical advice and choose to birth at home with a "holistic" midwife. In this exploratory multiple case study, grounded theory and triangulation were employed to examine 10 cases. The women, their partners, and (regular and holistic) health care professionals were interviewed in an attempt to determine whether there was a pattern to their experiences. Two propositions emerged. The dominant one was a trajectory of trauma, self-education, concern about paternalism, and conflict leading to a negative choice for holistic care. The rival proposition was a path of trust and positive choice for holistic care without conflict. We discuss these two propositions and make suggestions for professionals for building a trusting relationship using continuity of care, true shared decision making, and an alternative risk discourse to achieve the goal of making women perceive the hospital as safe again.

Narrative intervention: Stories from the front lines of oncology health care

This study examined the experiences of health care professionals who participated in monthly narrative oncology groups. Ten professionals participated in separate, semi-structured, face-to-face interviews. Using a qualitative research design, the transcriptions of the interviews were analyzed using a phenomenological approach. The analysis yielded descriptive information about the professionals' positive experiences of participating in narrative oncology sessions and provides insight into the importance of such a group through five themes: (1) Shared perspectives and bearing witness, (2) Comfort in confidentiality and a safe-space, (3) Group-care becomes self-care, (4) Writing gives structure, and (5) Patient stories. Implications for incorporating narrative intervention in an oncology setting are discussed in this paper.

Exchanging narratives-A qualitative study of peer support among surgical lung cancer patients

AIM AND OBJECTIVE

The aim of this study was to examine how hospitalised, surgical lung cancer patients experience talking to a former patient, and how the former patient experiences the role as supportive.

BACKGROUND

During hospitalisation, patients often create a community in which they can engage with fellow patients. The exchange of experiences with others in a similar situation might increase opportunities for support and complement nursing care, but there is a need for more evidence and understanding on the topic.

DESIGN

The methodological framework is based on the French philosopher Paul Ricoeur's text interpretation theory. Qualitative interviews were conducted with nine patients, including a peer informant, using a narrative structure. The analysis was conducted on three levels: (i) naïve reading, (ii) structural analysis and (iii) critical interpretation .

RESULTS

Four themes were developed from the analysis of the interviews: Exchanging emotional thoughts is easier with a peer; Talking to a peer reduces loneliness; Being ambiguous about a relationship with fellow patients; and Being the main person in the conversation with a peer. Sharing stories about having similar symptoms and undergoing similar journeys predominated, and the key feature of the contact between patients was the commonality of their stories.

CRITICAL INTERPRETATION AND CONCLUSION

Telling one's story to a former patient, and thereby creating a joint, common story, is the essence of this study. The support received in this process can be empowering because knowledge of the illness experience is shared and increased. This can help create new coping strategies. The contact with a former patient offered a way to confirm one's thoughts and to find a way out of the illness perspective, by seeing how the former patient had recovered.

RELEVANCE TO CLINICAL PRACTICE

The nursing field faces challenges in the relational aspect of caring because of ever greater efficient and shortened hospital stays; therefore, the peer support concept is becoming increasingly relevant. Patient peers offer each other their own perspectives, and it is important to raise awareness of the value of this and incorporate it into patient stays in hospital.

Protection and restriction: A mixed-methods study of self-reported well-being among youth with intellectual disabilities

BACKGROUND

As most mental health studies of school-aged children with intellectual and developmental disabilities (IDD) are based on proxy ratings, the subjective views of these young persons are rarely explored. The present study explores experiences of well-being, mental ill-health, family, school, and peer relations in students in special education.

METHODS

Ten students in special education, aged 13-16 years, answered the Wellbeing in Special Education Questionnaire (WellSEQ) and participated in semi-structured interviews. Data were analyzed using a mixed methods phenomenological research approach.

RESULTS

The general agreement between questionnaire responses and interview accounts appears to be good, and the students emphasized mainly positive emotions and good mental health. Students described their school environment and family relations as inclusive contexts experienced as both protective and restrictive.

CONCLUSION

Using well-adapted research instruments enables students with IDD to communicate subjective experiences of well-being and how it relates to aspects of their everyday environment.

"Hope crept in": a phenomenological study of mentally ill artists' biographic narrative

BACKGROUND

The ways in which involvement in art practice may support a recovery trajectory in the lives of the mentally ill are well documented although evidence is charged with lacking clarity and of being inconclusive. Numerous studies, however, indicate benefits such as cognitive distraction; "derailing" of negative thinking patterns; increased social capital; and enhanced sense of belonging.

AIMS

This study used narrative interviews to explore what meanings were made by people with mental health difficulties of engaging in an ongoing visual art practice.

METHODS

Phenomenological Interpretative Analysis (IPA) was used to analyse 50 interviews. Two superordinate themes of regression and progression were identified through which to explore the shifts in narrative between exploring one's past and looking ahead to the future. In this context, the theme of hope emerged, and the research explored the ways in which the individual's art practice was implicated in engendering and sustaining it.

RESULTS

Results suggest that artistic activity facilitated a contained autobiographical analysis and a reimagining of oneself in the future, in which hope played a fundamental part.

CONCLUSION

This research suggests that a dialectic between despair and hope is facilitated by the autobiographic elements of an art practice. Through this movement from a perceived static past to a more fluid future is experienced.

Being old and living alone in urban areas: the meaning of self-care and health on the perception of life situation and identity

BACKGROUND

Living alone in urban areas when getting old is an important and necessary field for research as the growth of the urban population worldwide increases, and due to the fact that people live longer. How older people manage their self-care and health, and how this might influence their identity and life situation may be very important to understand when planning for a new, upcoming older generation. The aim of this study was to elucidate the meaning of self-care and health for the perception of life situation and identity among single-living older individuals in urban areas in southern Norway.

METHODS

A phenomenological-hermeneutic approach inspired by Ricoeur was applied. Nine single-living older persons in urban areas, 70-82 years of age, and identified to be in good health were interviewed. The interviews were audiotaped, transcribed verbatim, and analyzed using a phenomenological-hermeneutic method.

RESULTS

Strength and a time dimension characterized the meaning of self-care and health for the perception of life situation and identity as narrated by the group of single-living older individuals in urban areas in southern Norway. The informants were, as older individuals, caring, autonomous, and robust characters, who had gone through difficult times in life, and in a resilient way moved towards a new future. They valued and were grateful for what they had learned in their lives and could go forward and still experience and explore.

CONCLUSION

Self-care is significant in the perception of life situation and identity among single urban older people in this study, and characterized by strength, temporality, gratitude, autonomy, and natality. Society needs to acknowledge the strengths and capabilities of older people to a greater extent.

The meaning of long-term caregiving for patients with frontal lobe dementia

Nursing staff that work with patients with frontal lobe dementia (FLD) experience challenges that may lead to physical and psychiatric distress. The aim of this study was to capture the feelings, experiences, and reflections of the health staff regarding interactions with and caring for patients with FLD and to highlight what it means for health staff to care for patients with FLD through their daily work. This is a qualitative study with a phenomenological hermeneutic approach. Ten health staff members who work with patients with FLD were interviewed using semistructered interviews. The focus during the interview was the experiences of the staff through their everyday work. The interviews were recorded and then transcribed verbatim. The material was analyzed using a phenomenological hermeneutic approach. The result of the study identifies three themes that highlight the meaning of caregiving for patients with FLD, that is, being aware of the relationship with the patients, being insecure, and being safe. The patients’ unpredictable behaviour puts the relationship between the staff and the patients on trial. It is essential in caregiving to see the human behind the disease and the behaviour. The interest of finding new solutions in the caregiving is awakened through the relation with the patients, through reflections with colleagues, external guidance and by support from the staff leader.

"They can do whatever they want": Meanings of receiving psychiatric care based on a common staff approach

This study deepens our understanding of how patients, when cared for in a psychiatric ward, experience situations that involve being handled according to a common staff approach. Interviews with nine former psychiatric in-patients were analyzed using a phenomenological-hermeneutic method to illuminate the lived experience of receiving care based on a common staff approach. The results revealed several meanings: discovering that you are as subjected to a common staff approach, becoming aware that no one cares, becoming aware that your freedom is restricted, being afflicted, becoming aware that a common staff approach is not applied by all staff, and feeling safe because someone else is responsible. The comprehensive understanding was that the patient's understanding of being cared for according to a common staff approach was to be seen and treated in accordance with others' beliefs and valuations, not in line with the patients' own self-image, while experiencing feelings of affliction.