In her own words: a phenomenological analysis of stories told by female service members and veterans after traumatic brain injury

PURPOSE

Given the majority of Service Members and Veterans (SMV) who have sustained a traumatic brain injury (TBI) are male, the female experience with TBI has not been captured in the general understanding of TBI. To improve understanding of the experience of female SMV after TBI utilizing a qualitative phenomenological approach on stories as told by female SMV.

MATERIALS AND METHODS

Ten female SMV participated in storytelling workshops and created video stories documenting their personal experience with TBI. Workshops were hosted by the VA Palo Alto Health Care System Polytrauma System of Care (VAPAHCS PSC). A grounded thematic analysis was conducted on the video stories.

RESULTS

Three common content themes emerged from all the stories: (1) negative psychological and emotional impacts of TBI, (2) acceptance and healing process associated with recovery, and (3) military contexts. Negative psychological and emotional impacts included intrapersonal impacts such as negative emotions, suicidal ideation, and dealing with cognitive and physical challenges, and interpersonal impacts in relationships and loss of independence. Notably, all the stories acknowledged an acceptance and healing process, characterized by several subthemes including motivational factors, TBI education, spirituality, and advocacy work. Lastly, each story mentioned military context, highlighting the unique experience within this population.

CONCLUSIONS

This phenomenological examination adds evidence-based understanding to the experience after TBI among female SMV. Each story uncovered nuanced and multifaceted issues that women experience in their TBI recovery. Our findings provide context to guide future intervention on the care, support, and TBI recovery for the female SMV population.

Nurses' lived experience of peacebuilding

Nursing has a unique opportunity to address issues of structural violence that contribute to poor health outcomes. Models for designing nursing care relative to the social determinants of health can be adapted from the discipline of peace studies and the phenomenon of peacebuilding. The aim of this qualitative study was to describe the lived experience of peacebuilding from the perspective of community or public health nurses. Interviews were conducted with eight participants. Attributes of the peacebuilder included fostering human relationships that value the inherent worth and dignity of others, nurturing a character of humility and moral courage, and contemplating the personal cost of engaging in prolonged processes of peacebuilding. Practices of peacebuilding included mediating conflict through multilayered processes, accompanying others to places of empowerment, and utilizing interdisciplinary teaching and learning to build capacity for change. Increasing an understanding of the lived experience of peacebuilding by nurses is relevant to nursing research, theory, and practice, and adds to a broader understanding of peacebuilding.

Parent-Child Grief Interactions: A Qualitative Analysis and Conceptual Framework of the Lived Experiences of Young Widowed Parents

A young parent's death is an unexpected event that incurs family stress and grief for the surviving parent and young children. However, few studies have examined widowed parents' grief experiences and parent-child interactions following a co-parent's death. Guided by phenomenology, this qualitative study examined the lived experiences of (N = 12) surviving parents grieving the loss of their co-parent. Data were collected using semi-structured interviews and analyzed using an inductive analytic procedure. Findings included themes of (1) not showing grief with child; (2) talking through grief/emotions with child; (3) maintaining connection between deceased parent and child; (4) timing of sharing things with children; and (5) utilizing bereavement and group support. These findings suggest that support services for surviving parents include providing information to them about the timing of when to share mementos with children and psychoeducation on emotion sharing and masking as part of the grief process with young children.

Empirical Phenomenological Inquiry: Guidance in Choosing Between Different Methodologies

Empirical phenomenological inquiry and analyses are of high relevance and applicability for nursing and health care. Phenomenology has clear roots in philosophy, which needs to be brought into an empirical phenomenological inquiry. However, all study of phenomena and experience does not qualify as phenomenological inquiry. The aim of this article is to provide guidance for how to relate different empirical phenomenological methodologies that are in play in the broader field of healthcare research, and thus support healthcare researchers in navigating between these methodologies. For pedagogical purposes, we present commonalities and differences as related to descriptive and interpretive phenomenological inquiries throughout the research process. The merits and criticisms of empirical phenomenological inquiry are commented on.

Exploring the Lived Experience of Families Waiting for Surgical Patients: A Qualitative Study

Family-centered care is an important aspect of perioperative nursing, especially during the perioperative waiting period that separates patients from their families or significant others. However, there is a lack of understanding on what waiting means to family members or significant others. In this hermeneutic phenomenological study, we explored the lived experiences of family members waiting for surgical patients. We identified a shared experience during waiting that we called a "time to focus on self." We identified five supporting themes that shaped this meaning of waiting: the environment, activities, communication, expectations, and feelings. The perioperative waiting experience may be a necessary time of self-reflection and self-care for family members when responsibilities for loved ones are temporarily on hold. Perioperative nurses can provide family-centered interventions to address the physical and emotional needs of individuals who are waiting and improve their experience.

Experiences of women undergoing infertility treatment from embryo transfer until pregnancy test and their conceptualization of their embryo

AIM

This study aims to explore women's experiences with embryo transfer (ET) until pregnancy test and their conceptualization of their embryo.

METHOD

The sample of this descriptive phenomenology study consists of 17 women with ET. The data were collected through in-depth interviews. The thematic analysis developed by Braun and Clarke was used for data analysis.

RESULTS

Analysis of the interviews led to the emergence of five themes and 14 sub-themes. The theme "pregnancy in biological terms" has two sub-themes: "considering herself pregnant" and "the first moment with the baby". The theme "not an embryo, my child" has three sub-themes: "world of hope", " unnatural but normal" and "attachment to embryo". The theme "daily life after ET" has three sub-themes: "living life in the usual way", "process of self-listening", and "the negative effects of drugs on the body". The theme "seeking ways to ensure fertility" has four sub-themes: "complete bed rest", "the search for information: the internet", "practice an infertility diet" and "spiritual support with prayer". Finally, the theme "caring after the transfer" has two sub-themes: "need more information" and "unmet women-oriented care".

CONCLUSION

In this study, it was determined that women had intense physical and emotional experiences during the waiting period after ET and their daily lives were affected. It was also understood that the embryo means "baby/child/son/daughter" to them and that they establish a close bond with their embryos. Women's needs are not sufficiently known until post-ET pregnancy testing. Explaining the experiences of women after IVF-ET and the meanings of their embryo will help determine the issues they need in holistic care.

Exploring the Challenges of Social-Emotional Learning Integration in Secondary Schools: A Phenomenological Research in Vietnam

Introduction

With the advantage of the restructured education in Vietnam, the social-emotional learning (SEL) framework has been gradually piloting applied into the educational curriculum. However, the SEL integration is only effective in primary school.

Methods

This study applied qualitative phenomenological research, which used in-depth interviews with students and core teachers who have experienced SEL from previous studies to explore and explain the SEL integration is not successful at the secondary level.

Findings

Four findings showed the current challenges of SEL's integration in Vietnamese educational curriculum: 1) the incompatibility between the current curriculum and the teachers' pedagogical capacity; 2) the perceived difficulties in integrating SEL into educational activities; 3) the limited focus on understanding the students' psychology; and 4) students cannot develop their social-emotional competence.

Discussion

When the challenges can be solved, corresponding to the solutions discussed, can the SEL framework be properly integrated into Vietnamese education, as well as designing an integrated continuous SEL-orientated curriculum across school levels, meeting the requirements of the new educational curriculum.

"The Ugly Face of Old Age": Elders' Unmet Expectations for Care and Support in Rural Ethiopia

As migration, urbanization, and aging accelerate in developing nations, traditional family supports for elders are diminishing. With these trends in mind, hermeneutic phenomenology was used to examine the experiences of 10 rural Ethiopian elders of age 70 and older. Narrative data from in-depth interviews revealed three prominent themes: the "good old days," drained happiness, worry and pessimism. Elders felt devalued by their children, grandchildren, and youth in general. Compared to how they treated their own parents, elders believed that their children's sense of filial obligation was weak and unreliable. Interactions were described as undermining, embarrassing, and abusive. Elders were pessimistic about the prospect of reliable caregivers, even expressing a wish to die before they become dependent on others for care. Despite such challenges, participants viewed aging as a privilege. New cooperative models of community-based care are needed to ensure that elders in developing nations can expect adequate care throughout their lives.

A Qualitative Study Examining Parental Involvement in Youth Sports over a One-Year Intervention Program

The purpose of this 12-month intervention program was to examine parent-child relationship changes within the sports context. A qualitative interpretative phenomenological analysis was used for the study design. Ten families consented to in-depth interviews. The participants were 10 youth sport parents who had one child each aged 5-6 years. The intervention program involved the participation of all the parents and children. The program integrated psychological, educational, and sports skills into pre-organized sports training sessions. The study results revealed that the intervention program had a positive impact on the parent-child relationship in the sports context. Additionally, the study results suggest that parental involvement in the intervention program positively affected parent-child attachment, the quality of interpersonal relationships between the parent and the child, and effective parenting strategies. Future intervention programs should include both parent and children dyads.

'Know that You are not Alone.' Influences of Social Support on Youth Newly Diagnosed with HIV in Kibera, Kenya: A Qualitative Study Informing Intervention Development

The role of social support in assisting youth in developed countries cope with their HIV diagnosis has been examined through a vast body of research; yet, there remains a gap in research around the effects of social support among youth living in sub-Saharan African countries including Kenya. This study aimed to examine the role of social support among Kenyan youth living with HIV, specifically with regard to the variations in influences of this social support. We conducted semi-structured focus group discussions with youth (ages 18 to 27) living in the informal urban settlement of Kibera in Nairobi, Kenya (n = 53). Data analysis followed a phenomenological inquiry framework, and seven major categories of perceived social support influences were identified: (1) linkage to services, (2) antiretroviral (ARV) adherence, (3) self-acceptance of HIV status, (4) healthy and positive living, (5) understanding of what it means to be living with HIV, (6) HIV status disclosure, and (7) family and occupational strengthening. The findings from this study suggest that Kenyan youth living with HIV can benefit from social support in a multitude of ways and can occur across several socio-ecological levels. Future research should further examine these influences, specifically regarding intervention development across socio-ecological levels.

van Manen's phenomenology of practice: How can it contribute to nursing?

Phenomenology of practice is a useful, rigorous way of deeply understanding human phenomena. Therefore, it allows research to be conducted into nursing's most sensitive and decisive aspects. While it is a widely used research approach and methodology in nursing, it is seldom addressed and made use of in its practical and applied value. This article aimed to approach the global outlook of van Manen's hermeneutic-phenomenological method to better understand its theoretical background and to address and support the contribution this method can make to nursing, if rigorously applied. For a professional discipline like nursing, van Manen's approach is especially interesting because, in addition to contributing to the body of knowledge of nursing, it provides a special kind of knowledge that allows nurses to act in a more reflective manner, and with tact and skill, in certain situations and relationships that arise in their daily practice. A more in-depth understanding of this research methodology may help nurse-researchers make good use of it and also harness knowledge derived from this type of research. This comes as a result of assuming that phenomenological texts, the final product of the research, have tremendous educational potential for people who read them carefully.

"Shared Destiny": The Dynamics of Relationships in Families of Patients With Brain Injury

This qualitative research focused on the relationships between family members of patients with acquired brain injury (ABI). The aim was to explore the dynamics between caregivers of the family member with a brain injury during rehabilitation hospitalization, and the relationships between them and the rest of the extended family. Twenty semistructured interviews were conducted with family members. In each family, the spouse of the patient and another family member involved in caregiving were interviewed. The importance of the relationships between family members during rehabilitation hospitalization justifies the examination undertaken in this research. Findings point at the change that took place in the relationships between family members because of the need to cope with a relative's injury. It is possible that direct intervention in the dynamics of the relationship, especially between the family of origin and the nuclear family of the injured person, can benefit extended families in coping with the crisis.

Understanding the scholarly writing development of nurses enrolled in U.S. clinical doctoral programs

PROBLEM

Faculty teaching nurses enrolled in clinical doctoral programs need to understand the process of student scholarly writing development so that students can be prepared to share knowledge and communicate effectively in scholarly formats.

METHODS

A hermeneutic phenomenological study that sought to understand the scholarly writing development of nurses enrolled in a clinical doctoral program was conducted.

FINDINGS

Findings from interviews with six Doctor of Nursing Practice students revealed three themes: learning throughout life, influence of emotions, and getting through the gate.

CONCLUSION

Based upon these findings, recommendations for further development of doctoral student writing are suggested so that students can disseminate their knowledge in a scholarly manner, improve practice, and contribute to the profession.

Patients with anorexia nervosa who self-injure: a phenomenological study

PURPOSE

This study investigates self-injury from the perspective of patients with anorexia nervosa.

DESIGN AND METHODS

A phenomenological design was used. Twelve patients participated. Data were collected using a semi-structured interview guide.

FINDINGS

Participants display self-injurious behavior predominantly in situations when they are forced to eat. They are terrified of gaining weight and use self-injurious behavior to cope with their anxiety. Self-injury is envisioned as a technique to regain control of their own eating pattern without bothering anyone. They feel shame for not controlling their emotions more constructively.

PRACTICE IMPLICATIONS

Healthcare professionals should systematically observe signals and explore less harmful strategies that help to regulate overwhelming feelings.

[The transformation of nurses in holding and containing: a reflective group for end-of-life care]

BACKGROUND

Caring for dying patients is an emotional burden for nurses.

PURPOSE

This study used reflective groups to explore the process of transition that nurses go through in caring for dying patients.

METHODS

We adopted a phenomenological approach. Data were collected from nurses participating in 12 reflective groups. All nurses worked in oncology / hospice units in a general hospital in Taipei. We used thematic analysis to analyze data.

RESULTS

Findings identified a transition in how nurses handled and contained their emotions within three main themes: (1) containing unpredictable reality, (2) cautious "holding back" in discussion, and (3) self-cultivation in order to serve others. These findings led us to extrapolate the three issues of wounded healer, facing others, and altruism in caring.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

This study represented the holding and containing of nurses in caring for dying patients and held group dialogues to facilitate reflection. Findings will be used to facilitate nurse self-awareness and improve end-of-life care quality.

Understanding the creative processes of phenomenological research: The life philosophy of Løgstrup

The creative processes of understanding patients' experiences in phenomenological research are difficult to articulate. Drawing on life philosophy as represented by the Danish philosopher K.E. Løgstrup (1905-1981), this article aims to illustrate Løgstrup's thinking as a way to elaborate the creation of cognition and understanding of patients' experiences. We suggest that Løgstrup's thoughts on sensation can add new dimensions to an increased understanding of the creative process of phenomenological research, and that his thinking can be seen as an epistemological ground for these processes. We argue with Løgstrup that sense-based impressions can facilitate an flash of insight, i.e., the spontaneous, intuitive flash of an idea. Løgstrup stresses that an "flash of insight" is an important source in the creation of cognition and understanding. Relating to three empirical phenomenological studies of patients' experiences, we illustrate how the notions of impression and flash of insight can add new dimensions to increased understanding of the creative processes in phenomenological research that have previously not been discussed. We illustrate that sense-based impressions can facilitate creative flash of insights that open for understanding of patients' experiences in the research process as well as in the communication of the findings. The nature of impression and flash of insight and their relevance in the creation of cognition and understanding contributes to the sparse descriptions in the methodological phenomenological research literature of the creative processes of this research. An elaboration of the creative processes in phenomenological research can help researchers to articulate these processes. Thus, Løgstrup's life philosophy has proven to be valuable in adding new dimensions to phenomenological empirical research as well as embracing lived experience.

Perinatal loss in low-income African American parents

OBJECTIVE

To examine the experience of low-income, African American parents surrounding perinatal loss and to describe how other life stressors influenced the parents' responses and caring needs.

DESIGN

Descriptive, using a phenomenologic approach.

SETTING

All data were collected in person. Interviews were held in parents' homes or, at the request of three parents, in an office in the university between 5 and 21 weeks after the loss.

PARTICIPANTS

A total of 23 parents (17 mothers and 6 of their partners) were interviewed after a perinatal loss (16 weeks gestation or later) or a neonatal death (first 28 days of life). Follow-up interviews were held with 21 of these parents.

RESULTS

Four themes were revealed: (a) recognizing problems and responding to the loss, (b) dealing with stressful life events, (c) creating and cherishing memories of the baby, and (d) living with the loss.

CONCLUSIONS

The results of this study reveal experiences not previously reported and provide initial insight on the loss experience in this group of parents. Health care professionals should be aware of the presence of additional stressful events that parents may be experiencing and intervene appropriately to provide culturally competent care in a sensitive manner.