Qualitative Health Research

Because little is known about how low-income Latino and African American men attribute meaning and adapt to prostate cancer treatment—related symptoms relative to masculine identity, in this study we sought to develop a descriptive model of this process. Using qualitative methods, 60 Latino and 35 African American/Black men were interviewed by language- and ethnicity-matched male interviewers using a semistructured guide. Interviews were audiotaped and transcribed verbatim. Spanish transcripts were rigorously translated to produce English transcripts. Analysis using grounded theory techniques found that men constructed masculine identities that were influenced by early experience, challenged by several factors including prostate cancer treatment, and underwent a renegotiation process that resulted in the maintenance of their identity as men. Development and testing of interventions that support this process will facilitate the adaptation process for men in a culturally relevant manner.

Focusing beyond survival, the priority of modern burn care is optimal quality of life. Our aim with this study, which was informed by phenomenology, was to describe and identify invariant meanings in the experience of life after major burn injury. Fourteen adults having sustained a major burn were interviewed, on average, 14 months postinjury, and asked about their experience of important aspects of life. The accident meant facing an extreme situation that demanded vigilance, appropriate action, and the need for assistance. The aftermath of the burn injury and treatment included having to put significant effort into creating coherence in their disrupted personal life stories. Continuing life meant accepting the unchangeable, including going through recurrent processes of enduring, grief, fatalism, comparisons with others, and new feelings of gratefulness. Furthermore, a continuous struggle to change what was changeable, to achieve personal goals, independence, relationships with others, and a meaningful life, were all efforts to regain freedom, aiming for a life as it was before—and sometimes even better.

In this article, I explore the communication in an online self-help group for Norwegian women with breast cancer, aiming to add further knowledge to the question of whether the online context functions as a “liberating realm” for alternative discourses about illness. My analysis is conducted within an action-oriented framework and is based on participant observation of the online communication and qualitative interviews of women who participated in the group. Based on the analysis, I argue that proposals of a replication of dominating offline discourses in online communication are affirmed. More precisely, I argue that a “socially desirable” story about the cancer “hero” was further circulated in this online context, and that experiences of resignation and meaninglessness were not woven into the communication. Offering some reflections on this process, I suggest that it has active and voluntary aspects that need attention in further research.

Children with autism might display unpredictable and volatile behavior that places them in considerable physical danger and creates stress for the family. Families of autistic children often have limited freedom and experience difficulty with everyday activities. In this qualitative ethology study, we examined the effect of integrating service dogs into ten families with an autistic child. Data included participant observation, video recordings of family—parent—dog interaction, and semistructured interviews with the parents. The themes were (a) the dog as a sentinel of safety, (b) gaining freedom through enhanced safety, facilitating public outings and family activities, and (c) improving social recognition and status, in which the presence of the dog promoted awareness of autism and affected social interaction. The triadic relationship between parent, autistic child, and service dog constantly evolves. This research provides valuable information for parents interested in having a service dog for their autistic child, and has implications for long-term human—animal companionship for children with special needs and their caregivers.

To date, research on complementary and alternative medicine (CAM) use by cancer patients has tended to provide a “snapshot” of experience, with little attention given to the evolution of experience over time. Drawing on data from solicited diaries, this article examines individual cancer patients' temporal experiences of CAM. Our findings suggest that experiences of CAM are variable over time and space, and furthermore, that the everyday act of “doing CAM” is considerably more problematic than is often reported in face-to-face interview or survey studies. This is explored in relation to the tension between the perceived need for restrictive self-discipline alongside a sense of the emancipatory potential of CAM; the role of CAM therapists in reconceptualizing disease; and the complex interplay between CAM-derived notions of self-healing and acceptance of individual mortality. We argue that an emphasis on the temporality of cancer patients' CAM engagement is necessary to access a more nuanced understanding of the lived experiences of cancer patients.

Little of our empirical knowledge regarding how family caregivers of persons with Alzheimer's disease (AD) manage their self-care needs is grounded in the perspectives of caregivers themselves. Using a grounded theory methodology, we explored self-care behaviors of nine spousal caregivers and developed a substantive theory of finding normalcy for self that reflects how spousal caregivers restore self-care behaviors in the context of a constant state of flux. Self-care worthiness, a new concept, emerged as a salient condition of finding normalcy. This provides a starting point for understanding self-care in spousal caregivers and illuminates the intricate process of caring for self while caring for a significant other with AD.

As the population in the United States and around the globe ages, families are faced with decisions about caregiving for elderly parents. Research suggests that daughters often take on these stressful caregiving responsibilities, with varying levels of help from siblings. In this article, we examine these sibling relationships within the caregiving context, considering the ways in which siblings negotiate the division of tasks for elderly parents and make sense of siblings who provide little help in caregiving activities. Our content analysis of interviews with 25 family caregivers indicated that there was little negotiation of caregiving tasks. Furthermore, family caregivers make sense of sibling participation in caregiving in three ways. First, some caregivers account for caregiving as an individual activity for which they are especially suited. Second, some caregivers see caregiving as stemming from values about family life, but excuse nonparticipant siblings by defining them as outside family boundaries. Finally, caregivers with strong family values who could not make sense of siblings through an exclusionary frame engaged in verbal backtracking during the telling of their stories as a way of making sense of personal caregiving responsibilities.

Wide variations in how contemporary consumers think about health and make health care decisions often go unrecognized by health care marketers and public policy decision makers. In the current global environment, prevailing Western viewpoints on health and conventional biomedicine are being challenged by a countervailing belief system forming the basis for alternative health care practices. The ways American consumers once thought about health have changed and multiplied in this new era of competing health paradigms. Our study provides empirical evidence for this assertion in two ways. First, it demonstrates that in the current environment consumers think about health and health care in a multiplicity of very different ways, leading to the conclusion that we should not classify health care consumers as either conventional or alternative. Second, the results provide clues as to how individuals holding diverse health theories make health care decisions that impact health behaviors, treatment efficacy, and satisfaction judgments.

Utilizing an interactionist perspective, two associated sensitizing constructs, and a combination of social psychological theory, this article reports on the influence of the peer group on individual perceptions, and its impact on initiation and persistence of bullying. The specific research question, “How does the need to conform with peers and the peer group influence the initiation and persistence of bullying others?” is investigated. Semistructured, one-on-one interviews with a purposive sample of 51 Grade 7 students (aged 12 years) were conducted during school time to investigate factors that influence students to bully others and what might help them to stop. Emerging from the theme of peer group was the need for belonging and group status, in particular social norms or the need to conform, which was influential when students described why they initiated and persisted with bullying others. The influence of labeling, the group process, and the aspiration to be like others within their group emerged as key constructs. The implications of these data for schools will be described and recommendations made.

The individual's experience of kidney failure, transplantation, and recovery is not as well documented as might be expected. Often it is written about by outsiders (medical practitioners, care providers, academics), whereas the insider's (patient's) expertise is occluded. This conforms to the experience of many people living with illness and disability. The rendering of people as other (not like the norm) comes at a cost to their humanity. People who are ill or disabled can themselves succumb to a way of writing that simplifies their experience and objectifies themselves. I consider what it means to tell the story of oneself against a background of illness autoethnography, my own story of growing up medicalized and living with end-stage renal disease. I identify three types of illness autoethnography, one of which creates a tension between researcher as agent and researcher as object of research, and compels the reader to constantly realign himself or herself.

Cross-cultural qualitative research is rare and challenging because of difficulties of collecting reliable and valid information when conducting research in a language other than the researcher's primary language. Although standards of rigor exist for the data collection, analysis, interpretation, and reporting of qualitative data, no such standards exist for translation of translinguistic qualitative research. Therefore, a new methodology modeled after Brislin's translation principles was utilized with 60 Latino participants experiencing side effects as a result of prostate cancer treatment. Interviews were conducted in Spanish, transcribed verbatim, and then translated by research staff. By adapting Brislin's process, a new methodology was developed that more accurately conveys the true meaning of the participant's experience, is more appropriate and meaningful, and opens doors to researchers interested in conducting research in a language other than their own, while at the same time ensuring the reliability and validity of study data.