Qualitative Health Research

Electronic health records (EHRs) have become ubiquitous in clinical practice. Given the rich biomedical data captured for a large panel of patients, secondary analysis of these data for health research is also commonplace. Yet, there are many caveats to EHR data that the researchers must be aware of, such as the accuracy of and motive for documentation, and the reason for patients’ visits to the clinic. The clinician—the author of the documentation—is thus central to the correct interpretation of EHR data for research purposes. In this study, I interviewed 11 physicians in various clinical specialties to bring attention to their view on the validity of research using EHR data. Qualitative, in-depth, one-on-one interviews were conducted with practicing physicians in inpatient and outpatient medicine. Content analysis using a data-driven, inductive approach to identify themes related to challenges and opportunities in the reuse of EHR data for secondary analysis generated seven themes. Themes that reflected challenges of EHRs for research included (1) audience, (2) accuracy of data, (3) availability of data, (4) documentation practices, and (5) representativeness. Themes that reflected opportunities of EHRs for research included (6) endorsement and (7) enablers. The greatest perceived barriers reflected the intended audience of the EHR, the interpretation and meaning of the data, and the quality of the data for research purposes. Physicians generally expressed more perceived challenges than opportunities in the reuse of EHR data for research purposes; however, they remained optimistic.

Self-management is pivotal for effective chronic disease management. However, this concept remains unexplored among people with endometriosis, who often experience chronic pain and significant impacts on their quality of life. This research explored participants’ experience managing endometriosis and their understanding and integration of self-management into their lives. Inductive reflexive thematic analysis was used to analyze transcripts from 15 semi-structured interviews among people with endometriosis. The themes captured many aspects of self-management and included (1) perceptions of control, (2) engaging in self-management behaviors, (3) active decision-makers versus recipients of care, (4) establishing a patient–provider partnership, and (5) support is vital. The extent to which participants engaged in self-management varied, however, is consistent with self-management literature for other chronic conditions suggesting that there is a role for self-management among people living with endometriosis.

During the last three decades, an increased amount of research on errors in health care has been conducted. Studies show that physicians find it challenging to handle errors because of the blame and guilt that errors cause. Communicating with colleagues has been identified as vital for coping with errors and for creating a just culture; however, many physicians do not usually discuss their errors. Knowledge about how junior doctors experience errors is vital to ensure that they both receive emotional support and learn from errors. To capture junior doctors’ perceptions and experiences, we used a qualitative, exploratory design based on virtual focus groups. We conducted seven virtual focus groups with 22 junior doctors from 11 specialties. We defined three main themes: (1) how the junior doctors conceptualized medical errors, (2) how they experienced talk about errors among colleagues, and (3) the context in which this talk took place. The participants experienced errors as challenging elements in their working life; however, they struggled to define it. They described inconsistencies regarding the reasons for discussing errors within the learning environment, with some being experienced as constructive (providing education and support) and some as destructive (involving blame and shame). There was a discrepancy between the wish to normalize error and the lack of sharing between colleagues. Our study shows that error in health care is a complex phenomenon that challenges junior doctors’ navigation in clinical practice. Despite efforts to implement an open and just culture, this has not yet been achieved.

The objective of this research was to extend current knowledge on the psychological and emotional aspects around patients’ preparation for amputation surgery. This research explored amputees’ perspectives on their preparation for amputation surgery and how patients can be better supported for this procedure. Data was collected through semi-structured interviews and online qualitative questionnaires with 17 amputees who underwent upper- or lower-limb amputation within the United Kingdom. The interviews were analyzed using reflexive thematic analysis. The analysis generated three themes describing participants’ experiences of being prepared for this surgery and their ideas on how this process could be improved: (1) Making sense of amputation surgery, (2) Patients’ experiences of information and support from healthcare staff, and (3) Patients’ views on approaches to preparation. This research highlighted the importance of information provision and support from healthcare staff, along with the potential benefits of utilizing experiential knowledge through peer support to enhance feelings of preparedness for amputation surgery.

People living with HIV (PLHIV) in Ecuador experience challenges including discrimination, violence, and limited access to healthcare, which impacts their mental health and well-being. However, research shows that PLHIV also rely on social resources to foster resilience. In the Ecuadorian context, there is no literature exploring these narratives, which results in a lack of qualitative data to improve the reality of PLHIV in the country. To gain a deeper understanding of these stories, 15 semi-structured interviews were undertaken (15 verbatim hours) within the context of a peer- and professional-led support group for PLHIV and were analyzed through a thematic approach based on Skovdal and Daniel’s conceptual framework on resilience and adversity. Findings suggest that PLHIV face multifaceted challenges across the home, community, and political-economy spheres. Families and communities can elicit pain and fear, leading individuals to avoid discussing their diagnosis due to ongoing rejection. Further, discrimination perpetuated within the public health sector, as well as societal violence, exacerbates adversity. Nevertheless, participants stress the indispensable role of family support, community networks, and accessible healthcare in fostering resilience. Specifically, support, emotional reassurance, and willingness to learn enabled PLHIV to build resilience. These findings emphasize the need for approaches that counter discrimination, enhance well-being, ensure integral and intersectional healthcare access, and promote knowledge around HIV.

Women who are giving birth need to be met with compassion and understanding from healthcare professionals. However, there are growing concerns about the perceived lack of compassion in the delivery of healthcare services in general and maternity care in particular. We conducted 15 qualitative interviews with women who had given birth in Norway within the previous year, asking them to describe their experiences of compassionate care. We aimed to explore what healthcare professionals “do” that is experienced as compassionate. The analysis was informed by Paul Gilbert’s theory of compassion and a concept analysis of compassionate midwifery undertaken by Ménage and colleagues. The compassionate caring actions of healthcare professionals that were identified in the women’s narratives generated five themes: attuning actions, validating actions, contextualizing actions, empowering actions, and small acts of kindness. The findings build on the prior theoretical concepts used for the study and provide a nuanced account of how women perceive compassionate care from healthcare professionals. They could contribute to understanding more of the meaning and nature of compassionate care during childbirth. The analysis indicates the importance of ensuring that compassionate care is at the very core of maternity care services.

Cycle syncing is a menstrual health trend on TikTok that involves aligning exercise and diet with the four menstrual cycle phases. Cycle syncing is part of the conversation on social media about women’s reproductive health. However, clinical research on the effects of cycle syncing is inconclusive, and there is the potential that this trend could further perpetuate misinformation and gender stereotypes. Research suggests that social media can affect health behaviors, highlighting the need to understand if women intend to participate in cycle syncing. Guided by the Reasoned Action Approach, this study used focus groups (n = 39) to examine young women’s attitudes, normative beliefs, and control beliefs about participating in cycle syncing, and critical feminist theory to sensitize resulting themes. Results suggest that normative beliefs emphasize support for the behavior among women, yet participants suggest that men would not support this behavior. Additionally, positive beliefs about cycle syncing content sourced from inconclusive scientific literature underscores concerns regarding the potential dissemination of misinformation in women’s health practices on social media. Findings also fit into a larger discussion about “hormonophobia” and contraception on social media. Theoretical implications for mixed methods research and future directions are discussed.

In 2020, Ecuador was among the most affected places in the world in the context of the COVID-19 emergency. Serious problems of structural inequality and governance resulted in corpses lying in the streets of Guayaquil—Ecuador’s largest city—while local communities resisted in different ways. We interviewed 18 participants who engaged in actions of solidarity during this context, critically analyzed their discourses, and generated relevant themes. There was a structural scheme of (pandemic) brutality that determined embodied experiences of horror, conditioned by a governance of abandonment and its related problems. To confront such horror, solidary community resistance focused on food, physical and mental health, management of corpses, community-led communication, online education, and political participation. We interpret that this was a process of social determination of collective health and discuss important theoretical, methodological, and ethical–political implications.

The Health Sustainable Development Goal (SDG3) focuses on achieving universal healthcare coverage (UHC) through people-centered primary care and access to affordable high-quality healthcare services, medicines/vaccines, and specialized care professionals without undue financial stress. However, achieving UHC can be challenging if healthcare providers and patients cannot communicate meaningfully. Severe language barriers affect access to healthcare services. This study explores how linguistic diversity and language use barriers impact person-centered care delivery and access to healthcare services in a multilingual Ghanaian healthcare setting. Data were collected through in-depth individual interviews with patients (n = 17), caregivers (n = 11), and nurses (n = 11), one group interview with four patients, and participant observations. Data transcripts and field notes were inductively and manually coded and analyzed thematically. The study revealed that language barriers affect effective nurse–patient communication and interaction. Healthcare professionals and patients shop for translators and interpreters to overcome communication challenges. The study also found that healthcare professionals used medical jargon to emphasize their identity as experts despite its consequences on nurse–patient interactions and patient care. Miscommunication and misunderstanding due to language barriers derail nurse–patient therapeutic relationships and undermine patient disclosure, participation in the care process, and care quality, leading to adverse UHC outcomes. Therefore, serious attention must be paid to language use contingencies to achieve universal care, especially in resource-scared and multilingual healthcare contexts.

This study aimed to explore the experience of family-centered care (FCC) for high-risk infants admitted to the neonatal intensive care unit (NICU) among their parents and healthcare providers (HCPs) using the grounded theory methodology to understand the processes and interactions involved. By employing the grounded theory approach described by Corbin and Strauss, in-depth interviews were conducted with parents and HCPs experienced in NICU settings. Participants were selected via theoretical and snowball sampling, and data were managed and analyzed concurrently using MAXQDA software. The analysis was performed through open coding, process analysis, and category integration. The analysis of the experiences of FCC for high-risk infants in the NICU produced a detailed framework involving 71 concepts, 27 subcategories, and 11 upper categories. Through process analysis and category integration, the study identified a significant process termed “Union of care” characterized by four sequential phases: [Wandering]–[Approaching with one mind]–[Becoming a harmonious team]–[Carrying on the care]. This process model underscores the dynamic and collaborative nature of FCC in the complex environment of the NICU. This study highlights the importance of dynamic interaction and mutual understanding between parents and HCPs in FCC for high-risk infants. The promotion of a cooperative approach is recommended, with a focus on open communication, respect for parental roles, and HCPs’ facilitation of parental involvement in care processes. Future research should consider larger and more diverse participant groups to broaden understanding and develop more inclusive FCC strategies.

This article explores understandings of health and risk in relation to club drug use, through in-depth interviews with young adults (n = 35) using club drugs in Oslo, Norway. In contemporary society, negotiations around physical health are at the center of people’s perceptions of everyday life. From a sociological perspective, risk perceptions and health perspectives can be seen as affecting the use of various club drugs and the meaning given to these phenomena. The aim of this study is to explore how young adults perceive drug use and health and how they relate to health perceptions in their clubbing experiences. At the theoretical level, the article aims to develop risk denial theory as outlined by Peretti-Watel, by proposing a fourth risk denial technique in addition to scapegoating, self-confidence, and comparison between risks. This fourth technique is described as Compensating behaviors and shows how young adults’ emphasis on health both in talk and action is important for understanding their behaviors. The participants describe what they did and emphasized in their talk that this was important. Findings demonstrate how the compensating behaviors consist of both actions and talk; they talk about exercise, use of supplements, and fluid replacement; this is a risk denial technique that arguably also works as a form of harm reduction from below. The study offers insights into how and why young adults use club drugs and explores how they legitimize such use.

Community arts interventions demonstrate positive effects on mental health recovery by fostering creativity, self-expression, and social interaction. This study explores the participation process in the Artistic Couples project, which provides collaborative spaces for artists with mental health conditions and local artists. We followed up six artistic couples participating in the project using a narrative-in-action process over 6 months in various community settings. Our aim was to understand the experiences of artists during their participation in Artistic Couples and to uncover the mental health benefits derived from their involvement. Coupled and individually semi-structured interviews and participant observation were employed. Data analysis was conducted using narrative analysis. The results of the collaborative process among participants are reflected in three primary areas: (1) Meeting, engagement, and connection; (2) Dialogue, teamwork, and creative process; and (3) Personal development and learning. The research findings suggest that participating in the Artistic Couples project facilitates self-expression, a sense of social connection, and improved artistic skills among participants, fostering mutual support and effective interpersonal communication. Moreover, participants reported experiences of learning and personal development. Consequently, the study advocates for creating new community spaces that encourage collaborative practices within mental health services. These spaces should promote free expression and facilitate discussions on personal matters, including mental health challenges.