IU Indianapolis ScholarWorks :: Browsing by Subject "Qualitative"

Browsing by Subject "Qualitative"

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A qualitative study of pain and related symptoms experienced by people with Ehlers-Danlos syndromes
(Frontiers Media, 2024-01-03) Schubart, Jane R.; Mills, Susan E.; Francomano, Clair A.; Stuckey-Peyrot, Heather; Medical and Molecular Genetics, School of Medicine
Introduction: Individuals with Ehlers-Danlos syndromes (EDS) often have complex and multi-faceted symptoms across the lifespan. Pain and the related symptoms of fatigue and sleep disorders are common. The objective of this qualitative study was to understand how participants manage their pain and related symptoms. Methods: The design was a qualitative thematic content analysis. Twenty-eight interviews were conducted to collect data from individuals who were participants in a prior quantitative longitudinal study. A semi-structured interview guide was designed to focus on and understand the trajectory of pain, sleep, fatigue, and general function. The interview continued with questions about coping mechanisms and obstacles to maintaining a sense of well-being. Results: Symptoms reported by participants were widespread and often interwoven. Pain was universal and often resulted in fatigue and disordered sleep which impacted physical function. Most participants reported that their symptoms worsened over time. Participants reported a wide range of effective interventions and most reported developing self-care strategies to adapt to their disabilities/limitations. Solutions included complementary interventions discovered when conventional medicine was unsuccessful. Very few relied on a "system" of health care and instead developed their own strategies to adapt to their disabilities/limitations. Discussion: EDS symptoms are often debilitating, and their progression is unknown. For most participants, symptoms worsened over the time. Even though participants in our study, by experience, were self-reliant, the importance of knowledgeable medical providers to help guide self-care should be emphasized.
Adolescent and Adult HIV Providers' Definitions of HIV-Infected Youths' Successful Transition to Adult Care in the United States
(Mary Ann Liebert, 2017-10) Philbin, Morgan M.; Tanner, Amanda E.; Ma, Alice; Chambers, Brittany D.; Ware, Samuella; Kinnard, Elizabeth N.; Hussen, Sophia A.; Lee, Sonia; Fortenberry, J. Dennis; Pediatrics, School of Medicine
It is important for both individual- and population-level health that HIV-infected individuals progress through the Care Continuum. However, HIV-infected youth frequently disengage from care during transition from pediatric/adolescent to adult care; only 50% remain in adult care after 1 year. Understanding how providers define and approach a successful healthcare transition can improve the delivery of HIV-related services during critical years of HIV treatment. We conducted 58 staff interviews across 14 Adolescent Trials Network clinics (n = 30) and 20 adult clinics (n = 28). We used the constant comparative method to examine how providers defined and approached youths' successful transition. Providers identified four components critical to successful transition: (1) clinical outcomes (e.g., medication adherence and viral suppression); (2) youth knowing how to complete treatment-related activities (e.g., refilling prescriptions and making appointments); (3) youth taking responsibility for treatment-related activities and their overall health (e.g., "when they stop reaching out to the adolescent [clinic] to solve all their problems."); and (4) youth feeling a connection and trust toward the adult clinic (e.g., "they feel safe here"), with some providers even prioritizing connectedness over clinical outcomes (e.g., "Even if they're not taking meds but are connected [to care], …that's a success."). The identification of key components of successful transition can guide focused interventions and resources to improve youth maintenance in the HIV Care Continuum as they transition to adult care. Identifying what facilitates successful transitions, and the gaps that interventions can target, will help to ensure HIV-infected youth remain healthy across their lifespan.
Barriers and facilitators to chemotherapy initiation and adherence for patients with HIV-associated Kaposi's sarcoma in Kenya: a qualitative study
(Springer, 2022-07-06) McMahon, Devon E.; Singh , Rhea; Chemtai, Linda; Semeere, Aggrey; Byakwaga, Helen; Grant , Merridy; Laker-Oketta , Miriam; Lagat, Celestine; Collier , Sigrid; Maurer , Toby; Martin , Jeffrey; Bassett , Ingrid V.; Butler , Lisa; Kiprono , Samson; Busakhala , Naftali; Freeman, Esther E.; Dermatology, School of Medicine
Background Kaposi sarcoma is one of the most prevalent HIV-associated malignancies in sub-Saharan Africa and is often diagnosed at advanced stage of disease. Only 50% of KS patients who qualify for chemotherapy receive it and adherence is sub-optimal. Methods 57 patients > 18 years with newly diagnosed KS within the AMPATH clinic network in Western Kenya were purposively selected to participate in semi-structured interviews stratified by whether they had completed, partially completed, or not completed chemotherapy for advanced stage KS. We based the interview guide and coding framework on the situated Information, Motivation, Behavioral Skills (sIMB) framework, in which the core patient centered IMB constructs are situated into the socioecological context of receiving care. Results Of the 57 participants, the median age was 37 (IQR 32–41) and the majority were male (68%). Notable barriers to chemotherapy initiation and adherence included lack of financial means, difficulty with convenience of appointments such as distance to facility, appointment times, long lines, limited appointments, intrapersonal barriers such as fear or hopelessness, and lack of proper or sufficient information about chemotherapy. Factors that facilitated chemotherapy initiation and adherence included health literacy, motivation to treat symptoms, improvement on chemotherapy, prioritization of self-care, resilience while experiencing side effects, ability to carry out behavioral skills, obtaining national health insurance, and free chemotherapy. Conclusion Our findings about the barriers and facilitators to chemotherapy initiation and adherence for KS in Western Kenya support further work that promotes public health campaigns with reliable cancer and chemotherapy information, improves education about the chemotherapy process and side effects, increases oncology service ability, supports enrollment in national health insurance, and increases incorporation of chronic disease care into existing HIV treatment networks.
Barriers to guideline-concordant antibiotic use among inpatient physicians: A case vignette qualitative study
(Wiley, 2016-03) Livorsi, D.; Comer, Amber R.; Matthias, Marianne S.; Perencevich, E.N.; Bair, M.J.; Department of Communication Studies, School of Liberal Arts
BACKGROUND: Greater adherence to antibiotic-prescribing guidelines may promote more judicious antibiotic use, which could benefit individual patients and society at large. OBJECTIVE: To assess physician knowledge and acceptance of antibiotic-prescribing guidelines through the use of case vignettes. DESIGN: We conducted semistructured interviews with 30 inpatient physicians. Participants were asked to respond to 3 hypothetical case vignettes: (1) a skin and soft tissue infection (SSTI), (2) suspected hospital-acquired pneumonia (HAP), and (3) asymptomatic bacteriuria (ASB). All participants received feedback according to guidelines from the Infectious Diseases Society of America (IDSA) and were asked to discuss their level of comfort with following these guidelines. SETTING: Two acute care teaching hospitals for adult patients. INTERVENTION: None. MEASUREMENTS: Data from transcribed interviews were analyzed using emergent thematic analysis. RESULTS: Participants were receptive to guidelines and believed they were useful. However, participants' responses to the case vignettes demonstrated that IDSA guideline recommendations were not routinely followed for SSTI, HAP, and ASB. We identified 3 barriers to guideline-concordant care: (1) physicians' lack of awareness of specific guideline recommendations; (2) tension between adhering to guidelines and the desire to individualize patient care; and (3) skepticism of certain guideline recommendations. CONCLUSIONS: Case vignettes may be useful tools to assess physician knowledge and acceptance of antibiotic-prescribing guidelines. Using case vignettes, we identified 3 barriers to following IDSA guidelines. Efforts to improve guideline-concordant antibiotic prescribing should focus on reducing such barriers at the local level.
Erratum to: Providing Patients with Implantable Cardiac Device Data through a Personal Health Record: A Qualitative Study
(Thieme Medical Publishers, 2017-10) Daley, Carly N.; Chen, Elizabeth M.; Roebuck, Amelia E.; Ghahari, Romisa Rohani; Sami, Areej F.; Skaggs, Cayla G.; Carpenter, Maria D.; Mirro, Michael J.; Toscos, Tammy R.; BioHealth Informatics, School of Informatics and Computing
Examining an Altruism-Eliciting Video Intervention to Increase COVID-19 Vaccine Intentions in Younger Adults: A Qualitative Assessment Using the Realistic Evaluation Framework
(MDPI, 2023-03-11) Zhu, Patricia; Tatar, Ovidiu; Haward, Ben; Steck, Veronica; Griffin-Mathieu, Gabrielle; Perez, Samara; Dubé, Ève; Zimet, Gregory; Rosberger, Zeev; Pediatrics, School of Medicine
COVID-19 vaccine-induced immunity wanes over time, and with the emergence of new variants, additional "booster" doses have been recommended in Canada. However, booster vaccination uptake has remained low, particularly amongst younger adults aged 18-39. A previous study by our research team found that an altruism-eliciting video increased COVID-19 vaccination intentions. Using qualitative methods, the present study aims to: (1) identify the factors that influence vaccine decision-making in Canadian younger adults; (2) understand younger adults' perceptions of an altruism-eliciting video designed to increase COVID-19 vaccine intentions; and (3) explore how the video can be improved and adapted to the current pandemic context. We conducted three focus groups online with participants who: (1) received at least one booster vaccine, (2) received the primary series without any boosters, or (3) were unvaccinated. We used deductive and inductive approaches to analyze data. Deductively, informed by the realist evaluation framework, we synthesized data around three main themes: context, mechanism, and intervention-specific suggestions. Within each main theme, we deductively created subthemes based on the health belief model (HBM). For quotes that could not be captured by these subthemes, additional themes were created inductively. We found multiple factors that could be important considerations in future messaging to increase vaccine acceptance, such as feeling empowered, fostering confidence in government and institutions, providing diverse (such as both altruism and individualism) messaging, and including concrete data (such as the prevalence of vulnerable individuals). These findings suggest targeted messaging tailored to these themes would be helpful to increase COVID-19 booster vaccination amongst younger adults.
The experience of post-craniotomy pain among persons with brain tumors
(2018-04-16) Foust, Rebecca Elizabeth; Von Ah, Diane M.; Draucker, Claire B.; Carpenter, Janet S.; Kroenke, Kurt; Stone, Cynthia
Post-craniotomy brain tumor patients often experience pain in the post-surgical period which can negatively affect recovery and surgical outcomes. Research with this population has focused on pharmacological treatments of post-craniotomy pain and measurement of pain intensity. Little is known about how these patients experience the quality of their pain and how this pain is managed. The purpose of this dissertation was to provide an in-depth description of the experience of post-craniotomy pain during the post-surgical period. The information gained about how post-craniotomy patients experience pain and pain management will contribute the development of effective, tailored interventions to enhance patient satisfaction and outcomes. This dissertation project was composed of two components. The first component was an integrative review of literature examining the evidence of pain and associated symptoms in adult (aged 21 and older), post-craniotomy brain tumor patients. The review examined studies from the past fourteen years that focused on the incidence and treatment of postcraniotomy pain. It revealed that the majority of post-craniotomy patients experience moderate to severe pain after surgery. This pain is associated with nausea, vomiting, changes in blood pressure, and increased length of hospital stay. The second component was a qualitative descriptive study of a sample of 28 adult (aged 21 and older) post-craniotomy patients hospitalized on an inpatient neurosurgical stepdown unit at a Midwestern urban teaching hospital. During semi-structured interviews, participants described their experiences of post-craniotomy pain and of their experiences of postcraniotomy pain management. Data generated from the qualitative descriptive study were analyzed and resulted in two qualitatively derived products. The first was a description of participants’ experiences of the quality of their post-craniotomy pain during the post-surgical period. The six types of pain quality described were pain as pressure, pain as tender or sore, pain as stabbing, pain as throbbing, pain as jarring, and pain as itching. The second was a description of how post-craniotomy patients experience the management of their pain during the post-surgical period. The four groups of types of pain management experiences described were pain-as-non-salient, routine pain management; pain-as-non-salient, complex pain management; pain-as-salient, routine pain management; and pain-as-salient, complex pain management.
Factors that influence the emotional impact of memory problems in older adults: A qualitative descriptive study
(Wiley, 2022) Hill, Nikki L.; Bratlee-Whitaker, Emily; Wion, Rachel K.; Madrigal, Caroline; Bhargava, Sakshi; Mogle, Jacqueline; School of Nursing
Background: Associations among psychological health and memory concerns in older adults are well-established, but much of this research is quantitative. Objectives: This study examined how memory problems influence emotional well-being in older adults without dementia, and whether this differs by cognitive status and current depressive or anxiety symptoms. Methods: A qualitative descriptive design was used to examine our research questions. Community-dwelling older adults without dementia (n = 49, Mage = 74.5[10.1], 63% women) completed a cognitive assessment, questionnaires and two semi-structured interviews. Content analysis was used to code and categorise the transcribed interview data, then identify themes within and across participant groups. Results: Five themes described the influence of memory problems on emotional well-being: Evoking Emotions, Fearing Future, Undermining Self, Normalising Problems and Adjusting Thinking. Memory problems' impact on emotional well-being varied by current anxiety symptoms, characteristics of the problem and personal experience with dementia. Conclusion: The emotional impact of memory problems tended to differ by affective symptoms, not cognitive status. Older adults who report memory concerns without objective evidence of impairment may be at risk for negative impacts to mental health and well-being. Implications for practice: Cognitive screening guidelines should consider best practices for responding to memory concerns when cognitive testing results are normal.
From testing the water to riding the waves : new master of social work graduates' journey from student to professional
(2015-07-23) Larimer, Susan; Lay, Kathy; Adamek, Margaret E.; Bennett, Robert B.; Draucker, Claire Burke; Khaja, Khadija
Every year, more than 200 schools of social work graduate thousands of Master of Social Work (MSW) students. These graduates enter the world of work and continue on their journey toward becoming professional social workers. Surprisingly, very little is known in social work about the transition from student to professional, especially for MSW graduates. Related literature in nursing and education is reviewed in order to have a foundational knowledge of the transition process for similar professionals. The research questions for this study were: (a) What is the process of transition from student to employee like for new MSW graduates? (b) What are the factors that influence this transition during the first 18 months for MSW graduates? and (c) Are there critical junctures in the processes of transitioning from being a student through the first 18 months of MSW employment that are related to satisfaction and/or professional growth? This dissertation used qualitative, constructivist grounded theory methodology in order to study this relatively unknown subject. The conceptual model that emerged in this study is called Riding the Waves, and illustrates the transition process for new graduates learning to become a professional social worker. There are five stages of this model: Testing the Waters, Jumping In, Sinking or Swimming, Treading Water, and Riding the Waves. In Testing the Waters, critical issues of finding a job, negotiating a salary and licensure are salient. In Jumping In, new graduates experience orientation, examine preparedness from school and encounter the real world of work as opposed to their expectations. In Sinking or Swimming, new graduates negotiate not knowing, supervision, dealing with emotions and difficult work situations. In Treading Water, new graduates explore finding a balance between self-care and compassion fatigue and articulate job and compassion satisfaction. In the last stage, Riding the Waves, new graduates are more stable, gain confidence, find their voice and discuss what is ahead for them. Implications for social work students, educators, and employers are discussed including better preparing students for the transition, improving orientation and supervision, and providing the support that these new professionals require and deserve.
How and Why Patients Adhere to a Prescribed Cardiac Rehabilitation Program: A Longitudinal Phenomenological Study of Patients with Acute Coronary Syndrome
(MDPI, 2022-01-28) Kaushal, Navin; Nemati, Donya; Gauthier-Bisaillon, Raphaëlle; Payer, Marie; Bérubé, Béatrice; Juneau, Martin; Bherer, Louis; Health Sciences, School of Health and Human Sciences
Background: Adherence to cardiac rehabilitation remains a challenge despite established evidence that engaging in regular exercise is a strong preventive measure to experiencing a second cardiac event. A recent study found a six-month cardiac rehabilitation program to be effective for facilitating regular exercise behavior among patients diagnosed with acute coronary syndrome. The purpose of this study was to conduct a phenomenological investigation using Colaizzi’s descriptive technique to understand mechanisms responsible for behavior change. Methods: Data were collected and analyzed among patients with acute coronary syndrome at a cardiac rehabilitation using semi-structured interviews that were conducted over the phone across three months. Conclusion: Thematic analysis of 15 semi-structured interviews resulted in 124 statements that were analyzed. The data yielded seven themes that included “motivation to follow prescribed exercise program”, “volitional decision”, “capability of performing exercise”, “connectedness to peers”, “planning”, “habit formation”, and “adopting healthy behaviors beyond exercise”. The emerged themes align with construct definitions of the self-determination theory, which include the three psychological needs (autonomy, competence, and relatedness), in addition to autonomous motivation, which represents internally driven reasons to participate in exercise. Planning and habit formation themes support contemporary research that identifies these constructs responsible for behavioral maintenance. While these themes help explain exercise participation, the final theme, adopting healthy behaviors beyond exercise, reflects the impact of the program on having a change towards a healthier lifestyle. The findings highlight the complexity of exercise behavior, and that long-term participation is likely explained by amalgamating the self-determination theory.

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