Browsing by Subject "qualitative"

Now showing 1 - 5 of 5
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    Exploring diabetes management of low-income, Type 2 diabetics using a communication perspective
    (2016-07) Breidenbach, Mary Angela; Parrish-Sprowl, John
    In this exploratory, qualitative study, the author examined the lived experiences of low-income type 2 diabetics around managing their diabetes. Semi-structured, individual interviews were conducted with volunteer participants from a Midwest student outreach clinic (N=14; 8 men, 6 women). Interviews were first analyzed using LUUUUTT model from the Coordinated Management of Meaning (CMM) theory for gaps between stories lived and stories told. Findings suggest that the lived experience of the majority of the participants had low social support and heightened stress around managing their diabetes. Using the Communication Complex framework, the patterns of interactions around these two tensions were analyzed to make suggestions for change.
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    Interpretations of Communication Experiences of Pharmaceutical-Sponsored Clinical Educators
    (2020-08) Barshinger, Timothy Allen; Bute, Jennifer J.; Matthias, Marianne; Petronio, Sandra G.; Jones, Josette
    This qualitative study explored the communication experiences of clinical educators who provide patient education on behalf of pharmaceutical company sponsors. It investigated how these educators navigate a medical encounter within the domain of three regulatory drivers—on-label compliance, fair-balance presentation, and adverse event reporting. The study used the ecological model of communication in medical encounters and the theory of Communication Privacy Management (CPM) as the lenses for interpreting the data. The main data were telephonic interviews with twenty-six clinical educators who delivered education services for pharmaceutical companies. Member checking, in the form of three post-interview focus groups, was also used. Seven themes emerged: (a) political/legal contexts factors greatly influenced clinical educators’ communication with patients; (b) the influence of factors within this contexts would frequently force educators to experience ethical dilemmas; (c) a new context, the disease and treatment context, emerged from the interviews as having significant influence in the conversation dynamics; (d) educators employed communication strategies to better navigate within the political/legal and disease and treatment context ecological factors; (e) educators believed they needed to establish and maintain trust throughout the engagement process for them to successfully solicit meaningful patient disclosures; (f) educators managed the information disclosed to them by patients using routinized rules as well as changing rules; and (g) educators managed multiple types of confidant roles with patients including stakeholder, deliberate, and reluctant. A main implication for this study is that educators feel ethically and morally bound to do whatever was necessary to avoid breaching the trust they established with patients. For some, this attitude prevailed over their obligation to deliver a compliant educational engagement. Hence, pharmaceutical companies need to recognize that for many of their clinical educators, the question of whether to be compliant is not a legal or policy matter. It is a moral and ethical issue. That being said, educators were also skilled at using communication strategies to navigate through the compliance and disease and treatment barriers that functioned as self-management barriers. Many of those skills often served to influence the way educators created privacy rules and managed privacy decisions related to their patient engagements.
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    Intersections of occupational participation and borderline personality disorder: A grounded theory approach
    (Taylor and Francis, 2020-01) Wasmuth, Sally; Mokol, Emily; Szymaszek, Karolina; Gaerke, Kyra-Jo; Manspeaker, Trevor; Lysaker, Paul; Tommasi, Marco; Occupational Therapy, School of Health and Human Sciences
    Borderline personality disorder (BPD) is characterized by intense emotions, self-harm, unstable self-image, and risky behaviors, which impede wellness and interfere with occupational participation. However, literature on occupational participation of people with BPD is scarce and has mostly focused on women. This study explores and elucidates intersections of occupational participation and BPD in a sample of mostly male veterans in order to identify potential ways occupational therapists and other health professionals can support wellbeing for this population. Grounded theory analysis was conducted on data collected using the Indiana Psychiatric Illness Interview (IPII), a semi-structured interview designed to elicit illness personal narratives. Analysis yielded three main themes—influencing environment, internal experience, and occupation—and several subthemes including being abused, arising problems, feeling neglected, feeling victimized, escape, self-segregating, positive change, participating/engaging, and substance abuse. Occupations both influenced and were influenced by the environment and internal experiences. Environments appeared to influence internal experience, but internal experiences did not influence environments directly. Rather, internal experiences impacted a person’s occupations which, in turn, impacted their environments. Participants’ occupational lives revealed, as expected, several subthemes depicting negative and/or isolating experiences. However, participants’ occupations directly impacted both their environmental contexts and internal experiences, suggesting occupational performance may be a powerful mechanism of change for this population. Findings offer promise that occupational therapists could facilitate health-promoting occupational participation which, in turn, may result in more positive and health-promoting environments and internal experiences.
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    Medical Student Responses in Critical Appraisal: A Qualitative Analysis
    (2022-05-06) Vetter, Cecelia J.; Menard, Laura M.; Blevins, Amy E.; Trujillo, Daniel J.
    Title: Medical Student Responses in Critical Appraisal: A Qualitative Analysis Objectives: To identify themes in medical student critical appraisal skills when asked to complete an evidence-based medicine (EBM) assignment. Researchers will analyze identified themes to find common approaches used by medical students when critically appraising a research article. Methods: Our team (three medical librarians and a statistician) will conduct a qualitative analysis of first year clerkship (third year of medical school) students’ responses to an EBM assignment wherein students are asked to critically appraise a research article and apply it to patient care. Previously, we noted that many students use factors such as journal reputation or impact factor as proxies for critically appraising study methodology and results. The librarian team is conducting a qualitative analysis of textual responses by gathering one years’ worth of quiz responses. Each team member is individually reviewing each response for general themes. After this open coding is completed, librarian team members will collaboratively develop a code list. Each team member will then code each assignment individually. Statistics will be run for inter-rater reliability and discrepancies will be resolved by librarian group consensus. Results: The team will present main and secondary themes. Commentary and examples will be provided by the librarian team on trends seen in medical student critical appraisal. Conclusions: This project is ongoing. However, we anticipate that our results will inform EBM instruction by identifying common themes in medical trainees' early attempts to apply critical appraisal skills to a clinical scenario.
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    Transitioning HIV-infected adolescents to adult care at 14 clinics across the United States: Using adolescent and adult providers’ insights to create multi-level solutions to address transition barriers
    (Taylor and Francis, 2017-10) Philbin, Morgan M.; Tanner, Amanda E.; Chambers, Brittany D.; Ma, Alice; Ware, Samuella; Lee, Sonia; Fortenberry, J. Dennis; Pediatrics, School of Medicine
    HIV-infected adolescents have disproportionately low rates of care retention and viral suppression. Approximately half disengage from care while transitioning to adult clinics, in part due to fragmented care systems and lack of streamlined protocols. We conducted 58 qualitative interviews with social service and health care providers across 14 Adolescent Trials Network clinics (n=28) and 20 adult clinics that receive transitioning adolescents (n=30) from August 2015 – June 2016. We used the constant comparative approach to examine processes, barriers, and facilitators of adult care transition. Transition barriers coalesced around three levels. Structural: insurance eligibility, transportation, and HIV-related stigma; Clinical: inter-clinic communication, differences in care cultures, and resource/personnel limitations; and Individual: adolescents’ transition readiness and developmental capacity. Staff-initiated solutions (e.g., grant-funded transportation) were often unsustainable and applied individual-level solutions to structural-level barriers. Comprehensive initiatives, which develop collaborative policies and protocols that support providers’ ability to match the solution and barrier level (i.e., structural-to-structural), are sorely needed. These initiatives should also support local systematic planning to facilitate inter-clinic structures and communication. Such approaches will help HIV-infected adolescents transition to adult care and improve long-term health outcomes.