Browsing by Subject "qualitative research"
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Item 911 Calls for Emergency Medical Services in Heart Failure: A Descriptive Qualitative Study(Wolters Kluwer, 2022-09) Jung, Miyeon; Hays, Laura M.; Pang, Peter S.; Newhouse, Robin P.; Arkins, Thomas P.; O'Donnell, Daniel; Cook, Ryan; Gradus-Pizlo, Irmina; McAdams, Ellen; Pressler, Susan J.; School of NursingBackground Heart failure (HF) is a common condition leading to activation of emergency medical services (EMS). Objective The aim of this study was to describe reasons given by persons with HF, family members, or other caregivers for requesting EMS activation during 911 calls. Methods In this descriptive qualitative study, a content analysis was performed on transcribed audio files of 383 EMS requests involving 383 persons with HF in the community. Results One hundred forty-seven calls (38.4%) were placed by the family members, 75 (19.6%) were placed by the patients, 56 (14.6%) were placed by healthcare workers or personnel from living facilities, and the remaining calls (n = 105, 27.4%) were placed by others (eg, friends, neighbors, officers). Three broad categories of symptoms, signs, and events were identified as the reasons for an EMS request. Frequently reported symptoms were breathing problems (55.4%), chest pain (18.3%), and other pain (eg, head, extremities) (16.7%). Signs included decreased consciousness (15.4%), swelling (5.7%), and bleeding (5.0%). The reported events involved falls (8.1%), heart attack (6.3%), hypoxic episodes (6.0%), stroke (5.2%), and post–hospital-discharge complications (4.7%). In most calls (74.9%), multiple reasons were reported and a combination of symptoms, signs, and events were identified. Heart failure diagnosis was mentioned in fewer than 10% of the calls. Conclusions Overall, symptoms and signs of HF exacerbation were common reasons to activate 911 calls. Falls were frequently reported. Under the duress of the emergent situations surrounding the 911 call, callers rarely mentioned the existence of HF. Interventions are needed to guide patients with HF and their family members to promote the management of HF to reduce EMS activation as well as to activate EMS quickly for acute changes in HF conditions.Item Adolescent Birth Mothers After Unintended Pregnancy and Infant Open Adoption(2009-12-08T19:11:56Z) Clutter, Lynn B.; Sims, Sharon L.Birth mothers of open adoption are not well studied. This inquiry explored birth mothers’ experiences surrounding unintended pregnancy and infant open adoption placement. The focused objective was to describe adolescent birth mothers’ lives following pregnancy and adoption placement. This qualitative study used naturalistic inquiry, with participants giving 1 to 2 hour tape recorded telephone interviews. Verbatim transcripts were de-identified and systematically analyzed. Birth mother samples were at either 1 to 5 years or 5 to 15 years after infant open adoption placement. Overall both samples chronicled stories from preconception through current life. Birth mothers of both samples were unanimous in their support of open adoption. The sample of 10 birth mothers who were interviewed 1 to 5 years postplacement shared life descriptions from prepregnancy; pregnancy with the decision for open adoption placement and choice of adoptive family; birth in context with the adoptive parents and birth child; postpartum and discharge. Postplacing birth mother findings were presented using the acronym AFRESH: A–adoption accomplishments; F–fresh start; R–relationships; E–emotions; S–support; H–healing. Personal, social, and relational benefits of open adoption far outweighed pregnancy, birth, and emotional challenges. Even though the process and outcome were “hard,” and included personal obstacles, the open adoption placement was “best.” Birth children were viewed as thriving, blossoming, and having a wonderful life. Adoptive families were cherished like those of extended family. Birth mothers thought health care providers should share the option, and then provide adoption friendly care. They also would advise pregnant teens to choose open adoption. Results from the 5 to 15 years postplacement sample of 5 birth mothers yielded themes of (1) satisfaction about decision for open adoption, choice of adoptive couple, and seeing a thriving birth child; (2) personal milestone accomplishments in education, finances, work, life, and relationships; (3) a sustaining sense of being a better person with an improved life; and (4) the essential need for support during and after the process.Item Adolescents’ Perceptions of Contraception Access through Pharmacies(MDPI, 2020-03-28) Meredith, Ashley H.; Vahary, Emily B.; Wilkinson, Tracey A.; Meagher, Carolyn G.; Vielott, Thomas; Ott, Mary A.; Pediatrics, School of MedicineAdolescent pregnancy is an important public health issue, and pharmacist prescribing has the potential to expand contraceptive access and decrease unintended pregnancy. However, little is known about acceptability and uptake of pharmacist prescribing among adolescents, particularly among youth in socially and politically conservative regions of the country. The study objective was to identify how young women in Indiana perceive pharmacist contraceptive prescribing. Participants were recruited from clinics and completed a simulated pharmacist contraception-prescribing encounter; a demographic and behavioral questionnaire; and an in-depth qualitative interview focused on adolescent perspectives on pharmacist prescribing. Data were analyzed using thematic analysis. Sixty young women aged 14–21 years (mean age 17.0 ± 1.7 years) completed in-depth interviews. The majority expressed interest in pharmacist contraceptive prescribing (n = 33, 55.9%). Three overarching themes were identified, focusing on accessibility; quality of care; and pharmacist knowledge and youth friendliness. Subthemes highlighted the need for improved confidential access; a desire for additional pharmacist training in contraception; and interactions with a pharmacist that can relate to the young person. Increased awareness of the perceptions of young people can inform state policies and pharmacy protocols. Pharmacists, because of their accessibility, are well poised and equipped to assist in this public health concern.Item Advancing Faculty Research in a “Bricolage” Environment"(International Journal on Engineering, Science and Technology, 2023) Killian, Larita J.; Agreda, Sergio Garcia; Escobar, Mariana Pérez; IUPUC Division of BusinessIn the typical, academic career path, individuals enter faculty roles immediately after graduate school, commencing their academic careers with research skills and a fledgling research agenda. Many faculty, however, take an indirect route to research. They may work in the commercial or nonprofit sector for years before joining the academy, allowing their research skills to fade. Some individuals who never completed research training are recruited as faculty due to their years of professional experience; this is especially true in business, engineering, and health care. When institutional expectations and personal goals change, however, these individuals may suddenly face the need to conduct research. They have the motivation but lack the necessary skills and confidence. This is especially true when institutions decide to seek accreditation that requires research activity among faculty. To help Bolivian faculty achieve research success, we developed a condensed workshop on qualitative, applied research and conducted it four times, in-person and online, following the action research model. The condensed workshop proved effective in helping faculty boost their research productivity, though participants expressed a desire for more extended coaching and support. Future workshops will include increased opportunity for collaboration. The workshop can be adapted to other regions.Item Community engagement of adolescents in the development of a patient-centered outcome tool for adolescents with a history of hypospadias repair(Elsevier, 2019-10-01) Chan, K. H.; Panoch, J.; Carroll, A.; Downs, S.; Cain, M. P.; Frankel, R.; Cockrum, B.; Moore, C.; Wiehe, Sarah; Urology, School of MedicineIntroduction: Hypospadias may lead to long-term issues with urination, sexual function and psychosocial well-being. Limited evidence exists regarding the healthcare communication preferences of male adolescents regarding sensitive topics. Objective: The purpose of this qualitative study was to explore the healthcare communication preferences of male adolescents regarding sensitive topics (e.g. urinary and sexual issues) and engage them in in the initial stages of development a patient-centered outcomes tool for adolescents with a history of hypospadias repair. Study Design: A multi-disciplinary team with communication design expertise, pediatric urology experts, and health services researchers developed a self-reported toolkit for adolescent patients who had hypospadias repair as children. The toolkit featured short writing/diagramming exercises and scales to facilitate participant reflections about genital appearance, urination, sexual function and psychosocial well-being. We recruited students from two local high schools for two focus groups to obtain feedback about the usability/acceptability of the toolkit’s appearance/content. We inquired about language preferences and preferred format and/or setting for sharing sensitive information with researchers. The focus groups were audio recorded, professionally transcribed, checked for accuracy and analyzed by two coders using qualitative content analysis. Major themes and subthemes were identified and representative quotes were selected. Results: We conducted two focus groups in January 2018 with 33 participants, ages 14-18. Participants preferred language that would make patients feel comfortable as well as serious, clinical language rather than slang terms/sexual humor (Extended Summary Table). They recommended avoidance of statements implying that something is wrong with a patient or statements that would pressure the patient into providing answers. They suggested fill-in-the-blank and open-ended responses to encourage freedom of expression and colorful graphics to de-emphasize the test-like appearance of the toolkit. Most participants preferred a toolkit format to a one-on-one interview to discuss sensitive topics such as urinary or sexual issues. Participants would prefer either a male interviewer or would like to have a choice of interviewer gender for individual qualitative interviews, and they recommended a focus group leader with a history of hypospadias repair. Discussion: This study provides a rich description of a group of male high school students’ experiences with healthcare providers and researchers. Its qualitative design limits generalizability and our findings may not be similar to adolescents with a history of hypospadias repair. Conclusion: We used focus group feedback on the toolkit prototype to refine the tool for use in a future study of adolescents with history of hypospadias repair.Item Community Engagement of Adolescents in the Development of a Patient-Centered Outcomes Tool for Adolescents with a History of Hypospadias Repair(Elsevier, 2019) Chan, Katherine H.; Panoch, Janet; Carroll, Aaron; Downs, Stephen; Cain, Mark P.; Frankel, Richard; Cockrum, Brandon; Moore, Courtney; Wiehe, Sarah; Pediatrics, School of MedicineIntroduction Hypospadias may lead to long-term issues with urination, sexual function and psychosocial well-being. Limited evidence exists regarding the healthcare communication preferences of male adolescents regarding sensitive topics. Objective The purpose of this qualitative study was to explore the healthcare communication preferences of male adolescents regarding sensitive topics (e.g. urinary and sexual issues) and engage them in in the initial stages of development a patient-centered outcomes tool for adolescents with a history of hypospadias repair. Study Design A multi-disciplinary team with communication design expertise, pediatric urology experts, and health services researchers developed a self-reported toolkit for adolescent patients who had hypospadias repair as children. The toolkit featured short writing/diagramming exercises and scales to facilitate participant reflections about genital appearance, urination, sexual function and psychosocial well-being. We recruited students from two local high schools for two focus groups to obtain feedback about the usability/acceptability of the toolkit’s appearance/content. We inquired about language preferences and preferred format and/or setting for sharing sensitive information with researchers. The focus groups were audio recorded, professionally transcribed, checked for accuracy and analyzed by two coders using qualitative content analysis. Major themes and subthemes were identified and representative quotes were selected. Results We conducted two focus groups in January 2018 with 33 participants, ages 14-18. Participants preferred language that would make patients feel comfortable as well as serious, clinical language rather than slang terms/sexual humor (Extended Summary Table). They recommended avoidance of statements implying that something is wrong with a patient or statements that would pressure the patient into providing answers. They suggested fill-in-the-blank and open-ended responses to encourage freedom of expression and colorful graphics to de-emphasize the test-like appearance of the toolkit. Most participants preferred a toolkit format to a one-on-one interview to discuss sensitive topics such as urinary or sexual issues. Participants would prefer either a male interviewer or would like to have a choice of interviewer gender for individual qualitative interviews, and they recommended a focus group leader with a history of hypospadias repair. Discussion This study provides a rich description of a group of male high school students’ experiences with healthcare providers and researchers. Its qualitative design limits generalizability and our findings may not be similar to adolescents with a history of hypospadias repair. Conclusion We used focus group feedback on the toolkit prototype to refine the tool for use in a future study of adolescents with history of hypospadias repair.Item Early Childhood Development in Children Born to HIV-Infected Mothers: Perspectives From Kenyan Clinical Providers and Caregivers(SAGE, 2018-01-01) McHenry, Megan S.; Oyungu, Eren; McAteer, Carole I.; Ombitsa, Ananda R.; Cheng, Erika R.; Ayaya, Samuel O.; Vreeman, Rachel C.; Pediatrics, School of MedicineObjective. To understand the perspectives of clinical providers and caregivers regarding early childhood development (ECD) in children born to HIV-infected mothers in Kenya. Methods. This was a qualitative study of provider and caregiver perspectives on ECD at 5 Kenyan HIV clinics, using semistructured interviews and focus group discussions. Constant comparison and triangulation methods were employed to elucidate the concepts of ECD. Results. Twenty-five providers and 67 caregivers participated. While providers understood ECD in terms of milestones, caregivers strongly equated ECD with physical growth. Factors affecting ECD, such as nutrition, perinatal effects, and illness, were perceived differently by providers and caregivers. Both groups generally believed that HIV-infected children would have typical ECD if adherent to their HIV treatment. Conclusions. Important considerations regarding ECD in this population were uncovered. Understanding provider and caregiver perspectives’ on ECD in HIV-exposed children is critical for promoting ECD in this community.Item The Everyday Lives of Adolescent Girls with Epilepsy: A Qualitative Description(2009-11-04T18:21:53Z) MacLeod, Jessica S.; Swenson, Melinda M.; Foote, Carrie; Austin, Joan Kessner; Sims, Sharon L.This study is a qualitative description of the everyday lives of adolescent girls with epilepsy. The primary purpose of the research was to determine whether or not elements of stigma were present in narratives about participants’ day-to-day living. The researcher used open-ended and semi-structured interview techniques in a series of interviews with four adolescent girls with epilepsy. Elements of stigma were present in some of the constructed themes; however, the researcher also uncovered other unexpected themes. Themes constructed by the researcher included: 1) I Am Like Everyone Else (Except for my Seizures); 2) There are Worse Things than Epilepsy; 3) My Parents Trust Me; 4) Am I Having a Seizure?; 5) Bullying Because of Seizures; 6) Bullying Because of Something other than Seizures; 7) Coping with Bullying; 8) Academic Difficulties;9) Disclosure Management; 10) Seizures are Scary to Have and to See; and 11)If I have a Seizure, Don’t Attract Attention to Me! The researcher considers topics thought to be important to adolescents with epilepsy about which the participants kept silent. The researcher makes suggestions about how the research can be used to improve health care practice and guide educational policies for adolescent students with epilepsy. Based on the findings, the researcher suggests areas for future research in nursing and educational policy.Item Exploring perceptions and experiences of patients who have chronic pain as state prescription opioid policies change: a qualitative study in Indiana(BMJ, 2017-11-12) Al Achkar, Morhaf; Revere, Debra; Dennis, Barbara; MacKie, Palmer; Gupta, Sumedha; Grannis, Shaun; Medicine, School of MedicineObjectives The misuse and abuse of prescription opioids (POs) is an epidemic in the USA today. Many states have implemented legislation to curb the use of POs resulting from inappropriate prescribing. Indiana legislated opioid prescribing rules that went into effect in December 2013. The rules changed how chronic pain is managed by healthcare providers. This qualitative study aims to evaluate the impact of Indiana’s opioid prescription legislation on the patient experiences around pain management. Setting This is a qualitative study using interviews of patient and primary care providers to obtain triangulated data sources. The patients were recruited from an integrated pain clinic to which chronic pain patients were referred from federally qualified health clinics (FQHCs). The primacy care providers were recruited from the same FQHCs. The study used inductive, emergent thematic analysis. Participants Nine patient participants and five primary care providers were included in the study. Results Living with chronic pain is disruptive to patients’ lives on multiple dimensions. The established pain management practices were disrupted by the change in prescription rules. Patient–provider relationships, which involve power dynamics and decision making, shifted significantly in parallel to the rule change. Conclusions As a result of the changes in pain management practice, some patients experienced significant challenges. Further studies into the magnitude of this change are necessary. In addition, exploring methods for regulating prescribing while assuring adequate access to pain management is crucial.Item Exploring Service Philosophy Statements Using Qualitative Content Analysis(ISAST, 2020-12) Moffett, Paul; Weare, William H., Jr.; University LibraryThis paper will describe a study in which we examined service philosophy statements at a diverse group of North American academic libraries. We used qualitative content analysis to examine their form and content to identify common themes, trends, and ideas. Public services librarians spend much of their time wrestling with nebulous topics such as service quality, customer satisfaction, and user experience. Improvements in these areas necessitate strengthening the quality of the service and the culture in which it’s delivered. One approach to establish standards for consistent service delivery is for libraries to implement service philosophy statements. A service philosophy statement also communicates directly with users what they can—and should—expect from the library. Before we could develop and implement a service philosophy statement at our respective libraries, we wanted to understand the specific ways that service philosophy statements communicate service expectations to users. We will describe the series of steps we followed to conduct our research, such as creating the coding frame, segmenting the data, pilot coding, evaluating and modifying the coding frame, analyzing the data, and interpreting the findings. Finally, we will review the challenges we encountered during this process, as well as lessons we learned about qualitative content analysis.