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'Whatever Happened to Qualitative Description?' (Sandelowski, 2000) was written to critique the prevailing tendency in qualitative health research to claim the use of methods that were not actually used and to clarify a methodological approach rarely identified as a distinctive method. The article has generated several misconceptions, most notably that qualitative description requires no interpretation of data. At the root of these misconceptions is the persistent challenge of defining qualitative research methods. Qualitative description is a 'distributed residual category' (Bowker & Star, 2000). Cambridge, MA: The MIT Press) in the classification of these methods. Its value lies not only in the knowledge its use can produce, but also as a vehicle for presenting and treating research methods as living entities that resist simple classification. © 2009 Wiley Periodicals, Inc. Res Nurs Health 33:77-84, 2010 [ABSTRACT FROM AUTHOR]

Latina mothers of infants and toddlers are at high risk for developing serious depressive symptoms if they are newly immigrated and have limited English proficiency (LEP). Depressive symptoms compromise these mothers and result in severe consequences for their US.-born children. A randomized clinical trial of a short-term, in-home psychotherapy intervention for symptomatic mothers in an area of the United States where bilingual mental health providers were scarce used teams of English-speaking advanced practice psychiatric mental health nurses and bilingual community interpreters who were trained in a conduit, consecutive model of interpretation. The article describes the development of a theoretically congruent interpreter model, the training program that supported it, the challenges that surfaced and lessons learned during successful implementation in the field. Future refinements in progress and uses of the model are discussed. [ABSTRACT FROM AUTHOR]

Background and Research Objective: Despite the known benefit of self-care strategies for symptom management in heart failure (HF), most patients are unable to perform self-care activities successfully. This study therefore examined how communication about the HF regimen between patients and their physicians is experienced and understood by both partners. Subjects and Methods: Six pairs (n = 12) of adult patients with HF who were admitted for acute symptom exacerbation and their physicians were interviewed for this qualitative descriptive study in the inpatient setting. Semistructured in-depth interviews were conducted. Data were analyzed using content analysis. Results: Both patients and providers described adherence to the HF regimen as 'work.' Both reported the same list of tasks and knowledge requirements as key components of the HF regimen, and both reported delegating their own regimen-related work to others. Despite these similarities, perceptions of the nature and complexity of the work of the HF regimen differed. Patients described the regimen as 'hard work,' but physicians perceived patients as nonparticipatory in self-care, in spite of the instructions being 'easy.' Patients perceived themselves as understanding what to do but needing help with how to carry out self-care. By contrast, physicians perceived patients as not understanding what the regimen requires and therefore needing more repetition of knowledge-based instructions. Conclusion: The self-care regimen in chronic HF is characterized by both patients and physicians as work, but patient-physician dyads show divergent understandings of that work. Future research to improve adherence should move beyond the patient to look at the nature of the work itself and the relationship of the patient and caregivers to the work. [ABSTRACT FROM AUTHOR]

A process evaluation of nurses' implementation of an infant-feeding counseling protocol was conducted for the Breastfeeding, Antiretroviral and Nutrition (BAN) Study, a prevention of mother-to-child transmission of HIV clinical trial in Lilongwe, Malawi. Six trained nurses counseled HIV-infected mothers to exclusively breastfeed for 24 weeks postpartum and to stop breastfeeding within an additional four weeks. Implementation data were collected via direct observations of 123 infant feeding counseling sessions (30 antenatal and 93 postnatal) and interviews with each nurse. Analysis included calculating a percent adherence to checklists and conducting a content analysis for the observation and interview data. Nurses were implementing the protocol at an average adherence level of 90% or above. Although not detailed in the protocol, nurses appropriately counseled mothers on their actual or intended formula milk usage after weaning. Results indicate that nurses implemented the protocol as designed. Results will help to interpret the BAN Study's outcomes. [ABSTRACT FROM AUTHOR]

Objective: Preventive health behavior patterns and practices are influenced by many factors. Knowledge about a person's core values may improve the ability to predict decisions related to behaviors such as healthy eating.Methods: In this cross-case comparison study, we illuminate the meanings ascribed to the core value "health" in relationship to fruit and vegetable intake for colorectal cancer survivors and for persons with no cancer history.Results: We found that both survivors and non-survivors gave three accounts of how the value "health" influenced having a healthy diet. These were: (1) good health was necessary to fulfill/attain other values; (2) health was a manifestation of God's will; and (3) good health was not possible unless one values responsibility.Conclusion: Understanding a person's core values provides insight about how values may act as motivators for behavior change.Practice Implications: Practitioners using motivational interviewing techniques should include a values clarification exercise to improve their assessment of how values influence behaviors. [ABSTRACT FROM AUTHOR]

Aim. This paper offers a discussion of the reading and writing practices that define systematic review. Background. Although increasingly popular, systematic review has engendered a critique of the claims made for it as a more objective method for summing up research findings than other kinds of reviews. Discussion. An alternative understanding of systematic review is as a highly subjective, albeit disciplined, engagement between resisting readers and resistant texts. Reviewers of research exemplify the resisting reader when they exclude reports on grounds of relevance, quality, or methodological difference. Research reports exemplify resistant texts as they do not simply yield their findings, but rather must be made docile to review. These acts of resistance make systematic review possible, but challenge claims of its greater capacity to control bias. Conclusion. An understanding of the reading and writing practices that define systematic review still holds truth and objectivity as regulative ideals, but is aware of the reading and writing practices that both enable and challenge those ideals. [ABSTRACT FROM AUTHOR]

Systematic review is typically viewed in the health sciences as the most objective -- that is, rigorous, transparent, and reproducible -- method for summarizing the results of research. Yet, recent scholarship has shown systematic review to involve feats of interpretation producing less certain, albeit valuable, results. We found this to be the case when we tried to overcome the resistance to synthesis of a set of qualitative and quantitative findings on stigma in HIV-positive women. These findings were difficult to combine largely because of fuzzy conceptualizations of stigma and the volume of unique quantitative findings. Our encounter with findings resistant to synthesis heightened our awareness of the extent to which all systematic reviews are accomplished by practices that paradoxically 'distort [research findings] into clarity.' © 2008 Wiley Periodicals, Inc. Res Nurs Health 31:454-465, 2008 [ABSTRACT FROM AUTHOR]

Aim. This paper is a discussion detailing the decisions concerning whether to include or exclude findings from a meta-analysis of report of quantitative studies of antiretroviral adherence in HIV-positive women. Background. Publication constraints and the absence of reflexivity as a criterion for validity in, and reporting of, quantitative research preclude detailing the many judgements made in the course of a meta-analysis. Yet, such an accounting would assist researchers better to address the unique challenges to meta-analysis presented by the bodies of research they have targeted for review, and to show the subjectivity, albeit disciplined, that characterizes the meta-analytic process. Data sources. Data were 29 published and unpublished studies on antiretroviral adherence in HIV-positive women of any race/ethnicity, class, or nationality living in the United States of America. The studies were retrieved between June 2005 and January 2006 using 40 databases. Review methods. Findings were included if they met the statistical assumptions of meta-analysis, including: (1) normal distribution of observations; (2) homogeneity of variances; and (3) independence of observations. Results. Relevant studies and findings were excluded because of issues related to differences in study design, different operationalizations of dependent and independent variables, multiple cuts from common longitudinal data sets, and presentation of unadjusted and adjusted findings. These reasons led to the exclusion of 73% of unadjusted relationships and 87% of adjusted relationships from our data set, leaving few findings to synthesize. Conclusion. Decisions made during research synthesis studies may result in more information losses than gains, thereby obliging researchers to find ways to preserve findings that are potentially valuable for practice. [ABSTRACT FROM AUTHOR]

Aim. In this paper we present a theory-based taxonomy of the methods used to implement change in practice. Background. Implementation research is characterized by inconsistent terminology for the methods employed and inattention to differences in the relevance of methods across different disciplines. Studies of the effectiveness of implementation have yielded mixed results. Positive effects shown have been small. The limited success of many efforts to implement change in practice may be due, in part, to the absence of a framework to guide the use of implementation methods. Method. A provisional taxonomy of implementation methods, derived from theory and existing taxonomies, was used to content analyse a convenience sample of 43 reports of empirical studies of the implementation of one or more research-based practice changes involving nurses that had been published between 1995 and 2005. This taxonomy was revised throughout the course of analysis to capture more completely the information in each report. Findings. Following the analysis, nine of the 11 methods in the provisional taxonomy were retained, two were removed and five new methods were identified. The final taxonomy includes 14 implementation methods organized into five categories: (a) increasing coordination; (b) raising awareness; (c) persuasion via interpersonal channels; (d) persuasion via reinforcing belief that behaviour will lead to desirable results and (e) increasing behavioural control. Conclusions. The taxonomy presented here differs from prior taxonomies by focusing on nursing and by providing a clear and mutually exclusive guide to implementation methods. By deriving the initial coding strategy from theory, the taxonomy links the methods to theoretical constructs that may inform the selection of methods across different practice changes and settings. [ABSTRACT FROM AUTHOR]

The new imperative in the health disciplines to be more methodologically inclusive has generated a growing interest in mixed research synthesis, or the integration of qualitative and quantitative research findings. Qualitative metasummary is a quantitatively oriented aggregation of qualitative findings originally developed to accommodate the distinctive features of qualitative surveys. Yet these findings are similar in form and mode of production to the descriptive findings researchers often present in addition to the results of bivariate and multivariable analyses. Qualitative metasummary, which includes the extraction, grouping, and formatting of findings, and the calculation of frequency and intensity effect sizes, can be used to produce mixed research syntheses and to conduct a posteriori analyses of the relationship between reports and findings. [ABSTRACT FROM AUTHOR]

The purpose of this case study was to examine the daily symptom experience of a teenage girl, Abby, undergoing treatment for cancer. Quantitative and qualitative data collection and analysis techniques were used to ascertain patterns in daily experiences of pain, nausea, vomiting, retching, stress, sleep alterations, and anxiety. A time-series analysis focused on change and variability in patterns of symptom data. A key finding was that the predictability evident in Abby's symptom patterns were in direct contrast to her perception that there was no predictability or pattern to her symptoms. Her perceived lack of control over her symptoms generated worry, anxiety, and depression and led Abby to question whether she could continue with the treatment. Abby represented a case of 'fighting the treatment,' as opposed to 'fighting the cancer,' and it is the difference between these responses that may explain children's overall ability to tolerate intensive chemotherapy. [ABSTRACT FROM AUTHOR]

The surge of interest in qualitative metasynthesis coincides with qualitative researchers' growing concern over the 'crisis of representation.' Central to this crisis is the challenge to the assumption that any human subjects inquiry can ever authentically represent those subjects. The crisis of representation is intensified in qualitative metasynthesis projects because of the potentially large differences that can exist between lived and narrated lives, and between participants' accounts and researchers' accounts of those accounts, and because of the virtual lack of difference thought to characterize the relationship between reality and representation. This crisis can be offset by offering critical/discursive readings of research reports in addition to traditional empirical/analytical readings. Reviewers can thereby preserve both truth and representational humility as regulative ideals. Clinicians can thereby better appraise the utilization value of qualitative metasyntheses. [ABSTRACT FROM AUTHOR]

Early in the U.S. HIV/AIDS pandemic, the role of substance abuse in the spread of AIDS was clearly established. However, the relationship of HIV and substance abuse is more complex than simply noting that injection drug use is a mode of transmission for the virus. HIV infection and substance abuse disorders interact in a complex fashion, with each acting as a potential catalyst or obstacle in the treatment of the other. In this article, we report the results of a qualitative metasynthesis of studies containing information on substance abuse among HIV-positive women, using 74 published and unpublished reports. The data on 1,548 women, who were primarily mothers from minority groups, allowed us to construct a trajectory that describes the events of their lives with regard to substance abuse and its intersection with HIV infection. [ABSTRACT FROM AUTHOR]

OBJECTIVE: NADESIGN: NASETTING: NAPOPULATION: NAINTERVENTIONS: NAMAIN OUTCOME MEASURE(S): NARESULTS/CONCLUSIONS: In this article, the author focuses on the uses of numbers in analyzing, interpreting, and re-presenting qualitative data in primarily qualitative studies. Specifically, she considers the use of numbers to generate meaning from qualitative data; to document, verify, and test researcher interpretation or conclusions; and to re-present target events and experiences. The desire to move 'beyond numbers' should not prevent qualitative researchers from using numbers to get there. Qualitative researchers are challenged to use numbers in ways that produce both trustworthy findings and evocative reports of those findings. They must decide when to count and what is countable in order to make their use of numbers count. [CINAHL abstract] [ABSTRACT FROM AUTHOR]

AIM(S) OF THE PAPER: This paper questions the validity of a boundary presumed to exist between technology and humane care. It argues the need for reconciliation of presumed tension(s) between technology and person focused care and the need to reconsider our ways of understanding the relations between technology and nursing. BACKGROUND/RATIONALE: Recent scholarship in the social sciences related to reproductive and imaging technologies and emergency resuscitation are examined and arguments are presented that question the appropriateness of a humanist view that emphasizes technology on the nonhuman and nonnatural side of a human/nonhuman, nature/artifice divide. It is argued that what determines experiences such as dehumanization is not technology per se but how individual technologies are used and operate in specific user contexts, the meanings that are attributed to them, how individuals or cultural groups define what is human, and the organizational, human, political and economic technological system (technique) that creates rationale and efficient order within nursing, health care and society. CONCLUSION: The paper concludes by asking whether the commonplace appeal to resolve tensions between humane care and technology has erroneously highlighted technology as the reason for impersonal care, and encourages re-examination of the relationship(s) between technology, humane care and nursing practice. [ABSTRACT FROM AUTHOR]

New technology has allowed nurses to enter the world of science, but it's also kept them on the threshold between scientific work and 'woman's work.' [ABSTRACT FROM AUTHOR]

The perceptions and interactions of mothers and fathers of seven sets of twins and one set of triplets were compared to those of parents of 49 singleton infants. Couples were typically interviewed together three times during the pregnancy and at 1 week and 3 months post-partum. Two-weekly observations of mother-father-infant interactions were conducted after the first postnatal interview. Three major themes were apparent in the interviews--the positive and negative specialness for multiple births, difficulties involved in managing more than one infant, and attachment issues--that were also evident during the observations. Although there were few differences in care-giving and interactive behaviours between the multiple birth and singleton parents, the logistics of caring for more than one infant dictated that multiple birth infants were left alone more and looked at, talked to and held less often. Couples used different strategies to care for their infants, varying in both the extent to which they interacted preferentially with the infants and in the relative involvement of the mother, father and others. [ABSTRACT FROM AUTHOR]

OBJECTIVE: NA DESIGN: NA SETTING: NA POPULATION: NA INTERVENTIONS: NA MAIN OUTCOME MEASURE(S): NA RESULTS/CONCLUSIONS: Qualitative research is, in one important sense, all about time. Time in qualitative research is both an analytic variable and an object of study, and it is central to the ontology of key paradigms of inquiry for qualitative research, as well as to qualitative methodologies themselves. Temporal factors play a critical role in purposive sampling, the content and structure of data collection and analysis techniques, and in the re-presentation of data in the qualitative research report. The Trajectory Model is a useful framework for sampling, data collection, and analysis. The Storyline Graph is a tool especially useful in narrative research. [CINAHL abstract] [ABSTRACT FROM AUTHOR]

Approximately 50% of infertile couples will become parents through pregnancy or adoption, but they experience major difficulties while working towards this goal. Infertility treatments are associated with physical pain and psychological distress, and adoption procedures are prolonged and emotionally stressful. The extent to which these stressors alter the parenting of these couples is not known. The purpose of this study, therefore, was to examine the early parent-infant interactions in infertile couples who become parents through pregnancy or adoption. Two groups of infertile couples (30 who achieved pregnancy and 21 who adopted) and a group of 19 couples without fertility problems were observed interacting with their infants twice, 7 to 21 days after the infant's arrival and a week later, at a time when both parents were at home. Their babies were between 9 days and 5 months of age. Behaviours of the mother, father and infant were recorded every 10 seconds, beginning when the baby was picked up and ending when the baby was put down asleep or 1 1/2 hours had passed. Repeated measures ANOVAs were used to compare the three groups over the observations. There were no differences between fertile and infertile biological parents. Adopted infants showed more alertness, less sleeping, more smiles, and more looking than biological infants. Adoptive mothers spent less time as the sole interactor. Adoptive parents spent more time in playing with their infants and held and touched them less than did biological parents. Infertility, therefore, does not appear to affect early parenting. In general, the amounts of behaviours exhibited by infertile biological parents were very close to those of fertile parents. Differences in the behaviours of adoptive as compared to biological parents can best be explained as responses to the behaviours of their older infants, rather than as evidence of different parenting styles. [ABSTRACT FROM AUTHOR]

A secondary analysis of information obtained from 288 interviews, conducted with 62 childbearing couples in the course of a qualitative and longitudinal study, suggests that much of the work of expectant parenthood is oriented toward getting to know the fetus. This article emphasizes the epistemological (as opposed to the emotional) relationship between parent and fetus. [ABSTRACT FROM AUTHOR]

Thirty-six couples with a history of infertility reported their physical, positive emotional, and negative emotional symptoms during pregnancy. The women experienced more physical symptoms than did the men. Both the men and women experienced second-trimester decreases in negative emotional symptoms and third- trimester increases in negative emotional symptoms. The women's physical symptoms also showed a second-trimester dip. Each symptom type was correlated for husbands and wives, but only 6 husbands showed evidence of couvade syndrome by exhibiting exact correspondence with their wives' symptoms. Symptom attunement appears to be a better term than couvade for most infertile men's experiences of pregnancy. [ABSTRACT FROM AUTHOR]

Although infertility has been described as an experience with long-term implications for the well-being of couples affected by it, few studies have examined any part of the aftermath of infertility. This article describes the ways in which infertility shapes the pregnancy course in couples who have struggled to conceive. The findings are drawn from 162 interviews conducted with 60 couples (41 infertile and a comparison group of 19 fertile) expecting a child, who were participants in a longitudinal field study involving both childbearing and adopting couples. During the course of the study, 63 pregnancies were observed. The core variable distinguishing the infertile from the fertile couples' pregnancies was relinquishing infertility. Beyond this variable, infertility emerged as important, but only one of a number of factors altering the experience of contemporary childbearing. [ABSTRACT FROM AUTHOR]

The author emphasizes the need for nursing researchers to consider the words that they will use in their qualitative research. She said that it is important to choose the proper words to use because words can either distill or dilute the essence of the experiences qualitative researchers hope to illuminate. She offers an example on how qualitative researchers can exaggerate their findings.

The article describes a scenario in qualitative research wherein a doctoral student wants to develop an instrument to assess children's adherence to treatment. The components of qualitative research are enumerated. A contributing factor to the lack of qualitative analysis courses available and required is cited.

Abstract Background We describe the study design, procedures, and development of the risk counseling protocol used in a randomized controlled trial to evaluate the impact of genetic testing for diabetes mellitus (DM) on psychological, health behavior, and clinical outcomes. Methods/Design Eligible patients are aged 21 to 65 years with body mass index (BMI) ≥27 kg/m2 and no prior diagnosis of DM. At baseline, conventional DM risk factors are assessed, and blood is drawn for possible genetic testing. Participants are randomized to receive conventional risk counseling for DM with eye disease counseling or with genetic test results. The counseling protocol was pilot tested to identify an acceptable graphical format for conveying risk estimates and match the length of the eye disease to genetic counseling. Risk estimates are presented with a vertical bar graph denoting risk level with colors and descriptors. After receiving either genetic counseling regarding risk for DM or control counseling on eye disease, brief lifestyle counseling for prevention of DM is provided to all participants. Discussion A standardized risk counseling protocol is being used in a randomized trial of 600 participants. Results of this trial will inform policy about whether risk counseling should include genetic counseling. Trial registration ClinicalTrials.gov Identifier NCT01060540

Editorial. Comments on the conceptions of nursing with the development of 20th century technology. Encounters of nursing with technology; Accessibility of electronic technology; Adaptation of the triadic sign-model to the semiotic study of technology.

Introduction: Numerous studies have identified the importance of parenting behaviors to the well-being of children with chronic physical conditions. Synthesizing the findings of these studies has potential to identify which parenting behaviors are associated with specific aspects of child well-being., Method: We retrieved research reports addressing the relationship between parenting behaviors and well-being in children with chronic physical conditions, and categorized parenting behaviors based on Skinner, Johnson, and Snyder's (2005) core dimensions of parenting (warmth, rejection, structure, chaos, autonomy support, and coercion) Through meta-analysis, we examined relationships between parenting dimension and child well-being variables., Results: Fifty-four reports from 47 unique studies met inclusion criteria. Parent warmth was associated with less child depression, better quality of life, better physical functioning, and fewer externalizing behavior problems. Parent rejection was associated with more child depression, internalizing/externalizing behavior problems, and poorer physical functioning. Parent structure was associated with better child physical functioning. Parent chaos was associated with poorer child physical functioning. Parent autonomy support was associated with better quality of life and fewer externalizing behavior problems. Parent coercion was associated with more child depression, poorer quality of life, poorer physical function, and more internalizing behavior problems., Conclusion: The results identify multiple, potentially modifiable parenting dimensions associated with well-being in children with a chronic condition, which could be targeted in developing family-focused interventions. They also provide evidence that research using Skinner's core dimensions could lead to conceptualization and study of parenting behaviors in ways that would enable comparison of parenting in a variety of health and sociocultural contexts. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Recognizing the bi-directional relationship between family functioning and child well-being in the context of childhood chronic conditions, researchers have tested family-focused interventions aimed at promoting both child and family well-being through improving the family's condition management capacity. Based on a sample of 70 interventions for families in which there was a child with a chronic physical condition, this analysis examined the nature of family engagement in the interventions. Data were extracted from the intervention reports using a standardized template; conventional content analysis was used to describe family engagement. Interventions varied in focus, structure, and level of family engagement. Investigators most often sought to improve condition control or management, with parent engagement focused on improving capacity to manage the treatment regimen. Few investigators addressed capacity building in the context of family functioning. Recommendations are made for reporting standards for family-focused interventions and for enhancing the family systems grounding of interventions.