Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “thematic analysis methods”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMed2003

Patients' perspectives on statin therapy for treatment of hypercholesterolaemia: a qualitative study.

BACKGROUND: Health Care Practitioners' attempts to implement secondary prevention targets for coronary heart disease (CHD) may be restricted by low rates of persistence with statin therapy. There is a need to understand why some patients, despite having established CHD and elevated cholesterol, do not comply with their prescribed statin regimen. AIM: To explore patients' perspectives on compliance with statin therapy. SETTING: Primary care, West of Scotland. METHODS: The research approach was qualitative. Thirty-three patients prescribed statin therapy and identified as having different patterns of compliance (poor moderate and good) were interviewed. The in-depth interviews were conducted on a one to one basis. Patients prescribed statin therapy for less than three months were excluded. Data were analysed thematically with the assistance of QSR Nudist. FINDINGS: From analysis of the narrative data, two broad categories, i.e. 'Patient-health care provider communication' and 'Health beliefs' were identified. These categories encompassed six main themes: 'Initiation of therapy'; 'Subsequent feedback'; 'Sources of misconceptions'; 'Unconditional acceptance'; 'Conditional acceptance'; 'Deferment and Rejection'. Acceptance of and compliance with statin therapy appeared to be associated with the provision, interpretation and feedback of information during patient-practitioner consultations, and patients' beliefs about personal health status, cholesterol, and recommended cholesterol-lowering strategies. CONCLUSIONS: Patients' beliefs and understanding about cholesterol, and the role of cholesterol modifying strategies should be determined prior to the initiation of therapy and at appropriate intervals thereafter.

Adult↗
PubMed2004

How information retrieval technology may impact on physician practice: an organizational case study in family medicine.

RATIONALE: Information retrieval technology tends to become nothing less than crucial in physician daily practice, notably in family medicine. Nevertheless, few studies examine impacts of this technology and their results appear controversial. AIMS AND OBJECTIVES: Our article aims to explore these impacts using the medical literature, an organizational case study and the literature on organizations. METHODS: The case study was embedded in an evaluation of the implementation of medical and pharmaceutical databases on handheld computers in a Canadian family medicine centre. Six physicians were interviewed on specific events relative to the use of these databases and on their general perception of impacts of this use on clinical decision making and the doctor-patient relationship. A thematic data analysis was performed concomitantly by both authors. RESULTS AND CONCLUSION: Findings indicate six types of impact: practice improvement, reassurance, learning, confirmation, recall and frustration. These findings are interpreted in accordance with both a medical and organizational perspective. The fit with the literature on inter-organizational memory supports the transferability of the findings. In turn, this fit suggests how information retrieval technology may change physician routine. This study suggests a new basis for evaluating the impact of information retrieval technology in daily clinical practice. In conclusion, our paper encourages policy-makers to develop, and physicians to use, this technology.

Canada↗
PubMedDate not supplied

The role of significant others in adolescent diabetes: a qualitative study.

PURPOSE: The purpose of this study was to explore perceptions of how diabetes influences adolescents' perceptions of quality of life in general and their relationships with parents, peers, school, and their physician. METHODS: The authors recruited adolescents between the ages of 13 and 18 years living with type 1 diabetes mellitus from a midwestern metropolitan area. Qualitative analysis of the focus group data followed a set procedure: (1) audio review of the tapes, (2) reading through the transcriptions, (3) discussions among investigators, (4) determination of conceptual themes, and (5) assignment of relevant responses to appropriate thematic constructs. RESULTS: The 5 focus groups involved 31 adolescents. From the discussions that occurred within the 5 focus groups, the following themes were identified: personal perceptions of living with diabetes (which included living with diabetes, testing and injections, and blood sugar fluctuations), impact on relationships (which included relationships with their parents, their friends/peers, and their physician), and impact on school. CONCLUSIONS: Diabetes in adolescence is fraught with equal and opposite demands. One consequence of this internal push/pull is that adolescents become more afraid to do appropriate developmental activities. This can have a significant impact on their normal progression to independence and adulthood, ironically at odds with the increased responsibility they have had to assume throughout their lives to care for their disease. Much of the clinical time and research still focuses on the devices of diabetes care: testing and treatment. While these are important tools in improving the outcomes of people with diabetes, they will have little impact on the adolescent until the developmental consequences of diabetes on their lives are simultaneously addressed.

Adolescent↗
PubMed2006

Priority setting in developing countries health care institutions: the case of a Ugandan hospital.

BACKGROUND: Because the demand for health services outstrips the available resources, priority setting is one of the most difficult issues faced by health policy makers, particularly those in developing countries. However, there is lack of literature that describes and evaluates priority setting in these contexts. The objective of this paper is to describe priority setting in a teaching hospital in Uganda and evaluate the description against an ethical framework for fair priority setting processes--Accountability for Reasonableness. METHODS: A case study in a 1,500 bed national referral hospital receiving 1,320 out patients per day and an average budget of 13.5 million US dollars per year. We reviewed documents and carried out 70 in-depth interviews (14 health planners, 40 doctors, and 16 nurses working at the hospital). Interviews were recorded and transcribed. Data analysis employed the modified thematic approach to describe priority setting, and the description was evaluated using the four conditions of Accountability for Reasonableness: relevance, publicity, revisions and enforcement. RESULTS: Senior managers, guided by the hospital strategic plan make the hospital budget allocation decisions. Frontline practitioners expressed lack of knowledge of the process. RELEVANCE: Priority is given according to a cluster of factors including need, emergencies and patient volume. However, surgical departments and departments whose leaders "make a lot of noise" are also prioritized. Publicity: Decisions, but not reasons, are publicized through general meetings and circulars, but this information does not always reach the frontline practitioners. Publicity to the general public was through ad hoc radio programs and to patients who directly ask. Revisions: There were no formal mechanisms for challenging the reasoning. Enforcement: There were no mechanisms to ensure adherence to the four conditions of a fair process. CONCLUSION: Priority setting decisions at this hospital do not satisfy the conditions of fairness. To improve, the hospital should: (i) engage frontline practitioners, (ii) publicize the reasons for decisions both within the hospital and to the general public, and (iii) develop formal mechanisms for challenging the reasoning. In addition, capacity strengthening is required for senior managers who must accept responsibility for ensuring that the above three conditions are met.

Decision Making, Organizational↗
PubMed2005

[The significance of the removal of the uterus for women: a qualitative study].

OBJECTIVE: To identify the myths accepted by women about to undergo hysterectomy regarding the consequences that removal of their uterus might have on their lives. METHODS: A sample of 10 hospitalized women with surgical indication for hysterectomy was used to perform a qualitative study, with semi-structured interviews carried out during the preoperative period. A profile questionnaire was used with questions about personal features and semi-structured inquiries to facilitate deeper questioning. With authorization of the subjects, interviews were recorded and transcribed to perform a thematic analysis of the content. RESULTS: The myths most often mentioned during the interviews were: loss of femininity, frigidity, change in personality, possible change in body appearance (since they would be "hollow", "empty", "have a hole inside their belly"), interference in the affective and sexual life and the belief that their companion might change in relation to them (assuming that they would be hollow, cold, and with no sexual attraction). CONCLUSION: The interviewed women accepted a number of myths about the consequences that removal of their uterus would have on their lives. These myths are related to the social identity of the gender and to a lack of knowledge about their body its organs and functions.

Adult↗
PubMed2003

A clinical model for the assessment of posture and balance in people with stroke.

PURPOSE: The lack of models to define and describe rehabilitation processes have often been identified as limiting research and the development of clinical practice. This study describes the development of a clinical model to address a key aspect of stroke physiotherapy--the assessment of posture and balance. METHOD: Twenty seven experienced neurological physiotherapists (PT) in six focus groups were used. Participants were shown photographs of a typical stroke patient in sitting and standing positions and were asked 'What would you note if you were assessing the posture and balance of this patient?' Answers were displayed on flip charts to allow immediate feedback about the accuracy and completeness of data. Thematic content analysis was then used. RESULTS: A complex reasoning process emerged to answer three main questions: What can the patient do? How does s/he do it? Why does s/he do it that way? To answer these questions physiotherapists established balance disability (by observing the patient's ability to perform a series of increasingly demanding balance tasks), identified postural and movement impairments (by observing alignment and movement of body segments relative to each other and to the expected norm for that patient) and assessed muscle activity (by observation and palpation). CONCLUSIONS: Focus groups have been used to elicit a clinical model for the assessment of posture and balance, the content of which will be used to inform a new outcome measure.

Evaluation Studies as Topic↗
PubMed2001

Barriers to help seeking in people with urinary symptoms.

BACKGROUND: Urinary incontinence is a common problem but, for those experiencing significant clinical symptoms, help seeking has been reported to be as low as 20%. As many of these people could be helped by simple interventions, there is a clear need to identify barriers to help seeking and develop interventions to overcome these barriers. OBJECTIVES: This study explores help-seeking behaviour in people with urinary symptoms such as leakage, frequency, nocturia and urgency in order to identify barriers to service use. METHOD: Thirty-one people who either had agreed to treatment as part of an intervention study or who were receiving treatment at a hospital out-patient clinic for their urinary problems took part in unstructured, taped interviews. Respondents were questioned about their views on help seeking for urinary problems and their personal experiences of consultations. The data were transcribed, coded and thematic analysis carried out. RESULTS: The most common theme to emerge was a lack of knowledge of the condition and of available treatments. Urinary symptoms frequently were considered a normal part of ageing or childbirth, or it was felt that these types of symptoms were inappropriate for medical intervention. Older people were not only more likely to accept symptoms but were also less likely to want to bother their GP. Patients did not always communicate their concerns about urinary symptoms to their GP, through either embarrassment or misconceptions of what is a 'medical problem'. CONCLUSIONS: There is a clear need for health education and health promotion in this area. Future work should explore professionals' knowledge and views of these types of conditions with the aim of providing guidelines for management in primary care.

Adult↗
PubMed2004

Making portfolios work in practice.

BACKGROUND: A portfolio captures learning from experience, enables an assessor to measure student learning, acts as a tool for reflective thinking, illustrates critical analytical skills and evidence of self-directed learning and provides a collection of detailed evidence of a person's competence. AIMS: This paper reports data on how assessors and nursing students match learning outcomes and/or competencies to their practice and then reconstruct those experiences into the format required by the portfolio documentation. The data were gathered as part of a larger study to evaluate the use of portfolios in the assessment of learning and competence in England. METHODS: This three phase stakeholder evaluation was designed to gain the views of those involved in designing, implementing and using portfolios in nurse education. In phase 2, 122 students and 58 nurse teachers were interviewed about their perceptions of portfolio use, and a further 32 students and 26 assessors were interviewed after they had been observed taking part in an assessment process. Thematic data analysis was used. FINDINGS: Assessors and students underwent a complex process of deconstructing learning outcomes/competences to fit these to their practice. These then had to be reconstructed through the written medium to fit the structure of the portfolio. Confirmation that this met teachers' expectations was essential to allay feelings of insecurity. CONCLUSIONS: To achieve maximum benefit from the portfolio as a learning tool to link theory and practice, there needs to be a clear fit between the model of portfolio and the professional practice that is to be assessed. Outcomes and competences, as well as the type of evidence required to demonstrate their achievement, and integration of the whole experience should match the students' stage of professional and academic development. Over-complex approaches to practice assessment, particularly in the early stages of students' careers, can detract from clinical learning in favour of learning how to complete the portfolio successfully.

Clinical Competence↗
PubMed2003

Gendered nursing education and practice in Iran.

Through qualitative ethnographic methods, the researcher gendered nursing education and practice among human nursing students and faculty. Interaction with nursing students and faculty occurred in a familiar turf using the native language in interviews and on field observations. Settings included classrooms, skills laboratory, faculty offices, clinical areas, and informants' homes. Formal and informal interviews, observations, and printed materials provided useful data to reach consistent common patterns. Thematic analysis and triangulation of data identified gender variations in care and compassion, spirituality, economic motives, and practice preference. Integrated experiences of pre-Islamic period were used to describe the current developments of gendered nursing education and practice in the Islamic Republic of Iran. Study of gendered nursing education and practice brings attention to the cultural significance of gender issues. This body of knowledge will benefit American nurses and educators by increasing their cultural understanding of gender.

Adult↗
PubMed2006

Illness beliefs in schizophrenia.

Beliefs about health and illness shape emotional responses to illness, health-related behaviour and relationships with health-care providers in physical illness. Researchers are beginning to study the illness beliefs of people with psychosis, primarily using models developed in relation to physical illness. It is likely that modifications to these models will be necessary if they are to apply to mental disorders, and it is probable that some of the assumptions underlying the models will be inappropriate. In particular, different dimensions of understanding may be present in mental illness in comparison to those identified in physical illness. The present study examines the beliefs of 20 patients in the UK diagnosed with schizophrenia, including 10 currently psychotic inpatients and 10 outpatients in remission, about their experiences, using qualitative interviews and thematic analysis. Patients currently experiencing psychosis did not identify their experiences as separable 'illnesses' and did not have 'illness beliefs'. Patients currently in a period of remission appraised their experiences as distinct from their own normal behaviour, but used conceptual frameworks of understanding that deviated significantly from conventional 'health belief' models. Patients' ways of understanding mental illness did not parallel those described in physical illnesses. Methods for assessing beliefs about mental illness should therefore not be transferred directly from studies of beliefs about physical illness, but should be tailored to the nature of patients' beliefs about mental illness.

Adult↗
PubMed2006

[Spatial distribution of M. tuberculosis-HIV coinfection in São Paulo State, Brazil, 1991-2001].

OBJECTIVE: To assess the spatial pattern of tuberculosis incidence in relation to the AIDS epidemic, with the aim of investigating the geographical influence on causality. METHODS: All AIDS cases from State of São Paulo, notified to the Brazilian Ministry of Health between 1991 and 2001, were included. The cases were stratified by municipality, by administrative health regions, AIDS transmission categories, gender and years since diagnosis. A Gaussian geostatistical model was used to construct a thematic risk map, utilizing the tuberculosis incidence among AIDS cases as the response variable. RESULTS: Exploratory analysis showed two patterns of AIDS incidence: one for the state capital, and another, with increasing risk, for the other municipalities. The more populous regions presented higher risk of tuberculosis transmission, with a pattern that matched the land occupation pattern, from east to west. The health regions with the highest AIDS incidence coefficients (per 10,000 inhabitants) were Santos (53.5), São José do Rio Preto (43.1), Ribeirão Preto (42.4) and São Paulo (40.3). The health regions with greatest tuberculosis incidence among AIDS cases were Santos (44.9%), Franco da Rocha (39.9%), Osasco (39.6%) and São Paulo (38.9%). CONCLUSIONS: The results allow the conclusion that geographical coordinates presented an association with tuberculosis risk, but not with AIDS risk.

Brazil↗
PubMed2006

Facilitating change in school health: a qualitative study of schools' experiences using the School Health Index.

INTRODUCTION: As school-based efforts increase to address the epidemic of childhood obesity, a priority for health professionals and educators will be to identify effective tools appropriate for use in schools to help guide health promotion programs and policies. This article describes the results of a qualitative research study examining school staff and community members' experiences working with the Centers for Disease Control and Prevention's School Health Index, a self-assessment and planning tool that addresses nutrition and physical activity. METHODS: In-depth interviews were carried out with faculty, staff, and community collaborators in nine public schools that were using the School Health Index to develop nutrition and physical activity initiatives for students. Interviews were conducted twice: once after a school had completed the School Health Index and once approximately 1 year later. Transcript data from interviews with 34 participants were analyzed using thematic analysis. RESULTS: Findings indicated that school experiences differed markedly depending on whether they received help from an outside facilitator to work with the School Health Index. Unlike staff in schools working on their own, school staff working with outside facilitators described completing the School Health Index in a collaborative way, creating action plans, and working as a team to implement health promotion initiatives. In addition, the involvement of an outside facilitator supported schools in undertaking more complex tasks with a greater degree of collaboration across the school and local communities in order to achieve goals. CONCLUSION: Outside facilitators may significantly enhance schools' efforts to work with the School Health Index and influence the organizational strategies they use to implement health promotion initiatives.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

[Knowledge and informative needs of patients with the diagnosis of schizophrenia, explored with focus group methods].

SUMMARY. Aims - Psychiatric patients often are not informed about their diagnosis and their involvement in the decision making process is rare. Aim of the study was to explore the informative needs of patients with schizophrenia and the knowledge about their illness. Method - Three focus groups were conducted with 25 long-stay patients with the diagnosis of schizophrenia, attending the Mental Health Centre of the South-Verona Community-based Mental Health Service. The group discussions were audiotaped and transcribed. Results - The authors identified 18 different thematic categories which were used by two raters to classify all patient contributions. The interrater reliability was satisfactory. The qualitative analysis evidenced that patients have little knowledge about their illness. Patients had confuse and vague ideas on schizophrenia but their knowledge on drug names, dosages and side effects appeared precise and detailed. Several patients have looked for information in encyclopedias and medical dictionaries. Conclusion - The findings suggest a need of patients affected by schizophrenia for an information exchange with their psychiatrists that takes into account their informative needs, corrects wrong beliefs and actively involves them in therapeutic decisions.

Cognition↗
PubMed2006

An exploration of Latino smokers and the use of pharmaceutical aids.

BACKGROUND: Latino smokers are less likely than white non-Latino smokers to use nicotine replacement therapy (NRT) or bupropion when trying to quit smoking. The current study explored sociocultural and psychosocial factors related to nonuse of smoking-cessation medications among Latino smokers. METHODS: Structured discussions were held with six separate focus groups of current smokers (n =49) who self-identified as Latino, had attempted to quit in the past 12 months, and were aged 35 to 64 years. Participants were recruited from Latino-serving health clinics, community events, and community organizations. Session recordings were transcribed, and content analysis was used to organize themes into categories. RESULTS: Six thematic categories emerged across most or all discussion groups: (1) smoking is a weakness rather than an illness, (2) pharmaceuticals are generally avoided, (3) NRT is mistrusted, (4) bupropion is widely rejected, (5) views are mixed regarding ethnic dimensions of smoking and quitting, and (6) misconceptions are common regarding smoking and cessation. CONCLUSIONS: Cognitive reframing strategies should be developed and tested for Latino smokers who decline pharmacologic smoking-cessation assistance for reasons other than well-informed autonomous choice.

Bupropion↗
PubMed2003

Advice nursing practice: on the quality of the evidence.

OBJECTIVE: The primary objective was to review the research regarding advice nursing practice to determine the content areas investigated and the quality of the evidence. METHODS: A systematic review of advice nursing research was done in electronic databases, reference lists, and the literature identified by experts (N = 527). After deletion of duplicates and clinical and theoretical articles, full text reviews were done on 62 studies. RESULTS: Eight thematic content areas were identified: delivery and continuity of care to populations, appropriateness of advice given, patient/provider satisfaction, disposition/utilization after calls, reason for calling, cost analysis, process of decision-making, and documentation. The most frequently investigated subject was delivery/continuity of care (n = 16). IMPLICATIONS: For certain chronic disease populations, interventions using telephone advice for social support, education, and symptom management improve clinical outcomes. Availability and use of protocols and guidelines do not guarantee standardized care or ensure that appropriate advice will be given. Consumer satisfaction with advice nursing is high, and appears to be related to the intervention component of the nursing process. The priority for future research should be given to those studies that describe the character and suitable dose of the nursing intervention that is advice nursing.

Chronic Disease↗
PubMed2004

Posttrial HIV vaccine adoption: concerns, motivators, and intentions among persons at risk for HIV.

BACKGROUND: Suboptimal uptake of existing vaccines, potential obstacles specific to HIV/AIDS stigma and mistrust, and marked health disparities suggest that it is vital to investigate consumer concerns, motivations, and adoption intentions regarding posttrial HIV vaccines before a vaccine is publicly available. METHOD: Nine focus groups were conducted with participants (n = 99; median age, 33 years; 48% female; 22% African American, 44% Latino, and 28% white) recruited from 7 high-risk venues in Los Angeles using purposive venue-based sampling. A semistructured interview guide elicited concerns, motivators, and adoption intentions regarding hypothetical U.S. Food and Drug Administration-approved HIV vaccines. Data were analyzed using narrative thematic analysis and Ethnograph qualitative software. RESULTS: Concerns included vaccine efficacy, vaccine-induced infection, vaccine-induced HIV seropositivity, side effects, cost/access, trustworthiness, and relationship issues. Motivators included protection against HIV infection and the ability to safely engage in unprotected sex. Participants expressed reluctance to adopt partial efficacy vaccines and likelihood of increased sexual risk behaviors in response to vaccine availability. CONCLUSION: Tailored interventions to facilitate uptake of future U.S. Food and Drug Administration-approved HIV vaccines and to prevent risk behavior increases may be vital to the effectiveness of vaccines in controlling the AIDS pandemic.

AIDS Vaccines↗
PubMed2026

Impact of precision oncology research in pediatric poor prognosis cancer: patient, parent and healthcare provider perspectives.

BACKGROUND: Comprehensive genomic analyses are increasingly accessible to children, adolescents and young adults (AYAs) with poor prognosis cancers. Challenges and successes of pediatric precision oncology studies from the perspectives of AYA patients, parents and healthcare providers (HCPs) are poorly described. METHODS: Between March 2021 and May 2023, we interviewed AYA patients (12-21 years), parents and HCPs who participated in pediatric precision oncology studies for poor prognosis cancers in British Columbia. Interviews followed an investigator-developed semi-structured topic guide. Data were coded inductively and deductively by one qualitative researcher and one trainee, supported by two additional team members. Analytic themes were established using qualitative thematic analysis. RESULTS: We interviewed 9 AYAs, 10 parents, and 17 HCPs. We identified five analytic themes: importance of clear communication of study information between patients, families and multidisciplinary HCPs; a need to support disclosure, understanding and clinical integration of research results; barriers to accessing innovative therapy and mitigation strategies; approaches to managing parent, patient and HCP hopes and expectations; personal challenges and stressors related to participation. CONCLUSIONS: We highlight unmet needs and offer practical considerations for integrating precision oncology into clinical practice. Considerations include educating and supporting oncologists through genomics results disclosure, increasing engagement with multidisciplinary HCPs, streamlining access to study information and results, coordinating efforts to clinically validate results and access therapies, and establishing real-world outcome data to inform clinical decision-making. Implementation of these strategies will optimize care for patients and families who are navigating poor prognosis cancers.

Humans↗
PubMed2006

Dependent personality traits and information processing: assessing the interpretation of ambiguous information using the Thematic Apperception Test.

OBJECTIVES: This study was designed to investigate interpretation bias in people with dependent personality traits. METHOD: Eight Thematic Apperception Test (TAT) cards were administered to participants (N=56) who scored high or low on DSM-III-R dependent personality pathology. Two independent judges rated the TAT stories using a rating list based on the cognitive model of the dependent and paranoid personality disorder. RESULTS: Controlling for self-esteem, the dependent interpretation bias appeared to be specific for dependent personality pathology. SEM analysis supported a mediation model in which beliefs mediate the relationship between DSM-III-R traits and interpretation bias. CONCLUSIONS: The findings in this study support the hypothesis that people with dependent traits are characterized by a schema-related interpretation bias and that this bias is mediated by dependent beliefs.

Adult↗