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 73 records · Page 4Linked to original sources
PubMed2004

Primary mental health workers in child and adolescent mental health services.

BACKGROUND: The interface between primary care and specialist services is increasingly seen as crucial in the effective management of child and adolescent mental health (CAMH) problems. In the United Kingdom, a new role of primary mental health worker (PMHW), has been established in order to achieve effective collaboration across the interface through the provision of clinical care in primary care settings and by improving the skills and confidence of primary care staff. However, little is known about the development of this innovative role in service contexts. Issues raised during the early stages of implementation may have important implications for the preparation and development of professionals who undertake the role. AIMS: The aim of this paper is to report on a study that examined key issues in implementation of the PMHW role in six health authorities in England. METHODS: Case study evaluation was conducted, using thematic analysis of 75 qualitative interviews with key stakeholders from different professions (e.g. PMHWs, general practitioners, health visitors, psychiatrists and service managers) and representing different sectors (primary care, specialist services and community child health services). FINDINGS: The study identified three models of organization (outreach, primary care-based and teams). Each was associated with different advantages and disadvantages in its effects on referral rates to specialist services and the development of effective working relationships with primary care providers. Problems associated with accommodation and effective integration of PMHWs with specialist services, and tensions caused by the two different roles that PMHWs could undertake (direct clinical care vs. consultation-liaison) were common across all sites. CONCLUSIONS: The PMHW role is an important development that may go some way towards realizing the potential of primary care services in CAMH. The implementation of new roles and models of working in primary care is complex, but may be facilitated by effective planning with primary care providers, clear goals for staff, and a long-term perspective on service development.

Adolescent↗
PubMed2006

Pain management in sickle cell disease.

OBJECTIVES: Sickle cell disease (SCD) is an inherited blood disorder characterized by recurrent 'crisis' pain, which is the most common reason for repeated hospital admission. The nature of this pain, however, is poorly understood, and the pain is often sub-optimally managed. METHODS: A focus group format, interpreted using thematic analysis, was used to gain a greater understanding of the barriers that SCD patients face in managing their pain and their perceptions of the treatment that they receive from healthcare professionals. RESULTS: Key issues emerging from the focus groups that adversely affected participants' pain management included: feeling isolated by their experience of 'crisis' pain, not being listened to, and limitations to social support networks. Specific issues relating to seeking medical care included lack of understanding about SCD by nonspecialist clinicians, feelings of being low priority due to the 'invisible' nature of their pain, and feeling mistrusted by medical staff when seeking analgesia. DISCUSSION: Feelings of isolation may drive maladaptive coping strategies and manifest in anger, aggression and active avoidance of service use. Suggested service improvements include the active targeting of isolated individuals in the form of pain discussion groups or self-help groups, and greater provision of specialised services.

Adaptation, Psychological↗
PubMed2003

What medical students value in a population health tutor: characteristics for consideration in staff recruitment and development.

BACKGROUND: Recent moves to integrate aspects of population health into medical curricula have created new staff development challenges for many institutions. Small group teaching in population health is a relatively new initiative, often requiring recruitment of additional staff and considerable training. This analysis identifies the tutor characteristics rated most positively by medical students in a small-group course in population health and discusses their implication for staff recruitment and development. METHOD: Retrospective evaluation of tutors by students using a self-administered questionnaire. Overall tutor rating was analysed against various tutor characteristics, using univariate logistic regression methods. Optional qualitative comments were summarized by thematic methods and triangulated with findings from the quantitative analysis. RESULTS: Creating a supportive group climate was the tutor attribute most positively evaluated by students (OR=9.62, 95%CI 4.46-20.83). Perceived interest in teaching (OR=8.93, 95%CI 3.83-20.83) and the ability to give useful feedback (OR=8.40, 95%CI 4.07-17.54) were also highly rated by students as valuable qualities in their tutors. Qualitative analysis highlighted the importance of informed comment, good knowledge and expert input from tutors. CONCLUSION: Whilst a degree of content expertise in population health was desirable in a tutor, its value was secondary to good facilitation skills and an enthusiasm for teaching when student evaluation was considered. Faculties implementing small-group methods of teaching population health should consider facilitation skills and interest in teaching as priorities when recruiting and training staff. As is the case for self-directed student-led learning in basic and clinical sciences, these appear to be more influential than content expertise, from the students' perspective.

Australia↗
PubMed2003

[A competency-based approach for nursing care instruction. Analysis of teaching practices].

The aims of this qualitative research is in understanding how the teaching methods of nursing instructors favor the student's development in competency. Eight nursing instructors were interviewed in a non-directive approach. A thematic as well as a structural analysis of the data indicates that in the majority of cases, their methods are based primarily on an impression and conditioning model, and in an isolated approach on an interactive and constructive model. The analysis of the nursing instructors' accounts in regards to their role as educators illustrates: an inadequacy between teaching goals and the choices of pedagogical methods; an ambivalent and unclear understanding of their role as instructor leading to the privileging of strategies for their success rate over teaching quality. inconsistencies in conveying the training and qualification evaluations as well as between the theoretical and clinical evaluations. In conclusion, various individual strategies, institutional and national, are offered with the view of favoring a competence-based approach for nursing training.

Attitude of Health Personnel↗
PubMed1999

Research triangulation to derive meaning-based quality-of-life theory: adolescent resilience model and instrument development.

We describe the triangulation of qualitative and quantitative research methods used to develop and test the Adolescent Resilience Model (ARM). The differences in meaning-based and function-based health-related quality of life (HRQL) are discussed, and method triangulation is presented as a means of developing models of HRQL that represent the perspectives of the adolescent and family. Qualitative methods of phenomenology, simultaneous concept analysis, focus groups and thematic analysis were used to generate the ARM. Quantitative instrumentation and structural equation model development and testing were used to evaluate the ARM. A decision-making process for combining qualitative and quantitative research, so that both approaches are equally valued and used, is also presented. Int. J. Cancer Suppl. 12:125-131, 1999.

Adolescent↗
PubMed2005

The specialist palliative care nurse: a qualitative study of the patients' perspective.

BACKGROUND: Relatively little is known about patients' perceptions of the work and role of the specialist palliative care nurse. Understanding the patients' perspective can help to evaluate services, improve quality of care, and identify misunderstandings. OBJECTIVES: To explore the experiences of those who said that they had a 'terminal illness', focusing on patients' perceptions of the work and role of these nurses. DESIGN: Qualitative study with narrative interviews. SETTING: England and Wales. PARTICIPANTS: Forty-one people recruited through those working in hospices, community nurses, general practitioners, support groups, a national newspaper, and a conference on palliative care. Twenty-five people talked about the work of specialist palliative care nurses. METHOD: Interviews were fully transcribed; followed by a thematic analysis with constant comparison. RESULTS: Patients valued the nurses' work, particularly their advice on practical matters, information given about their disease, emotional support, advice on symptoms, and help with communication. They were glad that help was readily available. However, some patients who had been referred to the service did not realise that specialist palliative care nurses may be involved at a relatively early stage in a person's illness, and sometimes felt distressed by an early referral. One woman felt she had not had the emotional support she needed and another knew of women who had been upset because these nurses had discussed topics such as place of death 'too early'. However, people recognised the difficulties nurses faced in their work. CONCLUSIONS: Although our study differs from other studies, particularly in the way people were recruited, our findings support previous studies that have shown that specialist palliative care nurses are highly valued by those who have a terminal illness. It is important for people to understand that these nurses may be involved from the time of diagnosis and that roles have changed.

Adult↗
PubMed2000

Fatigue in advanced cancer -- meaning before measurement?

The fatigue experienced by patients with advanced cancer has received little attention either in clinical practice or amongst researchers. To date, attention has been directed at the fatigue experienced by patients receiving chemotherapy or radiotherapy, with little being directed at the experiences of patients with advanced cancer within the context of a rapidly declining health status. In light of the paucity of information available to inform practice a study was undertaken to explore the nature and impact of fatigue as experienced by 15 patients with advanced cancer, a relative or friend of their choice, and health care professionals involved with their care. The aims were threefold: (i) to gain further understanding of this debilitating problem from divergent perspectives; (ii) to identify potential intervention strategies to be evaluated in future studies; and (iii) to attempt to inform palliative care research methodology where previously poorly understood and inadequately articulated symptoms, such as the fatigue of advanced cancer, are addressed. This paper focuses on issues relating to the third of the three study aims. Seven men and eight women with a variety of cancers, predominantly breast, ovarian, lung and prostate cancer were interviewed. Demographic data, disease history, biochemical markers, weight, nutritional status and medication profile were also recorded. Patients completed visual analogue scales (VAS) recording perceptions of severity of fatigue and pain, and distress caused by the fatigue, during the previous week. Each patient also completed the Hospital Anxiety and Depression Scale (HADS). Following verbatim transcription, taped interviews were subject to processes derived from thematic content analysis, and Glaser and Strauss' constant comparative method. Case note data, VAS and HADS were subject to descriptive statistics. Each participant within this study articulated the importance of addressing the struggle of finding meaning in something as inherently disabling as the fatigue experienced. This led to the conclusion that valid and reliable measurement of complex facets of terminal illness is dependent on extrapolating meaning before undertaking measurement. This paper, drawing on patient focused data, sets out to support that assertion.

Antineoplastic Agents↗
PubMed2002

Physical disability and the experience of chronic pain.

OBJECTIVES: To obtain an insider's view about disability-related pain to help rehabilitation clinicians understand the experience and to show how people with disability manage daily living and encounters with other people. DESIGN: Qualitative methods by using open-ended interviews and thematic analysis. SETTING: Rehabilitation research program. PARTICIPANTS: Nine adults with chronic physical disability and pain were recruited from study groups. The 9 included people with spinal cord injury, acquired amputation, or cerebral palsy. INTERVENTION: Interview protocol. MAIN OUTCOME MEASURE: Phenomenologic analysis of interviews based on codewords derived from interview topics and themes. RESULTS: Study participants described pain as a part of daily living that influenced many lifestyle decisions. They characterized pain as plural, meaning that it has multiple locations, distinctive descriptions, and different implications. They also were concerned about pain being a mystery, having unclear causes and consequences. Typically they described pain as a personal venture, with little or dissatisfying communication about pain with family, friends, or health care providers. CONCLUSIONS: Understanding pain associated with physical disability can help guide rehabilitation practitioners in their pain assessments, interventions, and related research. Our findings suggest that some people with disability-related pain may benefit from reassurance and specific planning for expected and unexpected pain episodes.

Activities of Daily Living↗
PubMed2005

Prediction of active sites for protein structures from computed chemical properties.

MOTIVATION: Identification of functional information for a protein from its three-dimensional (3D) structure is a major challenge in genomics. The power of theoretical microscopic titration curves (THEMATICS), when coupled with a statistical analysis, provides a method for high-throughput screening for identification of catalytic sites and binding sites with high accuracy and precision. The method requires only the 3D structure of the query protein as input, but it performs as well as other methods that depend on sequence alignments and structural similarities.

Bacterial Proteins↗
PubMed2005

Efficient application of Internet databases for new signal processing methods.

This paper highlights the ways in which Internet databases may be efficiently used to foster the application of progress in biomedical sciences via data sharing and new algorithms. Employing the Internet to accelerate the pace of interdisciplinary research has significant potential, yet as with all new technologies, the first applications often cause more disappointment than positive outcomes. We discuss examples of solutions to the basic issues: (1) finding the relevant datasets (in portals connected via the Inter-neuro infrastructure), (2) reading the particular format in which the data was stored (using the SignalML language for metadescription of time series), (3) choosing the right method for the data analysis (we provide a brief review of the methods used for the analysis of EEGs, and discuss two of them in detail: Directed Transfer Function and Matching Pursuit), and (4) sharing the software for chosen methods of analysis (via repositories such as the eeg.pl thematic portal).

Algorithms↗
PubMed2006

Research to practice in The Journal of Continuing Education in the Health Professions: a thematic analysis of volumes 1 through 24.

INTRODUCTION: Authors have stressed the importance of the broader contextual influences on practice improvement and learning and have expressed concern about gaps between research and practice. This implies a potential expansion of the knowledge base for continuing education in the health professions (CEHP) and an increased emphasis on research evidence for that knowledge. How has the content of The Journal of Continuing Education in the Health Professions (JCEHP) reflected those changes? What are the implications for CEHP practitioners? METHODS: Based on all abstracts, tables of contents, and editorials, a thematic analysis was completed for volumes 1 through 24 of JCEHP. All texts were downloaded into qualitative analysis software and coded. Main code categories included demographics of articles, concepts relating to CEHP as a discipline, knowledge translation and outcomes-oriented continuing education, and theories and frameworks. Key themes were identified. RESULTS: Key themes include categories of topics included in JCEHP over the years, the increased prominence of research in JCEHP, a dual research evidence-to-practice gap, the professionalization of continuing education providers, and interdisciplinarity and the links with broader frameworks that have been proposed for CEHP. DISCUSSION: Two sets of research-to-practice gaps are portrayed in the journal: the gap between clinical research and practice and the gap between research and practice in CEHP. To close the first gap, authors have asserted that the second gap must be addressed, ensuring that CEHP practices themselves are evidence based, driven by theory-based research. This is a variation on prior debates regarding the need to define CEHP as a discipline, which uses the language of professionalization. The increased focus of continuing education on the contexts of health care providers' practices has multiplied the topics that are potentially relevant to CEHP practice.

Education, Medical, Continuing↗
PubMed2005

Why do residents fail to answer their clinical questions? A qualitative study of barriers to practicing evidence-based medicine.

PURPOSE: Physicians fail to pursue answers to most of their clinical questions, despite exhortations to practice evidence-based medicine (EBM). While studies have revealed several barriers practicing physicians experience in answering clinical questions, residents may encounter unique obstacles. The authors conducted a qualitative study to explore residents' experience in trying to answer their clinical questions. METHOD: In 2003, the authors studied a convenience sample of 34 residents, representing 54% of the residents in a university-based internal medicine program. A professional facilitator convened and audiotaped three focus groups with the residents, following a discussion guide. The key question elicited the barriers residents encountered in attempting to answer their clinical questions. A thematic analysis of the transcripts was performed, using the constant comparison method of analysis. Two investigators met after independently analyzing each of the transcripts to compare coding structures, review theme exemplars, and reach consensus for differences. RESULTS: Eight main themes emerged that characterize the EBM barriers, including access to medical information, skills in searching information resources, clinical question tracking, time, clinical question priority, personal initiative, team dynamics, and institutional culture. The analysis suggested a conceptual model in which residents may encounter different barriers in every step of the EBM process. Furthermore, attitudinal or cultural barriers may lead a resident to abandon the pursuit of a question before some of the technical barriers would be encountered. CONCLUSION: Residents face several EBM barriers, some of which are unique to their status as trainees. While increased informatics training and reliable, rapid, and point-of-care access to electronic information resources remain necessary, they are not sufficient to help residents practice EBM. Educators must also attend to their attitudes toward learning and to the influence of programmatic and institutional cultures.

Adult↗
PubMed2003

Becoming a web-based learner: registered nurses' experiences.

AIMS: The purpose of the study was to describe Registered Nurses' experiences when taking a web-based course from either the workplace or home, and the impact of their learning on clinical practice. RATIONALE: Little is known about the web-based learners' experience, particularly when courses are accessed from the nursing practice setting. Even less is known about whether nurses transfer their web-based learning to clinical practice. METHODS: A qualitative design employing focus group interviews was used. Participants included hospital and community nurses from three Canadian provinces and one territory. Data were collected at three points over a 6-month period and analysed using a thematic analysis process. These findings emanate from a larger study using survey method and focus group interviews. RESULTS: The focus group interviews captured the hurdles nurses faced during the first weeks when they struggled with technology, re-framed their views of teaching and adjusted to web-based learning from home and work. These first stressful weeks were followed by a period during which nurses developed relationships with the teacher and peers that enabled them to focus on learning and prevented attrition. Most nurses reported the web course was convenient and that they would be interested and comfortable using technology for learning and work purposes in the future. Six weeks after the course was completed, nurses articulated a number of ways the course had improved their practice. CONCLUSION: Initial weeks in a web-based course can be very challenging for novice Internet users, however, most nurses who completed the course reported a positive learning experience. Nurses, employers and educators should evaluate computer skills, computer access and the learning environment when preparing for web-based learning.

Adult↗
PubMed2005

Synthesising qualitative and quantitative evidence: a review of possible methods.

BACKGROUND: The limitations of traditional forms of systematic review in making optimal use of all forms of evidence are increasingly evident, especially for policy-makers and practitioners. There is an urgent need for robust ways of incorporating qualitative evidence into systematic reviews. OBJECTIVES: In this paper we provide a brief overview and critique of a selection of strategies for synthesising qualitative and quantitative evidence, ranging from techniques that are largely qualitative and interpretive through to techniques that are largely quantitative and integrative. RESULTS: A range of methods is available for synthesising diverse forms of evidence. These include narrative summary, thematic analysis, grounded theory, meta-ethnography, meta-study, realist synthesis, Miles and Huberman's data analysis techniques, content analysis, case survey, qualitative comparative analysis and Bayesian meta-analysis. Methods vary in their strengths and weaknesses, ability to deal with qualitative and quantitative forms of evidence, and type of question for which they are most suitable. CONCLUSIONS: We identify a number of procedural, conceptual and theoretical issues that need to be addressed in moving forward with this area, and emphasise the need for existing techniques to be evaluated and modified, rather than inventing new approaches.

Bayes Theorem↗
PubMed2002

Cautious caregivers: gender stereotypes and the sexualization of men nurses' touch.

AIM: The aim of this research was to explore the experience of men nurses and the ways in which gender relations structure different work experiences for women and men in the same profession. BACKGROUND: Men are now entering the nursing profession in record numbers and challenging the notion that men are inappropriate in caregiver roles or incapable of providing compassionate and sensitive care. A limitation of the current state of knowledge regarding caring and men nurses is that it is primarily focused on men nursing students, not practising nurses. Little is known about men nurses' practices of caring and how such practices reflect the gendered nature of nursing and nurses' caring work. METHODS: The theme of men nurses as cautious caregivers emerged from data that were collected in two rounds of semi-structured interviews with eight men nurses practising in Nova Scotia, Canada. Thematic analysis, informed by feminist theory and masculinity theory, was used as the method for analysing the data. FINDINGS: For men nurses, the stereotype of men as sexual aggressors is compounded by the stereotype that men nurses are gay. These stereotypes sexualize men nurses' touch and create complex and contradictory situations of acceptance, rejection and suspicion of men as nurturers and caregivers. They also situate men nurses in highly stigmatized roles in which they are subject to accusations of inappropriate behaviour. For men nurses, this situation is lived as a heightened sense of vulnerability and the continual need to be cautious while touching and caring for patients. Ultimately, this situation impacts on the ability of men nurses to do the caring work they came into nursing to do.

Adult↗
PubMed2006

A qualitative study of factors affecting chemotherapy use in older women with breast cancer: barriers, promoters, and implications for intervention.

STUDY OBJECTIVE: The incidence of breast cancer increases with advancing age and yet women 65 and older (hereinafter referred to as 'older' women) do not always receive the most intensive treatments, such as adjuvant chemotherapy. The causes of underutilization of chemotherapy in this age group are poorly delineated. The purpose of the study was to explore older breast cancer patients' attitudes towards chemotherapy and factors that influenced their decisions to use or not use this treatment modality. DESIGN: Qualitative methods were used to conduct race/ethnicity-specific focus groups. A thematic analysis was performed using NVIVO. SETTING AND PARTICIPANTS: Drawn from the Washington, DC area, participants were 34 ethnically diverse older breast cancer survivors (18 Caucasians, 10 African-Americans, and 6 Latinas). Focus groups were conducted in a local church; a senior center, and the Lombardi Cancer Center. MAIN RESULTS: Results showed that many women felt they had no 'choice' and did what the doctor told them to do. For those who reported participation in the decision, time spent exchanging information with the woman's physician and the inclusion of family members promoted perceptions of optimum decision-making leading to the use of chemotherapy. Two barriers to using chemotherapy were negative expectations about side effects and lack of information specific to the woman's individuals' circumstances. Women of color reported less physician communication and information, in part due to language difficulties and perceived bias; these factors acted as barriers to chemotherapy. CONCLUSION: Physicians could provide specific and limited information to patients and family members to promote realistic expectations and optimum decisions about chemotherapy, given the risks involved in this treatment modality. Interventions should be developed and tested to enhance communication that is sensitive to older women's culture, family structure, illness experiences, preferences, and expectations.

Adult↗
PubMed2026

Power as equal ability, knowledge and resistance: Systematic review of experiences of adults with noncommunicable diseases.

PURPOSE: To analyse subjective experiences of power of adults with noncommunicable diseases in relationships with healthcare practitioners as well as underlying facilitators and barriers of these experiences. METHODS: Systematic review (4 databases) of experiences using reflexive thematic analysis underpinned by critical realist approach. The analysis was conducted with an abductive reasoning using previous theories on social power as well as retroduction. RESULTS: Based on 24 studies, we formed three themes, which depict experiences of power as 1) the position, equal ability and freedom to make one's own choices and (re)negotiate within shared dialogue, 2) the ability to use knowledge to claim one's rights, 3) resistance. Facilitators were connected to acknowledgement as an equally valuable individual, positive healthcare practitioner attitudes and actions towards patient activity and views, safety in the relationship as well as to sufficient, clear and varied information. Main barriers were experiences of dehumanisation, negative healthcare practitioner attitudes and actions, perceived or assumed practitioner domination in interactions, lack of or incomprehensible knowledge and testimonial smothering. CONCLUSION: Results suggest that adults with noncommunicable diseases may experience power primarily as a positive power: being acknowledged as having legitimate position to make decisions and being in possession of varied knowledge through which they can gain agency to protect and claim their rights, by resisting, if necessary. Healthcare practitioners are in key position to support these experiences through positive transforming actions, while knowledge asymmetries, persistent inequality and paternalistic structures continue to hinder it.

Humans↗
PubMed2003

Being dialysis-dependent: a qualitative perspective.

technology of renal dialysis offers a way in which life can be sustained, so it is not surprising that the complex, diverse and evolving iatrogenic aspects of dialysis-dependency continue to be researched. However, there has been a tendency to take for granted the human process of making sense of the intrusiveness of dialysis. This study was designed to explore the meanings of dialysis-dependency. The study sample was 10 participants: five female, five male; five on peritoneal dialysis, five on haemodialysis; whose ages ranged from 22 to 68 years. Using a narrative methodology the following methods were used: in-depth interviews, narrative and thematic analysis, fieldwork/notes from five renal units, participant validation, and journal reflections. A thematic analysis revealed the continuum themes of Freedom-Restrictions, Being Normal-Being Visible, Control-Acquiesce, Hope-Despair and Support-Abandon. The themes portrayed as continuums serve to remind health care professionals that those with chronic illnesses strive to make sense of what is happening to them. Variations within each of these themes can occur daily, weekly or monthly. Acceptance may never be reached or may be tentative. Some clients will strive for control and freedom to choose for themselves, others will acquiesce to the overwhelming changes wrought in their lives. Thus, health care professionals might consider placing the personal meanings of those who are dialysis-dependent to the fore, being sensitive to the sufferings wrought by the regime, which treats but does not cure, which sustains life but does not heal.

Adult↗