New Trends in Qualitative Research

Scientific Congresses: What is Our Future?

Combining interviews and drawings: methodological considerations

Abstract: Framework: In qualitative research, drawing on a blank sheet of paper during the interview is one of the tools in the researcher’s toolbox. This technique is increasingly used in social sciences, but is still rarely included in research on social support for the chronically ill. Goals and Methods: The objective of this paper is to analyze the advantages of an innovative research method that uses both drawings and semi-structured interviews to study support networks of chronically ill patients. This method was used to conduct a qualitative research on changes in chronically ill support networks in France during the lockdown period (March-May 2020). The study triangulates three types of sources: 1. From chronically ill patients' oral accounts of their experience of lockdown, collected during 32 semi-directive interviews; 2. From the chronically ill patients’ drawings of support networks they were asked to make by the end of the interviews; 3. From their oral description of the drawn elements. Results: The drawing technique has several advantages: i. the playful nature of the drawing facilitates the degree of adhesion and interest in the investigation process, ii. it leads to greater reflexivity on the part of the respondents, iii. triangulation of the data from the narratives and the network drawings brings to light some unexpected results: it highlighted which types of support are valued or invisibilized and revealed the important support role of non-humans during lockdown. Conclusions: The complementary use of drawings and narratives allows a more detailed and complex qualitative analysis. However, this method requires investigators to take special precautions before, during and after the field work.

Reconstruction of Daily life: The Lived experience of the Family post-caregiver

Abstract: Contextualization/Justification: Thinking about the family post-caregiver is recognizing the complexity inherent to the trajectory of care. Although the experience of caring has been widely explored, little is known about the experience of the post-caregiver, the reconstruction of their daily life is essential to understand the resumption of life of the family’s post-caregiver. Goal: This investigation started from the question: What is the post-caregivers’ experience in the reconstruction of their daily life? It aims to understand the post-caregivers' experience in the reconstruction of their daily life. This study is based on a phenomenological methodology with an interpretive design embedded in the Interpretative Phenomenological Approach. The eleven participants had been previously accompanied by an Integrated Continuous Care Team. Organization: An in-depth, unstructured interview was conducted, enabling participants to share significant moments after the decease of the person they had taken care of and to share how they reconstruct their daily life. The phenomenon of reconstruction daily life of this participants' is revealed in the dynamic of the simultaneous relationship: with the past, recalling what was experienced, with the present, in the recognition of the self as well as in their continuous response as they return to the world and to life and, with the future, envisioning an imaginary of challenges and uncertainties. It is in everyday life that participants are reconnected with themselves, with others and with the world. Final Considerations: Through this study, nurses will be able to access the lived experience of these post-caregivers and to challenge themselves in the way they provide care, valuing the expertise to pay attention, improving their intervention in presence. The Integrated Continuous Care Teams in the Community Care Units could be challenged to strengthen support networks for family’s post-caregivers in cooperation with other partners and social resources.

Change Management as a requirement for introducing ICT in curriculum delivery - the Gauteng Experience

Abstract: The main objective of this study is to establish the role that change management plays in introducing ICT in curriculum delivery with special reference to Gauteng Province. A desktop literature review and a mixed method approach was adopted to gather information on how change management can impact on the effectiveness of ICT integration, not only in the South African context but also on the global and African context. The study findings were that the support for ICT integration in education is overwhelmingly positive; ICT is seen as having made a positive contribution to education and also noted that more training is required to improve teachers’ competencies in ICT usage. Also, more support needs to be provided to the principals, School Management Teams (SMTs) and School Governing Bodies (SGBs) in terms of training. In order to optimise the results of the change management process in ICT integration into the curriculum, the researcher recommended the following: establish a change management committee whose sole mandate is to ensure an effective integration of ICT projects; ensure sufficient and effective continuous training support to the educators, principals, SMTs and SGBs before, during and after launch of the ICT project. Moreover, the study recommends that continuous evaluation of the change process to assess if intended objectives are being achieved as well as ensuring that undivided buy-in and support from the district and top management are the steps to be observed so that change management process happens effectively in schools. Funding is key to ensure that there is provision of ICT equipment in schools and to invest in the ongoing maintenance and upkeep of the infrastructure.

Thermalism in Portugal: corporate response to the COVID-19 pandemic - Strategy, Safety, Human Resources and marketing approach

Abstract: Framework: Health tourism is currently one of the fastest growing forms of tourism. In Portugal, the “Tourism Strategy 2027” highlighted thermal activity as a means of economic development in the country's regions. On March 11, 2020, WHO declared a covid-19 pandemic. In Portugal, all thermal establishments took the initiative to suspend activity. After the lockdown period the units had to adapt to restart following the guidelines of the health authorities. Goals This study aims to emphasize the spa health tourism sector in Portugal in the context of the Covid-19 pandemic, analyze consumer behavior, and suggest future research on the topic. Paper organization: We present qualitative research, through content analysis using WebQDA software and a bibliometric analysis of co-occurrence of keywords in the thermal field, using the VOSviewer software. The analysis was conducted considering public statements from representatives of 21 units in mainland Portugal, published in the media, as of March 2020. Results: The analyses point to a high appreciated value by the customers to the item safety and to the aesthetic and medicinal treatments. There were no differences in behavior between public and private entities. All regions in mainland Portugal behaved the same way in terms of compliance with the health organization's guidelines, seeking to give the customer more safety and confidence. The training and actions of the human resources were essential to adapt the spas to guarantee strict safety and hygiene rules, as well as the respect for physical distance. In terms of marketing and innovation, the biggest references from the clients are at the product level. Final considerations: The current context of the Covid-19 pandemic favors the use of spas for their curative aspect related to lung problems, post-disease. There are several opportunities for hydrotherapy and research associated with the sector. It is important to draw new lines connected to its potential role in accelerating healing and prevention of coronavirus.

Automatized visualization methods for the qualitative analysis of teachers' collegial discussions

Abstract: In this paper, we discuss a set of procedures for the visualization of conversation data, based on machine learning and text mining algorithms. The methodological function of these visualization methods is to support (rather than substitute) humanistic and interpretive qualitative data analysis. The context of our methodological discussion is the study of teachers’ learning communities. Enabling collegial learning among teachers has been argued to play a pivotal role in both teachers’ professional development and students’ learning. The problem is that the interpretive study of collegial discussions among teachers, which are typically considered a fruitful context for the study of teachers' collegial learning, is both time-consuming and cognitively demanding. Several scholars have discussed the potential of including machine learning and text mining in the toolbox of qualitative data analysis as a way to analyze large qualitative data sets and solve the time demand problem. However, the literature discussing the use of machine learning and text mining for qualitative research typically conceives the algorithms as substitutes for the work of the researcher. These automatized approaches are introduced to categorize the data, substituting the researcher in the analysis process. In contrast, we discuss the potential rewards of using automatized methods to support the analysis of teachers’ collegial discussions. We introduce a set of visualization procedures based on semi-supervised topic modeling and supervised classification algorithms and discuss how these visualizations can provide additional elements useful for the analysis of collegial discussions. Whereas these visualizations do not substitute interpretive analysis, we argue that they can support researchers’ interpretations by reducing data, identifying patterns of interactions, and possibly, visualizing group-level learning.

Bibliographic and content review on the use of technology in people with disabilities during the pandemic

Abstract: The crisis caused by the appearance of the COVID-19 pandemic has caused serious problems in the educational field worldwide. An unprecedented scenario has been generated for people with disabilities or disabilities, which presents major problems such as social isolation, emotional imbalance, and the widening of the digital divide. The general objective of the research has been: "Analyse the scientific production related to the use of Information and Communication Technologies as a means to improve the teaching and learning process of people with disabilities and autism spectrum disorders during the pandemic". A bibliographic, documentary and content analysis of the publications resulting from the international database, Google Scholar, which meet the eleven defined inclusion and exclusion criteria, was carried out, selecting a total of 50 articles. A table of categories was elaborated, with a double methodology: in the first place deductive, through the analysis of the existing literature on the subject analysed, selecting the fundamental categories of study. On the other hand, it is inductive, through the construction of emerging categories that arise when performing data analysis. It has been verified that most of the references are written by a single author, corresponding to doctoral theses that delve into the use of technologies to improve communication and learning of people with visual and hearing disabilities as the most relevant cases, during the period of confinement. caused by COVID-19. Likewise, it has been observed that there are still many difficulties and a great problem in access to information and communication technology resources by this group, requiring greater help from public and private institutions. The findings found show that it is necessary to provide greater access to technologies by the public administration, while physical or motor disabilities should have greater importance in the scientific literature, since they are the least treated.

Nobody listens, nobody wants to hear you: Access to healthcare/social services for women in Canada

Abstract: In Canada, an unacceptable number of women live below the poverty threshold. Some subgroups of women, such as Indigenous, visible minorities, immigrants and refugees, older adults, and single mothers are more likely to live in poverty, as they face multiple systemic barriers preventing their financial stability. Further, socioeconomic status, employment, gender, and access to healthcare and social services negatively impact women’s well-being and health. Yet little is known about how these factors affect healthcare behaviours and experiences for women living on a low income. Our goal is to describe and understand how gender and income influence access to healthcare and social services for women living on a low income. Methods: Partnered with a not-for-profit organization, we explored the experiences of women living on a low income in Kingston, Canada. Using participatory, art-based research and hermeneutic phenomenological approaches, our data collection methods included photovoice, semi-structured interviews and culture circles. A purposive sample was recruited. Analysis was conducted following the social determinants of health framework by Loppie-Reading and Wien. Results: Participants perceived the healthcare and social services systems as unnecessarily complex, disrespectful, and dismissive-one where they are mere spectators without voice. They do not feel heard. They also identified problematic issues regarding living conditions, housing, and fresh food. Despite these experiences, participants are resilient and optimistic. Implications: Learning from participants has indicated priority issues and potential, pragmatic solutions to begin incremental improvements. Changing system design to enable self-selection of food items is one example. Conclusion: For an individual to feel others view them as unworthy of care, especially if those ‘others’ are the care providers, is ethically and morally distressing-and it certainly does not invite system-use. While our early findings reveal considerable system improvements are required, we are inspired by and can learn from the strength of the participants.

The Negative Impact of COVID-19 in Elderly: A Systematic Review

Abstract: Introduction: Early in the pandemic, older people were identified as one of the most vulnerable population. More than 80% of deaths occur in adults over the age of 65. Several conditions have been clearly established to protect the elderly, such as banning visits to nursing homes. Therefore, it is important to fully understand how this pandemic has affected the elderly. This study covers the negative effects on the physical and mental health of the elderly during COVID-19 pandemic. Methodology: A systematic review of the literature to identify COVID-19 papers with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) using PubMed, Google Scholar, Science Direct, BioMed Central (BMC) and Frontier in 2020 and 2021. Included studies are those that investigate the psychological and physical impact on elderly (>=60 years old) resulting from the impact of the COVID-19 pandemic. Unrelated, duplicated, unavailable full texts/abstract-only papers, and studies that analyzed mental and behavioral disorders due to the use of alcohol and other drugs are excluded. Results: A total of 12 studies are included out of 352. Impact of COVID-19 on physical health to elderly were weight loss, lesser time of exercise, decreased social activities, increased respiratory and heart diseases, and increased mortality. On the other hand, identified impact on mental health were higher depression, anxiety, fear of acquiring COVID due to irresponsible younger generations, discrimination and isolation, increased levels of loneliness, and generalized anxiety. Conclusion: The findings summarized in this review suggest that older adults experienced negative consequences for the ongoing pandemic, both physically and mentally. This information will be useful to responsible institutions when acting and making decisions for elderly regarding health care access and public health measures.

Health interventions for self-management: the role of qualitative approaches in mixed methods research

Abstract The long-term success of health intervention programs for self-management is often compromised by the difficulties felt by participants to maintain adherence to prescribed behavioral changes. Mixed methods research can expand understanding and the insights of complex health research problems such as self-management in chronic conditions. The purpose of this paper is to share key contents of a symposium focusing on the application of mixed methods research in the context of person-centered education, held during the 6th World Conference on Qualitative Research. More specifically, it aims at: 1) exploring examples of implementing mixed methods research in health interventions for self-management of chronic conditions and other health risks; 2) promoting insights and knowledge on the ‘why and how of combinations’ in mixed methods studies; and 3) exploring the valuable role of qualitative strands in mixed methods in the wider context of health research. Three studies are explored as examples of application of mixed methods in self-management programs, considering the experiences of participants for changing self-care behaviors and challenges faced for maintaining such changes. Convergent and explanatory sequential designs have been used, combining questionnaires and semi-structured interviews for data collection. Data analysis included procedures such as thematic analysis and descriptive statistics (examples 1 and 3), and thematic analysis and descriptive/inferential statistics (example 2). Results show how mixed methods designs can contribute to develop self-management strategies, to be considered in planning future interventions, and to expand understanding about their impact as well. Likewise, these examples emphasize why mixed methods can bring added value both to process and results of health research. Thus, exploring the application of mixed methods into a wider context is of utmost importance since the complexity of health phenomena is growing and requires equally complex research designs to capture them.

Factors contributing to and preventing mothers of children 1-6 aged from participating in the labour market in Kazakhstan

Abstract: Mothers of young children in Kazakhstan experience challenges to do paid work as the result of flaws in the state policies, motherhood penalty in the labor market and cultural barriers in the family institution. Absence of parental leave for fathers, three years unpaid maternity leave and shortage of state-subsidized childcare services reinforce traditional breadwinner family institution where women are the main caregiver and increase gender inequality. The labor market factors preventing mothers from fulfilling their fullest potential are wage gender gap, discrimination, and employers’ reluctance to hire women of reproductive age, and a lack of flexible work options. Within the family sphere, women in Kazakhstan spend three times more time on unpaid domestic work compared to men and mothers of young children are likely to have higher workload. The research aims to explore the main barriers preventing mothers of children 1-6 aged from participating in the labor market in Kazakhstan. The research applied the qualitative research method and conducted three focus group discussions among 15 mothers of young children residing in cities Almaty in Southern Kazakhstan. The results demonstrate that women face cultural and family barriers to do paid work in cosmopolitan Almaty and experience challenges to enter and remain in the labor market as a result of underdeveloped state policies and motherhood penalty in the labor market. Mothers of children 1-6 aged in Kazakhstan need sufficient number of childcare services for children aged under 3 subsidized by the state, flexible work schemes at workplace and policy incentives for fathers to take paternity leave.

The big challenge out here is getting stuff: How the social determinants of health affect diabetes self-management education for seniors

Abstract: In Canada, diabetes self-management education (DSME) programs are offered to enable individuals with diabetes to successfully implement and sustain lifestyle changes, with the goal of reducing risk of complications and morbidity. Researchers have demonstrated how older adults with diabetes often fail to achieve or maintain diabetes self-management (DSM) competencies, increasing complication risk. Further, little is known about the influence of the social determinants of health (SDH) on DSME, potentially producing additional inequalities for these adults; the WHO defines SDH as non-medical factors (e.g., education; food insecurity) that impact health outcomes. The study goal was to better understand how the SDH affect DSME for older adults living with diabetes. Methods: In our qualitative study we used participatory, art-based, and hermeneutic phenomenology research methodologies. Data collection included photovoice and semi-structured phone interviews. Fourteen older adults with diabetes participated (11 men, 3 women; aged 65 years or older). A SDH framework (Loppie-Reading and Wien) guided the thematic analysis. Results: The findings illuminate how participants live with the effects and pressures of the SDH. Proximal determinants of health revealed in participants’ stories included health behaviours (diabetes self-management practices), physical environments (rurality), socioeconomic status (income), and food insecurity (accessing healthy food). Intermediate determinants comprised health-care systems (accessing DSME in their community) and community resources and capacities (limited infrastructure due to rurality). Distal determinants involved the pandemic (isolation due to mobilization restrictions). Conclusion: Our study demonstrated how the SDH affect DSME and DSM for older adults. Participants were continuously rearranging their diabetes needs to accommodate other life priorities. Additionally, rural living is described as a barrier to DSM, as accessing diabetes education, food, medications, and gas is at a distance-a particular inconvenience during wintertime. Our findings will guide future design, planning and implementation of DSME programs for older adults in this rural setting.

How to care for patients with heart failure - A systematic review of nursing interventions

Abstract: Background: Heart Failure (HF) is a highly dysfunctional disease, with impact on the biopsychosocial dimensions of the patients. The worldwide progressive growth of HF incidence, caused by longer life expectancy, results in higher HF rehospitalization rates. HF patients’ rehospitalization is mostly a result of avoidable causes, including limitations in knowledge regarding HF self-care and impaired therapeutic adherence; therefore, the intervention of nurses is essential. Goals: To identify nursing interventions to address alterations in Basic Human Needs (BHN) and to promote relief of symptoms for HF patients as they transition from hospital to home, including follow-up care. Method: A systematic review in CINAHL and MEDLINE databases to answer the study question: In patients with HF, what nursing interventions help to improve BHN, promote relief of symptoms and aid the transition from hospital to home? Results: Nine studies were included. Nursing interventions focused on relief of symptoms during hospitalization to promote well-being and the individual’s health status. Preparing the patient’s transition from hospital to home earlier in their admission allows for the identification and adequate response to patient needs. Language adaptation during health education and a periodic follow-up were effective measures to promote independence in HF self-care and to reduce mortality and rehospitalization rates. Even though these interventions show positive results, they are not frequently used in clinical practice given a lack of specialized education about HF among healthcare professionals and empowerment culture, as well as an incapacity for adequate patient follow-up. Final Considerations: The nurse is responsible for helping the patient to develop skills to manage their symptoms (e.g., recognize relevant symptoms) and the therapeutic regimen; if successfully achieved, this promotes empowerment, thus reducing readmissions and promoting well-being.

Resumo: Enquadramento: A Insuficiência Cardíaca (IC) tem se revelado uma doença altamente disfuncional, com impacto nas dimensões biopsicossociais dos doentes. O crescimento progressivo mundial da incidência de IC, causado pelo aumento da esperança de vida, resulta em maiores taxas de reinternamentos. O reinternamento acontece sobretudo por causas evitáveis - conhecimento prejudicado no autocuidado com IC e adesão terapêutica prejudicada, portanto, a intervenção do enfermeiro é essencial. Objetivos: identificar as intervenções de enfermagem para satisfazer as Necessidades Humanas Fundamentais (NHF) prejudicadas e promover compensação de sintomas, cuidados de transição do hospital para o domicílio e acompanhamento do paciente. Método: revisão sistemática nas bases de dados CINAHL e MEDLINE para responder à questão do estudo: Em pacientes com IC quais são as intervenções de enfermagem que promovem a satisfação das NHF prejudicadas, promovem compensação de sintomas e cuidados de transição do hospital para o domicílio? Resultados: Nove estudos foram incluídos. As intervenções de enfermagem focadas na compensação dos sintomas durante a hospitalização, promovem o bem-estar e o estado de saúde do indivíduo. Preparar a transição do paciente para casa desde a admissão permite a identificação precoce e a resposta adequada às necessidades do paciente. A adaptação da linguagem durante a educação para a saúde e o acompanhamento periódico revelaram-se medidas eficazes para promover a independência no autocuidado da IC e a queda das taxas de mortalidade e reinternamento. Apesar de apresentarem ótimos resultados, essas intervenções não são tão frequentes na prática clínica, justificadas pela falta de conhecimentos especializados sobre IC entre os profissionais de saúde, cultura de empowerment e incapacidade de manter um acompanhamento adequado dos pacientes. Considerações Finais: O enfermeiro é responsável por ajudar o paciente a desenvolver habilidades para a gestão de sintomas (reconhecer sintomas relevantes) e do regime terapêutico, promovendo o empowerment, reduzindo assim os reinternamentos e promovendo o bem-estar.