Abstract
The Construction of Meaning Around Sickle Cell Disorder in Saudi Arabia: The Hidden Disease
Areej Abunar, Queensland University of Technology/King Abdulaziz University
Carol Windsor, Queensland University of Technology
Joanne Ramsbotham, Queensland University of Technology
Fatin Al Sayes, King Abdulaziz University Hospital
Sickle-cell disorder is a significant health problem that may lead to disability or death and requires critical management and prevention. In Saudi Arabia, where the incidence of sickle-cell disease is relatively high, there is a lack of research on how this disease is experienced in this country. This research sought to explore the social processes that underpin the construction of meaning around sickle-cell disorder in Saudi Arabia. The research was underpinned by theoretical tenets drawn from the traditions of pragmatism, symbolic interactionism, and social constructionism. Data collection and analysis were guided by the constructivist grounded theory methods of Charmaz. Forty individual in-depth interviews were undertaken with doctors, nurses, and parents or caregivers involved in the care of people with sickle-cell disorder. Shaping a reality, the core category generated in the research, represents the social processes that underpinned the construction of meaning of the participants. The dimensions of the experience of sickle cell were contextual and multilayered. The interrelationship of interactions and the social and cultural environment gave focus to the salient issue of the social invisibility of sickle-cell disease and how this positioned patients and carers. Thus, the research generated in-depth insight into how patients, families, and health care professionals worked to make sense of and negotiate the social and cultural dimensions of this disease.
Research and Evaluation Are Not the Same! What Qualitative Health Researchers Need to Know About Programme Evaluation
Jeffery Adams, Massey University
Stephen Neville, AUT University
Research and evaluation are often conflated and qualitative (and quantitative) health researchers often work in both fields without seemingly acknowledging these disciplines are quite distinct. In this presentation, we draw on key evaluation literature and argue that the purposes of research and evaluation are not the same and that qualitative researchers need to be open to acknowledging these differences and adopt different orientations when undertaking research and when undertaking evaluation activities. As well as presenting the perspectives of two qualitative health researchers who embraced this challenge, we present an evaluation model which draws on programme theory-driven evaluation approaches with an emphasis making value judgements as to the quality and success of initiatives. This approach is very suitable for health-related programme evaluation because making value judgements about a programme is a fundamental purpose of evaluation. Within this approach, there is a role for qualitative health researchers—but they must think and act like programme evaluators!
Asian Gay and Bisexual Men’s View on Life in Auckland: Implications for HIV Health Promotion
Jeffery Adams, Massey University
Stephen Neville, AUT University
In New Zealand, nearly one quarter of the gay and bisexual men newly diagnosed with HIV are of Asian ethnicity. However, little is understood about the sociocultural issues facing Asian gay and bisexual men in Auckland, New Zealand (the largest city), how they understand and experience their lives, and their views on sexuality. The purpose of the research was to inform the development of HIV health promotion and social marketing for Asian men. A qualitative study using a descriptive research design using individual, in-depth interviews was undertaken to investigate the views of self-identified Asian gay and bisexual men. Forty-seven men (born in New Zealand and overseas) were interviewed. The presentation outlines the methods we employed to engage with this relatively hard to reach group, including the use of peer recruiting and interviewers of different ethnicities. This research confirms the heterogeneous makeup of the gay community in Auckland. These groups of men expressed conservative views and espoused traditional values. Most of the men identified as gay, and all were comfortable with feeling sexually attracted to other men. Overall, they had limited engagement with the gay community. A number of men experienced discrimination mainly from the gay community, with little discrimination from mainstream society reported. Being resilient was evident in these data and particularly within men who identified as Chinese. A number of implications for HIV prevention and health promotion for Asian gay and bisexual men developed from these research results will be also be presented.
Amplifying Voices of Young People With Participatory Mapping and Photovoice
John C. Aitken, La Trobe Rural Health School
Virginia Dickson-Swift, La Trobe Rural Health School
Jane Farmer, La Trobe University, Bundoora
When discussing issues of health and wellness, it is often difficult to gain the confidence and trust of young people to enrol in community-based participatory research. Photovoice allows young people to control over which images they use to convey their feelings about places which affect their health and well-being. Photovoice provides a bottom-up reflective tool for researchers to use in an attempt to elicit opinions about health and well-being from this cohort. This tool can enhance interviews that elicit information that may not normally be presented without the added visual stimulation of the photos. This project used photovoice and participatory mapping to identify places that affected their health and well-being of young people aged 16–22. Thematic analysis was used for both photos and the narrative participants provided. Places were identified as healthy and unhealthy and were mapped to develop a therapeutic landscape for participants. This project highlighted the challenges of dealing with a cohort that feels marginalised from community activities, does not always regularly attend classes, and has a desire to remain independent and free from the regular constrictions of the structured education system. The results indicate that these students have a desire participate in community discussions and wish to be part of community activities, but lack the confidence, support, and strategies to achieve these goals. These young people need places, they perceive as safe, to develop the social, education, and life skills that will help address these challenges.
Qualitative Analysis and Interpretation of Eye Movements in the Management of Screen-Based Patient Deterioration Scenario
Modi Al Moteri, Taif University, Monash University
Simon Cooper, Monash University
Mark Symmons, Monash University
Virginia Plummer, Monash University
The “look-but-fail-to-see” phenomenon, in which a person clearly looks at important information but fails to actually see it and act accordingly, has been offered as an explanation for critical lapses in various contexts, including road safety and air traffic control. We investigated the situation in which nurses fail to notice cues that would have averted a sometimes fatal deterioration in patient condition. Experienced and novice nurses treated a simulated patient for hypovolemic shock. During the scenario, their eye movements and mouse clicks were tracked using a Tobii × 60 eye tracking system. Immediately post trial, a video recording elicitation interview was conducted in which nurses watched a playback of their own responses and eye fixations and they were asked to explain their behavior and thinking. Qualitative analysis was established by predefining eight Areas of Interest (AOIs) from the digital scenario. Then, from videos that recorded eye movements, the sequence of nurses’ eye movements towards the predefined AOIs was graphically described in a chart as time-related line of symbols. By providing visual identification of the eye movements’ pattern, the existence of a look-but-fail-to-see phenomenon among nurses in a simulated setting was evident. Several types of visual cognition that are manifested by eye movements were uncovered. To gain deeper understanding of the phenomenon, the visual presentations were also supplemented by statements extracted from the interview replies. The visual presentation contextualizes and guides the data extraction from the interview, helps to reduce and summarize the data, and subsequently facilitates the thematic analysis.
Seeing Is Not Believing: The Disparity Between Mental Health Nurses’ Perceptions and Actual Practice
Nofaa Alasmee, Monash University, King Abdul-Aziz University
Wendy Cross, Monash University
Kay McCauley, Monash University
Barriers and Enablers to Falls Prevention in Acute Hospitals: A Multi-Center Study to Inform the Tailoring of the Implementation of the 6-PACK Falls Prevention Program as Part of a Randomised Controlled Trial
Anna Barker, Monash University
Darshini Ayton, Monash University
Patricia Livingston, Deakin University
Sandy Brauer, University of Queensland
Voices of Displacement: Creating Sound Portraits of Identity and Belonging
Alison M. Baker, The Victoria Institute for Education, Diversity and Lifelong Learning, Victoria University
Christopher C. Sonn, College of Arts, Victoria University
In our research, we set out to explore the effects of displacement by examining identity construction and belonging from the vantage point of South African emigrants who left the country to come to Australia following the removal of Apartheid in 1994. To facilitate the process of storytelling, we drew on arts-based inquiry, using material objects such as souvenirs, photographs, and other mementos during the interview process to trigger memories and generate reflection. With the hopes of reaching a broader audience, we sought to create a documentary film developed through the research process. However, faced with challenges regarding participants willingness to be videotaped, we began an iterative process that led us to the development of a new method: sound portraiture. Sound portraiture blends audio-documentary techniques and qualitative arts-based and narrative methods, privileging participants’ voices and conveying the complexity of their stories through the layering of sounds. With our research aims and analysis guiding the process, we attempted to create sound portraits that negotiated the multiple and often conflicting voices, histories, and subject positions that are present as migrants psychologically straddle home and host lands. Similarly, in developing and shaping these stories, we wanted to go beyond creating a singular story and develop sound narratives that speak to the history of colonialism, Apartheid, and the continuities of privilege and oppression in people’s lives. Finally, we make a case for the use of sound portraits as an aesthetic representation of lived experience.
Becoming Amai (Mother) in a Foreign Land: Balancing Childbearing, Child Rearing, and Migration
Sandra Benza, La Trobe University
Pranee Liamputtong, La Trobe University
School of Public Health, La Trobe University
Becoming a mother is a life transition often accompanied by challenges, and these are greater for migrant women in a foreign land. This natural process of motherhood is often enjoyable for the women and their families, but it can be overwhelming if the transition occurs while the woman is attempting to settle in a new country. Australia has an ethnic diverse population with a growing number of African migrants. Despite this, there is limited research about the African women, particularly Zimbabwean women, taking on the mothering role in their new homeland. In this paper, we discuss the lived experiences of being a mother amongst Zimbabwean women who gave birth to child/children in Zimbabwe and in Melbourne, Australia. A qualitative research was conducted with 15 Zimbabwean mothers through in-depth interviewing, drawing, and photo elicitation methods. Data were analyzed using thematic analysis method. Findings suggest that the women coped with two identities: that of being an immigrant and a mother. They had to deal with ideologies of good motherhood that were influenced by their new immigrant status. Our findings confirm existing literature which suggest that motherhood is a significant life transition that can prove challenging when a woman is settling in a new country where the culture is different. Participants in our study expressed varied remarks regarding the role of motherhood while adapting to a new culture. Lack of support from family members was apparent. The unfamiliarity with the healthcare system in the new country was one of the issues raised. Zimbabwean women revealed how lack of communication from healthcare providers had impacted their understanding of the Australian health care system. Surprisingly, most Zimbabwean women did not regret their decisions of making Australia their new home because there was a greater sense of security and stability to access education, health, and housing resources. However, the reality of being a migrant mother was far from their anticipation of an easier life in their adopted country. Our findings have implications for the provision of culturally sensitive health and social services for Zimbabwean women in particular and immigrant women in general.
Philosophical Positioning in Grounded Theory: Striking the Balance
Melanie Birks, James Cook University
Jane Mills, James Cook University
In undertaking a grounded theory study, the researcher must have a high level of self-insight and understanding. Positioning oneself as a researcher means becoming aware of philosophical preferences and methodological alignments. In all approaches to grounded theory research, theoretical sensitivity is an important concept and one that is often difficult to grasp even by experienced researchers. The development of theoretical sensitivity during the research process itself is essential for ensuring an integrated and abstract grounded theory. Theoretical sensitivity is intrinsically linked to the position taken by the researcher and the degree of reflexivity. This presentation will explore the position of the researcher in the context of various grounded theory traditions. Theoretical sensitivity will be defined and discussed in relation to a priori knowledge of the researcher and their familiarity with the literature in respect of the broad area of enquiry. Techniques to enhance and raise the researcher’s theoretical sensitivity will be described and explored in the context of methodological approaches to the use of essential grounded theory methods. The use of techniques to promote a reflexive approach to grounded theory research assures the quality and ethical integrity of the products of the research by identifying how the researcher and their history are present in the research process.
Uncovering Diverse Experiences Following Disaster Using Participant-Guided Mobile Methods
Karen Block, University of Melbourne
Lisa Gibbs, University of Melbourne
Elyse Snowdon, University of Melbourne
Addressing the Complexities of Medication Communication in Hospitalised Children: Methodological Considerations
Narelle Borrott, University of Melbourne
Elizabeth Manias, Deakin University
Carlye Weiner, The University of Melbourne
Ellie Rosenfeld, The University of Melbourne
Communication has a critical role in the delivery of safe patient care. Within healthcare institutions, breakdowns in communication are a major contributing factor of medication events that lead to patient harm. Children are particularly vulnerable to medication events due to their weight and organ immaturity and varying levels of cognitive development and emotional maturity. The aim of this presentation is to examine the benefits of using a variety of data collection methods to reveal the complexities affecting communication processes between hospitalised children, family members, and health professionals of different disciplines. In our study, we used a mixed-methods, “bottom-up” approach to examine medication communication, which included a clinical audit of documented medication events; interviews with hospitalised children, family members, and health professionals; audio-recorded observations of clinical practice; and focus groups with health professionals. Each data collection method enabled a different perspective to be considered. The clinical audit facilitated examining the linkages between actual medication events with associated problems relating to communicative processes. Interviews provided information about perceived barriers and facilitators to effective communication from the perspective of particular individuals. Observations revealed how actual communication encounters and contextual influences affected medication communication. Focus groups with health professionals facilitated a process of reciprocity to determine taken-for-granted perspectives of how medication communication occurs. Using a mixed-methods approach in medication communication provided rich data in considering the complexities of sociocultural and environmental influences and actual communication encounters on medication management, and their links with the occurrence of medication events.
Exploring Trauma Survivors’ Experiences of Accessing and Using Health Services for Recovery
Sandra Braaf, Monash University
Belinda J. Gabbe, Monash University
Nicola Christie, University College of London
The impact of major trauma has long-term consequences with disability prevalent in patients at 2 years postinjury. Maximising recovery and independence is dependent on appropriate access to treatment and disability services. However, little is known about patterns of recovery and health service utilisation and how these change over time. This study aimed to explore trauma survivors’ experiences of accessing and using health services in the community setting. Semistructured telephone interviews were conducted with 60 hospitalised major trauma patients 3 years after injury. Participants were recruited from the Victorian State Trauma Registry. Purposive sampling was used to ensure representation by gender, compensation status, region of residence, and care delivered at major and nonmajor trauma services. The interviews were audio recorded and transcribed, and thematic analysis was performed. Participants reported varying levels of need for, and satisfaction with, health services provided by general practitioners, physiotherapists, occupational therapists, psychologists, and surgical specialists. They perceived their recovery from serious trauma to be unique and not always well understood by health providers. Many experienced difficulty accessing health services owing to regional locations and due to ineligibility for funding by government and compensation agencies. Most participants reported being responsible for the coordination of their own health care, despite reporting limited knowledge of available health services and difficulty matching their needs to suitable health care providers. The onus of care coordination in the community setting rested largely with injured patients. These findings suggest the recovery continuum for seriously injured patients could be facilitated by informed care coordinators.
I’m Gonna Tell You a Story: Exploring the Pitfalls and Possibilities of Qualitative Story Completion Methods
Virginia Braun, The University of Auckland
Victoria Clarke, University of the West of England
Naomi Moller, Open University
The field of qualitative data collection is fertile for innovation, and story completion, a technique rarely used in qualitative research, offers an exciting alternative to self-report measures. Story completion was initially developed as a projective technique to uncover “hidden” or unconscious meanings in clinical practice. People are provided with the start of a story (the story stem/cue) and are invited to complete it. First proposed as a method of qualitative data collection in 1995, we have explored story completion and suggest it has much to offer qualitative researchers. It is particularly suited for use by researchers (such as students) who are both time and experience limited, and given appropriate research topics and questions, offers the potential of generating data that are as rich as those generated by more commonly used “interactive” methods such as interview or focus groups. Stories can be interpreted as providing access to psychological or social meanings around the topic. In social constructionist story completion research, data are theorised as reflecting (dominant) sociocultural discourses surrounding the topic of interest, rather than deep psychological motivation. Drawing on our research, we overview this approach, highlighting key design decisions, analytic strategies, and some of the challenges presented by the technique.
Engagement and Participation of Men in Mediation
Katherine Britton, University of Western Australia
The focus of this presentation is on a critical case analysis of one man’s experience of Family Law mediation. The aim is to inform mediators’ education and training in order to contribute to the development of more meaningful postseparation relationships for all the family members. It is part of a qualitative study that examined parents’ perceptions of the effectiveness of Parenting Plans. Twenty-three separated/divorced parents (12 females and 11 males) in Western Australia participated in semistructured interviews. The critical case was analysed in the light of the sociopolitical factors that impacted on the development of mediation services, some men’s patterns of professional help seeking and understandings of men’s grief following separation/divorce. These factors can have direct application to men’s participation in mediation. This critical case analysis has the potential to add to an emerging area of research.
Inclusive Qualitative Research With People With Intellectual Disability: A Systematic Mapping of the Field
Katie Brooker, University of Queensland
Kate van Dooren, University of Queensland
Allyson Mutch, University of Queensland
Inclusion is a right of all members of the population, but for people with intellectual disability this right is strengthened by international declarations such as the United Nations Convention on the Rights of Persons with Disabilities. Acknowledging this right, researchers must be actively committed to inclusive, rigorous, and appropriate methods that engage with and capture the views of this population group to inform understanding of their lived experiences. Inclusive research accommodates difference, including communication differences; facilitates and supports the process of active informed consent; uses broad-based recruitment practices; and genuinely engages participants. This inclusive approach is further informed by a social model of disability which acknowledges that disability occurs when environments do not accommodate difference and that action and reasonable accommodations must be made by researchers to correct this. In accordance with this approach, we systematically mapped the literature to identify the approaches being used to conduct inclusive qualitative research engaging people with intellectual disability. In the first study internationally to consolidate and critique the use of qualitative methods with this population group, we found researchers generally made some accommodations through language, questioning style, and the use of visual materials and communication aids; however, few studies took a comprehensive approach to inclusion, while some were extremely limited, continuing to focus on the views of family members and staff rather than individuals. A handful of studies provided noteworthy examples of inclusive practice, while alternative or novel methods, such as photovoice, were flagged as areas warranting further consideration.
Narrative Inquiry With Immigrant Fathers: A Flexible Methodology
Elizabeth Burgess-Pinto, MacEwan University
The process of migration produces transitions and disruptions in the dynamics of family life including changes in roles and relationships. In general, there is very little research on father/daughter relationships from the perspective of the father. In a narrative inquiry study, I sought to understand the research puzzle: How do newcomer fathers story and restory their relationships with their adolescent daughters during the processes of migration and settlement? I collaborated with three newcomer fathers using conversation and dialogue to develop a storied view of their experiences. The inquiry followed a recursive, reflexive process within the conceptual framework of the commonplaces of temporality, sociality, and place. The fathers shared their stories of being the father of a daughter transitioning through adolescence and to Canada. In keeping with the relational ontology of narrative inquiry, I shared memories of my immigration experiences and of my memories of my father. From the narrative accounts of the fathers, from the experiences they shared, I pulled narrative threads that reverberated across their stories. Four common threads emerged: (1) liminality, (2) the resonance of mothers, (3) fatherhood as an intimate relationship, and (4) information and communication technologies. The fathers’ stories highlight the need to focus on making space for voices that are rarely heard in research and nursing. The relational process of narrative inquiry which focuses on the discovery of insight and understanding can influence nursing which is also a reflective, negotiated practice.
Practice-Based Qualitative Research: Experiences of Walk In Counselling and Traditional Counselling
Cheryl-Anne Cait, Wilfrid Laurier University
Michelle Skop, Wilfrid Laurier University
Jocelyn Booton, Wilfrid Laurier University
Carol Stalker, Wilfrid Laurier University
Long waiting lists for mental health services in Ontario, Canada, are common. Community-based agencies have increasingly turned to the walk-in counselling (WIC) model to reduce wait times and improve accessibility. The WIC model has challenged long held conventions about how organizations provide service. This qualitative analysis of a smaller sample selected from a larger study looks at the effectiveness of the WIC model and examines the role of practice-based qualitative methods in mixed-method research. Using a sequential explanatory design, collection of quantitative data and analysis constituted the first phase of the research, with qualitative data collection and analysis following. This qualitative inquiry used a multiple case study design with a sample of 48 participants, interviewed over the phone using a semistructured interview guide. A thematic analysis was conducted, starting inductively allowing us to openly hear the words of participants. Construction of Life Circumstances, the overarching theme, included personal histories and experiences. A participants journey through and experience with both models of counselling was characterized in four interconnected ways: accessibility; barriers and/or facilitators which influence a person’s ability to obtain and receive services; meaning of service, participants way of making sense of the service; and readiness for service, the degree to which a participant is motivated and able to commit to and engage in counselling and system failure, not meeting participants needs once engaged in service. Findings challenge accepted knowledge about how services are delivered, providing an alternative discourse of what is considered helpful.
Youth Participation, Power, and Ownership in an Action Research Doctoral Project
Maggie Callingham, Victoria University
Research that is predicated on democratic principles attempts to position participants as active partners in the research process. Youth Participatory Action Research (YPAR) is an example of democratised research that seeks to move beyond participants as subjects, and beyond tokenistic participation, to integral participation where youth are coresearchers with a vested interest in the research process and its outcomes. However, participation, power, and ownership, which are central tenets in democratised research, can become constrained when doctor of philosophy (PhD) candidates undertake democratic, participatory forms of research. Constraints around participation, power, and ownership in an action research doctoral project initially arise because doctoral researchers are required to formulate their projects through the university candidature processes before fieldwork commences. There are also tensions around democratic tenets because it is through their doctoral projects that PhD candidates are required to demonstrate their capacities as researchers, as opposed to coresearchers. The presenter’s own doctoral study, that involved an YPAR project in a school, is drawn on to highlight the accountability tensions between compliance with institutional requirements and a commitment to democratic principles. Hart’s Ladder of Participation (1992) was found to provide a helpful reference point upon which to monitor the democratic, participatory integrity in an action research doctoral project. According to Hart (1992), there is a substantial difference between youth participation on adult terms and democratic youth participation; it can be the difference between tokenism and active citizenship. PhD candidates who undertake democratic, participatory forms of research are faced with having to negotiate these differences.
Family Members Experience of Facilitated Family Presence During Resuscitation
Erla Champ-Gibson, Washington State University
Roxanne Vandermause, Washington State University
Cynthia Corbett, Washington State University
Billie Severtsen, Washington State University
Family presence during resuscitation (FPDR) is not a new topic in health care. For 30 years, there has been discussion around the risks and benefits of having family members present during resuscitation. During that time, numerous research studies have been done from the perspective of nurses, physicians, patients, and family members regarding their biases, experiences, and preferences related to family members being present with the patient during resuscitation. Studies conclude that being present is a beneficial experience for the family member, the patient, and the staff. A key component of FPDR is the presence of a family facilitator to be with the family throughout the experience. There are recommendations regarding the responsibilities of the facilitator, but its practice is inconsistent and there are no studies on the effectiveness of the facilitator. An aspect of family presence that has not been studied is the family members’ experience of facilitated FPDR from a 3-month postevent perspective. A philosophical hermeneutic research approach was used to explicate family members’ experiences of facilitated FPDR. Interviews were conducted using a conversational dialogue that evolved from an opening statement and question. Transcribed interviews and interpretive analyses comprised the data that produced patterns and themes that will be presented in this presentation. Results will inform the ways in which family facilitators influence family members experiences while present during resuscitation on a loved one. This study contributes to the most recent literature on family-centered care associated with care in life-threatening situations.
Is Philosophical Hermeneutics Still Useful in Today’s Pragmatic Qualitative Research Environment?
Erla Champ-Gibson, Washington State University
Roxanne Vandermause, Washington State University
In recent years, qualitative research has gained recognition in contributing useful knowledge to enhance practice. There has also been an increased push for generalizable methodologies resulting in practice interventions. However, in this research, environment of pursuing knowledge and evidence-based research as an end result, the question arises, is there still a place for the simplistic pursuit of what shows itself in interpretive research? Critical to understanding how a person experiences an event is understanding the temporal location of ones being during an experience and the language used to communicate that experience to another. The historical philosophical underpinnings of time, being, language, and dialogue shape and influence not only the research and interpretive process but also the dissemination of the findings. When philosophical hermeneutic research findings are shared, approaches to a shared dilemma innately stimulate a sense of greater understanding on the part of the audience. In the moment of understanding by practitioners, adaptations to interventions and practice are immediately inferred. With the use of multiple methodologies in qualitative research today, maintaining and preserving a deep understanding of the core components of interpretive research will help to preserve its ontological foundation. This presentation will demonstrate the relevance of a philosophical hermeneutic research approach by exemplifying how a deeper understanding of a phenomenon can inform and change practice.
From “Journey” and “Story” to Music: An Alternative Metaphor
Gary Chitty, Deakin University
“Journey” and “story” metaphors are frequently used for qualitative research findings. The findings of the author’s doctor of philosophy, “Learning in Network Organisations,” reveal the inadequacies of these conceptual devices, leading to alternative interpretive constructs. Concepts associated with music are identified as more appropriate portrayal metaphors. Rapidly changing workplace environments have prompted the need to redefine boundaries to describe knowledge acquisition. Constructs of learning such as experiential learning, the learning organisation, and learning network theory assume story-like qualities, with characters, plots, settings, and dialogues. Literature frequently adopts a case study, story form portraying journeys from one stage to another. Conventional workplace learning theory often refers to single social hierarchies, with organisations comparable to the social milieu of stories. In contrast, a network organisation typically identifies internal core functions and loosely coupled activities that might be performed by other organisations which become “network members,” connected by information and communication technologies. In the absence of a single organisational culture, and with minimal face-to-face communication, the problematic portrayal of a story is replaced with varied modes of expression, linguistic nuances, cultural interpretations, and dysfunctions. These elements of organizational discourse are more typical of contemporary music composition than of “stories of journeys.” Contemporary linguistic literature refers to musical elements of discourse which are highly relevant to organizational communication. To describe learning in network organisations, concepts associated with music such as aesthetics, harmony, discord, context, dynamics, and form are applied as interpretive constructs to establish meaning.
Working Together: Internationally Qualified Nurses Working in the Australian Health Care System
Ylona Chun Tie, James Cook University
Melanie Birks, James Cook University
Jane Mills, College Healthcare Sciences, James Cook University
Nursing is a global workforce. Australia’s attraction from a lifestyle perspective, coupled with nursing shortages worldwide, has seen the recruitment of overseas trained registered nurses to work in this country. The aim of this study is to explore factors that contribute to the assimilation of internationally trained registered nurses into the Australian healthcare system and to develop a theory of the process of that adaptation. This presentation reports on a doctoral study employing a grounded theory research design. Australian registered nurses and internationally qualified registered nurses are the focus of the study. As grounded theory is an inductive methodology, participant recruitment is guided by the data analysis and theoretical sampling of data including healthcare system stakeholders and relevant documents. It is anticipated that the outcome of this study will assist nurse leaders, educators, and policy makers to better understand the process that overseas trained registered nurses undergo to assimilate successfully into the Australian healthcare workforce. Through developing an explanatory scheme of the process of assimilation and adaptation, this study will produce recommendations that will enhance the environment for registered nurses.
Report Writing as an Integral Part of Research Design: Reflections on Contrasting Re-Presentations Derived From the Same Data
Tim Clement, Southern GP Training and Deakin University
This presentation compares two written outputs from the same study, where the overarching research question was, “What happens during ad hoc supervision of General Practitioner (GP)-registrars?” Ad hoc encounters are one of the main mechanisms for ensuring patient safety in general practice training, where trainees are required to seek timely support from their on-site supervisor. The first output was a lengthy report for the project’s funders, structured around five descriptive case studies. The findings were presented in an orthodox manner, where the textual data were disaggregated into fragments and then regrouped and presented in a series of thematic headings. The second paper was written for an academic journal, a secondary analysis of data from one of the five original cases. The article was structured using data from just one “complete” ad hoc encounter; represented as an extended data sequence with an accompanying interpretive commentary. In the presentation, we examine the methodological interests that we had in writing these contrasting accounts. We explore the key issue of representation for academic and practitioner audiences and suggest that report writing is too often marginalised, rather than being an integral part of research design. We offer our reflections on the methods and styles of writing that are routinely done and approved for publication as a challenge to researchers and editors of mainstream academic journals about research designs and what gets published.
“There Is Method in It”: Re-contextualizing an Analytical Framework Adapted From Systemic Functional Linguistic Theory
Rosemary Clerehan, Monash University
Rachelle Buchbinder, Cabrini Institute, Monash Department of Clinical Epidemiology & Monash University
Francis Guillemin, University of Lorraine, University Paris Descartes
One area of practical usefulness for revisioning applications of theory is in improvement of healthcare texts for the general public. Such texts can be of life-and-death importance for readers and are arguably not an appropriate locus for experimentation with atheoretical approaches. Empirical investigation of real-world issues has been an area increasingly dominated by applied linguistics since the so-called linguistic turn in the 20th-century qualitative research. Systemic functional linguistic (SFL) theory has been extensively used for analysis of spoken, written, and multimodal texts. Its application to different fields and genres is its strength, such that nothing is lost by its adaptation to new fields and modes, and there is much to be gained. It is concerned with the interaction of text and context, providing analytical tools which can be used to evaluate the suitability of a text for its purpose. Three dimensions of a situation are identified as impacting on language: the mode of communication, the relationship between the participants involved, and the topic or focus of the activity. In recent years, SFL has been used for investigating the quality and perceived usefulness of drug information leaflets, using the evaluative linguistic framework (ELF; e.g., Hirsh et al., 2009), which has yielded insights not afforded by other methods. We have begun to explore how the ELF can be adapted for use on healthcare questionnaires (O’Neill, in press) to assess their appropriateness for the target audience. The relative ease with which this can be done illustrates the rigour of the theory.
Real-Time Netnography: Rejecting the Passive Shift
Leesa Costello, Edith Cowan University
Marie-Louise McDermott, Diverse Productions
Although netnography emerged in the 1990s, it is a term unfamiliar to many ethnographers and is still touted as a new methodology. Once explained, ethnographers often understand it in terms of online ethnography. While this is helpful, netnography, however, offers a set of steps and analytic approaches that can be applied across a spectrum of involvement online. Its focus is on gaining entree to an online community, distinguishing between participant observation and nonparticipant observation. The idea of netnographic enquiry implies a need for human presence in communication, involving the netnographer in a mutual text. It necessarily shares the research role with participants, as they require and acquire information. Both parties contribute to a continuous dialogue. While our netnographic approach requires researchers to implant themselves in the online environment, freeing themselves from preconceived ways of knowing, we contend it is the frameworks which underpin the research purpose that should be kept in reserve for checking against final interpretations. We hold that the term netnography is becoming devalued in ways that give rise to both misperceptions and missed opportunities regarding the development and management of sustainable online communities specifically. Passive nonparticipatory netnographic studies seem to be the most popular, where lurking and monitoring in online communities is seen to imply that analyses are carried out naturalistically and free from researcher bias. This rather touching belief and the convenience of passive monitoring may be threatening the premise upon which netnographic methodology retains its qualitative rigour.
Attuning Joyfully in Kairos Time at the Moment of Birth
Susan Crowther, AUT University Auckland NZ
Growing from concern that something of significance at birth is hidden or lost, this presentation explores the experience of joy at the time of birth. The Heideggerian notion of attunement reveals how those present at birth find themselves attuned in certain ways that determine how birth is interpreted and understood as meaningful. Stories of birth collected and analysed using hermeneutic phenomenology from mothers, birth partners, obstetricians, and midwives revealed attuned joy across professional groups and in different types of births and locations. Joy was revealed as shared embodied, spatial, and essentially gathering experience. Coalescence of these emergent themes reveals deepening insights of a moment involving numinous encounters in and beyond clock time named Kairos time. This is a time of unexpected profound insight. Relational encounters deepened at birth out of an overwhelming joy; a joy providing profound meaning that provokes further thinking about how modern maternity care is collectively attuned. Kairos time at birth needs safeguarding, as this time is something precious. This is rarely spoken, taught, or written. This paper argues that sensitively attuning to Kairos time at birth, in all locations and types of birth, allows for something shared and extraordinary to unfold. To feel at the moment of birth is an invitation that beckons us all to be there in tactful ways. The findings of this study unfolded poetically. The presentation ends with how poetry gifts knowing that prose alone is unable to do. Ethical approval was gained through Auckland University of Technology Ethics Committee, New Zealand.
Taking Another Look: A Reflection on the Benefits and Challenges Involved in Conducting a Secondary Analysis of Qualitative Data
Christine Cummins, AUT University
Nicola Kayes, Centre for Person Centred Research, AUT University
Deborah Payne, Centre for Midwifery & Women’s Health Research, AUT University
Secondary analysis involves the use of existing data to pursue research questions other than the primary study it was collected for. It is being increasingly advocated as a pragmatic use of research, an accelerated approach to answering a research question, and as a way of relieving the burden of participating in research for vulnerable, hard to reach, or over-researched participant groups. Secondary analysis also provides for an additional in-depth analysis than was taken in the primary study. It can provide an opportunity to explore topics not central to the original research; combine data sets from similar studies with the same population; examine health issues across illness groups, time and space; and/or allow data to be viewed from a different conceptual lens. Such analysis however poses epistemological, ethical, and practical challenges for the qualitative researcher. The importance of context and the embeddedness of the researcher in the coconstruction and analysis of qualitative research are two of the challenges that need to be grappled with. When a secondary analysis is conducted by researchers associated with the primary study much of these concerns can be addressed; however, this closeness to their original study brings its own challenges. This presentation will explore some of the challenges experienced when applying an alternate theoretical perspective to data exploring participant perspectives of the therapeutic relationship in neuro-rehabilitation.
Digital Storytelling in Research: The Exploration of Power Inequities
Nadia De Vecchi, La Trobe University
Amanda Kenny, La Trobe Rural Health School, La Trobe University
Susan Kidd, Psychiatric Services Professional Development Unit Bendigo Health
Participatory research methods aim to generate new knowledge resulting from a broad, inclusive approach. These methods are useful to change organisational culture, but tackling issues of power and inequality are central. Critiques of many participatory approaches claim that power and dominant discourses can be perpetuated by the approach. This can occur through the inability to create a reciprocal and respectful space where participants can constructively address power imbalances and inequality. This presentation examines the use of digital storytelling as a participatory research method that is useful to explore power inequities. Digital storytelling is a process of presenting a personal narrative of experience in a multimedia format with voiceover, visuals, sound effects, and music. The aim is to produce a deeply moving personal story of experience that can be used to generate dialogue about the story subject. The group process of digital storytelling production offers the opportunity for participants and researchers to reflect deeply on what is articulated in the group. Using examples of digital stories that were created to examine culture in mental health services, digital storytelling is explored as a contemporary method for the coproduction of knowledge, and a tool that encourages participation in research.
Building Rigour Into Action Research: Experiences From a 5-Year Evaluation of Health in All Policies in South Australia
Toni Delany, Southgate Institute for Health, Society and Equity, Flinders University
Fran Baum, Southgate Institute for Health, Society and Equity, Flinders University
Angela Lawless, Southgate Institute for Health, Society and Equity
Policy-orientated action research is designed to understand policy process as well as to shape it. Such research must be flexible enough to deal with shifts in policy context but also sufficiently structured, and rigorous, to produce meaningful findings that can reliably inform future policy action and contribute to general understanding of policy. The paper will discuss how we have achieved a balance between flexibility and structure within a 5-year evaluation of the South Australian Health in All Policies initiative. The design of the research is based on a participatory approach where policy actors are included both as participants in the research design and as informants. We will examine how this has helped to ensure the responsiveness of the research, while also creating the need for the sometimes divergent agendas of researchers and policy actors to be negotiated. The research is also based on a multimethod approach tailored to ensure that it remains flexible enough to cope with the rapidly changing policy context while also satisfying the research aims and objectives. The role of theory in supporting action research will be addressed through a discussion about how we have applied theory to inform our analysis of policy practice, to understand the policy process in general, and to support the research approach being applied. The presentation will demonstrate how the traditional conventions of qualitative rigour can be upheld during contemporary policy research to strengthen the practical relevance and theoretical validity of the findings that are produced.
Undertaking Qualitative Research on Sensitive Topics: Researchers Experiences
Virginia Dickson-Swift, La Trobe Rural Health School, La Trobe University
Qualitative research is often an emotional journey—not only for the participants but also for others who may be involved along the way. There is growing evidence that researchers, research supervisors, transcriptionists, and research assistants can also be emotionally challenged whilst participating in qualitative research, particularly research that focuses on sensitive topics. It is now more than 20 years since Raymond Lee authored the seminal works Doing Research on Sensitive Topics, Researching Sensitive Topics and Dangerous Fieldwork highlighting that researchers may face a range of challenges throughout their research projects. More recently, he warned that “the emotional challenges that researchers face when doing fieldwork is now difficult to ignore” (Lee, 2012, p. 114). Given Lee’s warning and the growing numbers of reports from researchers both empirically and anecdotally, an empirical study to investigate these challenges was warranted. Drawing on earlier empirical work with researchers in Australia (Dickson-Swift, 2005), an international study focusing on the experiences of researchers was designed. This presentation will report on preliminary findings from this study that aimed to explore the challenges that researchers using qualitative methods have faced in the conduct of their research. Using an open access blog, personal accounts were solicited from researchers using qualitative methods. Early analysis of blog postings highlights the many challenges that researchers face. These findings will be useful to assist in the development of safety protocols for those undertaking qualitative research.
Using Ethnodrama to Create an Interactional Intervention as Part of Modelling in Complex Intervention Research Design
Sue Duke, University of Southampton
Sally Anstey, University of Cardiff
Sue Latter, University of Southampton
This paper reports our experience of using ethnodrama to model an interactional intervention designed to support family carers managing the pain medicines of people with advanced cancer, part of a Phase I and II study Cancer Carer Medicines Management. First, working with clinicians, we mapped the research evidence and interview data gathered from clinicians, patients, and unpaid carers onto our theoretical model. Second, we organised this mapping onto a typical narrative structure of professional conversations to produce a draft “script.” Third, we performed the script to a group of experienced palliative care nurses, rehearsing it until the nurses were satisfied that it was clinically authentic and the researchers were satisfied that it included the initial research findings. The interaction was then video-recorded, transcribed, and analysed for content, process, and plot. From this analysis, we produced a script: an interactional, coherent vehicle for each component of the resulting complex intervention. The analysis of the video-recorded script enabled simplification of interventional components (the interventional plot) in a mnemonic (which will aid the clinical delivery of the intervention) and description of the parameters and purposes of each interventional component. To our knowledge, this is the first time that ethnodrama has been used to design a complex intervention and provides an example of established qualitative methodologies coexisting within the boundary of experimental research design. Ethnodrama provided an interactive and collaborative process of modelling a clinically authentic, well-described intervention.
Introducing Creative Insight Method: Using Arts-Based Processes to Explore and Reveal Individual and Shared Understandings
Jane Edwards, Deakin University
Arts-based research practices have been used in the social sciences since the 1990s. Patricia Leavy (2009) has defined arts-based research practices as “a set of methodological tools used by qualitative researchers across the disciplines during all phases of social research, including data collection, analysis, and representation” (p. ix). Arts-based research involves a range of art forms such as poetry, music, drama, dance, or visual art. These are used to explore and process topics and themes offering a dynamic means for increasing insight and understanding. In this paper, the author will introduce Creative Insight Method which she has developed over many years of group facilitation and qualitative research studies with healthcare students, health practitioners, and academic colleagues as well as supervision of doctor of philosophy studies using arts-based methods involving service users. The method will be elaborated with examples and consideration of the processes of involving people in arts interaction who may not have experience in creative expression or collaboration.
How to Meet Household Challenges and Strengthen Service Users’ Housing Competence?
Rita Elisabeth Eriksen, Diakonjemmet University College
This presentation is a part of an educational and developmental study, which took place in Norwegian municipal social services (MSS). The study focuses on why housing competence is central to people’s lives and how users coping with household challenges may be strengthened by user participation and task-centered coping approaches (TCCAs). The research question was: How did the users experience their housing competence and everyday life situations when terminating their collaboration with the professionals? The design was based on a way of participatory action research, where the researcher was positioned as a partly participating researcher. The researcher tried to (1) attain knowledge from the individualized activities of the users and professionals and (2) use this knowledge as a contribution to developing their practice. Individualization meant matching the approaches of the professionals to the experienced needs of the individual user. Seventy-four users from four MSS were recruited. The informants were struggling with addiction and/or mental health challenges. This presentation is based on forms of retrospective self-evaluation, which the users filled out after their collaboration of TCCA. The data were collected without the researcher’s influence. Their assessments emerge from the evaluation. However, the researcher has chosen quotations from the informants and consecutively made her evaluations of them. The study showed that the group of informants was very heterogeneous. Adjustments to the systematic household guidance of the users on an individual level were vital to succeed. The presentation will explore the key research findings. The users’ own experiences and views will form a central aspect of this.
Understanding Demand for Indigenous Tourism in Australia: A Case Study Using a Photo-Based Methodology
Trinidad Espinosa-Abascal, Victoria University
Martin Fluker, Victoria University
Min Jiang, Victoria University
Tourism is often suggested as a promising development strategy for assisting indigenous communities achieve economic independence, improving general living conditions while also protecting the culture and natural resources. However, without adequate visitation, the good intentions of tourism policy cannot be achieved. In Australia, visitor participation in indigenous tourism is very low. Existing studies for indigenous tourism in Australia tend to be limited to investigating domestic demand, with the majority of previous research taking a quantitative approach. In order to fill this research gap, this study adopts an innovative approach to investigate domestic visitors’ tourism activity choices at the Grampians National Park, Victoria. The research used a mixed-methods approach under a qualitative framework in a case study involving 52 domestic visitors. The methods included an on-site survey instrument used to collect demographic data; a photo-based sorting ranking procedure to understand visitor intention to participate in indigenous tourism, and semistructured interviews using the photo-based sorting ranking procedure as a photo-elicitation technique to explore the motivations for, and barriers to, engaging in indigenous tourism. The results reveal that by using a qualitative approach with an innovative tool, a deeper understanding of the visitor motivations and barriers can be achieved. The present research contributes to the advance of the knowledge on motivations and barriers in regard to indigenous tourism. With this new knowledge, strategies can be developed to increase participation in indigenous tourism that will result in economic and social benefits for communities.
Boundary Riders
Doseena Fergie, Australian Catholic University
Alicia Evans, Australian Catholic University
Nerida Blair, Australian Catholic University
Indigenous people’s experiences of education at all levels and in all countries have been well documented as being fraught by institutional racism and divergent experiences. Different ontological and epistemological centres and frameworks play out in a contested space. When indigenous higher degree students embark on a journey engaging postgraduates, research-divergent views and experiences emerge. Place a non-indigenous supervisor and an indigenous cosupervisor on the journey and cultural perspectives form a kaleidoscope of interesting dialogue. This presentation will story each of the travellers individual journeys as well as the different places where all travellers meet. The journey’s focus is centred on the students research which engages Victorian Aboriginal women in their stories about postnatal depression. The presentation will employ performative dialogue or storying, embodying a key element of indigenous ontology and research methodology. Through Yaninonyin, the travellers will story the challenges, the highlights of each and all true collaborative research. They will showcase negotiating the boundaries in truly contested spaces. Will each of the three performers submit to the other? Come and hear the informative dialogue and illustrations that demonstrate that research can be bounded in its methodologies. In that they can be neocolonial and paternalistic, having the potential to do harm and provide little benefit to Aboriginal and Torres Strait Islander peoples or, on the other hand, have the potential to be boundless and culturally appropriate.
Developing Action Research to Improve the Use of Online Learning Platforms
Lydia Forsythe, Londes Strategic Healthcare Consulting; Walden University
Online learning platforms can be robust course rooms encompassing many electronic tools to engage students in the process of learning. So the questions to ask are how will the use of new technology increase student engagement in a course, how effective are the course delivery methods in assisting students in meeting course learning objectives, and what specific changes in course delivery methods encourage student engagement and learning? A way to approach these questions is to involve the end user, the students. Using action research and the communication theory, the Coordinated Management of Meaning faculty can partner with the students to gain perspective and insight as to what makes an online course room effective. By creating mock course rooms to compare and contrast the use of new tools and new types of assignments, faculty course developers can partner with students to develop enhanced learning experiences. Given students have to be able to engage and use course room tools within the context of assignments, students need to be involved in the development of courses. This research creates a space to define a partnership in learning where both the faculty and the students create reflective practice by sharing knowledge and experiences related to the online learning environment.
“I’m Still a Person … and I Have an Opinion”: Novice Researchers’ Experiences of Engaging With People With Communication Impairments Within a Social Constructivist Paradigm
Abby Foster, The University of Queensland
Lucette Lanyon, La Trobe University
Lucy Knox, La Trobe University
Communication difficulties, such as those resulting from stroke or brain injury, have the potential to restrict an individual’s capacity to participate socially. These difficulties—the result of cognitive and/or linguistic deficits—may manifest in impairments in written and verbal expression, understanding the spoken word and reading, or difficulties with memory, sequencing and planning for language. Despite a stated purpose of qualitative research being to provide a voice to vulnerable populations, people with communication disorders are frequently excluded from research participation. This has the potential to exacerbate the experience of voicelessness and limit the capacity for their experiences to be understood. As novice qualitative researchers with backgrounds in clinical speech pathology, the authors believe in the potential value of including this population in qualitative research studies. This presentation will explore the authors’ experiences in undertaking research with participants with communication disorders, within a social constructivist epistemology. Using examples from interview transcripts of three separate research projects, interwoven with quotes from the researchers’ field notes and reflections, the challenges, experiences, and value of combining this epistemology with this population will be explored. In particular, three key areas will be discussed:(1) the experience of exclusion for people with communication impairments, (2)the additional challenges associated with coconstructing meaning with people with communication impairments, and (3)learning and doing at the same time within a social constructivist paradigm.
Beyond the Bounds: An Exploration of the Intersection Between Narrative Medicine and Narrative Research
Margaret McAllister, Central Queensland University
Ann Framp, Central Queensland University
Narrative medicine, an approach to health care that recognizes the value of listening and responding to people’s stories of illness and recovery (Charon, 2005) and Narrative research, a collection of methods that explore how human beings come to understand and give meaning to their lives through story (Squire et al., 2014), have different objectives but shared benefits. Both have potential to produce perspective transformation in their participants and audiences. Both can vividly embody and humanise an experience, making its meaning accessible to others who may not otherwise understand. Both can trigger profound changes in the way people and systems interact and come to know their worlds and enact changes. Both can evoke an understanding for how experience is contextualised at personal, institutional, and social levels. An innovative approach to narrative research as it has been applied within the context of nursing will be discussed in this presentation. We reflect on narrative’s transformative power for disciplines such as nursing which are replete with stories of suffering but also courage and resilience. We consider what can be achieved when these stories are powerfully explored and conveyed using narrative methods. We draw upon a narrative research project that has used narrative methods to yield and reconstruct pivotal stories of health care experiences from a group of people afflicted by a devastating illness known as hereditary diffuse gastric cancer. The objective of this project was to produce stories that could become transformative narratives for nursing—sensitising listeners to each story’s lessons for practice and empowering participants to have their say about their unique and personal illness-adaptation experience so that clinicians would understand and approach their work in the future appreciating the value of an empathic orientation and deep listening. Our experience in this research has reinforced the value and clarified the process for the conduct of participatory processes that evoke the voices and past experiences of participants through narrative methods and which later transform those experiences into stories that have relevance for teaching and inspiring nurses for the future.