The 16th International Interdisciplinary Conference October 3–5, Vancouver, Canada: Qualitative Health Research

<span title="">2010</span> <i title="SAGE Publications"> <a target="_blank" rel="noopener" href="https://fatcat.wiki/container/l2xkbgn2lzbifmlwxjuyytbdta" style="color: black;">International Journal of Qualitative Methods</a> </i> &nbsp;
This paper presents the results of focus groups conducted to prepare for the potential rollout of PrEP, or preexposure prophylaxis. PrEP would involve taking a pill a day of antiretroviral drugs, the only known effective treatment for AIDS, as a way to help prevent HIV, particularly in high-risk populations. Methods: During the summer of 2009, 10 focus groups were conducted with 77 at-risk African American young adults in Atlanta, GA, ages 18 to 24. Participants for 8 of the focus groups (58
more &raquo; ... ticipants) were recruited by trained ethnographers working in communities with high STD/HIV prevalence. Two focus groups (19 participants) were venue specific, held via support groups for young African American men who have sex with men (MSM). Focus groups assessed knowledge, risk perceptions, and stigma about HIV/AIDS, access to health care, and attitudes about this potential new biomedical HIV prevention technology. Results: Focus group participants evidenced limited knowledge about HIV transmission and safer sex practices and frequent mention of attitudes reflecting stigma/myths. Ninety percent of the participants were without any health care insurance, and were unable to afford or did not like taking prescribed oral medication. If PrEP proves to be highly effective, accessible, and free, these young adults would be interested in utilizing a daily dose of antiretrovirals for HIV prevention. Conclusions: Focus group results uncovered culturally specific dynamics that will need to be considered in program design. The experience from this study could help inform plans for operations research during PrEP implementation with this population. Persons with dementia (PWD) are often faced with the reality of multiple housing transitions in the course of their illness. This paper is part of a larger qualitative prospective study that aimed at understanding the meaning of "home" and "relocation" for persons with dementia. The findings are based on the data from in-depth follow-up interviews with 16 persons with mild to moderate dementia, at 2 and 6 months after International Journal of Qualitative Methods 9(4) QHR Conference Abstract 335 relocation to a retirement residence. Participants' efforts to place themselves in their new living environments ("place integration") were closely linked to their ability to integrate relocation into their overall life history, self-identity and meaning in life ("ego integrity"). The process began with an immediate need to "settle in" and perform their personal and instrumental activities of daily living (ADL & IADL) in order to meet their most basic survival needs. A satisfactory completion of this phase was associated with a sense of "comfort." The next phase involved their attempts to "fit in" the new social environment to satisfy their higher order social ADL needs associated with a sense of "connection." The transition created a simultaneous need to renew their conception of "self" ("checking in") in order to reconcile their desire to maintain a sense of "continuity" in the face of the changing realities of their existence. The failure to achieve the above led to feelings of being displaced, "in suspense," alienated, etc. The findings reaffirm the importance of "personal-as-identity care" in dementia and inform the design of supportive interventions. Discussion continues on the dimensions of role transition with significant innovations in programs targeted toward new graduate nurses entering practice. We suggest that if students and new graduates are to successfully transition and practice within an ethical context, educators need to understand the complexities of role transition in order to support their students. This narrative inquiry explored the meaning of the role transition process through the eyes of 22 students enrolled in a licensed practical nurse (LPN) to bachelor of science in nursing (BSN) bridging program. The students' stories are woven with stories of educators to a broader understanding of the process of role transition. Integration of time and context in the construction of the meaning of role transition was essential in understanding the transition process as it transpired over a 24-month period time frame, from entry into academia to 3 months following graduation. The stories and interview transcripts were examined using Clandinin and Connelly's (2000) elements: personal and social interaction and temporality of past, present, future, and place. A resistance narrative emerged where the student grieved "letting go" of the former role. This story transformed over time to an acceptance narrative which gave prominence to confidence, positive coping and balanced lifestyle. These narrative structures provided insights into how LPN to BSN students came to understand their role transformation experience and professional growth. Implications of this study point to the importance of implementing socialization strategies throughout the educational process to better prepare students for the challenges of professional practice. The role of physical punishment in child physical abuse is well documented. Based on findings that attitude is the most powerful predictor of physical punishment use, public health agencies have mounted International Journal of Qualitative Methods 9(4) QHR Conference Abstract 336 education campaigns that aim to reduce parental approval of this practice. These campaigns are based on attitude research, virtually all of which is quantitative, employing brief checklists and rating scales to measure parents' beliefs about the acceptability, appropriateness, and necessity of physical punishment. The purpose of this interpretive descriptive study was to deepen our understanding of the dimensions of parents' perspectives on discipline with young children. A sample of 30 participants was recruited through day care centers and included 25 mothers and 5 fathers. Their mean age was 31.5 years, and each participant was a parent of at least one child aged 2 to 5 years. Semistructured interviews were conducted to determine parents' views of and approaches to discipline and their goals in using their disciplinary approaches. Data analysis involved review of transcripts to identify and agree upon coding categories, coding of transcripts, and creation of descriptive grids as described by Knafl and Webster (1988) to identify themes. In this presentation, the themes of acting proactively to promote positive behavior (e.g., teaching and guidance), reacting to stop or change behavior (e.g., physical and nonphysical responses), and the emotionality of the situation will be discussed. The application of these findings to parent education programming directed at promoting positive parenting and decreasing punitive and physical responses with children will be presented. In fall 2009, 25 gay Asian males (GAMs) and 19 gay White males (GWMs) who expressed an interest in Asian men were interviewed using a semistructured schedule of questions on race preferences in sexual or romantic relationships. The interviews were audiotaped, transcribed, and analyzed for their recurrent themes. I focus on the rationales behind the men's racial preferences and their implications within a larger social structure where whiteness is constructed as a default state of being and non-Whites are regarded as the "other." Three themes emerged from GWM's preferences for GAMs: (a) feminization: seeing Asian men as less masculine. (b) infantalization: seeing Asian men as young and boyish and venerating of age. (3) orientalization: seeing Asian men as "exotic" others from mysterious cultures (see Edward Said's "Orientalism"). In contrast, conflicting themes emerged from GAM's preferences for GWMs. On one hand they saw such preferences as "natural" in a majority White society; on the other, they saw themselves as typecast and fetishized by White men and, as a result, saw sexual and racial politics as unavoidable in their quests for sex and love. Implications for sexual and racial politics will be discussed. The presence of diverse ethnic groups within Canada, which has the largest immigration program in the world, can no longer be ignored when addressing matters of health and wellness. As part of this global migration, new religious imports have also contributed to national diversity whereby a great degree of immigrants place a strong emphasis on spirituality and religion in their everyday lives. This emphasis on spirituality and religion is highly gendered, raced, and classed. It is particularly great among many African derived cultures fundamentally shaping their everyday lived experiences. The aim of this exploratory study was to develop a deeper understanding of the meanings and experiences of health and wellness among a group of Afro-Caribbean first generation Canadian women of faith. One-on-one semistructured interviews were conducted with 13 women who were all regular church attendees at various Protestant denominations within a metropolitan Canadian city. For these women, spirituality in International Journal of Qualitative Methods 9(4) QHR Conference Abstract 338 and long term needs. Thematic analysis revealed the following four themes: (a) surviving through sex work; (b) seeking long term solutions; (c) enduring stigma; (d) health service utilization. Women's narratives illustrate that "reducing" her body to a sexual function is influenced by the macro limitations within which she is bound. Yet, she engages as an active participant in every day resistive strategies within her available set of structural possibilities and limitations. Shopping for Treatment: Tuberculosis in Urban Slums in Delhi, India Aruna Bhattacharya Public Health Foundation of India "L," 34, a daily wager in a garment factory was suffering from TB from last 14 months.. He narrated about his experience with several doctors and their treatment regime with great precision with their names and with the location of their clinics. At the time of the documentation of this case study, L was undergoing treatment for TB under DOTS's category-II regimen, which was for seriously ill and relapse cases of tuberculosis. To begin with, he had bouts of fever which he ignored till the time there was remarkable weight loss and loss of appetite. He resorted to private allopathic doctor, where he was given antibiotics and advised for chest X-ray. He took the treatment for 5 days, and his X-ray showed tuberculosis in his right lung, yet he preferred to leave the treatment as it was expensive for him to continue. After this, he sought treatment from an array of practitioners, and in all he sought treatment from five practitioners before resorting to a government hospital, where he was referred to a DOTS center for TB treatment. Pathway for shopping for treatment was private allopathic doctor (left the treatment after diagnosis; expensive treatment) to unregistered practitioner (no improvement in health) to faith healer (no improvement in health) to private allopathic doctor (visited on family's intervention, failed to comply because of expensive treatment) to unregistered practitioner (no improvement in health) to government hospital (advised to start TB treatment from nearest DOTS center) to DOTS center (taking treatment in category-II regimen). Many qualitative methods scholars consider critical action research a method by which we may engage with the lived experiences of subjects in a reflexive manner and work to effect change, emphasize human rights and agency, and decolonize the research process. Often overlooked is the degree to which this tool is a highly political device, neither displaced from ideology nor detached from the intersections of race, class and gender. As a window through which to view, as well as extend, this critique of critical action research, the paper draws from my experience as researcher in the conflict-affected area of Mindanao, Southern Philippines, working in maternal child health. The central focus is on the role and political nature of the framework of emancipation in critical action health research within war and conflict-affected areas. I argue that, within these settings, the method is embedded in a web of power relations and a global capitalist political economy and it may therefore unfold in ways detrimental to its underlying principles. Thus, though this critical paradigm may function to "unshackle" communities from imported ways of knowing, it may simultaneously and covertly reproduce problematic and westernized policies that render the recorded lived experiences invisible. In short, the presentation highlights the nuanced yet critical junctures in which participatory research, and the researcher, may emerge as agents of veiled, compassionate coercion nothing short of a new spectre of colonialism.
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