Abstracts, Oral Presentations for Qualitative Health Research Conference, October 2016

2017 International Journal of Qualitative Methods  
Communities that support the engagement of their oldest residents enhance the livability for all and support older people to age in place. Many older people prefer to remain living in familiar communities where they have established connections, and the evidence suggests these connections are particularly relevant in rural communities. Although engagement is known to be beneficial to the health and well-being of older people, little is known of how the oldest old engage in rural communities. To
more » ... explore the perceptions of people aged 85 years and over about their engagement in Warkworth, a rural area in New Zealand, a qualitative descriptive methodology utilizing semistructured interviews was used. Fifteen participants aged between 85 and 93 years were recruited. Two themes were identified. Firstly, "getting there and back" identified mobility as essential for engagement, in particular being able to drive. Secondly, "places to go, people to see" embodied the important contribution social networks and belonging to groups made to engagement. Characteristics of the physical and social environment presented both barriers to and enablers for engagement. To support engagement, communities require appropriate infrastructure and resources. Options to support people aged 85 years and over to remain engaged in their rural community are discussed. Gay and bisexual men (GBM) generally experience poorer health outcomes than men in general. In addition, migrant and ethnic minority gay men are considered to be at particular risk including for HIV acquisition. In New Zealand, the population of Asian GBM is increasing rapidly, but there is very little information available to understand how these men experience their lives and the implications of this for HIV prevention and health promotion more broadly. Interviews with 44 Chinese and South Asian GBM (migrant and locally born) were undertaken to identify areas of actual and potential risk for these men in achieving good health including sexual health. The research found these men had variable family support in relation to their sexuality, and this was typically driven by conflicting personal and family/cultural values and expectations. Many men were not well connected with other GBM and relied on gay social apps to make contacts. Some men reported coercion in sexual encounters and being compromised in their sexual decisionmaking. While the men had good knowledge about HIV and risky sexual practices, there was wide variation in HIV testing practices. Although many men reported experiencing very little discrimination in general life, a number reported considerable discrimination from within the gay community. These findings suggest there are a number of social conditions and norms which impact on these men's health and well-being; and rather than just relying on individual resiliency to overcome these, it is also important to address them directly. Over half of early breast cancer patients are prescribed endocrine therapy. Studies suggest that up to 50% of women do not adherence to therapy; most patients stop treatment prematurely. As health-care institutions do not have the human resources to monitor medication adherence closely in this population, alternative means of interaction need to be explored. We developed a theoretically informed text messaging program to monitor and encourage positive medication taking behaviors. We then interviewed women prior to program enrollment about their information and support-seeking behaviors regarding their breast cancer. After they received the program for 6 weeks, we then interviewed them again about their experiences. We used an interpretive description approach to characterize their experiences both before and after the program and aim to use the findings of this study to improve program delivery and meet the needs of this unique population. Cancer treatments are increasingly shifting towards oral anticancer medications (OACMs). OACMs tend to have complex administration and handling instructions and require patients to understand and implement self-management concepts. Traditionally, medication counseling for these OACMs is a onetime occurrence which can be long, complex, and dominated by the health-care provider. This results in poor patient learning. The aim of our study is to explore the medication experiences of metastatic breast cancer patients taking oral anticancer medications as we pilot a novel approach to medication counseling. The Sunnybrook Breast Cancer Centre in Toronto, Canada, has piloted a novel approach to medication counseling, providing both in-person and telephone counseling while the patient is on therapy. Breast cancer patients were interviewed and asked to describe their experiences. Interviews were audio-recorded, transcribed, and analyzed using an interpretive description approach. There are two themes that have thus far arisen out of the data. First, patients describe stronger relationships with their healthcare teams as a result of these phone calls and feel they are receiving higher quality care. However, despite an increase in the number of interactions, patients continued to describe situations that had resulted from a lack of information or awareness of optimal self-management. This finding is of importance, as it will guide future work in improving patient communication.
doi:10.1177/1609406916688525 fatcat:vyx3hgftjffjpn7qblsv36a5ka