Applying a new concept of embedding qualitative research: An example from a quantitative study of carers of people in later stage dementia

BACKGROUND: Qualitative methods are increasingly included in larger studies to provide a richer understanding of people's experience. This paper explores the potential of using a novel approach to embedded qualitative design as part of an observational study examining the effectiveness of home support for people in later stage dementia in England. The method involved collecting and analysing unsolicited conversational comments made by participants as they completed standardised measures. An evaluation of the method is presented using the voices of participants to illustrate its potential. METHODS: The conversations of 17 carers recruited to an observational study were audio recorded to gather commentary made while completing a structured interview. Data were interrogated using thematic analysis to investigate the feasibility of conducting an embedded qualitative study, the potential richness of the material and participants' reactions to formal questioning and participating in research. RESULTS: The findings revealed that qualitative data were available from this approach. Analysis generated three themes from carers: conflicting carer emotions; the importance of maintaining normality and agency within day-to-day life; and tensions between these desires and making use of formal services. Important issues for carers were revealed establishing the benefit of using the method. The advantages of exploiting unsolicited conversation included enhancing understanding of people's lived experience, reducing participant burden in research and easing the process of data collection. In addition, it provided an opportunity to evaluate individuals' experience of the research process. CONCLUSIONS: The findings demonstrate how unsolicited comments during structured interviews may appear incidental but can reveal important aspects of living with dementia. The method also emphasised methodological challenges for research in dementia, including the influence and impact of the research context. Further research is required to evaluate the method with other groups including people with dementia themselves

Living with the elderly is related to a better performance in the recognition of facial expressions of emotion among older individuals

Abstract Background: Cohabitation with the elderly may bring benefits to social relationships and exert an influence on the recognition of facial expressions of emotion. Objective: Compare emotion recognition skills between a cohabitation group (CHG) of older adults who live with a dependent elderly individual and a non-cohabitation group (NCHG) of older adults who do not live with an elderly individual. Methods: Interviews were conducted with 62 older adults in the CHG and 56 in the NCHG. The two groups were similar with regard to gender, age, schooling, degree of dependence, cognitive performance, and depressive symptoms. A dynamic task with six emotions (anger, disgust, happiness, surprise, sadness, and fear) and four levels of intensity was administered to evaluate the recognition of facial emotions. Results: The CHG performed better than the NCHG regarding the correct identification of emotions, specifically surprise (60%), disgust (60%, 80%, and 100%), fear (80%), and sadness (80% and 100%). Discussion: Cohabitation with an elderly individual seems to offer benefits to older adults in terms of recognizing facial expressions of emotion.</div