An exploration of problematic interviewee behaviors in qualitative research

The interview is a staple of many qualitative approaches. Although textbooks offer extensive guidance to researchers about conducting interviews, less guidance is available about problematic interviewee behaviors, such as flattery or statements indicative of social desirability response bias. In this study, a secondary analysis of 22 phenomenological interview transcripts, we sought to examine problematic interviewee behaviors. More than 300 pages of typed text were subjected to line-by-line scrutiny, yielding only six potential instances of the phenomenon. Each could be interpreted several ways. What appeared to be flattery could also be perceived as simple gratitude or appreciation. We concluded that problematic behavior was rare in this data set

How patients and nurses experience the acute care psychiatric environment

The concept of the therapeutic milieu was developed when patients’ hospitalizations were long, medications were few, and oneto- one nurse–patient interactions were the norm. However, it is not clear how the notion of ‘therapeutic milieu’ is experienced in American acute psychiatric environments today. This phenomenological study explored the experience of patients and nurses in an acute care psychiatric unit in the USA, by asking them, ‘What stands out to you about this psychiatric hospital environment?’ Three figural themes emerged, contextualized by time, which was a source of stress to both groups: for patients there was boredom, and for nurses, pressure and chaos. Although they shared some themes, nurses and patients experienced them differently. For instance, nurses felt caged-in by the Plexiglas-enclosed nursing station, and patients felt caged-in by the locked doors of the unit. The findings from this US study do not support the existence of the therapeutic milieu as described in the literature. Furthermore, although the nurse–patient relationship was yearned for by nurses, it was nearly absent from patients’ descriptions. The caring experienced by patients was mainly derived from interactions with other patients

Review: Community-Based Participatory Research Approach to Address Mental Health in Minority Populations

In this review, a synthesis of studies employing community-based participatory research (CBPR) to address mental health problems of minorities, strengths and challenges of the CBPR approach with minority populations are highlighted. Despite the fact that minority community members voiced a need for innovative approaches to address culturally unique issues, findings revealed that most researchers continued to use the traditional methods in which they were trained. Moreover, researchers continued to view mental health treatment from a health service perspective

"Take my hand, help me out:" Mental health service recipients‘ experience of the therapeutic relationship

The purpose of this study was to describe mental health service recipients‘ experience of the therapeutic relationship. The research question was 'what is therapeutic about the therapeutic relationship?‘ This study was a secondary analysis of qualitative interviews conducted with persons with mental illness as part of a study of the experience of being understood. This secondary analysis used data from 20 interviews with community-dwelling adults with mental illness, who were asked to talk about the experience of being understood by a health-care provider. Data were analysed using an existential phenomenological approach. Individuals experienced therapeutic relationships against a backdrop of challenges, including mental illness, domestic violence, substance abuse, and homelessness. They had therapeutic relationships with nurses (psychiatric/mental health nurses and dialysis nurses), physicians (psychiatrists and general practitioners), psychologists, social workers, and counselors. Experiences of the therapeutic relationship were expressed in three figural themes, titled using participants‘ own words: 'relate to me‘, 'know me as a person‘, and 'get to the solution‘. The ways in which these participants described therapeutic relationships challenge some long-held beliefs, such as the use of touch, self-disclosure, and blunt feedback. A therapeutic relationship for persons with mental illness requires in-depth personal knowledge, which is acquired only with time, understanding, and skills. Knowing the whole person, rather than knowing the person only as a service recipient, is key for practising nurses and nurse educators interested in enhancing the therapeutic potential of relationships

Mental Health Patients’ Experiences of Being Misunderstood

Mental health patients describe “being understood” as an experience that evokes feelings of importance, worthiness, and empowerment. However, the experience of “being misunderstood” is more prevalent in patients’ relationships with health care providers. Negative consequences such as vulnerability, dehumanization, and frustration reveal that being misunderstood has the potential to damage or destroy therapeutic relationships. The purpose of this secondary analysis was to examine mental health patients’ experiences of being misunderstood

Hall‘s essay on an authentic meaning of medicalization: An extended discourse.

The purpose of this article is to inform emerging theoretical understanding of medicalization by challenging, updating, and affirming a previously published essay on this topic by Hall. We accomplished this through the creation of a discourse among the 3 authors using the essay, written entirely from a personal perspective, and integrated our own personal experiences as nurses and patients. Hall's essay on the authentic meaning of medicalization provided a critical understanding of medicalization of cancer describing the factors, forces, and consequences, seeking to raise consciousness and provoke reform. The 3 of us added our voices to her narrative seeking to expand the discourse on medicalization and inform theory development. We have shared our individual and collective voices and identified elements that might point the way to theoretical emergence and ending with our own call for nursing to evolve further as a field worthy of human inspiration

Peaceful awakenings: Taking the “alarm” out of the alarm clock.

The quality of my daily awakening ritual changed dramatically a few months ago when I was exposed to the Timex Nature Sounds alarm clock. Prior to this, it had never occurred to me to use something other than the traditional buzzer-type alarm clock that I had had since 1986 because “it still worked.” While this was true, it worked by emitting a loud obnoxious sound that stimulated a fight or flight response. Now, I start the day with nature sounds (“ocean surf”), which is much more peaceful than my old alarm clock

Facilitating communication: How to truly understand what patients mean

The nurse-patient relationship will always remain pivotal to effective management of illness. Peplau (1952/1991) maintained that understanding was an essential component of the nurse-patient relationship. Consistent with Peplau’s assertion, Cleary, Edwards, and Meehan (1999) found that understanding significantly influenced nurse-patient interactions in acute psychiatric-mental health settings. Jackson and Stevenson (2000) cited understanding as a central theme in their study about the reasons people with acute psychiatric illnesses need nurses. Although understanding is what patients want, studies suggest they do not experience it from nurses (Shattell, 2002; Thomas, Shattell, & Martin, 2002). In fact, one study revealed that the greatest understanding came from other patients (Thomas et al., 2002). In this article, we describe communication guidelines useful to nurses in facilitating patients’ experience of being understood

Commentary on Kao, H., Reeder, F., Hsu, MT, & Cheng, SF. A Chinese view of the Western nursing metaparadigm.

Drs. Kao, Reeder, Hsu, and Cheng fused three convergent world views—Taoism, Confucianism, and Rogers’ Unitary View of Human Beings—in an unambiguous review of the nursing metaparadigm. Their discussion is framed by the need for holism and cultural competence in an ever-evolving, multicultural world. Although the authors seemed to delicately balance the relative merits of both Eastern and Western thought, it is clear from their writing that holistic nurses should not heuristically put Western philosophies above all others

I have always felt different:The experience of childhood AD/HD

Childhood attention-deficit/hyperactivity disorder (ADHD) is one of the most important psychiatric problems of our time. This study examined the experience of childhood ADHD within the contexts that are most significant to this age group—home, school, and friendships. The sample included 16 college-enrolled young adults (ages 18-25) with a self-reported history of ADHD. Participants revealed feelings of difference, misunderstanding, and struggle in all areas of their lives (home, school, and friendships). Nurses can use these findings to improve the care and long-term outcomes of children diagnosed with ADHD