Theme in Qualitative Content Analysis and Thematic Analysis

Qualitative design consists of various approaches towards data collection, which researchers can use to help with the provision of both cultural and contextual description and interpretation of social phenomena. Qualitative content analysis (QCA) and thematic analysis (TA) as qualitative research approaches are commonly used by researchers across disciplines. There is a gap in the international literature regarding differences between QCA and TA in terms of the concept of a theme and how it is developed. Therefore, in this discussion paper we address this gap in knowledge and present differences and similarities between these qualitative research approaches in terms of the theme as the final product of data analysis. We drew on current multidisciplinary literature to support our perspectives and to develop internationally informed analytical notions of the theme in QCA and TA. We anticipate that improving knowledge and understanding of theme development in QCA and TA will support other researchers in selecting the most appropriate qualitative approach to answer their study question, provide high-quality and trustworthy findings, and remain faithful to the analytical requirements of QCA and TA.Qualitatives Design besteht aus verschiedenen Ansätzen zur Datenerhebung und -analyse, die insbesondere für die Erstellung kultureller und kontextueller Beschreibungen und die Interpretation sozialer Phänomene anwendbar sind. Qualitative Inhaltsanalyse (QCA) und thematische Analyse (TA) stellen beides qualitative Ansätze dar, die üblicherweise von Forscher_innen aus unterschiedlichen Disziplinen gleichermaßen eingesetzt werden. Allerdings besteht in der internationalen Literatur eine Leerstelle in Bezug auf den Begriff von "Thema" in beiden Ansätzen und des Prozesses der Entwicklung von Themen. Daher gehen wir in unserem Beitrag auf diese Leerstelle ein und stellen Unterschiede und Ähnlichkeiten zwischen beiden Methoden in Bezug auf das "Thema" als Endprodukt der Datenanalyse dar. Zur Unterstützung unserer Sichtweisen und zur Erstellung international fundierter analytischer Begriffe von "Thema" greifen wir auf die aktuelle Literatur aus unterschiedlichen Disziplinen zurück. Wir gehen davon aus, dass Forscher_innen von einem vertieften Verständnis des Prozesses der Themenentwicklung in mehreren Hinsichten profitieren, nämlich bei der Auswahl einer geeigneten Methode für die Beantwortung ihrer Forschungsfrage, bei der Erzielung qualitativ hochwertiger und valider Ergebnisse sowie dabei, den analytischen Anforderungen an QCA und TA gerecht zu werden

A longitudinal investigation into patients' experiences of chronic low back pain (CLBP) using interpretative phenomenological analysis (IPA).

Background/aim: Chronic low back pain (CLBP) is a variant of chronic pain and an overarching term for a diverse number of painful and benign conditions of the lower spine. Research has shown that CLBP challenges biomedical explanation and treatments and incurs passive coping strategies. Despite the enduring nature of CLBP there are few longitudinal studies. The aim of this investigation was to gain understandings of any consistencies and changes in the experiences of participants' experiences of living with CLBP. Design: A qualitative, longitudinal IP A research project that explored participants' pain experiences over two years (2005-2007). Methods: Semi-structured interviews were conducted with a purposeful sample of ten participants recruited from the waiting list of a chronic pain clinic. Each participant was interviewed prior to attendance and twice after treatment. The data were recorded and transcribed accounts were analysed using IPA. Results: The participants foreground the physicality of the pain. Further interpretive work showed that whilst participants emphasised the physicality of their condition they experienced embodied, multidimensional experiences characterised by loss. Most participants' continued to manage their pain within a biomedical model of understanding and behavioural focused coping strategies. In comparison, participants who experienced a period of painlessness due to medical interventions demonstrated a reappraisal of their situation and a trend towards adopting a wider, biopsychosocial understanding accompanied by changing coping strategies. Conclusion: The accounts revealed the relationship between the participants' painful body and self concept. For some participants, a respite from pain paralleled increasing psychosocial coping strategies and a future orientation that reflected changes in illness beliefs in the absence of a formal psychological intervention. In comparison, remaining participants continued to demonstrate a narrow repertoire of coping and loss orientation. Participants' responses to CLBP resonated with the grieving processes of bereaved individuals. Clinical implications are discussed with recommendations for future research

Looking for the “Little Things”: A Multi-Disciplinary Approach to Medicines Monitoring for Older People Using the ADRe Resource

As prescribing has become the dominant modality of medical treatment, the “pharmaceuticalization” of practice has often resulted in treatment “at a distance”, with doctors having limited contact with patients. Older and poorer people, who are socially distanced from medical prescribers, suffer more adverse drug reactions (ADRs) than the general population. This paper advocates a team approach to checking patients in care homes systematically for ADRs, using information from manufacturers’ guidelines. It explains the benefits of medicines monitoring to protect older patients from iatrogenic harm, such as over-sedation and falls. The ADRe profile is a sophisticated paper-based check-list, which helps nurses and carers play an active role in monitoring signs symptoms that indicate problems. Better monitoring allows doctors and pharmacists to adjust prescribing and respond to identified ADRs. We argue that Implementation of tools like ADRe can be accelerated by changes to the regulatory regime and better inter-professional cooperation

Iranian Physicians’ Perspectives Regarding Nurse–Physician Professional Communication: Implications for Nurses

Author's accepted version (post-print).This is a post-peer-review, pre-copyedit version of an article published in Research and Theory for Nursing Practice. The final authenticated version is available online at: http://dx.doi.org/10.1891/1541-6577.31.3.202.acceptedVersio

Does the Association between Depressive Symptomatology and Physical Activity Depend on Body Image Perception? A Survey of Students from Seven Universities in the UK

This cross-sectional study assessed the association between depression and PA in university students of both genders and the role of body image perception as a potential effect modifier. Undergraduate students (N = 3706) from seven universities in the UK completed a self-administered questionnaire that assessed sociodemographic information; a range of health, health behaviour and health awareness related factors; the modified version of Beck’s Depression Inventory (M-BDI); educational achievement, and different levels of physical activity (PA), such as moderate PA (at least 5 days per week moderate exercise of at least 30 minutes), and vigorous PA (at least 3 days per week vigorous exercise of at least 20 minutes). Only 12.4% of the sample achieved the international recommended level for moderate PA, and 33.1% achieved the recommendations for vigorous PA. Both moderate and vigorous PA were inversely related to the M-BDI score. Physically active students, regardless of the type of PA, were significantly more likely to perceive their health as good, to have higher health awareness, to perform strengthening exercises, and to be males. The stratified analyses indicated that the association between depression and PA differed by body image. In students perceiving their body image as ‘just right’, moderate (>4th percentile) and high (>5th percentile) M-BDI scores were inversely related to vigorous PA. However, in students who perceived their body image as ‘overweight’, the inverse association was only significant in those with high M-BDI scores. We conclude that the positive effect of PA on depression could be down modulated by the negative impact of a ‘distorted’ body image on depression. The practical implications of these findings are that PA programmes targeting persons with depressive symptoms should include effective components to enhance body image perception

Nurse-led medicines’ monitoring in care homes, implementing the Adverse Drug Reaction (ADRe) Profile improvement initiative for mental health medicines: An observational and interview study

This study investigated the implementation and clinical impact of an Adverse Drug Reaction Profile (ADRe) used to assess the prescription regimes of older residents of nursing and care homes. Administration of ADRe was observed for 30 residents prescribed mental health medicines in ten care homes. The study pharmacist reviewed completed ADRes against medication records. Policy context was explored in 30 interviews with service users, nurse managers and strategic leads in Wales.Residents were aged 60–95, and prescribed 1–17 (median 9 [interquartile range (IQR) 7–13]) medicines. ADRe identified a median of 18 [IQR 11.5–23] problems per resident and nurses made 2 [1–2] changes to care per resident. For example: falls were reported for 9 residents, and care was modified for 5; pain was identified in 8 residents, and alleviated for 7; all 6 residents recognised as dyspnoeic were referred to prescribers. Nurses referred 17 of 30 residents to prescribers. Pharmacists recommended review for all 30. Doubts about administering ADRe, sometimes expressed by people who had not yet used it, diminished as it became familiar. ADRe was needed to bridge communication between resident, nurses and prescribers. When barriers of time, complacency, and doctors’ non-availability were overcome, reporting with ADRe made prescribers more likely to heed nurses’ concerns regarding residents’ welfare. Clinical gains were facilitated by one-to-one time, staff-resident relationships, and unification of documentation

Feeling Healthy? A Survey of Physical and Psychological Wellbeing of Students from Seven Universities in the UK

University students’ physical and psychological health and wellbeing are important and comprise many variables. This study assessed perceived health status in addition to a range of physical and psychological wellbeing indicators of 3,706 undergraduate students from seven universities in England, Wales and Northern Ireland. We compared differences in these variables across males and females, and across the participating universities. The data was collected in 2007–2008. A self-administered questionnaire assessed socio-demographic information (e.g., gender, age), self-reported physical and psychological health data, as well as questions on health awareness, health service use, social support, burdens and stressors and university study related questions. While females generally reported more health problems and psychological burdens, male students felt that they received/had fewer persons to depend on for social support. The comparisons of health and wellbeing variables across the different universities suggested some evidence of ‘clustering’ of the variables under study, whereby favourable situations would be exhibited by a cluster of the variables that is encountered at some universities; and conversely, the clustering of less favourable variables as exhibited at other universities. We conclude that the level of health complaints and psychological problems/burdens is relatively high and calls for increased awareness of university administrators, leaders and policy makers to the health and well-being needs of their students. The observed clustering effects also indicated the need for local (university-specific) health and wellbeing profiles as basis and guidance for relevant health promotion programmes at universities

Translation and psychometric testing of the Farsi version of the Seattle angina questionnaire

Abstract Background Angina pectoris causes substantial psychological and functional disabilities and adversely effects quality of life in patients. The aim of this study was to investigate the psychometric properties including validity and reliability of the Farsi version of the Seattle angina questionnaire. Methods The ‘forward-backward’ procedure was applied to translate this questionnaire from English to Farsi. The translated version of the Seattle angina questionnaire was assessed in terms of validity and reliability with a convenience sample of 200 patients suffering from angina pectoris who were recruited from the inpatient ward (post CCU) and outpatient department at two teaching hospitals in an urban area of Iran. Validity was assessed using content, face and construct validity. The calculation of the Cronbach’s alpha coefficient and the test-retest method helped with the assessment of reliability of the questionnaire’s five subscales. Construct validity of the questionnaire was evaluated using exploratory factor analysis. Results The results of exploratory factor analysis indicated a five-factor solution for the questionnaire including ‘physical limitation in middle to strenuous activities’, ‘physical limitation in slight activities’, ‘angina pattern and discomfort of treatment’, ‘treatment satisfaction’ and ‘disease perception’ that jointly accounted for 64.42% of variance observed. Convergent validity was mostly supported by the pattern of association between the Seattle angina questionnaire-Farsi version and the SF-36. Cronbach’s alpha of the subscales ranged from 0.60 to 0.86 and test-retest scores ranged from 0.79 to 0.97 indicating a good range of reliability. Conclusions The Seattle angina questionnaire-Farsi version had acceptable psychometric properties. Therefore, it can be used to assess health-related quality of life and assess the effects of different medical and nursing interventions on patients’ quality of life