Qualitative Description: A “How-To” Guide

This guide is based on multiple presentations we have given to doctoral students about the use of qualitative description (QD) and our own work using QD over the past 21 years. We were motivated to make this guide widely available due to the lack of adequate resources (manuscripts and textbooks) that cover QD. It is our hope that others will be open to this pragmatic approach, which is both creative and rigorous and can be useful for exploring phenomena from a qualitative perspective. Many published articles claim to use QD (e.g., approximately 3,600 in PubMed). However, guidelines for conducting a QD study are lacking. Kim et al. (2016) expressed a similar sentiment in their systematic review of studies that used QD. The lack of a rigorous systematic approach leads to inconsistencies in sampling procedures, inadequate sample sizes, and lack of theoretical or conceptual orientations to build knowledge. Research that uses QD is not intended to find underlying interpretive meanings or to describe the culture of a group; it is designed instead to describe the rich, truthful perspectives of those experiencing a specific and focused situation or phenomenon. The results of a QD study are expressed in common, easy-to-understand language. Therefore, it is especially useful when working with clinical populations, communities, and across different cultural groups. The QD approach provides rich description and makes an important contribution to knowledge development. We hope that this guide will become an essential reference for those interested in using this specific qualitative approach

Are you a caregiver infographic

After our 2018 Nursing-Interprofessional Salon that focused on older adults\u27 wellness, we formed the Are You a Caregiver Initiative. We developed an infographic to help individuals self-identify as a caregiver and to link them with available caregiver support resources. We plan to disseminate this infographic within the UMassMemorial system as well as surrounding environs. The infographic can be adapted for use in other communities as well

Grandparent Education Through Simulation-Diabetes

PURPOSE: The purpose of this study was to explore the feasibility of using human patient simulation (HPS) to teach type 1 diabetes (T1DM) management to grandparents of grandchildren with T1DM. METHODS: Thirty grandparents (11 male, 19 female) of young grandchildren (aged 12 and under) with T1DM were recruited from an urban medical center. Experimental group (n = 14) grandparents received hands-on visual T1DM management education using an HPS intervention, and control group (n = 16) grandparents received similar education using a non-HPS intervention. FINDINGS: This study demonstrated the feasibility of recruiting and retaining grandparents into a clinical trial using HPS to teach T1DM management. Post intervention, all grandparent scores for T1DM knowledge, confidence, and fear showed significant improvement from time 1 to time 2, with HPS group grandparent scores showing consistently larger improvement. CONCLUSIONS: The consistency of larger HPS-taught grandparent score improvement is suggestive of a benefit for the HPS teaching method. Early multimethod Certified Diabetes Educator (CDE)-provided T1DM education is an important point of entry for inducting grandparent members onto the grandchild\u27s diabetes care team

Fathers\u27 reflections on parenting young children with type 1 diabetes

PURPOSE: To describe fathers\u27 experiences in parenting and managing the care of their young children with type 1 diabetes. DESIGN AND METHODS: This qualitative descriptive study used 16 open-ended, in-depth interviews with 14 purposively selected, involved, educated, stably employed fathers of 15 children younger than 10 years old. The fathers were asked to describe their perspective of the initial diagnosis, how they learned diabetes care, their day-to-day care and parenting experiences, and what strategies they used in the day-to-day management. Data were managed using NVivo software and analyzed using principles of naturalistic inquiry and qualitative content analysis. RESULTS: The overarching theme was From sadness to action, with six categories emerging: (1) shock and awe (after diagnosis), (2) quick response to the diagnosis and learning diabetes care: suck it up and do it, (3) staying in the loop (practicing the skills, tasks, and responsibilities of diabetes management), (4) partnerships in care (tag teaming or co-parenting), (5) active participation (being actively involved in their children\u27s day-to-day care and benefiting from participating in this care), and (6) mantra for living with diabetes: child first, diabetes second. CLINICAL IMPLICATIONS: Nurses working with children with diabetes can use the results of this study to better understand the role of fathers in the care of these children. Fathers underscored the importance of practicing diabetes care-related tasks to improve their confidence when caring for children alone. Their practical and philosophical strategies for managing their children\u27s chronic illness have recently been incorporated into a parent mentor intervention for children newly diagnosed with type 1 diabetes

Reframing the influence of the Health Insurance Portability and Accountability Act on research

The purpose of this article is to review the Health Insurance Portability and Accountability Act (HIPAA), the Privacy Rule, the Security Rule, and common issues encountered by researchers related to these federal privacy and security requirements. This article discusses the misconceptions that researchers may hold about HIPAA, including the process for reviewing protected health information when preparing to conduct a study, potential constraint on participant recruitment, and application of HIPAA to a researcher\u27s clinical population. We also present ways to reframe the negative connotations associated with this regulation and provide tips for researchers about how to work with HIPAA when planning and conducting a study and reporting on study findings. Finally, we suggest that the principles of HIPAA be considered when conducting studies in international settings

Development and Psychometric Testing of the Peer-Mentor Support Scale for Parents of Children With Type 1 Diabetes and for Youths With Type 1 Diabetes

PURPOSE: The purpose of this study was to develop and evaluate the psychometric properties of the Peer-Mentor Support Scale (PMSS), a measure of peer-mentor support provided to parents of children with type 1 diabetes (T1D) and to youths with T1D. METHODS: A multistage process was undertaken to include the following: item construction based on qualitive data from those who have experienced peer-mentor support, cognitive interviewing with parents and youths, content validity assessment, pilot testing of the scale, and psychometric evaluation of the PMSS with 165 participants. RESULTS: The final version of the PMSS included 17 items, scored on a 4-point Likert scale, with higher scores corresponding with greater peer-mentor support. The Cronbach\u27s alpha was .85 (n = 165), and the intraclass correlation coefficient was .78 (n = 38). No significant relationship was found between the PMSS score and general social support, suggesting that peer-mentor support is distinct from general social support. Principal components factor analysis with varimax rotation was performed, indicating that the scale was unidimensional and explained 59.3% of the variance in peer-mentor support. CONCLUSION: The PMSS is a reliable and valid 17-item instrument that can be used to measure the unique contributions of peer mentorship for parents of children with T1DM and for youths with T1DM

Methodological challenges collecting parent phone-call healthcare utilization data

Recommendations by the National Institute of Nursing Research and other groups have strongly encouraged nurses to pay greater attention to cost-effectiveness analysis when conducting research. Given the increasing prominence of translational science and comparative effective research, cost-effective analysis has become a basic tool in determining intervention value in research. Tracking phone-call communication (number of calls and context) with cross-checks between parents and healthcare providers is an example of this type of healthcare utilization data collection. This article identifies some methodological challenges that have emerged in the process of collecting this type of data in a randomized controlled trial: Parent education Through Simulation-Diabetes (PETS-D). We also describe ways in which those challenges have been addressed with comparison data results, and make recommendations for future research

Making a Connection: Family Experiences With Bedside Rounds in the Intensive Care Unit

BACKGROUND: The hospitalization of a family member in an intensive care unit can be stressful for the family. Family bedside rounds is a way for the care team to inform family members, answer questions, and involve them in care decisions. The experiences of family members with intensive care unit bedside rounds have been examined in few studies. OBJECTIVES: To describe (1) the experiences of family members of patients in the intensive care unit who participated in family bedside rounds (ie, view of the illness, role in future management, and long-term consequences on individual and family functioning) and (2) the experiences of families who chose not to participate in family bedside rounds and their perspectives regarding its value, their illness view, and future involvement in care. METHODS: A qualitative descriptive study was done, undergirded by the Family Management Style Framework, examining families that participated and those that did not. RESULTS: Most families that participated (80%) found the process helpful. One overarching theme, Making a Connection: Comfort and Confidence, emerged from participating families. Two major factors influenced how that connection was made: consistency and preparing families for the future. Three types of consistency were identified: consistency in information being shared, in when rounds were being held, and in informing families of rounding delays. In terms of preparing families for the future, families appeared to feel comfortable with the situation when a connection was present. When any of the factors were missing, families described feelings of anger, frustration, and fear. Family members who did not participate described similar feelings and fear of the unknown because of not having participated. CONCLUSION: What health care providers say to patients\u27 families matters. Families may need to be included in decision-making with honest, consistent, easy-to-understand information

Maternal management behaviors for young children with type 1 diabetes

PURPOSE: To describe the process that mothers raising young (0-4 years old) children who are newly diagnosed with type 1 diabetes move through to attain the necessary skills to care for their children. STUDY DESIGN AND METHODS: A mixed methods design was used, including qualitative interviews with 28 mothers of young children with type 1 diabetes. Principles of naturalistic inquiry were used to guide the data collection process, management, and analysis of the qualitative findings. RESULTS: The process paralleled two of three management approaches and associated behaviors previously described by Gallo and Knafl. Strict adherence behaviors included rigidly following the team recommendations and avoiding strange environments outside the home. Flexible adherence behaviors strove to bring spontaneity back into family life. Selective adherence was not used by this population. CLINICAL IMPLICATIONS: Nurses working with these mothers can provide information and support to help them transition from using strict adherence to the more user-friendly flexible adherence, while avoiding the pitfalls of the possibly harmful third approach of selective adherence. Nurses need to remember to praise the parents\u27 efforts at managing their children\u27s diabetes, for our acknowledgment of their work is empowering and affirming

A Clinical Trial of a Video Intervention Targeting Opioid Disposal After General Surgery: A Feasibility Study

BACKGROUND: The opioid epidemic continues and although some initiatives have shown promise in reducing the number of opiates prescribed, few studies have focused on education of general surgery patients about home storage and safe disposal. The purpose of this feasibility study was to explore the use of an online video intervention to prepare surgical patients to properly dispose of unused opioids. METHODS: Eligible patients undergoing elective general surgery between August and October 2019 were enrolled into this prospective randomized controlled feasibility study. Patients with reported opioid use preoperatively were excluded from the study. The control group followed usual care, and the intervention group received usual care plus a brief educational video guided by the theory of reasoned action describing safe storage and disposal practices of unused opioid pills. Measures were collected at baseline and 2 wk postoperatively. RESULTS: A total of 40 participants were enrolled in the study; average age was 44.7 (range 21-75 y); most were Caucasian, educated, and employed. Recruitment took 11 wk, and the retention rate was excellent at 85%. Differences in opioid disposal were not significantly different by age, sex, education, or type of surgery. The video intervention was positively received, but the majority (80%) still stored their pills unsecured. CONCLUSIONS: Results demonstrate that a video intervention addressing safe storage and disposal practices of unused opioids is feasible, and more research is needed to determine efficacy in increasing rates of secure storage and disposal of unused opioid pills