Charlotte Handberg

Revisiting Symbolic Interactionism as a Theoretical Framework Beyond the Grounded Theory Tradition

The tight bond between grounded theory (GT) and symbolic interactionism (SI) is well known within the qualitative health research field. We aimed to disentangle this connection through critical reflection on the conditions under which it might add value as an underpinning to studies outside the GT tradition. Drawing on an examination of the central tenets of SI, we illustrate with a field study using interpretive description as methodology how SI can be applied as a theoretical lens through which layers of socially constructed meaning can help surface the subjective world of patients. We demonstrate how SI can function as a powerful framework for human health behavior research through its capacity to orient questions, inform design options, and refine analytic directions. We conclude that using SI as a lens can serve as a translation mechanism in our quest to interpret the subjective world underlying patients’ health and illness behavior.

Men's reflections on participating in cancer rehabilitation: a systematic review of qualitative studies 2000–2013

This paper aims to report on a systematic review of qualitative studies on mens reflections on participating in cancer rehabilitation. Nine databases were systematically searched to identify qualitative papers published between 2000 and 2013. Papers were selected by pre-defined inclusion criteria and subsequently critically appraised. Key themes were extracted and synthesised. Fifteen papers were selected and represented. Four central themes were identified in the analytical process: ‘changed life perspective’, ‘the masculinity factor’, ‘a desire to get back to normal’ and ‘the meaning of work’. Six peripheral themes were identified: ‘the meaning of context’, ‘music’, ‘physical training’, ‘religion’, ‘humour’ and ‘the unmentionable’. The themes were synthesised into an integrative model representing mens reflections on participating in cancer rehabilitation. We conclude that existing qualitative literature offers insight into mens reflections on cancer rehabilitation and highlights the interrelationship between mens reflections on their changed life perspective, masculinity, orientation towards a normal life and getting back to work. Further research-based knowledge is needed to explore (1) the underlying causes and patterns of the mens needs, preferences and choices in rehabilitation; and (2) the health professional perspective on male cancer rehabilitation.

Systematic Literature Review on ICF From 2001 to 2013 in the Nordic Countries Focusing on Clinical and Rehabilitation Context.

We present a systematic review on International Classification of Functioning, Disability and Health (ICF) used in the Nordic countries from 2001 through 2013, describing and quantifying the development in utilization of ICF, and describe the extent to which the different components of the ICF have been used. A search was conducted in EMBASE, MEDLINE and PsycInfo. Papers from Nordic countries were included if ICF was mentioned in title or abstract. Papers were assigned to one of eight categories covering the wide rehabilitation area; furthermore, area of focus was assigned. Use of ICF components and intervention were coded in papers categorized as “clinical and/or rehabilitation contexts” or “non-clinical contexts”. One hundred seventy papers were included, of these 99 papers were from the categories “clinical and/or rehabilitation contexts” or “non-clinical contexts”. Forty-two percent of the 170 included papers were published in the period 2011 - 2013. There was an increase in ICF-relevant papers from 2001 to 2013, especially in the categories “clinical and/or rehabilitation contexts” and “non-clinical contexts”. The most represented focus areas were neurology, musculoskeletal, and work-related areas. All five or at least four ICF components were mentioned in the results or discussions in most papers, and activity was most frequently mentioned.

Reflections on patient involvement in research and clinical practice: A secondary analysis of women's perceptions and experiences of egg aspiration in fertility treatment

The importance of patient involvement is increasing in healthcare, and initiatives are constantly implemented to reach the ideal of involved and educated patients. This secondary analysis was initially embedded in a randomized controlled study where the aim was to gain insight into perceptions and experiences within a group of women undergoing fertility treatment through two focus group interviews. In this secondary analysis, we investigated how patient involvement was strived for in both clinical practice and research. During the analysis, it became apparent that the women exercised and maintained a clear perspective on their hope for a child, Project Child, while the interviewer pursued a treatment perspective, Project Treatment. Despite different perspectives, the conversation during the interviews seemed effortless, and it became apparent how the interviewer and the participants were actually focusing partly on the same, but primarily on different issues but without addressing or acknowledging this. Knowledge and awareness of the difference in perspectives is important when healthcare professionals seek to involve patients both in clinical practice and in research. Patient involvement in both research and clinical practice has shown to be a challenge and entails that pathways are organized and decisions shared by healthcare professionals.

Healthcare Professionals’ Attitudes to Rehabilitation Programming for Male Cancer Survivors

Purpose: The purpose of this study is to describe and interpret the attitudes and conduct of hospital healthcare professionals (HCPs) in association with male cancer survivors and their municipal rehabilitation participation. Design: Ethnographic fieldwork was conducted, consisting of participant observation and nine semistructured focus group interviews with 58 hospital HCPs. Methods: Using interpretive description methodology with symbolic interaction as a theoretical framework, data were collected through fieldwork in three oncology wards in Denmark. Findings: Attitudes about both gender and rehabilitation were identified as overarching obstructions within hospital HCP conduct toward promoting men’s participation in cancer rehabilitation. Conclusions: Gender and rehabilitation perceptions formed barriers in this context, suggesting that male cancer survivors’ rehabilitation outcomes may be compromised by HCP attitudes and conduct. Clinical Relevance: These findings provide insight into approaches to guide HCPs to take responsibility for rehabilitation and to take gender into account in their work.

Not for the World of Theorizing But for the Need of Knowledge in the Nursing Discipline: The Significance of Establishing a National Interpretive Description Network

Research networks have significant value and are essential for conducting high-quality applied health research. In this article, we describe the establishment, content, and contribution of a Danish national qualitative interpretive description (ID) network. There are only a few examples of clinical research networks and in most qualitative research methodology is not highly prioritized. Still, a number of nurses and allied health professionals work with qualitative methods and applied health research. This may call for different kinds of networks depending on the geographical context, management support, background, and goal of the network. In this article, we share our knowledge of different kinds of networks and in particular our experiences with an ID knowledge-creating network. The network has provided us with results in the form of stimulating professional conversations and discussions. It has also strengthened the methodological depth of our research and the epistemological standpoints.

Lessons learnt on the meaning of involvement and co-creation in developing community-based rehabilitation

Abstract Purpose: To describe and analyse social interactions among the users, partners and stakeholders involved in developing a rehabilitation park to determine a future approach to community-based rehabilitation. Materials and methods: The design was qualitative using the methodology interpretive description and symbolic interactionism as the theoretical framework. Data was generated through a two-year ethnographic fieldwork throughout the development of the SPARK (Sound Park Activities Rehabilitation and Climate) rehabilitation park. The participants were users, partners, and stakeholders of the park and data consisted of participant observations comprising observations, informal conversations, and field notes. Results: Three themes formed an understanding of the significance of involvement; A shared vision reflected the participants’ joint overall idea for the rehabilitation park containing possibilities for health promotions for everyone. Perceived solidarity represented an experience of a project where everyone’s opinion counted whilst Profound Acknowledgement signified a state of a deeper experience of being valued and heard. Conclusions: The findings suggest consistent and continuous involvement of users, partners, and stakeholders, creating possibilities for co-creation in rehabilitation in new settings. The development of rehabilitation parks like the SPARK park in a shared public arena may benefit people with disability, and everyone and further help reduce stigma around disability. Implications for Rehabilitation The rehabilitation definition forms the base for co-creation of rehabilitation initiatives among people in need of rehabilitation as such and professionals with different approaches and professions. Conducting rehabilitation practice in a shared outdoor arena may provide professional development and expansion towards interdisciplinary approaches across diagnoses and professions. Outdoor rehabilitation may (despite different target groups) function as a facilitator for professional and chance meetings in the park and thereby create a community for meeting across professional disciplines, founding, and enabling a practice that allows to reflect on and learn from different approaches within rehabilitation. Community-based rehabilitation in a public shared arena may generate possibilities for reducing stigma towards people with disability.

“Understanding my ALS”. Experiences and reflections of persons with amyotrophic lateral sclerosis and relatives on participation in peer group rehabilitation

Abstract Purpose: The aim of this study was to gain insight into experiences and reflections of persons with amyotrophic lateral sclerosis and relatives concerning the peer group rehabilitation programme “More Life – Less Illness”. Methods: This qualitative study used the Interpretive Description methodology with Symbolic Interactionism as the analytical framework. Eighteen programme participants representing persons with amyotrophic lateral sclerosis (n = 8) and relatives (n = 10) were included. Data consisted of individual interviews and participant observation. Results: The analysis revealed two categorical themes, “Sense of Community Building” and “Understanding my ALS”, which represented the participants’ experiences and reflections on peer group rehabilitation. Through the analysis, it became apparent that “Sense of Community Building” gave rise to an increased and personalised understanding of amyotrophic lateral sclerosis among the participants. As a part of the continuous processing of the knowledge gained, “Facing Facts” and “Retaining Normality” appeared as subthemes regarding the participants’ ability to live a less dependent and more meaningful life. Conclusions: This study of peer group rehabilitation for persons with amyotrophic lateral sclerosis and relatives indicates that programme participation leads to positive experiences in terms of living a shared meaningful life despite severe disability. The findings may guide practice to develop longitudinal peer group rehabilitation programmes with joint inclusion of persons with amyotrophic lateral sclerosis and relatives. Implications for Rehabilitation Peer group rehabilitation may facilitate an increased and personalised understanding of what it means to live with amyotrophic lateral sclerosis. A programme design with six months of sequential sessions enables a continuous processing of shared experiences and gained knowledge. Joint participation of persons with amyotrophic lateral sclerosis and their relatives supports both their internal relationship and social networking. Peer group rehabilitation in amyotrophic lateral sclerosis should help overcome obstacles concerning the needs of participants, accessibility, and geographical distance.