Johanna Spiers

A longitudinal interpretative phenomenological analysis of the process of kidney recipients’ resolution of complex ambiguities within relationships with their living donors

Much previous research into living kidney donation has focused on the decision-making of the donor, despite evidence suggesting this may be a more psychologically challenging time for the recipient. This longitudinal study explores the experiences of four recipients of kidneys from living donors throughout the transplant process. Transcripts were analysed using interpretative phenomenological analysis. Three themes arose from the data, which were as follows: changing perceptions of relationships with kidney donors; upbeat, temporal strategies for remaining positive and journey of the self. Findings from the first theme are presented in detail here. It was found that each participants’ relationship with their donor grew and developed in different ways, presenting their own complex challenges in terms of developing relationships and ambiguity around the decision to use the chosen donor.

The psychological challenges of living with an ileostomy : an interpretative phenomenological analysis

Objectives: Ileostomy, in which the small intestine is redirected out of an abdominal wall so that waste is collected using a bag, is used to treat conditions including inflammatory bowel disease and colorectal cancer. This article reports an in-depth idiographic analysis of the experience of living with an ileostomy. Method: Twenty-one participants took part in semistructured interviews about their lives and relationships. Those interviews were transcribed verbatim and analyzed using the experiential qualitative methodology interpretative phenomenological analysis. Results: Two superordinate themes arose from the data: ileostomy’s intrapersonal impact and the impact of ileostomy on relationships with others. The authors found that ileostomy may destabilize the sense of self, disrupt body image, and alter experience of age and sexuality. Other participants were able to use their illness to positively reframe the self. Disclosure of ileostomy status was difficult for some. Intimate and friend relationships were often challenged by stoma status, whereas other family relationships were largely characterized as supportive. Conclusions: Ileostomy may impact upon both intra- and interpersonal aspects of the lives of those who live with it, in both negative and positive ways. Consequently, the sense of self can appear challenged, and relationships with partners, family members and friendships could be causes of distress. On the other hand, some partners were supportive, and children were found to be sources of comfort.

Waiting for a kidney from a deceased donor: an interpretative phenomenological analysis

Abstract Demand for kidneys from deceased donors far outstrips supply. Despite this, there appears to be little research that focuses solely on the experience of waiting for a kidney from a deceased donor. This study uses the qualitative methodology interpretative phenomenological analysis to explore the lives of 10 people on the transplant list, with the aims of illuminating the potential psychological challenges those on the list may face during this time, and providing information to help clinicians more fully support such people in the future. Two themes connected to the experience of waiting – adjustment to the uncertainty of waiting and thinking about receiving a kidney from a living donor – are presented here. Participants describe a sense of confusion and uncertainty around life on the list, and discuss their strategies for dealing with this. Novel complexities around the ambiguous challenge of receiving an organ from a deceased donor are revealed. It is recommended that health care teams provide a forum for this patient group to work through these feelings of confusion and ambiguity.

The treatment experiences of people living with ileostomies: an interpretative phenomenological analysis

AIMS The aim of this study was to explore treatment and healthcare experiences of people living with ileostomies, so nurses can build on best practice while caring for these patients. BACKGROUND Ileostomies, where the small intestine is re-directed out of a stoma in the abdominal wall so waste is collected using a bag, are used to treat conditions including inflammatory bowel disease. Existing research suggests that although life with a stoma can be challenging, ileostomy patients are largely supported by multi-disciplinary teams. However, more research is needed to understand the nuances of these relationships and experiences of treatment, with a view to improving clinical care. DESIGN Participants took part in semi-structured interviews consisting of open-ended questions about their experiences of life with an ileostomy and their treatments and time in hospital. Points of interest were followed up. Data were collected between July-December of 2014. METHODS The qualitative method interpretative phenomenological analysis was used to analyse interviews with 21 people living with ileostomies. FINDINGS We present findings from two clinical themes: Issues around treatment and Relationships with multi-disciplinary teams. Surgical complications were common and several participants reported concerns about addiction to painkillers. Varying attitudes were found around reversal surgery. Many reported experiencing distressing, dehumanizing care, while some felt supported by excellent healthcare providers. CONCLUSION People living with ileostomies have a very mixed experience of multi-disciplinary teams and treatments and much could be done to support them more fully. For example, more information about ileostomies could be given to patients and more training given to nurses around stomas.

The Experience of Antiretroviral Treatment for Black West African Women who are HIV Positive and Living in London: An Interpretative Phenomenological Analysis

Antiretroviral therapy (ART) offers a powerful intervention in HIV but effectiveness can be compromised by inadequate adherence. This paper is a detailed examination of the experience of medication in a purposively selected group of people living with HIV. In-depth interviews were conducted with 10 HIV positive, West African women of black heritage living in London, UK. This group was of interest since it is the second largest group affected by HIV in the UK. Interviews were subjected to interpretative phenomenological analysis, an idiographic, experiential, qualitative approach. The paper details the women’s negative experience of treatment. ART can be considered difficult and unrelenting and may be disconnected from the women’s sense of health or illness. Participants’ social context often exacerbated the difficulties. Some reported an improvement in their feelings about the medication over time. These findings point to some intrinsic and social motivators which could act as spurs to adherence.

Using Autobiographical Poetry as Data to Investigate the Experience of Living with End-Stage Renal Disease

The experience of living with End-Stage Renal Disease (ESRD) and being on dialysis is a complex and life-changing one that has received some investigation within the qualitative psychological realm (see e.g. Gill & Lowes, 2008; Martin-McDonald, 2003; Polaschek, 2003). This is a period of time that can lead to difficulties with autonomy and empowerment (Burnette & Kickett, 2009; Hagren, Petterson, Severinson, Lutzen & Clyne, 2001).