Julianne Cheek

At the Margins? Discourse Analysis and Qualitative Research

Discourse analysis is a qualitative research approach that offers the potential to challenge our thinking about aspects of the reality of health and health care practice. In this article, the author explores one approach to discourse analysis and examines how it offers possibilities for different ways of viewing health and health care practices. She concludes by raising questions as to whether discourse analysis is at the margins of qualitative research, whether that matters, and where discourse analysis might take those margins.

The North West Adelaide Health Study: detailed methods and baseline segmentation of a cohort for selected chronic diseases

The North West Adelaide Health Study is a population-based biomedical cohort study investigating the prevalence of a number of chronic conditions and health-related risk factors along a continuum. This methodology may assist with evidence-based decisions for health policy makers and planners, and inform health professionals who are involved in chronic disease prevention and management, by providing a better description of people at risk of developing or already diagnosed with selected chronic conditions for more accurate targeting groups for health gain and improved health outcomes. Longitudinal data will provide information on progression of chronic conditions and allow description of those who move forward and back along the continuum over time. Detailed methods are provided regarding the random recruitment and examination of a representative sample of participants (n = 4060), including the rationale for various processes and valuable lessons learnt. Self-reported and biomedical data were obtained on risk factors (smoking, alcohol consumption, physical activity, family history, body mass index, blood pressure, cholesterol) and chronic conditions (asthma, chronic obstructive pulmonary disease, diabetes) to classify participants according to their status along a continuum. Segmenting this population sample along a continuum showed that 71.5% had at least one risk factor for developing asthma, chronic obstructive pulmonary disease or diabetes. Almost one-fifth (18.8%) had been previously diagnosed with at least one of these chronic conditions, and an additional 3.9% had at least one of these conditions but had not been diagnosed. This paper provides a novel opportunity to examine how a cohort study was born. It presents detailed methodology behind the selection, recruitment and examination of a cohort and how participants with selected chronic conditions can be segmented along a continuum that may assist with health promotion and health services planning.

What's in a Number? Issues in Providing Evidence of Impact and Quality of Research(ers)

One of the challenges facing qualitative researchers in a climate in which audit culture has permeated many facets of the institutions in which they research is how to establish the impact and quality of their research. When examining track records, granting institutions place significant emphasis on publication performance. Although the quality and impact of publications have traditionally been assessed by peer review, there is currently a global trend toward the development, refinement, and increased use of quantitative metrics, particularly citation analysis and journal impact factor. In this article, the authors share their experience of using the metrics citation analysis and journal impact factor in the preparation of an application for funding. Their aim is twofold: to raise awareness about potential issues in the practical application of these metrics; and to offer critique about and, they hope, “quality” to the writing and rhetoric concerning how to measure publication impact and quality.

An open letter to The BMJ editors on qualitative research

Seventy six senior academics from 11 countries invite The BMJ ’s editors to reconsider their policy of rejecting qualitative research on the grounds of low priority. They challenge the journal to develop a proactive, scholarly, and pluralist approach to research that aligns with its stated mission

Healthism: A New Conservatism?:

Health care is a space occupied, shaped, and colonized by a variety of players at a variety of times. Such players include health practitioners of different kinds; individuals referred to variously and even simultaneously as consumers/patients/clients/customers, depending on who is doing the speaking and in what contexts; families and significant others; managers; accountants; lawyers; educators; and researchers, as well as governments both local and national. Players move in and out of this space (or are allowed in or are moved out) all the time. They might find parts of themselves/their lives/their situations in this space, whereas other parts are not found there. Health care is indeed a contested and troubled space, one that is increasingly uncertain and ambiguous. In this article, I explore aspects of this uncertainty and ambiguity in current health care practice and what this might mean for individuals receiving the services and those providing and/or researching those services.

Crushing or altering medications: what's happening in residential aged‐care facilities?

Objectives: To determine the extent to which medications are altered or crushed prior to administration to residents of aged‐care facilities, the medications involved and the methods employed.

Moving them on and in: The Process of Searching for and Selecting an Aged Care Facility

This exploratory, descriptive study examined the search and selection process for an aged care facility following discharge of a family member from an acute setting. Few studies have examined this process and its effects on families. Individuals from 25 families where a family member had been recently admitted to an aged care facility following discharge from an acute setting were interviewed. This article reports participants’ perceptions of the search and selection process and its effect on the family. Five major themes emerged from the data: good fortune, wear and tear on the sponsor, dealing with the system, urgency, and adjusting. The results can be used to inform and assist families and health professionals working with families in this situation.

Qualitative Inquiry, Ethics, and Politics of Evidence Working Within These Spaces Rather Than Being Worked Over by Them

Just as qualitative research is “endlessly creative and interpretative,” qualitative researchers find themselves in the position of having to be endlessly creative and interpretive with respect to the various spaces they move in and out of as they conceptualize, conduct, write, and report their research. Some of these spaces are shaped by new and mutated forms of “old” regimes of truth based in audit culture, others by refracted forms of methodological fundamentalism and imperialism emanating from without but significantly also increasingly from within, writing and talking about qualitative research. Navigating and moving in and out of these spaces creates tensions but also possibilities for qualitative researchers. This article aims to encourage a focus on better understanding these spaces.

Vietnamese women and pap smears: issues in promotion

Objective: Australian data indicate that Vietnamese‐born women in Australia have a significantly higher incidence of cervical cancer than other Australian women. This study explored self‐reported factors associated with Vietnamese‐born womens participation in cervical screening.

Influencing Practice or Simply Esoteric? Researching Health Care Using Postmodern Approaches

Increasingly, contemporary health literature has begun to explore the potential of postmodern approaches to enable new and different analyses of health care practice. Paradoxically, as the use of postmodern approaches has increased, so has the lack of clarity with respect to what constitutes a postmodern approach. Challenges to postmodern approaches to research have come from those who argue that they contribute nothing to either the understanding of the reality of health care or the improvement of the delivery of health care services. This article will explore what postmodern research approaches are and use examples of research to illustrate how such approaches can inform understandings of health and health care practice, thereby opening up possibilities for change. It is designed to encourage people with an interest in postmodern approaches to undertake research that has clear applicability to, and influence on, health care practice.