Maria Clark

The state of qualitative research in health and social science literature: a focused mapping review and synthesis

Abstract Pluralism and creativity are inherent and important parts of the qualitative endeavour. The multiplicity of approaches and methods can, however, be confusing. We undertook a focused mapping review and synthesis to obtain a snap-shot profile of the state of qualitative research in health and social science literature. We retrieved 102 qualitative articles published between January and March 2015 from six leading health and social science journals. Articles were scrutinised for alignment between researchers’ reported orientation (methodological or philosophical positioning) and the techniques used (methods). In the sampled articles level of alignment was generally high, with considerable mastery of qualitative approaches evident. However, the complexity of the qualitative landscape highlighted in our review, led us to develop a diagrammatic representation: The Qualitative Research Level of Alignment Wheel™. This educational resource/teaching aid is designed to assist qualitative researchers (particularly those more novice) and research students to locate the orientation and techniques of their studies. As an important contribution to the international field of qualitative inquiry, it will assist in understanding and accounting for points at which techniques are melded and orientations blended. In turn this will lead to the individual and collective qualitative endeavour as being a coherent one.

Suggestions regarding adaptation of the STRICTA guidelines for reporting acupuncture practice and research

Dear Editor, We are writing to share some thoughts regarding our use of the STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) guidelines1 in two recent reviews of acupuncture for plantar heel pain.2 ,3 STRICTA was, of course, designed as a guide for the reporting of acupuncture and similar interventions. We needed to evaluate reporting from particularly diverse sources for review purposes, so we made a number of adaptations to the criteria (detailed below). We felt that some of the original items did not capture enough of the data that we were interested in, so we subdivided them to create some additional items. STRICTA item 1c addresses the ‘extent to which treatment was varied’. We found this ambiguous; as well as varying between individual patients or practitioners, treatments may vary between successive sessions. To make this distinction, we subdivided this item into 1ci (individualisation) and 1cii (follow-up variation). Item 4b (‘setting and context’) includes instructions to practitioners and information for …

Rationales and treatment approaches underpinning the use of acupuncture and related techniques for plantar heel pain: a critical interpretive synthesis

Background Acupuncture shows promise as a treatment for plantar heel pain (PHP) or plantar fasciitis (PF), but data heterogeneity has undermined demonstration of efficacy. Recognising that acupuncture is a diverse field of practice, the aim of this study was to gain a broader, global perspective on the different approaches and rationales used in the application of acupuncture in PHP. Methods We built upon an earlier systematic review (which was limited by the necessity of a methodological focus on efficacy) using the critical interpretive synthesis (CIS) method to draw upon a wider international sample of 25 clinical sources, including case reports and case series. Multiple tracks of analysis led to an emergent synthesis. Results Findings are presented at three levels: primary (summarised data); secondary (patterns observed); and tertiary (emergent synthesis). Multiple treatments and rationales were documented but no single approach dominated. Notable contradictions emerged such as the application of moxibustion by some authors and ice by others. Synthesis of findings revealed a ‘patchwork’ of factors influencing the approaches taken. Conclusions The complexity of the field of acupuncture was illustrated through the ‘lens’ of PHP. The ‘patchwork’ metaphor provides a unifying framework for a previously divergent community of practice and research. Several directions for future research were identified, such as: importance of prior duration; existence of diagnostic subgroups; and how practitioners make clinical decisions and report their findings. CIS was found to provide visibility for multiple viewpoints in developing theory and modelling the processes of ‘real world’ practice by acupuncturists addressing the problem of PHP.

How public health nurses’ deal with sexting among young people: a qualitative inquiry using the critical incident technique

BackgroundGlobally, the potentially harmful effects of using cell phone technology for ‘sexting’ among young people, is a public health concern. The background literature indicates that sexting might have adverse psychosocial consequences for some young people who share partially nude images (‘selfies’). Public health nurses (PHNs) could offer guidance to children and young people on digital safety, yet little is known about their role in this regard. This study explored PHNs’ knowledge and confidence in addressing the issue among young people.MethodA qualitative study was undertaken using the Critical Incident Technique. The study took place in 2016. Eighteen semi-structured interviews were conducted with PHNs in a region of England. Data were analysed through thematic analysis, and managed through the use of NViVo 11 software. From the entire data set, thirteen critical incidents were identified of which nine were deemed relevant for reporting in this paper.ResultsPHNs regarded sexting as a contemporary ‘normalised’ practice that takes place in what young people consider to be trusting relationships. PHNs’ knowledge was informed by media reports that supported their beliefs about young peoples’ vulnerability to risk-taking sexual behaviour. They were not confident about discussing sexting with young people, even though some PHNs had done so in light of concerns about potential child sexual exploitation.ConclusionPHNs have a role to play in advising young people on digital safety, but findings of the study show that their role is not fully realised. They have some knowledge of sexting as a possible signifier of abusive behaviour. However, they are not always confident in dealing with the issue. Improving PHNs ability to promote digital safety through better understanding of technology use among young people is good safeguarding practice. This may, in turn, better define this important nursing contribution to public health.

A Profile of Gender-Based Violence Research in Europe: Findings From a Focused Mapping Review and Synthesis:

This article reports the findings from a new form of review: a focused mapping review and synthesis. The aim was to create a contemporary, snapshot profile of the nature and scope of gender-based violence (GBV) studies conducted in Europe. GBV is one of the most prevalent human rights violations in the world affecting mainly women and girls. The policy context of GBV in Europe has gathered momentum in recent years, but we do not have a clear picture of how this relates to research activity. Thirteen journals were purposively selected on their likelihood to publish GBV research. All articles published in these journals during 2015 and meeting our inclusion criteria were retrieved. Data were extracted according to (1) types of methodologies used, (2) geographical location of research, and (3) patterns of research activity/interest. Thirty-two articles met the inclusion criteria. Many titles and abstracts were not explicit about the gendered nature of the research which made retrieval and analysis difficult. A range of methodologies were reported, with single-country research conducted more than international collaborations. Intimate partner violence and sexual abuse attracted most research interest. No studies explored female genital mutilation/cutting and only one investigated early and forced marriage. The findings have implications regarding GBV research in Europe, and we explore them in relation to relevant European policy. Researchers can help raise the profile of the gendered nature of most violence-related research by being explicit about this in their publications. Increasing opportunities for cross-national research will help address the global nature of GBV. Tackling GBV requires synergy of empirical evidence and policy to drive the agenda.

Two to Tanka: poetry as a duoethnographic method for exploring sensitive topics

Duoethnography is a method of dialogical reflection that combines different voices and juxtaposing worldviews in order to glean fresh perspectives on wider social or professional issues. In this paper we use poetry to support an inter-professional duoethnographic exploration of sensitive issues in nursing and healthcare. Using a method of linked tanka poetry, we bring together perspectives from our respective work in nursing and occupational therapy to explore the sensitive issues of loss, death, dementia, cultural conflict and trauma. We demonstrate collaborative poetry writing as a novel, useful approach in duoethnography, demonstrating how tanka poems – short, structured poems originating from 7th-century Japan – are effective in supporting reflexive dialogue. Drawing on theoretical underpinnings and practical experience, we highlight the opportunities and challenges of using tanka poetry to facilitate collaborative discussion and problem-solving. We highlight how tanka could support difficult conversations between practitioners, researchers, service users, educators and students through its succinct immediacy. Moreover, by showcasing the use of collaborative poetry writing as a method of inquiry, this paper offers a novel methodological contribution to the broader area of qualitative research for education, research and practice.

Abused women's experiences of a primary care identification and referral intervention: A case study analysis.

AIMS The aim of this study was to report the findings of a qualitative case study that investigated abused womens experiences of an identification and referral intervention and to discuss the implications for nurses, specifically those working in primary and community care. BACKGROUND Domestic violence and abuse is a significant public health issue globally but it is a hidden problem that is under-reported. In the UK, Identification and Referral to Improve Safety is a primary care-based intervention that has been found to increase referral rates of abused women to support and safety services. This paper reports on the findings of an evaluation study of two sites in England. DESIGN Qualitative study with a case study design. METHODS In line with case study design, the entire evaluation study employed multiple data collection methods. We report on the qualitative interviews with women referred through the programme. The aim was to elicit their experiences of the three aspects of the intervention: identification; referral; safety. Data collection took place March 2016. FINDINGS Ten women took part. Eight had exited the abusive relationship but two remained with the partner who had perpetrated the abuse. Women were overwhelmingly positive about the programme and irrespective of whether they had remained or exited the relationship all reported perceptions of increased safety and improved health. CONCLUSION Nurses have an important role to play in identifying domestic violence and abuse and in referral and safety planning. As part of a portfolio of domestic violence and abuse interventions, those that empower women to take control of their safety (such as Identification and Referral to Improve Safety) are important.

Letter: Suggestions regarding adaptation of the STRICTA guidelines for reporting acupuncture practice and research

Das Problem der Studie ist die Scheinakupunktur. Die klassische chinesische Akupunkturtheorie geht davon aus, dass es keine Wirkung hat, wenn man 2 cm neben dem Meridian sticht. Dies hat sich in den letzten Jahren, vor allem durch die deutschen Modellvorhaben, als Fehlannahme herausgestellt. Inzwischen wissen wir, dass es kaum einen Unterschied macht, wo akupunktiert wird, solange man sich innerhalb der richtigen Segmente befi ndet. Für die Organe des gynäkologisch-urologischen Raumes sind das die Segmente Th10 bis L2. Es besteht ein kleiner Unterschied zwischen Nadelungen z. B. der Blasen-Leitbahn und weiter außen liegenden Punkten, da lateral die Dichte der Nervenversorgung geringer ist. Deshalb ist in der Studie der Unterschied zwischen Elektroakupunktur an Akupunkturpunkten und Scheinakupunktur etwas weiter lateral nicht sehr groß, zumal sich elektrische Reizungen großfl ächiger als die reine Nadelung ausbreiten und in ihrem Radius schlecht steuern lassen. Eigentlich sollten die Vergleiche mit einer Scheinakupunktur obsolet sein. Wichtiger wäre ein Vergleich mit einer anderen bewährten Therapie, z. B. Beckenbodentraining oder Duloxetin, der medikamentösen Standard-Therapie für Urininkontinenz.

Review: The reflexive role of Tanka poetry in domestic abuse research

I enjoyed reviewing this paper. It offered a novel insight into the role of Tanka poetry in qualitative domestic abuse research and contributes to reflexive methodology. Tanka’s emergence as clandestine love poetry in 7th-century Japan led to the author’s modern application in domestic abuse research. The five-versed Tanka derived from interview data is carefully crafted and supported by literary analysis. The author examines the ethical question of ‘Whose voice?’ in poetic research and discusses the professional and personal challenges, emotional labour and potential vicarious trauma in sensitive practice and research with abused women. Value for practice is contingent upon future clinical and research application. The strength of this contribution lies in what the author describes as the short, sharp immediacy of the Tanka verse. Sharing the poems is useful for all persons needing cues to talk about domestic abuse. The poems are also a creative arts resource for trauma-informed healthcare. Poetic immediacy is evident here: