Pranee Liamputtong

Doing sensitive research: what challenges do qualitative researchers face?

As health researchers we need to investigate a wide range of topics to enhance our understanding of the many issues that affect health and well-being in todays society. Much of the health research undertaken today involves face-to-face encounters with participants using qualitative methodologies. There is a growing recognition that undertaking qualitative research can pose many difficulties for researchers. However, very little research has focused directly on the experiences of researchers while undertaking qualitative research and the issues that their involvement in the research raises for them. To explore these issues, one-to-one interviews were conducted with 30 qualitative health researchers. A grounded theory analysis revealed that researchers can face a number of challenges while undertaking qualitative research. These include issues relating to rapport development, use of researcher self-disclosure, listening to untold stories, feelings of guilt and vulnerability, leaving the research relationship and researcher exhaustion. These results are discussed and recommendations for researchers involved in qualitative research are made.

Blurring Boundaries in Qualitative Health Research on Sensitive Topics

Qualitative health researchers immerse themselves in the settings that they are studying. This immersion involves personal interaction with their participants, with the result that the boundaries between the researcher and the group of people under study can easily become blurred. Although health researchers have been undertaking qualitative research for many years, recognition of boundary issues inherent in this type of research have received little attention. To investigate such issues, the authors conducted interviews with 30 qualitative health researchers. A grounded theory analysis of the interview transcripts revealed that researchers can identify a number of boundaries in their research, including the boundaries between researcher and friend, researcher and counselor or therapist, and professional boundaries. The authors discuss the findings and offer recommendations for qualitative health researchers involved in researching sensitive topics, including the need for researchers to consider the impacts that undertaking research might have on them.

Risk to Researchers in Qualitative Research on Sensitive Topics: Issues and Strategies

Traditionally, risk assessments in research have been limited to examining the risks to the research participants. Although doing so is appropriate and important, there is growing recognition that undertaking research can pose risks to researchers as well. A grounded theory study involving a range of researchers who had undertaken qualitative health research on a sensitive topic was completed. Analysis of the in-depth, face-to-face unstructured individual interviews with 30 Australian public health researchers provided evidence that researchers do confront a number of physical and emotional risks when undertaking research. Training, preparation, and supervision must be taken into account so that the risk to researchers can be minimized. Researchers need to consider occupational health and safety issues in designing research projects that deal with physical and emotional risks. Recommendations for professional supervision, policy development, and minimum training standards for researchers are provided.

Online Dating and Mating: The Use of the Internet to Meet Sexual Partners

Australia has experienced a large increase in Internet usage, and online dating is used for seeking romantic and sexual partners. Using a qualitative approach, 15 people who use online dating took part in in-depth, online chat interviews. Nearly all participants used multiple dating sites to seek partners and making use of email, chat and webcam to engage with, assess, validate and qualify their potential sexual partners. They would “filter” the identity of other online daters before taking further actions. They used an array of filters and filtering processes to determine when and how they might progress to face-to-face meetings with these other online daters, and if and how there might be sexual outcomes from these meetings. Participants filtered using the text, photographs, chat, and webcam opportunities available online, and followed progressive personalized steps in communication and engagement in the lead-up to meeting other online daters in person.

HIV AND AIDS, STIGMA AND AIDS SUPPORT GROUPS: PERSPECTIVES FROM WOMEN LIVING WITH HIV AND AIDS IN CENTRAL THAILAND

In this paper, community attitudes toward women living with HIV and AIDS at the present time from the perspectives of women in Thailand are examined. We also look at strategies women use in order to deal with any stigma and discrimination that they may feel or experience in the community. The paper is based on our larger study of the experiences of women living with HIV and AIDS and their participation in clinical trials. In late 2007 and early 2008 we carried out a number of in-depth interviews with women living with HIV and AIDS in central Thailand. We find that women living with HIV and AIDS still deal with stigma and discrimination in their everyday life. However, from the womens narratives, we also find more positive attitudes from local communities. Some women deal with stigma and discrimination by joining and participating in HIV and AIDS support groups that have emerged in response to the AIDS epidemic in Thailand. We argue that women are not passive victims, but that they act in their own agencies to counteract any negativity they might encounter.

Doing Research in a Cross-Cultural Context: Methodological and Ethical Challenges

Conducting cross-cultural research is rife with methodological and ethical challenges. Researchers are challenged with many issues when carrying out their research with people in cross-cultural arenas. This chapter serves to set the scene of this book and points to several salient issues in doing research in cross-cultural settings. I aim firstly to provide discussion on the essence of cultural sensitivity in cross-cultural research. I will then discuss matters relating to language issues and the use of bicultural researchers in cross-cultural research. I shall suggest strategies to gain access to research participants in cross-cultural research. Lastly, I will examine moral and ethical issues in cross-cultural research, and discuss the thorny subject of informed consent in cross-cultural research.

Knowledge and acceptance of human papillomavirus vaccination: perspectives of young Australians living in Melbourne, Australia

BACKGROUND This paper explores knowledge of and attitudes toward sexually transmissible infections, human papillomavirus (HPV) vaccination and vaccine acceptability among young people in Australia. It also explores factors influencing acceptance and attempts to identify gender differences in knowledge and acceptance. METHODS The study employed a qualitative approach and involved 14 in-depth interviews with young men and women aged between 18 and 23 years who reside in Melbourne, Australia. RESULTS The findings suggest that knowledge of HPV is inadequate; however, this was not found to have any impact on vaccine acceptance, which was reported as high. No clear gender differences were found in virus and vaccine knowledge and vaccine acceptance. CONCLUSION It is clear in the present study that vaccination is generally viewed positively by the young men and women involved in the study and the health beliefs of these individuals have been shaped largely by several factors including cost of the vaccine, access to the vaccine and personal susceptibility to the virus.

Stigma, Discrimination and Living with HIV/AIDS: A Cross-Cultural Perspective

Preface.- Chapter 1: Stigma, Discrimination and HIV/AIDS across Cultures: An Introduction Pranee Liamputtong.- PART I. STIGMA, DISCRIMINATION, HIV/ AIDS - THEORETICAL UNDERSTANDING.- Chapter 2: Stigma Experienced by People Living with HIV/AIDS Valerie A. Earnshaw and Seth C. Kalichman.- Chapter 3: Gender and AIDS Stigma Robert Wyrod.- Chapter 4. HIV-related Stigma across Cultures: Adding Family into the Equation Connie Y.Y. Ho and Winnie W.S. Mak.- Chapter 5. Disclosure and Stigma: A Cultural Perspective Minrie Greeff.- Chapter 6. HIV Stigmatization among Healthcare Providers: Review of the Evidence and Implications for HIV Care Jessie Naughton and Peter A. Vanable.- PART II. THE EXPERIENCES OF STIGMA AND DISCRIMINATION ACROSS SOCIAL AND CULTURAL GROUPS.- Chapter 7. Morality, Discrimination, and Silence: Understanding HIV Stigma in the Socio-Cultural Context of China Yanqiu Rachel Zhou.- Chapter 8: Stigma and Discrimination towards People Living with HIV: Socio-Cultural Aspects, Experiences, and Ethical and Legal Responses in Colombia Chantal Aristizabal-Tobler.- Chapter 9: Internalized Stigma among African American Living with HIV: Preliminary scale Development based on Qualitative Data Deepa Rao, Michele Andrasik, Xeno Acharya and Jane Simoni.- Chapter 10. HIV-related Stigma and Discrimination in Puerto Rico: The Role of Sympathy on Attitudes towards Persons Living with HIV/AIDS Lisa R. Norman.- Chapter 11: HIV-Related Stigma and HIV Disclosure among Latinos on the U.S.-Mexico Border John A. Sauceda, John S. Wiebe, Deepa Rao, Cynthia R. Pearson and Jane M. Simoni.- Chapter 12: The Experience of HIV-Related Stigma in South Africa Maretha Visser and Heather Sipsmau.- Chapter 13: Spaces of Disclosure and Discrimination: Case Studies from India Ajay Bailey and Shrinivas Darak.- Chapter 14: Stigma, Modernization, Sex Behavior, and Infection Risk among Chinese Youth Eli Lieber, Ioakim Boutakidis and Dorothy Chin.- Chapter 15. Layered Stigma andd HIV/AIDS: Experiences of Men who have Sex with Men (MSM) in South Africa Allanise Cloete, Seth C. Kalichman and Leickness C. Simbayi.- Chapter 16. Emerging Gay Identities in China: The Prevalence and Predictors of Social Discrimination against Men who have Sex with Men Jenny X. Liu and Kyung-Hee Choi.- Chapter 17. Strange Bedfellows: HIV-Related Stigma among Gay Men in Australia John B.F. de Wit, Dean A. Murphy, Philippe C.G. Adam and Simone Donohoe.- Chapter 18: The Hierarchical Experience of Stigma in HIV/ Hepatitis C Co-Infected Gay Men Gareth J. Owen.- PART III. DEALING WITH AND MANAGEMENT OF STIGMA AND DISCRIMINATION.- Chapter 19. HIV/AIDS Related Stigma among African Americans in the southern United States Pamela Payne Foster and Susan W. Gaskins.- Chapter 20. An Antitode to Stigma? The People Living with HIV Stigma Index in Malawi and the United Kingdom (UK) Lucy Stackpool-Moore, Maureen L. Chirwa, Sam de Croy, Alastair Hudson, David Kamkwamba, Ruth Kundecha, Pamela T. Mahaka, Sue Onyango and Eunice Sinyemu.- Chapter 21: Achieving Harmony: Moving from Experiencing Social Disgust to Living with Harmony in People with HIV/AIDS in the Thai Context - Quantar Balthip, Julie Boddy and Jirapa Siriwatanamethanon.- Chapter 22: AIDS Support Groups and Women Living with HIV/AIDS in Thailand - Pranee Liamputtong, Niphattra Haritavorn and Niyada Kiatying-Angsulee.- Chapter 23: Gender Differences in Stigma and Community Support among People Living with HIV/AIDS in Thailand - Fumihiko Yokota and Mark VanLandingham.

The views of older Chinese people in Melbourne about their quality of life

This paper reports the findings of a study using both quantitative and qualitative approaches of the quality of life of older Chinese people in Melbourne. A total of 60 participants was recruited: 30 were residents of three Chinese hostels and 30 were members of a Chinese welfare society. Along with the established scales of health status, functioning and self-reported life satisfaction, to give a broader perspective the participants were asked about their general health, level of depressive mood and independence. In-depth interviews were conducted with a convenience sub-sample of six informants to explore other important aspects of their quality of life. The hostel group was found to be less healthy, less independent, more depressed and less satisfied with their lives than the community group, but nonetheless were generally satisfied with their lives, as revealed during the in-depth interviews. A good quality of life was found to be associated with good health, independence, secure finance, a meaningful role, strong ethnic community and family support, low expectations, no worries, and a sense of the familys love and respect. The findings reinforce the notion that the quality of life is truly multi-dimensional. They also demonstrate that a high self-rated quality of life in old age is achievable and, indeed, was being enjoyed by most of the participants. The research has made a substantial contribution to understanding the circumstances of Chinese-origin older people in Australia and has useful lessons for studies of other ethnic groups.

Pregnancy, childbirth and motherhood: A meta-synthesis of the lived experiences of immigrant women

INTRODUCTION pregnancy, childbirth and motherhood are natural processes that bring joy to individual women and families. However, for many migrant women, becoming a mother while attempting to settle in a new country where the culture is different, can be a challenge for them. AIM to identify and synthesise qualitative research studies that explore the perceptions of pregnancy, childbirth and motherhood, and lived experiences of migrant women in their new home country. METHODS the seven steps of Noblit and Hare׳s meta-ethnography was used to conduct the meta-synthesis. Searches for literature of qualitative studies were conducted in May and June 2013 using PubMed, CINAHL, Google Scholar and La Trobe University databases. Studies published in English addressing pregnancy, childbirth and motherhood experiences of women from immigrant backgrounds met the inclusion criteria. FINDINGS 15 studies published between 2003 and 2013 related to the pregnancy, childbirth and motherhood experiences for women from migrant backgrounds were eligible for the meta-synthesis. Four major themes were identified as common in all the qualitative studies: expectations of pregnancy and childbirth; experiences of motherhood; encountering confusion and conflict with beliefs; and dealing with migration challenges. CONCLUSIONS migrant women׳s pregnancy, childbirth and motherhood experiences are influenced by societal and cultural values, and they vary depending on the adjustment process in the new home country. The provision of culturally sensitive maternal health services enhances positive outcomes of a healthy mother and healthy infant. Supportive structures that address the issue of language and cultural barriers seem to promote antenatal clinic attendance, prevent pregnancy and childbirth complications, and enhance their positive motherhood experiences. IMPLICATIONS women from immigrant backgrounds have the right to receive adequate and sensitive health care during the childbearing and childrearing times regardless of their migrant status.