Ulrika Hallberg

Giving low priority to oral health care. Voices from people with disabilities in a grounded theory study.

Objective. Our knowledge of how people with disabilities look upon oral health and dental care is limited. The aim of this study was thus to explore how the people with disabilities experience the encounter with dental health care. Material and Methods. With a focus on dental care and oral health, qualitative interviews with 16 informants with cognitive and/or physical disabilities were analysed in accordance with the qualitative method of grounded theory. Results. A core category identified and labeled “giving low priority to oral health care” was found to be related to four other categories: “being afraid of losing control”, “having difficulties complying with instructions”, “having a desire for continuity”, and “wishing to be just like everyone else”. The results show that oral health and dental care are important, but are not considered a priority by the people with disabilities. General health issues have much higher priority but do not include oral health, which consequently can affect oral health negatively. Conclusions. Of several factors identified that could be improved to make dental visits more pleasant for patients are enhancing a sense of control in the patient and improving continuity.

Oral health -- not a priority issue a grounded theory analysis of barriers for young patients with disabilities to receive oral health care on the same premise as others.

Oral health problems are reported more frequently in children with disabilities, but the reasons for this are not fully known. The present study was conducted to illuminate and to gain a deeper understanding of the possible barriers preventing children with disabilities from receiving oral health care on the same premise as others. Transcribed in-depth interviews with 65 informants (14 parents, 18 dental health-care professionals, 17 medical health-care professionals, and 16 individuals with disabilities) were analysed in open, axial, and selective coding processes according to Grounded Theory. The results showed that no-one seems to take an overriding responsibility for the oral health of young patients with disabilities. This was described in a formal theory showing that defective knowledge about importance of oral health, limited ability to focus on oral health, and uncertainty in treating the unknown in patients, family, and dental and medical health-care professionals result in a situation in which oral health is left out in young patients with disabilities; it is not a priority issue.

Situation and psychosocial well-being of older sisters to children with disabilities or chronic illnesses - the forgotten children?

It is estimated that about 18% of all children aged between 5 and 17 years suffer from some kind of disability or chronic illness (Pastor, Reuben, & Loeb, 2009). Most of these children live at home with their parents and siblings, which put high demands not only on the parents but also on the siblings (Abrams, 2009) who have been described as the ‘‘forgotten children’’ (Madan-Swain, Sexson Brown, & Ragab, 1993) and a ‘‘population at risk’’ (Hannah & Midlarsky, 1985). The number of research studies concerning these siblings has increased over the past decades even if most of the studies concern children with cognitive disabilities (Pit-ten Cate & Loots, 2000). It is not evident that one can generalize these results to children with physical disabilities or chronic illnesses since the demands of the different types of conditions put on the adjustment ability to their families are somewhat different (Sloper & Turner, 1993). Furthermore, most of this research studies the sibling’s situation and wellbeing from the mother’s perspective (Sari, Baser, & Turan, 2006; Stoneman, 2005) and siblings as a group and, thus, are not gender- or age-specific studies. (Published: 2 July 2013) Citation: Int J Qualitative Stud Health Well-being 2013, 8 : 21755 - http://dx.doi.org/10.3402/qhw.v8i0.21755

Living at the edge of one's capability: Experiences of parents of teenage daughters diagnosed with ADHD

Living with a child with a disability is often perceived as a permanent stressor to the family and it affects all aspects of family life including the well-being of family members. Since little is known about parenting teenage daughters diagnosed with ADHD, the aim of the study was to gain a deeper understanding of the main problem involved using a grounded theory approach. Interviews were carried out with 12 parents, 11 mothers and 1 father, of teenage daughters diagnosed with ADHD. The parents’ situation was conceptualized as living at the edge of ones capability with the properties having the sole parental responsibility, fighting for professional support, being on duty around the clock and trying to solve family conflicts. Parents described how their health was negatively affected by their life situation.

Hiding parts of one's self from others – a grounded theory study on teenagers diagnosed with ADHD

The aim of this study was to gain deeper knowledge of how teenagers with the diagnosis of ADHD experience their disorder, treatment and the consequences of diagnosis and treatment in their daily lives. Ten teenagers were interviewed in depth. The interviews were analyzed according to the grounded theory method. In the analysis of the data the core category hiding parts of ones self from others emerged. Four other categories were also identified: being different from others; wanting to be like everybody else; keeping the medical treatment a secret; and feeling worried about the future. The teenagers strove for normalcy and wanted to be like everyone else. They tried their utmost to conceal their diagnosis and medical treatment from others, such as schoolmates, friends and the reference group.

Differences in health and well-being of parents of children with disabilities

When a child with a disability is born, reaction of most parents, regardless of gender, span a range of feelings, starting from denial, shock, anger to, hopefully, at last, reconciliation with the circumstances. Different research studies have shown that most of such parents experience increased levels of stress and extended responsibility due to their new situation, and gender differences do determine the experience and reaction to the situation and also the health and well-being of those affected. Women tend to be more affected by stressful life events in general than men, especially when these events affect individuals with whom they have a relationship, such as family members. Women also report a decreased sense of control in stressful situations*they experience more psychological distress and depression and they tend to use more emotion-focused coping-strategies than men such as verbalizing the problems and seeking support from others. Mothers of children with disabilities experience a higher level of stress and depression than fathers. It has been proven that the depressive symptoms of the mothers increase with the age of the child. This is related to the expectance of the child’s need for care. A younger child is expected to require more care than an older child, having a disability or not. Mothers of children with disabilities also report a higher rate of marital dissatisfaction while the same does not apply to their fathers. The more severe the mother’s subjective perception of the child’s disability, the higher the rate of marital discord reported, which is probably because the more severe the child’s disability, the more time the mother has to spend with the child, leaving very little time left to be spent with her spouse. (Published: 16 April 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 24343 - http://dx.doi.org/10.3402/qhw.v9.24343

Charmaz, Kathy (2006). Constructing grounded theory: a practical guide through qualitative analysis. London: SAGE

This is a very useful book on constructing grounded theory for both untrained and more experienced researchers, which we warmly welcome and recommend to colleagues and students on different university levels. The different steps of grounded theory, from data collection to analysis of qualitative data, are clearly described and discussed in the book. We, i.e. the authors of this review paper, have all used the grounded theory method in our recent doctoral theses in medicine, psychology, public health, and odontology, respectively. We were grateful for the possibility to read and learn from this excellent new book, which fills a gap in the existing arsenal of qualitative method books. Constructivist grounded theory has emerged as a promising approach between positivism and postmodernism with an assumption that multiple realities exist rather than ‘‘one and only real reality’’. Our aim is also to give the readers of the International journal of qualitative studies on health and well-being*QHW a brief summary of the content of the book, chapter by chapter.Charmaz, Kathy (2006). Constructing grounded theory: a practical guide through qualitative analysis. London: SAGE

School situation for specially abled children - How can we as qualitative researchers contribute?

School is and should be an important part in the lives of all children and youth. Much time is spent in school, and it serves not only as an educational arena but also as a social arena that fosters us as human beings. Lifelong friendships are ultimately developed in school, which serve as a protection when life gets rough. Our achievements in school predict our later possibilities to attend higher education and in turn possibilities to find a job, which has an influence on our social and financial standard, as also our health and wellbeing. (Published: 16 April 2014) Citation: Int J Qualitative Stud Health Well-being 2014, 9 : 24396 - http://dx.doi.org/10.3402/qhw.v9.24396

Children with disabilities - An overview of their situation

Children with disabilities are a fast-growing group in all societies, and their situation is often strained not only by their disability itself but also by a lot of other challenging circumstances they have to face. What are included in these challenging situations and what can we as qualitative researchers do to improve their situation? (Published: 12 February 2014) Citation: Int J Qualitative Stud Health Well-Being 2014, 9 : 23899 - http://dx.doi.org/10.3402/qhw.v9.23899

Book review : "Developing grounded theory. The second generation"

Developing grounded theory. The second generation is a very useful and clarifying book arisen from a one-day symposium on advances in qualitative methods in Alberta, 2007. The conference was sponsored by the International Institute for Qualitative Methodology (IIQM). For the first time, the students of Barney Glaser and Anselm Strauss, “the second generation” of grounded theory researchers, met to discuss grounded theory and its developments. With the exception of Janice Morse, the authors of this book worked directly with Anselm Strauss and Barney Glaser. In this volume they provide a description of the history, principles and practice of the grounded theory methods.