The generalizations developed by qualitative researchers are embedded in the contextual richness of individual experience. Qualitative data management strategies that depend solely on coding and sorting of texts into units of like meaning can strip much of this contextual richness away. To prevent this, some authors have recommended treating individual accounts as whole cases or stories, but whole cases are difficult to compare with one another when the goal of the research is to develop generalizations that represent multiple accounts. In this article, the authors describe the ways in which three different qualitative researchers combined across-case coding and sorting with a variety of within-case data management and analysis techniques to produce contextually grounded, generalizable findings.

Objective: To examine the experience of low-income, African-American parents surrounding perinatal loss and to describe how other life stressors influenced the parents' responses and caring needs.Design: Descriptive, using a phenomenologic approach.Setting: All data were collected in person. Interviews were held in parents' homes or, at the request of three parents, in an office in the university between 5 and 21 weeks after the loss.Participants: A total of 23 parents (17 mothers and 6 of their partners) were interviewed following a perinatal loss due to pregnancy (16 weeks gestation or later) or a neonatal death (first 28 days of life). Follow-up interviews were held with 21 of these parents.Results: Revealed four themes: (a) recognizing problems and responding to the loss, (b) dealing with stressful life events, (c) creating and cherishing memories of their infant, and (d) living with the loss. Conclusions:The results of this study reveal experiences not previously reported, and provide a beginning understanding of the loss experience in this group of parents. Health care professionals should be aware of the presence of additional stressful events that parents may be experiencing and intervene appropriately to provide culturally competent care in a sensitive manner.

No abstract

This study evaluates parents’ and health care providers’ (HCPs) descriptions of hope following counseling of parents at risk of delivering an extremely premature infant. Data came from a longitudinal multiple case study investigation that examined the decision-making and support needs of 40 families and their providers. Semi-structured interviews were conducted before and after delivery. Divergent viewpoints of hope were found between parents and many HCPs and were subsequently coded using content analysis. Parents relied on hope as an emotional motivator, whereas most HCPs described parents’ notions of hope as out of touch with reality. Parents perceived that such divergent beliefs about the role of hope negatively shaped communicative interactions and reduced trust with some of their providers. A deeper understanding of how varying views of hope might shape communications will uncover future research questions and lead to theory-based interventions aimed at improving the process of discussing difficult news with parents.

No abstract

No abstract

No abstract

Objective-To describe nurse behaviors that assisted parents to make life support decisions for an extremely premature infant before and after the infant's birth.Design-Qualitative, longitudinal, collective case study where interviews were done pre-and postnatally and medical chart data were collected.Setting-Interviews were conducted face-to-face in a private room in the hospital, in the mother's home, or over the telephone.Participants-A sample of 40 cases (40 mothers, 14 fathers, 42 physicians, 17 obstetric nurses, 6 neonatal nurses, and 6 neonatal nurse practitioners) was recruited from three hospitals that provided high risk perinatal care. Parents were at least 18 years of age, English speaking, and had participated in a prenatal discussion with a physician regarding treatment decisions for their infant due to threatened preterm delivery. Physicians and nurses were those identified by parents who had spoken to them about life support treatment decisions for the infant.Methods-Using a semi-structured interview guide, a total of 203 interviews were conducted (137 prenatal, 51 postnatal, and 15 end-of-life). For this analysis, all coded data related to the nurse's role were analyzed and summarized.Results-Parents and nurses both described several nurse behaviors: providing emotional support; giving information, and meeting the physical care needs of mothers, infants, and fathers. Physicians' description of the nurse behaviors focused on the way nurses provided emotional support and gave information. Conclusions-Nurses play a critical role in assisting parents surrounding life support decisions.Keywords decision making; role of nurses; parent support; life support decisions Life support decisions for infants surrounding a pregnancy with a threatened preterm delivery between 22 and 25 weeks gestation remain challenging for parents and clinicians (Batton, 2009;Chiswick, 2008). Despite the gains in survival rates of preterm infants from 1965 to 1995, the rates have not improved in the last decade (Meadow & Lantos, 2009 1. Life support decisions for infants surrounding a pregnancy with a threatened preterm delivery between 22 and 25 weeks gestation remain challenging for parents and clinicians. 2.For both parents and nurses, providing emotional support was the most commonly reported way that nurses assisted parents during decision making.3. Parents reported that nurses played a very important role as parents were making critical decisions.NIH Public Access