The global response to mitigate the spread of the COVID-19 pandemic brought about massive health, social and economic impacts. Based on the pressing need to respond to the crisis, clinical trials and epidemiological studies have been undertaken, however less attention has been paid to the contextualized experiences and meanings attributed to COVID-19 and strategies to mitigate its spread on healthcare workers, patients, and other various groups. This commentary examines the relevance of qualitative approaches in capturing deeper understandings of current lived realities of those affected by the pandemic. Two main challenges associated with the development of qualitative research in the COVID-19 context, namely “time constraints” and “physical distancing” are addressed. Reflections on how to undertake qualitative healthcare research given the evolving restrictions are provided. These considerations are important for the integration of qualitative findings into policies and practices that will shape the current response to the pandemic and beyond.
ObjectiveTo synthesize the recent qualitative literature and identify the integrative themes describing the parenthood experiences of refugees, asylum-seekers and undocumented migrants.MethodsWe searched seven online databases for the period January 2006 to February 2017. We included English and French published peer-reviewed articles and graduate-level dissertations, which qualitatively examined the parenthood experiences of refugees, asylum-seekers and undocumented migrants. We summarized study characteristics and performed a thematic analysis across the studies.ResultsOne hundred thirty eight studies met inclusion criteria. All but three were conducted in high-income countries, mainly in the US. Migrants studied were mostly undocumented from Latin America and refugees from Sub-Saharan Africa. Almost all studies (93%) included mothers; about half (47%) included fathers; very few (5%) included extended family members. We identified three integrative themes: 1) experiencing hardship and/or loss in the context of precarious migration and past traumas; 2) building resilience and strength by bridging language, norms and expectations; and 3) living transnationally: obligations, challenges and resources. Each theme contributed to shaping the parenthood experience; the transnationalism theme intersected with the themes on hardship and loss and resilience and strength.ConclusionMore research is needed with fathers, extended family members, asylum-seekers and in the LMIC context. A transnational lens needs to be applied to programs, policies and future research for refugee, asylum-seeker and undocumented migrant parents. Addressing transnational concerns (family separation and reunification), acknowledging transnational resources, fostering a transnational family identity and conducting transnational and longitudinal studies are potentially pivotal approaches for this sub-population of parents.Electronic supplementary materialThe online version of this article (10.1186/s12992-017-0299-4) contains supplementary material, which is available to authorized users.
Despite an alarmingly high rate of attempted suicide among trans adults, few studies have investigated suicide protective factors among this population. The current study was aimed at identifying suicide protective factors among trans adults using a qualitative methodology. A sample of self-identified trans adults (N ϭ 133) was recruited from LGBT LISTSERVs across Canada. Participant were predominantly White and ranged in age from 18 to 75 years old (M ϭ 37). Qualitative data were collected online via open-ended questions and analyzed using thematic network analysis. A hybrid inductive-deductive coding framework was created by combining published suicide protective factors and participants' responses. Five organizing themes were identified, namely social support, gender identity-related factors, transition-related factors, individual difference factors, and reasons for living. Results provide important insights for suicide prevention workers and mental/medical health professionals who work to promote the health and well-being of trans clients and their families. Clinical implications are discussed, such as the importance of aiding trans clients who seek transition-related care to gain access to care in a timely manner.
BackgroundAlthough asthma morbidity can be prevented through long-term controller medication, most patients with persistent asthma do not take their daily inhaled corticosteroid. The objective of this study was to gather patients’ insights into barriers and facilitators to taking long-term daily inhaled corticosteroids as basis for future knowledge translation interventions.MethodsWe conducted a collective qualitative case study. We interviewed 24 adults, adolescents, or parents of children, with asthma who had received a prescription of long-term inhaled corticosteroids in the previous year. The one-hour face-to-face interviews revolved around patients’ perceptions of asthma, use of asthma medications, current self-management, prior changes in self-management, as well as patient-physician relationship. We sought barriers and facilitators to optimal asthma management. Interviews were transcribed verbatim and transcripts were analyzed using a thematic approach.ResultsPatients were aged 2–76 years old and 58% were female. Nine patients were followed by an asthma specialist (pulmonologist or allergist), 13 patients by family doctors or pediatricians, and two patients had no regular follow-up. Barriers and facilitators to long-term daily inhaled corticosteroids were classified into the following loci of responsibility and its corresponding domains: (1) patient (cognition; motivation, attitudes and preferences; practical implementation; and parental support); (2) patient-physician interaction (communication and patient-physician relationship); and (3) health care system (resources and services). Patients recognized that several barriers and facilitators fell within their own responsibility. They also underlined the crucial impact (positive or negative) on their adherence of the quality of patient-physician interaction and health care system accessibility.ConclusionsWe identified a close relationship between reported barriers and facilitators to adherence to long-term daily controller medication for asthma within three loci of responsibility. As such, patients’ adherence must be approached as a multi-level phenomenon; moreover, interventions targeting the patient, the patient-physician interaction, and the health care system are recommended. The present study offers a potential taxonomy of barriers and facilitators to adherence to long-term daily inhaled corticosteroids therapy that, once validated, may be used for planning a knowledge translation intervention and may be applicable to other chronic conditions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-015-0044-9) contains supplementary material, which is available to authorized users.
SSc organizations may be able to address limitations in accessibility and concerns about SSc support groups by implementing online support groups, better informing patients about support group activities, and training support group facilitators.
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