An interpretative phenomenological study of midwives supporting home birth for women with complex needs

Background As the landscape of women presenting for maternity care changes, so do the challenges associated with providing quality, informed and compassionate care, particularly for women with complex needs. Aim To explore the lived experience of midwives in facilitating care for women with complex needs who choose to birth at home. Method A qualitative design is employed, using an interpretative phenomenological analysis informed by hermeneutic principles. Purposive sampling is used to recruit midwives through social media and JiscMail. Data are collected via semi-structured interviews. Findings Two interpretative themes arose. A ‘radical midwife’ embraces the phrase ‘radical’ by positioning midwives between traditional beliefs and practices, physiological processes, midwife knowledge and skill set by applying current evidence and professional context. A ‘conflicted midwife’ arises out of this dichotomy and exposes the realities of striving for radicality while the negotiating ‘the system’. Conclusions It is no longer acceptable to assume that home birth for women with complex needs is exceptional. This must be the catalyst to move towards a constructive discourse with midwives, women and the wider team to address and expand the evidence base and pathways to support those who are already facilitating this care and those who will inevitably continue to provide care ‘outside of current guidelines’.

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Uncovering the realities of delusional experience in schizophrenia: a qualitative phenomenological study

10.31234/osf.io/d3xrb ◽

2021 ◽

Author(s):

Jasper Feyaerts ◽

Wouter Kusters ◽

Zeno Van Duppen ◽

Stijn Vanheule ◽

Inez Myin-Germeys ◽

...

Keyword(s):

Lived Experience ◽

Interpretative Phenomenological Analysis ◽

Phenomenological Study ◽

Explanatory Models ◽

Structured Interviews ◽

Person Perspective ◽

Schizophrenia Spectrum ◽

Qualitative Phenomenological ◽

Everyday Reality ◽

Qualitative Phenomenological Study

Background Delusions in schizophrenia are commonly approached as empirical false beliefs about everyday reality. Phenomenological accounts, by contrast, have suggested that delusions are more adequately understood as pertaining to a different kind of reality-experience. To date, however, the specific nature of delusional reality-experience has not been subject to systematic empirical study. It is also unclear howthis alteration of reality-experience should be characterized, which dimensions of experiential life are involved and whether delusional reality may differ from standard reality in various ways. Furthermore, little is known about how delusional patients value and relate to these experiential alterations. This study aimed to investigate the natureof delusional reality-experience, and its subjective apprehension, in individuals with lived experience of delusions and a schizophrenia-spectrum diagnosis.Methods In this study, individuals with lived experience of delusions and a schizophrenia-spectrum diagnosis formed a purposeful sample. Phenomenologically driven semi-structured interviews were conducted to explore the nature of delusional reality-experience and participants’ subjective valuation of these experiences. Interpretative Phenomenological Analysis (IPA), a qualitative method tailored to the in-depth exploration of participants’ first-person perspective, was used to analyse participants’ accounts.Findings Between Mar 2, 2020 and Sep 30, 2020, 18 adults with a clinical schizophrenia-spectrum diagnosis and lived experience of delusions participated in the interview-study. The findings suggest that delusions are often embedded in wide-ranging alterations of basic reality-experience, involving quasi-ineffable atmospheric and ontological qualities that undermine participants’ sense of the world as unambiguously real, fully present, and shared with others. We also found thatdelusional reality-experience can differ from standard reality in various way (i.e., in a hypo –and hyper-real form), across multiple dimensions (e.g., meaningfulness, necessity/contingency, detachment/engagement), and that participants are often implicitly or explicitly aware of the distinction between delusional and standard reality. Finally, delusional experience can have an enduring value and meaning that is not fully captured by a strictly medical perspective.Interpretation Increased awareness and recognition of the distinctive nature of delusional reality-experience, in both clinical and research settings, can improve diagnostic accuracy, explanatory models, and therapeutic support for delusional individuals whose lived realities are not always evident from an everyday perspective.

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P37 Exploring the experience of pain flares in adolescent inflammatory and non-inflammatory musculoskeletal disorders: a phenomenological study

Rheumatology ◽

10.1093/rheumatology/kez416.004 ◽

2019 ◽

Vol 58 (Supplement_4) ◽

Author(s):

Sonia Khanom ◽

John McBeth ◽

Michelle Briggs ◽

Janet McDonagh

Keyword(s):

Lived Experience ◽

Musculoskeletal Disorders ◽

Interpretative Phenomenological Analysis ◽

Phenomenological Study ◽

Conflicts Of Interest ◽

Psychological Symptoms ◽

Daily Life ◽

Physical Exertion ◽

Visual Aids ◽

Structured Interviews

Abstract Background Adolescents with inflammatory and non-inflammatory rheumatic musculoskeletal disorders (RMD) experience acute exacerbations in pain, referred to as pain flares in the adult literature. But little remains known about what pain flares are, why they occur, how they are managed and what lasting effects they have during adolescence. This study explored the lived experience of pain flares in adolescents with RMD. Methods Adolescents with juvenile idiopathic arthritis (JIA) or chronic idiopathic pain syndromes (CIPS) were recruited from a UK tertiary paediatric and adolescent rheumatology centre. Data were collected using semi-structured interviews and visual aids, and analysed using interpretative phenomenological analysis. Results Participants were eight females and two males aged between 13 and 17 years (M = 14.7, SD = 1.25). Four participants had JIA and six had CIPS. All participants experienced periods when pain deviates from their usual variation in pain, but none reported using the term pain flare to describe these experiences. These experiences were conceptualised as a journey of change from their 1) daily life with pain, 2) pre-flare period, 3) flare period, to their 4) post-flare period. 1) In daily life, adolescents report a level of pain that is usual for them which they manage and continue their daily routines around. 2) Pain, at times, increased beyond usual levels and adolescents reported noticing when a pain flare was coming on (e.g. due to physical exertion). They employed strategies for managing the pre-flare period, however, if they did not succeed in preventing a flare, or when flares occurred without a trigger or controllable cause, pain began to intrude on their lives. 3) All pain flares were described as an increase in the intensity of their usual pain, and were also associated with an increase in the location, duration and/or quality of pain; an increase in other unpleasant symptoms such as fatigue, psychological symptoms, headaches and/or sickness; and a reduction in physical, emotional, cognitive and/or social functioning. The frequency of flares was variable, ranging from weekly flare events to less than two a year. Flares were generally short lived, lasting a few hours to a few days. The majority of flares were managed with parental input, with adolescents seeking medical support when a flare was perceived to be associated with infection in JIA. 4) As flares were brought under control, the pain returned to usual levels but the psychological symptoms outstayed the pain. Participants took actions to regain the level of normality experienced in daily life. Conclusion Participants had varying interpretations of what constitutes a flare, but the key finding was that flares are not only an increase in pain intensity, but other features are also required to change. These findings help to differentiate flares from normal variation in pain. Conflicts of Interest The authors declare no conflicts of interest.

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Living with Heart Failure during the COVID-19 Pandemic: An Interpretative Phenomenological Analysis

Clinical Nursing Research ◽

10.1177/10547738211016614 ◽

2021 ◽

pp. 105477382110166

Author(s):

Alessia Martina Trenta ◽

Davide Ausili ◽

Rosario Caruso ◽

Cristina Arrigoni ◽

Massimo Moro ◽

...

Keyword(s):

Heart Failure ◽

Coping Strategies ◽

Lived Experience ◽

Interpretative Phenomenological Analysis ◽

Phenomenological Analysis ◽

Structured Interviews ◽

Hospital Organization ◽

Challenging Situation ◽

And Coping ◽

Negative Feelings

This study aimed to explore lived experience of patients with heart failure (HF) during the COVID-19 pandemic. A qualitative study was conducted using an interpretative phenomenological analysis (IPA). Data collection performed in March-May 2020, using in-depth, semi-structured interviews on a purposive sample. Data were analyzed according to the IPA methodology, and triangulation, bracketing, journaling, and member checking were used to assure rigor. 14 patients with HF were enrolled, and three main themes described their lived experience during the COVID-19 pandemic: Vulnerability, Hanging in the balance, and Coping strategies. These people felt particularly vulnerable to the novel virus and experienced uncertainty due to hospital organization changes. Because of this, they felt like they were hanging in the balance, experiencing various negative feelings. Nevertheless, they managed to deal with this challenging situation by implementing some peculiar coping strategies. The COVID-19 represents a significant challenge for patients with HF, impacting significantly on their lives.

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Music enables the holistic development and discovery of self: A phenomenological study of two Christian musicians

Psychology of Music ◽

10.1177/0305735616665911 ◽

2016 ◽

Vol 45 (3) ◽

pp. 400-416 ◽

Cited By ~ 2

Author(s):

Annabella S. K. Fung

Keyword(s):

Music Education ◽

Identity Formation ◽

Interpretative Phenomenological Analysis ◽

Phenomenological Study ◽

Social Contexts ◽

Value Systems ◽

Structured Interviews ◽

Holistic Development ◽

Human Needs ◽

Self Discovery

Music draws on body, space, time and relationships to offer a sacred experience. Musicking makes personal, social, emotional and spiritual connections with people. Cultural identity is formed through the arts, and the spirituality in music is a medium through which people explore their identities. This study examines how music facilitates the holistic development of two Melbourne-born Chinese-Australian Christian musicians. The Confucian Evolving Self Model, Maslow’s Hierarchy of Human Needs, and music education aims offer conceptualising scaffolds to illuminate their self-discovery. Interpretative Phenomenological Analysis was used to report on multiple semi-structured interviews undertaken over three years. This study considered the interaction of various value systems – the fusion of Confucianism, Christian and psychological cultures in the process of musical development and identity formation. It fills a research gap and complements existing approaches to understanding the social contexts influencing the acquisition of musical skills and musicians’ occupational choices. The permissive parenting that both participants experienced might account for them being able to follow a career in music without familial resistance. The current findings can advocate for music education because the spiritual aspects of musical experiences were perceived as a mirror in fostering the holistic development of both participants.

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Recovery colleges: long-term impact and mechanisms of change

Mental Health and Social Inclusion ◽

10.1108/mhsi-01-2021-0002 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Holly Thompson ◽

Laura Simonds ◽

Sylvie Barr ◽

Sara Meddings

Keyword(s):

Mental Health ◽

Lived Experience ◽

Positive Impact ◽

Evidence Base ◽

College Attendance ◽

Personal Recovery ◽

Structured Interviews ◽

Content Type ◽

Educational Paradigm ◽

Long Term Impact

Purpose Recovery Colleges are an innovative approach which adopt an educational paradigm and use clinician and lived experience to support students with their personal recovery. They demonstrate recovery-orientated practice and their transformative role has been evidenced within mental health services. The purpose of this study is to explore how past students understand the influence of the Recovery College on their on-going recovery journey. Design/methodology/approach An exploratory, qualitative design was used and semi-structured interviews took place with 15 participants. Data was analysed using the “framework method” and inductive processes. Findings All participants discussed gains made following Recovery College attendance that were sustained at one year follow-up. Three themes emerged from the data: Ethos of recovery and equality; Springboard to opportunities; and Intrapersonal changes. Originality/value This research explores students’ experiences a year after attendance. This contrasts to most research which is completed immediately post course. This study contributes to the emergent evidence base highlighting the longitudinal positive impact of Recovery Colleges. This study is of value to those interested in recovery-oriented models within mental health. Recovery Colleges are gaining traction nationally and internationally and this research highlights processes underlying this intervention which is of importance to those developing new Recovery Colleges.

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The role of family adaptation in the transition to adulthood for youth with medical complexity: a qualitative case study protocol

Journal of Transition Medicine ◽

10.1515/jtm-2021-0005 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Lin Li ◽

Nancy Carter ◽

Jenny Ploeg ◽

Jan Willem Gorter ◽

Patricia H. Strachan

Keyword(s):

Lived Experience ◽

Transition To Adulthood ◽

Evidence Base ◽

Adult Health ◽

Structured Interviews ◽

Adult Services ◽

Development Framework ◽

Medical Complexity ◽

Life Course Health

Abstract Background For youth with medical complexity and their families, the transition to adulthood is a stressful and disruptive period that is further complicated by the transfer from relatively integrated and familiar pediatric services to more fragmented and unfamiliar adult services. Previous studies report that families feel abandoned, overwhelmed, and unsupported during transition. In order to provide better support to families, we need to understand how families currently manage transition, what supports they need most, and how key factors influence their experiences. The aim of this study is to understand how families of youth with medical complexity adapt to the youth’s transition to adulthood and transfer to adult health care, social, and education services, and to explain how contextual factors interact to influence this process. Methods Informed by the Life Course Health Development framework, this study will use a qualitative explanatory case study design. The sample will include 10–15 families (1–3 participants per family) of youth with medical complexity (aged 16–30 years) who have lived experience with the youth’s transition to adulthood and transfer to adult services. Data sources will include semi-structured interviews and resources participants identified as supporting the youth’s transition. Reflexive thematic analysis will be used to analyze interview data; directed content analysis will be used for documentary evidence. Discussion While previous studies report that families experience significant challenges and emotional toll during transition, it is not known how they adapt to these challenges. Through this study, we will identify what is currently working for families, what they continue to struggle with, and what their most urgent needs are in relation to transition. The anticipated findings will inform both practice solutions and policy changes to address the needs of these families during transition. This study will contribute to the evidence base needed to develop novel solutions and advance policies that will meaningfully support successful transitions for families of youth with medical complexity.

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FAMILY DEMENTIA CAREGIVERS’ EPIPHANIES AND CHANGES IN THEIR APPROACH TO CARING FOLLOWING THE VIRTUAL DEMENTIA TOUR

Innovation in Aging ◽

10.1093/geroni/igz038.2042 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S554-S554

Author(s):

Candace C Harrington ◽

Candace C Harrington

Keyword(s):

Lived Experience ◽

Family Caregiving ◽

Phenomenological Study ◽

Structured Interviews ◽

Dementia Caregivers ◽

Term Care ◽

Health Indices ◽

Person Perspective ◽

Eye Opening

Abstract Previous interventional studies have failed to show long-term improvements in caregiver stress, health indices, burden, or delay in long-term care placement. The Virtual Dementia Tour® (VDT) provides a vicarious first-person perspective of symptoms related to dementia. This interpretative phenomenological study revealed family dementia caregivers’ perceptions of the VDT® and its impact on their perception of a person living with dementia. In-depth open semi-structured interviews were conducted with ten VDT® participants following a community event. Participants’ statements described a life-changing process with eye-opening epiphanies about the lived experience of dementia and served as a “call to action” to change their approach to caring. Innovative advances in family caregiving research are critical to support this valuable geriatric workforce. This original study provided new knowledge about the value of the VDT® to inform interventions that harness the unrecognized power of vicarious experiences like the VDT® for family dementia caregivers to improve long-term outcomes.

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Women’s Decision-Making About Birthplace Choices: Booking for Birth Center, Hospital, or Home Birth in the North of England

International Journal of Childbirth ◽

10.1891/2156-5287.8.2.115 ◽

2018 ◽

Vol 8 (2) ◽

pp. 115-134

Author(s):

Carol Lambert ◽

Julie Jomeen ◽

Wilf McSherry

Keyword(s):

Decision Making ◽

Phenomenological Study ◽

Social Representations ◽

Home Birth ◽

Structured Interviews ◽

Birth Center ◽

The North ◽

Knowing That ◽

Center Hospital ◽

Women In Decision Making

Aim:This article presents findings from an interpretive phenomenological study that illuminates unique characteristics of the different social representations of antenatal primigravida and multigravida women who book to birth their babies in a birth center, hospital, or at home.Methods:Semi-structured interviews were conducted with 19 women and analyzed by interpretive phenomenological analysis.Findings:Analysis revealed different social representations independent of each other that illustrate how these social groups, determined by women’s collective voices, are uniquely characterized by group views, beliefs, misinterpretations, and preconceptions that establish what influences women in decision-making about choice of birthplace.Conclusion:Women make decisions about what they want for themselves in this birthing experience. These decisions are made long before this impending experience. Recognizing the different social representations of women in pregnancy reveals deeper insight into the complexities of women’s decision-making about birth choices and highlights why some women might opt for certain choices. Knowing that some women may make decisions based on little or misrepresented information confirms midwives are best placed in their interactions with women to provide positive influences, empowering them to make decisions based upon what they want for themselves. This affirms the woman and her midwife should remain partners in the decision-making process.

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Understanding the lived experience of British non-offending paedophiles

Journal of Forensic Practice ◽

10.1108/jfp-10-2019-0046 ◽

2020 ◽

Vol 22 (2) ◽

pp. 71-81

Author(s):

Harriet Dymond ◽

Simon Duff

Keyword(s):

Sexual Abuse ◽

Lived Experience ◽

Interpretative Phenomenological Analysis ◽

Sexual Attraction ◽

Well Being ◽

Future Research ◽

Structured Interviews ◽

Content Type ◽

Management Techniques ◽

The Uk

Purpose Research into paedophilia mainly uses offender samples; thus, little is understood about non-offending paedophiles. The limited body of research has been conducted in North America or Europe whose health and legal systems differ from those in the UK. Using semi-structured interviews, the purpose of this study is to explore the experience of three non-offending British paedophilic males. Design/methodology/approach The interview discussed their paedophilia, refraining from offending and perspectives on treatment initiatives. Data were analysed using interpretative phenomenological analysis. Findings Three superordinate themes emerged: “paedophilia as more than a sexuality,” “acceptance leads to management” and “barriers to support.” These encapsulated how paedophilia was understood, how accepting one’s sexual attraction is tantamount to well-being and the various obstacles to providing support were discussed. Research limitations/implications Acknowledging the sampling considerations (size and recruitment), the results implicate research into paedophilia. The onset of paedophilia was chronologically associated with typical sexual attraction, and not the result of sexual abuse as some theories suggest. Furthermore, the tenets of attraction to children extending beyond sexual desire were highlighted. Practically, the results influence future research into the area and highlight the dearth in our understanding of diverse behavioural management techniques (i.e. computerised images of children or human-like dolls). Originality/value This paper presents novel insight into the aspects of paedophilia, excluding offensive behaviour and highlights the need for affordable, UK-based services targeted towards people with a paedophilic attraction to manage child sexual abuse preventatively and not reactively.

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Taught resilience programmes: a case study from the perspective of employees of a large pharmaceutical company based in the UK

Continuity & Resilience Review ◽

10.1108/crr-05-2020-0019 ◽

2020 ◽

Vol 2 (2) ◽

pp. 111-129

Author(s):

Frances Costello

Keyword(s):

Lived Experience ◽

Interpretative Phenomenological Analysis ◽

Structured Interviews ◽

Content Type ◽

Individual Resilience ◽

Personal Resilience ◽

The Uk ◽

Almost All ◽

The Impact

PurposeResearch was undertaken to understand whether taught resilience programmes which highlight the protective factors of resilience would impact individual resilience outcomes. The research focussed on specific resilience dimensions, change agility, physical, emotional and mental resilience, purpose in life and recovery; in an attempt to bridge the gap in understanding whether it is possible through taught programmes to improve resilience through the creation of new habits.Design/methodology/approachThe research was conducted using interpretative phenomenological analysis methods and used semi-structured interviews with 12 participants to understand participants lived experience of a one-day personal resilience programme, conducted within a private global manufacturing organisation.FindingsThe research found that all 12 participants interviewed 12–18 months post-programme made sustainable habits changes increasing personal resilience levels. Participants built new habits into their everyday lives, in the physical dimension exercising more regularly, taking breaks, changes in nutrition and creating better sleep patterns. Through increased understanding of emotional intelligence participants were able to react more favourably to adverse situations and through mental increased resilience focus achieve work and home priorities. In understanding the change journey participants found that they were able to move more quickly through the change cycle. Almost all participants found understanding their life purpose difficult and were not able to give a conclusive answer to what this might be, they found that attending the programme helped reflection in this dimension.Originality/valueThe paper includes an overview of previous resilience research but differs in its examination of the impact of a specific taught resilience programme in a large private sector organisation using IPA methodology.

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