The good, the bad and the ugly: A qualitative secondary analysis into the impact of doping and anti-doping on clean elite athletes in five European countries

Background: Although a precise percentage of athletes doping has remained elusive, evidence to date suggest that the majority of athletes are ‘clean’. Protecting clean sport, and the rights of athletes to a clean sport environment, is at the centre of anti-doping policies. To better support and enable clean athletes and sport, an understanding of the clean athlete lifeworld is required. This study explores and discusses several ways that clean athletes have been and are affected by doping and anti-doping. Methods: Qualitative Secondary Analysis (QSA) was used to re-analyse and interpret 13 focus group transcripts generated from the ‘Research-Embedded Strategic Plan for Anti-Doping Education Clean Sport Alliance Initiative for Tackling Doping’ (RESPECT) project to explore the impact of doping and anti-doping on clean athletes (see Petroczi et al. 2021). The sample in the parent study included 82 self-declared clean elite athletes, active and recently retired, from Germany (n=23) Ireland (n=14), the Netherlands (n=15), Slovenia (n=14), and the UK (n=16), who collectively represented 36 different sports. Results: Reflexive thematic analysis generated three themes. The first overarching theme captured the harm done by clean athletes having to coexist with dopers (i.e., denied medals, money, moments and memories; altered expectations and perceptions of the self; incite suspicion). The second overarching theme highlighted how clean athletes are undermined by lenient and poor treatment of dopers and clean athletes respectively. The third overarching theme described the anxiety experienced by clean athletes over mistakes that could lead to anti-doping rules violations. Conclusion: The impacts of doping on clean athletes - direct or indirect - are experienced by all clean athletes in some way. The results indicate that current approaches to anti-doping rule compliance frequently undermine clean athletes and the perceive legitimacy of the anti-doping system. With considerable qualitative data on athletes’ views available, secondary data analysis offers a cost effective, quick, and feasible approach for anti-doping research.

Data reuse across international contexts? Reflections on new methods for International Qualitative Secondary Analysis

This research note reports on five online workshops by an international team of scholars, the authors, with shared interests in drug (mis)use. The workshops comprise a novel form of collective international qualitative secondary analysis (iQSA) exploring the possibilities for, and value of, qualitative data reuse across international contexts. These preparatory workshops comprise the preliminary stages of a longer programme of methodological development of iQSA, and we used them to identify what challenges there may be for translating evidence across international contexts, what strategies might be best placed to support or facilitate analytical engagement in this direction, and if possible, what empirical value such exchange might have. We discuss how working across international contexts involved the authors in new 'translational' work to address the challenges of establishing and sharing meaning. Such ‘translation’ entailed a modest degree of empirical engagement, namely, the casing of empirical examples from our datasets that supported an articulation of our various research studies, a collective interrogation of how, why and which such cases could be used for best translational effect and a collective reflexive engagement with how these cases generated new and novel questions that in turn re-engaged us with our own data in new ways. Descriptions of our datasets, therefore, emerged as multifaceted assemblages of ‘expertise’ and comprised the evidential bases for new empirical insights, research questions and directions.

Strategies for Reducing Rationed Nursing Care: Qualitative Secondary Analysis

Introduction: Nursing students spend a meaningful part of their professional training in clinical practice. However, to a significant extent, they actively or passively contribute to the occurrence of rationed nursing care in clinical practice. Therefore, it is crucial that they actively participate in implementing targeted strategies to reduce rationed nursing care. Aim: To explore nursing students′ experience with strategies focusing on the reduction of rationed nursing care. Methods: We chose a qualitative secondary analysis to address unpublished data related to nursing students′ experience with strategies focusing on reducing rationed nursing care. The data included a set comprising of 148 pages with transcribed verbatim of 18 semi-structured interviews. The data were analyzed by a deductive content analysis. Results: Based on the outcome of the secondary analysis, we identified two meaningful categories: Preventive strategies in clinical practice and Importance and meaning of preventive strategies. These two categories reflected nursing students′ experience with targeted strategies to reduce rationed nursing care in clinical practice. Conclusion: Proposal and subsequent implementation of preventive strategies are essential for reducing rationed nursing care phenomenon from the clinical practice environment. The perspective of nursing students is vital due to their intensive perception of rationed nursing care in clinical practice. Students may identify areas that work-place staff may not explicitly focus on and consider important but jeopardize the quality of care or patient safety.

How gender shapes interprofessional teamwork in the operating room: a qualitative secondary analysis

Background Despite substantial implications for healthcare provider practice and patient outcomes, gender has yet to be systematically explored with regard to interprofessional operating room (OR) teamwork. We aimed to explore and describe how gender and additional social identity factors shape experiences and perceptions of teamwork in the OR. Methods This study was a qualitative secondary analysis of semi-structured interviews with OR team members conducted between November 2018 and July 2019. Participants were recruited across hospitals in Ontario, Canada. We conducted both purposive and snowball sampling until data saturation was reached. Transcripts were analyzed thematically by two independent research team members, moving from open to axial coding. Results Sixty-six interviews of OR healthcare professionals were completed: anesthesia (n=17), nursing (n=19), perfusion (n=2), and surgery (n=26). Traditional gender roles, norms, and stereotypes were perceived and experienced by both women and men, but with different consequences. Both women and men participants described challenges that women face in the OR, such as being perceived negatively for displaying leadership behaviours. Participants also reported that interactions and behaviours vary depending on the team gender composition, and that other social identities, such as age and race, often interact with gender. Nevertheless, participants indicated a belief that the influence of gender in the OR may be modified. Conclusions The highly gendered reality of the OR creates an environment conducive to breakdowns in communuication and patient safety risks in addition to diminishing team morale, psychological safety, and provider well-being. Consequently, until teamwork interventions adequately account for gender, they are unlikely to be optimally effective or sustainable.

Attachment theory and music therapy: What was the relevance of attachment theory to a student’s music therapy programme for ‘at-risk’ mothers and their babies?

<p>This qualitative secondary analysis research project sought to explore the relevance of attachment theory as it might apply to a music therapy programme set up and run within a residential service for ‘at risk’ mothers and their babies. The explicit purpose of the music therapy programme was to assist the mothers in bonding with their babies. The researcher was a student music therapist on placement at the facility, involved in weekly one-to-one sessions with a total of nineteen young women and their babies, over the time that each was resident at the facility. The music therapist also ran some weekly group sessions (mothers with babies) as part of the facility’s mandatory education programme. The music therapy programme took place over twenty-two weeks, with a two week break after the first ten weeks. The research analysis commenced on completion of the programme. Thematic analysis was used to look at two types of data; data from the placement (including clinical notes and personal reflective journal), and literature on attachment theory. There was an initial review of selected literature on attachment theory and music therapy. The researcher/student music therapist then carried out an inductive qualitative secondary analysis of the data that had been generated as a standard part of her practice over the period of the student placement. This was followed by a further examination of attachment theory literature to confirm key aspects of the theory. The findings from the inductive analysis were then looked at in the light of those identified key features of attachment theory. The research findings showed many strong links between key concepts of attachment theory, and the patterns that emerged from the placement data, manifesting on a number of different levels. However some patterns might be more usefully explained and/or elucidated by other theories. Findings suggested that attachment theory provided a useful framework and language for observing and understanding the interactive behaviours and external and personal structures that appeared to work for or against mother-infant bonding. In addition, the music therapy programme seemed a particularly suitable vehicle for promoting positive mother-infant bonding. However it was found that although the music therapy programme may have been helpful in a positive mother-infant bonding process, there was no evidence to suggest that this would necessarily extend to promoting a secure attachment relationship, given the personal, structural and legal factors associated with the high ‘at-risk’ context. An attachment-based music therapy programme may well have a more useful role to play in a lower risk context where mothers and babies remained for longer in the facility, and where the programme could continue throughout the women’s transition into the community and beyond.</p>

Attachment theory and music therapy: What was the relevance of attachment theory to a student’s music therapy programme for ‘at-risk’ mothers and their babies?

<p>This qualitative secondary analysis research project sought to explore the relevance of attachment theory as it might apply to a music therapy programme set up and run within a residential service for ‘at risk’ mothers and their babies. The explicit purpose of the music therapy programme was to assist the mothers in bonding with their babies. The researcher was a student music therapist on placement at the facility, involved in weekly one-to-one sessions with a total of nineteen young women and their babies, over the time that each was resident at the facility. The music therapist also ran some weekly group sessions (mothers with babies) as part of the facility’s mandatory education programme. The music therapy programme took place over twenty-two weeks, with a two week break after the first ten weeks. The research analysis commenced on completion of the programme. Thematic analysis was used to look at two types of data; data from the placement (including clinical notes and personal reflective journal), and literature on attachment theory. There was an initial review of selected literature on attachment theory and music therapy. The researcher/student music therapist then carried out an inductive qualitative secondary analysis of the data that had been generated as a standard part of her practice over the period of the student placement. This was followed by a further examination of attachment theory literature to confirm key aspects of the theory. The findings from the inductive analysis were then looked at in the light of those identified key features of attachment theory. The research findings showed many strong links between key concepts of attachment theory, and the patterns that emerged from the placement data, manifesting on a number of different levels. However some patterns might be more usefully explained and/or elucidated by other theories. Findings suggested that attachment theory provided a useful framework and language for observing and understanding the interactive behaviours and external and personal structures that appeared to work for or against mother-infant bonding. In addition, the music therapy programme seemed a particularly suitable vehicle for promoting positive mother-infant bonding. However it was found that although the music therapy programme may have been helpful in a positive mother-infant bonding process, there was no evidence to suggest that this would necessarily extend to promoting a secure attachment relationship, given the personal, structural and legal factors associated with the high ‘at-risk’ context. An attachment-based music therapy programme may well have a more useful role to play in a lower risk context where mothers and babies remained for longer in the facility, and where the programme could continue throughout the women’s transition into the community and beyond.</p>

‘I Think it Just Made Everything Very Much More Intense’: A Qualitative Secondary Analysis Exploring The Role Of Friends and Family Providing Support to Survivors of Domestic Abuse During The COVID-19 Pandemic

The COVID-19 pandemic, and associated social restrictions, have amplified women’s experiences of domestic abuse (DA). In usual times, female DA survivors reach out to those around them (friends, family members, neighbors, and colleagues) for support. Accessing of both professional and informal support by survivors has increased during the pandemic. Informal supporters are often deeply invested and immersed in situations of DA because of the closeness of relationships. The accounts of informal supporters are rarely sought, yet these are people who may have a considerable awareness of what is happening. The aim of this study was to explore how the pandemic had impacted people’s assessment of abusive situations and their ability to provide informal support. This paper reports a secondary analysis of qualitative data collected in 2020 in England. The data were gathered in 18 in-depth interviews with people who knew a female friend, relative, neighbor, or colleague who had experienced DA. The age range of participants was 25–69 years, three were men and fifteen were women. A reflexive thematic analysis was carried out. Findings indicated: (i) the pandemic had changed people’s ability to read situations and assess risk (ii) perpetrators were exploiting the pandemic to further abuse (iii) within the context of the pandemic there was additional challenge to offering support (iv) informal supporters found creative ways to remain in-touch and to continue offering support. Further research with informal supporters is needed to ascertain how best to support and equip people, without imposing an impossible burden.

Experiencing trauma during or before pregnancy: qualitative secondary analysis after two natural disasters (Preprint)

BACKGROUND Despite the existing knowledge about stress, trauma and pregnancy and maternal stress during natural disasters which could be linked to adverse birth and child health outcomes, little is known about what types of trauma pregnant or preconception women experience during natural disasters. In May 2016, the worst natural disaster in modern Canadian history required the evacuation of nearly 90,000 residents of the Fort McMurray Wood Buffalo (FMWB) area of northern Alberta. Among the thousands of evacuees were an estimated 1850 women who were pregnant or soon to conceive. In August 2017, Hurricane Harvey devastated Texas and Louisiana, with 30,000 people forced to flee their homes due to the intense flooding. An estimated 40,000 pregnant women were living in Houston at the time of the flooding. OBJECTIVE To explore immediate and past traumatic experiences of pregnant or preconception women who experienced one of two natural disasters (a wildfire and a hurricane) as captured in their expressive writing. Research questions were: (1) What trauma did pregnant or preconception women experience during the fire and the hurricane? (2) What past traumatic experiences, apart from the disasters, did the women discuss in their expressive writing? METHODS A qualitative secondary analysis of expressive writing using thematic content analysis was conducted on the expressive writing of 50 pregnant or preconception women who experienced the 2016 Fort McMurray Wood Buffalo Wildfire (n=25) and the 2017 Houston Hurricane Harvey (n=25) Narrative data in the form of expressive writing entries from participants of two primary studies were thematically analyzed. One of the expressive writing questions was used in this analysis: “What is the most traumatic, upsetting experience of your entire life, especially that you have never discussed in great detail with others?” NVivo 12 supported thematic content analysis. RESULTS For some women, the natural disaster elicited immense fear and anxiety that surpassed past traumatic life events. Others, however, disclosed significant past traumas that continue to impact them, including betrayal by a loved one, abuse, maternal health complications, and illness. CONCLUSIONS We recommend a strengths-based and trauma-informed care approach in both maternal health and post-disaster relief care.