Global Update
“It’s no skin off my nose”: why people take part in qualitative research.
LOCATION: Lothian, SCOTLAND
As part of a longitudinal qualitative study looking at newly diagnosed patients’ perceptions of diabetes service
provision in Lothian, Scotland, researchers have explored the factors that motivated participants to take part in the
research. Participants taking part in the year-long study were asked to discuss why they initially decided to become
involved in the study and what had motivated them to stay involved. Following a qualitative analysis of participants’
responses, four main themes emerged shedding light upon their motivation. Firstly, participants reported
that the health context in which they had been recruited for the study had impacted upon their decision to become
involved, with health professionals’ views of the study as helpful being influential. Secondly, altruism emerged as
a major motivator for research participation, with patients’ citing the influence of their desire to help others. Thirdly,
participants’ belief that they ‘had nothing to lose’ and their perception that qualitative research is an inherently safe
activity contributed to their decision to be interviewed. The final major theme to emerge from the research related to
participants feeling that the process of being interviewed was in itself therapeutic. This research makes an important
contribution to understanding factors underpinning people’s decision to become involved in research projects and
indicates that for many patients participation in qualitative health
research is seen as a positive thing.
Publication Details: Peel E., Parry O., Douglas M., & Lawton J. (2006) “It’s no skin off my nose” : why people take part in qualitative research. Qualitative Health Research. 16; 10: 1335- 1349.
Impaired psychosocial outcome of donors after living donor liver transplantation: a qualitative case study
LOCATION: Berlin, GERMANY
Adult-to-adult living donor liver transplantation (LDLT) of the right hepatic lobe has been developing into an established
therapy for treating pre-terminal liver diseases. Unfortunately, scant knowledge has to date been available on the psychosocial
outcomes of living donors. In response to this dearth of knowledge, a qualitative german study has aimed to investigate the patterns
for impaired psychosocial outcomes experienced by donors after LDLT. Donor hepatectomies were performed in thirty
donors at the Charité Berlin. Six months after surgery, six of the thirty donors with negative moods and physical complaints in
psychometric monitoring were examined. The post-operative interviews were transcribed and analysed using current qualitative
research methods. These six donors (20%) reported various unspecific complaints and psychological conflicts. Sadness
was expressed about organ rejection and death of the recipient. Anxieties about the recipient and their own health were verbalised.
Disappointment and anger refer to the experience that they were not as fully appreciated by the medical system and their
social environment as expected. The negative emotions of donors with impaired psychosocial outcomes could be related to
a decrease in self-esteem in the post-operative course. Adequate medical and psychological treatment opportunities for these
donors should be provided.
Publication Details: Walter, M., Papachristou, C., Pascher, A., Danzer, G., Neuhaus, P., Klapp, B.F. & Frommer, J. (2006) Impaired psychosocial outcome of donors after living donor liver transplantation: a qualitative case study. Clinical Transplantation. 20; 4: 410- 415.
Priority setting in developing countries health care institutions: the case of a Ugandan hospital.
LOCATION: Toronto, CANADA
With demand for health services outstripping resources availability, priority setting can be considered to be one of the
most significant challenges facing health policy makers, particularly those in developing countries. In spite of this,
there is presently a lack of literature to describe and evaluate priority setting within these contexts. In response to this,
researchers have set out to describe how priority setting occurs in a large Ugandan teaching hospital and evaluate this
description against an ethical framework for fair priority setting processes referred to as ‘Accountability for Reasonableness.’
In the course of this research, 70 in-depth interviews were conducted with a range of health professionals and
planners and the results thematically analysed and evaluated using four conditions of accountability for reasonableness:
relevance, publicity, revisions and enforcement. The findings of this research indicate that the priority setting decisions
being made within the hospital did not reflect the conditions of fairness set out in the ethical framework. It was found
that to improve this situation, it is necessary for the hospital to engage frontline practitioners, publicise the reasons for
decisions both within the hospital and to the general public, and develop formal mechanisms for challenging the reasoning
underpinning resource prioritisation. Furthermore, this research suggests that capacity strengthening is required for
senior managers to enable them to accept responsibility for ensuring that the above three conditions are met.
Publication Details: Kapiriri L., & Martin D. (2006) Priority setting in developing countries health care institutions: the case of a Ugandan hospital. BMC Health Services Research. 6; 122.
Cardiac pain or panic disorder? Managing uncertainty in the emergency department
LOCATION: Auckland, NEW ZEALAND
Panic disorder can have a significant adverse impact upon the physical and mental wellbeing of sufferers, yet can be difficult
for health professionals to recognise and diagnose. For some patients, panic disorder causes chest pain which may result in patient
admission to hospital emergency departments. As a result, well developed nursing assessment and management responses
to these patients are important. Responding to this, researchers in New Zealand have explored the challenges that panic disorder
presents emergency department nurses. This qualitative study looked at emergency nurses' differentiation of non-cardiac
chest pain from panic disorder and has raised significant issues in the nursing assessment and management of such clients.
After gathering data through focus group interviews and analysing it qualitatively, three prominent themes - prioritising time,
managing uncertainty and ambiguity, and the life-threatening lens - emerged. The findings confirm that biomedical assessment,
when used in isolation, is not always effective at diagnosing panic disorder. The research highlights the importance of
psychosocial assessment and affirms the important role that emergency nurses play in reversing the cycle of repeat presenters
with non-cardiac chest pain.
Publication Details: Hamer, H.O., & McCallin A.M. (2006) Cardiac pain or panic disorder? Managing uncertainty in the emergency department. Nursing Health Sciences. 8; 4: 224 -230.
