Theory and interpretation in qualitative studies from general practice: Why and how?

Malterud, Kirsti

doi:10.1177/1403494815621181

Cited by 113 publications

(114 citation statements)

References 41 publications

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“…However, the categories and themes represent empirical findings and were not predefined in the analysis. As discussed by Malterud, findings from qualitative research are unavoidably affected by theory, and discussing findings with a background in relevant theory could contribute to improving the understanding of the data . By addressing the authors’ theoretical and practical preunderstandings, we aim to facilitate transparency of the analysis done in this study.…”

Section: Discussionmentioning

confidence: 99%

The influence of an eHealth intervention for adults with type 2 diabetes on the patient–nurse relationship: a qualitative study

Lie

Karlsen

Graue

et al. 2019

Scandinavian Caring Sciences

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Background A constructive patient–nurse relationship is beneficial in self‐management support approaches. Research indicates eHealth interventions hold a potential for self‐management support for adults with type 2 diabetes. However, eHealth may change the patient–nurse relationship. No studies to date have addressed how eHealth self‐management support interventions with written asynchronous communication can influence the relationship between patients and nurses. Aim The aim of this study was to explore how an eHealth intervention based on the Guided Self‐Determination program (eGSD) influences the patient‐nurse relationship from the perspective of patients participating and the nurses conducting the intervention. Methods A qualitative approach with individual semi‐structured interviews was used. Ten patients with type 2 diabetes who completed the eGSD and four nurses who delivered the intervention participated. The data were transcribed verbatim, and qualitative content analysis was used to analyse the text. Results The findings revealed two themes: ‘eGSD facilitates a reciprocal understanding and a flexibility in the relationship’ and ‘eGSD creates a more fragile relationship’, reflecting ambiguous experiences with the eGSD. Conclusion and relevance to clinical practice The findings indicate that eGSD influences the patient–nurse relationship by facilitating reciprocal understanding and flexibility. Both patients and RNs acknowledged these outcomes as beneficial. Nevertheless, familiar in‐person consultations were expressed as integral for the patient–nurse relationship. As written communication in eHealth is a novelty, it demands new knowledge and expertise that RNs must master. Findings from this study may therefore be acknowledged when developing and implementing eHealth interventions. Education programs in written eHealth communication, as well as guidelines and frameworks on how to professionally and effectively conduct eHealth services while maintaining supportive patient–nurse relationships, should be a priority for institutions that educate healthcare personnel, health institutions and other stakeholders.

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Section: Discussionmentioning

confidence: 99%

The influence of an eHealth intervention for adults with type 2 diabetes on the patient–nurse relationship: a qualitative study

Lie

Karlsen

Graue

et al. 2019

Scandinavian Caring Sciences

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show abstract

“…On the other hand, his experiences from similar situations were also significant elements of his preconceptions, certainly having an influence on dialogue and analysis. Using Pellegrino’s ideas about professional autonomy as theoretical framework enabled us to narrow the scope of analysis, putting less emphasis on information that did not pertain to the dilemmas concerning patients’ request conflicting with the GP’s autonomy [5,13]. …”

Section: Discussionmentioning

confidence: 99%

What happens when the doctor denies a patient’s request? A qualitative interview study among general practitioners in Norway

Nilsen

Malterud

2017

Scandinavian Journal of Primary Health Care

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ObjectiveTo explore general practitioners (GPs’) experiences from consultations when a patient’s request is denied, and outcomes of such incidents.Design and participantsWe conducted a qualitative study with semi-structured individual interviews with six GPs in Norway. We asked them to tell about experiences from specific encounters where they had refused a patient’s request. The texts were analysed with Systematic Text Condensation, a method for thematic cross-case analysis.Main outcome measuresAccounts of experiences from consultations when GPs refused their patients’ requests.ResultsSubjects of dispute included clinical topics like investigation and treatment, certification regarding welfare benefits and medico-legal issues, and administrative matters. The arguments took different paths, sometimes settled by reaching common ground but more often as unresolved disagreement with anger or irritation from the patient, sometimes with open hostility and violence. The aftermath and outcomes of these disputes lead to strong emotional impact where the doctors reflected upon the incidents and sometimes regretted their handling of the consultation. Some long-standing and close patient–doctor relationships were injured or came to an end.ConclusionsThe price for denying a patient’s request may be high, and GPs find themselves uncomfortable in such encounters. Skills pertaining to this particular challenge could be improved though education and training, drawing attention to negotiation of potential conflicts. Also, the notion that doctors have a professional commitment to his or her own autonomy and to society should be restored, through increased emphasis on core professional ethics in medical education at all levels.

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“…) and everyday life (Borg ; Scott ) were the analytical resources that guided the researchers' interests and interpretations in this step of analysis. This reflects an ‘editing analysis style’ (Crabtree & Miller ; Malterud ). We found that the professionals told several stories about experiencing uncertainty when supporting users, which resulted in dilemmas and challenges for them, and chose these findings as topics for further analysis.…”

Section: Methodsmentioning

confidence: 99%

Community mental health work: Negotiating support of users' recovery

Reed

Josephsson

Alsaker

2017

Int J Mental Health Nurs

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Mental health services have changed over the past decades through an increased emphasis on deinstitutionalization and normalization, and with recovery processes situated in everyday life as a new locus of support. These changes have led to a need for new knowledge and methods concerning the provision of community mental health services. The aim of the present study was to explore how community mental health workers provide support to users, by investigating professionals' own narratives of how they work. Seven community mental health workers participated in narrative interviews, which were subject to a qualitative, interpretive analysis. A primary finding was that community mental health workers provide flexible and individually-adjusted support through engaging in negotiations with users, management, and others. Our findings show both opportunities and challenges of negotiating support, raising the following question for discussion: How and when are negotiations a valuable way for professionals and users to collaborate?

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Theory and interpretation in qualitative studies from general practice: Why and how?

Cited by 113 publications

References 41 publications

The influence of an eHealth intervention for adults with type 2 diabetes on the patient–nurse relationship: a qualitative study

The influence of an eHealth intervention for adults with type 2 diabetes on the patient–nurse relationship: a qualitative study

What happens when the doctor denies a patient’s request? A qualitative interview study among general practitioners in Norway

Community mental health work: Negotiating support of users' recovery

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