PURPOSE:Home is more than a place of care delivery, yet little is known about how community-dwelling older adults with health concerns in Japan understand its meaning. This study explored the shared meanings of home among them and derived implications for home care. METHODS:This qualitative study involved reflexive thematic analysis within a non-positivist framework. Fifty-four adults aged 65-95 years living in urban, suburban, and rural areas were purposively recruited through home-visit nursing services and an online survey panel. Semi-structured interviews were conducted in Japanese. Interview data were transcribed verbatim and analyzed iteratively in Japanese. FINDINGS:Four themes were generated: "autonomy and independence," "residential environment that sustains daily life," "familiar place with attachment," and "personally meaningful connections with others." Home was understood as more than a physical residence: a familiar, cherished, and personally meaningful foundation for sustaining a self-determined and independent life, personal identity, and relationships with others, extending beyond the dwelling to the surrounding community. CONCLUSIONS:The findings suggest that home care professionals should understand what home means as a lived place to each older adult, support independence and safety while respecting autonomy, familiarity, and preferences, and facilitate meaningful connections at their preferred relational distance.
PURPOSE:What drives a person towards death and what it entails to try to kill oneself is not fully understood. This study aimed to examine suicidality as a phenomenon, and to elucidate the essential meaning of being suicidal. METHODS:Applying Reflective Lifeworld Research, the phenomenon of being suicidal was explored through interviews with seven adult suicide attempt survivors (4 men, 3 women; aged 18-54) with various diagnoses. Interviews were analysed using meaning-oriented analysis. RESULTS:The four essential structures Fragile vitality versus inherent lethality, suicidal isolation, incentive of death and surrendering to death constitutes the essence of being suicidal. Being suicidal is a movement from everyday struggle for meaning and value in a perceived meaningless existence, into a fixed suicidal isolation marked by unbearable psychological pain, conviction of worthlessness and exclusion, paralyzing forces and cognitive-existential shutdown. The transition from thought to action is shaped in silent solitude by the incentive of death rather than will or choice. The inner drive towards death appears as a compelling, liberating, inevitable force impossible to resist on one's own. CONCLUSION:This study provides deep understanding about the suicidal mind which may be used in development of assessment instruments and interventions for suicide prevention.
BACKGROUND:Type 2 diabetes mellitus (T2DM) poses an escalating challenge in resource-limited settings where daily self-care practices are often compromised. The everyday realities of individuals with T2DM in Sub-Saharan Africa remain insufficiently understood. This study explored self-care experiences among adults with T2DM in South Ethiopia, focusing on factors shaping their daily lives and well-being. METHOD:A qualitative descriptive design with reflexive thematic analysis was employed. In-depth interviews were conducted with 21 purposefully selected participants (12 patients, 9 providers) from three hospitals in South Ethiopia. Provider interviews provided complementary contextual information about health system barriers. Well-being, from participants' perspectives, was defined by the ability to maintain daily activities, fulfill family roles, and sustain hope. RESULTS:Analysis of patient interviews yielded four major themes capturing the experience of self-care: 1) Navigating daily self-care routines (medication intake, diet management, self-monitoring, and foot care); 2) Multilevel barriers eroding well-being (medication stock-outs, economic constraints, cultural beliefs, lack of support, knowledge gaps, provider training deficits); 3) Education and counselling as sources of empowerment (building knowledge, instilling hope); and 4) Envisioning supportive environments (continued counselling, medication availability, peer support). Healthcare provider interviews provided complementary contextual information about health system barriers. CONCLUSION:For individuals with T2DM in South Ethiopia, self-care involves daily negotiation shaped by economic hardship, cultural factors, and health system limitations. Empowering patients through tailored support, continued counselling, peer support network, and reliable healthcare systems is essential for enhancing their health and well-being.
BACKGROUND:Walking regularly in natural settings is a common healthy activity for Australian parents and their preschool children. Extant research conveys that walking in nature provides cognitive, emotional and physical benefits for both parents and children. Children with autism are less likely to participate in physical activity or access nature regularly, and autistic adults are less likely to hold pro-environmental views. While research exploring the experiences of typical parents and preschoolers exists, the perceptions of parents of preschool children with autism on walking is yet to be studied. METHODS:This paper examines the experiences of parents of children with autism using Bronfenbrenner's bioecological model as a theoretical framework. We recruited 20 parents of preschoolers with autism and a comparison group of 12 parents of preschoolers without autism and invited them to complete an online qualitative survey about walking together in nature. RESULTS:Five themes were generated from their responses, including calm, connection, coordination and communication, with an additional theme of priority. Parents identified that walking in nature provided opportunities for developmental growth for their children such as increased communication, connection and calm, but also highlighted challenges such as differences in moving together in coordination. CONCLUSION:We advocate that supporting family priorities includes supporting their ability to access everyday activities such as walking in nature, a common activity that provides rich opportunities for parents and their preschoolers with autism.
PURPOSE:Primary care follow-up of women with previous GDM is often lacking. Little is known about effective approaches to improve follow-up and promote a healthy lifestyle. METHOD:Semi-structured individual interviews were conducted with 17 purposively sampled women with previous GDM in southern Sweden. The interviews were audio-recorded, transcribed verbatim, and qualitative content analysis was performed. RESULTS:Three main categories were found: "a missed proactive opportunity caused by insufficient GDM follow-up", "need for a holistic approach to health and wellbeing", and "ambivalence toward tech-enhanced lifestyle management". Women with previous GDM felt abandoned by healthcare after labour, since follow-up in primary care was lacking. Follow-up was viewed as proactive and requested, preferably in the form of a holistic approach to health. Motherhood and future T2DM risk were the strongest motivators for healthy lifestyle behaviours. Overall, they were cautiously optimistic regarding digital solutions in facilitating follow-up and lifestyle improvement. The capability opportunity motivation-behavior (COM-B) framework was applied, highlighting key determinants of women's ability to make lifestyle changes. CONCLUSIONS:Promoting a healthy lifestyle among women with prior GDM requires efforts at multiple levels to reduce long-term diabetes risk. Structured primary care follow-up and person-centred lifestyle support can be potentially enhanced through digital health interventions.
BACKGROUND:This paper examines the emotional experiences of vulnerable Lebanese youth in light of the context of prolonged and uninterrupted social, political, and economic crises impacting Lebanon in recent years. METHOD:Conducted as part of the "Yes to Emotions in Youth" (YEY) program, which focused on emotional intelligence (EI) training at a semi-private school in Lebanon, the research analyzes the emotional diaries from 145 students (98 girls) aged 15-17. These diaries were analyzed using thematic analysis informed by Colaizzi's phenomenological method. The study adopts the framework of trait Emotional Intelligence and utilized Brasseur et al. (2013) model of five emotional competences: identification, understanding, expression, regulation, and utilization of emotions. RESULTS:Four overarching themes were discerned: (One) Emotional identification: unpleasant emotions and triggers; (Two) Emotional identification: pleasant emotions and triggers; (Three) Coping and emotional regulation: maladaptive practices; and (Four) Coping and emotional regulation: adaptive practices. While the sampled population is, in general, attuned with, and shows competence in identifying emotions and their triggers, many of the youth participants struggled with regulating these emotions adaptively. DISCUSSION:The findings highlight the disparate layers of EI-informed coping in relation to emotion identification and regulation among youth grappling with the precarity of daily life.
PURPOSE:It has become increasingly recognized that sexual side effects from serotonergic antidepressants can last long after the medication has been discontinued, but little is known about the lived experience of post-SSRI sexual dysfunction (PSSD) and its impact on people's identities, relationships, and mental health. This qualitative study aimed to understand the experiences of people living with PSSD in the United Kingdom. METHODS:Ten participants were invited to take part in a semi-structured interview, and the data were analysed using an interpretive phenomenological approach. RESULTS:Three themes, encompassing eight subthemes, were identified: (1) distrustful of professionals; (2) a changed me; and (3) living with the impact. The participants discussed their experiences of being dismissed and unheard, feeling emotionally numb, and making sense of the change and losses they have experienced. Implications for clinical practice include the importance of professionals being aware of PSSD and its potential impact. CONCLUSIONS:PSSD can affect every aspect of daily life, impacting more than just individuals' sexual functioning and satisfaction. Further research is needed on effective treatments, including psychological interventions, which can offer meaningful support.
PURPOSE:To illuminate the meanings of encountering patients in a suicidal process from the perspective of ambulance clinicians. METHODS:Narrative interviews were conducted with eighteen ambulance clinicians in Sweden. Data were analyzed using a phenomenological hermeneutical approach inspired by the philosophy of Ricœur. RESULTS:The main theme, "Navigating a fragile capability," reveals a profound tension within professional identity. Traditionally anchored in technical agency, this identity is challenged by a movement toward vulnerability and shared humanity. Capability in these encounters is defined not only by medical problem-solving but by the courage to remain present during existential crises. Entering the patient's narrative imposes an extensive responsibility, where experiences of indecisiveness and powerlessness emerge as expressions of moral sensitivity rather than professional inadequacy. CONCLUSIONS:Encountering suicidal patients reveals professional capability as a fragile construct dependent on reciprocity, requiring a shift from technical agency toward an ethical presence when medical protocols reach their limit. By validating being with as a clinically meaningful component of care, the encounter moves beyond procedural care toward a meaningful ethical aim. Practically, professional standards must expand beyond technical management to integrate relational competence and existential care as core elements of prehospital practice.
BACKGROUND:Workplace stress is inversely correlated with job satisfaction and, when left unmanaged, can manifest as burnout. Prior research shows pharmacists under the age of thirty years and Early Career Pharmacists (ECPs) are at an especially high risk of burnout. This study aimed to: (i) explore the experiences of ECPs dealing with stress, (ii) determine the sources of stress and joy experienced by ECPs, and (iii) to explore strategies used by ECPs to reduce stress. METHODS:ECPs were recruited through social media. Following informed consent, semi-structured interviews based on Critical Incident Technique (CIT) were conducted in January-February 2025. Data were analysed using CIT and reflexive thematic analysis. RESULTS:Twenty-four ECPs (mean age 29 years; mean experience 4 years; 75% female) described 80 critical incidents. Key stressors included: 1) lack of support by management, 2) self-imposed unrealistic expectations among ECPs and 3) feeling disrespected as healthcare professionals. Participants described a need for belonging and peer connection as a coping strategy. CONCLUSION:The wellbeing and retention of pharmacists is paramount to an effective healthcare workforce and optimal patient care. These results have highlighted the areas requiring attention for pharmacist wellbeing, career retention and workforce sustainability.
PURPOSE:Policies in Norway and similar countries emphasize the inclusion of next of kin in healthcare. However, research shows that many experience limited involvement and recognition. This study explores how next of kin to individuals with severe self-harm experience and make sense of healthcare encounters in a Norwegian context. METHODS:The study draws on in-depth interviews with 15 parents, partners, and siblings of individuals engaging in severe self-harm. Reflexive thematic analysis was employed, guided by a phenomenological sensibility. RESULTS:Three interconnected themes illuminated different aspects of participants' encounters with healthcare services. "In the hands of the system" captures experiences of navigating the healthcare system while concerned for a loved one's wellbeing. "Who do I become when excluded" highlights participants' experiences of their experiential knowledge being marginalized and how emotional involvement appeared to undermine their credibility. "The ones who stand by" reflects concerns about their own wellbeing and that of the wider family, alongside a desire for greater recognition and support. CONCLUSIONS:The results suggest that healthcare encounters involve not only support and participation but also recognition of next of kin's experiential knowledge and needs, which appears to shape their sense of legitimacy and ability to remain involved in care.
Purpose This study aimed to describe the phenomenon of losing human life by suicide, based on the lived experiences of suicide survivors and professionals. Methods Phenomenological participatory action research was conducted, comprising 50 group sessions with 51 participants including suicide survivors, registered nurses, response police officers, and general practitioners. Results The essence of losing human life through suicide is characterized by profound emotional vulnerability when confronted with an existential tragedy. This means a powerlessness and an abrupt shift in existence, awakening the instinct to escape and the responsibility to act. Being the messenger of death is a heavy burden, and a sense of abandonment arises when survivors are left alone. Simply being together as human beings awakens a sense of vulnerability and a strong impulse to uphold human dignity. Conclusions These findings underscore that everyone involved is vulnerable to existential challenges following suicide and provide insight into the fragility of humanity. Professionals need awareness of their own vulnerability and moral courage to encounter survivors as fellow human beings. Support for survivors should acknowledge that grief and existential suffering do not follow fixed timelines. The methodological combination of phenomenology and participatory action research proved fruitful, generating rich insights and offering a promising approach for future studies.
INTRODUCTION:Liver transplant recipients undergo emotional, social and existential changes. Adaptation begins before surgery and continues long after discharge. However, no longitudinal grounded theory study has described this process across the transplantation trajectory. This study explored how individuals adapted by addressing their main concerns. METHODS:Twelve adults (mean age 49.3 years, range 25-70) were interviewed pre- and post-transplantation. Data collection and analysis proceeded concurrently using Charmaz's constructivist grounded theory and the constant comparative method. RESULTS:The grounded theory conceptualised adaptation as striving for a life in social belonging. This process was explained through five interrelated categories: Comprehending, Accepting, Adapting, Coping and Balancing. Before transplantation, participants sought to maintain social belonging by preserving continuity in everyday life despite disruption, uncertainty and hope, reflecting existential concerns and conceptualised as optimising a disruptive situation. One year after transplantation, the process shifted from maintaining to reconstructing social belonging by rebuilding stability while managing vulnerability and ongoing uncertainty, reflecting existential concerns related to vulnerability and the future, conceptualised as managing an uncertain presence. Although the categories persisted across time, their meanings evolved throughout the transplantation trajectory. CONCLUSION:Adaptation after liver transplantation involves creating a stable new normality, that accommodates uncertainty, gratitude, vulnerability and hope.
PURPOSE:The aim of this qualitative descriptive study was to explore young children's perspectives on participation and care experiences in child health clinic nursing encounters. Knowledge of children's experiences and views can help professionals support children's right to participation. METHODS:Data were generated using a multi-method approach that included researcher-initiated role-play, stimulated recall interviews, Storycrafting, painting and drawing. Eleven children aged 5-7 years and 12 parents participated. Children were involved in selecting methods and settings. Thematic and semiotic analyzes were conducted, supported by researcher triangulation. The Consolidated Criteria for Reporting Qualitative Research checklist guided reporting. RESULTS:Clinic visits emerged as shared and meaningful experiences for children. Children's narratives highlighted their wish to act as active agents, the importance of play, toys and rewards, the need for psychosocial support and proximity to a support person, and the significance of the clinic's physical appearance. Vaccinations, physical measurements and adults' restrictive actions were described as memorable aspects that shaped children's care experiences. CONCLUSIONS:Clinic visits emerged as shared and meaningful experiences for children. Children's narratives highlighted their wish to act as active agents, the importance of play, the need for psychosocial support, and the significance of the clinic's environment. Vaccinations, physical measurements and adults' restrictive actions were described as memorable aspects that shaped children's care experiences.
BACKGROUND:Childhood overweight and obesity are prevalent in Chile and globally. Health care responses typically emphasise biomedical and risk-focused approaches, with limited attention to children's own perspectives. OBJECTIVE:This study explored how children clinically classified as overweight or obese understand health, growth and weight within health contexts. METHODS:Participants were recruited from primary care clinics in two municipalities in Santiago, Chile. Semi-structured online interviews were conducted with 18 children aged 10-12 years during COVID-19 restrictions, incorporating visual tools such as body silhouettes and body mapping to facilitate discussion. Data were analysed using reflexive thematic analysis. RESULTS:Three major themes were identified: Translating Fatness: everyday words and the softening of body labels; Body shapes, shame, and the making of 'unhealthy' bodies; and Making Sense of Measurement: Receiving, Interpreting and Negotiating Medical Labels. CONCLUSIONS:The study highlights that children actively interpret and negotiate weight-related messages, drawing on emotional, social, and cultural frames rather than biomedical ones. Clinical encounters can heighten body awareness and stigma. Clinical practice should prioritise non-stigmatising communication, value children's perspectives, and adopt approaches that support wellbeing during growth and identity development.
Purpose To synthesize qualitative evidence on factors influencing patients’ participation in cardiac rehabilitation after a first acute myocardial infarction. Methods A search of eight databases was conducted from inception to May 2026. Included studies were quality assessed using JBI criteria, and findings were synthesized using a hybrid approach that combined meta-aggregation for data extraction with thematic synthesis for interpretive analysis. Results The synthesis of 9 qualitative studies yielded 33 synthesized findings. These findings were organized into three key themes: (1) the complex process of identity transformation following a first acute myocardial infarction (2) the dynamic interaction between motivators and barriers affecting participation in cardiac rehabilitation and (3) the fundamental importance of support systems in shaping patient experiences. Conclusion Participation in cardiac rehabilitation among patients experiencing their first acute myocardial infarction is influenced by multiple factors. To enhance engagement, clinical healthcare providers should address identity disruption, strengthen intrinsic motivation, and facilitate peer and family support through tailored, multidisciplinary, and psychosocially integrated strategies.
PURPOSE:When young unaccompanied refugees are settled in a local municipality, they are expected to gradually take responsibility for organizing their everyday lives, including accessing public services. This study aims to examine these young people's experiences of health-related support and primary healthcare in everyday life when settled in Norway. METHOD:In-depth interviews with nineteen young unaccompanied refugees (18-25 years) from Afghanistan, Eritrea, and Syria. The interviews were analysed using interpretive phenomenology. Theoretically, Axel Honneth's philosophy of recognition is applied. RESULTS:The young unaccompanied refugees use their agency to manage daily life, support and care for family abroad, and attend school; however, the absence of primary relations loving forms made them vulnerable in terms of self-confidence, as described in Honneth's taxonomy. They emphasized that professionals must integrate care and recognition into routine services to maintain their well-being and dignity. Teachers and school nurses offered relational continuity and meaningful support, but the participants felt that their concerns were insufficiently acknowledged by GPs when presenting indistinct symptoms such as headaches or stomachaches. Still, most of the young participants reported high-quality care from their GP when dealing with acute or clearly defined medical issues. CONCLUSION:The young refugees revealed both agency and vulnerability. They also expressed unmet needs for recognition, particularly within their primary relationships. In this context, teachers and school nurses provided availability, continuity and person-centred care, enabling participants to feel recognized and able to manage everyday life. Although GPs encounter them less frequently and within stricter time constraints, their role remains pivotal. Strengthening GPs' capacity to recognize young refugee patients as whole persons, including their need for recognition and their emotional vulnerability, represents an important area for improvement.
Background Most applications for depression lack comprehensive theoretical integration and qualitative assessments of university students’ needs remain insufficient. Objective This study aimed to explore the needs and experiences of university students with depressive symptoms and develop a theory-driven app design framework tailored to the target population. Methods A post-positivist qualitative framework was used to recognize the value of subjective experience. Semi-structured interviews were conducted with 32 students with moderate to moderately severe depression. Reflexive thematic analysis was used to identify themes in the data. Results Three themes emerged: app design, help-seeking processes, and core features of cognitive behavioral therapy. Students emphasized the importance of discreet, user-friendly design, such as positive naming, privacy protection, and flexible reminder functions. Although some expressed concerns regarding the empathy and reliability of artificial intelligence, others valued its anonymity and capacity to provide immediate support. Regarding theoretical integration, participants considered monitoring emotions and physical sensations essential but also highlighted the need for diverse and personalized methods. The conceptualization of self-monitoring data was considered useful for facilitating clinical consultations. Conclusion Students considered theory-based health education as effective for improving mental health knowledge and promoting help-seeking awareness. The findings support clinical decision-making in developing more effective digital tools.
PURPOSE:The current study sought to understand and explore how gamblers retrospectively characterise the shifts in their emotional valence across a gambling session, and how they interpret changes in their emotional arousal as a gambling session unfolds. METHODS:A total of 20 Australian gamblers, aged between 20 and 63 years (Mage = 34.9, SDage = 10.23), participated in retrospective semi-structured interviews. Participants were asked to reconstruct and narrate the emotional shifts experienced across gambling sessions and elucidate how they interpreted and understood the changes in their emotions as a gambling session unfolded. Data was analysed via reflexive thematic analysis using an interpretivist epistemological framework. RESULTS:Five key themes were constructed from the data: (1) Affective Recovery: Feelings of Pride and Competence Through Mastery; (2) Affective Shift: Isolation to Feelings of Belonging; (3) Navigating Experiences of Negative Valence; (4) Anticipatory Excitement to In-Game Arousal; and (5) Escalating Affective Intensity and Emotional Urgency. CONCLUSION:This study challenges traditional paradigms by demonstrating that both positive and negative emotions act as highly fluid drivers during and after a gambling session. These insights may prompt further research into investigating emotional mechanisms that drive and maintain an individual's gambling.
PURPOSE:To explore the experiences of older people and formal caregivers of value-creating continence care, focusing on toileting and containment strategies, in relation to the Art of Connectedness framework. METHOD:A qualitative, explorative design. The interviews were conducted with 14 older people. Individual interviews and focus groups were held with 14 formal caregivers. An abductive qualitative content analysis was conducted, alternating between deductive interpretation-based on the three themes in the framework-and inductive analysis of the interview data. RESULTS:In relation to the co-created care theme, establishing a relationship and respecting preferences were highlighted by the participants and aligned with the framework, while trust was less prominent. In personalized care, meeting individual needs were described in ways that extended the framework: older people stressed the importance of time, while formal caregivers highlighted incontinence pads being individualized. Maintaining self-determination was emphasized by formal caregivers, as in the framework, but varied among older people. In the reflective care theme, showing empathy and upholding dignity were valued by older people in nursing homes and by formal caregivers, which was consistent with the framework. CONCLUSIONS:The findings reveal aspects of care that contribute to value-creating continence care for older people receiving toileting assistance and containment strategies. While the framework provided a useful structure, variations emerged between older people and formal caregivers what they considered important. This indicates the importance of developing a self-reported instrument to evaluate older people's satisfaction with the assistance they receive. The findings provide insights that can help increase awareness of the value of how promoting well-being for older people in daily continence care practice. The findings could inform community care policy aimed at improving continence care for older people.
PURPOSE:Participation in the local community is linked to well-being among seniors, yet little is known about how experiences of mattering shape community participation. This study aims to generate a more nuanced understanding of what facilitates and inhibits participation in community contexts, thereby contributing to the expansion of research on how seniors experience community participation through the lens of mattering. METHODS:Thirty-six seniors from two Norwegian municipalities participated in semi-structured interviews. Interviews transcripts were analyzed using reflexive thematic analysis. RESULTS:Three themes emerged. Feeling seen in the community: This highlights how seniors experience community participation as more than attendance at community events. It involved being recognized, welcomed, and believing that one's actions make a meaningful contribution. Mattering to others: This emphasizes the emotional significance of being invited, remembered, or missed. Such relational cues strengthened social connectedness and well-being. When mattering fades: This reflects experiences of reduced participation following retirement and being classified as "old." Many described a sense of invisibility, which weakened their motivation to participate in the community. CONCLUSIONS:Participation is fundamentally relational. Feeling valued and believing one's presence makes a difference are central to seniors' well-being. Community practices that promote recognition may strengthen mattering.
