This study aims to examine the metaphorical perceptions of caregivers of older adults receiving palliative care services regarding the anticipatory grief process. Designed within a hermeneutic phenomenological orientation and analyzed through thematic analysis, data were collected from 80 caregivers through semi-structured interviews. Data analysis utilized metaphor analysis and thematic analysis methods. The findings are structured across two main axes: “metaphorical perceptions regarding grieving” and “metaphorical perceptions regarding being a grieving individual.” While participants conceptualized the experience of grief through intense emotional flux, a depletion of self, and a permanent emotional burden, they also associated it with processes of acceptance, adaptation, and spiritual coping. The results demonstrate that anticipatory grief is a process involving emotional transformation, identity shifts, and existential restructuring. The study emphasizes that metaphor analysis is a significant tool that can be used for the early identification of complicated/prolonged grief risk and points to the necessity of strengthening psychosocial supports for caregivers in palliative care.
Drawing on sustained engagement with reflexive thematic analysis (RTA) across health professions education and health systems research within an academic health system in the Arabian Gulf, this commentary explores what becomes visible when RTA is practiced not merely as a procedural framework but as an interpretive sensibility. Rather than revisiting Braun and Clarke’s familiar six-phase framework of RTA, the paper reflects on how RTA functions across mixed-methods inquiry, iterative implementation work, conceptual framework development, and contextually grounded qualitative research. Two conceptual provocations are offered. The first reframes thematic interpretation through the metaphor of colour mixing, proposing that themes are analyst-generated hues selected from a theoretically expansive interpretive spectrum. The second draws on Peter Gray’s theory of free play to conceptualise reflexivity as a form of courageous intellectual play. Together, these provocations argue for a methodological vocabulary that positions interpretation as reflexive, creative, and theory-situated work, rather than procedural extraction, whether that ‘theory’ is a named framework or the analyst’s own inductive, constructivist engagement with the data.
Participant identifiers, such as pseudonyms or numerical labels, are often attached to quoted data extracts in qualitative research. These identifiers may be considered markers of methodological rigour, analytic breadth, and transparency. Yet, qualitative inquiry encompasses diverse epistemological and analytic traditions, raising questions about whether participant identifiers necessarily serve the same methodological purpose across approaches. In this Pearls, Piths, and Provocations perspective, I draw on examples from my own research practice, experiences with peer review, and feedback from research ethics committees, and critique unquestioned use of participant identifiers. I suggest researchers consider adopting a more mindful and methodologically aligned approach to participant identification practices. Rather than treating identifiers as default indicators of rigour, greater emphasis should be placed on clearly explaining how data were generated, selected, and analysed, and on ensuring that reporting practices align with the aims and epistemological assumptions of a study.
The diagnosis of a psychotic disorder in youth often leads to high costs, emotional distress, and isolation for caregivers. Yet, caregiving experiences are underexplored in research, resulting in a potentially missed area to enhance care. We aim to explore the experiences, perceptions, and help-seeking efforts of families supporting youth with first-episode psychosis (FEP). We conducted semi-structured interviews with 20 caregivers of 17 individuals diagnosed with a psychotic disorder within the past 5 years (age range = 12–35, mean age at diagnosis = 21). Interviews covered caregivers’ experiences, perceptions, and help-seeking efforts. We transcribed interviews and used thematic analysis informed by an interpretative phenomenological lens. We organized our findings into three domains. First, an inward-facing, youth-focused domain of Caring with three themes: Making Sense , Loss of the Envisioned Child , and Strengths . Second, an inward-facing, caregiver-focused domain of Coping with three themes: Fractures and Bonds , Emotional Load , and Caregiver Role and Identity. Third, an outward-facing domain of Connecting with three themes: Navigating Systems of Care , Cultural , Social , and Religious Context , and Independence . Our framework underpinning the lived experiences of caregivers may serve as a resource for caregivers, clinicians, and policymakers to inform earlier intervention and improve outcomes for young individuals with FEP.
Mothers raising children with developmental disabilities in American Samoa navigate caregiving within fa’a Samoa ( the Samoan way of life ), where family, culture, and spirituality are deeply intertwined. Yet, the lived experiences of these mothers remain largely undocumented. This study explored how mothers make meaning of caregiving and its implications for holistic well-being within this unique cultural and geographic context. Using interpretative phenomenological analysis with culturally congruent focus group methods, 15 mothers participated across three focus groups. Data were interpreted through the Fonofale model, a Pacific framework conceptualizing well-being through interconnected cultural, spiritual, physical, mental, and familial dimensions. Two superordinate themes emerged: (a) impossible choices between inadequate on-island services and family-fragmenting off-island care and (b) painful tensions between cultural expectations of obedience and children’s disability-related behaviors, often leading to stigma and isolation. Across both themes, mothers described strain across every dimension of the Fonofale, revealing caregiving as a totalizing experience affecting cultural belonging, family integrity, spiritual life, and emotional well-being. Findings highlight the need for culturally embedded developmental disability supports that strengthen rather than fracture Pacific family and community systems.
