Cancer Cachexia Care: The Contribution of Qualitative Research to Evidence-Based Practice

Background: Despite its prevalence and prognostic impact, primary cachexia is not well understood. Its potential to cause considerable psychological stress indicates the need for qualitative research to help understand the perspectives of those affected.

Objective: The aims of this study were to describe the perspectives of patients with primary cachexia, of their relatives, and of the healthcare professionals involved in their care and to demonstrate how this evidence can be applied in practice at 4 different levels of application ranging from empathy to coaching.

Methods: A review of the qualitative literature and empirical qualitative investigation was used to understand the experiences of patients and relatives and the perspectives of professionals.

Results: The main worries expressed by patients and relatives concerned appetite loss, changing appearance, prognosis, and social interaction. We also describe their coping responses and their views of professionals’ responses. The main concerns of professionals related to poor communication, lack of clinical guidance, and lack of professional education.

Conclusions: Understanding patients’, families’, and professionals’ perspectives, and mapping that understanding onto what we know about the trajectory and prognosis of the condition, provides the evidence base for good practice. Qualitative research has a central role to play in providing the knowledge base for the nursing care of patients with cachexia.

Implications for Practice: The evidence provided can improve nurses’ insight and assist them in assessment of status, the provision of guidance, and coaching. There is a need for the development of a holistic, information-based integrated care pathway for those with cancer cachexia and their families.

Qualitative research on chronic illness:A commentary on method and conceptual development

This concluding essay discusses some crucial methodological issues raised by other papers in this issue. It also suggests directions for further conceptuel development concerning the qualitative research on chronic illness.

Money matters: using qualitative research for policy influencing on gender and welfare reform

The UK government has been considering the design and delivery of the proposed “universal credit”, the centerpiece of its welfare reforms. The authors draw on findings from their own research, about how low/moderate-income couples manage money and negotiate gender roles, to demonstrate their relevance to exploring the gender implications of the proposals for universal credit. Findings from this and other similar studies are used to explore the value of qualitative research to policy design and debates – in particular to supplement economic modeling, which has been highly influential in driving the current UK government's thinking on welfare reform. The authors discuss the reasons why insights about gender relations within the household revealed by such qualitative research appear to have been resisted in the reform.

Ethical dilemmas for clinical psychologists in conducting qualitative research

Clinical psychologists often use qualitative methods to explore sensitive topics with vulnerable individuals, yet there has been little discussion of the specific ethical issues involved. For clinicians conducting qualitative research, there are likely to be ethical dilemmas associated with being both a researcher and a practitioner. We argue that this overarching issue frames all other ethical issues raised. This article provides an overview of the range of ethical issues that have been discussed in general in relation to qualitative research and considers the specific nature of these in relation to the discipline of clinical psychology. Such issues will be exemplified by reference to some of our own research and practice and the extant literature. We conclude with some suggestions for good practice, although our aim is to trigger debate rather than to establish prescriptive guidelines.

Innovative qualitative research methods with children aged 4-7 years

There is a growing body of knowledge that uses innovative qualitative methods to support and facilitate the involvement of young children, aged 7 years and under, in the research process. Across several fields of study the recent growth in research that engages with young children stands in sharp contrast with the situation just a few years ago where there was a dearth of activity and knowledge in this area. Designed to seek their views, experiences and perspectives the range of methods is now burgeoning. This chapter explores reasons for the growth in the use of innovative qualitative methods, the underlying principles through which the engagement of young children has been achieved and the different types of method with detailed case examples. For each method the main critical issues regarding their effectiveness are identified and discussed in further detail. The latter sections of the chapter focus on contemporary issues regarding the use of innovative methods. Highlighted, in particular, are some of the common concerns and criticisms with regards to the trustworthiness, reliability, validity and generalizability of the data that is collated using innovative qualitative methods.

The Value and Contribution of Qualitative Research to Inform Nurse Education and Policy in Response to the Child’s Experience of Hospital

The aim of this article is to consider the value of qualitative research to inform nurse education and policy for the hospitalized child and young person (CYP). The theoretical issues and tensions inherent in qualitative research with children and young people’s nursing are presented in conjunction with a discussion and analysis of how the epistemological and ontological concepts underpin and guide research. It is then followed by an exploration of their influence on enabling nurses to understand the CYP’s perspective, before finally leading to an analysis of the impact on the development of policy and research.