Recruiting in public places : A strategy to increase diversity in qualitative research samples

For some research projects, recruiting in public places is an invaluable addition to sampling strategies. It complements the more traditional recruitment strategies by providing researchers with' opportunities to include people in the research who would otherwise be excluded. One of the limitations of selective and snowball sampling is that participants often come from the same social group. Participants from these social groups often share similar experiences and ways of thinking about those experiences. The aim of recruiting in public places is to move beyond this 'in group' to ensure a wider perspective. This paper illustrates how recruiting in public places can provide greater sample diversity for theoretical strength. The paper begins with a brief overview of recruiting in public places. It then describes the theoretical considerations associated with this recruiting strategy. The paper demonstrates how recruiting in public places facilitates grounded theory by providing comparisons that are informed by diverse experiences. Using examples and a case study, we illustrate how recruiting in public places can complement selective, snowball and theoretical sampling to ensure a more comprehensive sample.

Development of a condition-specific measure of quality of life for children with cerebral palsy: empirical thematic data reported by parents and children

Background: Although there is increasing recognition that quality of life (QOL) and health-related quality of life (HRQOL) are important outcome variables in clinical trials for children with cerebral palsy, there are substantial limitations in existing measures of QOL. This study identify themes of QOL for children with cerebral palsy and their parents to guide the development of a new condition-specific QOL scale. Methods: A qualitative study of parent and child views on QOL composition was conducted, using a grounded theory framework. Families participated in semistructured interviews on QOL until thematic saturation was reached (n = 28 families). Results: Overall, 13 themes emerged from the interviews: physical health, body pain and discomfort, daily living tasks, participation in regular physical and social activities, emotional well-being and self-esteem, interaction with the community, communication, family health, supportive physical environment, future QOL, provision of, and access to services, financial stability, and social well-being. Conclusions: Research with parents and children with cerebral palsy, representative of severity across the disease spectrum and socio-economic status, reinforced and expanded on the traditional themes that have underpinned QOL measurement development. This has implications not only for the development of a new QOL scale for children with cerebral palsy, but also for clinical interventions and community care management.

Technology and marginalization: a case study of the limited adoption of the intranet at a state-owned organisation in rural Australia

Taking a critical theory approach and the pluralist view of technology, this paper examines the problems in organizational communication that arose due to the implementation of a limited intranet electronic mail system as the main channel of communication between a rural stateowned organization and its city-based Head Office, installed at the sole discretion of the latter.
The intranet was provided only to the administration division and managers of some units due to financial constraints. This required others to receive information carried via the intranet through a gatekeeper who due to information and work overload, failed to disseminate the information effectively and efficiently. Using a combination of qualitative data collection methods, this study found that the intranet had marginalized those without access to it and reinforced the privileged position of those already with higher status within the organization, contrary to the utopian predictions
of new technologies as leading to social equality.

Young women with diabetes: using internet communication to create stability during life transitions

Aims and objectives. The aim of the current study was to explore and describe the strategies young women with Type 1 diabetes used to manage transitions in their lives. This paper will describe one aspect of the findings of how women with Type 1 diabetes used the Internet to interact with other people with diabetes and create stability in their lives.

Background. Individuals living with diabetes develop a range of different strategies to create stability in their lives and enhance their well-being. Changing social and emotional conditions during life transitions have a major impact on diabetes management. Although the literature indicates that strategies enabling the individuals to cope with transitions are important, they remain under-researched.

Design. Using grounded theory, interviews were conducted with 20 women with Type 1 diabetes. Constant comparative data analysis was used to analyse the data and develop an understanding of how young women with Type 1 diabetes used the Internet to create stability in their lives.

Findings. The findings revealed that the women valued their autonomy and being in control of when and to whom they reveal their diabetic status, especially during life transitions and at times of uncertainty. However, during these times they also required health and social information and interacting with other people. One of the women's main strategies in managing transitions was to use Internet chat lines as a way of obtaining information and communicating with others. This strategy gave women a sense of autonomy, enabled them to maintain their anonymity and interact with other people on their own terms.

Conclusions. Having meaningful personal interactions, social support and being able to connect with others were fundamental to the women's well being. Most importantly, preserving autonomy and anonymity during such interactions were integral to the way the women with Type 1 diabetes managed life transitions.

Relevance to clinical practice. Health professionals need to explore and incorporate Internet communication process or anonymous help lines into their practice as a way to assist people manage their diabetes.

Young women with type 1 diabetes' management of turning points and transitions

The authors used grounded theory to explore and develop a substantive theory to explain how 20 young women with type 1 diabetes managed their lives when facing turning points and undergoing transitions. The women experienced a basic social problem: being in the grip of blood glucose levels (BGLs), which consisted of three categories: (a) the impact of being susceptible to fluctuating BGLs, (b) the responses of other people to the individual woman’s diabetes, and (c) the impact of the individual women’s diabetes on other people’s lives. The women used a basic social process to overcome the basic social problem by creating stability, which involved using three interconnected subprocesses: forming meaningful
relationships, enhancing attentiveness to blood glucose levels, and putting things in perspective. Insights into the processes and strategies used by the women have important implications for provision of care and service delivery.

Fine motor difficulties: the need for advocating for the role of occupational therapy in schools

Background: Fine motor difficulties can impact on the academic, social and emotional development of a student. Aim: The aims of this paper are to: (i) investigate the need for support to students experiencing fine motor  difficulties from the perspective of their classroom teachers, and (ii) report on the level of knowledge teachers have in regard to the role of occupational therapists in supporting students with fine motor difficulties.  Methods: Fifteen teachers from a stratified random sample of public schools within two regions of Victoria, Australia, were interviewed in this qualitative, grounded theory investigation. Results: Results showed that the current level of support for students with fine motor difficulties is inadequate. Conclusion: Occupational therapists in Victoria need to advocate their role in developing the fine motor skills of students at both an organisational and an individual level in order to increase the access of students with fine motor difficulties to occupational therapy services.

The relevance of role models to older aged generation Y consumers

This study assesses the relevance of role models, specifically sports role models, and the related concepts of anti-heroes and gender to Generation Y consumers in the older age group of 18-29 year olds. A qualitative study, following a post-positivist inquiry paradigm was conducted. The specific research strategy used was grounded theory, utilising deductive thought processes coupled with the process of constant comparison. A series of semi-structured in-depth interviews were carried out. Results suggest that direct relevance to the subject under investigation is a key determinant of role model choice. Gender is also found to have significant effect, as is media, both in the creation of role models and anti-heroes.

Perioperative managers: role stressors and strategies for coping

This qualitative study explored the role stressors experienced by perioperative nurse managers, and identified resources and strategies they used in order to cope with the multiple demands upon their role. Grounded Theory methodology was used to inform the inquiry through interviews with the participants and thematic analysis of the data. The perioperative nurse managers who participated in the study indicated that the major stressors they experienced were related to managing their staff. Stress was reduced through the use of hospital resources and peer support, referring to post management education and information obtained from attending conferences. In addition, they used team building strategies, balanced priorities and engaged in social activities. These findings will assist directors of nursing and other nursing leaders in formulating the direction of appropriate support and structure for the development perioperative nurse managers.

Healthy eating, activity and obesity prevention: a qualitive study of parent and child perceptions in Australia

Preventative health strategies incorporating the views of target participants have improved the likelihood of success. This qualitative study aimed to elicit child and parent views regarding social and environmental barriers to healthy eating, physical activity and child obesity prevention programmes, acceptable foci, and appropriate modes of delivery. To obtain views across a range of social circumstances three demographically diverse primary schools in Victoria, Australia were selected. Children in Grades 2 (aged 7–8 years) and 5 (aged 10–11 years) participated in focus groups of three to six children. Groups were semi-structured using photo-based activities to initiate discussion. Focus groups with established parent groups were also conducted. Comments were recorded, collated, and themes extracted using grounded theory. 119 children and 17 parents participated. Nine themes emerged: information and awareness, contradiction between knowledge and behaviour, lifestyle balance, local environment, barriers to a healthy lifestyle, contradictory messages, myths, roles of the school and family, and timing and content of prevention strategies for childhood obesity. In conclusion, awareness of food ‘healthiness’ was high however perceptions of the ‘healthiness’ of some sedentary activities that are otherwise of benefit (e.g. reading) were uncertain. The contradictions in messages children receive were reported to be a barrier to a healthy lifestyle. Parent recommendations regarding the timing and content of childhood obesity prevention strategies were consistent with quantitative research. Contradictions in the explicit and implicit messages children receive around diet and physical activity need to be prevented. Consistent promotion of healthy food and activity choices across settings is core to population prevention programmes for childhood obesity.

Can web design methodologies (actually) help practitioners?

There exist many web design methodologies and the new ones are constantly being added to the pool of those offered to practitioners. However as previous research shows, practitioners either do not know, do not use or even do not care for these development approaches. This paper examines web design practice, and the design of visual aspects in particular, in order to establish whether any of the existing methodologies would actually address the practitioners concerns. Through grounded theory analysis, it transpires that from amongst several examined approaches, IS-based web design methods are dealing with great many practical issues which designers perceive as most pressing.

The perceptions of expert coaches about effective leadership in sport

Research on effective leadership in sport has identified a number of characteristics and situations that impact on coaching effectiveness. These include coach effect on athlete satisfaction and performance, self-esteem and trait anxiety. This research has focused on athletes' perceptions of or preferences for specific leadership behaviors and actual coach behaviors identified by observing coaches. Few studies have recognized the views of the expert coach as a potentially valuable source of information regarding effective leadership and the coaching process. The present study investigated expert coaches' perception and interpretation of the leadership process. Twenty successful coaches working with Australian junior elite sport participants were purposefully sampled to cover a diversity of sports (team and individual) and provide a gender balance across sports. Through in-depth interviews, based on Grounded Theory, the study examined three aspects of coaching, which provided the basis of the interview guide. These were coaching history and influences, effective coaching behaviors, and coach training and accreditation. Eight major themes emerged: (a) influence of history on coaching behaviors, (b) knowledge of the sport, (c) pedagogy skills, (d) coaches' personal qualities, (e) coach-athlete relationships, (f) coaches' evaluation of the athlete, (g) coach and athlete outcomes, and (h) enjoyment of the coaching process. The results highlight the important role coaches play in future coach development, the impact of coach self-efficacy attributed to athlete self-efficacy, and how coach-related outcomes drive the coaching process. These results have noteworthy implications for coach education programs.

People living with ALS/MND tell the diagnosis story : what happened before they knew

Background: Being told that one has a life threatening disease is shattering, but for some people it comes as a relief, following as it does the years of uncertainty and traumatic experiences that lead to diagnosis. The need to debrief the experience is paramount before the story of living with the disease can be told.
Objectives: The purpose of this paper is to describe the extended and often demoralising process of diagnosis for people with ALS/MND.
Methods: Grounded theory methodology was used to explore the life and world of people diagnosed and living with ALS/MND. Data were collected via in-depth interviews with 25 people with the disease, their stories and photographs, poems and books they identified as important, and field notes. The textual data were analysed using constant comparative analysis. All people who volunteered were included in the study. Many participants with communication challenges worked with the researcher to tell their stories.
Results: Participants recounted the processes they experienced prior to the time when they were finally given a reason for the perplexing behaviour of their bodies. The diagnosis story was revealed as a sequence of: ‘recognizing a problem’, ‘seeking medical help’, ‘being on the diagnostic roundabout’, ‘confirming ALS/MND’, ‘reevaluating life and the future’, then ‘living with ALS/MND’. Consequences included a loss of trust in the competence of the health care system, which had implications for seeking help later when living with the disease.
Discussion: Participant distress seemed to have more in common with the stress linked to post-traumatic stress disorder (PTSD). Participants continued to relive the diagnosis experience in their dreams and daily lives many months after diagnosis, which impacted negatively on their well-being. For this group of people, the diagnostic process itself was the traumatic stressor. It seemed that telling their stories gave them the opportunity to debrief and have their words recorded. Debrief support is recommended whenthe ALS/MND diagnosis is finalized, and continued, to prevent long-term reliving of the diagnostic process.
Conclusion: Health professionals continue to address the issues around the process of giving the ‘bad news’ of ALS/MND. This ‘diagnosis story’ may provide additional guidance in addressing the process so as to limit potential harm and promote well-being for people with the disease and their families.

Board directors and conflict of interest : a study of a sport league

Conflict of interest is one aspect of governance that has the potential to damage both an organisation and those who govern that organisation. Board directors of sport organisations are faced with a number of influences particular to sport business, which can impact on the process of managing conflict of interest. This research identified processes and attributes that influence directors: selection processes, outside roles, experience, regulation, education, motivation and qualifications. Directors and CEOs drawn from a sample of five Australian Football League (AFL) clubs and members of the AFL commission were interviewed. Data analysis was undertaken using a constructivist grounded theory method, and key processes (selection processes and director education) and attributes (outside roles, experience, regulation, motivation and qualifications) of non-executive directors were identified. By better understanding the influences on board directors in sport organisations, and the impact of these on managing conflict of interest, the potential for damage to the directors and the organisation may be decreased.

The mother-daughter guilt dynamic : effects of type 1 diabetes during life transitions

Aim. The aim of the study was to explore and describe the strategies young women with type 1 diabetes used to manage life transitions. The paper describes one aspect of how guilt dynamic often operates between mothers and daughters and how the women managed the guilt dynamic to create stability in their lives.
Background. When a child is diagnosed with diabetes, major transitional changes occur in the relationships between the mother and her child. The changes affect the psychological and social aspects of their lives and have a major impact on how young women manage their diabetes. A guilt dynamic between mothers and young women with diabetes emerged as a major theme in a larger study that investigated how young women with diabetes managed life transitions. Although the literature indicates that mothers of chronically ill children experience guilt feelings towards their children, little research was identified that addressed the emotional dynamics between mothers and daughters with diabetes.
Design. Using grounded theory method, interviews were conducted with 20 women with type 1 diabetes and five mothers during 2002 and 2003. Constant comparative analysis was used to analyse the data and develop an in-depth understanding of the experience of living with diabetes during life transitions.
Findings. The findings revealed that guilt feelings created a two-way dependency between mothers and their daughters with diabetes. The two-way dependency involved feelings of being a burden to each other, difficulty balancing responsibilities for diabetes management, difficulty relinquishing emotional and social dependency especially during life transitions. In addition, these issues were rarely discussed openly with each other or with health professionals. The findings provide additional information about the human experience of the mother–daughter relationship and the effect on coping with diabetes in the context of life transitions.
Conclusions. Understanding the impact diabetes has on the emotional and social well being of both women with type 1 diabetes and their mothers is critical in planning appropriate support for both groups. Most importantly, it is critical to understand the guilt dynamic that operates during young women with diabetes' life transitions when the daughters' dependency on their mother's control and responsibility for diabetes management undergo changes resulting in emotional responses, especially guilt feelings.
Relevance to clinical practice. Health professionals need to understand the emotional and social impact of the guilt dynamics between young women with type 1 diabetes and their mothers. Adequate and appropriate support can minimize the guilt feelings and enhance stability and quality of life for both mothers and their daughters, especially during major life transitions, such as motherhood.

The empowerment process in people with diabetes : an Iranian perspective

Background: Empowerment and power are well-researched concepts concerning people with chronic diseases. However, few researchers have focused specifically on the process of empowerment in Iranian people with diabetes. Understanding the empowerment process could help health professionals facilitate empowerment.
Aim: To explore the empowerment process in Iranian people with diabetes.
Method: A grounded theory research design was used incorporating in-depth interviews to collect the data from men and women aged 21–73 years (n = 16). Data were collected between February and July 2007. Constant comparative analysis was undertaken to identify key categories.
Findings: Participants indicated being embarrassed by the diagnosis, thirsting to learn, living in the shadow of fear, accepting diabetes as reality, managing diabetes and feeling empowered were distinct but interconnected phases in the empowerment process. The empowerment process was influenced by cultural and religious beliefs including the concept of the doctor as holy man, accepting diabetes as God's will, caring for the body because it was God's gift, paying attention to symptomatic disease, and support from peers and family, especially daughters.
Conclusion: The empowerment process consists of several distinct but interconnected phases. The findings will help health professionals develop a deeper understanding of how Iranian people with diabetes become empowered.