Adolescent chronic illness : a qualitative study of psychosocial adjustment

Introduction: The purpose of this study was to investigate the psychosocial issues facing young people living with a chronic medical condition.

Materials and Methods: Subjects were young people with a range of medical conditions who were on a waiting list to participate in the Chronic Illness Peer Support programme at the Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia. Young people agreed to in-depth interviews which were taped and transcribed. Thematic analysis was undertaken by two researchers working independently.

Results: Thirty-five young people were interviewed. Thematic analysis revealed five broad themes: control (in control, under control, out of control); emotional reactions (happiness, frustration, anger, sadness, anxiety); acceptance (of illness, of others, of self); coping strategies, and; a search for meaning. The importance of social connections was emphasised. While illustrating the difficulties of managing a chronic medical condition during adolescence, a generally positive message emerges about these young people.

Conclusions: Many young people with chronic illness appear relatively resilient in the face of the adjustment challenges presented by their illness. Interventions that allow a young person to explore meaning, build self-esteem, and acceptance through positive social connections are likely to improve adjustment outcomes in this group.

Characteristics of physically active and inactive men from low socioeconomic communities and housing estates : a qualitative study using the socioecological model

This qualitative study compares experiences of men from low socioeconomic status (SES) communities who achieved sufficient physical activity (PA) with those who did not. The socioecological model of health guided interviews with men (n=25) and community health workers (n=4) to explore individual, interpersonal, organizational, community, environmental and policy influences on PA participation. Men generally reported that they had poor health, financial barriers, were unfamiliar with community PA facilities and programs, had limited social support, and lived in unsafe neighbourhoods. There were clear differences between active and inactive men. Inactive men described their inability to cope with poor health, and consequent perceptions of disconnection. They did not identify positive PA outcomes and seemed consumed by stressful life situations. Active men identified barriers to existing programs such as the exclusive culture of PA facilities. It is important that personal circumstances are understood, and financial and cultural barriers addressed to promote PA among men from low SES communities.

Changing green subjectivities in outdoor and environmental education : a qualitative study

This article draws on a longitudinal qualitative study of Australian tertiary students studying Outdoor and Environmental Education. It draws on the work of Foucault and Darier to consider how ‘environmental governmentality’ shapes the conduct, desires and attitudes of these students over time. Attention is drawn to normalising and disciplinary effects of mainstream environmental discourse alongside an exploration of some of the inconsistencies and ruptures in how participants interact with discourses of environmentalism.

Qualitative estimation of camera motion parameters from video sequences

We propose a simple technique for extracting camera motion parameters from a sequence of images. The method can estimate qualitatively camera pan, tilt, zoom, roll, and horizontal and vertical tracking. Unlike most other comparable techniques, the present method can distinguish pan from horizontal tracking, and tilt from vertical tracking. The technique can be applied to the automated indexing of video and film sequences.

Attitudes and experiences : qualitative perspectives on erectile dysfunction from the female partner

This study explored the woman’s experience of her partner’s erectile dysfunction (ED) focusing particularly on sexual experiences, relationship satisfaction, and communication. One hundred women completed a semistructured interview, providing information about how ED impacted her relationship with her partner. For some women, there was a sense of hopelessness and frustration surrounding their sex lives, while for others, her partner’s ED had led to efforts towards increasing non-physical intimacy and sexual communication. These findings demonstrate the importance of the relationship, including communication between the partners, in a women’s experience of her partners’ ED.

'Just bloody fat!' : a qualitative study of body image, self esteem and coping in obese adults

The rise of the ‘obesity epidemic’ in Western societies has led to an increased public gaze on obese individuals. Yet there is limited research that explores through qualitative methods the increased impact it has had on obese individuals’ perceptions of self, body image and coping strategies, using their own words. This paper presents the findings of interviews with a community sample of 142 obese adults in Australia. We examined how obese individuals felt about themselves and their bodies, what influenced these feelings, and the subsequent coping strategies employed. While participants were able to identify many positive characteristics about their inner self, the vast majority used negative language to describe their physical appearance. Many participants described feelings of ‘guilt’, ‘shame’ and ‘blame’ associated with their weight. Coping strategies included striving for perfection in other areas of their life, social isolation, maximising aspects of their appearance and ‘fat’ acceptance. This study shows that, while different groups of obese adults experience, cope with and compensate for the influence of weight-based stereotyping in many different ways, they still feel an unrelenting otherness and difference associated with their weight.

"They all work...when you stick to them" : a qualitative investigation of dieting, weight loss, and physical exercise, in obese individuals

Background
To explore the extent to which people living with obesity have attempted to lose weight, their attitudes towards dieting, physical exercise and weight loss solutions, why their weight loss attempts have failed, and their opinions about what would be most beneficial to them in their struggle with their weight.

Method
Qualitative study, using open-ended interviews, of 76 people living with obesity in Victoria, Australia in 2006/7. Individuals with a BMI of 30 or over were recruited using articles in local newspapers, convenience sampling, and at a later stage purposive sampling techniques to diversify the sample. Data analysis was conducted by hand using a constant, comparative method to develop and test analytical categories. Data were interpreted both within team meetings and through providing research participants the chance to comment on the study findings.

Results
Whilst participants repeatedly turned to commercial diets in their weight loss attempts, few had used, or were motivated to participate in physical activity. Friends or family members had introduced most individuals to weight loss techniques. Those who took part in interventions with members of their social network were more likely to report feeling accepted and supported. Participants blamed themselves for being unable to maintain their weight loss or 'stick' to diets. Whilst diets did not result in sustained weight loss, two thirds of participants felt that dieting was an effective way to lose weight.

Conclusion
Individuals with obesity receive numerous instructions about what to do to address their weight, but very few are given appropriate long term guidance or support with which to follow through those instructions. Understanding the positive role of social networks may be particularly important in engaging individuals in physical activity. Public health approaches to obesity must engage and consult with those currently living with obesity, if patterns of social change are to occur.

Being 'fat' in today's world : a qualitative study of the lived experiences of people with obesity in Australia

Objective  To develop an in-depth picture of both lived experience of obesity and the impact of socio-cultural factors on people living with obesity.

Design  Qualitative methodology, utilizing in-depth semi-structured interviews with a community sample of obese adults (body mass index ≥30). Community sampling methods were supplemented with purposive sampling techniques to ensure a diverse range of individuals were included.

Results  Seventy-six individuals (aged 16–72) were interviewed. Most had struggled with their weight for most of their lives (n = 45). Almost all had experienced stigma and discrimination in childhood (n = 36), as adolescents (n = 41) or as adults (n = 72). About half stated that they had been humiliated by health professionals because of their weight. Participants felt an individual responsibility to lose weight, and many tried extreme forms of dieting to do so. Participants described an increasing culture of ‘blame’ against people living with obesity perpetuated by media and public health messages. Eighty percent said that they hated or disliked the word obesity and would rather be called fat or overweight.

Discussion and Conclusion  There are four key conclusions: (i) the experiences of obesity are diverse, but there are common themes, (ii) people living with obesity have heard the messages but find it difficult to act upon them, (iii) interventions should be tailored to address both individual and community needs and (iv) we need to rethink how to approach obesity interventions to ensure that avoid recapitulating damaging social stereotypes and exacerbating social inequalities.

Do health beliefs and behaviors differ according to severity of obesity? A qualitative study of Australian adults

Public responses to obesity have focused on providing standardized messages and supports to all obese individuals, but there is limited understanding of the impact of these messages on obese adults. This descriptive qualitative study using in-depth interviews and a thematic method of analysis, compares the health beliefs and behaviors of 141 Australian adults with mild to moderate (BMI 30−39.9) and severe (BMI ≥ 40) obesity. Mildly obese individuals felt little need to change their health behaviors or to lose weight for health reasons. Most believed they could “lose weight” if they needed to, distanced themselves from the word obesity, and stigmatized those “fatter” than themselves. Severely obese individuals felt an urgent need to change their health behaviors, but felt powerless to do so. They blamed themselves for their weight, used stereotypical language to describe their health behaviors, and described being “at war” with their bodies. Further research, particularly about the role of stigma and stereotyping, is needed to fully understand the impact of obesity messaging on the health beliefs, behaviors, and wellbeing of obese and severely obese adults.