Methodological considerations in children's focus groups

Focus groups are a well-known qualitative approach to gathering data in health science research. The literature on focus groups, however, primarily discusses adults as subjects. Unfortunately, the scant reports of studies using children as participants in focus groups have not described their methods in detail. This article discusses the use of children (age 6-12) in focus groups, and highlights methodological considerations in this approach, with particular attention to the integration of developmental principles. Focus groups with children can capture their perspectives, original ideas, and insights, which are often neglected in more traditional pediatric research. Focus groups can also serve as an innovative approach to understanding children's experiences from a developmental perspective. Further, focus groups free children and investigator from the data-gathering limitations placed by literacy/reading levels that plague quantitative methods using self-report. By using relatively homogeneous groups, common cultural, emotional, and cognitive processes and responses are revealed that normally would not come to light in structured data collection. Focus groups offer a rich, interactive and developmentally effective approach to planning, content and evaluation in research with children.     

Planning and conducting focus group research with nurses

Focus groups are increasingly popular in nursing research. However, proper care and attention are critical to their planning and conduct, particularly those involving nursing staff. This article uses data gleaned from prior research to address the complexities present in clinical settings when conducting focus groups with nurses. Applying their combined experiences of conducting studies with nursing staff, the authors present a data-derived approach to thorough preparation and successful implementation of focus group research, offering a unique contribution to the literature regarding this research strategy.     

Focus group interviews as a data collecting strategy

BACKGROUND: Focus group interviews are a method for collecting qualitative data and have enjoyed a surge in popularity in health care research over the last 20 years. However, the literature on this method is ambiguous in relation to the size, constitution, purpose and execution of focus groups. AIM: The aim of this article is to explore some of the methodological issues arising from using focus group interviews in order to stimulate debate about their efficacy. DISCUSSION: Methodological issues are discussed in the context of a study examining attitudes towards and beliefs about older adults in hospital settings among first-level registered nurses, nursing lecturers and student nurses. Focus group interviews were used to identify everyday language and constructs used by nurses, with the intention of incorporating the findings into an instrument to measure attitudes and beliefs quantitatively. CONCLUSIONS: Experiences of conducting focus group interviews demonstrated that smaller groups were more manageable and that groups made up of strangers required more moderator intervention. However, as a data collecting strategy they are a rich source of information.     

Extending the boundaries: autoethnography as an emergent method in mental health nursing research

An exploration of the 'self' is generally considered a fundamental and necessary place from which to commence practice as a mental health nurse. Self-awareness and attention to one's own feelings, thoughts, and experiences can contribute to the therapeutic use of self in effective provision of mental health nursing care. This purposeful use of self, inherent in the role of the mental health nurse, may also be seen as synchronous to the role of the qualitative researcher who seeks to uncover the meaning of others' experiences. Autoethnography is a qualitative research method that connects the researcher's personal self to the broader cultural context. Evocative writing, where the writer shares personal stories on their experiences, is used to extend understanding of a particular social issue. This paper will argue how this emerging method in social science research is of particular relevance to mental health nursing research and practice.     

The phenomenological focus group: an oxymoron?

Title. The phenomenological focus group: an oxymoron?. Aim. In this paper we explore the congruence of focus group interviews within a phenomenological framework. Background. Focus groups as a research method are popular in nursing. Similarly, phenomenology is a dominant methodology for nurse researchers globally. A number of nurse researchers have combined focus groups and phenomenology, but there are others who argue that they are incompatible. Discussion. The argument against using focus groups in phenomenological research is that phenomenology seeks essential characteristics or ‘essences’ of phenomena in a manner that requires an individual to describe their experiences in an ‘uncontaminated’ way. We recognize that traditionally most phenomenological interviews are conducted with only one interviewer and one respondent, but we question whether this needs to continue. We suggest means by which individual lived experience can be preserved within a group context. We draw on our own experience and the phenomenological literature to argue that focus groups are congruent with phenomenological research and extend this argument further by proposing that group interviews in phenomenology are actually beneficial because they stimulate discussion and open up new perspectives. Our observation is that some researchers who combine focus groups and phenomenology appear to do so uncritically and we argue that this is unacceptable. Conclusions. It is important for nurse researchers to develop critical awareness of the research methodologies and methods they employ. We argue that the phenomenological focus group is not an oxymoron. Rather, the use of focus groups can provide a greater understanding of the phenomenon under study.     

Focus groups: issues of analysis and interpretation

Focus groups have become a popular method in nursing research. Their history can be traced back to marketing research methods, but they have also been used in qualitative, ethnographic research. Our study, which used this approach as part of data collection, raised many issues of analysis and interpretation: in particular, the importance of paying attention to the sequence of focus group discussions, the individuals involved, and the social context of the focus group. We conclude that focus groups are not a 'quick and easy' method of collecting data, and that issues of validity and the relationship between focus group data and other data require careful consideration.     

A critical review of social and health inequalities in the nursing curriculum

ContextSocial and health inequalities are a reality around the world and one of the most important challenges in the current age. Nurse educators can respond to these challenges by incorporating curricular components to identify and intervene in social and health inequalities.ObjectiveTo examine how social and health inequalities have been addressed in the nursing curriculum.DesignInformed by the work of Paulo Freire, a critical literature review was performed to examine how social and health inequalities have been addressed in the nursing curriculum.Data Sources and Review MethodsIn July 2015, we searched for articles published from 2000 to 2015 in ERIC, CINAHL, Web of Science, Scielo, MEDLINE and LILACS databases. Main search terms included “disparity” or “inequality” and “curriculum” and “nursing.” We included studies published in academic journals in English, Portuguese and Spanish.ResultsA total of 20 articles were included in this review. Most of the articles (15) were from the United States and described educational experiences in implementing courses in nursing undergraduate curricula. Limited experiences with graduate nursing education were identified. Social and health inequalities were approached in these articles through elements such as social justice, cultural competence, cultural safety, and advocacy. A concern to reduce social and health disparities was noted. We identified three major themes in the articles included in this review: 1) elements in the curricula that can contribute to reducing social and health inequalities; 2) educational and research strategies used to address the theme of inequalities; 3) a focus on socially vulnerable populations to increase awareness on social and health inequalities.ConclusionFindings suggest that nursing education initiatives align with the recommendations from the World Health Organization to address disparities. There is also a need to identify existing conceptual and practical content on inequalities in the nursing curriculum through future research.     

Literature review: considerations in undertaking focus group research with culturally and linguistically diverse groups

Aims. This integrated literature review seeks to identify the key considerations in conducting focus groups and discusses the specific considerations for focus group research with culturally and linguistically diverse groups. Background. The focus group method is a technique of group interview that generates data through the opinions expressed by participants. Focus groups have become an increasingly popular method of data collection in health care research. Although focus groups have been used extensively with Western populations, they are a particularly useful tool for engaging culturally and linguistically diverse populations. The success of focus groups in this context is dependent upon the cultural competence of the research team and the research questions. Methods. The electronic databases Medline, CINAHL, Embase, Psychlit and the Internet using the Google Scholar search engine were explored using the search terms ‘focus group’, ‘cultural sensitivity’, ‘transcultural nursing’, ‘transcultural care’, ‘cultural diversity’ and ‘ethnic groups’. Hand searching of reference lists and relevant journals was also undertaken. English language articles were selected for the review if they discussed the following issues: (i) methodological implications of the focus group method; (ii) strengths and limitations of the focus group method; (iii) recommendations for researchers and (iv) use of the focus group in culturally and linguistically diverse groups. Conclusions were drawn from each of the articles and consensus regarding a summary of recommendations was derived from a minimum of two authors. Results. Findings from this review revealed several key issues involving focus group implementation including recruitment, sample size, data collection, data analysis and use within multicultural populations. Strengths and limitations of the focus group method were also identified. Conclusions. Focus groups are a useful tool to expand existing knowledge about service provision and identify consumer needs that will assist in the development of future intervention programmes, particularly within multicultural populations. Careful planning related to methodological and pragmatic issues are critical in deriving effective data and protecting participants. Relevance to clinical practice. Focus groups can facilitate increased understanding of perspectives of culturally and linguistically diverse groups and thereby shape clinical practice to better meet the needs of these groups.     

Learning that cannot come from a book: An evaluation of an undergraduate alcohol and other drugs subject co-produced with experts by experience

Alcohol and other drugs (AOD) use is a significant public health issue and is associated with high mortality and morbidity rates. Despite this, people who use drugs are often reluctant to seek care due to the lack of trauma-informed treatment and harm reduction treatment options, as well as experiences of stigma and discrimination in health services. Arguably, AOD education that is co-produced with people who use alcohol and drugs can enhance future health professionals' ability to practice in ways that support the needs of this population. This paper reports on a qualitative co-evaluation of a co-produced undergraduate nursing AOD subject. The AOD subject was co-planned, co-designed, co-delivered, and co-evaluated with experts by experience, who have a lived experience of substance dependence and work as advocates and peer workers. Following the delivery of the subject in 2021 and 2022, focus groups were undertaken with 12 nursing students. Focus group data indicate that the co-produced subject supported participants to understand and appreciate how stigma impacts on nursing care and how to recognize and undertake ‘good’ nursing care that was oriented to the needs of service users. Student participants noted that being co-taught by people who use drugs was particularly powerful for shifting their nursing perspectives on AOD use and nursing care and took learning beyond what could be understood from a book. Findings indicate that co-produced AOD education can shift nursing students' perceptions of AOD use by providing access to tacit knowledge and embodied equitable and collaborative relationships with people who use drugs.     

Group concept mapping for evaluation and development in nursing education

The value of course evaluations has been debated since they frequently fail to capture the complexity of education and learning. Group Concept Mapping (GCM), a participant-centred mixed-method was explored as a tool for evaluation and development in nursing education and to better understand students' learning experiences, using data from a GCM-based evaluation of a research training assignment integrating clinical practice and research data collection within a Swedish university nursing program. Student nurses (n = 47) participated in a one-day GCM exercise. Focus group brainstorming regarding experiences from the assignment that the students considered important and instructive yielded 98 statements that were individually sorted based on their student-perceived relationships, and rated regarding their importance/instructiveness and need for development. Quantitative analysis of sort data produced a 2-dimensional map representing their conceptual relationships, and eight conceptual areas. Average cluster ratings were plotted relative to each other and provided a decision aid for development and planning by identifying areas (i.e., “Research methodology”, “Patients' perspectives”, and “Interviewer role”) considered highly important/instructive and in high need for development. These experiences illustrate the use and potential of GCM as an interactive participant-centred approach to evaluation, planning and development in nursing and other higher health science educations.     

我国护理学博士研究生教育培养目标定位的探索性研究

[目的]探讨我国护理学博士研究生教育培养目标定位,为系统研究论证我国护理学博士研究生教育培养目标奠定基础。[方法]采用Delphi专家咨询法,在文献研究、理论分析、质性访谈基础上形成了2种培养类型（科学学位、专业学位）、4种角色定位以及20种角色功能备选务目的问卷。请44名从事护理教育、护理管理及临床护理的专家参与咨询,采用Likert5级标度法进行评价。[结果]经过2轮咨询后专家形成一致性意见;“科学学位”护理学博士主要有2种角色定位（护理研究者、护理教育者）,发挥11种角色功能;“专业学位”护理学博士有4种角色定位（护理实践者、护理教育者、护理管理者、护理研究者）,发挥18种角色功能。[结论]科学学位与专业学位培养目标定位应各有侧重。科学学位护理学博士研究生教育培养目标应定位于培养高层次的护理科研、教育人才,专业学位护理学博士研究生教育应侧重于培养护理实践领域的高层次专门人才。     

The implementation of Bachelor's of Science in Nursing education in Pakistan

Currently nursing education at the Aga Khan University in Karachi, Pakistan consists of a 3 year diploma program, a 2 year post-registered nurse (RN) of Bachelor’s of Science in Nursing (BScN) completion program and a new 4 year generic Bachelor’s of Science in Nursing program. The purpose of this paper is to describe the evaluation process and findings of the newly implemented BScN program. The program is unique, as it is the first and only BScN program throughout Pakistan. Therefore, it has the responsibility of setting the standards for university nursing education for the entire country. Sampling for this qualitative evaluation study included the first class admitted into the BScN program, nursing faculty, and nursing staff involved in clinical experiences of the BScN students. The sample was divided into homogeneous focus groups to elicit the data. Focus groups were audio-taped with results being categorized into themes. Findings from this evaluation study support a typology of learning discussed in the literature related to nursing education. In addition, faculty experiences of implementing the new program mirror those of faculty from other countries.     

Striving for independence: experiences and needs of service users with life limiting conditions

Title.  Striving for independence: experiences and needs of service users with lifelimiting conditions.
Aim.  This paper is a report of a study to explore what service users with a range of life-limiting conditions identify as their key experiences and needs generally and, specifically, from health and social care services.
Background.  Whilst internationally palliative care has a primary focus on service users who have cancer, there is growing evidence that those with non-cancer life-limiting conditions have similar palliative care needs. The literature has mainly been focused on independence, choice and control at an individual level, with wider influences on the maintenance or attainment of independence ignored.
Method.  A participatory approach was used in 2003–2004, with both the researcher and a group of service users working together in all stages of the study. Twenty-five participants in receipt of support from an acute hospital, primary care, social services and a hospice took part. Face-to-face individual interviews and small discussion groups were conducted and data were analysed thematically.
Findings.  Eight different but interconnected themes were identified. Independence/dependence was an overarching theme, with negotiation between independence and dependence being evident across all themes. This theme and the influence of health and social care services on the experience of living with life-limiting conditions are the focus of this paper.
Conclusion.  Palliative care and practitioners should focus on maximizing independence at both the individual and structural levels. How services for those with life-limiting conditions are provided and relationships with health and social care staff can directly impact on an individual's experience of independence, choice and control.     

Art, science and social science in nursing: occupational origins and disciplinary identity

Art, science and social science in nursing: occupational origins and disciplinary identity
This paper forms part of a wider study examining the history and sociology of nursing education in England between 1860 and 1948. It argues that the question of whether nursing was an art, science and/or social science has been at die 'heart' of a wider debate on die occupational status and disciplinary identity of nursing. The view that nursing was essentially an art and a 'calling', was championed by Florence Nightingale. Ethel Bedford Fenwick and her allies insisted that nursing, like other professions, was a 'scientific' and technical enterprise. Social scientists later came to challenge nursing's claim to professionalism by analysing nursing work first within die context of industrial psychology. But they also advocated a rapprochement between nursing, health services and social science research, a challenge which we are in nursing, still striving to meet This paper argues for a strong coalition of nursing with its former nineteenth century ally, social science, in die continuing struggle for change within nursing and health care policy. Rather than searching for some rarified and purified essence of nursing knowledge, it argues that nurses need to join forces with sociologists and economists in striving to shape die agenda for health services research and provide die evidential basis for health policy transformation more generally.     

Social support: some pragmatic implications for health care professionals

The role of social support in promoting recovery from chronic illness has been the focus of a debate within the nursing and social science research communities This paper reviews the literature on this important issue and discusses the implications for patient management In providing holistic patient care, health care professionals need to reflect on the impact of this research for their clinical practice     

Registered nurses' perceptions of educational preparation for professional work and development in their profession

There is a lack of knowledge regarding graduate nurses' experiences of preparation in nursing education for their work in health care. The aim was to describe registered nurses' (RNs) perceptions of preparation in nursing education for their professional work and development in the nursing profession. The sample consisted of 339 RNs with 3 years experience taken from Swedish class registers for graduation in nursing education. A questionnaire was sent by post to 327 RNs. The response rate was 70.3%. The results (n=219) show that the most important domains of knowledge for RNs' work were biological science, medical science and nursing, whereas humanities and social science were less important. The importance of medical science was significantly lesser in community care and nursing in emergency care. Research methodology was of little importance for RNs' work. RNs could not make use of or conduct research in their work but research planning was significantly higher for those with extensive university education. This study mainly indicates that RNs need a stimulating work environment, including mentoring and support to enable continuous professional development in health care.     

Clinical networks for nursing research

As a central feature of national research and development strategies, clinical effectiveness emphasizes the importance of rigorous experimental research in nursing. It is naïve to assume that over‐worked practitioners, with little research training and supervision, can undertake this type of research. Traditional approaches to research support rely on the practitioner registering for a higher degree and academic supervision. This assumes that the responsibility for research lies with practice, with higher education adopting a reactive stance in supporting research and development in nursing. The literature demonstrates a growing number of innovative models for facilitating nursing research. These, however, tend to focus on single appointments with limited and predefined access to clinical areas and patient populations. This article details a new initiative from the Clinical Nursing Practice Research Unit (CNPRU) that aims to support programmatic research in nursing practice through Clinical Networks for Nursing Research. Our research strategy is to contribute to the development of nursing science by facilitating effective collaboration between clinicians and higher education in core clinical specialties, including stroke rehabilitation, diabetes, mental health and community nursing. Each researcher has developed networks with a number of clinical areas, locally, regionally or nationally, through seminars, conferences or newsletters, to link practitioners and generate answerable research questions. Network communications also rely heavily on the establishment of interactive websites. This strategy has resulted in a number of collaborative, evaluative studies including clinical trials in rehabilitation, diabetic nursing and primary care.     

The experiences of a group of pre-registration mental health nursing students

Research that only utilises mental health students as a sample group is quite rare. Yet there are many potential stressors that may impact on the experience of these students including; the theory-practice gap, the learning culture experienced in clinical practice, the effects of the programme's assessment and learning strategies and the intentional and unintentional effects of the curriculum. Therefore the aim of this study was to explore the experiences of a group of mental health student nurses by utilising these four concepts as a framework. Focus groups were used to generate data and the sample consisted of fourteen mental health branch students who, within the pre-registration nursing programme, formed a problem-based learning group. The group met on an annual basis at key junctures during the three-year diploma programme. The focus groups were tape-recorded and the data interpreted and organised by utilising an adapted form of content analysis. Three themes were identified; the conflicting pressures of life as a mental health student nurse, adjustment to problem based learning and experiences in mental health practice and views on mentorship. A discussion of the implications of the findings for the planning of nursing curricula and mental health branch programmes is outlined.