Climber, mediator, and marathoner: narrative inquiry of career motivation changes of pre-service CSL teachers throughout teaching practicum.

Introduction: The growing global demand for foreign language learning contrasts sharply with the shortage of second language teachers. In Chinese as a second language (CSL) education, although the number of pre-service CSL teachers is increasing, few continue in the profession after completing their teacher education courses. Methods: To investigate the reasons behind this trend, this longitudinal narrative inquiry examined the career motivations of three participants during their teaching practicum. The study focused on identifying key narrative clues based on metaphors emerging from their narratives. Results: The research found that the participants' career motivations were influenced by their teaching practice and experienced various dynamic changes. Key motivational factors included self-efficacy and intrinsic self-fulfillment, with a notable influence from the unique cross-cultural motivation associated with second language teaching. Discussion: The study underscores the significant role of narratives and metaphors in understanding changes in teacher career motivations. It suggests that enhancing self-efficacy and intrinsic motivation, alongside recognizing cross-cultural motivations, could be crucial in addressing the retention issues among pre-service CSL teachers.

Listen to me, I really am sick! Patient and family narratives of clinical deterioration before and during rapid response system intervention.

AIM: To explore patient and family narratives about their recognition and response to clinical deterioration and their interactions with clinicians prior to and during Medical Emergency Team (MET) activations in hospital. BACKGROUND: Research on clinical deterioration has mostly focused on clinicians' roles. Although patients and families can identify subtle cues of early deterioration, little research has focused on their experience of recognising, speaking up and communicating with clinicians during this period of instability. DESIGN: A narrative inquiry. METHODS: Using narrative interviewing techniques, 33 adult patients and 14 family members of patients, who had received a MET call, in one private and one public academic teaching hospital in Melbourne, Australia were interviewed. Narrative analysis was conducted on the data. RESULTS: The core story of help seeking for recognition and response by clinicians to patient deterioration yielded four subplots: (1) identifying deterioration, recognition that something was not right and different from earlier; (2) voicing concerns to their nurse or by family members on their behalf; (3) being heard, desiring a response acknowledging the legitimacy of their concerns; and (4) once concerns were expressed, there was an expectation of and trust in clinicians to act on the concerns and manage the situation. CONCLUSION: Clinical deterioration results in an additional burden for hospitalised patients and families to speak up, seek help and resolve their concerns. Educating patients and families on what to be concerned about and when to notify staff requires a close partnership with clinicians. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Clinicians must create an environment that enables patients and families to speak up. They must be alert to both subjective and objective information, to acknowledge and to act on the information accordingly. REPORTING METHOD: The consolidated criteria for reporting qualitative research (COREQ) guidelines were used for reporting. PATIENT OR PUBLIC CONTRIBUTION: The consumer researcher was involved in design, data analysis and publication preparation.

"I needed something to hook me." A narrative study on adherence to Pilates.

INTRODUCTION: Exercise adherence is necessary for achieving long-term benefits. Along with other elements, stories and narratives can play a role in understanding and promoting adherence. The aim of the present study was to explore how stories and narratives may affect adherence to Pilates. METHOD: 8 Pilates practitioners who had been participating in a Pilates program for 6 or more years were interviewed. Data obtained were analysed using thematic narrative analysis, (focusing on the whats of stories) and holistic narrative analysis (examining how narratives acted on adherence). RESULTS AND DISCUSSION: Results highlight pain, Pilates as a health-related method, and the social relations as characters, plots and scenarios of stories enhancing long-term participation in Pilates. Exercise is medicine and eudaimonic well-being are presented as narratives articulating the coherence to practitioners' adherence. They act for participants subjectivizing their Pilates practice into a serious commitment to health. CONCLUSION: Stories and narratives are relevant to give meaning and sense to the adherence to Pilates. A focus on stories can be added as a strategy to promote adherence to Pilates.

"Unable to Feed My Hungry Child": Experiences of Mothers Caring for Children With Prader-Willi Syndrome.

Mothers' experiences of caring for children with Prader-Willi Syndrome (PWS) is largely unknown. With no treatment for PWS, parents undertake (extra)ordinary care practices to keep children safe from overeating and self harm. Knowledge of these care practices could lead to effective interventions. Narrative inquiry was used to study everyday experience with Canadian mothers. Participants cared for a child 3 to 17 years old who had hyperphagia. Participants were interviewed 8 to 12 times each over the course of a year. Narrative accounts were co-composed through a collaborative process of analysis. Engaging with participants' everyday experiences amplified complex care needs for families and gaps in health and social care systems. Narrative threads focused on engaging in (extra)ordinary care practices, rigid care work to keep children healthy and safe, tension from others while enacting these care practices, and difficulty conforming to social expectations with childrearing and care work. Recommendations for practice and policy include (a) shifting from untenable care practices, (b) reconceptualizing care work, and (c) alternative care models.

UK survey on experiences of men with non-cancer-related lymphoedema: part one.

This initial article delves into the methodology, methods and theories, while the subsequent article will centre on the discoveries, discussion and conclusion. The study aimed to address the research question: how do men perceive their engagement in the self-management of non-cancer-related lymphoedema? An interpretivist qualitative methodology was employed, utilising an online survey based on the validated lymphoedema quality of life tool (LYMQoL). The data underwent inductive narrative inquiry. The study incorporated theories such as hegemonic masculinity and the health, illness, men and masculinities (HIMM) framework. The findings will be detailed in the second article in this series. This article has delineated the objective, methodologyand methods, employing a qualitative interpretivist approach through narrative inquiry. The study incorporated masculinity theories, including hegemonic masculinity and HIMM. The second article will present the findings and their significance within the broader literature.

Unpacking a female language teacher's identity transformations: a perspective of multiple I-positions.

The narrative inquiry investigates the construction and evolution of a female Chinese language teacher's identity across her pre-service and in-service phases. Utilising data from interviews, class observation and written reflections, the research examines how internal and external aspects shape her identity development. It specifically explores the role of third positions, meta positions, and promoter positions drawing on the dialogical self theory. The findings reaffirm that a teacher's identity is fluid and influenced by personal and professional factors. Over time, however, strong teaching beliefs and a growth mindset emerge as pivotal drivers for sustained and positive teacher development. The paper concludes by offering implications for pre-service teacher education and female teachers' continuing professional development.

" full of opportunities, but not for everyone": A narrative inquiry into mechanisms of labor market inequity among precariously employed gay, bisexual, and queer men.

BACKGROUND: This study brings lesbian, gay, bisexual, transgender (trans), and queer (LGBTQ+) populations into scholarly discourse related to precarious employment through a political economy of queer struggle. METHODS: Drawing on narrative inquiry, 20 gay, bisexual, and queer men shared stories of precarious employment that were analyzed using Polkinghorne's narrative analysis. RESULTS: Results tell an overarching narrative in three parts that follow the trajectory of participants' early life experiences, entering the labor market and being precariously employed. Part 1: Devaluation of LGBTQ+ identities and adverse life experiences impacted participants' abilities to plan their careers and complete postsecondary education. Part 2: Participants experienced restricted opportunities due to safety concerns and learned to navigate white, cis, straight, Canadian ideals that are valued in the labor market. Part 3: Participants were without protections to respond to hostile treatment for fear of losing their employment. CONCLUSIONS: These stories of precarious employment illustrate unique ways that LGBTQ+ people might be particularly susceptible to exploitative labor markets.

Managing the COVID-19 Pandemic: Experience of Managers in Healthcare: A Narrative Inquiry.

The pandemic represented a challenge for hospital managers at different levels, required to reorganise services without compromising care. This study aimed to analyse the experiences of hospital managers during the COVID-19 pandemic. A narrative inquiry was conducted in a multisite acute hospital. Data were collected through narratives and open-ended questions. Direct and non-direct-care managers were invited to participate. Data were analyzed considering Clandinin & Connelly's (2000) framework and Braun & Clarke, (2006). Thirty-six narratives and open-ended question responses were analysed. Participants were nurses (n = 20), doctors, technicians, administrative and hospitality service managers. Themes were grouped into three narrative dimensions: (1) personal-"the emergency engulfed us", (2) practical/professional-"managing the pandemic", (3) social-"the strength of the team and people". Different narrative threads were identified between direct-care and non direct-care managers. Problems faced, factors helpful for management and suggestions for improvement were also reported. The pandemic had an important impact on managers and their roles, in terms of the need for clear concise information, staff support, and adequate professional and technical resources. A sense of unity and belonging facilitated management.

The experiences of international students in a Canadian faculty of nursing: A narrative inquiry study.

BACKGROUND: In response to the global need for nursing faculty, and nurses in leadership and advanced clinical practice roles, students from different countries come to Canada for their graduate nursing education. The positive reputation and the perceived advantages of the education system are particularly compelling to applicants from the countries located in the Global South. However, these students come from different social, historical, political, cultural, and educational backgrounds that deeply influence their learning experiences in Canada. OBJECTIVE AND METHODOLOGY: The aim of this narrative inquiry study was to understand the experiences of international graduate nursing students. The focus was to unravel two puzzles of this inquiry: What stories across social, historical, political, cultural, and educational borders shaped students' identities and ways of knowing? How did the experience in Canada impact their identities? SETTING AND PARTICIPANTS: Participants were invited from a Master of Nursing program at a research-intensive University in Western Canada. METHODS: Participants engaged in series of conversations over a period of one year. RESULTS: Multiplicity of borders and identity making, border making, and border crossing, were the threads that resonated across the narrative accounts. CONCLUSION: These narrative threads provided insights into the lived experiences of tensions, the shifting of identities, and the day-to-day challenges that international students face while learning in Canada. Being aware of these experiences and acknowledging them could be a significant stride towards addressing the issues of racism, inequity, and exclusion for international students within Canadian graduate nursing education.

A Narrative Inquiry of Critical Events Supporting Professional Identity Formation in Introductory Pharmacy Practice Experiences.

OBJECTIVE: Professional identity formation (PIF) is the process of internalizing a profession's core values and beliefs so that one begins to think, act, and feel like a member of that profession. PIF occurs over an individual's professional socialization in stages, precipitated by critical moments or experiences. The purpose of this study was to answer the following: (1) What are the critical events for pharmacy student PIF in introductory pharmacy practice experiences?; and (2) How do these events support or challenge PIF? METHODS: This study used critical event narrative inquiry methodology. A critical event is an experience that creates a change in understanding and affects professional performance. Semistructured interviews were conducted with pharmacy students who completed introductory pharmacy practice experience rotations in community (first year) and hospital (second year) settings. Interviews were coded and analyzed using narrative analysis. RESULTS: Twelve first-year and 10 second-year students participated in this study. Narratives revealed that common experiential education experiences resulted in a deeper understanding of core role elements (ie, professional autonomy, responsibility, interprofessional collaboration, and patient-centered care), leading to changes in agency, knowledge, and anticipated future behaviors. While first-year participants' narratives mainly focused on understanding pharmacist roles ("what"), second-year participants focused on understanding the process to fulfill those roles ("how to"). Emotions, assuming responsibility, external validation, and preceptor guidance supported these events. CONCLUSION: Critical events in introductory pharmacy practice experiences affect and shape pharmacy students' PIF. These events are relevant to pharmacy education because these experiences can result in changes in knowledge, agency, or future behaviors for students.

"Nothing's changed, baby": How the mental health narratives of people with multiple and complex needs disrupt the recovery framework.

The dominant narrative in mental health policy and practice has shifted in the 21st century from one of chronic ill health to a 'recovery' orientation. Knowledge of recovery is based on narratives of people with lived experience of mental distress. However the narratives of people experiencing structural inequalities are under-represented in recovery research. Meanwhile, uses of recovery narratives have been critiqued by survivor-researchers as a co-option of lived experience to serve neoliberal agendas. To address these twin concerns, we undertook a performative narrative analysis of two 'recovery narratives' of people with multiple and complex needs, analysing their co-construction at immediate/micro and structural/macro levels. We found two contrasting responses to the invitation to tell a recovery story: a narrative of personal lack and a narrative of resistance. We demonstrate through reflexive worked examples how the genre of recovery narrative, focused on personal transformation, may function to occlude structural causes of mental distress and reinforce personal responsibility in the face of unchanging living conditions. We conclude that unacknowledged epistemological assumptions may contribute to co-constructing individualist accounts of recovery. A critical, reflexive approach, together with transparent researcher positionality, is imperative to avoid the epistemic injustice of a decontextualised form of recovery narrative.

"You're Not Understood, and You're Isolated": A Narrative Account of Loneliness by Black Older Adults in Ontario, Canada.

Loneliness among older adults is a leading health and social concern globally and in Canada, including racialized and minoritized groups. Although previous studies have explored loneliness among ethnic minoritized groups in Canada, little is known about the constellating factors contributing to loneliness among native-born and immigrant Black older adults (BOAs) in Canada and their unique ways of dealing with the experience. Our study explores the constellating factors shaping loneliness experiences among BOAs living in Ontario. Using a narrative approach, we purposively selected and interviewed 13 BOAs. Time as a driver of change, a sense of belonging reinforced through place identity, and challenges of making a new home were dominant themes. Our finding highlights the need for increased cultural sensitivity at the micro and macro levels, which will improve a sense of belonging and reduce loneliness among racialized immigrant older adults.

Critical approaches to English language teacher education: A narrative inquiry into trainee teachers' experiences as speakers of English.

Working within the framework of critical language teacher education, this article concerns itself with the disenfranchising experiences of a group of trainee English language teachers as speakers of English in the world. It presents the results of a mixed-method narrative inquiry carried out with 198 trainee teachers studying undergraduate and postgraduate degrees in Teaching English as a Foreign Language in the South of Spain. Both a questionnaire and structured interviews were used to collect participants' narratives of the disenfranchising experiences they have had as English speakers, their reflections on the factors that played a role in those experiences and their tools to manage them. The ATLAS.ti program was used to carry out the content analysis of the narratives, using both deductive and inductive categories. Results point to the need to address the interrelation of language, power and identity as part of teacher training programs and adopt a critical perspective in English language teacher education in order to equip future teachers to better understand communication and the factors that play a role in it, balance power inequalities in communicative interactions and deal with disenfranchising experiences as English speakers in the world.

Miracles in medicine: A narrative inquiry exploring extraordinary events in pediatrics.

Background and Aims: Whether miracles are seen as a source of conflict between healthcare teams and families, a foolish or even harmful belief, or a hindrance to system-wide improvements and scientific inquiry, miracles within medicine have long been questioned. We were interested in the perspectives of pediatricians on miracles and how that has informed their care of patients. We also sought to explore the intersection and relationship between the medical sciences, faith, and how we view miracles. Methods: Using narrative inquiry as a research methodology, we had conversations and explored the experiences of physicians who work directly within pediatric clinical care. We used purposeful sampling by emailing several pediatricians whom we felt might have been interested in the project and may have had experiences with perceived medical miracles. All conversations were conducted over Zoom and recorded. Results: We conducted one to three conversations with each participant. During our analysis, we identified two threads. First, participants described miracles mostly as favorable and fortuitous events that invoked a sense of wonder due to contextual factors such as geography, access to resources, time in history but also previous experiences and the expectations of the clinician. Second, there is a complex dynamic within and between the medical sciences and the faith commitments of clinicians and families, especially when facing life-limiting or end-of-life illness. Conclusions: The stories that our participants told not only informed their past experiences and how they remembered them but also their present and future experiences. Exploring the topic of medical miracles allowed us to better understand the social discourses that shape our perceptions of miracles, death, and the role of the physician. These stories offer us hope and possibility in a time when we as a medical community may have lost our sense of wonder and the ability to notice miracles.

"They were quick, insipid, and stuck to the typical medical checkups": A Narrative Study on Women's Expectations and Experiences of Maternity Care in Bangladesh.

The quality of healthcare service delivery is generally determined by how patients' expectations were met successfully. This narrative study explores how women perceive and experience healthcare during childbirth in the context of Bangladesh. This study is inspired by Clandinin and Connelly's three-dimensional paradigm of narrativity that combines temporality, social interaction, and place. To unearth patient-driven narratives, the researcher purposely picked 12 women who gave birth in different private and public health facilities in Bangladesh. Four themes standout from the women's narratives. Excerpts of women's stories have been included in discussing the themes as well as author's conviction on this phenomenon. Most of the participants experienced a shared level of difficulty in choosing the health facilities (private vs public), motivated primarily by delivery costs and social background. Women with a higher level of education and financial means often opted to give birth in private facilities due to their negative perception and experience of the public facility. There was evident discontent when doctors decided for cesarean deliveries. Women were dissatisfied by providers' general lack of empathy and vicarious emotion. However, those women who gave birth in public hospitals expressed some degree of satisfaction which might be attributed to their low expectations and moderate social standing. Women's stories also delved into how societal norms, taboos, and elderly relatives put them in uncomfortable situations. To improve patient-provider interactions, healthcare practitioners should prioritize patient-centered care and collaborative decision-making. Reducing healthcare disparity and resolving superannuated pregnancy norms are also critical challenges.

Patient's experiences of diabetes care at a tertiary health facility in Lilongwe, Malawi.

BACKGROUND: Little is known about experiences of rural people with diabetes care at a tertiary health facility in low-income settings. Understanding their experiences is essential for developing effective diabetes care interventions. METHODS: The study employed a qualitative narrative inquiry. Participants were identified at a diabetes clinic at a tertiary-level healthcare facility. Ten participants from the rural areas attending the diabetes clinic were purposively selected. Data were collected through in-depth interviews in the privacy of the homes of the study participants and analysis was done using the Riessman approach to thematic narrative analysis. RESULTS: In this study, the following four themes emerged: (1) the long pathway to a diagnosis of diabetes; (2) Poverty-related hardships and diabetic clinic attendance; (3) The impact of health worker attitudes and behavior on diabetes care; and (4) Low resources and their impact on self-management. CONCLUSIONS: Rural-based patients living with diabetes encounter enormous challenges as they access diabetes care. One of the challenges is delayed diagnosis of diabetes. There is a need to introduce point-of-care (POC) testing to improve diabetes diagnosis. In addition, there is a need to strengthen awareness campaigns among the population so that people are well informed about the signs and symptoms of diabetes to promote early diagnosis. Diabetes care must be decentralized from tertiary hospitals to primary health centers. This will improve access to diabetes care and reduce the burden associated with traveling a long distance to access diabetes care in Malawi.

Perspectives on creative well-being of older adults.

The growing aging population has become a significant global issue in recent years, increasing the need for research that examines aging-related phenomena such as personal growth and development in later life. A major challenge in achieving this aim is the prevailing deficit perspective on aging, which is so pervasive that it often overshadows older adults' contributions to society and diminishes the opportunities encountered in older adulthood. Although perspectives on the nature of aging are gradually changing in a positive way, and the developments in medicine are improving health-related aspects of aging, it is still a worldwide challenge to eradicate negative stereotypes around aging. This article explores empirical perspectives on aging by analyzing diverse narratives gathered from open-ended interviews we conducted in Finland from 2019 to 2021. Focusing on their aging experiences and the value of a broad range of creative engagements and interventions that older adults have joined voluntarily, the study aims to provide a better understanding of personal perspectives of aging, the creative well-being of older adults, and the growing diversity of experiences within the older age group. Based on the findings of this study, we highlight the importance of promoting older adults' engagement in art-based interventions to enhance their creativity and well-being in later life, as well as fostering aging-friendly co-creative approaches in such interventions by involving the older adults themselves in the process.

Application and Extension of the Alcohol Recovery Narratives Conceptual Framework.

Recovery narratives are personal stories of health problems and recovery. A systematic review proposed a conceptual framework characterising alcohol misuse recovery narratives, consisting of eight principal dimensions, each with types and subtypes. The current study aims to apply and extend this preliminary conceptual framework. Semi-structured interviews were conducted to collect alcohol misuse recovery narratives from adult participants. A two-stage inductive and deductive thematic analysis approach was used to assess the relevance of the dimensions and types included in the preliminary conceptual framework and identify new components. The sample consisted of 11 participants from diverse socioeconomic backgrounds who had previously displayed varying degrees of alcohol misuse. All conceptual framework dimensions (genre, identity, recovery setting, drinking trajectories, drinking behaviours and traits, stages, spirituality and religion, and recovery experience) were present in the collected narratives. Three dimensions were extended by adding types and subtypes. Whilst the existing conceptual framework fitted the collected narratives, a new dimension describing the alcohol environment was required to fully characterise narratives. Types included in the alcohol environment dimension were policy and practice and social dynamics. The extended framework could guide the production of resources enabling clinicians to engage with narratives shared by their clients.

A narrative inquiry into caregivers' experiences and management after a relative's suicide attempt in a rural community in Northeast Thailand.

Suicide attempts have long-term negative consequences for families. This study reports a narrative inquiry using a social constructionist perspective to investigate how caregivers in rural northeast Thailand describe their experiences and management strategies following a family member's suicide attempt. From thematic analysis, three themes emerged: (1) distress and embarrassment, (2) managing to prevent re-attempts, and (3) letting go and moving on with my life. The implications discussed for mental health professionals include recognizing caregivers' experiences and developing more effective ways to manage the risk of future attempts.

Reflexivity and Relational Spaces: Experiences of Conducting a Narrative Inquiry Study With Emerging Adult Women Living With Chronic Pain.

Clandinin and Connelly's narrative inquiry methodology was used to understand the lived and told stories of two emerging adult women (aged 18-29) living with chronic pain. The aim of this paper is to share the experiences of the first author-a graduate student and novice researcher-of creating relational spaces with emerging adult women living with chronic pain, and the experience of co-creating knowledge through the methodological lens of narrative inquiry. There are 12 qualitative touchstones that narrative inquirers attend to when using narrative inquiry, and we present the experiences of a novice narrative inquirer in relation to selected touchstones. Narrative inquiry can greatly contribute to nursing knowledge, and implications for nursing practice and research are discussed.