Incorporating verbal and nonverbal aspects to enhance a model of patient communication in cancer care: A grounded theory study.

PURPOSE: High-quality communication is essential to patient-centered care. Existing communication models and research tends to focus on what is said verbally with little attention to nonverbal aspects of communication. In sensitive and emotionally intensive healthcare encounters, such as in cancer care, provider and patient nonverbal behavior may be particularly important for communicating with empathy. Therefore, the aim of this study was to develop a conceptual model of communication that accounts for nonverbal behavior. METHODS: We followed a systematic grounded theory design that involved semi-structured interviews with 23 providers, including nurse practitioners, physicians, surgeons, and physician's assistants. Using constant comparative analysis, we analyzed transcripts and developed a grounded theory model of communication accounting for nonverbal behavior. RESULTS: The major themes included building rapport, gauging how patients will take bad news, ensuring patients' understanding of their conditions, staying honest but hopeful, centering but guiding patient through cancer care, conveying empathy while managing heightened emotions, and ensuring patient understanding. Throughout the process, providers synthesize both verbal and nonverbal information and apply what they learn to future encounters. CONCLUSIONS: The results extend existing models of patient-centered communication and invite communication intervention and research that incorporates nonverbal behavior. The model contributes an understanding of the full process of communication in clinical encounters.

Fundamentals of qualitative analysis in family medicine.

The primary purpose of this article is to provide family physician researchers interested in conducting a qualitative research study a concise guide to the analysis. Drawing from approaches outlined in popular research methodology textbooks and employing an exemplar from a minority health disparities research study, this article outlines specific steps useful for researchers and practitioners in the field of family medicine. This process of qualitative data analysis is situated within the larger framework of qualitative research to better position those new to qualitative designs to more effectively conduct their studies. A 10-step process useful for guiding qualitative data analysis is provided. The 10 steps include (1) assembling data for analysis, (2) refamiliarising oneself with the data, (3) open or initial coding procedures, (4) generating categories and assigning codes to them, (5) generating themes from categories, (6) strategies of validation, (7) interpreting and reporting findings from the participants, (8) interpreting and reporting findings from the literature, (9) visual representations of data and findings, and (10) strengths, limitations, delimitations and suggestions for future research. This work provides clear and accessible guidelines for conducting qualitative data analysis for emerging researchers that is applicable across a wide array of topics, disciplines and settings.

In Their Own Words: The Significance of Participant Perceptions in Assessing Entomology Citizen Science Learning Outcomes Using a Mixed Methods Approach.

A mixed methods study was used to transcend the traditional pre-, post-test approach of citizen science evaluative research by integrating adults' test scores with their perceptions. We assessed how contributory entomology citizen science affects participants' science self-efficacy, self-efficacy for environmental action, nature relatedness and attitude towards insects. Pre- and post-test score analyses from citizen scientists (n = 28) and a control group (n = 72) were coupled with interviews (n = 11) about science experiences and entomological interactions during participation. Considering quantitative data alone, no statistically significant changes were evident in adults following participation in citizen science when compared to the control group. Citizen scientists' pre-test scores were significantly higher than the control group for self-efficacy for environmental action, nature relatedness and attitude towards insects. Interview data reveal a notable discrepancy between measured and perceived changes. In general, citizen scientists had an existing, long-term affinity for the natural world and perceived increases in their science self-efficacy, self-efficacy for environmental action, nature relatedness and attitude towards insects. Perceived influences may act independently of test scores. Scale instruments may not show impacts with variances in individual's prior knowledge and experiences. The value of mixed methods on citizen science program evaluation is discussed.