Exploring Vegan Mothers' Experiences of Making Food Choices for Infants and Young Children.

OBJECTIVE: Our study aimed to explore vegan mothers' experiences and decision-making processes when feeding their children (up to 3 years old). METHODS: We conducted a qualitative photo-elicitation interview study in the United Kingdom. Eight vegan mothers provided 5 photographs of food choices they had made for their children and completed online photo-elicitation interviews to discuss these images. Data were transcribed verbatim and analyzed using reflexive thematic analysis. RESULTS: Five themes were developed: role modeling eating behavior, shared decision-making, nutritional guidance for vegan parents, fear of judgment for being vegan, and desire for convenience. CONCLUSIONS AND IMPLICATIONS: Findings illustrate the complexity of the decision-making process and highlight the need for targeted resources for vegan parents. There is a need for awareness raising and training for health care professionals and the development of vegan-specific child-feeding resources to facilitate the provision of evidence-based nutritional guidance for vegan parents.

An exploration of successful psychosocial adjustment to long-term in-centre haemodialysis.

OBJECTIVES: Haemodialysis extends life for people with end-stage kidney disease (ESKD) worldwide, but it imposes significant psychosocial burdens and there is little evidence about successful adjustment. This study aimed to improve understanding of successful psychosocial adjustment to in-centre haemodialysis (ICHD; dialysis in a hospital or satellite unit). METHODS: Individual semi-structured interviews were conducted with a purposive sample of 18 people with ESKD who had all received in-centre haemodialysis in the UK for at least 90 days in the last two years. An inductive thematic analysis was employed to identify themes from the verbatim interview transcripts. RESULTS: There were four themes: 1) reaching a state of acceptance, which described the importance of accepting the necessity of dialysis; 2) taking an active role in treatment, which described how being actively involved in treatment gave participants greater feelings of autonomy and control; 3) utilising social support networks, which described the benefits of instrumental and emotional support; and 4) building emotional resilience, which described the importance of optimism and positivity. CONCLUSIONS: The themes demonstrated elements of successful adjustment that could be targeted by interventions to promote psychological flexibility and positive adjustment among people receiving in-centre haemodialysis worldwide.

"I don't know if I understood the whole process from the beginning": A photo-elicitation exploration of the experience of mastectomy and breast reconstruction decision making.

Objectives: Policy and guidance assume that reconstruction following mastectomy will have physical and psychological benefits, however research has disputed whether this is always the case. This study aimed to explore mastectomy experiences and reconstruction decision making. Methods: Semi-structured interviews about self-curated participant photographs of the breast cancer experience were analysed using interpretative phenomenological analysis (IPA). Results: Three themes were developed: 'Life before mastectomy'; 'I don't know if I understood the whole process from the beginning'; and getting back to 'normal'. Conclusions: Decisions regarding reconstruction were influenced by needs of others, and surgeons' communication and behaviour and negative experiences were prominent. Over time participants came to terms with physical and psychological impacts of mastectomy reporting re-finding themselves alongside acceptance of their post mastectomy bodies. However, many participants were living with the fear that their cancer may one day return. Communication skills training for healthcare professionals should be a priority to ensure decisions made result in the best possible outcomes for patients. Innovation: Photo-elicitation is a novel research method enabling rich investigation of mastectomy experiences. Self-curation of images enables patient-led discussions about mastectomy experience and illustrates the importance of life context. Photographs may have value within clinical training to facilitate understanding of patient experiences.

Exploring thoughts about pain and pain management: Interviews with South Asian community members in the UK.

OBJECTIVE: This research sought to explore the pain management beliefs of members of the South Asian community living in the UK. In particular, their understanding of the key components of cognitive behavioural therapy (CBT) informed pain management programmes (PMPs) was explored. METHODS: Snowball sampling was used to recruit 10 participants from a South Asian background for interview. Interviews were guided by a semi-structured interview schedule and explored pain history, specific pain experiences, community member expressions of, and reactions to, pain, treatment expectations and perceptions of self-management. Interviews were transcribed verbatim and subjected to descriptive thematic analysis. RESULTS: Four themes were developed: impacts of chronic pain, within-group variations in responses to chronic pain, personal responsibility vs. paternalistic care, and the acceptability of pain management concepts (relaxation and meditation, exercise and physical activity, and thoughts and beliefs: the dangers of pain healers). CONCLUSIONS: This work highlights how discourses around the impacts of chronic pain; beliefs about, and preferences for, approaches to care; and the acceptability of pain management concepts fit with existing PMP content. Recommendations are made regarding opportunities for social prescribing; consideration of the incorporation of acceptable forms of physical activity, including yoga and walking, within PMPs; and the potential benefit of highlighting role models and creating social opportunities for these activities. Some beliefs and practices in this area are under-researched, and further work that explores gender and generational differences in pain perceptions, and the potential dangers of the use of pain healers is needed.

'I am free in my wheelchair but pain does have a say in it though': The meaning and experience of quality of life when living with paraplegia and chronic pain.

This study investigated how wheelchair-using individuals with paraplegia and chronic pain make sense of the factors associated with quality of life based on interviews using photo-elicitation and interpretative phenomenological analysis. Three superordinate themes emerged in the analysis: experiencing quality of life through the perception of self and identity, interpersonal relationships as facilitators and barriers to quality of life and life in a wheelchair: pain experience and management. Quality of life for those living with paraplegia and chronic pain is experienced as a complex interaction across several life domains. The use of photographs may improve the communication of pain-related experiences and understanding by healthcare staff.

Exploring the Facilitators and Barriers to Physical Activity in Older People With Sight Loss.

This study aimed to explore facilitators and barriers to physical activity in older people with sight loss. Focus groups were conducted with 13 community-dwelling older adults with sight loss ranging from poor to completely blind. Transcripts were analyzed using an inductive thematic analysis. Facilitators and barriers are experienced in three ways: psychologically; through opportunity and access; and at a societal and policy level. Campaigns are needed to challenge unhelpful age-related stereotypes at both psychological and societal levels. Additionally, interventions grounded in evidence and theory should be trialled and evaluated for increasing physical activity in this population.

How do older people with sight loss manage their general health? A qualitative study.

PURPOSE: Older people with sight loss experience a number of barriers to managing their health. The purpose of this qualitative study was to explore how older people with sight loss manage their general health and explore the techniques used and strategies employed for health management. METHODS: Semi-structured face-to-face interviews were conducted with 30 participants. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. RESULTS: Health management challenges experienced included: managing multiple health conditions; accessing information; engaging in health behaviours and maintaining wellbeing. Positive strategies included: joining support groups, clubs and societies; using low vision aids; seeking support from family and friends and accessing support through health and social care services. CONCLUSION: Healthcare professionals need to be more aware of the challenges faced by older people with sight loss. Improved promotion of group support and charity services which are best placed to share information, provide fora to learn about coping techniques and strategies, and give older people social support to prevent isolation is needed. Rehabilitation and support services and equipment can only be beneficial if patients know what is available and how to access them. Over-reliance on self-advocacy in current healthcare systems is not conducive to patient-centred care. Implications for Rehabilitation Sight loss in older people can impact on many factors including health management. This study identifies challenges to health management and highlights strategies used by older people with sight loss to manage their health. Access to support often relies on patients seeking information for themselves. However, self-advocacy is challenging due to information accessibility barriers. Informal groups and charities play an important role in educating patients about their condition and advising on available support to facilitate health management.

Living together with age-related macular degeneration: An interpretative phenomenological analysis of sense-making within a dyadic relationship.

In this article, we present an idiographic analysis of a couple's experience of living and coming to terms with age-related macular degeneration. Interpretative phenomenological analysis was used to explore three joint interviews, conducted over an 18-month period, with a married couple (aged 82 and 77 years) both living with age-related macular degeneration. Three themes are discussed: the disruption of vision impairment, managing mutual deterioration and resilience through togetherness. We discuss the existential challenges of vision impairment and consider the applicability of Galvin and Todres' typology of well-being as a means of understanding well-being in older adults.