The 16th Q ualitative He alth Research Conference CONFERENCE ...

The 16th Qualitative Health Research Conference
QHR
2010
CONFERENCE
PROGRAM
October 3—5, 2010
The Coast Plaza Hotel & Suites
Vancouver, British Columbia, Canada
All Photos Courtesy of Tourism Vancouver

Acknowledgements
We gratefully acknowledge the support of the
following organizations:
LEVY SHOW SERVICE INC.

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Table of Contents
Welcome Message 3
Presenter Information 4
General Information 4
Conference Overview 5
Joint Workshop Day Overview 8
Joint Workshop Day Room Schedule 9
Floor Plan 10
Plenary Sessions 13
Concurrent Sessions Schedule 14
Poster Sessions Schedule 29
Abstracts, Poster Sessions 32
Abstracts, Concurrent Sessions 54
Abstracts, Symposiums 113
Index of Authors 122
Forthcoming Events 128
Advertisements 133

Welcome from the Dean, Faculty of Nursing, University of Alberta
Welcome to the annual Qualitative Health Research
(QHR) and Advances in Qualitative Methods
(AQM) Conferences! We are delighted to have you
join us in Vancouver for these exciting meetings. I
can see that there will be discussion of many fascinating
and important research questions.
As many of you know, the Faculty of Nursing at the
University of Alberta has long supported the International
Institute for Qualitative Methodology
(IIQM) and will continue to do so. In the Fall of
2009, we conducted a review of IIQM and obtained
input and suggestions from many IIQM members
and stakeholders that we have used to plan for the
future of IIQM. The prime focus of IIQM will be on
qualitative health research and advancing qualitative
inquiry and qualitative methods.
IIQM provides an important international forum for presentation and publication of
qualitative research findings (through QHR and AQM), provides opportunities for
networking among qualitative researchers, fosters advancement of qualitative inquiry/methods
(e.g., through AQM and the IJQM), and provides training for graduate
students and researchers (through workshops at conferences, as well as the
Thinking Qualitatively Workshop Series offered every summer). Through its local,
national and international linkages, it is an important structure that supports knowledge
development through the use and advancement of qualitative research methods.
As part of the review, we decided on a new governance structure for IIQM. At the
University of Alberta, research institutes fall under the responsibility of one Faculty
and its Dean. Hence, IIQM reports to the Dean through the Associate Dean
Research. We have appointed an Advisory Board to provide the scientific leadership
for IIQM. The Board consists of four qualitative researchers from the Faculty
of Nursing at the University of Alberta as well as three qualitative researchers from
other disciplines and universities. The Associate Dean Research and the Editor of
the International Journal of Qualitative Methods also serve on the Board in an exofficio
capacity. Amanda Shuya, who has an MBA and extensive leadership experience
in non-profit and university settings, will ensure that the goals of IIQM
will be met and the recommendations of the Board implemented. Christine Tyrie
continues as an Administrative Assistant with IIQM and we appreciate her ongoing
contributions.
Enjoy the conference! We look forward to your ongoing support of IIQM and to
the development of new knowledge through qualitative research.
With best wishes,
Anita Molzahn, RN, PhD, FCAHS
Professor and Dean, Faculty of Nursing, University of Alberta
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Presenter Information
Presenters
Please check the time for your presentation in this program, as it may have changed.
Change Boards
Due to circumstances beyond our control, there will always be last minute withdrawals from the
program. The change board is located near the registration desk in the Conference Foyer with
information about cancelled sessions (as up-to-date as possible).
Poster Printing
VanPrint
1001 Denman Street
Mon-Fri: 10:30am-6pm
Email: westend@vanprint.com
Website: http://www.vanprint.com/index.html
Poster Sessions
Presenters are asked to hang their posters prior to 9:00am on the day they are schedule to present.
Velcro and tacks will be available at the Registration Desk. The posters will be on display in the
Conference Foyer the whole day with two designated poster session times, 10:00am-10:30am &
2:30pm-3:00pm.
Concurrent Sessions
Oral presentations will be allotted a 30 min time slot, 20 mins for presenting and 5-10 for questions.
Please keep to the allotted time, and to the scheduled time slot, as people may want to move
between rooms during sessions. PPT files will be loaded on the computer prior to your arrival.
Symposiums
Symposiums will last for 90 minutes and consist of three, 20-minute papers followed by 30 minutes
of discussion. PPT files will be loaded on the computer prior to your arrival.
Please note: If your PPT has changed or you did not send it, please load it between sessions
on the computer in the room you are scheduled to present.
General Information
E-mail and Internet Services
Email and Internet services are available in Business Centre within hotel, on a first come first serve
basis through Concierge Desk. For those who wish to reserve a specific time there is a charge of
$10.00 for 30 minutes or $15.00 per hour. Conference participants will be able to access WIFI by
obtaining a access code from the Registration Desk.
Photocopying
UPS is located beneath the hotel in the mall. Hours are Mon-Fri, 8:30am to 6:00pm, Sat. 10:00am
- 5:00pm. Concierge Desk is sometimes able to assist but are very busy with all the guests of the
hotel.
Currency Exchange
Front Desk (less than $100.00) otherwise lots of Banking Institutions within a 5 minute walk on
Denman Street.
Smoking
Garden Terrace located on the Conference level or outside of front entrance but away from the
door.
Public Transportation
Bus - runs every 10-15 minutes on Denman Street and Concierge Desk can assist with taxi service.
Parking
Is located beneath the hotel and the rates are as follows; Overnight guests - $25.00, 6am to 6pm -
$14.00, 6pm to 6am - $10.00, Hourly - $4.50
Fitness Facilities
Denman Fitness is connected to the hotel and is complimentary for guests staying in the hotel.

Conference Overview
Saturday, October 2, 2010
7 : 0 0 p m – 8 : 0 0 p m Registration & Information Desk Conference Foyer
Sunday, October 3, 2010
7 : 3 0 a m – 3 : 0 0 p m Registration & Information Desk Conference Foyer
8 : 0 0 a m – 9 : 0 0 a m Light Continental Breakfast Conference Foyer
Denman Ballroom
Keynote Address: Dr. Janice Morse
‘Qualitative Research: Taking Stock’
9 : 0 0 a m – 1 0 : 0 0 a m
1 0 : 0 0 a m – 1 0 : 3 0 a m Poster Session K & Coffee Refresher Conference Foyer
1 0 : 3 0 a m – 1 2 : 0 0 p m Session A: Concurrent Sessions Various Rooms
1 2 : 0 0 p m – 1 : 0 0 p m Lunch Denman Ballroom
1 : 0 0 p m – 2 : 3 0 p m Session B: Concurrent Sessions Various Rooms
2 : 3 0 p m – 3 : 0 0 p m Poster Session K (continued) & Coffee Break Conference Foyer
Book Display & Exhibits Open
Conference Foyer
3 : 0 0 p m – 4 : 3 0 p m Session C: Concurrent Sessions Various Rooms
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Conference Overview
Monday, October 4, 2010
8 : 0 0 a m – 3 : 0 0 p m Registration & Information Desk Conference Foyer
Conference Foyer
Light Continental Breakfast
8 : 0 0 a m – 9 : 0 0 a m
Book Display & Exhibits Open
Keynote Address: Dr. Judith Wuest
9 : 0 0 a m – 1 0 : 0 0 a m ‘Are We There Yet? Positioning Qualitative Research
Denman Ballroom
Differently’
1 0 : 0 0 a m – 1 0 : 3 0 a m Poster Session L & Coffee Refresher Conference Foyer
1 0 : 3 0 a m – 1 2 : 0 0 p m Session D: Concurrent Sessions Various Rooms
1 2 : 0 0 p m – 1 : 0 0 p m Lunch Break Denman Ballroom
1 : 0 0 p m – 2 : 3 0 p m Session E: Concurrent Sessions Various Rooms
2 : 3 0 p m – 3 : 0 0 p m Poster Session L (continued) & Coffee Break Conference Foyer
Conference Foyer
3 : 0 0 p m – 4 : 3 0 p m Session F: Concurrent Sessions Various Rooms
Cocktail Reception
Windows on the Bay, 35 th Floor
Come and enjoy the sunset in the west over the Pacific Ocean and
watch the moon rise over the Rocky Mountains in the east!
*one complimentary drink ticket with delegate registration
*cash bar* *door prizes*
6 : 0 0 p m – 8 : 0 0 p m

Conference Overview
Tuesday, October 5, 2010
8 : 0 0 a m – 3 : 0 0 p m Registration & Information Desk Conference Foyer
8 : 0 0 a m – 9 : 0 0 a m Light Continental Breakfast Conference Foyer
Denman Ballroom
Keynote Address: Dr. Clive Seale
‘Quality in Qualitative Research’
9 : 0 0 a m – 1 0 : 0 0 a m
1 0 : 0 0 a m – 1 0 : 3 0 a m Poster Session M & Coffee Refresher Conference Foyer
1 0 : 3 0 a m – 1 2 : 0 0 p m Session G: Concurrent Sessions Various Rooms
1 2 : 0 0 p m – 1 : 0 0 p m Lunch Denman Ballroom
1 : 0 0 p m – 2 : 3 0 p m Session H: Concurrent Sessions Various Rooms
2 : 3 0 p m – 3 : 0 0 p m Poster Session M (continued) & Coffee Break Conference Foyer
Book Display & Exhibits Open
Conference Foyer
3 : 0 0 p m – 4 : 3 0 p m Session J: Concurrent Sessions Various Rooms
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Joint Workshop Day Overview
Wednesday, October 6, 2010
8 : 0 0 a m – 1 : 3 0 p m Registration & Information Desk Conference Foyer
8 : 0 0 a m – 9 : 0 0 a m Light Continental Breakfast Conference Foyer
9 : 0 0 a m – 1 0 : 1 5 a m AM/Full Day Sessions See Room Schedule Below
1 0 : 1 5 a m – 1 0 : 3 0 a m Coffee Refresher Conference Foyer
1 0 : 3 0 a m – 1 2 : 0 0 p m AM/Full Day Sessions Continued See Room Schedule Below
1 2 : 0 0 p m – 1 : 0 0 p m Lunch Break Denman Ballroom
1 : 0 0 p m – 2 : 3 0 p m PM/Full Day Sessions See Room Schedule Below
2 : 3 0 p m – 2 : 4 5 p m Coffee Break Conference Foyer
2 : 4 5 p m – 4 : 0 0 p m PM/Full Day Sessions Continued
See Room Schedule Below

Joint Workshop Day Room Schedule
Wednesday, October 6, 2010
Room AM Session (9am-12pm) PM Session (1pm-4pm)
Bayside ATLAS.ti - Gina Higginbottom and Shireen Bell Introduction to Keyword Analysis - Clive Seale
Performing Qualitative Cross-Cultural Research - Pranee Liamputtong
Beach
Issues in Qualitative Video Based Research - Jude Spiers
Pacific
Introduction to Qualitative Interviewing - Gina Higginbottom
In-depth Interviewing: Theory and Practice
as Part of a Self-Evaluation Learning
Process - Victor Minichiello, Gail Hawkes,
John Scott
Gilford
Writing Successful Proposals for External Funding - Alex Clark
Barclay
An Approach to Generating Substantive Grounded Theory: Theoretical Coding, Theoretical Sampling, and Theoretical Writing
- Judith Wuest
Parkside
Doing cross-case analysis: Online and Off - Samia Khan, Vanesa Mirzaee,
Robert VanWynsberghe
PhotoVoice: Benefits, Challenges and Practicalities
- Cindy Jardine
Mountain
Suite
Generating and Analyzing Focus Group Data - Rose Barbour
Nelson
Integrating Qualitative and Quantitative Methods (Mixed Methods) - David Morgan
Denman
An Introduction to Narrative Inquiry - Vera Caine, Andrew Estefan, Pam Steeves
Comox
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Coast Plaza Hotel & Suites Floor Plan

Coast Plaza Hotel & Suites Floor Plan
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Coast Plaza Hotel & Suites Floor Plan

Plenary Sessions
Dr. Janice Morse Sunday, October 3 9:00am - 10:00am
Qualitative Research: Taking Stock
In this address, I will consider the contribution of qualitative inquiry. What is the role of qualitative
inquiry in humanizing health care? Is it important? If so, are particular skills and methods are
necessary to conduct qualitative health research? Further, if special skills and methods are required
and not everyone can do qualitative health research, how does one become a qualitative health
researcher? Having created a niche, how do we build a subdiscipline in health research with all the
paraphernalia that entails: our specialist journals, courses, conferences, and even perhaps, a society?
Dr. Judith Wuest Monday, October 4 9:00am - 10:00am
Are We There Yet? Positioning Qualitative Research Differently
Almost two decades ago, Janice Morse and colleagues launched this conference, and the journal
Qualitative Health Research to provide a venue for qualitative health research scholarship. The
health research climate was then resistant to qualitative research methods and often suspicious of
the credibility of findings. Both the conference and the journal offered us important pathways for
sharing advances in qualitative methods and disseminating peer-reviewed findings. Qualitative
scholars in health research competing in funding competitions often found it necessary to portray
in traditional scientific language how qualitative methods, while different, were as rigorous as
quantitative methods. Further researchers often justified qualitative research approaches by placing
their contributions in opposition to quantitative approaches with respect to what they might
offer. This emphasis on difference expanded as we embraced paradigm debates and argued about
location of particular research approaches. Additionally, our deliberations have been complicated
by issues of agency among research participants. Increasingly, we have been challenged to reconsider
the boundaries between and among research methods and paradigms, and to develop research
approaches that are credible and useful for answering our research questions. I have grappled with
these shifting issues for the past 20 years as researcher, teacher and peer reviewer. More than 10
years ago when a colleague observed that one of my recently published reports of a grounded
theory study contained “testable hypotheses”, I reacted with dismay. I asserted that grounded theories
were not predictive models to be tested, but rather evolved through constant comparison with
data collected in other substantive areas. I was firmly entrenched in oppositional thinking, solidly
rooted in my research training. But as my program of research evolved, I gradually recognized
that less rigid methodological thinking was necessary in order to answer my emerging questions.
The focus of this presentation is consideration of how the position of qualitative research has
shifted over time and the implications of those shifts for building a program of research, acquiring
research funding, and contributing to improved practice. Based on my experiences with a program
of research of women‟s health related to violence against women and intimate partner violence, I
will discuss the appeal and pitfalls of concrete distinctions, the challenges of flexibility and convergence,
and the necessity of documenting how we move beyond difference toward a complete
research toolbox that is useful for improving health.
Dr. Clive Seale Tuesday, October 5 9:00am - 10:00am
Quality in Qualitative Research
Drawing on the thinking that led to my 1999 book on quality in qualitative research, and my experiences
of doing research since then, I will outline a rationale for taking a pragmatic approach to
producing quality and rigour in qualitative research. This involves the view that qualitative research
is a craft skill that develops with practice and experience. I will focus on particular examples
of work that achieves quality through different means, including approaches to sampling,
using numbers, accounting for negative instances, producing low inference descriptors, and keyword
analysis.
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Concurrent Sessions: Sunday, October 3, 2010
Session A: 10:30am - 12:00pm
Room 1
Comox
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 2
Denman
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 3
Nelson
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 4
Gilford
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
i
ii
iii
i
ii
iii
i
ii
iii
i
ii
A.1: Place, Health and Environment
Understanding Perceptions of Community Environment:
Combining Photovoice and a Unique Analytical Approach
Shopping for treatment: Tuberculosis in urban slums in
Delhi, India
Being Fully Present: A Phenomenological Study of Psychologists'
Experiences of Compassion Fatigue
A.2: Living with Mental Illness
Developing a theoretical framework for patients' adherence
to antipsychotic medication
Suicide from the perspectives of older men who experience
depression.
Crossing boundaries - transformational stories of adult
children of parents with serious mental illness
A.3: Nursing Transitions
Transitioning From The Nurse Practitioner Student to the
New Nurse Practitioner
Lessons Learned in Innovation: Role Transition Experiences
of Clinical Nurse Leaders
Effective Transition to Clinical Practice for International
Students undertaking the one-year Bachelor of Nursing
course.
A.4: Spirituality and Health
Buddhism, Biomedicine, and happiness in the healing traditions
of contemporary Bhutan
Understanding Health and Wellness Through Faith: Afro-
Caribbean Insights on What it Means to be Healthy and Well
iii An Arras of Prayer
Session Chair:
June Trevoy
Laura Flaman, Candace
Nykiforuk,
Helen Vallianatos,
Kim Raine
Aruna Bhattacharya
Denise Larsen,
Wendy Austin
Session Chair:
Kim Foster
Amy Hon, Sylvie
Marshall-Lucette
John L. Oliffe, John
Ogrodniczuk,
Christina Han
Kim Foster
Session Chair:
Rose Sherman
Florence Myrick,
Olive Yonge
Rose Sherman
Anthony Welch,
Theresa Harvey,
Carolyn Robinson
Session Chair:
Amanda Duncan
Amanda Duncan
Nike Ayo
Corinne Crockett,
de Sales Turner

Concurrent Sessions: Sunday, October 3, 2010
Session A: 10:30am - 12:00pm
Room 5
Barclay
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 6
Pacific
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 7
Beach
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 8
Parkside
10:30 -
11:00
11:00 -
11:30
i
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ii
iii
i
ii
iii
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A.5: Symposium
Motherhood, drought and elder abuse: Stories from three
generations of women who participate in the Australian
Longitudinal Study on Women's Health.
‘The perfect mother wouldn’t have that’: Australian
women’s experiences of motherhood and postnatal depres-
ii Narratives from women in drought
iii
Abuse in older age: Australian women’s experiences of elder
abuse.
A.6: Methods: Indigenous and Marginalized Populations
Walking the Borderland: Embracing Indigenous Methodologies
in the Midst of Academia
"Under the Microscope": The Challenges, Risks, and Responsibilities
of Conducting Health Research with Marginalized
Populations.
Applied Research Agenda: Qualitative Methods and the
Health System
A.7: Methods: Dialogue
Realist Evaluation: Its role and use in clinical programme
evaluation
Building bridges between different social-science approaches:
Moving between and across “the bottom up” and
“the top down” standpoints.
Using qualitative inquiry to explore the breast cancer experience
of Chinese-Australian women: Reflections on the
issues and challenges of data collection and analysis
A.8: Pregnancy and Childbirth
Women’s Experiences During In Vitro Fertilization Leading
to Maternal Embryo Attachment
ii Stories of Life and Birth: An intergenacional study
Session Chair:
Deborah Loxton
Catherine Chojenta,
Deborah Loxton,
Jane Rich, Sarah
Wright, Deborah
Loxton
Deborah Loxton,
Lynette Adamson
Session Chair:
Jude Spiers
Donna Kurtz,
de Sales Turner,
Helen Cox,
Jessie Nyberg
Cheryl Pritlove,
Parissa Safai
Tanyana Jackiewicz
Session Chair:
Paul Linsley
Paul Linsley
Manuela Ferrari
Cannas Kwok, Kate
White
Session Chair:
Tammy Lampley
Tammy Lampley
Natalia Salim,
Hudson Santos
Junior,
Dulce Maria R.
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Concurrent Sessions: Sunday, October 3, 2010
Session B: 1:00pm - 2:30pm
Room 1
Comox B.1: Issues in Aging: Transitions
Session Chair:
Yvonne Eaves
1:00 - 1:30 i Managing complexity: Transition from the ground-up. Susan Townsend
1:30 - 2:00 ii
2:00 - 2:30 iii
Room 2
Denman
1:00 - 1:30 i
Room 3
Nelson
1:00 - 1:30 i
1:30 - 2:00 ii
2:00 - 2:30 iii
Room 4
Gilford
1:00 - 1:30 i
1:30 - 2:00 ii
2:00 - 2:30 iii
Retrospective Views of Care Recipients' and Caregivers'
Perspectives on Nursing Home Placement
An Exploration of Adjustment Efforts of Persons with Dementia
After Relocation to a Retirement Residence
B.2: Immigrant, Refugees and Health
"Here" and "There": Life Stories of Iranian Immigrants and
Refugees from the Diaspora
B.3: Ethics: Human Participants
Beyond Faith, Hope & Charity: Becoming a Health Research
Subject
"Ethics is for Human Subjects Too": Understanding Participant
Responsibility in Health Research
Researching research ethics: ethics & methods in a qualitative
case study
B.4: Professional Issues: Identity
We are what we do: how identity is constructed through
meaningful activity.
Professionalism in a new site of nursing practice: A study of
nursing self-employment
U.S. Registered Nurses' Personal Use of Traditional Chinese
Medicine: Resulting Shifts in Professional Identities and
Nursing Practices
Yvonne Eaves
Faranak Aminzadeh,
William Bill Dalziel,
Frank Molnar, Linda
Session Chair:
Merrill Turpin
Fay Mahdieh Dastjerdi
1:30 - 2:00 ii Home safety for newly-arrived refugees Merrill Turpin
2:00 - 2:30 iii
Phenomenological Study of Social Media Messages from
Under the Haitian Rubble
Susan Speraw,
Maureen Baksh-
Griffin, Suzanne
Session Chair:
Susan M. Cox
Anne Townsend,
Susan M. Cox
Susan M. Cox, Michael
McDonald,
Sara Hancock
Anne Townsend,
Susan M. Cox
Session Chair:
Sharon Bertrand
Jackie Taylor
Sarah Wall
Sharon Bertrand

Concurrent Sessions: Sunday, October 3, 2010
Session B: 1:00pm - 2:30pm
Room 5
Barclay
1:00 - 1:30 i
1:30 - 2:00 ii
2:00 - 2:30 iii
Room 6
Pacific
Room 7
Beach
1:00 - 1:30 i
1:30 - 2:00 ii
2:00 - 2:30 iii
B.5: Family
Family Members' and Critical Illness: "Working To Get
Through"
Nurse family members: 'the call to care' for our own relatives
Shifting from Critical Care to Comfort Care: Communication
between Health Care Providers and Families
B.6: Professional Practice
1:00 - 1:30 i Uncovering Tacit Knowledge in Public Health
1:30 - 2:00 ii
2:00 - 2:30 iii
Social Work Practices in Health Care Institutions Operating
in Turkey
Constructing the meaning of letting go: an exploration of
the transition process from Licensed Practical Nurse to
Baccalaureate-Prepared Nurse
B.7: Pregnancy, Addictions and Violence
Alcohol consumption among pregnant women: How do
service providers and mothers learn about and react to
official guidelines?
Taking a risk: Exploring alcohol and pregnancy with women
in Scotland
Impact of family and personal history of abused pregnant
women on their coping with current IPV
Session Chair:
Jennifer Stephens
Virginia Vandall-
Walker,
Alexander M. Clark
Patricia McClunie-
Trust
Cynthia Peden-
McAlpine,
Joan Liaschenko
Session Chair:
Anita Kothari
Anita Kothari, Debbie
Rudman,
Maureen Dobbins,
Michael Rouse,
Shannon Sibbald,
Nancy Edwards
Emre Kol
Anne Barbara Arthur,
Katherine
Fukuyama
Session Chair:
Elaine Moody
Deborah Loxton,
Catherine Chojenta,
Jennifer Powers
Katharine Ford
Linda Rose, Shreya
Bhandari, Kristin
Marcantonio, Linda
Bullock, Jackie
Campbell,
Phyllis Sharps
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Concurrent Sessions: Sunday, October 3, 2010
Session C: 3:00pm - 4:00pm
Room 1
Comox
3:00 - 3:30 i
3:30 - 4:00 ii
Room 2
Denman
3:00 - 3:30 i
3:30 - 4:00 ii
Room 3
Nelson
3:00 - 3:30 i
C.1: Professional Identity and Practice
A paediatric occupational therapist's use of information
when making clinical decisions
Women in Orthodontics and Work-Family Balance: Challenges
and Strategies
C.2: Complementary and Alternative Health
Developing a Culturally Specific Instrument on Complementary
and Alternative Medicine Use through Reminiscence
The Lived Experience of Latinas Who Listen to Music for
Chronic Pain
C.3: Ethics: General
Tyranny of 'Or': Research or Dissemination? Obligation or
Exploitation? through community-academic research
3:30 - 4:00 ii Putting a Face on Medical Error: a patient perspective
Room 4
Gilford
3:00 - 3:30 i
3:30 - 4:00 ii
Room 5
Barclay
C.4: Work and Work Place Issues
Prospective Outcomes of Injury Study (POIS): Results from
Phase One of a Qualitative Study
Reducing Healthcare Associated Infections in the Vancouver
Region
C.5: Parenting (1)
Session Chair:
Louanne Keenan
Merrill Turpin, Jodie
Copley
Sarah Davidson,
Louanne Keenan
Session Chair:
Jennifer Stephens
Cheryl Killion
Patricia Shakhshir
Session Chair:
Sherry Dahlke
Hendricus A. Van
Wilgenburg,
M. Nancy Comeau
Sarah Kooienga,
Valerie Stewart
Session Chair:
Bonnie McIntosh
Mary Butler, Sarah
Derrett
Daniyal Zuberi
Session Chair:
Jude Spiers
3:00 - 3:30 i Good or Bad Mother Lee Murray
3:30 - 4:00 ii Parents' Perspectives on Discipline with Young Children
Room 6
Pacific
3:00 - 3:30 i
3:30 - 4:00 ii
C.6: Methods: Translation and Interpretation
Lost in translation? Methodological messes and lessons
learned using interpreters during interviews with injured,
Snakes and Ladders: Tripartite Challenges of Translating,
Transcribing and Accuracy Checking Qualitative Interviews
Christine Ateah,
Marie Edwards,
Joan Durrant
Session Chair:
Alexander M. Clark
Agnieszka Kosny,
Ellen MacEachen
H. Bindy K. Kang,
Dataar Kaur
Cheema, John L.
Oliffe, Sunjiv K. Lit

Concurrent Sessions: Monday, October 4, 2010
Session D: 10:30am - 12:00pm
Room 1
Comox
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 2
Denman
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 3
Nelson
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
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ii
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D.1: Panel Discussion - Writing for Publication
D.2: Living with Chronic Illness
Procedural Justice and decision-making in early
rheumatoid arthritis
Susac's Syndrome: An ethnomethodological
analysis of the social practices that constitute
disease and illness
Seeking Habitus in Cardiac Rehabilitation: A
Bourdieusian Analysis
D.3: HIV and AIDS Prevention
Impacts of Being a Peer Group Leader for HIV
Prevention on Health
Attitudes and Program Preferences Regarding
Pre-Exposure Prophylaxis (PrEP) Among Young
Adults at Risk for HIV
The use of ARV and quality of life: An African
study
Session Chair:
Alexander M. Clark
This panel is ideal for students and post doctoral students who are interested in
learning the ‘Top 5’ need to know tips provided by each panel member. There will
be two members from each of the following categories; Reviewer, Editor, Writer
Session Chair:
Patricia Babinec
Anne Townsend, Paul Adam,
Catherine Backman, Susan M.
Cox, Linda C. Li
Patricia Babinec
Jan Angus, Lisa Seto, Craig Dale,
Cheryl Pritlove, Marnie Kramer-
Kile, Alexander M. Clark,
Beth Abramson, Jennifer Lapum,
Susan Marzolini, Jennifer Price,
Paul Oh
Session Chair:
Minrie Greeff
Kathleen F. Norr,
Chrissie P.N. Kaponda,
Linda L. McCreary, Kristina
Davis, Mary Kalengamaliro
Mary Anne Adams, Donna Smith
Minrie Greeff, Susan Wright,
Eva Manyedi, S. Shaibu, Mabedi
Kgositau, Winnie Chilemba,
Angela Chimwaza, Lucy Kululanga,
Lignet Chepuka
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Concurrent Sessions: Monday, October 4, 2010
Session D: 10:30am - 12:00pm
Room 4
Gilford D.4: Innovation in Knowledge Translation
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 5
Barclay D.5: Parenting (2)
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 6
Pacific
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 7
Beach
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
i
ii
iii
i
ii
i
ii
iii
D.6: Sex Work
Connecting Gender and Health Inequalities to Resistance
and Survival in Kathmandu: Lived Experiences of Former
Street-based Commercial Sex Workers
Structural Violence and Vulnerability to HIV/AIDS: A Case
Study of Brothel-based Female Sex Workers in Delhi, India
Courtesy Stigma: A Hidden Health Concern Among Frontline
Service Providers to Sex Workers?
D.7: Participatory Action Research
i Empowering Stroke Survivors Through Action Research
ii
iii
Knowledge Translation and Qualitative Research: The Tao
of Puzzles
The Liaison Program: Supporting Knowledge Translation and
Evidence Uptake
Using video to link data collection and analysis with knowledge
translation and exchange
The relationship between arts and phenomenology: From a
research study
Arranging for alternative caregivers: Challenges to safe care
for parents of children with disabilities and chronic conditions.
The Politics of Critical Action Research in Conflict-Affected
Areas in the Global South: The Case of Reproductive Health
in Mindanao, Philippines
Developing inclusive participatory approaches: reflections
on research partnerships with 'seldom heard' older people
Session Chair:
D. Ann Vosilla
John L. Oliffe, Joan
Bottorff, Gayl Sarbit
D. Ann Vosilla
Paul Holyoke
Session Chair:
Shirley Mogale
Reimei Hong, Anthony
Welch
Lise Olsen, Mariana
Brussoni,
Anton Miller, Maureen
O’Donnell
iii Communicating about congenital anomalies with parents Hagit Peres
Session Chair:
Rachel Phillips
Iccha Basnyat
Shamshad Khan
Rachel Phillips
Session Chair:
Angela Zwiers
Shannon Hebblethwaite,
Lyn
Curley
Danielle Bishop
Denise Tanner, Jo
Ellins

Concurrent Sessions: Monday, October 4, 2010
Session E: 1:00pm - 2:30pm
Room 1
Comox
1:00 - 1:30 i
1:30 - 2:00 ii
2:00 - 2:30 iii
Room 2
Denman
1:00 - 1:30 i
1:30 - 2:00 ii
2:00 - 2:30 iii
Room 3
Nelson
1:00 - 1:30 i
1:30 - 2:00 ii
2:00 - 2:30 iii
E.1: Mental Illness: Health Services
A psychosocial rehabilitation programme for institutionalized
chronically mentally ill patients
Using Institutional Ethnography to Explore Community
Treatment Orders
Looking through different Lenses; Case Study Research of a
UK Mental Health Integrated Care Pathway
E.2: Symposium
Using social theory to explain health behaviours: The Realist
Complexity Approach and research into heart disease
The Realist Complexity Approach and how it draws on critical
realism
Understanding agency in why people with heart disease are
active: Patients’ accounts of facilitators and barriers
Understanding ‘structure’ in why people with heart disease
are not active: Professional accounts of facilitators and
E.3: HIV and AIDS
Understanding the needs of HIV-positive gay men at time of
diagnosis for a more comprehensive and appropriate response
A Qualitative Evaluation of the Pre-Release Planning Program
for HIV+ Former Georgia State Prisoners
Qualitative study on factors influencing positive prevention
among people living with HIV/AIDS in Iran
Room 4
Gilford E.4: Potpourri
Session Chair:
Nicole Snow
Johanita Strumpher,
Nelis van Nikerk
Nicole Snow
Julie Hall
Session Chair:
Alexander M. Clark
Alexander M. Clark
Amanda Duncan, E.
June Trevoy,
Stephanie Heath,
Michael Chan,
Alexander M. Clark
E. June Trevoy,
Alexander M. Clark
Session Chair:
Donna Smith
Olivier Ferlatte,
Malcolm Steinberg
Donna Smith, Richard
Rothenberg
Seyedramin Radfar,
Pardis Nematollahi
Session Chair:
Elaine Moody
1:00 - 1:30 i Critical Narrative Approaches to Health Research Marla Buchanan
1:30 - 2:00 ii
N/A
N/A
Stress and Impact among Family Caregivers of Elders with
Dementia in Southern Taiwan
WITHDRAWN
Social representations as subsidies for the construction of
public health policies
WITHDRAWN
'Insiders' and 'outsiders' in hospital ethnography: Issues in
entrée and quality of data
Wen-Yun Cheng
Mariana Winckler,
Guillermo Johnson,
Neusa Bloemer
Benson A. Mulemi
21

22
Concurrent Sessions: Monday, October 4, 2010
Session E: 1:00pm - 2:30pm
Room 5
Barclay E.5: Professional Practice: Professional Care
1:00 - 1:30 i
1:30 - 2:00 ii
2:00 - 2:30 iii
Room 6
Pacific
E.6: Sexuality and Health
Session Chair:
Jude Spiers
1:00 - 1:30 i Gay men talking about health Jeffery Adams
1:30 - 2:00 ii Rural Men, Sexual Identity and Community Michael Kennedy
2:00 - 2:30 iii Gay men: Explaining health, improving health Jeffery Adams
Room 7
Beach
1:00 - 1:30 i
1:30 - 2:00 ii
2:00 - 2:30 iii
Room 8
Parkside
1:00 - 1:30 i
1:30 - 2:00 ii
2:00 - 2:30 iii
Perspectives on establishing relationships between
foreign patients and nurses in Japan.
'Woman centred care'? An exploration of professional
care in midwifery practice
Does the FAMCHAT Tool Enhance the Ethno-
Cultural Dimensions of Nursing Assessment at
the Royal Alexandra Hospital?
E.7: Methods: Engagement
Including Self When Researching Gendered Violence: Enabling
a Depth and Richness of Understanding Through the
Use of Sequential Methods of Analysis.
The Access Project: Utilizing Social Media in Building Networking
and Health Literacy Capacities for Youth Engagement
Speaking Truth to Power: Using photo-elicited research
methods with older adults
E.8: Living with Disabilities
Practical Considerations and Patterns of Collaboration in the
Marriage Relationship Among Persons with Disabilities
An Investigation of the Meaning of Work and its Translation
into Meaningful Retirement for People with Intellectual
Disabilities
Growing up & Growing Older with a Physical Impairment:
The Paradox of Normalization through Rehabilitation
Session Chair:
Sally Brown
Chiharu Nonaka,
Machiko Higuchi
Mari Phillips
Gina Higginbottom, Solina Richter,
Susan Young, Lucenia Ortiz,
Stella Callender, Joan Forgeron,
Michelle Boyce
Session Chair:
Karen Wood
Karen Wood, Sylvia
Abonyi,
Jennifer Poudrier
Cameron Norman,
Andrea Yip,
Sam Saad, Jill Charnaw-Burger,
Alison
Theresa Garvin,
Candace Nykiforuk,
Sherrill Johnson
Session Chair:
Sherry Dahlke
Celia Schulz
Joan Dacher, Barbara
Pieper
Laura Moll,
Cheryl Cott

Concurrent Sessions: Monday, October 4, 2010
Session F: 3:00pm - 4:00pm
Room 1
Comox
3:00 - 3:30 i
F.1: Work and Work Place Issues
Speaking Up, Being Heard: R.N. Views of Workplace
Communication
Session Chair:
Maryanne Garon
Maryanne Garon, Debra Balise,
Catherine Solorzano
3:30 - 4:00 ii Verbal Abuse: The Words that Divide Tanya Judkins-Cohn
Room 2
Denman
3:00 - 3:30 i
3:30 - 4:00 ii
Room 3
Nelson
3:00 - 3:30 i
F.2: Gender and Health
Gender and Prevention of Dengue Haemmorragic
Fever at Sawojajar Village, Malang City,
Self-identity, gender and experiences of coping
after stroke - a narrative analysis of stroke
F.3: Culture and Health
Cultural Explanatory Model of Depression
Among Iranian Women in Three Ethnic Groups
(Fars, Kurds, and Turks)
Session Chair:
Emma F. France
Lilik Zuhriyah, Enggar Fitri Loeki,
Al Rasyid Harun
Emma F. France, Clare Dow,
Kate Hunt
Session Chair:
Amanda Duncan
Masoumeh Dejman, Solvig Exblad,
Ameneh Setareh Forouzan
3:30 - 4:00 ii Holistic Model of Wellness Heather Morin
Room 4
Gilford
3:00 - 3:30 i
3:30 - 4:00 ii
Room 5
Barclay
3:00 - 3:30 i
3:30 - 4:00 ii
Room 6
Pacific
3:00 - 3:30 i
3:30 - 4:00 ii
F.4: Men’s Health
Prostate cancer support groups, health literacy
and consumerism: Are community-based volunteers
re-defining older men's health?
The Enigma of the Couvade Syndrome: Men's
experiences of pregnancy
F.5: Conceptualizing Cancer Experiences
Access to care theory development using one
academic's story of thyroid cancer and hypothyroidism
The cancer: A study of representations in patients
and primary caregivers.
F.6: Military Issues
A poor excuse? An examination of how the
PTSD defence plays out in the Canadian press
Family Reintegration Following Guard Deployment
Session Chair:
Alexander M. Clark
John L. Oliffe, Joan Bottorff
Arthur Brennan,
Sylvie Marshall-Lucette
Session Chair:
June Trevoy
Laurie Goldsmith
Jose Alfredo Lopez Huerta,
Agustin Zarate
Session Chair:
Angela Zwiers
Tamara Reid
Deborah Messecar
23

24
Concurrent Sessions: Tuesday, October 5, 2010
Session G: 10:30am - 12:00pm
Room 1
Comox
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 2
Denman
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
G.2: Access and Care
Session Chair:
Bonnie McIntosh
i Access to Renal Transplantation Kandace Landreneau
ii
iii
Meaning of Donation Experience for Living
Kidney Donors
Bush Battles- the challenges of providing acute
health care in rural contexts in Australia
Room 3
Nelson G.3: Self Management in Chronic Illness
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 4
Gilford
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
i
ii
iii
i
ii
iii
i
ii
iii
G.1: Symposium
Methodological issues when conducting research
with children and adolescents
The use of video technique in observing children’s
expressions of actions
The use of drawings and pictures as participatory
methods to encourage children to tell
about their perceptions on a specific theme
The use of focus group interviews with children
and adolescents
Self-management support in interdisciplinary
primary care organizations: Contradictions and
consequences
Unsupported Self-Management in Accounts of
Early Rheumatoid Arthritis: "I was just left in
limbo"
A model of integration of illness and self management
in Type 2 Diabetes
G.4: Decision Making
"You are Terrified and Wondering What is Going
on With Your Child": Parents' Experiences of
Expanded Newborn Screening
"Grasping the Grey": Making Meaning about
Huntington Disease Intermediate Allele Predictive
Test Results
'Knowing people are coping with what you have
to cope with is reassuring.' Why people use and
value experiential health information
Session Chair:
Jude Spiers
Maja Soderback, Maria Harder
Maria Harder, Karin Enskar,
Maja Soderback
Marie Golsater, Karin Enskar
Linda Rose, Laura Taylor, Anne
Belcher, L. Ebony Boulware,
Kathryn Dane, Sherrie Klunk,
Christine St. Ours,
Marie T. Nolan
Vicki Parker, Michelle Giles,
Glenda Parmenter,
Isabel Higgins,
Penny Paliadelis, Angela White
Session Chair:
June Trevoy
Patricia Thille, Grant Russell,
Robert Geneau
Anne Townsend, Paul Adam,
Catherine Backman, Linda C Li
Asa Hornsten, Lena Jutterstrom,
Asa Audulv, Berit Lundman
Session Chair:
Emma F. France
Jane DeLuca
Alicia Semaka, Lynda Balneaves,
Michael Hayden
Emma F. France, Vikki Entwistle,
Ruth Jepson, Sally Wyke

Concurrent Sessions: Tuesday, October 5, 2010
Session G: 10:30am - 12:00pm
Room 5
Barclay
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 6
Pacific
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 7
Beach
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
Room 8
Parkside
10:30 -
11:00
11:00 -
11:30
11:30 -
12:00
i
ii
iii
i
ii
iii
i
ii
iii
i
ii
iii
G.5: Social Adaption
The process towards integration - a psychosocial
process of adjusting to facial disfigurement
following surgical treatment for head and neck
or eye cancer
Understanding the impact on social participation
of an acquired speech impairment
A Mixed Method Study of Mental Illness, Compulsory
Treatment, and Self-Stigma
G.6: Methods: Innovations
Best Practices in Diagrammatic Elicitation: A
Novel Approach to Data Collection
The Access Project: A Rapid Response Model of
Engagement
A critical reflection on the methodological
challenges of conducting research with a community
arts program for older adults
G.7: Symposium
Utilizing phenomenology as a novice researcher:
Staying true to method?
Descriptive phenomenology: The best methodology
for the advanced cancer experience
Researcher as study participant: A discussion
using Heuristic Inquiry
Increasing the Level of Understanding about
Phenomenon of Interest through Self-
G.8: Professional Education: Preceptorship
Preceptorship and Practical Wisdom: A Process
of Engaging in Authentic Nursing Practice
The lived experience of the preceptor in evaluating
undergraduate nurses' clinical competence
Preceptor Education: A World of Possibilities
through E-learning Technology
Session Chair:
Amanda Duncan
Hanne Konradsen
Marian C. Brady,
Alexander M. Clark,
Sylvia Dickson, Gillian Paton,
Rosaline S. Barbour
James Livingston
Session Chair:
Elaine Moody
Muriah Umoquit
Cameron Norman, Sam Saad,
Andrea Yip, Jill Charnaw-Burger,
Alison Crepinsek
Elaine Moody, Alison Phinney
Session Chair:
Shirley Mogale
Natasha Hubbard Murdoch
Marilee Lowe
Gaylene Sorochuk
Session Chair:
Sally Brown
Florence Myrick, Olive Yonge
Louise McDonnell
Florence Myrick, Wendy Caplan,
Jayne Smitten, Kerry Rusk
25

26
Concurrent Sessions: Tuesday, October 5, 2010
Session H: 1:00pm - 2:30pm
Room 1
Comox
1:00 - 1:30 i
1:30 - 2:00 ii
2:00 - 2:30 iii
Room 2
Denman
H.1: Symposium
The synthesis of qualitative health research: current debates
and methodological developments
The synthesis of qualitative health research: searching for
qualitative research
The synthesis of qualitative health research: appraising the
quality of reporting of primary studies
The synthesis of qualitative health research: synthesis methods
and analytical techniques
Room 4
Gilford H.4: Health Equity
1:00 - 1:30 i
1:30 - 2:00 ii
2:00 - 2:30 iii
H.2: Health and Technology
Unraveling the complexities leading to health inequities: A
critical ethnography
The AIM Study: Access, Innovation, and Medicines - The
Impact of NAFTA on Access to Medicines in Mexico
H1N1 and Northern Canadian First Nation Communities:
Community Concerns and Trust in Government Action
Session Chair:
Alexander M. Clark
Kate Flemming
Allison Tong
Elizabeth McInnes
Session Chair:
Jude Spiers
1:00 - 1:30 i Caring TV as a client driven service design Katariina Raij
1:30 - 2:00 ii Consumer acceptance and adoption of ehealth Brian Hillier
2:00 - 2:30
Room 3
Nelson
1:00 - 1:30 i
1:30 - 2:00 ii
2:00 - 2:30 iii
Opportunities and difficulties with video-based research:
linking data collection and analysis
H.3: Addictions, Health Reduction and Health
Promotion
Partnering with Drug User Activists to Conduct
a Harm Reduction and Health Needs Assess-
Service Providers' and Street-Involved Youth
Perspectives on Preventing the Transition into
Injection Drug Use among Street-Involved
Youth: Successes, Barriers and Opportunities
for Youth Prevention Services
Access to Cigarettes, Access to Treatment: A
Youth Engagement Project to Explore the Relationship
Between Cigarette Proliferation &
Smoking Cessation
Paul Holyoke
Session Chair:
Angela Zwiers
Alexis Crabtree, Nichole Latham,
Jane Buxton
Jane Buxton, Larissa Coser,
Natasha Van Borek, Youth Co-
Researchers, Michael Botnick,
Catherine Chambers, Darlene
Taylor, Elizabeth Saewyc
Cameron Norman, Jill Charnaw-
Burger, Sam Saad, Andrea Yip,
Alison Crepinsek, Jessica Patterson,
Ilinca Lupea
Session Chair:
Shirley Mogale
Makie Kawabata ,
Denise Gastaldo
Benjamin Warren
Cindy Jardine, S.
Michelle Driedger

Concurrent Sessions: Tuesday, October 5, 2010
Session H: 1:00pm - 2:30pm
Room 5
Barclay
1:00 - 1:30 i
1:30 - 2:00 ii
2:00 - 2:30 iii
Room 6
Pacific
H.5: Child Safety
Methodology in an ecological framework: Hearing
parents' voices on child home safety
Fathers’ childhood injury prevention: risk and
protection decision-making
Child home safety: Are we tackling a 'wicked
problem' with 'tame solutions'?
H.6: Effective Pedagogy
1:00 - 1:30 i Dancing with Dementia
Session Chair:
Sherry Dahlke
Jean Simpson, Rob McGee,
Chrystal Jaye, Geoff Fougere
Mariana Brussoni, Lise Olsen,
David Sheftel, Anne George
Jean Simpson, Rob McGee,
Geoff Fougere, Chrystal Jaye
Session Chair:
Sally Brown
Anita De Bellis, Alison Wotherspoon,
Sandra Bradley, Bonnie
Walter, Pauline Guerin, Maggie
Cecchin, Jan Paterson
1:30 - 2:00 ii Power: Moral Implications in Nursing Education Jane Sumner
2:00 - 2:30 iii Promoting Student Success in Online Courses
Room 7
Beach
H.7: Symposium
Narrative Inquiries of Life-threatening Illness
1:00 - 1:30 i Storylines of Life-threatening Illness
1:30 - 2:00 ii
Representational Symbols of Life-threatening
Illness
2:00 - 2:30 iii Metonymic Spaces of Narrative Analysis
Room 8
Beach
1:00 - 1:30 i
1:30 - 2:00 ii
H.8: Death and Dying
Awareness of dying and dying trajectories in
people with heart failure and people with lung
disease, revisiting Glaser and Strauss.
Cardiopulmonary Resuscitation in the Emergency
Department
2:00 - 2:30 iii Shared Presence: Caring for a Dying Spouse
Sue Robertson, Penny Weismuller,
Mary Lehn-Mooney, Yvonne
Ginez-Gonzales
Session Chair:
Anita Molzahn
Laurene Sheilds, Anita Molzahn,
Anne Bruce, Kelli Stajduhar,
Kara Schick Makaroff,
Rosanne Beuthin
Kara Schick Makaroff, Rosanne
Beuthin, Laurene Sheilds,
Anita Molzahn, Anne Bruce,
Kelli Stajduhar
Anne Bruce, Laurene Sheilds,
Rosanne Beuthin, Kara Schick
Makaroff, Anita Molzahn,
Kelli Stajduhar
Session Chair:
Bonnie McIntosh
Neil Small, Merryn Gott
Stephen Brummell, Jane Seymour,
Gina Higginbottom
Lana McLouth Kanacki, Patricia
Roth, Jane Georges,
Patti Herring
27

28
Concurrent Sessions: Tuesday, October 5, 2010
Session J: 3:00pm - 4:00pm
Room 1
Comox
3:00 - 3:30 i
3:30 - 4:00 ii
Room 2
Denman
Room 3
Nelson
3:00 - 3:30 i
3:30 - 4:00 ii
Room 6
Pacific
3:00 - 3:30 i
3:30 - 4:00 ii
J.2: Culture, Sexuality and Health
J.3: Interdisciplinary Practice
Implications of within profession differences in
nurse-physician work relationships on efficiency
and care coordination.
Interprofessional Practice- possibility or pipedream
J.6: Living and Healing
"Head on to...": a film exploration of the lived
experience of brain injury
Session Chair:
Shirley Mogale
3:00 - 3:30 i Heteroracial Preferences of Gay Man and their David Aveline
3:30 - 4:00 ii
Room 4
Barclay
3:00 - 3:30 i
3:30 - 4:00 ii
Room 5
Gilford
3:00 - 3:30 i
3:30 - 4:00 ii
J.1: Living with Chronic Illness and Back Pain
Function and influences, but not as we know it:
Personal accounts across acute low back pain
experiences
Methodological shortcomings following a systematic
review of recent qualitative research
into chronic low back pain
Sexual norms and relationships: a qualitative
analysis of self-generated questions among
church attending youth in KwaZulu-Natal, South
Africa.
J.4: Pandemics and Disasters
Unsung Heroes: Disabled Responders to the
Rescue following Hurricane Katrina
Waiting for the Pandemic: Theatre, Embodiment
and Knowledge Generation
J.5: Immigrant, Refugees and Health
Newcomer Healthcare Experiences and Needs
in the Context of Settlement: An exploration of
patients and families accessing The Hospital for
Sick Children
Methodological Issues in Conducting Research
with Immigrant and Refugee Populations
Session Chair:
Benjamin J. Newton
Carol McCrum
Benjamin J. Newton, Zuzana
Rothlingova, Robin Gutteridge,
Jon H. Raphael
Elisabet Eriksson, Gunilla Lindmark,
Pia Axemo, Beverley
Haddad, Beth Maina Ahlberg
Session Chair:
Vicki Parker
Karen Dunn Lopez
Vicki Parker, Rebecca Mitchell,
Michelle Giles
Session Chair:
Sally Brown
Susan Speraw, Deborah Persell
Rebecca Godderis, Katherine
Rossiter
Session Chair:
Jennifer Levy
Jennifer Levy, Jahanara Khatun,
Atyeh Hamedani
Fay Mahdieh Dastjerdi
Session Chair:
E. June Tevoy
William Fairbank, Mary Butler

Poster Sessions: Sunday, October 3, 2010
Session K: 10:00am & 2:30pm
1 Epilogue of an Autoethnography
2
3
Telling in the shimmering. Perception of parents or caregivers
about the social interaction of their premature born
children.
Improving the Quality of Diabetes Care: Exploring the Perspectives
of GPs in Ireland
4 The Experience of Men Managing Fecal Incontinence
5
6
7
8
The perceived psychosocial consequences of the invisibility
of rheumatoid arthritis in young adults
A Needs Assessment of Cancer Survivors at Fox Chase Cancer
Center
"WALKING THE ROPE": Pakistani Children's Experience of
Growing up with Thalassemia Major
REDI Model of Relocation Pathway for Persons with Dementia
and their Family Caregivers Moving to a Retirement
Residence
9 Analysis of discourses in a health care context
10
11
12
Dynamic Case Study Portal: Facilitating the Integration of
Multiple Types of Evidence into Decision-Making and Research
Beyond the Pink Ribbon: The Lived Experience of Breast
Cancer Survivors
Trust and Functionality: Key Themes for a Personal Health
Record for Prevention
Lee Murray
Margreet Luinge, Ajay Bailey,
Inge Hutter
Sheena McHugh, Monica
O`Mullane, Ivan J. Perry, Colin
Bradley
Cynthia Peden-McAlpine,
Donna Bliss
Sarah Minton
Bonnie McIntosh, Stacie
Metz, Andrea Barsevick
Gul e Rana Mufti, Tina Cartwright,
Tony Towell
Faranak Aminzadeh, Frank
Molnar, William Bill Dalziel,
Linda Garcia
Elisabeth Dahlborg Lyckhage,
Ase Boman
Muriah Umoquit, Peggy Tso,
Victoria Hagens,
Mark Dobrow
Paige Wimberley
J. William Kerns, Anton Kuzel,
Alex Krist, Dan Longo
13 The Experience of Moral Distress Among Psychology Interns Simon Nuttgens
14
15
Writing An Effective "Methods" Section for Research Proposals:
Bettty Crocker Has the Recipe
Communication and the Casualization of Nursing: an Interpretive
Ethnography
Jeffrey Smith
Mary Batch
16 The Experience of Female Street Sex Workers Laura Klubben
17
18
19
The lived experience of the person at home following admission
of their spouse to an aged care facility: A work in
progress report.
Physicians' Experiences in End-of-Life Conversations with
Patients with Multi-morbid Medical Conditions
The meaning to nurses of the work process at the Intensive
Care Units of a University Hospital in São Paulo State
Lisa Hee
Elizabeth Stevens, Toby
Schonfeld, William Lyons,
Michelle Lampman
Elaine Oliveira, Wilza Spiri
29

30
Poster Sessions: Monday, October 4, 2010
Session L: 10:00am & 2:30pm
1
2
3
Transitioning of Internationally Educated Nurses (IENs) into
the Alberta Health System
An Exploration of the Culture of Prosecuting Violence
against Women (VAW) in South African Courts when the
Health Record is part of the Evidence
Narrative Beginnings: The Puzzles of Interpersonal Relationships
Between Registered Nurses Who Are The Significant
Other and Primary Caregiver of the Patient and The Registered
Nurses Who Care For The Patient In Health Care Facilities
Gina Higginbottom,
Shirley Mogale
Shirley Mogale
Helen Dempsey-Simmons
4 Family Reintegration Following Guard Deployment (poster) Deborah Messecar
5
Living within an emancipatory curriculum: An ethnomethodological
inquiry.
Maureen Makepeace-Dore
6 'Survivor'? Angela Zwiers
7
8
9
Analyzing Evidence Hierarchies in Obesity Recommendations
with a Complex Systems Lens
Understanding the Manitoba Medical Licensure Program for
International Medical Graduates (MLPIMG): Exploring Accreditation
Gap, Barriers, and Multiple Mentoring
Hermeneutic phenomenology as a method to understand
meaningful activities for people who live with schizophrenia
10 Parents' Experiences of Balance in Everyday Life
11
Do not intervene when they are close to the destination: A
way in providing dignified care to the Chinese elders in
Hong Kong
Lee Johnston, Carrie Matteson,
Diane Finegood
Bosu Seo, Sukhoe Choe
Regina Casey
Mineko Wada, Catherine
Backman, Susan Forwell,
Wolff-Michael Roth, James
Ponzetti
Mimi M. H. Tiu, Simon C.
Lam, Winnie-J.H.W. Chik,
Fiona W.K. Tang
12 Client Hope in Early Counselling Sessions Denise Larsen, Rachel Stege
13
14
15
The Structure of Life in Narratives of the oldest old: A Phenomenological
Study
Information Seeking Experiences of Pharmaceutical Policy
Makers
Single, After All These Years... The Impact of Spousal Loss
on Elder Widowers
Takeshi Nakagawa, Yukie
Masui, Yoichi Kureta, Midori
Takayama, Ryutaro Takahashi,
Yasuyuki Gondo
Devon Greyson, Steve Morgan,
Colleen Cunningham
Kathleen Pepin
16 Stories from Vietnam Debbie Shelton
17
18
Mental health service user perceptions regarding sexual
and relationship need
Student's accessing student health services : the health
professionals perspective
19 Nursing Student Perspectives of Course Evaluation in Korea
Edward McCann
Caitriona Nic Philibin
Seung Eun Chung, Miyoung
Kim

Poster Sessions: Tuesday, October 5, 2010
Session M: 10:00am & 2:30pm
1
From confinement to freedom of living: revealing the life
stories of those leaving a psychiatric hospital
Hudson Santos Junior, Natalia
Salim, Dulce Maria R. Gualda
2 Befriending Progra and Refugees' Social Support Systems Behnam Behnia
3
4
5
6
7
8
9
10
Experiences 'in the field': Analysing, explicating and reconciling
tensions between participatory qualitative and
'standardized' quantitative approaches to research
Migration, minorities and maternity services: a three country
international comparison
The reconstruction of a profession: a qualitative sociohistorical
analysis of medical liability rulings in Israel
A Study Evaluating a Set of Interventions for Preventing
Substance Abuse Problems in Canadian Aboriginal Youth
Beliefs and Practices of Expert Respiratory Care Faculty on
Critical-Thinking Learning: A Case Study
Preventing parents from their own perceptions of prevention
Pictures of Connection and Autonomy through the Lens of
Adolescent Girls with Disordered Eating
Preparing for Breastfeeding: Time between Intention and
Behaviour. Insights from a qualitative study.
Koushambhi Basu Khan, Alexandra
Mann, Joyce Lui, Judith
M. Lynam
Sarah Salaway, Birgit Reime,
Gina Higginbottom, Heinz
Rothgang, Kate Gerrish, Jule
Friedrich, Herbert Kentenich,
Beverly O’Brien, Kuldip Bharj,
Punita Chowbey,
Zubia Mumtaz
Smadar Noy
Hendricus A. Van Wilgenburg,
M. Nancy Comeau, Pam
Collins, Sherry H. Stewart
James Hulse
Maryam Amin,
Arnaldo Perez
Colleen McMillan
Alberta Oosterhoff, Hinke
Haisma, Inge Hutter
11 Challenging the boundaries of Practice Knowledge Matthew Walsh
12 The New Cutting Edge: Sustaining Quality Care
13
14
15
16
17
18
Midlife Lay and Professional Women Engage in Applying a
Participatory Research Approach to Develop Nutrition Education
Resources for Bone Health
Construction and Analysis of a Communication Tool for
Obese Patients
Perceptions and Misperceptions of the Anesthesiologist's
Role in Labour and Delivery: Implications for Quality and
Safety
Life in the Later Years: Exploring the Meaning of Retirement
among Ageing Adults with Intellectual Disabilities
Patient Perspectives of Tobacco Use Management in Smoke
Free Grounds Hospitals
Content analysis of male senior nursing students' perspectives
regarding how they decided to choose and continue
nursing career
Mickey Parsons, Patricia
Cornett
Gail K. Hammond, Gwen E.
Chapman
Thomas D. Merth, Carrie L.
Matteson, Diane T. Finegood
Saroo Sharma, Patricia Houston,
Pamela Morgan, Scott
Reeves
Sarah Baumbusch
Nicole Shopik, Annette
Schultz, Candace Nykiforuk,
Margie Kvern, Barry Finegan,
Mahvash Salsali, Mojtaba
Vaismoradi
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Abstracts, Poster Sessions
Listed alphabetically by first author
Preventing parents from their own perceptions
of prevention
Maryam Amin
University of Alberta
Arnaldo Perez
University of Alberta
Objective: A community-based participatory
research was employed to qualitatively explore
the perceptions of a group of new immigrant
and refugee parents about children's oral health
and prevention of caries. The ultimate goal is
developing a culturally appropriate oral health
promotion program to reduce dental decay in
children in high-risk populations. Methods: A
total of 81 new immigrant and refugee parents
participated in 12 focus groups. Participants
were recruited from Multicultural Health Brokers
Coop, a non-profit organization serving
newcomers in Edmonton. Focus groups were
conducted in participants' original language.
The interview guide was modified as the research
progressed. Results: Our analysis demonstrated
visible differences among the participating
communities, which confirmed the necessity
of customizing preventive strategies to meet the
needs of each community. Aspects such as
parents' cultural beliefs and level of knowledge
about oral health and dental services, their attitudes
toward prevention, and their perceived
barriers to optimum dental care were identified
as being important to be addressed in any health
promotion program. Parents in our study were
either prevention-oriented or treatment-oriented.
The emphasis placed on prevention seemed to
be related to health values and practices as well
as a strategy to avoid costly dental treatments.
Parent also appeared to overestimate their ability
to detect dental problems and they tended to
simplify oral diseases in young children. The
contradiction between parents' feeling of being
capable of detecting dental problems and taking
their child to a dentist only when there is a
problem was identified as the key barrier for
parents to provide timely care for their child's
oral health. Conclusion: While prevention is a
key to maintain children's oral health, the level
of parents' awareness of self-limitations and
their inadequate information and skills to address
issues related to prevention remain as an
important area that requires further investigation.
REDI Model of Relocation Pathway for Persons
with Dementia and their Family Caregivers
Moving to a Retirement Residence
Faranak Aminzadeh
The Ottawa Hospital
Frank Molnar
The Ottawa Hospital
William Bill Dalziel
The Ottawa Hospital
LInda Garcia
University of Ottawa
Relocation to a care facility is a major life event
for persons with dementia (PWD) and their
family caregivers. This poster presentation
describes the stages of decision making, critical
incidents, roles/responsibilities, and support
needs of PWD and their caregivers during a
move to a retirement residence. The study
adopted a prospective qualitative design. Data
were gathered during separate in-depth baseline
and follow-up interviews with 16 PWD and
their caregivers. A grounded theory approach
was used to guide data analysis. For most participants
in this study, the relocation decision
making involved a complex, dynamic, highly
interactive, and more or less consensual process
which extended from only a few months to
several years. Despite the uniqueness of each
case, a model emerged that captures the experiences
of the majority of participants. The REDI
model is marked by four stages of residential
decision making and transition. These are:
“Recognition”, “Exploration”,
“Destabilization”, and “Implementation”. During
these stages, family caregivers assumed
multiple important roles, including: “Noticing”,
“Monitoring”, “Information/Help Seeking,
“Initiating”, “Deferring”, “Picking Up the
Slack”, “Realizing”, “Pushing/Taking Over”,
“Searching & Selecting”, and “Making the
Move”. Relocation to a care facility is not a
concrete time limited event, but an ongoing
process of decision making, change, and adjustment
for PWD and their caregivers. The findings
have important theoretical and practice
implications and inform supportive strategies to
optimize the process and outcomes of the relocation
trajectory for both PWD and their family
caregivers.
Communication and the Casualization of
Nursing: an Interpretive Ethnography
Mary Batch
Queensland University of Technoloy
Literature tells us that the nursing profession is
becoming increasingly casualized, with around
50% of the Australian nursing workforce being
employed either part time or on a casual basis.
However it is not understood what impact nursing
casualization is having on organisational

communication and health care provision. Literature
suggests that communication is a vital
component of organisational effectiveness and
communication needs of employees must be
met to ensure positive organisational outcomes.
Existing work models though appear to be designed
to favour the full time worker and there
is evidence of marginalisation of casual and part
time workers by their full time colleagues and
managers.
This project has endeavoured to identify, describe
and understand the effects of casualization
on communication within a division of a
large metropolitan acute healthcare facility. It
has explored the relationship between casualization
and the communication culture via an interpretive
ethnographic approach. Methods used
include, participant and non participant observations
and field note records of fulltime, part time
and casual nurses within four units, for two hour
periods at a time. Audio taped and transcribed
semi-structured interviews and focus groups
have also been used to maximise data and facilitate
understanding. Ethnographic analysis has
been undertaken in order to develop concepts
and themes and the findings will be the subject
of the presentation.
Life in the Later Years: Exploring the Meaning
of Retirement among Ageing Adults with
Intellectual Disabilities
Sarah Baumbusch
University of British Columbia
The purpose of this study was to explore the
meaning of retirement to adults with an intellectual
disability in older age. Background: Five
adults between the ages of 50-60 years old
participated in in-depth interviews on the subject
of retirement. Four participants lived independently
in the community, one participant
lived with her mother. Two participants were
male and three participants were female. One of
the participants had a permanent part-time job at
a community living organization, three participants
worked three hours or less per week in
self employed arrangements, and one participant
was not employed. Method: The study used a
qualitative descriptive design. An interview
guide was used which included topics related to
retirement. Data were collected using semistructured
interviews. Participants were asked
about their expectations of retirement, what type
of things might change as they got older, and
what they thought was different for persons with
a disability than for the general population.
Data were analyzed to find content themes.
Findings: Three key themes emerged: 1) the
economics of retirement, 2) desire for choices in
retirement, and 3) changing relationships with
ageing parents, shaped the unique experience of
this time of life. Discussion: With increasing
life expectancy and deinstitutionalization, retirement
is a new phenomenon for this population.
Findings from this study illustrate the need for
education about and acknowledgement of this
major life transition for both adults with Intellectual
Disabilities and those in their support
networks.
Befriending Progra and Refugees' Social
Support Systems
Behnam Behnia
Carleton University
In their country of resettlement, refugees often
face the challenge of coming to terms with their
past traumatic experiences and dealing with the
difficulties of adjusting to a new society. Although
these stressful experiences constitute an
enormous challenge to refugees‟ well-being and
mental health, research indicates that the presence
of supportive resources such as family
members, friends, ethnic community, and adequate
formal services can assist refugees in
dealing with resettlement-related challenges.
However, in the country of resettlement, refugees
often suffer from lack of adequate support
systems due to such factors as family dislocation,
distrust, and community ideological polarization.
To strengthen refugees‟ support systems,
settlement agencies match refugees with volunteers,
who act as a friend and offer support and
friendship for a determined period of time. It is
reported that compared to other refugees,
matched refugees obtain employment sooner,
perform better in language acquisition, receive
less government financial assistance, have more
friends, and are more optimistic about their
future.
Despite its important contributions to
refugees‟ adjustment to a new society, very little
is known about befriending programs. To successfully
recruit befrienders and to ensure that
those who are recruited remain committed, it is
important to identify factors that encourage and
hinder their collaboration with refuges. Based
on information provided by twenty-five organizations
that offer befriending programs in Australia,
Canada, England, and the United States,
this paper discusses these issues. Such knowledge
could provide service agencies with insights
on how to strengthen refugees‟ support
systems.
Hermeneutic phenomenology as a method to
understand meaningful activities for people
who live with schizophrenia
Regina Casey
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University of British Columbia
This presentation will share preliminary findings
of a PhD study designed to better understand
participants experiences regarding the
meaning of everyday activities.
Literature indicates that people who live with
schizophrenia may experience their daily activities
differently and may be underoccupied (i.e.,
they may engage in fewer activities and may
have less variety in their daily activities.) In
addition current interventions designed to help
individuals get involved in activities are structured
around techniques with little evidence
such as setting goals, developing readiness for
change, and direct exposure to new activities.
Importantly, few studies have studied the concept
of meaning in activities from the perspective
of people who live with schizophrenia. It is
anticipated that study findings will contribute to
our understanding how the individual meanings
experienced by participants contributes to their
recovery process.
The presentation will share how the hermeneutic
phenomenological methodology contributed
to a deeper, more creative, and more humanistic
understanding of the topic at hand. Methodological
challenges and strengths will be shared.
Workshop participants will be encouraged to
share their expertise regarding this often under
utilized albeit challenging methodological approach.
Nursing Student Perspectives of Course
Evaluation in Korea
Seung Eun Chung
Chungju National University
Miyong Kim
Ewha Womans University
This study aims to identify nursing student
perspectives of course evaluation. It may help to
use effectively course evaluation in context of
nursing education. Data were collected through
focus group approach from June to August
2008. The participants were 28 nursing students
who were homogeneous in age and background.
The data were analyzed by using the constant
comparative method.
Three core themes were derived from the data.
The first was a meaning of the evaluation, including
a tool to gain access to their grades, a
communication channel, a routine event expected
at the end of a semester, an introduction
of their own standards. The second was characteristics
of the nursing students toward course
evaluation, including their passivity, the prob-
lem-oriented training they have received, narrow-mindedness,
close relationships with their
professors, a conspiracy against the evaluation.
The last was a motivation for significant evaluation,
including explanation of the goals of the
evaluation, feedback on the results, guarantee of
anonymity, adjustment of question items,
change of the time of the evaluation, ensuring a
greater variety in evaluation methods.
Analysis of discourses in a health care context
Elisabeth Dahlborg Lyckhage
Nursing, Health and Culture
Åse Boman
Nursing, Health and Culture
To develop nursing as a critical normative science
(Kirkevold, 2009), a description of the
various care areas and different health phenomena
is needed. This is being done on the basis of
various qualitative methods´, hence within
nursing discourse analysis is used to a limited
extent. The aim of this paper is to exemplify
phenomenon and topics within nursing that have
been studied by using discourse analysis. The
examples are from studies conducted during the
previous years by the authors. Discourses within
palliative care based on documents and observations
(2009), nursing as a subordinated profession,
based on media analysis (2009), and an
ongoing study about discourses within care of
children with diabetes based on policy documents
in the Nordic countries. Discourse analysis
provides data, such as interviews, actions
and documents to be analyzed in a broader
system of knowledge (Wilkinson & Kitzinger,
2000., Lupton, 1993). A discourse is a “systems
of thought and systematic ways of carving out
reality and is composed by structures of knowledge
that influences systems of practice”
(Chambon, 1999). All discourses are textual
and an intertextual drawing upon other
texts, contextually embedded in historical political
and cultural settings. A given text also transforms
in a manner that is socially constrained
and conditional upon relations of power
(Foucault 1979). As Bacchi (2005) urges it is
possible to adopt a more comprehensive dualfocus
agenda in discourse analysis, taking into
account the dual movement of discourse: the
way discourse speaks us and the way we speak
the discourse.
Family Reintegration Following Guard Deployment
(Poster)
Deborah Messecar
Oregon Health & Science University

The purpose of this qualitative study was to
describe veterans and families perceptions of
their experience with family reintegration and
the challenges reintegration presents among
Guard members deployed since the start of the
Afghanistan and Iraq conflicts. Participants
included both National Guard members, and or
family members of guardsmen deployed since
2001. A total of 45 participants, 26 Guard members,
and 19 family members participated in
focus group, couple, and individual interviews .
NVIVO 8 was used to analyze the interview
data. Charmaz‟ (2006) approach to coding data
was used to organize and categorize the findings.
Several skills that members develop while
deployed, later interfere with their ability to
resume family life when they return home.
These skills included: seeking safety, getting
things done in a hurry, expecting unilateral
decision making, ensuring predictability in the
environment, and stuffing emotions in order to
get the job done. The objectives in this presentation
are to describe the challenges families face
with reintegration as a result of the conditioning
that occurs during deployment due to the stressful
environment. Implications are that individuals
returning from deployment are often still
experiencing the stressful effects of deployment
and this can interfere with family life. Suggestions
for strategies to screen for these kinds of
problems will be provided.
This research is sponsored by the TriService
Nursing Research Program, Uniformed Services
University of the Health Sciences (Department
of Defense); however, the information or content
and conclusions do not necessarily represent
their official position or policy.
Narrative Beginnings: The Puzzles of Interpersonal
Relationships Between Registered
Nurses Who Are The Significant Other and
Primary Caregiver of the Patient and The
Registered Nurses Who Care For The Patient
In Health Care Facilities
Helen Dempsey-Simmons
University of Alberta
Interpersonal interactions and communication
with patients and their families are central to
nursing care; drawing on my own experience as
a nurse and educator I recognize the challenges
in knowledge translation and application of
interactive and family centered care. Over the
past twenty years I have been puzzled by the
interpersonal relationships between nurses who
care for their family members and who are the
primary caregiver of the patient and nurses who
care for the patients in health care facilities;
these complex interpersonal relationships not
only affect patient care but equally affect
nurses, who are family members, personally and
professionally.
In understanding my puzzles more deeply, I
have told and re-told my own story of relationships
between nurses who were assigned to care
for my son, my husband and me and the effects
this has had on me as mother and wife, but also
as nurse and educator. My telling and re-telling
has opened up more puzzles and questions.
In the quest for deeper knowing, through the use
of Narrative Inquiry, I will explore and examine
the complexities of such caregiver relationships
more fully. Through a poster presentation I will
explore my own narrative beginnings, through
the lens of the three dimensional narrative inquiry
space, and then elaborate on the puzzles
and wonders that have come to light through the
inquiry into my own experiences.
Lived Experiences of Nurse Caring Behaviors
and Attitudes by Women with Chronic
Illness
Pamela Embler
University of Alaska Anchorage
How do women with chronic illness perceive
being cared about or cared for by nurses? Caring
is multifaceted warranting investigation to
gain an understanding of its complexities. This
study investigated women with chronic illnessesâ€
experiences with nurses that shaped
their perceptions of nurse caring behaviors and
attitudes. This was a descriptive phenomenological
study interpreted by Giorgiâ€s procedural
steps. Interviews were analyzed for patterns
of similar descriptions. Participants were
five women ages eighteen and older with
chronic illness recruited from the Alaska Heart
Institute, Alaska. The results indicated that
what is believed by the nurse to be an expression
of caring is not always what is received by
the client as caring. Five shared patterned descriptions
were, 1. experiences from past caring
interactions influence future caring interactions;
2. caring reflects the nurseâ€s ability to protect
human dignity and safeguard humanity; 3.
formulation of trust is dependent upon caring
interactions; 4. collaboration among the client,
the family, and the nurse is dependent upon
caring interactions; 5. and caring interactions
reflect the nurseâ€s commitment to professionalism
and career satisfaction. The implication
to nursing practice is that the client population
is transforming from one of acute illness
and acute care to chronic illness and long-term
care in the outpatient setting. The nurse-client
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paradigm must change to meet the needs of the
client. Understanding perceptions of feeling
cared about or cared for by nurses is essential if
nurses are to meet clients where they exist on
the illness continuum.
Information Seeking Experiences of Pharmaceutical
Policy Makers
Devon Greyson
University of British Columbia Centre
for Health Services and Policy Research
Steve Morgan
University of British Columbia Centre
for Health Services and Policy Research
Colleen Cunningham
University of British Columbia Centre
for Health Services and Policy Research
For decades, social sciences research has investigated
barriers to research uptake by public
policy makers. In more recent years, a related
genre of research has focused on “knowledge
translation” between researchers and policy
makers. However, a lack of behavioural and
organizational theory sometimes undermines
knowledge translation strategies from the outset,
and promoters of “evidence based policy making”
have been critiqued for not fully taking into
account the context in which policy makers
function. This exploratory study investigates the
work-related information seeking experiences of
key informants engaged in various aspects of
pharmaceutical policy making.
As part of a broader research priority-setting
process, we conducted semi-structured interviews
with a purposive sample of 24 stakeholders
in pharmaceutical policy making. Participants
included: government and public
agency employees, health professionals, patient/
consumer advocates, and pharmaceutical industry
employees/consultants. Embedded within a
larger interview regarding needs and recommendations
for pharmaceutical policy research was
a critical incident portion centred around recall
of a time of need for policy-relevant information.
Data analysis is currently underway, utilizing
descriptive qualitative methods drawing on
grounded theory analytic strategies. Results will
be compared with existing models of information
seeking behavior, including Pettigrew &
Leckie‟s Information Seeking of Professionals,
to assess degree to which such theories apply
and/or are inadequate to explain the information
seeking experiences of pharmaceutical policy
makers. Due to information-related norms particular
to participants‟ work cultures, and to
changes in information availability over recent
years, existing theories of information behavior
may have limited applicability in today‟s policy
-making environments.
Midlife Lay and Professional Women Engage
in Applying a Participatory Research Approach
to Develop Nutrition Education Resources
for Bone Health
Gail K. Hammond
University of British Columbia
Gwen E. Chapman
University of British Columbia
Nutrition education resources are key tools used
by nutrition professionals to help people make
informed food choices. A potential limiting
factor in resource effectiveness is nutrition
professionals‟ standard practice of developing
resources in isolation of the intended users.
Canadian midlife women‟s dietary intake of
foods rich in calcium and vitamin D, two key
nutrients for bone health, is less than current
recommendations. Diet is a modifiable factor
impacting bone health and nutrition professionals
have a key role in providing effective dietary
services to Canadians. Using a collaborative
approach to develop nutrition education resources
may produce resources that better match
women‟s health needs.
To this end, a collaborative partnership of midlife
community women and nutrition professionals
used a participatory research (PR) approach
to develop two nutrition education resources: a
bookmark style print resource and a website that
combines women's personal stories with information
about food choices, physical activity,
and nutritional supplements. Qualitative interviews
conducted at the conclusion of the project
revealed varied ways in which all participants
valued and used the final resources in their
personal and professional lives. Reflective examination
of the benefits obtained from, and
challenges encountered in, this project suggests
that a PR approach may have limited applicability
in professional practice-based settings due to
increased demands on time. However, adopting
key elements of a PR approach by engaging in
inclusive and collaborative activities with intended
users of nutrition services may benefit
nutrition professionals‟ practice of developing
nutrition education resources.
The lived experience of the person at home
following admission of their spouse to an
aged care facility: A work in progress report.
Lisa Hee
Queensland University of Technol-

ogy
The aim of this presentation is to inform the
audience of a study that identifies the lived
experience of people whose spouse has been
admitted into an aged care facility for permanent
care. A hermeneutic phenomenological
approach will be utilised, underpinned by the
work of phenomenologist Martin Heidegger
(1889-1976). In Australia the Australian Bureau
of Statistics (2008) reveal that in 2003 there
were 2.5 million carers of whom, 18 %
(452,300) were aged 65 years and over. 83% of
these older carers are caring for a spouse. It has
been estimated that carers save the Australian
economy $16 billion annually. Their role in the
community is vital as they play a substantial
role in terms of physical, social and economic
needs for the current and future ageing population
of Australia. This trend is likely to be an
international one due to the growing ageing
population throughout the world. The United
Nations has identified that by 2050, the number
of older persons in the world will exceed the
number of young for the first time in history.
Little is known about carers who face enormous
challenges and changes to their existence once
their spouse is placed into an aged care facility.
This study will aim to inform carers, care staff
and other key stakeholders of new knowledge
gained from the perspective of the carer, to
better inform practices relevant to the carer.
This presentation will report progress of the
study including results from initial interviews
held with the carers.
Transitioning of Internationally Educated
Nurses (IENs) into the Alberta Health System
Gina Higginbottom
University of Alberta
Shirley Mogale
University of Alberta
Australia, Canada, the USA and the UK have
sought to redress nursing workforce deficits via
recruitment of IENs. Alberta Health Services
recently undertook recruitment drives in Australia,
India, the UK and the Philippines, and the
ethics of such recruitment drives are complex.
The IENs from these countries face challenges
regarding their transition into the new ethnocultural
setting. In order to understand these
challenges, a focused ethnographic study located
within the interpretive paradigm was
conducted. The study‟s aim was to understand
and explore in detail the transition of IENs into
the Alberta health system. Twenty two IENs
were recruited as participants for this study
through purposive sampling. Data were ob-
tained through semi-structured interviews which
were held twice, at 3 months, the initial stage of
transition, and at 9 months, when the IEN was
becoming more familiar with the new cultural
context and health care delivery systems. Key
preliminary constructs from the semi-structured
interviews include: discrepancy between nurses‟
expectations and reality, multi-factorial barriers
during transition, communication breakdowns at
recruitments stages, and discriminatory practices.
The semi-structured interviews will be
followed by ethnicity-specific focus group
interviews, with the intention of sharing and
validating the key constructs emerging from the
semi-structured interviews and to further explore
the issues. Individual interviews with keystakeholders
have been conducted. The results
will help optimize policy development regarding
recruitment of IENs, and establish the professional
and personal support mechanisms that
are necessary for a smooth transition of IENs
into the Canadian health care system.
Beliefs and Practices of Expert Respiratory
Care Faculty on Critical-Thinking Learning:
A Case Study
James Hulse
Oregon Institute of Technology
The development of critical-thinking skills
during the professional training of respiratory
therapists is imperative for good practice. This
qualitative, single case-study identifies criticalthinking
strategies and beliefs incorporated by
the faculty in an academically strong program.
These include faculty passion, well-planned
curricula and tying clinical experiences to classroom
instruction as important motivational
factors for students. Faculty believe the best
teaching strategies involve the students in
“learning by doing” activities that keep the
students from developing an excessive dependence
on them for learning. These activities
include problem-based learning and techniques
philosophically consistent with cooperative
learning such as presentations in class, organizing
and providing peer teaching, peer evaluation,
and classroom discourse. The development
of critical thinking is enhanced when program
characteristics include adequate numbers of
faculty, when instructors hold a graduate degree,
and when substantial program prerequisites
and high admissions standards are enforced.
The role of the student and faculty in the
development of critical thinking is represented
metaphorically in a mathematical equation that
describes the relationship between factors that
govern nutrient exchange where mother and
child meet in the placenta. The development of
critical thinking results from the successful
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implementation of sound beliefs. An effective
respiratory therapy learning environment has
key features that correlate with those described
by social learning theorists as occurring in the
zone of proximal development. In addition to
learn-by-doing strategies and techniques, faculty
must focus on the motivation they supply as role
models, and program characteristics.
Analyzing Evidence Hierarchies in Obesity
Recommendations with a Complex Systems
Lens
Lee Johnston
Simon Fraser University
Carrie Matteson
Simon Fraser University
Diane Finegood
Simon Fraser University
Recent reports to and by governments have
produced long lists of recommendations to
address childhood obesity. These recommendations
are based on various levels of evidence
including research, expert opinion and community
stakeholder engagement. A means of understanding
the relative contributions and relationships
between multiple recommendations,
sources of information and divergent evidence
bases used to create action agendas may help
decision makers effectively set priorities and
optimize resource investments.
We applied our complex systems intervention
level framework (based on Meadows‟ places to
intervene) to 170 recommendations made to
fight obesity in Canada and the United States.
Data were coded by two researchers according
to the 5 levels of our intervention framework:
paradigms, goals, system structure, feedback
loops and structural elements. The coded data
were then analyzed according to the level of
evidence on which the recommendations were
based.
Inter-coder agreement was high (98%). Most
recommendations (79%) were classified at the
lowest level as „structural elements‟, 8% were
identified as „goals‟, 5% as „feedback‟ and 4%
as „system structure.‟ Only 1 recommendation
was considered at the highest level of
„paradigm.‟ In strictly evidenced-based reports,
nearly all recommendations were at the structural
element level, whereas reports informed by
stakeholder engagement had a greater distribution
of recommendations at higher levels (20-
50%). The strengths and limitations of our
methodology for understanding this relationship
and the subsequent implications for solving
complex problems will be discussed.
Trust and Functionality: Key Themes for a
Personal Health Record for Prevention
J. William Kerns
Virginia Commonwealth University
Anton Kuzel
Virginia Commonwealth University
Alex Krist
Virginia Commonwealth University
Dan Longo
Virginia Commonwealth University
On average, Americans receive only half of
indicated preventive services due to a host of
patient, clinician, and system barriers. To assess
factors related to use/non-use of MyPreventive-
Care.net (MPC), a highly sophisticated prevention-focused
interactive personal health record
designed to promote 18 U.S. Preventive Services
Task Force-endorsed services, we conducted
a descriptive interpretive analysis of
transcripts and field notes from focus groups of
14 MPC users, 14 who were invited but who did
not use MPC, and 7 clinicians, from 8 practices
in the Virginia Ambulatory Care Outcomes
Research Network (VACORN). MPC gave
patients direct access to the information stored
in the electronic record of their primary care
clinician, displayed tailored recommendations,
provided links to online educational resources,
and generated patient and clinician reminders.
The major themes were Trust and Functionality.
Subthemes for Trust included Information Security,
Information Accuracy, and Clinician Trust
(based on patient-clinician relationships) for
information verification/interpretation and direction/advice.
Patient-clinician relationships
were crucial for Trust, and Trust was key for
registration and acceptance of information accuracy.
Functionality subthemes included Expectations,
Benefits, Problems, and Suggestions.
Additionally, patients want/expect medical
technological interventions to be both state-ofthe-art
and comprehensive.
While MPC has been shown to promote patient
self-management and to extend clinician care
outside of standard office encounters, its use by
patients is not only directly related to functionality,
but is also intimately linked to trust, based
in large part on patient-clinician relationships.
Experiences 'in the field': Analysing, explicating
and reconciling tensions between participatory
qualitative and 'standardized'
quantitative approaches to research
Koushambhi Basu Khan
University of British Columbia
Alexandra Mann

University of British Columbia
Joyce Lui
University of British Columbia
Lynam M. Judith
University of British Columbia
Qualitative and quantitative research methodologies
draw upon different assumptions about
knowledge and the questions they seek to examine
have different, but not incompatible, goals
and aims. The quality of any research study is
dependent upon the quality of the research data
gathered. Therefore, attentions to the processes
of data gathering and factors that potentially
influence participants‟ engagement with research
are important considerations.
This poster aims to illustrate some of the methodological
challenges faced in a three year
mixed methods research study, Social Pediatrics
Initiative (funded by CIHR), that incorporates
different methodological approaches to explicating
and tracing the development of an innovative
community based model of integrated
health care practice with marginalized populations
living in a poor neighbourhood. It aims to
bring to the fore the challenges and tensions of
enacting two diverse methods: 1) qualitative
participatory interviews conducted from a critical
theoretical perspective, and 2) the administration
of standardized survey questionnaires.
Although researchers may take up different
methodological approaches within the same
research programme, in this study we share
insights gained as we sought to be „true‟ to the
tenets of each methodological approach as they
were enacted.
We draw upon field data and reflections of
research assistants who conducted interviews
and surveys with vulnerable populations in the
field. The analysis illustrates the combination
of skills and knowledge needed in order to „do‟
mixed methods research, the processes that need
to be put in place to support the research endeavour
and additionally offers insights to inform
research „with‟ vulnerable populations.
The Experience of Female Street Sex Workers
Laura Klubben
University of British Columbia
Using a phenomenological methodology and a
participatory approach, I will explore the experience
of being a female street sex worker in
Vancouver‟s Downtown Eastside. The field of
counseling psychology could largely benefit
from this study because we currently know little
about the experience of being a female sex
worker (FSW) and having this knowledge
would largely enhance counselors‟ abilities to
develop appropriate therapeutic approaches so
that they could work with this population more
effectively. A major problem to consider when
researching an underserved population like
FSWs is how to research such a group in a way
that benefits the participants in addition to the
researcher. Thus, I intend to “hire” 5-6 FSWs
aged 19 and above to be both my research assistants
and my participants. As my participants,
they will tell or write about their experience of
being a FSW and, as my research assistants, we
will collaborate to determine the common
themes or the essence of being a FSW. In the
end I plan to not only publish a version of this
study in a more literary form so that those FSW
who are literate could read the narrative, but,
also, since many FSWs are illiterate, I would
like to audio record my publication and distribute
the recordings to agencies that work with
FSWs. I believe that FSWs could benefit from
hearing others‟ stories by possibly being able to
understand more about their lives while perhaps
seeing connections between their thoughts and
experiences and those of others‟.
An Evaluation of the Bravery Beads Program:
Perspectives from Children and Adolescents
with Cancer and their Parents
Donna Koller
Ryerson University
The Bravery Beads Program allows paediatric
oncology patients to collect beads to form a
necklace. Each bead represents a particular
medical procedure or event during their cancer
experience. The necklace enables children and
families to tell their story in a tangible and
visual way. Despite the growth of these programs
worldwide, there are no studies which
evaluate the program by directly accessing the
views of children and families in oncology. The
purpose of this study was to explore and evaluate
the psychosocial impact of the Bravery
Beads Program from the perspectives of children
with cancer and their parents. Participants
included: (1) children with cancer currently
involved in the Bravery Beads Program (ages 5–
18; N=8) and (2) their parents (mothers; N=8).
Participants were recruited from the Haematology/Oncology
program. McCracken‟s (1988)
well-established in-depth interview method was
used. Accordingly, participants were provided
the latitude to convey experiences and perspectives
relative to their developmental level, linguistic
uniqueness and priorities. For the majority
of children and parents, the beads provide a
valuable reminder of the cancer journey and
transcendental meaning, one that changes over
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time and increases in value as children grow
older. To assist in improving the delivery of the
Bravery Bead Program, recommendations were
provided by both children and parents. This
research can inform best practices, as a variety
of different disciplines including nursing are a
part of this program. As well, it can contribute
to the literature on psychosocial interventions in
paediatric oncology.
Client Hope in Early Counselling Sessions
Denise Larsen
University of Alberta
Rachel Stege
Hope Foundation of Alberta
Hope is one of four common factors considered
to account for the majority of client change
regardless of the counselling approach employed
(e.g., Hubble & Miller, 2004). Further,
major counselling approaches often claim hope
as an important factor without identifying how
client hope is effectively addressed (Larsen &
Stege, in press). Part of a larger project on hope
in the counselling process, this study employed
basic interpretive inquiry to examine where and
how clients experienced hope during early
counselling sessions (sessions 1-3). In this
study, ten clients were interviewed individually
(using Interpersonal Process Recall [Larsen,
Flesaker, & Stege, 2008]) while viewing a
videorecording of their recent counselling session
(n=5 psychotherapists). During these interviews,
clients identified interventions that impacted
their sense of hope. Results suggest that
clients experienced hope in various ways. Experiences
of low hope were confined to sharing
their problem stories. Hope-fostering experiences
were clearly linked to (a) aspects of a
strong therapeutic relationship, (b) interventions
that invited clients to (re)view themselves as
worthy human beings with purpose and capacity,
and (c) shifts in perspective that expanded
clients‟ understandings of situations, leading to
a sense of new options and possibilities. In
keeping with the trans-theoretical perspective of
common factors models, interventions experienced
by clients as hope-fostering were eclectic
in nature. Further, therapeutic relationship and
hope were intimately entwined experiences for
participants. Implications for practice and further
research will be discussed.
Living within an emancipatory curriculum:
An ethnomethodological inquiry.
Maureen Makepeace-Dore
University of British Columbia
Okanagan
Historically, nursing education has been delivered
using models focused on training rather
than educating students to critically know, be
and do in nursing. One particular nursing curriculum
termed "emancipatory", is meant to
liberate both students and faculty from the authoritarian
restraints of empiricist and behaviorist
models. This curriculum is based on the
philosophical tenets of critical and feministinformed
pedagogy. Students and faculty interact
within a climate of empowerment and emancipation
which supports empowered learning,
thereby facilitating clients to make informed
choices for their own health care. Critique and
praxis (reflection-in-action) are the processes
used to grapple with underlying assumptions
which can perpetuate tradtional practices leading
to injustice and the hegemony that helps
maintain the dominant dogmas in society.
This inquiry involves the exploration of how
nurse educators live within this emancipatory
curriculum. Ethnomethodology informed by a
critical feminist lens will be used to clarify their
experiences. How do nurse educators socially
construct their everyday knowledge as commonsense
understandings to help them make sense
of their realities?
Accessing the meanings tied to contexts in
which nurse educators teach can be explicated
by understanding their actions. Working with
the meanings nurse educators construct, resist or
dismiss about their worlds will facilitate a more
comprehensive understanding of the experiences.
Tensions, contradictions and ideological
influences implicated in the enactment of critical
pedagogical approaches may be illuminated
during the process.
Mental health service user perceptions regarding
sexual and relationship need
Edward McCann
Trinity College Dublin
To date, very few empirical studies exist that
investigate sexual and relationship issues and
people who experience enduring mental health
problems and less attention has been paid to the
personal accounts of clients in this respect. The
present study, carried out in the UK, involved
thirty people who were asked about past and
present relationship experiences and elicited
hopes and aspirations for future sexual and
relationship needs. A semi-structured interview
schedule was constructed that specifically addressed
potential sexual and relationship concerns
and was conducted face-to-face. The aim
was to capture in-depth perspectives of people
with a medical diagnosis of schizophrenia regarding
intimate relationships. Following data

analysis, categories and sub-categories emerged
and were systematically organised . The key
categories included: perceptions of intimacy,
establishing and maintaining relationships,
sexual concerns and issues, sexual knowledge
and understanding, stigma and self-esteem,
family planning and parenting, views about
prescribed medication, formal and informal
supports,. The results of the study showed that
people are willing and able to articulate
thoughts, feeling and beliefs in the area. The
findings are presented and the implications in
terms of mental health practice, education and
research are highlighted.
Improving the Quality of Diabetes Care:
Exploring the Perspectives of GPs in Ireland
Sheena Mc Hugh
University Colleg Cork
Monica O'Mullane
University College Cork
Ivan J. Perry
University College Cork
Colin Bradley
University College Cork
The aim of this study was to explore GPs‟ experiences
of providing diabetes care and their
thoughts on the factors affecting its development.
Semi-structured interviews were conducted with
a purposive sample of 30 GPs was selected
based on 3 sets of inclusion criteria; (a) location
(rural/urban), (b) computerised/noncomputerised
practice, (c) single-handed/group
practice. The topic guide was informed by findings
from a preceding national survey on the
organisation of diabetes care. Analysis was
conducted using a pragmatic approach drawing
on the Framework method.
Preliminary analysis has identified convergent
and divergent themes. There were dissimilar
attitudes as to how diabetes care should be
integrated between primary and secondary care
settings. The locus of care varied across participant
experiences from primary care-based management
to supplementing hospital-led care.
Lack of access to auxiliary services and resources
were among the common barriers to an
effective community-based service. Those GPs
who had developed a structured approach to
diabetes care tended to do so as a „labour of
love‟, often without direct recompense. There
were mixed attitudes towards the development
of a national register with some questioning its
use and benefit at a practice level. A number of
GPs felt a national register should to be tailored
to meet the needs of health professionals and
patients, and not solely used as a research tool.
There was ambivalence towards efforts to im-
prove care based on previous experience in the
Irish health setting. GPs would like to see the
development of regional based clinics in the
future and hoped for greater recognition of the
contribution of general practice to diabetes care.
Preliminary findings suggest a typology of care
models exist in Ireland with varying levels of
involvement by GPs and diverse access to services.
There were tentative attitudes towards
quality improvement initiatives including the
establishment of a register suggesting a sense of
inertia towards organisational change. Extending
high quality care to all patients with diabetes
can no longer rely solely on the interest of care
providers and may require commitment to systems-level
change.
A Needs Assessment of Cancer Survivors at
Fox Chase Cancer Center
Bonnie McIntosh
West Chester University
Stacie Metz
West Chester University
Andrea Barsevick
Fox Chase Cancer Center
This preliminary study aims to evaluate the
needs of breast, lung, prostate, or colorectal
cancer survivors treated at Fox Chase Cancer
Center (FCCC). Cross-sectional, confidential
and voluntary surveys that assessed topics of
concern for cancer survivorship were administered
at FCCC to: (1) cancer survivors with a
diagnosis of lung, breast, prostate, or colorectal
cancer and; (2) health care professionals treating
lung, breast, prostate, or colorectal cancer survivors.
To obtain sample characteristics, health
history sheets were administered to cancer survivors;
whereas, professional assessment sheets
were administered to health care professionals.
Focus group discussions were conducted with
cancer survivors and health care professionals;
however, one-on-one interviews were conducted
with participants who were unable to attend the
focus groups.
The majority of the health care professionals
(n=10) were White (90%), female (70.0%), and
working in their field for at least five years
(100%). Whereas, the majority of the cancer
survivors (n=25) were White (59.1%), female
(54.5%), married (84.2%), and holding a college/graduate
education/degree (36%). Recurrence
of metastasis, genetic issues, long-term
effects of chemotherapy, and pain management
were similar top concerns shared between both
groups. Cancer survivors expressed a strong
concern for financial issues; whereas, health
care professionals expressed a strong concern
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for insurance issues. Physical and occupational
therapies, as well as complementary and alternative
medicine were services that were desired
from both groups. Additional topics of concern
were expressed between cancer survivors and
health care professionals. Results extracted from
this assessment will be used to guide clinical
care for cancer survivors at FCCC.
Pictures of Connection and Autonomy
through the Lens of Adolescent Girls with
Disordered Eating
Colleen McMillan
McMaster University
The spoken word represents only one avenue in
which to capture the meanings and lived experiences
of adolescent girls with disordered eating.
This research used photo voice as one of several
modalities to elicit what the meanings of connection
and autonomy meant to girls aged 11 to
14 identified as at risk for the development of an
eating disorder by family physicians.
Disposable cameras captured the complex,
contradictory and multiple meanings woven into
the concepts of connection and autonomy as
experienced by these girls over a 4 month timeframe.
In several instances, the camera became
the voice of the participant, suggesting the fragility
of the spoken word. Connection was experienced
as tenous and embedded with food.
Another research outcome was the degree of
empowerment the camera offered to these girls.
The camera assigned ownership to the otherwise
silenced voice. In this way, images spoke the
unspoken.
Ongoing member check ensured trustworthiness.
It also revealed spaces that verbal questions
had failed to reach. The girls' increased
sense of agency over the course of the research
resulted in a photo exhibition that the girls organized.
Employing photo voice supported these girls to
pictorally speak of their experiences of connection
and autonomy in a safe and non judgemental
way and how these concepts relate to
disordered eating. Had only verbal methods
been used, important stories may have remained
marginalized, perhaps lost in translation. Thinking
outside of traditional methodologies extends
the possibilities of understanding populations
where language may have failed to convey
important messages.
Construction and Analysis of a Communication
Tool for Obese Patients
Thomas D. Merth
Simon Fraser University
Carrie L. Matteson
Simon Fraser University
Diane T. Finegood
Simon Fraser University
Support tools have been used to aid communication
and treatment decision-making between
patients and clinicians. Limited work has been
done that specifically addresses obesity. This
project will create a card based tool for use by
patients and clinicians that addresses an individual‟s
challenges in making healthy lifestyle
changes. The goal of informing patients about
the complex causes of their obesity is to increase
self-efficacy, which may lead to greater
success in making behaviour changes.
Cards will be developed with statements which
represent the complex causes of obesity based
on the Foresight Obesity System Map and a
literature review. Participants will complete
semi-structured interviews and report perceptions
about the causes of their obesity and what
they need to change. The deck will be reviewed
with subjects to highlight the range of variables
implicated in obesity. Participants will select
cards which specifically address their situation,
enabling them to focus behaviour changes on a
manageable set. Self-efficacy will be assessed
before and after the presentation of the cards. A
variety of qualitative methods are being explored
for analysis of the semi structured interview
data.
This tool may raise self-efficacy in obese patients
and lend better insight towards which
factors in their lives need change. Participant
feelings and beliefs associated with the exercise
will aid in improving the tool. The cards may
help individuals set priorities and goals, and
may serve as a tool to help them surface which
issues in a complex and sometimes overwhelming
environment are salient for them.
The perceived psychosocial consequences of
the invisibility of rheumatoid arthritis in
young adults
Sarah Minton
University of British Columbia
Rheumatoid arthritis (RA) can cause visible
physical changes, but often causes only invisible
chronic pain, stiffness, and fatigue that result in
disability. The invisibility of RA can have
traumatic emotional, psychological, and psychosocial
consequences. The purpose of this study
is to explore the psychosocial consequences of
the invisibility of RA as perceived by young

adults. Three female participants were interviewed
about their social experiences of living
with RA. A semi-structured interview guide
that included overarching themes of disability,
identity, stigma, and concerns was utilized.
Preliminary data suggests that participants face
difficulties in deciding when to disclose or not
disclose their condition, experience struggles in
living with an invisible condition, and in particular,
express concern about their future abilities
to become pregnant and care for children.
At the end of the interview, all of the participants
offered recommendations for improving
care for young adults with RA.
An Exploration of the Culture of Prosecuting
Violence against Women (VAW) in South
African Courts when the Health Record is
part of the Evidence
Shirley Mogale
University of Alberta
In developed countries like Canada, policies
addressing violence against women (VAW) are
geared towards the response of the criminal
justice system to the crime. In developing countries,
such as South Africa (SA), however much
are needed regarding policies that direct the
culture of prosecuting of VAW crimes within
the criminal justice system. The purpose of the
study is to explore the culture of prosecution of
VAW in SA when the health record is part of
the evidence. Sensory ethnography is the
method of choice. Data will be gathered using:
observation of the prosecutors when prosecuting
VAW cases, conversations with the prosecutors
in order to explore the culture of prosecuting
VAW, and analyzing relevant documents which
are used in prosecution of VAW cases. The
documentation of the sensory perceptions and
receptions will happen simultaneously with data
analysis. This will involve the analytic processes
of identification of domains, making taxonomy,
and componential analyses. Gaining
insight into the prosecution of VAW will provide
a scholarship that will enable nurses, as the
co-creators of the health record, with the necessary
knowledge require for it to be used as
evidence in courts. The scholarship will also
inform the policymakers in formulation of
policies in which the health record will be
endorsed as key evidence in prosecuting of
VAW cases.
"WALKING THE ROPE": Pakistani Children's
Experience of Growing up with Thalassemia
Major
Gul e Rana Mufti
University of Westminster
Tina Cartwright
University of Westminster
Tony Towell
University of Westminster
Thalassemia major, a hematological disorder,
imposes major demands on children, however,
we know little about their lived experiences.
Previous predominantly quantitative studies
have produced conflicting findings regarding
the impact of thalassemia on psychological
functioning and quality of life. This phenomenological
qualitative study viewed children as
social agents and aimed to understand their
experience of thalassemia major. This study
employed a sample of twelve children aged 8
to12 years living in Multan, Pakistan. Data
collection included focus groups, role-plays and
in-depth interviews, which were subjected to
Interpretative Phenomenological Analysis
(IPA). Findings suggested that the experience of
thalassemia hovered between two phases: a
“being different” phase dominated by pain and
restrictions, and a “sense of normalcy” phase
reflective of a self reformulation process and
integration of limitations. The move between
phases depended on children's struggle to
“minimize differences” which consisted of
various avoidance and acceptance based coping
strategies. Maintenance of the normalcy phase
required a constant struggle; any disruption
resulted in a shift towards „being different‟
phase. Disruptions were mostly due to uncontrollable
contextual factors and problems with
support system; however children sometimes
chose to be different to gain potential benefits
e.g. health care, special treatment and emotional
release. The dynamic nature of experience contrasts
with the linear progressive approach and
may account for the conflicting findings regarding
psychological functioning. Information
about current dominant phase and an understanding
of coping strategies and intervening
factors may help parents and professionals to
identify phase specific issues and provide appropriate
support and care.
Epilogue of an Autoethnography
Lee Murray
University of Saskatchewan
The autoethnography regarding my "secrets of
mothering" is never over; it is never finished.
Every day is another story. And stories bring
possibility and hope. Stories break the silence
and stories shed a light on secrets. As I reflect
on my dissertation I see my stories differently,
from a new perspective. I reflect on the choice
to use autoethnography as methodology, the
ethics approval process, the academic mom, the
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single mom, the illegitimate mom and see things
in a different light. This paper is an epilogue to
an autoethnographic dissertation. It is an
autoethnographic story looking back on a journey
that is bitter sweet in its ending. Of course,
it feels wonderful to be at this point of completion
in my work. However, it also means an
ending to my regular meetings with my cosupervisors.
And at the moment, the sadness
related to the ending overshadows the joy of
completion. I am wondering if this dissertation
is an ending or merely a beginning. The presentation
of the epilogue includes narrative reflection,
photos and audio-visual representation.
The Structure of Life in Narratives of the
oldest old: A Phenomenological Study
Takeshi Nakagawa
Osaka University
Yukie Masui
Tokyo Metropolitan Institute of
Gerontology
Yoichi Kureta
Showa University
Midori Takayama
Keio University
Ryutaro Takahashi
Tokyo Metropolitan Institute of
Gerontology
Yasuyuki Gondo
Osaka University
It is classically known in gerontology that elderly
people relatively maintain their subjective
well-being in the face of objective adversities.
Recently, it has been found that subjective wellbeing
improves with old age and aging, controlling
for related variables. Previous studies suggest
that an unknown developmental perspective
can elucidate subjective well-being in old age.
This study focused on the oldest old, who are
supposed to achieve this development. Descriptions
of their psychological state will help us
explore the developmental process. However,
the lived experience in oldest-old age has not
yet been well described in Japan.
The aim of the study was to describe and understand
the daily life experiences of the oldest old.
Interviews were conducted with 8 oldest-old
individuals: 4 women and 4 men living at home,
able to communicate, and needing physical
assistance. The authors used an interpretive
phenomenological method to analyze these
interviews. We focused on the meanings on
physiological, social, and psychological dimensions
of life, and classified the transcripts of the
oldest old into meaning units.
The following themes emerged from the analysis:
“connectedness,” “nothingness,”
“continuity,” and “creativity.” This means that
life is being connected with the universe, changing
into nothing, finding continuity in a changing
situation, and creating possibilities to act in
various adaptive ways. The authors understood
that an oldest-old individual experiences a subjectively
vital life in an objectively adverse
situation. In future research, a transcendental
perspective could help us understand the subjective
meanings of the elderly and explore the
psychological development in old age.
Student's accessing student health services :
the health professionals perspective
Caitriona Nic Philibin
Trinity College Dublin
College students would appear to have a higher
rate of mental health difficulties according to
some studies. The literature suggests there is an
increased risk of suicide in students however
there is limited research in the Irish context to
confirm or reject this theory.
The current literature surrounding this phenomenon
identifies a number of barriers from
service provision to service accessibility along
with the stigma and societal stressors encounter
by individuals and families with mental health
problems.
From a strategic perspective the Department of
Health and Children Health Strategy has committed
to positive mental health and to contribute
to a reduction in the percentage of the population
experiencing poor mental health. The
strategic aim is to support research and to work
in partnership with the Health Boards and local
communities to bring about positive change in
attitudes and to provide a supportive environment
for individuals who experience mental
health difficulties. This may in part be achieved
by increasing liaison between mental health
services along with integrated and seamless
community care services.
The first phase of this study conducted a survey
with health care professionals in, student health
service settings and student counsellors working
in third level colleges. The study used the Delphi
technique which explored the concept of
how students access Mental Health facilities, the
barriers experienced and how professionals
manage their caseload. The results of the survey
will be presented.
The reconstruction of a profession: a qualitative
socio-historical analysis of medical liability
rulings in Israel
Smadar Noy

Ashkelon Academic College
Ryan DeForge
3
During the last thirty years, the amount of medical
liability claims in Israel has increased dramatically.
Moreover, it seems that rulings are
changing in favor of plaintiffs. In trying to
understand that phenomenon I use thematic and
narrative analysis while carefully reading medical
liability rulings, legal writing and interviews
with lawyers and judges.
The analysis reveals a crucial change
in courts' attitudes toward the medical profession:
while in the 1960s and 1970s, the courts
idealized the medical profession (meaning that
physicians were perceived as a moral community
characterized with a sense of mission and
dedication), since the 1980s, physicians were
usually perceived as technical specialists and
were thus judged by technical and bureaucratic
standards, as well as by customer-service criteria.
In trying to explain these findings, I offer a
socio-historic explanation, locating the judicial
and medical professions in a wider sociopolitical
field of "countervailing powers". I
suggest that the judicial and medical professions,
which were established in Palestine during
the first decades of the 20th century, were
both marginal in the larger power-field. Furthermore,
these two professions shared some common
Ideological, epistemological, social, and
cultural characteristics that connected them. A
change in the power-relations began in the late
1970's. The legal profession gradually strengthened,
and reconstructed itself from a profession
into a central social institution. As part of this
process, courts have begun scrutinizing the
medical practice. Moreover, they have begun
reconstructing the meaning of medical profession
itself.
The Experience of Moral Distress Among
Psychology Interns
Simon Nuttgens
Athabasca University
Over the past ten years an increasing body of
literature has arisen that addresses the experience
of moral distress. As an ethical concern
that runs across many professions, especially
those that involve healthcare and allied professions,
moral distress is described as the experience
of knowing the morally right thing to do,
yet not doing it due to personal, social, or institutional
constraints. Known effects of moral
distress largely come from nursing research
where evidence points to many adverse effects,
including emotional distress, job stress, physical
health concerns, burnout, leaving one‟s job,
leaving one‟s profession, disillusionment, and
cognitive dissonance. Most importantly, moral
distress is known to impede ethical action and
diminish a positive ethical climate, thus increasing
the likelihood of harm to clients/patients.
As such, moral distress is of great concern to
healthcare professionals, administrators, and
consumers alike.
The purpose of the current research (presently at
proposal stage) is to examine moral distress
among psychology interns, a group that is especially
vulnerable to situations of moral distress
given the inherent power differentials that encompass
their role within the practice of psychology.
This poster session will highlight the
existing research and theory that guides the
present research, as well as the proposed methodology
(interpretive phenomenological analysis).
The meaning to nurses of the work process at
the Intensive Care Units of a University Hospital
in São Paulo State
Elaine Oliveira
State of São Paulo University -
UNESP
Wilza Spiri
State of São Paulo University -
UNESP
This study has resulted from the desire to comprehend
how intensive care unit (ICU) nurses
understand their work process. Nurses are the
professionals on the team who concatenate the
construction of live work as a result of their
insertion in the work processes and their articulating
potential on the team. This study aimed at
understanding the meaning to nurses of the
work process at the ICU of a university hospital
in São Paulo state. The methodological trajectory
is qualitative. Phenomenology enables the
search for the essence and understanding of the
meaning of the subjects‟ experience and includes
three moments: description, reduction
and comprehension. Interviews were conducted
by using the following guiding questions: What
is the work process like to ICU nurses? What is
it like to you to be an ICU nurse? The study
subjects were twelve nurses who worked at the
ICUs.The analyses showed four categories: The
work process in providing care/assistance at the
ICU - The work process in managing/
administrating the ICU – The work process in
teaching/educating at the ICU - The personal
dimension of work at the ICU. From the desire
to unveil the meaning of the work process to
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ICU nurses, it was identified that nurses are
fundamental in this process because they interact
with all professionals on the team and coordinate
actions as well as the care given to users.
The study on the work process showed the
complexity of relationships Understanding the
human essence in relationships allows for care
provision considering each individual‟s dimensions.
Preparing for Breastfeeding: Time between
Intention and Behaviour. Insights from a
qualitative study. (this paper is a part of
RIQSHA , Research Initiative in Qualitative
Studies in Health and in Ageing, a collaboration
between UoG and Hanze)
Alberta Oosterhoff
University of Groningen (UoG),
Netherlands & Hanze University of Applied
Sciences (Hanze), Groningen, Netherlands
Hinke Haisma
University of Groningen (UoG),
Netherlands
Inge Hutter
University of Groningen (UoG),
Netherlands
In the Netherlands 81% of the newborn infants
is nourished by mothers‟ milk exclusively. One
month after birth this is 48%. To get insight into
this decrease in the first month, qualitative
research on women‟s underlying motives for
infant feeding practice was conducted. Former
research using the Theory of Planned Behaviour
(TPB) has shown the importance to investigate
breastfeeding intentions (prepartum), the
actual behaviour (starting breastfeeding) and
behavioural continuation (longterm breastfeeding).
This study concentrates on the period
between intention and behaviour.
In a Dutch province data were collected by
qualitative methods. Pre- and post partum indepth
interviews (16) were conducted with 8
primiparous Dutch mothers who intended to
start breastfeeding. The TPB was used as a
deductive conceptual model and all interviews
were analyzed using grounded theory.
Interviewing both in the pre- and post partum
period showed that giving birth is experienced
as a major emotional life event. In between
intention and behaviour, preparation takes place.
Expectant mothers turn out to prepare themselves
more for motherhood and delivery, than
for breastfeeding. A lot of breastfeeding knowledge
is available, but at this preparation stage,
spread is limited. Mothers seem confident that
they will learn from „nature‟ and from maternity
care.
The TPB is a useful model, but breastfeeding is
a specific kind of health behaviour with much
time in between intention and behaviour, and
emotional events at the start. This should be
taken into account in order to eventually facilitate
mothers in their infant feeding choices.
The New Cutting Edge: Sustaining Quality
Care
Mickey Parsons
UT Health Science Center, San
Antonio
Patricia Cornett
Solucion International
The purpose of the study was to identify the
facilitators and barrers for healthcare organizations
to sustain Magnet Hospital Recognition.
Healthcare leaders are challenged to lead complex
organizational systems to fulfill the multitude
of regulatory, patient, and staff expectations
and provide excellent care. Recognition as
a Magnet Hospital by the American Nurses
Credentialing Center is the gold standard for
acknowledging excellence in nursing practice;
and, sustainability is the new cutting edge leadership
requirement.
The research design is qualitative, using
open-ended data-generating questions. A national
convenience sample of fifteen chief nurse
executives (CNOs) was selected from the total
number of credentialed Magnet Hospitals and
they were invited to be interviewed. A sample
question that elicited sustainability was "Please
describe some keys that led to the sustaining of
magnetism in your healthcare organization?"
Pattern coding was utilized to analyze the interview
records.
Fifteen Chief Nursing Officers were interviewed
with broad geographic representation
across the United States. Findings emerged in a
system framework for the macrosystem
(hospital level), mesosystem (departments), and
microsystem (nursing unit). Key facilitators and
barriers at each level were found. Leadership
philosophy and organizational structures supporting
quality care were key drivers.
The findings contribute to nursing and
healthcare leaders' educational preparation and
practice for organizational change and sustainability.
Knowledge of facilitators and barriers to
sustaining Magnet Recognition will further
inform the design of evidenced based organizational
systems and programs supporting a practice
environment that achieves quality patient
care outcomes.
The Experience of Men Managing Fecal
Incontinence
Cynthia Peden-McAlpine
University of Minnesota

Bliss Donna
University of Minnesota
The prevalence of fecal incontinence [FI] in
community-living persons has become increasingly
evident from epidemiological studies
globally. A recent systematic literature review
of population-based studies found that the
prevalence of FI in community-living men
across different age groups (5-8%) was only
slightly less than that in women (7-9%). Little is
known about how men‟s experiences of FI may
differ from women‟s experiences. The aims of
this study of community-living men with FI
were twofold: 1) to understand the experience of
men with FI from the perspective of the men,
and 2) to elicit men's practical knowledge about
self-care and management strategies for FI.
Van Manen‟s phenomenological research methodology
was used for this project. Ten men
were recruited from a sample of prior work on
FI. Unstructured audio-taped interviews were
conducted and transcribed. Data were analyzed
using Van Manen‟s approach to analysis using
the lifeworld existentials lived space, lived time,
lived relationships, and lived body. The findings
demonstrated that men attributed the worsening
of their symptoms to aging and did little planning
to control their FI. Men isolated themselves
and avoided confined spaces because of
concern of offending others with the odor.
Changes in body image and self confidence
were consistently discussed and health care
providers were perceived as being of little help
in providing symptomatic relief. Implications
for nursing practice include formulating questions
to assess the characteristics and nature of
FI and structuring FI intervention and evaluation
parameters that are sensitive to men‟s experiences.
Single, After All These Years... The Impact of
Spousal Loss on Elder Widowers
Kathleen Pepin
Odyssey HealthCare
Coping with life‟s adversities requires strength
of character. Widowhood is no exception. However,
limited evidence exists that fosters understanding
of the needs of men who outlive their
wives. The purpose of this study is to interview
widowed men to try to understand their thoughts
and concerns regarding widowhood.
A qualitative, hermeneutic-phenomenological
study design was used.
A significant level of independence was expressed
by the widowers. Knowledge deficit
concerning the location and availability of community
resources was apparent, particularly
among those participants who eschewed the
rituals of religion. Social interaction and physical
activity were preferred by most widowers,
but each claimed that it was a personal decision.
Of note, many expressed a significant desire for
female companionship that was platonic and
mutually supportive.
There exists support for the independence of
widowers in structuring their lives to suit their
needs. However, for older men who have been
married for a number of years, the absence of
the companionship of their spouses leaves a
void in their lives that they are not always prepared
to fill. A concomitant desire for practical
resources is not always met.
The highly personal and individualized issue of
spousal bereavement yields an abundance of
data supporting the theory of stress in widowers.
While depression was not a significant factor,
further research may more clearly support its
absence. In addition, the caveat of the potential
relationship between positive bereavement
practices and successful or happy marriages
warrants exploration.
Migration, minorities and maternity services:
a three country international comparison
Sarah Salaway
Sheffield Hallam University
Birgit Reime
Max Rubner Institut
Gina Higginbottom
University of Alberta
Heinz Rothgang
University of Bremen
Kate Gerrish
Sheffield Hallam University
Jule Friedrich
German College of Midwives (Bund
Deutscher Hebammen)
Herbert Kentenich
DRK Kliniken Berlin
Beverly O-Brien
University of Alberta
Kuldip Bharj
University of Leeds
Punita Chowbey
Sheffield Hallum University
Zubia Mumtaz
University of Alberta
A collaborative research team from three countries
– Canada, Germany and the UK – undertook
preliminary studies to gain understandings
of and develop conceptual and methodological
frameworks for comparing maternity care services
as provided for and experienced by migrants/minorities.
The objectives were to establish,
a) a comprehensive conceptual framework
informed by the three countries, b) a detailed
methodological approach to achieve meaningful
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comparison and operational feasibility across
settings, and c) an explicit operational structure
enabling effective collaboration and active
involvement of policy-makers, practitioners,
and users/consumers. A review of key policy
documents and published literature, and econsultation
with selected experts, provided for
exploration and documentation of relevant
terminology and theoretical concepts. Consultation
within practice settings and user groups,
three country-specific workshops, and a jointcountry
symposium (in Berlin, Germany) generated
substantial insights into the phenomena and
provided guidance for comparative study across
diverse settings. Several understandings were
found to be instrumental for guiding frameworks:
similar challenges of maternity service
exist despite contrasting policy and practice; a
qualitative meta-synthesis will be appropriate
for some countries offering adequate literature
bases (UK and Canada), yet comprehensive
qualitative study will be necessary to gather data
from others (Germany); and effective mechanisms
to engage service users, practitioners, and
academic advisors will enhance methodological
contributions (e.g. pertinence of research questions).
This preliminary work suggests that there
is significant potential for cross-country learning,
although at present the availability of quality
data and detailed understandings of migrant/
minority maternity experiences and outcomes is
shockingly absent across all three countries.
Content analysis of male senior nursing students'
perspectives regarding how they decided
to choose and continue nursing career
Mahvash Salsali
Tehran University of Medical Sciences
Mojtaba Vaismoradi
Tehran University of Medical Sciences
It seems unwise to employ various resources to
admit and educate nursing students and let
trained nurses leave after graduation and have
no plan to preserve the investment. In this regard,
male nursing students form the major part
of the concern in spite of nursing staff shortages.
As a first step to face the challenge, root
causes of leaving nursing should be sought from
students†perspectives. This study aimed to
explore male senior nursing students' perspectives
regarding how they decided to choose and
continue nursing career in Iran.
The design was a qualitative study using content
analysis approach. Through purposeful sampling,
14 senior male nursing students were
chosen. Semi-structured interviews were held
for data gathering.
Two main themes and four sub-themes emerged
from the data. The first theme was 'social unfamiliarity
with nursing' that with its two subthemes
as unreliable sources of information and
reality shock showed the unfamiliarity of public
with nursing. As the second theme, 'blurred
career continuance' was related to the students
plan to leave or continue nursing career in the
future. Its related sub-themes were: economic
vs. social preferences and assured selection but
unsupported made decision.
Some factors such as nursing image in public
and nursing education policies greatly influence
male nursing decision to apply for or leave
nursing career, which should be addressed in
designing any future strategy of alleviating
growing concern of nursing staff shortages.
From confinement to freedom of living: revealing
the life stories of those leaving a psychiatric
hospital
Hudson Santos Junior
University of São Paulo
Natália Salim
University of São Paulo
Dulce Gualda
University of São Paulo
Psychiatric Reform is an internationally discussed
issue. Its greatest challenge is to reconfigure
the instruments that assist bearers of
psychic disorders, in their fight for social inclusion.
This study sought to understand the meaning
they attribute to the experience of mental
disturbance and having undergone a deinstitutionalization
process. This is an ethnographic
study in which five collaborators, discharged
from a psychiatric hospital, participated. They
currently receive care in the alternative mental
health network in Campina Grande, Paraíba,
Brazil. Data were collected by oral history interview,
participant observation and field diary.
The results are structured into cultural categories
that depict events at different stages of the
collaborators‟ lives, in which mental suffering
arises with several facets. There are indications
of dehumanization in the asylum model and of
the tendency to alternative community-based
care. It can be stated the methodological approach
used, inserted into their social environment,
was an important source for capturing
their personal history and let everyday broader
socio-cultural contexts of its members‟ histories
and representations be understood. Besides
giving voice to the collaborators, so they might
share their life stories, they became aware of
their own experience of the illness and the transformations
they are experiencing. Such data
prompt reflection on psychiatric care, which

may make producing more congruent care viable.
Understanding the Manitoba Medical Licensure
Program for International Medical
Graduates (MLPIMG): Exploring Accreditation
Gap, Barriers, and Multiple Mentoring
Bosu Seo
University of Manitoba
Sukhoe Choe
University of Minnesota
The access of International Medical Graduates
(IMGs) to the Canadian physician workforce
has been a central issue in both health and immigration
policy. Recognition of the foreign
credentials of immigrants to Canada has been
particularly controversial in the case of physicians.
While many contend that IMGs face
artificially-constructed barriers created by the
profession, others emphasize the concern with
the quality of their training.
MLPIMG is a one-year program designed to
enhance the training of IMGs and then provide a
provisional license for work in an underserviced
rural/remote community. It admits
around 20 IMGs each year. However, there is
limited information of how IMGs appraise the
program and what extent they experience barriers
to enter it and provide practice after graduation.
Mentoring has been widely used in many organizations
and acknowledged as a valuable
tool for retaining employees and promoting
career success. In Canada‟s dynamic and diverse
healthcare environment, having a variety
of different types of mentoring relationships that
are comprised of both intraorganization and
extraorganization networks, multiple mentoring,
is perhaps indispensable to IMGs.
We propose to conduct semi-structured interviews
of recent IMGs to understand what and
how they encounter during and after MLPIMG
and how multiple mentoring help them to assimilate
in the profession. Interviews will be
digitally recorded and transcribed in verbatim.
NVivo 8 will be used for an analysis. We are
recruiting physicians who have participated in
MLPIMG since 2007, with the support from
CME in the University of Manitoba. Preliminary
results will be presented at the conference.
Perceptions and Misperceptions of the Anesthesiologist's
Role in Labour and Delivery:
Implications for Quality and Safety
Saroo Sharma
University of Toronto
Patricia Houston
University of Toronto
Pamela Morgan
University of Toronto
Scott Reeves
University of Toronto
The Institute of Medicine's Report, To Err is
Human, states that in order to identify error,
each team member needs to know their own
responsibilities as well as those of their team
members. Although anesthesiologists work in
diverse environments ranging from the operating
room to the labour and delivery (L&D)
suite, their role is often misperceived.
Obstetric reports clearly demonstrate that poor
interprofessional teamwork is a major cause of
adverse maternal and fetal outcome. Literature
from this domain, however, tends to concentrate
on nurse-obstetrician communication. There are
no studies looking specifically at the perceptions
and misperceptions of the anesthesiologist's
role, and how these may affect collaborative
working and patient care.
This study uses a case study approach to focus
on exploring the perceptions of L&D professionals
regarding the role of the anesthesiologist.
The cases are two L&D units, which represent
typical urban, academic L&D units across
Canada. A purposeful sample of 30 participants
has been used to ensure adequate representation
from all professional groups. Data collection is
on-going via semi-structured interviews. Similar
proportions of anesthesiologists, obstetricians,
nurses and midwives are being interviewed
at each site. Following inductive thematic
analysis member checking will be employed.
Emergent themes centre around: a fundamental
lack of understanding of the complexity of the
anesthesia process; fear of other professionals,
due to engrained stereotypes; a perceived lack
of support; the need for the anesthesiologist to
be in'control' of the clinical work situation; and
power imbalances which are enacted both
within and across professions.
Stories from Vietnam
Debbie Shelton
Arkansas State University
Many studies exist that support Posttraumatic
Stress Disorder (PTSD) amid returning veterans
from war. From past terms of "shell shock" and
"combat fatigue", the term PTSD has risen to
describe the effects of combat on soldiers who
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have experienced traumatic events related to
warfare. Traumatic events may include an
actual or potential threat to one's physical or
mental well being. Up to 15% of soldiers returning
from the Vietnam War, Persian Gulf
War and Iraq War present with PTSD compared
to 1% in the general population confirming that
involvement in wartime activities significantly
increases the risk of PTSD. Veterans from the
Vietnam War bridge the gap between the first
appearance of the disease process and the common
occurence that is now widely discussed
among war suvivors. In this grounded theory
study, I will analyze taped interviews of Vietnam
infantry veterans with self-reported PTSD
who saw combat in Southern Vietnam between
1968 and 1972. The interviews will take place
during their annual reunion. Informed consent
and issues of confidentiality will provide unique
challenges as the numbers attending the reunion
are smaller each year. The purpose of the study
will be to discover the veteran's process of identifying
their own early behavioral changes that
they viewed as abnormal personality characteristics
and what led them to seek symptom relief.
Results of the pilot study will be presented.
Ultimately, the results will be utilized to assist
Vietnam veterans in identifying symptoms of
PTSD and helping them find treatment.
Patient Perspectives of Tobacco Use Management
in Smoke Free Grounds Hospitals
Nicole Shopik
University of Alberta
Annette Schultz
University of Manitoba
Candace Nykiforuk
University of Alberta
Margie Kvern
Winnipeg Regional Health Authority
Barry Finegan
University of Alberta
Smoke free hospital grounds are the newest
strategy to address tobacco use within health
care settings. Protection from second-hand
smoke is the primary goal of these policies,
which commonly include a provision of additional
resources to address tobacco dependence
during hospitalization. Anecdotal evidence
suggested patient‟s tobacco dependence was not
being addressed. In this study we explored
patient perspectives of how tobacco use is managed
within hospitals with smoke free grounds
policies, which uncovered unintended policy
consequences. This qualitative descriptive study
is part of a larger study conducted at two Western
Canadian tertiary hospitals. Findings draw
on 82 semi-structured interviews with patients
(44% current, 37% former, 19% never smokers)
to explore experiences and expectations related
to tobacco dependence during their hospitalization.
Study results suggest that assessment of
smoking status was inconsistent, withdrawal
symptoms were inadequately addressed, there
was limited to no support for cessation efforts,
when patients left the hospital to smoke there
were significant patient safety and mobility
concerns identified, and a lack of policy enforcement.
In an absence of clear tobacco dependence
treatment protocols, beyond the availability
of nicotine replacement medications, the
proactive policy intentions of addressing tobacco
dependence are unachieved and patients
are exposed to significant risk. It is imperative
that hospitals and health authorities build capacity
among medical staff to effectively address
this unintended consequence. With this affirmative
action, health providers can capitalize on
the teachable moment that hospitalization offers
for tobacco intervention.
Writing An Effective "Methods" Section for
Research Proposals: Bettty Crocker Has the
Recipe
Jeffrey Smith
Creighton University
Writing a research proposal is a requirement for
almost all graduate degree programs in the
United States. For many graduate students writing
their first research proposal in graduate
school, the task is daunting. Identifying a research
title, problem statement, research purpose
and question complicates the matter for
many first-time research students/proposal
writers. This presenter will discuss a strategy
employed in an introductory graduate Research
Methods class that helps some students develop
a quality "Methods" section. The use of a Betty
Crocker cake mix box clearly demonstrates the
purpose, ingredients, and the sytematic "how to"
in order to replicate the picture seen on the front
of the box. The "Methods" section in research
writing presents the systematic "how to" replicate
the study, just as the recipe does for the
cake. Students' understanding of the purpose
and precise writing required in the "Methods"
section has yielded improved "Methods" sections
and more quality "Qualitative" research
proposals.
Physicians' Experiences in End-of-Life Conversations
with Patients with Multi-morbid
Medical Conditions
Elizabeth Stevens
University of Nebraska Medical
Center
Toby Schonfeld

Emory University
William Lyons
University of Nebraska Medical
Center
Michelle Lampman
Department of Veterans Affairs
Hospice is an excellent, though underutilized,
option for end-of-life care. Two major barriers
to physician referral of patients to hospice include
issues of medical fact (uncertainty or
inaccuracy in predicting death) and issues of
communication (how to talk to patients and their
families about dying). These difficulties may be
magnified in patients with multi-morbid medical
conditions – often characterized as “debility,
unspecified.”
The objective of this pilot study was to better
understand the challenges faced by physicians
in having end-of-life care discussions with
patients and families of patients with a diagnosis
of “debility, unspecified.” The research team
conducted four hour-long focus groups with
generalist physicians or house officers on faculty
in Internal Medicine or Family Medicine at
the University of Nebraska Medical Center.
Focus group questions were semi-structured and
explored three general themes: (1) differences
between having an end-of-life conversation with
patients and families of patients with a diagnosis
of “debility, unspecified” versus a single, terminal
diagnosis; (2) timing of the end-of-life conversation;
and (3) approaches to the end-of-life
conversation.
Preliminary results from this pilot study confirmed
the investigators‟ central hypothesis: it
is, in fact, more difficult for providers to have
end-of-life discussions with patients and families
of patients with a diagnosis of “debility,
unspecified” than it is with those who have a
single, terminal diagnosis. The results of this
study have implications for the development of
educational programs, prognostic tools, and
communication strategies to assist physicians in
having these conversations.
Determining Nurses' Understanding and Use
of Quality Indicators and Patient Safety Data
Bridgette Thom
Memorial Sloan-Kettering Cancer
Center
David Rice
Memorial Sloan-Kettering Cancer
Center
Judy Graham
Memorial Sloan-Kettering Cancer
Center
Nancy Kline
Center
Memorial Sloan-Kettering Cancer
Using grounded theory methodology, this study
explores the ways in which nurses understand,
and prefer to receive, data and other information
related to quality assurance and patient safety.
As accrediting bodies and regulatory agencies
increase the dissemination requirements of
quality indicators (e.g., patient fall rates and
pressure ulcer prevalence) to staff, the nursing
leadership committee of a comprehensive cancer
center sought to determine the most useful
and meaningful means of communication of
such information to staff. The study team, comprised
of representatives from the divisions of
nursing research and nursing quality management,
conducted semi-structured interviews
with focus groups of nursing administrators,
unit managers, clinical staff nurses, and assistive
personnel. Questions, which were developed
by the study team and validated by representatives
from the hospital-wide quality assurance
and patient safety departments, focused on
nurses‟ perceptions of quality indicators, both in
terms of definition and usefulness in practice;
nurses‟ understanding of regulatory requirements
as related to patient safety and quality
assurance; and nurses‟ appreciation of the relationship
between staffing levels and patient
safety and overall quality of care. Transcripts of
interviews and research team notes were coded
in three phases, open, axial, and selective, in
accordance with Corbin and Strauss. Initial
findings suggest that the preferred method of
dissemination varies both by nursing role and
nursing practice setting. As such, the quality
assurance department is adapting its strategies
for communication and will attempt to conduct
follow-up interviews to assess progress.
Do not intervene when they are close to the
destination: A way in providing dignified
care to the Chinese elders in Hong Kong
Mimi M. H. Tiu
The Open University of Hong Kong
Simon C. Lam
The Open University of Hong Kong
Winnie-J. H. W. Chik
The Open University of Hong Kong
Fiona W. K. Tang
The Chinese University of Hong
Kong
With an increase of the aging population, it is
foreseeable that more elders are required to
receive nursing care. Dignity is an essential
value of nursing practice. However, little is
known about how care can be provided to contribute
to the elders‟ sense of dignity.
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This hermeneutic phenomenological study
aimed to unravel the meaning of dignified care
from the elders‟ perspective. A purposive sampling
strategy was used to conduct this study.
Fourteen in-depth, unstructured interviews were
used to generate the data. Interviews were
audiotaped, transcribed, and analyzed using van
Manen‟s (1990) phenomenological method.
Allowing the elders to die with dignity was the
overarching theme from the interview. The
participants perceived that dying naturally without
having any life-sustaining treatment is considered
dignified dying. By giving them any
form of life-sustaining treatment, their sense of
being dignified was being intruded. It is the
matter of adding years to life or adding life to
years. In certain ways, while the health professional
can add years to life; by respecting the
wills of not having unnecessary prolongation of
life- perhaps life can be added to those years.
Do not intervene the elders when they are close
to their destination is definitely a way in providing
dignified care.
The findings of this study can contribute to the
development of strategies in providing dignified
care. In addition, the results also provide a basis
in proposing the use of advance directive in
Hong Kong.
Dynamic Case Study Portal: Facilitating the
Integration of Multiple Types of Evidence
into Decision-Making and Research
Muriah Umoquit
Cancer Care Ontario
Peggy Tso
Cancer Care Ontario/University of
Toronto
Victoria Hagens
Cancer Care Ontario
Mark Dobrow
University of Toronto
It is increasingly understood that a wide variety
of types of evidence are beneficial in the development
of population health decisions. This
evidence is produced not only by researchers
but also by practitioners and project managers
themselves, and much of it cannot be found in
published or publicly available sources. A key
factor in improving access to evidence and the
effective application of evidence of all types,
therefore, is the establishment of links between
research and decision-making at more than just
the “product” phase of each process.
The Dynamic Case Study (DCS) portal, hosted
on The Canadian Centre for Applied Research
in Cancer Control (ARCC) website, will be
designed to improve the availability of unpublished
and not easily accessible material related
to current issues in cancer control and facilitate
the exchange of ideas and information between
researchers and decision-makers, both within
and across jurisdictions. DCS acknowledges the
non-stagnate nature of cases, continuously updating
available material on topic areas that
have been chosen by decision makers. Centralizing
unpublished and not easily accessible
material into a searchable internet database is a
unique approach to knowledge translation and
dissemination of relevant and timely qualitative
evaluation findings. This project, currently in its
development stage, would be of interest to decision
makers and researchers in cancer services
and policy, including frontline practitioners and
non-government and voluntary organization
program coordinators.
A Study Evaluating a Set of Interventions for
Preventing Substance Abuse Problems in
Canadian Aboriginal Youth
Hendricus A. Van Wilgenburg
Dalhousie University
M. Nancy Comeau
Pam Collins
Sherry H. Stewart
We partnered with 10 Aboriginal communities
across Canada to support the creativity, health
and well being of youth and help meet the needs
of young people who may be involved in problematic
behaviours that adversely affecting
themselves, their families, and communities
(e.g., substance use). Through community engagement,
we created and evaluated an evidence
-based cognitive behavioural skill development
program informed by First Nations and Inuit
youth. The personality-and motivation-matched
interventions were grounded in the wisdom and
teachings of Elders and cultural advisors. Results
of qualitative process and outcome evaluation
are reported. Implications for improving
the health and well-being of Canadian Aboriginal
youth will be discussed.
Parents' Experiences of Balance in Everyday
Life
Mineko Wada
The University of British Columbia
Catherine Backman
The University of British Columbia
Susan Forwell
The University of British Columbia
Wolff-Michael Roth
University of Victoria
James Ponzetti

The University of British Columbia
Life balance is receiving increased attention in
studies and theoretical models promoting
healthy lifestyles. Despite extensive study, the
construct of balance is typically situated in
specific frameworks focusing on, for example,
merely paid work and family areas, or social
roles. Using these frameworks delimits an understanding
of other balance perspectives that
may be unique to individuals. Further, such
frameworks may impose a specific idea of balance
as essential to a healthy lifestyle on those
who perceive balance differently. A broader
exploration of how people experience balance is
warranted to better understand variation in
balance perspectives.
The aim of the study is to describe how people
experience balance in everyday life. The study
involves interviews with employed parents with
at least one child under 6 years old, on the assumption
that they must manage multiple activities
and demands on daily basis.
The research design is informed by a phenomenographic
approach. Using purposeful and
snowball sampling methods, the study to date
has recruited 11 heterosexual couples from a
metropolitan area. Both partners in the couple
were individually interviewed twice to talk
broadly about their everyday life. Interviews
were audio-taped and transcribed verbatim.
Transcribed interviews are being analyzed to
uncover parents‟ descriptions and perceptions of
balance and the situations in which it arises.
The preliminary findings highlight illustrative
balance perspectives and life situations including
relationships and labour division. The study
will suggest social support and tips for employed
parents that may ultimately enhance
their health and well-being.
Challenging the boundaries of Practice
Knowledge
Matthew Walsh
Charles Sturt University
Physical therapists are expected to be wellinformed
in their interactions with patients
within a context of evidence based practice. The
explosion of research and information in recent
years challenges physical therapists to select
and make sense of whatever knowledge is most
valuable for patient care. In this research we
show that Advanced Orthopedic Physical Therapists
(AOPTs) demonstrate a dynamic and open
stance towards knowledge not constrained by
the categories of evidence based practice. The
practice knowledge of AOPTs is shaped by
personal and professional experiences in combination
with more conventional (propositional)
forms of knowledge. The idea of phronesis (or
wise action) is a powerful and flexible means of
explaining the practice knowledge used by
AOPTs amidst the current complexities of the
clinical environment. Rather than seeing the
advancement of practice from a purely technical
rational approach, phronesis allows us to see the
importance of tactful, reflective action and
reasoning in developing practice knowledge.
AOPTs develop and test their practice knowledge,
through a dynamic ongoing balance between
action and reflection. This balance between
action and reflection shows that AOPTs
are always interpreting and reinterpreting their
practice knowledge in the light of practice itself.
The driving force is the ethical concern to provide
the best care for each individual patient.
How these therapists negotiate the current complexity
of practice is of value, not only to Physical
Therapists, but to any professional faced
with the challenges of reconciling the technical
rational approach demanded by evidence based
practice with the everyday realities of practice.
Beyond the Pink Ribbon: The Lived Experience
of Breast Cancer Survivors
Paige Wimberley
Arkansas State University
Historically cancer survivorship has been reserved
as a term for those who had lived five
years or greater after being deemed cancer free.
Now the term is used from diagnosis through
the remainder of the person's life. The trajectory
of breast cancer demonstrates evolutionary
changes in the concept dramatically. The dominant
cultural representation of breast cancer
survivor is one of a triumphant, happy, healthy
and feminine woman holding a place of honor
in the cancer world. Breast cancer is portrayed
as a disease to beaten by the power of medicine
and success is achieved by returning the when
the individual is returned to a fulfilling life.
Women are expected to share the experience
and present an optimistic picture of the outcome
of treatment. However the disease or its treatment
may have long-term or late effects that are
unexpected or their severity underestimated.
These effects significantly impact the individual's
life and ability to return to previous activities.
The complexity of experience and uncertainity
of treatment outcomes make it difficult to
fully articulate. The literature is replete with
information about the various aspects of being a
breast cancer survivor however a paucity of
information about totality of the experience and
how the individual begins to embody survivor-
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ship exists. The embodiment of breast cancer
survivorship is rooted in cultural expectations
which may or may not be congruent with the
individual's perceptions. Using a phenomenological
approach, this research seeks to understand
how women incorporate or reject the
prevailing cultural breast cancer survivor image.
'Survivor'?
Angela Zwiers
The University of Western Ontario
With advances in treatment and medical technology,
the rate of childhood brain tumour
„survivors‟ has increased. „Survivors‟ are often
left with chronic physical, psychosocial and
cognitive deficits as a result of varying factors
of treatment, location and type of brain tumour.
There is currently little qualitative research on
the resilience of childhood brain tumour
„survivors‟. Using a constructivist grounded
theory methodology of qualitative research, this
study examines the construction of the meaning
of „survivor‟ among adults who have „survived‟
a childhood brain tumour. This study is currently
in the data collection phase. Using web
posting advertisements and posters, this research
project has received some response. 10-
12 participants will be selected from respondents.
Eligible participants are between 18 and
28 years old, who experienced a childhood or
adolescent brain tumour and are living with at
least 5 years since their initial diagnosis. Participants
are currently being interviewed with a
series of open-ended questions regarding the
processes used to formulate their definition of
„survivor‟. Participants are also writing in journals,
reflecting on experiences that relate to the
meaning of „survivor‟ in daily life. Recorded
interviews will be transcribed and analyzed
using reflexivity and line-by line coding. Participant
identification and data will be kept in
confidence and psychological or social support
information will be provided. Findings will be
presented in research forums and various child
and youth health and cancer related conferences
in order to express a „consciousness of survival‟
and health needs of this population.
Abstracts, Concurrent Sessions
Listed alphabetically by first author
Gay men talking about health
Jeffery Adams
Massey University
Defining and describing health has traditionally
been the role of medical experts, but over the
last few decades a strong and rich literature has
established the importance of lay accounts of
health. One important gap relates to gay men‟s
accounts of health, which this paper addresses.
Using data from 11 focus groups involving 45
gay New Zealand men, five key ways gay men
talked about health are discussed: health is the
absence of disease, is functional ability, is fitness
and exercise, is psychological, and is multifaceted.
These constructions are underpinned by
two contrasting positions on a possible relationship
between sexuality that health – that there is
no link, or there is a definite link. The paper
concludes that while there are similarities in the
ways gay and other men talk about health, important
differences exist, which suggest that
issues of sexuality need to considered by health
policy and service planners if responsive health
services are to be available to gay men.
Gay men: Explaining health, improving
health
Jeffery Adams
Massey University
Understanding how gay men explain health
provides information vital to investigating and
enhancing gay men's health. This paper which
results from doctoral research undertaken in
New Zealand reports a critical analysis of the
way men drew on individual explanations and
discourses, and social and community explanations
and discourses, as ways to account for, and
to improve, health for gay men. The dominant
accounts were consistent with neoliberal theorizing,
which draws heavily on individualized
framing of health. Overall, the men articulated a
view that health was (primarily) the responsibility
of the individual, and the two main ways to
improve health (through using doctors and
being influenced by health promotion) that were
raised were consistent with this. However, the
men also invoked a social model of health that
drew on an invocation of heterosexism. Ways of
improving health focused on these same factors.
In the social and community accounts the focus
was on countering the negative consequences of
heterosexism, but also focused on negative
influences of the gay community. The implications
of both these framings for health service
policy and planning are also presented.
Attitudes and Program Preferences Regarding
Pre-Exposure Prophylaxis (PrEP) Among
Young Adults at Risk for HIV
Mary Anne Adams
Georgia State University
Donna Smith
Georgia State University

Background:
This paper presents the results of focus groups
conducted in order to prepare for the potential
roll-out of PrEP, or „Pre-Exposure Prophylaxis.
PrEP would involve taking a pill a day of antiretroviral
drugs - the only known effective
treatment for AIDS - as a way to help prevent
HIV, particularly in high-risk populations.
Methods:
During the summer of 2009, 10 focus groups
were conducted with 77 at-risk African American
young adults in Atlanta, GA, ages 18-24.
Participants for 8 of the focus groups (58 participants)
were recruited by trained ethnographers
working in communities with high STD/
HIV prevalence. Two focus groups (19 participants)
were venue-specific, held via support
groups for young African American men who
have sex with men (MSM). Focus groups
assessed knowledge, risk perceptions, and
stigma about HIV/AIDS, access to health care,
and attitudes about this potential new biomedical
HIV prevention technology.
Results:
Focus group participants evidenced limited
knowledge about HIV transmission and safer
sex practices and frequent mention of attitudes
reflecting stigma/myths. Ninety percent of the
participants were without any health care insurance,
and were unable to afford, or didn‟t like
taking prescribed oral medication. If PrEP
proves to be highly effective, accessible, and
free, these young adults would be interested in
utilizing a daily dose of anti-retrovirals for HIV
prevention.
Conclusions:
Focus group results uncovered culturallyspecific
dynamics that will need to be considered
in program design. The experience from
this study could help inform plans for operations
research during PrEP implementation with this
population.
An Exploration of Adjustment Efforts of
Persons with Dementia After Relocation to a
Retirement Residence
Faranak Aminzadeh
The Ottawa Hospital
William Bill Dalziel
The Ottawa Hospital
Frank Molnar
The Ottawa Hospital
Linda Garcia
University of Ottawa
Persons with dementia (PWD) are often faced
with the reality of multiple housing transitions
in the course of their illness. This paper is part
of a larger qualitative prospective study that
aimed at understanding the meaning of “home”
and “relocation” for persons with dementia. The
findings are based on the data from in-depth
follow-up interviews with 16 persons with mild
to moderate dementia, at two and six months
after relocation to a retirement residence. Participants‟
efforts to place themselves in their
new living environments (“place integration”)
were closely linked to their ability to integrate
relocation into their overall life history, selfidentity
and meaning in life (“ego integrity”).
The process began with an immediate need to
“settle in” and perform their personal and instrumental
activities of daily living (ADL & IADL)
in order to meet their most basic survival needs.
A satisfactory completion of this phase was
associated with a sense of “comfort”. The next
phase involved their attempts to “fit in” the new
social environment to satisfy their higher order
social ADL needs associated with a sense of
“connection”. The transition created a simultaneous
need to renew their conception of
“self” (“checking in”) in order to reconcile their
desire to maintain a sense of “continuity” in the
face of the changing realities of their existence.
The failure to achieve the above led to feelings
of being displaced, “in suspense”, alienated, etc.
The findings reaffirm the importance of
“personal-as-identity care” in dementia and
inform the design of supportive interventions.
Seeking Habitus in Cardiac Rehabilitation: A
Bourdieusian Analysis
Jan Angus
University of Toronto
Lisa Seto
University of Toronto
Craig Dale
University of Toronto
Cheryl Pritlove
York University
Marnie Kramer-Kile
University of Toronto/Mount Royal
University
Alexander M. Clark
University of Alberta
Beth Abramson
Saint Michael`s Hospital
Jennifer Lapum
Ryerson University
Susan Marzolini
Toronto Rehabilitation Institute
Jennifer Price
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Paul Oh
Women`s College Hospital
Toronto Rehabilitation Institute
The benefits of cardiac rehabilitation (CR)
include health behaviour change, increased
quality of life, and reduced mortality and morbidity.
However CR participants do not always
consistently attend or complete their programs.
Working from a realist perspective and drawing
on Bourdieu‟s concepts of habitus and cultural
capital, we explore adherence and noncompletion
from the perspectives of 16 men and
16 women within 3 months of enrolment in one
of three urban CR programs. Data sources
included an activity journal and two semistructured
interviews. Analysis consisted of
repeated readings and annotations of interviews,
development of a stable coding scheme, and
social theory-driven exploration of patterns or
typologies of experience. For Bourdieu, social
fields are spaces of struggle, and habitus (or
positionality) is linked with possession of valued
capital. Cultural capital may include the
collective sum of individual tastes, habits, bodily
skills and experience. It acknowledges transformation
through accrued status (credentials,
embodied skills and/or culturally valorized
attributes such as self-efficacy). As a process of
indoctrination into new health knowledge and
practices, CR is deeply intertwined with habitus.
Some study participants were sensitive to their
repositioning as “lacking” necessary health
related knowledge and self care skills. For these
participants, efforts to reinstate social position
included opposing strategies such as noncompletion
or irregular attendance at CR as a
“habitable” alternative. However, most embraced
CR as an opportunity to acquire new
cultural capital and some augmented CR by
seeking personally relevant knowledge not
provided in CR programs. Thus, CR attendance
may hold different meanings and achieve different
ends for participants.
Constructing the meaning of letting go: an
exploration of the transition process from
Licensed Practical Nurse to Baccalaureate-
Prepared Nurse
Anne Barbara Arthur
Vancouver Community College
Katherine Fukuyama
Vancouver Community College
Discussion continues on the dimensions of role
transition with significant innovations in programs
targeted towards new graduate nurses
entering practice. We suggest that if students
and new graduates are to successfully transition
and practice within an ethical context, educators
need to understand the complexities of role
transition in order to support their students. This
narrative inquiry explored the meaning of the
role transition process through the eyes of 22
students enrolled in a Licensed Practical Nurse
(LPN) to Bachelor of Science in Nursing (BSN)
bridging program. The students‟ stories are
woven with stories of educators to a broader
understanding of the process of role transition.
Integration of time and context in the construction
of the meaning of role transition was essential
in understanding the transition process as it
transpired over a 24 month period timeframe,
from entry into academia to three months following
graduation. The stories and interview
transcripts were examined using Clandinin and
Connelly‟s (2000) elements: personal and social
interaction and temporality of past, present,
future and place. A resistance narrative emerged
where the student grieved “letting go” of the
former role. This story transformed over time to
an acceptance narrative which gave prominence
to confidence, positive coping and balanced
lifestyle. These narrative structures provided
insights into how LPN to BSN students came to
understand their role transformation experience
and professional growth. Implications of this
study point to the importance of implementing
socialization strategies throughout the educational
process to better prepare students for the
challenges of professional practice.
Parents' Perspectives on Discipline with
Young Children
Christine Ateah
University of Manitoba
Marie Edwards
University of Manitoba
Joan Durrant
University of Maniotba
The role of physical punishment in child physical
abuse is well-documented. Based on findings
that attitude is the most powerful predictor
of physical punishment use, public health agencies
have mounted education campaigns that
aim to reduce parental approval of this practice.
These campaigns are based on attitude research,
virtually all of which is quantitative, employing
brief checklists and rating scales to measure
parents' beliefs about the acceptability, appropriateness
and necessity of physical punishment.
The purpose of this interpretive descriptive
study was to deepen our understanding of the
dimensions of parents‟ perspectives on discipline
with young children. A sample of 30 participants
was recruited through day care centres
and included 25 mothers and 5 fathers. Their
mean age was 31.5 years and each participant
was a parent of at least one child aged two to

five years. Semi-structured interviews were
conducted to determine parents‟ views of and
approaches to discipline and their goals in using
their disciplinary approaches. Data analysis
involved review of transcripts to identify and
agree upon coding categories, coding of transcripts,
and creation of descriptive grids as
described by Knafl and Webster (1988) to identify
themes. In this presentation, the themes of
acting proactively to promote positive behaviour
(e.g., teaching and guidance), reacting to stop or
change behaviour (e.g., physical and nonphysical
responses), and the emotionality of the
situation will be discussed. The application of
these findings to parent education programming
directed at promoting positive parenting and
decreasing punitive and physical responses with
children will be presented.
Heteroracial Preferences of Gay Man and
their Implication for Racial Politics
David Aveline
Mount Royal University (Calgary,
Ab)
In fall 2009, 25 gay Asian males (GAMs) and
19 gay White males (GWMs) who expressed an
interest in Asian men were interviewed using a
semi-structured schedule of questions upon race
preferences in sexual or romantic relationships.
The interviews were audio-taped, transcribed,
and analyzed for their recurrent themes. I focus
on the rationales behind the men's racial preferences
and their implications within a larger
social structure where whiteness is constructed
as a default state of being and non-whites are
regarded as the "other."
Three themes emerged from GWM's preferences
for GAMs: (1) Feminization: seeing
Asian men as less masculine. (2) Infantalization:
seeing Asian men as young and boyish and
venerating of age. (3) Orientalization: seeing
Asian men as "exotic" others from mysterious
cultures (see Edward Said's "Orientalism").
In contrast conflicting themes emerged from
GAM's preferences for GWMs. On one hand
they saw such preferences as "natural" in a
majority white society; on the other they saw
themselves as typecast and fetishized by white
men and, as a result, saw sexual and racial politics
as unavoidable in their quests for sex and
love.
Implications for sexual and racial politics will
be discussed.
Understanding Health and Wellness Through
Faith: Afro-Caribbean Insights on What it
Means to be Healthy and Well
Nike Ayo
University of Alberta
With the largest immigration program in the
world, the presence of diverse ethnic groups
within Canada can no longer be ignored when
addressing matters of health and wellness. As
part of this global migration, new religious
imports have also contributed to national diversity
whereby a great degree of immigrants place
a strong emphasis on spirituality and religion in
their everyday lives. This emphasis on spirituality
and religion is highly gendered, raced and
classed. It is particularly great among many
African derived cultures fundamentally shaping
their everyday lived experiences.
The aim of this exploratory study was to develop
a deeper understanding of the meanings
and experiences of health and wellness among a
group of Afro-Caribbean first generation Canadian
women of faith. One-on-one semistructured
interviews were conducted with
thirteen women who were all regular churchattendees
at various Protestant denominations
within a metropolitan Canadian city.
For these women, spirituality in line with their
Christian faith was a dominant overarching
theme underlining how they perceived the various
domains of what it means to be healthy and
well. Such domains of health and wellness as
indicated by participants include peace of mind,
benevolence, personal relationships, self-care
through aesthetics, financial stability, employment
status and exercise and diet.
Findings from this study will contribute to the
growing body of literature on spirituality and
health. Furthermore, having a diversified understanding
of what health and wellness means
among a heterogeneous Canadian population
could provide improved health services and
benefits to those who such professions aim to
work with.
Susac's Syndrome: An ethnomethodological
analysis of the social practices that constitute
disease and illness
Patricia Babinec
The University of Calgary
What is the value of an ethnomethodological
approach to the social construction of new
medical knowledge? A rare triad of symptoms
which include changes in personality, hearing
and vision was labeled “Susac‟s Syndrome” in
1986 in the United States. Currently, there are
200 diagnosed cases worldwide. The Susac's
Syndrome International Collaborative Study
(Susac-ICS) was created in 2010 to collect,
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analyze, and share information regarding the
clinical features, clinical spectrum, clinical
assessment, natural history, treatment, clinical
course, and long-term outcome of Susac's Syndrome.
Through participation in the Susac-ICS,
researchers, clinicians and patients will contribute
to the production of new medical knowledge.
What are the processes through which
physicians, researchers, caregivers and patients
collaborate to construct and represent a rare
disease? How do socially constructed and institutionally
shaped understandings of a rare medical
condition shape people‟s concerns with
caring about and living with confusing and
difficult bodily experiences? The aims of the
doctoral project on which this presentation is
based are: (1) to examine how communication
and other social practices construct and legitimize
bodily suffering (2) to demonstrate how
institutional ways of making sense shape and
are shaped by members‟ concerns. Ethnomethodology
is the study of the methods people use
to produce and sustain social order in social
interaction. By drawing on the ethnomethodological
literature, this presentation will discuss
how people within the institution of medicine
socially construct the terms, phenomena and
narratives that organize a disease entity.
Connecting Gender and Health Inequalities
to Resistance and Survival in Kathmandu:
Lived Experiences of Former Street-based
Commercial Sex Workers
Iccha Basnyat
National University of Singapore
Marginalization is arguably located in political
and economic systems such as: development,
housing, labor, migration, education and access
to health services. Impoverished structures that
limits women‟s education, jobs, access to resources
is often manifested into commercial sex
work. Therefore, this paper aims to (re)position
sex work, among Nepalese women as an effect
of macro policies (i.e. lack of access to education
and resources) that place women in the
margins. Based upon a theoretical discussion of
power, structure, health, resistance and the
politics of sex work (i.e. economics, law,
rights), this paper examines how lived experiences
offer an entry point to locating CSWs as
active participants enacting agency for day-today
living.
17 in-depth interviews were conducted with
former commercial sex workers currently working
as community mobilizers (CM) for a community
based organization that reaches out to
current CSW‟s for voluntary testing and counseling
(VCT). The interviews resulted in twenty
-two taped hours. The interviews were openended
and semi-structured that allowed the
researcher to inquire about navigating structures
for day-to-day living, access to macro structures,
maintaining health and long term needs.
Thematic analysis revealed the following four
themes: (a) surviving through sex work; (b)
seeking long term solutions; (c) enduring
stigma; (d) health service utilization. Women‟s
narratives illustrate that „reducing‟ her body to a
sexual function is influenced by the macro
limitations within which she is bound. Yet, she
engages as an active participant in every day
resistive strategies within her available set of
structural possibilities and limitations.
U.S. Registered Nurses' Personal Use of Traditional
Chinese Medicine: Resulting Shifts
in Professional Identities and Nursing Practicies
Sharon Bertrand
HealthForce Minnesota
Registered nurses in the U.S. are increasingly
utilizing Traditional Chinese Medicine (TCM)
for relief of personal medical issues. This qualitative
case study explores how nurses' TCM
experiences affect nurses' professional identities
and practices. Symbolic Interaction framed the
research design; data analysis utilized mixed
coding methods. The study included 20 semistructured
interviews of 10 practicing nurses
and 10 nursing faculty members in the Twin
Cities metropolitan area of Minnesota. When
sociological theories such as Total Institutions
and Presentation of Self by Goffman are applied
to the data, the basis for several new conclusions
emerges. For example, nursing subspecialty
practice norms within U.S. health care
influence how TCM experience affects nurses'
professional identities and nursing practices.
Second, because nursing is a mutable career,
nurses are able to incorporate TCM into their
nursing "toolbox." Finally, nurses try TCM and
share that information with others because the
inherent role of a nurse is to help others. As a
result, the shifting of nurses' professional identities
and nursing practices creates inroads for
integration of TCM into U.S. health care delivery.
Shopping for treatment: Tuberculosis in
urban slums in Delhi, India
Aruna Bhattacharya
Public Health Foundation of India
„L‟, 34, a daily wager in a garment factory was
suffering from TB from last 14 months.. He
narrated about his experience with several doc-

tors and their treatment regime with great precision
with their names and with the location of
their clinics. At the time of the documentation
of this case study, „L‟ was undergoing treatment
for TB under DOTS‟s category-II regimen,
which was for seriously ill and relapse cases of
tuberculosis.
To begin with, he had bouts of fever which he
ignored till the time there was remarkable
weight loss and loss of appetite. He resorted to
private allopathic doctor where he was given
antibiotics and advised for chest x-ray. He took
the treatment for five days and his x-ray showed
tuberculosis in his right lung, yet he preferred to
leave the treatment as it was expensive for him
to continue. After this, he sought treatment from
an array of practitioners and in all he sought
treatment from five practitioners before resorting
to a government hospital, where he was
referred to a DOTS centre for TB treatment.
Pathway for shopping for treatment was:Private
allopathic doctor (Left the treatment after diagnosis;
expensive treatment) to Unregistered
practitioner (No improvement in health) to Faith
healer (No improvement in health) to Private
allopathic doctor (Visited on family‟s intervention,
failed to comply because of expensive
treatment) to Unregistered practitioner (No
improvement in health) to Govt Hospital
(Advised to start TB treatment from nearest
DOTS centre) to DOTS centre (Taking treatment
in category –II regimen)
The Politics of Critical Action Research in
Conflict-Affected Areas in the Global South:
The Case of Reproductive Health in Mindanao,
Philippines
Danielle Bishop
York University
Many qualitative methods scholars consider
critical action research a method by which we
may engage with the lived experiences of subjects
in a reflexive manner and work to effect
change, emphasize human rights and agency,
and de-colonize the research process. Often
overlooked is the degree to which this tool is a
highly political device, neither displaced from
ideology nor detached from the intersections of
race, class and gender.
As a window through which to view, as well as
extend, this critique of critical action research,
the paper draws from my experience as researcher
in the conflict-affected area of Mindanao,
Southern Philippines, working in maternal
child health. The central focus is on the role
and political nature of the framework of emancipation
in critical action health research within
war and conflict-affected areas. I argue that,
within these settings, the method is embedded in
a web of power relations and a global capitalist
political economy and it may therefore unfold in
ways detrimental to its underlying principles.
Thus, though this critical paradigm may function
to „unshackle‟ communities from imported
ways of knowing, it may simultaneously and
covertly reproduce problematic and westernized
policies that render the recorded lived experiences
invisible.
In short, the presentation highlights the nuanced
yet critical junctures in which participatory
research, and the researcher, may emerge as
agents of veiled, compassionate coercion nothing
short of a new spectre of colonialism.
Understanding the impact on social participation
of an acquired speech impairment
Marian C Brady
Glasgow Caledonian University
Alexander M. Clark
University of Alberta
Sylvia Dickson
Glasgow Caledonian University
Gillian Paton
Glasgow Caledonian University
Rosaline S Barbour
University of Dundee
Stroke related impairment of movements required
to produce speech results in dysarthria.
Occurring in an estimated third of all people
who experience a stroke, it can persist for some
time after hospital discharge. This Scottish-wide
interview study explored the impact of dysarthria
on social participation following stroke.
Purposive sampling was used in order to include
24 individuals with varying degrees of dysarthria
severity and length of time since their
stroke. We recruited 15 men and 9 women of
different ages. The software package N-Vivo
supported thematic coding and facilitated systematic
data retrieval and analysis relied on the
constant comparative approach.
Interviews established that dysarthria can have
an important impact on participation, even when
the individual‟s speech is only mildly affected.
Interviewees reported dealing not only with the
isolating impact of their communication difficulties
but reduced opportunities for social
interaction due to changed employment and
social circumstances after their stroke. Other
people‟s manner of communicating with them
was also perceived to have altered in its quality,
sometimes resulting in exclusion from the interaction.
Participants‟ descriptions of their effortful
speech prohibited natural and spontaneous
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communication. Deliberate restriction of their
engagement in social interactions or choosing
simply to „opt-out‟ of social situations served to
compound their isolation.
Developing an understanding of the processes
involved in adapting to life with dysarthria after
stroke is valuable in relation to the prioritisation
and planning of both service provision and
therapeutic interventions.
The Enigma of the Couvade Syndrome:
Men's experiences of pregnancy
Arthur Brennan
Kingston University & St George's
University of London
Sylvie Marshall-Lucette
Kingston University & St George's
University of London
Couvade Syndrome is a world-wide phenomenon
occurring in industrialised countries but it
has wide international variance and its relationship
with ethnicity is consistent. It affects biological
fathers particularly during the first and
third trimesters of pregnancy with cessation of
symptoms after birth. International studies reveal
a lack of clarity in the syndrome‟s definition.
Nonetheless, a plethora of theories has
been put forward in an attempt to explain the
syndrome. This paper draws from a UK qualitative
study of the syndrome, which aimed to
explore the nature, frequency, duration and
cessation patterns of men‟s pregnancy-related
symptoms, suggestive of the Couvade Syndrome,
across the three trimesters of pregnancy
and labour. Ways in which these symptoms
were managed and explained were also investigated.
Fourteen expectant men, aged between
19 to 48 years, from diverse social and ethnic
backgrounds agreed to be interviewed. An inductive
analytical approach was used to examine
participants‟ report of their experiences. One
of the three emerging themes, the „Enigma‟ of
the syndrome will be the focus of this paper.
Thus, the unexplainable symptoms and those
based on conjecture will be discussed. The
nature of the syndrome will also be addressed
from the perspectives of those whom the men
had consulted about their symptoms. Conclusions
drawn from this study suggest that further
qualitative methodological studies would provide
additional insight into men‟s experience of
pregnancy. They might also highlight the need
for expectant men‟s health to be accorded a
greater profile in current antenatal care provision.
Cardiopulmonary Resuscitation in the Emergency
Department
Stephen Brummell
The University of Nottingham
Jane Seymour
The University of Nottingham
Gina Higginbottom
University of Alberta
In spite of media images to the contrary, unsuccessful
resuscitation in Emergency Departments
is the most common outcome. Staff involved in
cardiopulmonary resuscitation must therefore
evolve strategies for dealing with both the
stresses of resuscitation and sudden death. This
paper presents findings from a doctoral study
exploring resuscitation practices within Emergency
care, to identify how team members
construct a cardiac arrest, and conceptualise
death and dying.
An ethnographic approach was employed to
capture practices that were socially constructed
within emergency care. Data collection was in
two Emergency Departments in the North of the
UK, one semi-urban and one urban, using participant
observation and interviews. Participant
observation of resuscitation attempts was undertaken
in the semi urban primary unit only. Semi
structured interviews of nursing and medical
staff were undertaken in both units.
The approach to analysis involved the integration
of fieldnotes, analytical memos and interview
data to construct cases for interpretation.
Data revealed complex resuscitation categories
constructed by participants to differentiate resuscitation
situations. These categories were
constructed for each patient using a combination
of bodily and technical information that were
indicative of dying, but were given meaning by
their social context. Locating the patient within
the resuscitation categories was the main determinant
of whether resuscitation should continue,
and if so, for how long. Determining the
point when resuscitation was withdrawn required
the alignment of technical with bodily
dying, enabling participants to construct an
acceptable death.
Fathers’ childhood injury prevention: risk
and protection decision-making
Mariana Brussoni
University of British Columbia
Lise Olsen
University of British Columbia
David Sheftel
BC Council for Families
Anne George
University of British Columbia
Injuries are the main risk to children‟s health
and research has shown that parents‟ attitudes

and practices have a major impact on children‟s
injuries. Fathers have a major impact on various
aspects of child health and development yet
little is known about their roles in preventing
injuries. Every day fathers face decisions regarding
the level of risk they are willing to
expose their children to and the level of protection
they feel is necessary. Understanding of
their decision making process is limited, yet is
critical to injury prevention efforts.
Interviews were conducted with a diverse sample
of 32 fathers of children aged 2 to 7 years in
British Columbia. Questions addressed fathers‟
roles and typical activities with their children,
child safety concerns and safety practices.
Grounded theory methods guided data analysis.
Fathers believed a central part of their role was
helping their children grow and thrive. A key
aspect of this role involved actively exploring
the world with their children through a variety
of physical and play-based activities. Fathers
made decisions about the appropriateness of
activities, managing the dilemma between protecting
their child and exposing them to risk and
opportunity. They considered many positives
aspects of risk and minor injuries, as well as the
negative side of injury, including the potential
for physical and psychological consequences.
Injury prevention interventions can benefit from
understanding the meanings and priorities fathers
hold about their children‟s safety, creating
messaging that resonates with fathers to increase
relevance and success.
Critical Narrative Approaches to Health
Research
Marla Buchanan
The University of British Columbia
Qualitative approaches to health research most
commonly utilize methods that have long standing
in the human sciences. The typical approaches
used in research are grounded theory,
phenomenology, case study, and ethnography.
In the last two decades, critical approaches have
gained ground in qualitative methods. Critical
approaches based on critical social theory and
critical social linguistic theory have been developed
and include critical ethnography and critical
discourse analysis. Narrative methods are
also becoming popular in qualitative methods
however, there are few models of critical narrative
methods to draw from. In this presentation,
an overview of critical narrative methods of
research will be reviewed. Discussion of how
critical narrative methods have been used in
health research will also be addressed.
Prospective Outcomes of Injury Study
(POIS): Results from Phase One of a Qualitative
Study
Mary Butler
Otago University
Sarah Derrett
Otago University
Injuries are costly to individuals and society, but
we currently know little about injured people‟s
outcomes. The Prospective Outcomes of Injury
Study (POIS) is a multi-method study that aims
to determine the injury, health and social rehabilitation,
personal, social and economic factors
leading to disability outcomes after injury for
2500 New Zealanders. The study has been carried
out in the unique macro-social context of
New Zealand‟s no-fault system for personal
injury compensation, the Accident Compensation
Corporation (ACC). The lack of an adversarial
legal environment created by this system
tends to remove stress from claimants and can
promote an early return to work, but there has
been little qualitative work done on the experience
of claimants. In this paper we use an interpretive
phenomenological approach to explore
with 20 study participants their lived experiences
and perceptions of injury and outcomes
immediately after the injury. The suffering
caused by injury brings the injured person into
an existentially charged relationship with potential
carers from their personal network, ACC
and workplace. Bourdieu‟s (1985) concept of
social capital provides a theoretical framing,
which highlights the varying capacity of claimants
to secure benefits by virtue of their membership
in social networks. This paper examines
claimant behaviour and moral responses to care
as possible factors associated with the emergence
of disability.
Service Providers' and Street-Involved Youth
Perspectives on Preventing the Transition
into Injection Drug Use among Street-
Involved Youth: Successes, Barriers and
Opportunities for Youth Prevention Services
Jane Buxton
BC Centre for Disease Control
Larissa Coser
BC Centre for Disease Control
Natasha Van Borek
BC Centre for Disease Control
Youth Co-Researchers
BC Centre for Disease Control
Michael Botnick
BC Centre for Disease Control
Catherine Chambers
BC Centre for Disease Control
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Darlene Taylor
BC Centre for Disease Control
Elizabeth Saewyc
University of British Columbia
“The Youth Injection Prevention (YIP) Project”
is a research study collaboratively conducted by
the BC Centre for Disease Control, University
of British Columbia (University of British Columbia)
School of Population and Public Health,
University of British Columbia School of Nursing,
community partners and youth coresearchers.
It focuses on identifying service
components that may prevent the transition into
injection drug use among street-involved youth
aged 15-24 in Metro Vancouver, BC through
both service providers‟ and street-involved
youth‟s perspectives. Twenty-four (n=24) interviews
were conducted with service providers
from February-June 2009; fifteen interviews and
ten focus groups were conducted with streetinvolved
youth (n=60) from November 2009-
April 2010. Service providers and youth participants
were recruited through community partners.
Audio recordings and field notes from
interviews were transcribed verbatim. Emergent
themes were identified by constant comparative
method, while NVivo 8 qualitative software was
used to organize the data. Comparing youth and
providers‟ perspectives on this topic, more
similarities than differences emerged. Main
threads identified were: service components,
barriers and recommendations. Preliminary
findings suggest: (i) service components that
attract and engage youth include: capacity and
relationship building, non-judgemental policies,
peer education and recreational activities; (ii)
barriers that prevent youth from connecting with
services include: abstinence basedprogramming,
age restrictions, limited hours/
staffing and service location (iii) recommendations
for prevention strategies include community-specific
interventions, low barrier services
and youth input in program design, implementation
and evaluation. Study results will inform
youth-driven, community-based prevention
strategies that aim to prevent the transition into
IDU and/or reduce the harms associated with
injecting among street-involved at-risk youth.
Stress and Impact among Family Caregivers
of Elders with Dementia in Southern Taiwan
Wen-Yun Cheng
National Cheng Kung University
Dementia care is an overwhelming and a heavy
burden on family caregivers (FCs). However,
limited research has been published on the dayto-day
caregiving experience. The aim of this
research is to investigate the daily stressors and
overall impact among family caregivers of
elders with dementia. Data was collected using
an unstructured non-directive method in accordance
with in-depth life history interviews.
Narrative research explores personal experiences
and provides insights into caregiving
experience. Twenty-seven FCs, 12 males and 15
females, were recruited from neurological clinics
of a medical center in Southern Taiwan. The
age of the family caregivers ranged from 28 to
82, with a mean of 53.2 years. Themes were
organized using a content analysis approach.
The four subthemes for stressors included the
growth of behavioral problems, daily care dilemmas,
symptom changing chaos, and family
dynamic depletion. The four subthemes for
impacts included suffered physique, emotional
misery, disordered lifestyle, and deteriorated
interactions. The findings aim to provoke the
awareness of dementia and care related issues,
in hopes of establishing multidisciplinary management
protocol and advanced social welfare.
A comprehensive description of a narrative
research approach and interview skills could
help practitioners to facilitate and cultivate
person-centred care
"Ethics is for Human Subjects Too": Understanding
Participant Responsibility in Health
Research
Susan M. Cox
The W. Maurice Young Centre for
Applied Ethics, University of British Columbia
Michael McDonald
The W. Maurice Young Centre for
Applied Ethics, University of British Columbia
Sara Hancock
The W. Maurice Young Centre for
Applied Ethics, University of British Columbia
In Canada, all research involving human subjects
must undergo review to ensure that it conforms
to the ethical standards described in the
Tri-Council Policy Statement. Despite the considerable
energy devoted to ethical review, little
attention is however given to understanding the
experiences of those who volunteer as human
subjects. Why and how do they decide to participate
in research? Is research participation
viewed as a form of social responsibility or are
participants motivated primarily by more individualistic
benefits? Beyond respect, what if
anything do research participants feel they are
owed for their participation? And what do they
feel that they themselves owe the researcher
and/or the research? Drawing on in-depth individual
interviews conducted with a diverse
sample of 41 participants in health research, this
paper focuses on participant perspectives on

esponsibility in research. Highlighting the
range of ways that participants describe their
involvement in research and commitments to
being a „good‟ subject, we develop a typology
of narratives that sheds new light on the diverse
meanings of research participation. These narratives
are not mutually exclusive or prescriptive
but are, rather, best viewed as ideal types that
typify a set of circumstances and axiological
leanings. The understanding these narratives
contribute is salient to enhanced appreciation
for the social good that research participants
contribute. It also has significant implications
for researchers who seek more human-subject
centred approaches to research recruitment and
retention and research ethics boards who strive
to apply a subject-centred perspective in evaluating
the ethics of research protocols.
Partnering with Drug User Activists to Conduct
a Harm Reduction and Health Needs
Assessment
Alexis Crabtree
University of British Columbia
Nicole Latham
Vancouver Area Network of Drug
Users
Jane Buxton
BC Centre for Disease Control
The BC Yukon Association of Drug War Survivors
is an organization of drug user activists that
advocates for the health and human rights of all
people who use(d) drugs. This summer, members
of the BCYADWS and a researcher ally
will be taking a caravan to 21 communities
across BC to connect with isolated groups of
drug users, collect information about their access
to harm reduction services, learn about the
health needs of drug users outside the Greater
Vancouver Area, and develop action strategies
to improve services and care.
The caravan‟s series of popular education workshops
will invite participants to share their
experiences and brainstorm strategies to address
identified gaps. Facilitators will also share
stories and systems of drug user activism that
have met with success elsewhere and help participants
see how these might be implemented in
their own communities. Along the way, interviews
will be conducted with services providers
in the communities visited, and workshop facilitators,
themselves people who use(d) drugs, will
reflect with the researcher about the caravan
process and drug user organizing.
This presentation will report the preliminary
results of the needs assessment, particularly
speaking to the strengths and weaknesses of
harm reduction services across the province and
the treatment of drug users seeking traditional
health care outside of major urban centers. As
well, the presenter will communicate lessons
from the field about conducting research in
partnership with drug user activists.
An Arras of Prayer
Corinne Crockett
University of British Columbia
Okanagan
de Sales Turner
Deakin University
Prayer has been a topic of research often conducted
under the guise of such terms as directed
intentionality, distance healing, and focused
thought. Many studies demonstrate that positive
health outcomes result when health care practitioners
use prayer in their day-to-day interactions
with patients. Despite this, it is also reported
in literature that some health carers, for
example registered nurses, avoid using prayer in
their interactions with patients, for fear of being
ridiculed, negatively sanctioned, or even
shunned by patients.
In this presentation we weave a rich and textured
Arras of prayer, in the form of a vignette
constructed from the dialogue of 6 registered
nurses who self-reported using prayer as part of
their daily care for patients. These participants,
with whom we engaged in a narrative enquiry to
explore their use of prayer in practice, made
highly visible their prayer practices and revealed
their capacity to enhance not only the
healing environment of their patients, but also
that of their co-workers and themselves. Indeed,
as some participants suggested, through
prayer they became the healing environment of
and for their patients, a concept that for many
may be foreign.
Key words: narrative enquiry, prayer, intentionality,
patients
An Investigation of the Meaning of Work and
its Translation into Meaningful Retirement
for People with Intellectual Disabilities
Joan Dacher
The Sage Colleges
Barbara Pieper
The Sage Colleges
A discussion of retirement options for individuals
with intellectual and developmental disabilities
(I/DD) is relatively new. As individuals
with I/DD are living longer, members of this
vulnerable population are more likely to enter
into a retirement phase of life, much like the
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general population of older adults. Few if any
data are available to inform the planning, policy
agenda and resource allocation for this new
phenomenon.
The purpose of this project was to describe the
lived experience and meaning of work for a
group of 37 individuals (consumers), as the first
step in partnering with them and the agencies
that support them, to create meaningful retirement
options. The meaning of work ( as opposed
to retirement, a more abstract concept) is
a way of gaining access to thoughts and feelings
about an activity they engage in daily and serves
as a cornerstone and organizer of daily life.
Therefore the research question for this study
was: What is the lived experience of work?
The interview process involved 37 individuals
who responded to a series of discussion questions/prompts.
The discussions were videotaped;
each tape was transcribed and analyzed utilizing
van Manen‟s existential life world themes as
guides: spatiality, temporality, corporeality and
communality for a full explication of the meaning
of work.
Findings include the desire for meaningful
engagement, a new experience of work as fatiguing,
the centrality of the connection with
their community and work filling time that
would otherwise be empty. Implications for
policy and practice are described.
"Here" and "There": Life Stories of Iranian
Immigrants and Refugees from the Diaspora
Fay Mahdieh Dastjerdi
School of Nursing
Narrative inquiry provides an opportunity for
researchers to listen to people‟s life experiences.
The specific aim of this research was to learn
about the meaningful life experiences of Iranians
residing in Canada as narrated by immigrants
and refugees living in Edmonton, Alberta.
Using narrative inquiry methodology, I
conducted three in depth interviews with 17 first
-generation adult Iranian immigrants and refugees
(11 women and 6 men) who had immigrated
to Canada within the past 15 years. This
study revealed the richness of displaced narratives
and the attempts to reconstruct the meaning
of “self” sociolinguistically. Participants‟
descriptions of their life experiences revealed
themes of “living in limbo”, “re-figuration”,
“resistance”, “regret”, and “living here and
there”. They defined everyday life as an “on
going negotiation”. They tried to define and
give a meaning to “who they are” through language.
In construction of their displaced identities,
they attempted to understand the linguistic
and cultural differences of self-presentation. In
conclusion, listening to immigrant voices in
narrated life experiences can provide an opportunity
for Canadian institutions to introduce
specific health promotion strategies, and create
programs that are tailored to immigrants‟ needs
and improve their well-being. At the community
level, nurses play an important role in planning
new programs and services that give a voice to
the displaced individuals. Creating social
change is vital to improving immigrants‟ well
being, integration, and adjustment. The result of
this study suggests that health care providers
should move beyond holistic care and understand
that health is shaped within the context of
everyday life experiences.
Methodological Issues in Conducting Research
with Immigrant and Refugee Populations
Fay Mahdieh Dastjerdi
School of Nursing
The purpose of this presentation is to describe
the most common methodological issues that I
encountered when conducting research with
Iranian immigrants and refugees in Canada.
Conducting research with individuals from
developing countries such as Iran is different
than doing so with people from developed countries.
Such studies need special considerations
that take into account the historic and cultural
backgrounds of the people being researched--on
a contextual, conceptual, and linguistic level. In
qualitative research, the contextual differences
between a war-torn country and a society at
peace needs to be considered. Individuals who
experienced years of dictatorship, military and
ideological turmoil tend to be distrustful, doubtful,
and fearful. As a result, they are reluctant to
provide accurate information and reliable answer
to questions. Even if they trust researchers
and are willing to provide accurate information,
they may refuse to sign any documents (such as
consent forms) especially those used in government
related studies. The conceptual issue in
studying immigrants and refugees is to apply
appropriate use of instruments and their translations.
Since concepts and meanings are culturally
and linguistically constructed, it is difficult
to translate measurements, questionnaires, and
tools. This presentation explores methodological
issues used to study immigrants and refugees
from developing countries in general and from
Iran In particular. Finally, recommendations
will be discussed to resolve some of the major
difficulties encountered in each of these areas.
Women in Orthodontics and Work-Family
Balance: Challenges and Strategies

Sarah Davidson
University of Alberta
Louanne Keenan
University of Alberta
There has been a dramatic increase in the number
of females entering the orthodontic profession
over the past few decades; however, there
is very little published literature on female
orthodontists and work-family balance. This
phenomenological qualitative study involved a
purposive sample of 13 Canadian female orthodontists,
ranging in age from 29 to 59. Transcribed
semi-structured telephone interviews
were analyzed for recurrent and emerging
themes, which were validated by participants. A
team of qualitative researchers critiqued themes
and field notes; saturation of data was achieved.
Specific work-family balance challenges female
orthodontics identified included: scheduling
issues; dependence on referrals; large amounts
of paperwork; and lack of professional support.
Scheduling issues related to the length of treatments
(2 - 4 years), frequency of recalls (4-6
weeks), and large number of patients scheduled
per day (80 - 100). Lack of professional support
was similar to other specialties: limited number
of orthodontists; lack of female professional
mentors; and lack of guidance from professional
organizations. Female orthodontists defined
work-family balance as a means of finding
satisfaction in both personal and professional
capacities. They understood that achieving
balance involves compromise and establishing
priorities. Role conflicts and adaptations were
acknowledged. Adaptations to the maternal role
included: 1) timing of children; 2) maternity
leaves; 3) employing a support system; 4)
breastfeeding; 5) segregation from other mothers;
and 6) personal and relationship time. Adaptations
to the professional resulted in: 1)
changes to practice structure; 2) modifications
to practice during maternity leave; 3) cutting
back days; and 4) reassurance of referrals.
Dancing with Dementia
Anita De Bellis
Flinders University, Adelaide Australia
Alison Wotherspoon
Flinders University, Adelaide Australia
Sandra Bradley
Flinders University, Adelaide Australia
Bonnie Walter
Flinders University, Adelaide Australia
Pauline Guerin
Flinders University, Adelaide Australia
Maggie Cecchin
Alzheimer's Australia (SA)
Jan Paterson
Flinders University, Adelaide Australia
This qualitative research was based on community
participatory principles and „real life‟ case
studies to produce an educational resource for
undergraduate healthcare students across multiple
health disciplines in Australia on personcentred
care and how to interact with a person
who has dementia. An advisory group of practitioners
and experts provided 35 case studies
from their experiences. The case studies were
then themed into five categories, scripted and re
-enacted into five scenarios to illustrate positive
person work and malignant psychosocial interactions
demonstrating best practice to students.
Through this research, realistic composites in
the form of filmed docu-dramas were able to
explicitly illustrate how to interact with a person
who has dementia and were accompanied by a
workbook containing information on dementia
and the theoretical underpinning of personcentred
care, as well as reflective questions for
students and educators. The evaluation concluded
that undergraduate healthcare students,
after reading the workbook and viewing the
scenarios; became interested in dementia care,
improved their knowledge base on dementia,
increase their confidence in how to interact with
a person with dementia and also developed their
understanding of persons with dementia. An
evaluation by academics in four universities
across multiple disciplines also identified the
resource as highly valuable for teaching and
learning. The development and production of
the educational resource was accomplished by
the unique and innovative use of filmed reenactments
about the reality of clinical practice,
the application of person-centred care theory
and reflective questions on the case scenarios
researched from the field of practice.
Cultural Explanatory Model of Depression
Among Iranian Women in Three Ethnic
Groups (Fars, Kurds, and Turks)
Masoumeh Dejman
Karolinska Institutet
Solvig Ekblad
Karolinska Institute
Ameneh Setareh Forouzan
University of Social Science and
Rehabilitaion Science
Background: Depressive disorders are responsible
for as many as one in every five visits to
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primary care. Women suffer more than men
according to surveys in Iran and other countries.
This study explores how women‟s depression is
conceptualized among Iranian people in the
three cities located in Iran, representative of
three major ethnic groups (Fars, Kurds, and
Turks).
Methods: Thirty eight men and thirty eight
women from the general population, classified
by level of education participated in twelve
FGDs in the aforementioned cities by using a
case vignette describing a woman with major
depression. In addition, 25 depressed women
and 14 relatives were interviewed individually
regarding how these women and their families
conceptualize the patients‟ conditions and helpseeking
process. The content analysis was used
for analysing the data.
Results: Among most of the study participants
depressive symptoms were perceived as a transient
reaction to the stressors. Most participants
named the depressive symptoms as distress of
nerve/soul, problem of nerve/soul and depression.
Other names were “darikhma” (Turkish
participants), and “tarjoman” (Kurdish participants).
All connected the illness with an external
stressor caused by loss, environmental
causes, gender-linked stressors and internal
factors caused by emotional factors, cognition
distortion and hormonal factors. Coping mechanisms
involved two strategies: solving problems
by seeking help from family and friends, religious
practice, and engaging in pleasurable
activities, and seeking professional and traditional
support. The study participants tended to
have a psychosocial explanatory model linked
with preferred seeking help from informal healers
as the first treatment step.
"You are Terrified and Wondering What is
Going on With Your Child": Parents' Experiences
of Expanded Newborn Screening
Jane DeLuca
University of Rochester, Rochester,
NY
Neonatal screening has been altered by new
technologies which enable the detection of
many rare inborn errors of metabolism. As a
result, more infants are referred for evaluation
of abnormal screening results. Little is known
about the effects of the referral and evaluation
process on families. This study was a qualitative
description of parents' experiences of the newborn
screening evaluation process. Forty-four
parents from 30 families in New York State
whose infants had abnormal results were interviewed,
in most cases during the diagnostic
evaluation and after final results were known.
Forty-eight interviews were transcribed and
analyzed using content analysis.
Parents were derailed in their adjustment to life
with their new infants by the unexpected news
of abnormal screening results. The initial news
of the referral was terrifying for parents, and
few had any previous knowledge of newborn
screening. Parents selectively communicated the
news of the referral to family members and
friends. They also attempted to limit their distress
by managing their exposure to internet
information. While most parents found the visit
to the treatment center helpful, the events of
confirmatory blood sampling of infants, waiting
for final results, adjusting to a diagnosis, or
receiving inconclusive results were traumatic.
Some were left uneasy by the process and unsure
of the meaning of their results. Applying
new genetic technologies for the public good
can be problematic. Understanding the impact
of screening programs for families is essential
for avoidance of harm and to identify needed
improvements in parent education and services.
Buddhism, Biomedicine, and happiness in the
healing traditions of contemporary Bhutan
Amanda Duncan
University of Alberta
Often likened to the mythical Shangri-La, Bhutan
is a tiny country bordered by Tibet and
India, and is the last remaining independent
Buddhist kingdom. This ethnographic research
examines Bhutan‟s medical system along with
concepts of health, illness, and decision making
around treatment options. Taking a highly
contextual approach, the paper will also touch
on the larger socio-cultural and geo-political
framework, including: Tibetan Buddhism, rapid
culture change, and a development policy referred
to as Gross National Happiness (GNH).
This is a topic previously unexamined in one of
the least studied and difficult to access nations
in the world. Research was undertaken collaboratively
with a Bhutanese „counterpart‟ and
involved participant observation, semistructured,
and informal interviews. The medical
system in Bhutan is a unique combination of
Tibetan and Western Biomedical systems, along
with numerous other practitioners located within
Bhutan‟s Tibetan religious complex. Tibetan
medicine is a significant and largely unaltered
aspect of medicine and culture in Bhutan. This
research is important because it challenges other
models of culture change where Biomedicine, as
one aspect of the globalization process, comes
to dominate other indigenous or traditional
systems of medicine. Rather, findings reveal
that both Tibetan and Biomedical systems are
permeable and that health seekers in Bhutan are

pragmatic, flexible, and access multiple health
care options, which are often used in a complementary
way. Bhutan‟s health care system is a
model for a more integrated approach to health
care where Biomedicine and traditional medical
systems can be used side-by-side.
Implications of within profession differences
in nurse-physician work relationships on
efficiency and care coordination.
Karen Dunn Lopez
The University of Illinois Chicago,
College of Nursing
The ability for physicians and nurses to work
effectively with one another is critical to timely,
safe and high quality health care. Although
much has been written about nurse-physician
work relationships, a focus of prior research has
highlighted the differing perceptions between
nurses and physicians. In this qualitative study,
ten inpatient physicians and ten nurses were
interviewed about their work relationship. Semi
-structured interviews were transcribed verbatim
and analyzed using directed content analysis.
Directed content analysis begins deductively
with an existing conceptual model or theory.
Text that does not “fit” into the deductive coding
schema are assigned new codes inductively.
All codes are reexamined iteratively.
Unlike prior research, differences within the
professions emerged as being more important
than between professions. For physicians, differences
emerged between hospitalists and nonhospitalist
physicians. The hospitalists‟ role
structure and patterns of frequent informal patient-centered
communication positively influenced
perceptions of nurse-physician work
relationships. For nurses, differences emerged
between the BSN and ADN educated nurses.
BSN nurses were cognizant of the effect of
proactive communication with physician on care
efficiency, coordination and patient outcomes.
ADN nurses, feeling physicians were “above”
them, waited for physicians to approach them
and expressed more passive views of their role.
Despite earlier findings of differences between
the professions, there is much common ground
to exploit that can result in improved efficiency,
patient outcomes and work relationships. Expanding
understanding of how hospitalists and
BSN nurses work together may provide fertile
ground for developing new models for care
coordination in acute care.
Retrospective Views of Care Recipients' and
Caregivers' Perspectives on Nursing Home
Placement
Yvonne Eaves
mingham
The University of Alabama at Bir-
The elderly experience a higher incidence of
multiple chronic illnesses, disability, and dependency
than any other age group, thereby,
increasing their risk of institutionalization.
Thus, a pressing issue that faces families today
is whether to relinquish their caregiving role for
an elderly relative in favor of institutional longterm
care (LTC). Making decisions about the
long-term care of an elderly person is usually a
complicated task in that it is emotional and
conflictual. Often older adults, their families,
and health care providers hold differing beliefs
and opinions about the future care of elders.
The purpose of this ethnographic study is to
examine the caregiving trajectory and caregiving
transitions that occur over time in rural
African American families who provide care for
an older adult relative who suffers from one or
more chronic illnesses. This paper will report on
a sub-sample of five families in which the older
adults were current residents in a sub-acute or
LTC facility.
The Caregiving Transitions Interview Guide
was used to elicit narrative data from participants
who were asked to respond to questions
about episodic and emergent health events and
changes in the caregiving situation. Interviews
were audio-tape recorded and later transcribed
verbatim. The transcribed interviews and fieldnotes
were merged into a larger word processing
file for data coding and analysis. Analysis is
currently ongoing. However, preliminary results
suggest that the desires of health care professionals,
particularly physicians, and family
caregivers carried more weight in decisions
about LTC placement than the older adults who
had to relocate.
Sexual norms and relationships: a qualitative
analysis of self-generated questions among
church attending youth in KwaZulu-Natal,
South Africa.
Elisabet Eriksson
Uppsala University
Gunilla Lindmark
Uppsala University
Pia Axemo
Uppsala University
Beverley Haddad
University of KwaZulu-Natal
Beth Maina Ahlberg
Uppsala University
In South Africa, few studies have assessed HIV
prevention messages to young people within
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faith communities.
We conducted a self administrated questionnaire
survey among young men and women aged 15-
24 years affiliated to the Roman Catholic
church, the Lutheran church and the Assemblies
of God, during May to July, 2009, when they
convened at regional meetings. One item requested
participants to write questions that they
might have about sexuality and HIV/AIDS. The
questions (152) were then read repeatedly to
identify the main concerns expressed by the
youth. Codes were assigned to the text and then
sorted into categories, using NVivo8.
Young men and women mentioned similar
questions about sexuality and HIV/AIDS.
However, the young women were caught in a
conflict between the virginity ideal expected by
the church and also by their boyfriends, who
still wanted to have sex with them. Conversely,
young men expressed pressure from friends to
be sexually active. Regarding trust in a relationship,
young men were concerned about how to
detect if their partner was unfaithful, while
young women were anxious about how to cope
with a partner who is unfaithful.
In conclusion, young women in faith communities
appear to experience stronger demands to
abstain from premarital sex than young men.
Further, young people indicated a discrepancy
between messages on sexuality and their own
lived experience. These findings suggest that
faith communities need to address gender roles
in education on sexual relationships and HIV
prevention. Key debates and controversies will
be outlined.
"Head on to...": a film exploration of the
lived experience of brain injury
William Fairbank
Bridgeham Centre for World Peace
Mary Butler
Otago University
This seminar describes the results of an international
research collaboration, based on an ongoing
participatory action research project, between
Dr Mary Butler and brain injured artist
and film maker, William Fairbank. It aims to
increase research capacity within the brain
injury community. It is the sequel to a film
directed by William, 'Head on...", which was a
sustained examination of what it is like to have
short term memory loss, using actors and a
series of interviews. The film featured in this
paper looks at the lifelong adaptation to brain
injury from the perspective of five artists. It
starts with sculptures made by William in the
early years after his brain injury. These are in
the form of 'stations of the cross', which are on
permanent exhibition at Lincoln cathedral, and
they provide a meditation on the lived experience
of brain injury. The artists interviewed all
have the capacity to produce beautiful work,
even though they have all suffered from significant
brain injury. The film is an expression of
what the brain injury community believes that
people should know and it will be a useful tool
for rehabilitation therapists and families querying
what the future holds after a brain injury, as
well as a tool for reflection for people with brain
injury. The intention is that it will be come part
of a series expressing various aspects of the
experience.
Understanding the needs of HIV-positive gay
men at time of diagnosis for a more comprehensive
and appropriate response
Olivier Ferlatte
Simon Fraser University
Malcolm Steinberg
British Columbia Centre for Disease
Control
We conducted interviews with a sample of 20
HIV positive gay men to better understand their
needs at the time of HIV diagnosis to guide the
development of an accessible, enhanced intervention
post diagnosis. Interviews were recorded
and transcribed and then analyzed using
a thematic approach.
All men in our sample felt that the counseling
offered to them at the time of diagnosis was
inadequate and that in most cases their emotional
needs were ignored. What is more, most
men felt that the trauma and stigma they experienced
post diagnosis were dismissed or underestimated
by health care providers. Most participants
felt that counseling from a peer, that is
gay and HIV positive, would have been beneficial
to them in their dealing with their new
diagnosis. A central theme in our data was the
perceived benefit of having HIV positive peers
in social and support networks at the time of
diagnosis. Interviewees who noted an absence
of HIV positive peers in their networks appeared
to have dealt much more poorly with
their diagnosis, experienced greater stigma and
accessed community services much later than
interviewees with HIV positive peers in their
networks prior to diagnosis.
The results from this study led us to develop a
peer counseling support program for gay men
newly diagnosed with HIV. One aim of this
program is to assist participants in building a
supportive social network with other HIV positive
individuals, to help build early coping
strategies and nurture long term wellbeing.

Building bridges between different socialscience
approaches: Moving between and
across "the bottom up" and "the top down"
standpoints.
Manuela Ferrari
University of Toronto
In "Building bridges. The possibility of analytic
dialogue between ethnography, conversational
analysis and Foucault", Miller and Fox (2004)
engaged in a theoretically grounded examination
of the parallels between the three socialscience
approaches (ethnography, conversational
analysis, and Foucauldian discourse
analysis) in an attempt to elucidate the differences
and similarities among them. While I
value the authors' attempt to define and explain
the possibility of constructing bridges between
different social-science approaches, I feel that
the "so what" question was not fully answered
in the text. In an attempt to answer this question,
I used the "Obesity and Eating Disorders: Seeking
Common Ground to Promote Health Final
Report" to shed light on the methodological and
analytical process. This final report was created
as a summary of a discussion that took place
during a national symposium that brought together
researchers, practitioners, and policymakers
from the Obesity and Eating Disorders
fields.
Ethnography, conversational analysis, and discourse
analysis together fostered a better understanding
of the constructed aspect of my data.
Additionally, these three social-science approaches
allowed for further exploration of the
tension between Obesity and Eating Disorders
fields. Specifically, the three analytic approaches
helped to unpack both micro as well as
macro standpoints of the tension, as the language
used (e.g., the meaning attributed to
weight by participants) defines the actors' position
in this discussion (the bottom up) as well as
it contributes to the tension/polarization of the
two fields (the top down).
Understanding Perceptions of Community
Environment: Combining Photovoice and a
Unique Analytical Approach
Laura Flaman
University of Alberta
Candace Nykiforuk
University of Alberta
Helen Vallianatos
University of Alberta
Kim Raine
University of Alberta
Given rapidly increasing rates of obesity worldwide
there has been an increased emphasis
within research and practice to understand the
influence that community environments have on
physical activity and healthy eating choices.
The objective of the current project was to understand
individuals‟ perceptions of community
environments with respect to opportunities and
barriers for physical activity and healthy eating.
To do this results from a photovoice project in
four Alberta, Canada communities were analyzed
using a unique analytic approach; the
Analysis Grid for Environments Linked to Obesity
Framework. The results have important
implications for practice as through analysis it
was identified that participants conceptualized
factors that influenced their health more broadly
than physical activity and healthy eating; referred
to as general community health. Further,
the results also highlighted a number of areas
for future research: 1) understanding individual
perceptions of the macroenvironmental sector;
2) understanding why there is large emphasis
within research on understanding the microenvironmental
setting; 3) understanding why individuals
perceive the microenvironmental setting
as being important for physical activity and
healthy eating; and, 4) how sociocultural microenvironments
influence obesity. Focusing future
research on these areas will help to guide
practice by providing best practices about how
to intervene within community environments,
while ensuring that research echoes how individuals
perceive community environments.
Taking a risk: Exploring alcohol and pregnancy
with women in Scotland
Katharine Ford
The University of Liverpool
The risks of consuming alcohol during pregnancy
are well documented, and include spontaneous
abortion, stillbirth and a range of developmental
disabilities which are collectively
referred to as Foetal Alcohol Syndrome (FAS).
Despite ongoing debates over the level of exposure
to alcohol that is harmful to foetal development,
in 2007 the Scottish Government recommended
that women abstain from drinking
alcohol whilst pregnant or trying to conceive.
However recent research indicates that 1 in 4
women still consume alcohol during pregnancy
in Scotland. In this paper I present findings from
22 in depth interviews using Biographical Narrative
Interpretative Method (BNIM) with
women living in urban and rural environments,
all of whom had a child under the age of two.
To gain a deeper understanding of the place of
alcohol in their lives over time, I used a life
course and lifestyle perspective to explore their
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health and lifestyle choices during pregnancy.
Specific areas covered during the interviews
were their attitudes to drinking during pregnancy
and their awareness of the associated
risks and attitudes towards existing public
health campaigns and interventions. My findings
suggest that multiple factors influenced and
directed women‟s attitudes towards alcohol
consumption during their pregnancy, including
the social context in which they drank alcohol.
This paper will focus on the influence of the
immediate, local and social environment on
women‟s health and lifestyle choices during
pregnancy, whilst making reference to other
related themes, such as guilt, social exclusion
and confusion that women faced over the often
conflicting messages they received.
Crossing boundaries - transformational stories
of adult children of parents with serious
mental illness
Kim Foster
The University of Sydney
Adult children of parents with serious mental
illness are a substantial yet marginalised group
whose needs and experiences have remained
largely unrecognised in the literature and mental
health service provision. Previous, although
limited, research has focused on adult children‟s
vulnerability for problematic psychosocial outcomes,
whilst also revealing their potential for
considerable resilience.
This presentation navigates the boundaries of
narrative as inquiry and addresses the methodological
tensions between postmodernism and
narrative inquiry. The design and methods of
this postmodern narrative inquiry are presented.
The study sought to disturb the silences on the
issue of adult children of parents with serious
mental illness in Australia and bring to the
centre the voices of a diverse group of adult
children. In particular, transformational stories
shared by participants in the study will be discussed
in terms how they illuminate the process
of wounding and healing that may occur for
adult children. Ricoeur‟s three stage spiral of
mimesis - the narrative emplotment of experience
through time – provides a framework for
understanding the transformational role of narrative
through „narrative repair‟ of wounds of
experience. Narrative repair can offer transformative
potential which recognises individuals‟
ability to re-construct alternate stories of experience.
In this way, narrative healing from
wounding is a story of transformation where the
person can be supported, through intersubjective
connection with others such as health
professionals, family and friends, to shape an
alternate plot to dominant discourses and cultural
narratives on physical and/or mental and
emotional illness.
'Knowing people are coping with what you
have to cope with is reassuring.' Why people
use and value experiential health information
Emma F. France
University of Stirling
Vikki Entwistle
University of Dundee
Ruth Jepson
University of Stirling
Sally Wyke
University of Stirling
Information about other people‟s experiences of
health and healthcare (henceforth „experiential
health information‟ or „EHI‟) is increasingly
available, but very little is known about how
people use it. We report a qualitative investigation
on how people react to, evaluate and use
EHI for healthcare decisions.
We conducted twelve focus groups and nine indepth
interviews with 62 adults in the UK who
faced decisions related to ending a pregnancy
for fetal abnormality, prenatal testing, lymphoma
treatment, or caring for a relative with
dementia. Participants discussed their own
information use plus examples of information
they were shown. Thematic analysis examined
the use of EHI in different aspects of decisionmaking.
People had used EHI in several ways and valued
it for diverse reasons, e.g. to emphasize an
issue‟s significance; suggest options or help
them see they have a choice; help them consider
how they might feel after making particular
choices; and reassure them they are not alone/
abnormal. Some of these reasons reflected the
distinctive nature of EHI compared to more
generalized, „factual‟ information, indicating
that EHI seems to have a unique role in supporting
decision-making. Some participants assessed
EHI critically and most appeared cautious
and selective about its use, e.g. due to its
potential inaccuracy.
We argue that it is important to consider the
implications of EHI for different stages of decision-making
and that EHI can support goodquality
decision-making if presented carefully.
Self-identity, gender and experiences of coping
after stroke - a narrative analysis of
stroke survivors' perspectives
Emma F. France

University of Stirling
Clare Dow
University of Stirling
Kate Hunt
University of Glasgow
Chronic illness can disturb an individual‟s social
roles and identity and can lead to
„biographical disruption.‟ The impact of stroke
on an individual‟s self-identity has not been
widely researched, despite being a common,
disabling chronic illness. Furthermore, the experience
of illness may be gendered, yet little
research systematically compares men‟s and
women‟s experiences of how chronic illness
(stroke in particular) impacts on self-identity.
Our aim is to systematically compare the impact
of stroke on men‟s and women‟s (re)
constructions of their identity, and whether/how
the use of different narrative „genres‟ varies by
gender.
A diverse, purposive, UK sample of 21 female
and 25 male stroke survivors aged 29 to 93 was
recruited and interviewed using a narrative
approach between 2006 and 2007. Transcripts
are being analysed using thematic and narrative
analysis informed by a social interactionist
perspective as we are interested in examining
the ways in which men and women „do health‟
and „do gender‟ as they talk about life after
stroke. A holistic narrative analysis method is
adopted which identifies narrative „genres‟
including: restitution, chaos, quest, heroic,
tragic, comic and ironic genres. Ongoing analysis
compares the extent to which men and
women draw on each of these narrative genres
in order to make sense of their lives and identities.
To our knowledge, a systematic comparison of
narrative „genres‟ used by chronically ill men
and women is a new approach in chronic illness
and gender research, and extends previous work
on how „doing health‟ is a form of „doing gender.‟
Speaking Up, Being Heard: R.N. Views of
Workplace Communication
Maryanne Garon
California State University, Fullerton
Debra Balise
Kaiser Permanente, LAMC
Catherine Solorzano
California State University Fullerton
Nurses are central to patient care and patient
safety in hospitals. Their ability to speak up, and
be heard impacts patient safety. However, this
continues to be a problematic area for nurses.
Multiple factors influence communication in
health care, including hierarchical structures,
gender differences and implicit assumptions
about roles of physicians and nurses. This qualitative
study explored nurses‟ perceptions of
their own ability to speak up and be heard, and
of communication within their workplaces. The
study utilized a qualitative approach, consisting
of seven focus group interviews of 33 staff
nurses and nursing managers from a variety of
work settings in the western United States. Data
was analyzed using a thematic content analysis
method. From analysis, data fell into the organizational
categories of internal and external
influences on speaking up, how the message
was transmitted and received, and consequences
of speaking up. There was an overarching
theme of a disconnect in understanding between
managers and staff. It is anticipated that findings
from the study may increase understanding
of nurses‟ views of being able to speak out and
be heard within healthcare settings. This is a
highly important topic, in view of the ongoing
shortage of nurses and the emphasis on developing
positive work environment for nurses.
This research was supported by a CSU State
Special Fund Mini-Grant.
Speaking Truth to Power: Using photoelicited
research methods with older adults
Theresa Garvin
University of Alberta
Candace Nykiforuk
University of Alberta
Sherrill Johnson
University of Alberta
There has been growing interest in the utilization
of photography-based qualitative research
over the past decade. Over time, the number of
photography-based methods has grown, including
techniques such as autodriving, photoelicitation,
photo-interviewing and photovoice.
Each of these approaches uses photography as
way to enter participants‟ worlds in order to
generate reflexive, even dialogic, data that is
often co-constructed by both researcher and
participant(s).
The research reported here examines the use of
photo-elicited focus group interviews with two
groups of seniors around the topic of built environments
and aging. Older adults were recruited
via a local seniors‟ organization, provided digital
cameras, and asked to take photos during
about a list of thematic contrast word sets such
as: safe-unsafe; comfortable-uncomfortable; and
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easy to get around – hard to get around. Photographs
were then sorted and discussed in a
moderated focus group. The discussion was tape
-recorded, transcribed verbatim, and evaluated
using both inductive (emergent theme) and
deductive (assigned topic) formats. Findings
were then compiled into a final oral and visual
presentation and presented to participants and
managers of the seniors‟ organization, providing
an additional opportunity for feedback and
comment. As part of the process, participants
were asked to critically reflect on the use of
photo-elicited focus groups. Their responses
centered around three key issues: the learning
curve required for the digital cameras, independence
and autonomy, and the pleasure of
learning to rediscover their neighbourhoods via
a digital lens. These findings are discussed in
the context of the co-construction of knowledge
by researchers and participants.
Waiting for the Pandemic: Theatre, Embodiment
and Knowledge Generation
Rebecca Godderis
Wilfrid Laurier University
Katherine Rossiter
Wilfrid Laurier University
This presentation will explore the use of theatre
as a method of data generation within the context
of contemporary bioethics research.
Specifically, we will describe a project designed
to explore ethical issues inherent in pandemic
influenza planning and preparedness. Emerging
from a research project called the Canadian
Program of Research on Ethics in a Pandemic
(CanPREP) at the University of Toronto‟s Joint
Centre for Bioethics, our study involved working
with undergraduate students to create a
research-based play about significant ethical
dilemmas in pandemic planning and response.
Empirical examples informing this play were
drawn from contemporary and historical data
collected for the project. Although the original
goal of this project was to use theatre to translate
and disseminate existing data, early work
with students revealed that their lived experiences
of the recent H1N1 pandemic were a
valuable source of information and insight for
this project. Thus, an unexpected methodological
finding of this study surfaced as we relied on
theatrical techniques such as improvisation for
knowledge generation as opposed to knowledge
translation. In this presentation we will describe
the project, and specifically will focus on a
technique called embodied focus groups that we
developed throughout the duration of our work
with students. The development of embodied
focus groups as a methodology marks a particularly
fruitful marriage between social scientific
and theatrical practice as this approach captures
a level of complexity that is not available
through conversation alone.
Access to care theory development using one
academic's story of thyroid cancer and hypothyroidism
Laurie Goldsmith
Simon Fraser University
It is rare that theory development is complete
after one study. I recently developed a
grounded theory of access to health care and
have been interested in opportunities to refine
this theory with new data. My own health problems
presented such an opportunity; I was diagnosed
with thyroid cancer and became severely
hypothyroid after surgical removal of my thyroid.
I used autoethnographic techniques to
assemble my story. Data sources included my
notes from multiple visits with a family doctor,
a naturopath, a surgeon, and an oncologist,
copies of lab tests, my prospective weekly ratings
of my hypothyroid symptoms, my documentation
for my medical leave from work, and
my benefit claims and other financial records.
This autoethnography allowed me to develop
new categories, sUniversity of British Columbiaategories,
properties and dimensions in my
existing grounded theory of access to care.
Specifics include the development of a category
of "moving backwards", the addition of
"appropriateness" to the category of "usable
source of care," the addition of "supporting
behaviors" to the category of "health maintenance
behaviors," and the importance of distinguishing
between primary care experiences and
specialty care experiences. I will also describe
using these new analytic ideas to interrogate the
original data, to devise new sampling strategies,
and to suggest additional health care policy
implications.
The use of ARV and quality of life: An African
study
Minrie Greeff
North-West University
Susan Wright
Tshwane University of Technology
Eva Manyedi
North-West University
S Shaibu
University of Botswana
Mabedi Kgositau
University of Botswana
Winnie Chilemba
Kamuzu College of Nursing, University
of Malawi
Angela Chimwaza

Kamuzu College of Nursing, University
of Malawi
Lucy Kululanga
Kamuzu College of Nursing, University
of Malawi
Lignet Chepuka
Kamuzu College of Nursing, University
of Malawi
The main aim of antiretroviral therapy is to
delay or prevent the progression to AIDS and
death. Both non-adherence and side-effects will
have an influence on the personâ€s quality of
life. The relationship between Quality of Life
and ARV has mostly been studied using quantitative
methodologies. Most of the scales are
more focused on a Western perspective. Sub-
Saharan Africa has the highest incidence of HIV
and AIDS, however very little literature on the
use of ARV and Quality of Life in Africa is
available.
The aims of the study were to: 1) explore and
describe the experience of their quality of life
by PLHA in Africa since being on ARV; 2)
quantitatively test the quality of life of PLHA;
3) compare the findings from both these investigations
to evaluate the appropriateness of the
HAT-QoL within the African context.
A mixed method triangulation design was used
combining the findings of the quantitative measurements
and the qualitative findings from indepth
interviews with PLHA experiences of
quality of life since being on ARV. The study
was conducted in three African countries (South
Africa, Malawi and Botswana). Permission and
ethical approval to conduct the study was obtained.
A Purposive voluntary sample was used.
PLHA were mainly recruited through community-based
HIV and AIDS organizations and
health clinics.
Data analysis of the interviews is being done by
means of open coding and the quantitative data
using the SPSS program. Recommendations
will focus on changing the questionnaire should
the findings not reflect the African context.
Looking through different Lenses; Case
Study Research of a UK Mental Health Integrated
Care Pathway
Julie Hall
University of Nottingham & Nottinghamshire
Healthcare NHS Trust
The use of integrated care pathways (ICPs)
within psychiatric settings has gathered pace
internationally, whilst attracting a mixed and
inconclusive commentary. This research funded
by the UK Social and Economic Research
Council was designed acknowledging the lack
of robust evidence about their effect upon men-
tal health care. The aim being to systematically
determine how and to what effect an integrated
care pathway can be used to manage mental
health care. A case study research methodology
has been used to study a pathway used in acute
inpatient care on 6 wards in a UK mental health
NHS Trust over a 3 year period. The findings
shared in this paper were reached using data
collected from semi structured interviews with
healthcare professionals, focus groups with
service users and carers, documentary analysis
of health records and datasets of hospital episode
and performance information. Analysis of
the data reveals accounts of the how the pathway
has been used in day to day practice and
how this varies by geography and professional
group. There are critiques about integrated
working and individualised care, and the impact
of the pathway upon these. The accounts given
by service users and carers tell of contrasting
perspectives about involvement and choice, and
the content of their care whilst on the care pathway.
Additional dimensions are added by quantitative
data revealing the extent to which the
care pathway was implemented across the 6
wards, and datasets of hospital episode and
performance information consider the impact
upon the achievement of 7 day follow-up and
readmission rates. The application of complexity
theory as an explanatory framework, suggests
that mental health ICPs need to reflect the
relationships between stakeholders, variability
of illness and individual ways of living if they
are to provide a framework for managing care in
the future that accords with the needs of people
using mental health services.
Empowering Stroke Survivors Through
Action Research
Shannon Hebblethwaite
Concordia University
Lynn Curley
Grey Bruce Health Services
Person-centred care and empowerment have
received significant emphasis in health care.
Individuals with chronic health conditions such
as stroke often experience decreased self-control
when they can not actively participate in their
care. Disempowerment often results, contributing
to depression and decreased self-esteem.
Person-centred care attempts to address these
challenges by emphasizing the person‟s
strengths and continued capabilities. Community-based
agencies appear to be optimally
positioned to adopt a more person-centred approach
to caring for individuals with chronic
conditions. The current study is a communitybased
action research project, conducted in
collaboration with stroke survivors and a recrea-
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tion therapist who is part of a Community
Stroke Rehabilitation Team (CSRT). This
CSRT provides support to stroke survivors in
the community through a multidisciplinary
heath care team. Therapeutic Recreation is a
unique allied health profession that has been
included on the team. The role of the recreation
therapist is to work with stroke survivors to
provide individualized leisure assessment, collaboratively
develop an individual recreation
plan, and assist the stroke survivors to engage in
recreation as a means of addressing individualized
goals and objectives (e.g., increasing physical
mobility, enhancing self-esteem, decreasing
social isolation). By engaging the recreation
therapist and the stroke survivors in the action
research project, they have provided an in-depth
explanation of the experience of being a stroke
survivor. They have experienced increased
empowerment and have become active participants
in advocating for the needs of stroke survivors
and educating other stroke survivors
about the important role of recreation therapy in
the recovery process.
Does the FAMCHAT Tool Enhance the
Ethno-Cultural Dimensions of Nursing Assessment
at the Royal Alexandra Hospital?
Gina Higginbottom
University of Alberta
Solina Richter
University of Alberta
Susan Young
Royal Alexandra Hospital
Lucenia Ortiz
Royal Alexandra Hospital
Stella Callender
Royal Alexandra Hospital
Joan Forgeron
Royal Alexandra Hospital
Michele Boyce
Royal Alexandra Hospital
In 2006, Edmonton‟s population totaled one
million, with 189,775 people identifying themselves
as foreign born. The visible minority
group totaled 174,729 (17%) largely being of
Chinese, South Asian and Filipino origin. In
2006, interpretation services at the Royal Alexandra
Hospital (RAH) responded to 849 requests
representing 33 languages. Without culturally
appropriate care delivery, a negative
trajectory of events can occur ranging from
simple miscommunication to life-threatening
incidents. After critical literature review and
research evaluation, the FamCHAT assessment
tool was designated as highly pertinent and
transferable to acute/hospital settings. Our research
question was: Does the FamCHAT enhance
the ethno-cultural dimensions of nursing
assessment at the RAH? A descriptive case
study design was utilized consisting of: interviews
with unit managers, completion by three
unit nurses of the FamCHAT for every patient
admitted during a three month period, and three
focus groups with nursing staff from each unit
following implementation. Fifty two forms were
completed. Qualitative data was stored, managed,
classified and ordered with the aid of
Atlas/ti and using Roper & Shapira‟s (2000)
analysis framework which includes: coding for
descriptive labels, sorting for patterns, identification
of outliers or negative cases, generalizing,
constructs and theories, memoing, and
reflective remarks. A written narrative was then
constructed. Preliminary findings focus on five
key dimensions: usefulness of the FamCHAT,
cultural awareness of the participating nurses,
barriers to utilizing the FamCHAT, patient
perspectives, enhancements to nursing assessments,
and cultural competence. In conclusion,
participating nurses felt that the use of the Fam-
CHAT tool did enhance nursing care assessments.
Consumer acceptance and adoption of
ehealth
Brian Hillier
University of Regina
e-Health refers to healthcare which is provided,
enabled, or enhanced through technology. It is
a relatively new field in healthcare which utilizes
advances in technology to extend and enhance
healthcare delivery models while hopefully
reducing costs of delivery.
The advent and adoption of new technologies in
communication and healthcare combined with
the dissemination and comfort with these technologies
has removed many of the barriers in
terms of access to these technologies. As a
result, a new dynamic is growing in the market
place whereby consumers are researching health
related products ranging from drugs and disease
to diet.
This presentation seeks to further the understanding
of consumer attitudes toward a range
of possible e-Health services. By gaining this
knowledge programs can be tailored and conveyed
in manner which maximize perceived
benefits and minimize perceived risks associated
with these services, thereby increasing the
likelihood of successful program adoption.
Opportunities and difficulties with videobased
research: linking data collection and
analysis
Paul Holyoke
University of Toronto

While video-based research and reporting occurs
in other disciplines and video is occasionally
used in health services research for data
collection, this presentation will assess and
report on the opportunities and difficulties of
using video as the prime medium for all phases
of an HSR project, including analysis and project
reporting.
My presentation will use video and traditional
formats, and I will review my experience of
conducting a research project involving videorecorded
qualitative interviews with homecare
clients and others. Video clips from 30 interviews
were edited into shorter videos for preliminary
analysis. I video-recorded myself giving
my preliminary analysis, and then, for further
reflexive analysis, compiled and viewed
and reviewed videos with clips of interviewees
and myself, before coming to conclusions about
substantive research findings.
Findings of opportunities and difficulties include
these areas: different perspectives on the
ethical use of video-recorded images of participants
in various settings; technical recording
and editing issues; participant recruitment challenges;
consent issues among participants with
mild to moderate dementia; analysis/coding
using videos, not verbatim transcripts, and the
experience of including the researcher in the
analysis-stage videos; issues about the choice of
video clips for results reporting; cumbersome
mechanisms for project funding; and different
audience reactions to preliminary results reporting.
Using video to link data collection and analysis
with knowledge translation and exchange
Paul Holyoke
University of Toronto
Using a specific health services research (HSR)
project as a case study, this presentation will
explore and identify the opportunities and issues
related to using video for data collection and
analysis in HSR, as well as in the translation
and exchange of knowledge generated by the
research.
The research project focuses on home care
clients‟ experiences of personal support (phase
1) with a goal of identifying ways to modify
care delivery approaches (phase 2). These new
delivery approaches will be implemented on a
pilot basis in the fall of 2010 and evaluated in
early 2011 to see if the changes make home care
better from clients‟ points of view (phase 3).
In phase 1, interviews with 20 clients and 10
family members were videorecorded, and these
data (not verbatim transcripts) were recursively
analyzed. Video clips from the interviews were
assembled into short videos for further analysis
and initial reporting of results. In phase 2, in
summer 2010, both longer videos and traditional
written/powerpoint presentations will be compiled
to translate the findings to decisionmakers
and front-line workers in a healthcare
organization.
The conference presentation will be in video
and oral format. There will be a brief review of
the issues encountered in data collection and
analysis (phase 1) and in preparing the different
formats, but the emphasis of the presentation
will be on the findings related to the reactions of
the different audiences to the traditional and
video formats for knowledge exchange in phase
2.
Developing a theoretical framework for patients'
adherence to antipsychotic medication
Amy Hon
South West London and St George's
(Mental Health) NHS Trust
Sylvie Marshall-Lucette
Kingston University & St George's
University of London
Antipsychotic medication is central to the therapeutic
regimen of patients with First-Episode
Psychosis (FEP), in the UK. Although nonadherence
with medication is found to be a
common barrier to the effective treatment of
FEP, healthcare professionals‟ understanding on
how patients make decisions about adhering to
antipsychotics seems to be lacking in the literature.
This paper draws from the findings of a
qualitative study, which aimed to gain greater
insight of patients‟ antipsychotic medicationtaking
decisions and practices, from their own
perspectives.
A Grounded Theory approach was adopted to
conduct in-depth, semi-structured interviews
with twelve patients, aged 18 to 35 years,
treated with „Aripiprazole‟ in an „Early Intervention
Service‟ in the South of England. The
sample size was determined when theoretical
saturation was reached in the core category.
Interpretative and theoretical validity were
ensured through member checking, peer review
and constant comparative method.
The findings indicated that patients with FEP
adjusted their medication-taking practices according
to the effects of the illness or antipsychotics
on their lives. A theoretical framework
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for the uptake or non-uptake of antipsychotic
medication comprising three interrelated thematic
categories was developed and these were
quality of life, experiential insight and health
status. This cyclical model facilitated a collaborative
approach in medication-taking decisions
between patients and healthcare professionals.
The findings also have implications on shared
decision-making in the prescribing practices as
well as strategies to enhance adherence to antipsychotic
medication.
The relationship between arts and phenomenology:
From a research study
Reimei Hong
Queensland University of Technology
Anthony Welch
Queensland University of Technology
Art as painting, poetry, music and movie could
directly or indirectly express their experiences
of everyday life. As the essence of phenomenology
is to express human experience of daily life,
literary works, poetry, painting, movie and
music have become part of human experience to
express of daily life. The expression of life
provided insight into the ontological world of
humans as the artists construct a personal reality
amid the ebb and flow of daily living. From a
phenomenological research study of sole Taiwanese
mothers, the researcher conducted indepth
interviews from 15 sole Taiwanese mothers
to understand their lived experiences in
Taiwan. The rationales for including the arts in
the phenomenological study through painting,
poetry, music and movies are increasing impressive.
Several paintings and pictures had provided
from the participants to express their
experiences of being a sole mother. According
to the findings, the way of using arts can gain
deeply understanding through sole mothers‟ real
experiences.
A model of integration of illness and self
management in Type 2 Diabetes
Åsa Hörnsten
Umeå University
Lena Jutterström
Umeå University
Åsa Audulv
Mid Sweden University
Berit Lundman
Umeå University
Aim. To describe the process of illness integration
and self-management among people with
Type 2 Diabetes.
Background. Integration of illness is a developmental
process which refers to the emotional
and existential aspects of being ill and concerns
learning to live with a chronic illness. Integration
of illness defines the process a person
undergo from suspicion or information about a
diagnose to a situation where the illness management
is seen as a natural part of life. Despite
the common use of terms such as illness integration
and self-management, there exists little
research that investigates how these concepts
relate to one another.
Method. This paper reports a secondary analysis
of an interview study among people diagnosed
with Type 2 Diabetes, focusing on personal
understandings of illness. The research approach
was narrative interviews analysed with
qualitative content analysis.
Results. Illness integration in Type 2 Diabetes
in general run parallel with the self management
process and a turning point is reached when
people seem to easily adapt to the illness emotionally,
existentially and in practice in daily
life. Suspecting illness and/or being diagnosed;
Understanding and explaining illness; and Negotiating
illness and taking stands about self
management are important elements in this
process which is framed by the conditions
„Perceived seriousness and threat of disease;
Intensity and nature of emotional response;
Personal goals and expectations‟ and lastly
„Perceived effects of self-management‟.
Conclusions. Illness integration and self management
processes develop simultaneously and
may eventually end up in a turning point making
self management easier in daily life.
Applied Research Agenda: Qualitative Methods
and the Health System
Tanyana Jackiewicz
Telethon Institute for Child Health
Research
This presentation will draw on the experiences,
learning‟s and outcomes of a program of research
conducted by a team of researchers at the
Telethon Institute for Child Health Research, in
Perth Western Australia. The Collaboration for
Applied Research and Evaluation is a multidisciplinary
team of researchers who utilise both
qualitative and quantitative methods. This presentation
will focus on the successes and challenges
we have encountered in our qualitative
research agenda; with a focus on our relationships
with clinicians and service providers at
Perth‟s major maternity and major children‟s
hospitals and within the Western Australian
Health System.
Qualitative methods employed in our research

include case studies in ADHD as well as foetal
alcohol spectrum disorder; individual one of one
interview in our research with indigenous families
around end of life decision making and in
our research on gestational diabetes; focus
groups and interviews with homeless young
people and with first time mothers on their
breastfeeding experiences; most significant
change methodologies in evaluating a remote
indigenous home visiting program; and participatory
action research with indigenous communities
across a number of areas.
We will report on the relationship between us as
researchers and the service providers and the
impact that our qualitative research agenda has
had on positive changes in the health system
and the willingness and otherwise of clinicians
to embrace qualitative research. We will also
report on our programs of work that involve the
synergies of qualitative and quantitative methodologies.
H1N1 and Northern Canadian First Nation
Communities: Community Concerns and
Trust in Government Action
Cindy Jardine
University of Alberta
S. Michelle Driedger
The global outbreak of H1N1 in the spring of
2009 had a pronounced impact on some remote
northern communities in Canada. A study was
conducted with the Garden Hill First Nation in
Manitoba to determine how events associated
with the outbreak may have affected trust in
government action and to investigate specific
community concerns. Focus groups of men and
women within the vulnerable age range of 25
and 45 years were held in August 2009. In
general, participants expressed a moderate degree
of trust in the actions of public health agencies.
Women were often more trusting then
men, particularly with respect to believing that
officials would communicate honestly and
openly about the risks of the vaccine and in
providing new information as it became available.
Everyone rated their risk of contracting
the H1N1 virus as high or very high. People
expressed concerns about the challenges of
living in a remote community, and felt that the
well-being of their community was a low priority
for public health officials. Many people felt
they were unprepared (both in terms of information
on self-protection and the availability of
protective health supplies) for a potential second
outbreak. Although H1N1 is a current worry,
other issues such as living conditions were
noted to be ongoing concerns. The results of
this study highlight the need for government
agencies to specifically consider the unique
conditions and needs of Aboriginal peoples in
their pandemic planning, and to situate pandemic
risk response actions within the appropriate
socio-economic and cultural contexts.
Verbal Abuse: The Words that Divide
Tanya Judkins-Cohn
Baptist Health South Florida
Verbal abuse impacts patient care nurses producing
negative emotions and hindering delivery
of optimum care. Patient care nurses'
perceptions of what comprises verbal abuse are
varied. Two research studies were conducted to
determine the definition and characteristics of
the experiences of verbal abuse among patient
care nurses. The first study was quantitative and
measured 81 nurses' definitions of verbal abuse.
In the second study, qualitative interviews of
four nurses revealed their perceptions of verbal
abuse. The findings of the two studies were
combined to develop a visual graph of verbal
abuse that included a "curve of acceptance" and
a "line of forced tolerance". This evolving definition
of verbal abuse reflects how nurses perceive
the shift from what is acceptable to unreasonable
and how they are driven to tolerate
verbal abuse.
Shared Presence: Caring for a Dying Spouse
Lana McLouth Kanacki
Loma Linda University
Patricia Roth
University of San Diego
Jane Georges
University of San Diego
Patti Herring
Loma Linda University
There is limited research on female spouses and
their experience of their husbands' end-of-life
transition. The purpose of this grounded theory
study was to explore wives' perceptions of care
at their husbands' end-of-life. Participants interviewed
were 25 elderly widows (62-103 years
of age) with 19 husbands' deaths in a hospice
setting and 6 in the hospital. They were widowed
from 6 months to 10 years.
Going through this journey with their husbands,
widows recalled significant aspects of the experience
and the care their husbands received.
Three major themes were identified: awareness
of impending death, forming connections, and
realizing a sense of self. Being there emerged as
the central perspective or core phenomenon.
The emergent theory of Shared Presence: Caring
for a Dying Spouse was identified.
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Wives also commented on the importance of
"place" in their husbands' care and their feeling
of being set aside by health care professionals.
Exploration of the value of the wife's human
touch for her husband during this transition may
be perceived as having a valued role.
Implications for further research include further
testing of the emergent model with a larger
number of participants of varied ethnic and
religious perspectives, a narrowing of participants
by length of widowhood, place of death
and duration of marriage. Also there is some
indication that laughter and humor could be of
benefit for widows during the bereavement
process and this could be further addressed.
Snakes and Ladders: Tripartite Challenges
of Translating, Transcribing and Accuracy
Checking Qualitative Interviews
H Bindy Kaur Kang
University of British Columbia
Dataar Kaur Cheema
University of British Columbia
John L. Oliffe
University of British Columbia
Sunjiv K. Lit
University of British Columbia
Qualitative health research most often locates
the qualitative interview as a key data collection
technique. Ensuring that transcripts are
„verbatim‟ accounts is well acknowledged by
qualitative researchers as imperative to cleaning
the data as well as accurately representing what
was said. As global migration continues, conducting
research with individuals who do not
speak English is essential to including the health
and illness experiences of all citizens. According
to the 2006 Canadian Census, there were
more than 6 million Canadians who reported
speaking a mother tongue other than English or
French. For countries such as Canada where
migration continues and diasporic communities
have had a long historical presence, translation
issues have become paramount in delivering
essential services such as healthcare. To include
non-English and non-French speaking Canadians
in health research, translation of interview
documents and data can be costly. Inadequate
translation can have dramatic ethical consequences
and negatively impact the outcomes of
research studies. This presentation reveals challenges
faced by the researchers when translating,
transcribing and accuracy checking qualitative
interviews from Punjabi to English. Translation/transcription
vignettes from two research
programs involving British Columbians of
Punjabi ancestry are presented including recruit-
ing a bilingual translator; contending with challenging
concepts/words; formalizing translation
details; developing protocol on when to include
key Punjabi phrases and words; and developing
a translation dictionary. Recommendations are
also presented as a means of increasing the
trustworthiness of translated interview transcripts.
Rural Men, Sexual Identity and Community
Michael Kennedy
Georgian College
The relationship between rurality and men‟s
sexuality remain relatively unexplored. This
study addresses the knowledge gap in the research
literature by focusing on men who have
sex with men in rural areas across Ontario,
Canada. Employing a constructivist grounded
theory methodology, interviews were conducted
with 32 men across 28 geographic locales consisting
of populations of less than 10,000 people.
Men identified as gay, bisexual, queer/
bisexual or refused labels. These self-selected
identifiers were then explored to determine how
participants conceptualized and organized their
sexual identities in relation to context. Participants
held divergent management strategies that
resulted in two general identity grouping:
„natives‟ and „transplanters‟.
Structural Violence and Vulnerability to
HIV/AIDS: A Case Study of Brothel-based
Female Sex Workers in Delhi, India
Shamshad Khan
Simon Fraser University
In the last two decades or so, India‟s response to
AIDS – despite its frequent denial of the problem
until the late 1990s – has remained singularly
tied to the CDC-led and WHO-World
Bank-sponsored model of identifying and targeting
“high-risk groups” whose “risk behaviour”
and “lifestyle” are seen as a major threat
to their own health and to that of the “general
population.” So far, more than a thousand behaviour-centred
Targeted Interventions have
been implemented among different marginalized
groups and communities, and, over the next
few years, the number of these interventions is
expected to triple so as to cover all “high-risk
groups” – especially “female sex workers,”
“injecting drug users,” and “men who have sex
with men” – up to the “saturation” level.
Against this background, and based on a larger
critical ethnographic field research done in India
between 2003 and 2005, I focus on the social
and institutional contexts of vulnerability to
HIV. Especially, citing lived experiences of the

othel-based “female sex workers” in Delhi as
case examples, I argue that their vulnerability to
HIV and their inability to protect themselves
and others were deeply embedded in the social
structure, often beyond their control, and thus
required a more broad-based policy intervention
than a mere search for biomedical and behavioural
models, the so-called “magic bullet.”
This research seeks to fill the gap of critical
literature on HIV/AIDS in the developing world
and, by drawing our attention to “structural
violence,” hopes to contribute to a more egalitarian
public health and policy.
Developing a Culturally Specific Instrument
on Complementary and Alternative Medicine
Use through Reminiscence
Cheryl Killion
Case Western Reserve University
Despite the proliferation in use of complementary
and alternative medicine(CAM)in the general
population, research and health care communities
are challenged to know more about
CAM use among older African Americans.
Investigations of the self health management
tactics of African Americans are essential because
of the disproportionate high morbidity
and mortality rates in this population. Although
the benefits of CAM use are well documented,
the safety and efficacy of an array of approaches
are not known. Reported use of CAM among
adults over 55 among African Americans is
sparse and conflicting. This paper will provide
an overview of the development of a culturally
based instrument to be used to uncover CAM
therapies, including indigenous health practices,
used by elderly, urban dwelling African Americans;
the conditions for which CAM practices
are used; the rationale for using CAM; and
barriers and facilitating factors in CAM use.
Reminiscence was used as an approach to promote
revelations of CAM use and other health
practices. Group interviews, using reminiscence,
yielded culturally distinct data and categories
that were used for questionnaire construction.
Social Work Practices in Health Care Institutions
Operating in Turkey
Emre Kol
Anadolu University
Social work mainly focuses on human beings
and their welfare. However the history of social
work dates back to the existence of humankind,
the contemporary meaning of this profession
was composed during the 19th century. As
being one of the major branches of social work;
medical social work practices begun at the
beginning of the last century.
This presentation is consisting of three main
parts. In the first part; fundamentals of social
work and medical social work has been identified.
The second part mainly focuses on generic
social work approach and the theoretical foundations
of this concept. The third part of this
study includes an exploratory qualitative analysis
which was conducted in order to compare
the literature-based knowledge on social work
with the social work practices conducted in the
health care institutions located in Ankara and
Eskiºehir, Turkey.
The empirical material of the study is generated
through 8 semi-structured interviews conducted
with social workers working at the various
hospitals. The findings of the study revealed
that the social work practices are conducted in a
reactive, ad-hoc, problem-based manners. This
situation can be related to the relatively low
number of social workers working in Turkey
and low level of awareness about the overall
social work profession among public. The
amount of publications related to the practice of
medical social work in Turkey is relatively low.
For this reason, larger studies both in terms of
sample size and geographical scope should
conducted in order to understand the full picture
of this field.
The process towards integration - a psychosocial
process of adjusting to facial disfigurement
following surgical treatment for head
and neck or eye cancer
Hanne Konradsen
Gentofte University Hospital
Facial disfigurement, as a result of surgical
cancer treatment is challenging. This grounded
theory inspired longitudinal project followed
these patients for one year post-surgery. A substantial
theory of the process towards integrating
disfigurement was outlined. When returning
to everyday life the patients felt that their close
relatives often failed to understand what living
with disfigurement meant, but integrating disfigurement
was not something one could do
alone, and this became their main concern. The
main concern was resolved through interactional
integrating disfigurement which occurred in two
stages, from being a disfigured person to becoming
a person with a disfigurement. In stage1
the consequence of the patients‟ altered appearance
became present, and as the facial disfigurement
was so obvious and created a basis for first
impressions, other people tended to change their
behaviour towards the disfigured person. In this
stage there were two psychosocial sub processes;
noticing and dissociating. Responses
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from others were noticed and the emotions this
created within the patient were noticed. Dissociating
occurred through avoiding and through
temporarily forgetting. There was a constant
alternation between noticing and dissociating, in
a fragile balance with the feeling of being a
disfigured person, until it proceeded into the
integration of the disfigurement, with the feeling
of being a person with a disfigurement. The
movement into stage 2 occurred through the
subprocesses breaking the silence and integrating.
Integrating though were not a stable position,
outside events that impacted the patient
into a vulnerable position could trigger the
movement back into the first stage.
Putting a Face on Medical Error: a patient
perspective
Sarah Kooienga
Washington State University
Valerie Stewart
Providence Health System
Knowledge of the patient‟s perspective on
medical error is limited. Research efforts have
centered on appropriate communication or
disclosure from health care providers to patients
about medical error. Health care ethics direct
that disclosure take place for all medical errors.
Research has shown in many cases, particularly
for less serious outcomes, disclosure never
happens. If disclosure does occur, it is often
conducted in a manner that is highly dissatisfying
to the patient.
Findings for this study are based on a qualitative
phase of a larger randomized experiment. The
qualitative data collection involved a follow up
telephone call with a purposive sample of 30 lay
community participants from the larger study.
They agreed to “tell their stories” about medical
error in order to gain a better understanding of
the patient‟s perspective. Their stories of error
focused on their perceptions of lack of communication,
missed communication, provider‟s
poor interpersonal style of communication, or
poor treatment based on race, insurance status,
or other indicators of status. These experiences
greatly contrast with the formal definition of
error as failure to follow a set standard of care.
For these participants, being a patient was more
important than error as an actual event or how
an error is disclosed. In clinical practice, the
importance of respectful and dignified patient
centered communication remains paramount.
The patient‟s understanding of error must be a
key aspect of any quality improvement strategy.
Lost in translation? Methodological messes
and lessons learned using interpreters during
interviews with injured, immigrant workers
Agnieszka Kosny
Institute for Work & Health
Ellen MacEachen
Institue for Work & Health
In 2011 immigrant workers are expected to
account for almost all net labour force growth.
Yet many immigrants work in hazardous, precarious,
low waged jobs. We conducted a study
examining new immigrant‟s experiences after a
work injury. We explored workers‟ knowledge
of their rights, factors impeding and facilitating
the reporting of injuries and experiences workers
had with health care providers, employers
and the compensation system. We interviewed
14 service providers who worked with injured
immigrants (health care providers, settlement
workers, legal representatives, etc.) and 29
injured immigrant workers. Approximately half
of the interviews were done with the help of
interpreters.
This presentation examines the benefits and
pitfalls of using interpreters during the research
process. The use of interpreters allowed us to
interview participants with poor English language
skills and those who were marginalized
because of their immigration status. By including
these participants we were able to better
understand how barriers due to language affected
injured workers. However, the use of
interpreters during interviews also presented a
number of methodological, analytic and administrative
challenges. We discuss how confidentiality
and rapport were affected by the use of
interpreters and how comprehension problems
developed. In our study all participants spoke
some English and this presented unique challenges
during translated interviews. Further,
seemingly mundane administrative issues, such
as interview set up, transcription and data „read
throughs‟, had a significant bearing on data
quality. We offer important suggestions for
doing research with participants requiring interpretation.
Uncovering Tacit Knowledge in Public
Health
Anita Kothari
The University of Western Ontario
Debbie Rudman
The University of Western Ontario
Maureen Dobbins
McMaster University
Michael Rouse
The University of Western Ontario
Shannon Sibbald
The University of Western Ontario
Nancy Edwards

University of Ottawa
Planning a public health initiative is both a
science and an art. In the complex environment
in which public health practitioners work, often
under time constraints, where formal research
literature is unavailable or uncertain, public
health practitioners often draw upon „other
forms‟ of knowledge (e.g., tacit, or experiential,
knowledge). Through use of focus groups and
one-on-one interviews we aimed to gain a better
understanding of how tacit knowledge is used to
inform program initiatives in public health. This
study was designed as a narrative inquiry, which
is based on the assumption that we make sense
of the world we live in by telling stories. Six
public health units were purposively selected for
maximum variation, based on geography and
academic affiliation. Analysis revealed different
ways in which tacit knowledge was used to plan
the public health program or initiative, including
discovering the opportunity, bringing a team
together, and working out program details (such
as partnering, funding). The findings of this
study demonstrate that tacit knowledge is drawn
upon, and embedded within, various stages of
the process of program planning in public
health. The results will be useful in guiding the
development of future knowledge translation
strategies for public health organizations and
decision makers.
Walking the Borderland: Embracing Indigenous
Methodologies in the Midst of Academia
Donna Kurtz
University of British Columbia
Okanagan
de Sales Turner
Deakin University
Helen Cox
Deakin University
Jessie Nyberg
Explicitly defined research policies and the
protocols of Human Ethics Boards influence our
ability to gain ethics approval, as well as suggest
how we will engage in data collection,
undertake data analysis, advise participants of
participation requirements and disseminate our
findings. In this paper our thesis is that institutional
language requirements and procedures
often conflict with Indigenous cultural protocols,
values and traditions, making the truthful
description of how community based qualitative
research will be undertaken difficult. This presentation
shares a personal account of an aboriginal
researcher‟s journey of walking the borderlands
between academic and indigenous worldviews.
Using Indigenous Methodologies (IM) to guide
my doctoral research, honouring cultural traditions
and protocols were integral in working
with the community. The methodological research
process evolved as stories were told and
knowledge shared. In this study, Traditional
Talking Circles were used to create a culturally
safe environment for urban Aboriginal women
to talk about their health care experiences and
recommend strategies for change. Their insights
helped to shape the direction of the research
process. This fluid, nonlinearailty and unpredictability,
common in IM, challenged the often
unyielding university policies yet compelled the
researcher to stay true to the methodology described
within the Ethics application whilst
simultaneously respecting cultural protocols and
traditions. The successes and challenges of
embracing Indigenous Methodologies in the
midst of academia without losing sight of respect,
commitment, and accountability to Indigenous
peoples are offered.
Using qualitative inquiry to explore the
breast cancer experience of Chinese-
Australian women: Reflections on the issues
and challenges of data collection and analysis
Cannas Kwok
The University of Sydney
Kate White
The University of Sydney
As knowledge about the breast cancer experience
of Chinese women in Australia is limited,
our research team employed qualitative methods
to obtain rich information. Focus group
interviews were conducted with 23 Chinese-
Australian women in Cantonese or Mandarin by
the first author and two trilingual research assistants
who shared the participant‟s culture and
language. All three researchers had nursing
backgrounds and were both bicultural and trilingual.The
interviews were transcribed verbatim
and translated into English by these three researchers
using the back translation technique.
Every interview was analysed by all researchers
and translations were compared and discussed
until congruence was reached. Analysis was by
content analysis, and the second author, who is
from a different cultural and linguistic background
but has extensive nursing experience in
Australia, reviewed the themes obtained from
the data.
Drawing on this experience, we aim to describe
the lessons learnt about conducting crosscultural
and cross-linguistic research on a sensitive
topic, specifically data collection and analysis.
Communication skills training was very
helpful for facilitating discussions on a sensitive
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topic, even for interviewers from the same cultural
and linguistic background as the participants.
Having multiple translators, although it
posed significant time costs, helped provide data
consistency. Another challenge was working in
a cross-cultural and cross-linguistic team, as
different team members viewed the themes
differently. However, this also helped to reduce
bias by ensuring that certain findings were not
inappropriately labelled as culturally specific.
These lessons have implications for planning
cross-cultural and cross-linguistic qualitative
research studies involving sensitive topics.
Women's Experiences During In Vitro Fertilization
Leading To Maternal Embryo Attachment
Tammy Lampley
Cabarrus College of HEalth Sciences
and University of Nevada Las Vegas
The American Psychological Association has
identified the investigation of risk factors for
negative psychosocial outcomes for women who
confront infertility is required, as is documentation
of the effectiveness of interventions designed
to decrease psychological morbidity as a
research priority. The purpose of this research
was to understand the experiences of women
who receive IVF following embryo transfer and
prior to receiving the results of their first quantitative
beta hCG pregnancy test; and to discover
the meanings women ascribe to their nonimplanted
embryo(s) following embryo transfer
and prior to knowing their first quantitative beta
hCG result. The research question was: What
are the lived experiences of women who receive
in vitro fertilization during the period of time
following embryo transfer and prior to knowing
the outcome of their initial quantitative beta
hCG pregnancy test?
Van Manen‟s (1997) phenomenological method
and Four Existential Lifeworlds were used to
guide the interpretation and lead to the development
of a model which illuminated the women‟s
experiences. The analysis revealed Waiting was
the overarching essential theme and how the
women waited was revealed as eight subthemes:
Hope, Awareness, Doubt, Anxiety,
Isolation, Vulnerability, Despair, and Anticipation.
The long-term objectives of this study are
to educate nurses and other healthcare professionals,
and the women who experience IVF
including the families who support them; and
improve the level of health care received by this
already vulnerable group of women who experience
IVF. Implications for education, practice,
and research are included in the presentation.
Access to Renal Transplantation
Kandace Landreneau
University of Texas
Purpose: Nursing research literature provides
many studies and reviews regarding renal replacement
therapies for patients with Chronic
Kidney Disease (CKD). The purpose of this
study was to gather data through the use of
interviews to explore and explain the perceptions
of patients undergoing HD regarding their
access to renal transplantation.
Rationale: Research highlights inconsistencies
in how access to renal transplantation has been
presented. The most significant issue was the
lack of research focusing on access to renal
tranplantation.
Methods: This exploratory, descriptive study
used a phenomenological method. A convenient
sample was recruited from one urban dialysis
unit in a southern state of the USA. Saturation
was achieved during the 8th interview and
the final sample number was 8 participants.
Data collection consisted of audio-taped interviews
which were transcribed verbatim. The
analysis was performed using Colaizzi‟s phenomenological
technique.
Findings: Three themes emerged from analysis:
1) getting to transplant candidacy, 2) information,
and 3) impact on life. Participants perceived
they could be evaluated for a transplant.
The predominant theme reflected that most HD
participants had knowledge about access to
renal transplantation even though this included
much misinformation. Impact on life was also
perceived as important by these patients.
Implications: The areas of access to renal transplant,
education about current renal transplantation,
and other dynamics that impact their access,
need to be studied. Inquiry needs to remain
treatment specific and include all current
and accurate education about renal transplantation.
Being Fully Present: A Phenomenological
Study of Psychologists' Experiences of Compassion
Fatigue
Denise Larsen
University of Alberta
Wendy Austin
University of Alberta
The impact of compassion fatigue is described
as disengagement or lack of empathy by caregiving
professionals (Austin, et al., 2009). Taking
a relational ethics approach, engagement

etween client and psychologist is a moral
connection that creates the space for ethical
practice. However, little research has been conducted
on the experience of compassion fatigue,
often blurring its description with burnout,
secondary traumatization, and moral distress.
Part of a multi-disciplinary study, we present
results of a phenomenological study of compassion
fatigue amongst nine Canadian psychologists.
At the heart of the compassion fatigue
experience appear to be challenges in holding
one‟s personal/professional boundaries. Precursors
to compassion fatigue included high demands
on emotional energy at home, heavy
emotional investment in particular outcomes by
clients, and excessive workloads within seemingly
unresponsive/uncaring institutional contexts.
Participants struggled with frustration and
anger with particular clients and overwhelming
work contexts. The conflict between understanding
themselves as compassionate individuals
while witnessing their own anger threatened
participants‟ professional and personal identities.
Feeling engulfed and unhappy with
“negative” reactions toward some clients, they
worried about their capacity to provide competent
care. Concerned by the impact of compassion
fatigue, participants described attempts to
support healthy personal and professional
boundaries.
Newcomer Healthcare Experiences and
Needs in the Context of Settlement: An exploration
of patients and families accessing The
Hospital for Sick Children
Jennifer Levy
The Hospital for Sick Children
Jahanara Khatun
The Hospital for Sick Children
Atyeh Hamedani
The Hospital for Sick Children
An increasing proportion of patients at The
Hospital for Sick Children are either newcomers
to Canada - immigrants, refugees or refugee
claimants - or the children of newcomers. This
project sought to understand the experiences of
newcomers with a sick child and accessing care
at an acute, pediatric hospital. Evidence on
health disparities and the social determinants of
health indicate that newcomers have poorer
access to appropriate, quality healthcare, and
worse health outcomes. Moreover, a family's
already stretched resources may be further undermined
when a child is sick. Through qualitative
interviews with newcomer parents and
tailored interviews with children over age seven,
we explored settlement experience, social and
financial support, health beliefs, healthcare
seeking behaviour, and perspectives on health-
care. Interviews were conducted in participants'
preferred language of communication, with the
assistance of an interpreter when required. We
also reviewed participants' charts to examine the
use of interpreter services and referral to supportive
services. We identified particular points
of vulnerability; including, challenges in settlement,
financial constraints, limited health literacy
and self advocacy, confusion navigating the
healthcare and social services sectors, and limited
emotional support. The findings suggest
that newcomers require more specialized and
intensive services for optimal healthcare. To
respond to the needs of newcomers, the Hospital
for Sick Children's New Immigrant Support
Network has piloted an Intensive Case Management
Program, which intends to fill the identified
gaps.
Realist Evaluation: Its role and use in clinical
programme evaluation
Paul Linsley
The University of Lincoln
This presentation will outline the new and
emerging realist paradigm in evaluation research
and its use in evaluating clinical programmes
of activity, drawing on the presenters‟
own research and study.
The aim of realistic evaluation is to identify the
causal mechanisms and the conditions under
which certain outcomes are realized within a
given intervention or programme; or put more
concisely, what worked for whom in what circumstances?
In this way, realistic evaluation
not only addresses the effects of a programme
or intervention but also its inner workings or
mechanisms. Mechanisms do not reside in the
events or the behaviours of particular objects,
variables or individuals, but in the social relations
and organizational structures, which constitute
open systems.
In the realist world view, clinical activity and
outcomes cannot be explained in isolation;
rather, they can only be explained in the sense
of a mechanism that is introduced to effect
change in a constellation of other mechanisms
and structures, embedded in the context of preexisting
historical, economic, cultural, social
and other conditions.
In this way, effectiveness of the programme or
intervention is apprehended with an explanation
of why the outcomes developed as they did, and
how the programme was able to react to the
other underlying mechanisms, and in what
contexts. This analysis provides not only evidence
of effectiveness, but also an explanation
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that helps to develop and to improve both the
content and the targeting of future programmes
and clinical activity.
A Mixed Method Study of Mental Illness,
Compulsory Treatment, and Self-Stigma
James Livingston
Forensic Psychiatric Services Commission,
BC Mental Health & Addiction Services
A small proportion of people with mental illness
use community mental health services involuntarily
– either as a consequence of civil commitment
or criminal justice sanctions. Compulsory
community treatment is intended to protect the
welfare and safety of people with mental illness;
however, it may also reinforce stereotypes about
the mental health system and about people who
use the services.
Self-stigma refers to a complex, subjective
process – embedded within a socio-cultural
context – characterized by negative feelings,
maladaptive behaviour, identity transformation,
and adverse outcomes resulting from an individual‟s
experience, perception, and anticipation of
adverse social reactions on the basis of their
mental illness. This presentation describes a
prospective, mixed method (QUAN+qual),
longitudinal study that examined the experiences
and consequences of self-stigma for 91
people with severe mental illness who receive
compulsory community treatment in British
Columbia, Canada.
Qualitative data were analyzed using an inductive
thematic analytic framework to identify
predominant themes and recurring patterns. The
following six primary themes describe participants‟
qualitative narratives regarding selfstigma:
(a) Feeling/being knocked down; (b)
Passing-managing-overcoming; (c) Public (mis)
understanding; (d) Social identity/ location; (e)
Social disadvantage; and (f) Compulsory wellness.
In addition to discussing these themes, this
presentation will highlight how the supplemental
qualitative component of this quantitativelydriven
mixed method study allowed for both an
enriched exploration of the self-stigma construct
and an enhanced interpretation of the unexpected
quantitative patterns and trends that were
uncovered.
The cancer: A study of representations in
patients and primary caregivers.
Jose Alfredo Lopez Huerta
Universidad Autónoma de San Luís
Potosí
Agustín Zárate
Universidad Autónoma de San Luís
Potosí
The social studies related with health and disease
is a relevant study area. The purpose of this
research was to identify the cancer representation
as well as the social construction representation,
getting the require information according
to the qualitative approach. In order to get this
information we focused on the next techniques:
Semi standardized interview and non participant
observation.
We interviewed 18 primary caregivers and 13
patients and we did non-participant observation
for 25 days spread over the months of January,
February and August 2008, observations had an
average duration of three hours per day, were
used for recording field notes and recorded
conversations in the waiting room were transcribed
for analysis
We found that definitely there is social identity
criterions into this group, which justify the use
of social representations theory even though
there is no usual contact. We mainly identify
emancipated representations. We also identify
that the information which is consider to make
the representation, comes from people with
strong relationships.
In general the representation is based on: 1.
Spiritual and religious anchoring and 2. The
illness fatality objectify, therefore the medication
is good and the illness is bad. According to
the above information the causal explication of
cancer is mainly religious. The representation
changes in a positive way based on the physical
health improvement. Although the central core
of the disease stay the incurability disease. Due
to the people is afraid about a relapsed.
Alcohol consumption among pregnant
women: How do service providers and mothers
learn about and react to official guidelines?
Deborah Loxton
University of Newcastle
Catherine Chojenta
University of Newcastle
Jennifer Powers
University of Newcastle
Australian guidelines for alcohol consumption
among pregnant women have been the subject
of debate and change over the past decade. Until
2001 official guidelines recommended zero

alcohol consumption for pregnant women. From
2001 until 2009 pregnant women were advised
to avoid high alcohol consumption. From 2009
onwards, the Australian Government guidelines
recommend zero alcohol consumption for pregnant
women.
Despite these recommendations, Australian
research has shown that pregnant women are
unlikely to adhere to guidelines of zero alcohol
consumption during pregnancy, perhaps due to
the lack of an established link between low
alcohol consumption and adverse foetal outcomes.
While research into that subject continues,
another critical area that has not been well
examined involves the communication of alcohol
guidelines to pregnant women. The current
research examines how health service providers
and pregnant women learn about and react to
guidelines for alcohol consumption during
pregnancy.
Interviews with women who had recently had
children and focus groups with service providers
were conducted in Australian urban and
rural centres. Data have been content and thematically
analysed, with findings showing a
wide range of beliefs and attitudes toward alcohol
consumption during pregnancy. The main
theme arising from the data concerns the confusion
among both service providers and mothers
about „safe‟ drinking during pregnancy and
about what the guidelines are and what they
mean. Service providers also identified the
influence of a „drinking culture‟ as a major
determinant of alcohol consumption during
pregnancy. Implications for policy and practice
will be discussed.
Unraveling the complexities leading to health
inequities: A critical ethnography
Makie Kawabata
Japanese Red Cross Kyushu International
College of Nursing
Denise Gastaldo
Lawrence S. Bloomberg Faculty of
Nursing University of Toronto
Mechanisms that explain how social inequalities
lead to poorer health are complex and employing
a critical perspective has proved useful in
examining the experiences of vulnerable populations.
This study explored day labourers‟
pathways to health inequities through a critical
examination of their social contexts and cultural
behaviours in order to understand how social
structures impact the process of creating health
inequities.
Critical ethnography was conducted in a day
labourer district in Japan. Data from participant
observations, interviews with day labourers and
others, and relevant documents were analyzed.
We examined the dominant understandings of
day labourers‟ social contexts and their cultural
behaviours, reconstructed new perspectives, and
identified how the economic, political, and
cultural structures affect their experiences.
Day labourers have little control over their
working and employment conditions, including
exploitative wages and disadvantageous work
contracts. Their standards of living are far below
government established minimums. They
typically live in small rooms in transient hotels
in a socially segregated area. The seemingly
carefree lifestyles suggested by their temporary
labour and impermanent living arrangements,
which do much to create a public image of day
labourers as incompetent, lazy and lacking in
responsibility, does not reflect personal choice.
It is a lifestyle forced on them by their circumstances
and lack of financial and social resources
essential for them to turn their lives
around.
Taking a critical view of current dominant discourses
can help researchers provide plausible
evidence to policy makers to develop more
effective policy to reduce health inequities in
vulnerable populations.
Nurse family members: 'the call to care' for
our own relatives
Patricia McClunie-Trust
Waikato Institute of Technology
This presentation explores „the call to care‟ as a
central theme that emerged from my doctoral
research on nurses caring for their own relatives
in palliative care. The research explored the
challenges of living within families that make
unique demands on their nurse family members.
The methodological approach was informed by
Foucault‟s ideas about how people strive to
become ethical subjects through self forming
activities undertaken on the self in order to care
for the self and others. It was conducted as a
qualitative study with six female registered
nurse participants from different geographical
areas of New Zealand, who were interviewed
about their experience of caring for their dying
relative.
Nurses are called to care because they are present
within their own families with knowledge
and skills that influence how end of life care is
experienced by a relative. Caring discourse
positions nurses with responsibilities to their
own; responsibilities that require sensitivity in
knowing how to negotiate the relational spaces
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that constitute relationships with other family
members and health professionals. Family
discourse calls nurse family members to care as
daughters, wives or mothers within normative
understandings about the obligations that families
have to care for their ill or dependent members.
Expertise, in knowing as a nurse, positions
nurse family members as interpreters of information
and observers who watch over the ill
person‟s clinical care. This expertise, which
becomes visible in the exercise of professional
authority, challenges the normative frameworks
that classify and demarcate professional and lay
roles in palliative care.
Key words:
Nurse family member, the call to care, care of
the self, normative frameworks
Function and influences, but not as we know
it: Personal accounts across acute low back
pain experiences
Carol McCrum
University of Brighton
The 'how' and 'why' in recovery from acute low
back pain, or the development of chronic pain
and disability appear complex, multi-factorial
and remain poorly understood. From current
research, there is little evidence associating
pathology or physical findings with outcome.
'Psycho-social' factors are considered to play a
major role in the development of persistent
problems yet success in intervention remains a
challenge. This study has explored interview
and written accounts of acute low back pain
across experiences of recovery and persistent
problems to broaden understandings for practice
and research.
A narrative-discursive perspective has found a
complex relationship of social functions and
influences shaping experiences portrayed and
the accounts provided. Accounts were functioning
to characterise the nature and significance of
experiences while concurrently managing issues
of information credibility, personal character
and integrity, and personal accountability. An
orientation to wider socio-cultural considerations
and situated contextual influences also
shaped the experiences portrayed and the way
accounts were provided. Finally, an interrelated
influence was 'time', as a context and a feature
of relevance within acute low back pain experiences.
Reflecting other health professions, communication
and interaction are integral to all aspects of
physiotherapy practice, including intervention,
research strategies and evidence development.
The findings suggest the importance of recog-
nising the complexity of functions and influences
shaping personal experiences and the
accounts provided in the context of acute low
back pain. The research offers insights and
alternative perspectives on assumptions underpinning
interpretations within current practice
and research, which also extend as considerations
within other health problem contexts.
The lived experience of the preceptor in
evaluating undergraduate nurses' clinical
competence
Louise McDonnell
Trinity College Dublin
The role of the preceptor in undergraduate nurse
education is summarised as one of providing
supervision, teaching, feedback, as well as the
clinical evaluation of student nurses' performance
(An Bord Altranais 2003). Within the Irish
nursing context the evaluation of students' clinical
competence is central to the preceptorship
role, since the introduction of the degree programme
in 2002. Internationally, the literature
demonstrates the complexity of clinical competence-based
evaluation. However, from an Irish
perspective there is a dearth of research exploring
the experience of the preceptor in the process
of clinical competence evaluation.
The aim of this presentation is to report the
findings of a study exploring the preceptor's
lived experience in evaluating undergraduate
students' clinical competence. A hermeneutic
phenomenological approach was employed to
interpret the meaning of the research phenomenon.
A purposeful sample of ten preceptors
participated. Open-ended interviews were used
to facilitate data collection. Colaizzi's,(1978)
seven stage process framework guided the data
analysis. The central theme in the interpretation
of the lived experience was 'teaching and evaluating
clinical competencies'. Four related
themes emerged which were 'knowledge and
learning', 'questioning competence', 'competing
demands' and 'confidence in ability'.
The interpretation of the lived experience of the
preceptors was considered in the context of the
available literature addressing this area and a
number of implications for nurse education
were identified. The findings illuminate the
meaning of being a preceptor in evaluating
students' clinical competence, and the necessity
to value and support the formal role of the preceptor.
lm
Family Reintegration Following Guard Deployment

Deborah Messecar
OHSU
The purpose of this qualitative study was to
describe veterans and families perceptions of
their experience with family reintegration and
the challenges reintegration presents among
Guard members deployed since the start of the
Afghanistan and Iraq conflicts. Participants
included both National Guard members, and or
family members of guardsmen deployed since
2001. A total of 45 participants, 26 Guard members,
and 19 family members participated in
focus group, couple, and individual interviews .
NVIVO 8 was used to analyze the interview
data. Charmaz‟ (2006) approach to coding data
was used to organize and categorize the findings.
Several skills that members develop while
deployed, later interfere with their ability to
resume family life when they return home.
These skills included: seeking safety, getting
things done in a hurry, expecting unilateral
decision making, ensuring predictability in the
environment, and stuffing emotions in order to
get the job done. The objectives in this presentation
are to describe the challenges families face
with reintegration as a result of the conditioning
that occurs during deployment due to the stressful
environment. Implications are that individuals
returning from deployment are often still
experiencing the stressful effects of deployment
and this can interfere with family life. Suggestions
for strategies to screen for these kinds of
problems will be provided.
This research is sponsored by the TriService
Nursing Research Program, Uniformed Services
University of the Health Sciences (Department
of Defense); however, the information or content
and conclusions do not necessarily represent
their official position or policy.
Growing up & Growing Older with a Physical
Impairment: The Paradox of Normalization
through Rehabilitation
Laura Moll
University of Toronto
Cheryl Cott
University of Toronto
The purpose of this presentation is to describe
key preliminary findings from a study on growing
up & growing older with a lifelong physical
impairment. A qualitative methodology was
utilized consisting of narrative inquiry informed
by the Life Course Perspective. The life course
perspective is a dynamic approach that encompasses
multiple theories including sociology,
human development, and aging highlighting
how social, historical, and cultural contexts
shape peoples lives. Narratives are storied ways
of knowing and communicating that people use
to organize events in their lives and make sense
out of their experiences. Nine communitydwelling
individuals (3 men; 6 women), aged 26
-70, with mild to severe Cerebral Palsy were
recruited using a combination of purposive and
snowball sampling. Multiple (3-4), in-depth
interviews were completed with each participant
in order to co-construct their life stories. The
data analysis was iterative. NVIVO 8 was used
to organize the data supporting a systematic
caparison of emerging themes and categories, as
well as the central plot that weaves the participants‟
experiences together. “Normalization”
emerged as a key recurring theme in the participants‟
life stories. The focus of rehabilitation
on "normalizing" movement, particularly walking,
during childhood can lead to social psychological
challenges as well as problems later in
the life course as people encounter increasing
fatigue and decreasing functional abilities but
no longer have access to rehabilitation services.
The impact of attempts to normalize participants‟
physical performance throughout the
rehabilitation process during childhood and
adolescence on experience in adulthood will be
highlighted.
A critical reflection on the methodological
challenges of conducting research with a
community arts program for older adults
Elaine Moody
University of British Columbia
Alison Phinney
University of British Columbia
There has been a recent interest in conducting
research to explore the role of the arts in healthy
aging; however, such endeavors are often rife
with methodological challenges. The arts have
been associated with supporting older people as
they adapt to changes with age and may be
particularly important in supporting older people
who are at risk for social isolation. Research
on arts programs for older people has become
increasingly common but challenges remain in
conducting health research in the arts and with
community partners. In this paper I will critically
reflect on the methodological challenges in
a research project exploring aging and the arts
through a community partnership. I will present
the methods and findings from a program
evaluation study with a Community-Engaged
Arts program (CEA). The methods included 10
interviews with participants and staff, over 40
hours of observation and a questionnaire. Findings
indicated that the CEA program was important
to the participants in how they were able to
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make connections in their community and gain a
sense of belonging. Methodological challenges
in conducting the research will be presented and
discussed with particular attention to 1) the
historical influences on building relationships;
2) differences in the practice cultures of health
researchers and artists; 3) accountability tensions;
and 4) group cohesion. I will discuss the
significance of the methodological challenges
for both practitioners and researchers interested
in community arts for older adults.
Holistic Model of Wellness
Heather Morin
First Nations Health Council
Three Canadian longitudinal studies were conducted
in 1994 which examined issues related to
general health, child development/wellness and
economic well-being of the overall Canadian
population. Although these studies appeared to
be exhaustive, they failed to examine the realities
and cultural differences among our First
Nations people. As a result of this shortfall,
First Nations health experts created the First
Nations Regional Longitudinal Health Survey
(RHS). This survey was developed, administrered
and analyzed by First Nations people for
First Nations people, in providing culturally
appropriate community based research.
In 1997, the pilot RHS survey was completed in
BC with 16 First Nation communties participating;
in 2002/03 39 First Nations communities
participated and in 2009/10 49 First Nation
communities participated. Overall in BC there
are 203 First Nation communities so a quarter of
them are participating. The communities are
divided into small - population under 300; medium
population from 300 - 1499; and large -
1500 and higher There are four surveys that are
administrated by First Nation data collectors
intheir communities, child 0-11, youth 12-17,
adult 18-54, and Elders 55+. There is also a
community survey that looks at programs and
services in each of the particpating communities.
The model or framework, used to intrepret the
information collected as part of the RHS is
based on a holistic perspective of health, involving
the different components of mind, body,
spirit and moral/emotional well-being - each
contributing to a structure that serves to
strengthen our understanding of health.
'Insiders' and 'outsiders' in hospital ethnography:
Issues in entrée and quality of data
Benson A. Mulemi
University of Amsterdam
Participant observation is a hallmark of classical
ethnography. Many anthropologists value
„going or being native‟, as an outstanding quality
of ethnography. The basic premise for this
perception is that being an insider, or acting as
one, facilitates adequate grasp and representation
of emic perspectives of events and people‟s
experiences. Research and discourse on hospital
ethnography highlight both limitations to and
advantages of true or fake insiders in medical
settings. The opposite position of an „outsider‟
is taken by ethnographers who are foreign to
either a local ethnic culture or medical subculture.
Most hospital ethnographers fall in
either category and only a few are trained in
both anthropology and medical sciences. The
statuses of „native‟ or „stranger‟ in medical
settings affect access to fieldwork sites and
different actors‟ life worlds. These in turn affect
the quality of data and ethical considerations in
hospital ethnography. This article examines the
implications of outsider and insider positions for
hospital ethnography. It argues that either status
does not necessarily mean advantage or disadvantage.
Nevertheless, both statuses of „insider‟
and „outsider‟ require the obligation to be aware
of the associated biases.
Good or Bad Mother
Lee Murray
University of Saskatchewan
The normative discourse of good mothering is
everywhere. However, the socially constructed
texts do not fit with the aims, demands and
activities of mothering. The expectations do not
fit with the experience. What does the dominant
discourse say about mothering and the expectations
for the practice of mothering? How then
does the discourse of mothering affect the practice
of mothering and our reluctance to tell our
stories about what mothering is “really like”?
The paper will challenge the normative discourse
of mothering using autoethnographic
stories to examine and make sense of my experiences
as a mother. The stories represent my
voice, emotions, and practice of mothering.
Multiple meanings are then constructed through
the emotionality and subjectivity of me the
writer and you the reader/listener. My stories
provide understanding and interpretation at an
individual and societal level.
Preceptor Education: A World of Possibilities
through E-learning Technology
Florence Myrick
University of Alberta
Wendy Caplan

University of Alberta
Jayne Smitten
University of Alberta
Kerry Rusk
University of Alberta
Preceptorship is designed to socialize students
into their role as professionals, promote their
confidence and competence in the clinical/
community setting and foster the use of critical
thinking. In today‟s global context, opportunities
exist for local, rural, national and international
student placements which provide exciting
and mutually rewarding preceptorship experiences.
Presently, however, ongoing support
of the teaching/learning needs of our local and
distant preceptors warrants advancement. Despite
the recognized value of those involved in
preceptorship, little progress has been made
regarding the development of an infrastructure
that effectively supports their ongoing education.
This project, which was piloted from October
2008 through to and including February
2009, leveraged our established research and
teaching experience in preceptorship with technologies
that allowed us to create an accessible
and engaging e-learning space. This e-learning
space is designed to support preceptors in a
seamless fashion, improve the quality of the
student preceptorship experience and enhance
professional teaching capacity. Upon completion
of the project, participants were surveyed
and individually interviewed. Analysis of the
data reveals that participants found this program
not only to be informative and supportive but
also to be highly valued. The knowledge derived
from the findings of this study can serve
to: a) further enrich the substantive nature and
infrastructure of online preceptor education; and
b) contribute to the clarification of best practices
related to preceptor support, facilitation, and
ongoing professional development with a view
to enhancing the preceptorship experience.
Preceptorship and Practical Wisdom: A
Process of Engaging in Authentic Nursing
Practice
Florence Myrick
University of Alberta
Olive Yonge
University of Alberta
Nursing students are taught by preceptors who
socialize them into nursing through role modeling
and questioning, who create a climate for
learning and who impart knowledge or a way of
knowing about nursing. Previously it was
thought that the enhancement of critical thinking
together with the development of specialized
knowledge was the essential core to knowl-
edge acquisition. In two recent studies, however,
the researchers became increasingly aware
of the fact that while critical thinking is pivotal
to effective problem solving and decisionmaking,
responsible action and competent practice
requires another determinant, one that encompasses
but is not limited to critical thinking.
That determinant is practical wisdom or the
knowledge involved in the performance of
actions intended to generate good for fellow
human beings. It is the knowledge that compels
nurses to engage in appropriate decision-making
while integrating the rational component of
deliberation, a process that results in a more
thoughtful appreciation for the particular or
contextual human/patient situation. The objectives
of this study were threefold: a) to explore
the process that fosters practical wisdom in the
practice setting; b) to examine the dynamic of
practical wisdom and how it is represented in
the preceptor student relationship; and c) to
generate a substantive theory that can be used to
understand the phenomenon of practical wisdom
within the contextual reality of the preceptorship
experience A grounded theory method was
used to conduct this study. Data reveal a process
the researchers identify as “engaging in authentic
nursing practice.” Findings will be discussed.
Transitioning From The Nurse Practitioner
Student to the New Nurse Practitioner
Florence Myrick
University of Alberta
Olive Yonge
University of Alberta
Over the past several decades there has been a
concerted effort globally to reform health care.
Within the context of that reform the role of
nurse practitioner in primary care has been
reintroduced into areas traditionally considered
to be under the purview of the medical profession.
Because of this renewed interest in the
nurse practitioner role, educational programs
have been encouraged to specifically support
this role.
Preceptorship is a key teaching/learning approach
used by nursing programs in the education
of nurse practitioner students. Currently,
the literature is replete with research addressing
various aspects of the preceptorship experience.
To date, no studies have been conducted to
examine the process used to promote the education
of nurse practitioner students in the preceptorship
experience. Because preceptorship is an
optimal method used by faculty to teach nurse
practitioner students it is of particular importance
to determine how preceptorship actually
prepares nurse practitioners for their role in
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professional nursing practice.
Four main purposes of this research study were
to: a) examine the process involved in the acquisition
of knowledge by NP students throughout
the preceptorship experience; b) explore how
nurse practitioner preceptors impart their knowledge
throughout the teaching/learning process;
and c) determine how faculty contribute to the
nurse practitioner preceptorship experience. A
Glaserian grounded theory method is used to
guide this research. The findings indicate that
the core variable represents the following: Negotiating
the Liminal Space in the Nurse Practitioner
Student Preceptorship Experience. With
this in mind, findings will be discussed accordingly.
Methodological shortcomings following a
systematic review of recent qualitative research
into chronic low back pain
Benjamin J. Newton
Birmingham City University
Zuzana Rothlingova
Dudley Primary Care Trust
Robin Gutteridge
University of Wolverhampton
Jon H. Raphael
Birmingham City University
Chronic low back pain (CLBP) is an extremely
common condition with some estimating a
prevalence of 44% in a twelve month period
(Picavet and Schouten, 2003). To date, however,
there has been no systematic review of the
literature concerning the patient experience of
CLBP. This review sought to identify recent
qualitative research published in the last five
years, to identify common themes emerging
from the patient experience and to offer a methodological
critique of the research quality.
A search of eight databases (AMED, BNI, CI-
NAHL, EMBASE, IBSS, MEDLINE, PsycAR-
TICLES and PsycINFO) yielded 1482 abstracts.
The abstracts were independently reviewed by
two researchers and a total of 38 full-text papers
were obtained for review. The researchers independently
read these papers and assessed
whether they continued to meet the inclusion
criteria. Those papers that did were independently
critiqued using a modified version of the
Critical Appraisal Skills Programme for qualitative
research. The reviewers discussed the critique
of each paper and through a process of
agreement a final critique of each paper
emerged.
Preliminary analysis indicates a number of
methodological shortcomings. The choice of
theoretical framework in which the research was
conducted often lacked substantial justification.
Moreover reflexivity, a major aspect of qualitative
research, was often not considered or discussed.
However many articles did postulate
how their research might affect clinical practice.
The shortcomings highlighted by this review
need to be addressed in future research studies
so that qualitative research is seen as both rigorous
and credible in the academic and clinical
community.
Perspectives on establishing relationships
between foreign patients and nurses in Japan.
Chiharu Nonaka
National Center for Global Health
and Medicine
Machiko Higuchi
National College of Nursing, Japan
Japanese nurses face difficulties developing
relationships with foreign patients when attempting
to provide sufficient nursing care. The
purpose of this qualitative study was to clarify
experiences of Japanese nurses who have cared
for hospitalized foreign patients and examine
the process of establishing relationships using
grounded theory methodology. Semi-structured
interviews were conducted with 11 Japanese
registered nurses. Four major components were
revealed: intent to provide appropriate nursing
care to foreign patients, intent to understand the
diverse cultural backgrounds of foreign patients
from the perspective of one‟s own culture, indecision
regarding relationships with foreign
patients, and compromises between nurses and
foreign patients. There was considerable overlap
between these categories. One negative aspect
of establishing relationships with foreign patients
involved the unconscious expectation that
foreign patients should play the same roles as
Japanese patients. Throughout the interaction
process, nurses developed a deeper understanding
not only of their own culture, but also that of
foreign patients. Our findings underscore the
importance of facilitating the recognition and
promoting the acceptance of cultural differences
by nurses.
Access to Cigarettes, Access to Treatment: A
Youth Engagement Project to Explore the
Relationship Between Cigarette Proliferation
& Smoking Cessation
Cameron Norman
University of Toronto
Jill Charnaw-Burger
University of Toronto
Sam Saad
University of Toronto
Andrea Yip

University of Toronto
Alison Crepinsek
University of Toronto
Jessica Patterson
University of Toronto
Ilinca Lupea
University of Toronto
The Access Project was designed to foster narratives
on tobacco use by youth from across
Ontario within a positive mental health promotion
framework. Specifically, it aimed to explore
youth access to cheap/contraband cigarettes,
access to smoking cessation treatment,
and the relationship between access and smoking
prevalence.
The project utilized a variety of qualitative data
collection methods. Phase one engaged 12 youth
in media training and produced over 65 media
projects (photographs/videos accompanied by
written descriptions), which captured stories of
youth tobacco use and access within their communities
and were distributed using social network
platforms. Phase two utilized an Unconference-style
forum to engage 51 youth in three
Ontario regions. In self-organized group discussions,
youth shared individual experiences
around issues of access to cessation and treatment
options. Content analysis was performed
on data gathered from a thematic „sticky note‟
exercise and notes taken during breakout sessions.
The data suggests most youth are largely unaware
of standard treatment options available to
them, particularly those provided by the health
care system (i.e. physicians). Aside from turning
to peers for guidance, „going cold turkey‟ was
the most prominent treatment option presented.
On issues of contraband cigarettes, few youth
were aware or understood the health implications
of these tobacco products, while most
knew how and where to access cheap or contraband
products.
Findings suggest a need to create more attractive
pathways for youth to access cessation
options within the health system and for a policy
response to addressing knowledge about and
limiting access to contraband cigarettes.
The Access Project: A Rapid Response
Model of Engagement
Cameron Norman
University of Toronto
Sam Saad
University of Toronto
Andrea Yip
University of Toronto
Jill Charnaw-Burger
University of Toronto
Alison Cerpinsek
University of Toronto
The Access Project, a rapid-response health
promotion initiative, engaged 51 youth from
across Ontario in a one-day participatory workshop
to explore issues surrounding access to
contraband cigarettes and tobacco cessation
options. Using an engagement model based on
the Unconference and Open Space technology
and employing complexity science principles of
organizing, an interactive, dialogical, and safe
environment for participants to share experiences,
reflect and connect with one another
creates a platform for both data collection and
sensemaking (Norman, 2010).
Part of the process involves an agenda-setting
activity using „sticky notes‟, where each participant
anonymously submits what they see as the
most salient issues on a topic. Access to cheap/
contraband cigarettes and to smoking cessation
options were the focal point for this activity.
Ideas are posted to the wall for all participants
to see, while a rapid categorization and coding
system is employed to draw out salient themes,
which are used to seed small-group discussions
held later that day. Detailed notes are taken
during these small groups using flip chart paper
and then displayed for all participants at the end
of the discussions. Member checking is implemented
at each stage of the process.
This process of data capture, organization, reorganization,
and reflection is done in a manner
that is fully transparent to participants, allowing
them insight into the process of knowledge
generation, synthesis and dissemination in a
rapid format. This participatory process engages
youth while providing signified data that can be
transformed into actionable steps. The model
will be presented and discussed.
The Access Project: Utilizing Social Media in
Building Networking and Health Literacy
Capacities for Youth Engagement
Cameron Norman
University of Toronto
Andrea Yip
University of Toronto
Sam Saad
University of Toronto
Jill Charnaw-Burger
University of Toronto
Alison Cerpinsek
University of Toronto
Film, photography and social media are promis-
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ing means of capturing the research process and
eliciting and promoting youth narratives on
tobacco use within their local communities. The
Access Project sought to create and disseminate
youth driven media projects in innovative ways
through a variety of social media outlets such as
NING, Flickr and Facebook.
Twelve youth from across Ontario were given
media training and asked to produce media
projects, as well as share and discuss these
projects through various social networking sites
(e.g. Facebook, and Flickr). Over 65 media
projects were created (photographs/videos accompanied
by written descriptions) on issues of
tobacco use and access, using a wide range of
creative storytelling approaches including selfdocumentation
and one-on-one interviews with
peers, adults, and friends. Youth then blogged,
shared and discussed their media projects in a
virtual social forum (NING), where peer-to-peer
support and co-learning between both project
staff and youth took place. The NING social
network allowed for interactions and dialogue
around media projects to be captured in digital
format for later analysis.
The methodologies employed in the Access
Project allowed for the generation of a substantial
database of both process data and micronarratives
for analysis in a condensed timeframe.
Additionally, this methodology has a
capacity-building component as youth participants
gained enhanced media and social networking
skills, in addition to building upon their
existing health literacy capacities. Further, the
youth-generated projects allow for knowledge
translation and dissemination to wide and varied
audiences, a valued component of health promotion
and harm reduction strategies.
Impacts of Being a Peer Group Leader for
HIV Prevention on Health
Kathleen F. Norr
University of Illinois at Chicago
Chrissie P. N.. Kaponda
University of Malawi
Linda L. McCreary
University of Illinois at Chicago
Kristina Davis
Mary Kalengamaliro
Although peer groups have been widely used as
a successful intervention strategy for many
health issues, few studies have examined how
being a peer leader affects leaders themselves.
In this qualitative descriptive study, we interviewed
18 health workers who served as volunteer
peer leaders for at least 12 months, working
with groups of other health workers and com-
munity members in rural Malawi. The peer
groups focused on HIV prevention and had
positive outcomes for peer group members. The
18 peer leaders ranged in age from 26 to 48
years. Eleven were female, 15 were married,
and their education ranged from primary school
through college. Interviews were recorded,
transcribed, translated, and coded using content
analysis aided by Atlas.ti software. Inter-coder
agreement was > .85. Peer leaders expressed a
sense of hope towards the future because they
had better knowledge of HIV infection risks and
protective measures, and they reported decreasing
their own personal risky behaviors. They
exhibited pride in being change agents and
recounted many instances of spreading HIV
prevention messages beyond the peer groups, at
work and in their families and communities.
They challenged social norms by discussing
taboo topics of sexual risk behaviors and HIV.
Previous research has identified that health
workers in many African countries feel overwhelmed,
demoralized and hopeless in the face
of the AIDS epidemic. In contrast, these peer
leaders felt empowered by their experiences.
Involving health workers in efforts to address
the HIV epidemic may be one successful approach
to improve morale and reduce burnout.
The reconstruction of a profession: a qualitative
socio-historical analysis of medical liability
rulings in Israel
Smadar Noy
Ashkelon Academic College
During the last thirty years, the amount of medical
liability claims in Israel has increased dramatically.
Moreover, it seems that rulings are
changing in favor of plaintiffs. In trying to
understand that phenomenon I use thematic and
narrative analysis while carefully reading medical
liability rulings, legal writing and interviews
with lawyers and judges.
The analysis reveals a crucial change in courts'
attitudes toward the medical profession: while
in the 1960s and 1970s, the courts idealized the
medical profession (meaning that physicians
were perceived as a moral community characterized
with a sense of mission and dedication),
since the 1980s, physicians were usually perceived
as technical specialists and were thus
judged by technical and bureaucratic standards,
as well as by customer-service criteria.
In trying to explain these findings, I offer a
socio-historic explanation, locating the judicial
and medical professions in a wider sociopolitical
field of "countervailing powers". I
suggest that the judicial and medical profes-

sions, which were established in Palestine during
the first decades of the 20th century, were
both marginal in the larger power-field. Furthermore,
these two professions shared some common
Ideological, epistemological, social, and
cultural characteristics that connected them. A
change in the power-relations began in the late
1970's. The legal profession gradually strengthened,
and reconstructed itself from a profession
into a central social institution. As part of this
process, courts have begun scrutinizing the
medical practice. Moreover, they have begun
reconstructing the meaning of medical profession
itself.
Knowledge Translation and Qualitative Research:
The Tao of Puzzles
John L. Oliffe
University of British Columbia
Joan Bottorff
University of British Columbia
Gayl Sarbit
University of British Columbia
The purpose of this presentation is to illustrate
an innovative approach to knowledge translation
that used knowledge broker facilitated processes
to focus on fathers‟ smoking as a means to
developing an intervention to support fathers‟
tobacco reduction (TR). Innovative consultation
sessions were held with three groups to inform
the design of a father-centred tobacco reduction
intervention. Included were: a) new fathers who
smoked or quit during their partner‟s pregnancy
and post-partum, b) new mothers whose male
partners smoked, and c) health professionals,
service providers and policy makers with potential
to assist with piloting and implementing the
intervention. In our presentation details are
provided about the way in which puzzles and
other methods were used to communicate research
findings to the diverse consultation
groups in ways that triggered and stimulated
interaction and vigorous discussion among
participants, and generated new ideas. Iterative
processes were used for continuous revision of
the session protocols to best meet the needs of
the diverse consultation groups and to transition
previous findings into an intervention. Transcribed
data from the consultation groups were
content analyzed to identify directions for applying
the findings as interventions, as well as
distilling men-centred health promotion principles
to guide the efforts of other programs. The
success of these innovative methods to support
knowledge translation are evident in the novel
content and disseminating strategies, and these
details along with the print based version of the
father-centred tobacco reduction intervention
are shared in our presentation.
Prostate cancer support groups, health literacy
and consumerism: Are community-based
volunteers re-defining older men's health?
John L. Oliffe
University of British Columbia
Joan Bottorff
University of British Columbia
In this presentation the connections between
prostate cancer support groups (PCSGs) and
men‟s health literacy and consumer orientation
to health care services are described. The study
findings are drawn from participant observations
conducted at 16 PCSGs in British Columbia,
Canada and 54 individual interviews that
focused on men‟s experiences of attending
group meetings. Men‟s communication and
interactions at PCSGs provide important insights
for how men talk about and conceptualize
health and illness. For example, biomedical
language often predominated at group meetings,
and men used numbers and measures to engage
with risk discourses in linking prostate cancer
markers to various treatment options and morbidity
and mortality rates. Many groups afforded
opportunities for men to interact with
health care providers as a means to better understand
the language and logic of prostate cancer
management. The health literacy skills fostered
at PCSGs along with specific group-informed
strategies could be mobilized in the men‟s subsequent
clinical consultations. Consumer discourses
and strategies to contest power relations
with health care professionals underpinned
many men‟s search for prostate cancer information
and their commitment to assisting other
men. Key were patients‟ rights, and perhaps
responsibility, to compare diverse health products
and services in making decisions across the
trajectory of their prostate cancer. The study
findings reveal PCSGs as having the capacity to
contest as well as align with medical expertise
and services facilitating men‟s transition from
patient to informed health care consumers. The
processes through which this occurs may direct
the design of older men‟s health promotion
programs.
Suicide from the perspectives of older men
who experience depression.
John L. Oliffe
University of British Columbia
John Ogrodniczuk
University of British Columbia
Christina Han
University of British Columbia
Suicide is a major issue among older men, for
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which severe depression is often implicated as a
mediating factor. While various aspects of grief
and loss including bereavement and retirement
have been linked to older men‟s depression and
suicidal, the connections to masculinities are
poorly understood. Guided by the overarching
research question, how does depression and
suicide link to older men‟s masculine roles,
identities and relations, we present findings
drawn from semi-structured, individual interviews
with 22 men (55-79 years old) who selfidentified
or were formally diagnosed with
depression. Our findings revealed how cumulative
losses amid stoicism and/or social isolation
were central to men‟s unresolved grief. Prominent
were issues around self-assessing as a
failed provider and protector, judgments that led
men to ruminate while recognizing their older
age and mortality as eroding opportunities for
redemption. The participant‟s narratives revealed
external and internalized stigma as barriers
for acting on suicidal ideations that frequently
emerged from their negative thoughts.
That said, while guilt around the stigma endured
by a bereaved family was a barrier for suicide,
many participants contemplated a self-induced
death that was not obviously suicide as a means
to making available life-insurance benefits for
their family. Our findings reveal how masculine
ideals and participant‟s alignment to specific
performances influenced their actions and nonactions
around self harm and suicide. In concluding
the presentation we offer some recommendations
for how the diversity of masculinities
that emerge around men‟s mental illness
practices might be used to inform aspects of
older men-centered suicide prevention programs.
Arranging for alternative caregivers: Challenges
to safe care for parents of children
with disabilities and chronic conditions.
Lise Olsen
University of British Columbia
Mariana Brussoni
University of British Columbia
Anton Miller
University of British Columbia
Maureen O'Donnell
University of British Columbia
Research indicates a higher risk of injury for
children with different types of disability and
some chronic health conditions. Parents play a
large role in mitigating childhood injury risks,
yet there has been little research examining how
injury risks related to child disability or chronic
conditions are perceived and managed by parents.
One consistent issue for these parents is
the arrangement of safe care by alternate care-
givers.
Qualitative semi-structured interviews were
conducted with parents of children 1-5 years in
British Columbia, Canada. Questions addressed
parents‟ safety concerns, impact of children‟s
health challenges on safety efforts, and how
parents arranged for alternative caregivers.
Grounded theory methods guided data analysis.
Parents of children with a range of disabilities
and chronic conditions were interviewed for the
study. Findings included that some parents
regularly left children in the care of others while
others did so very rarely. Parents reported that a
lack of suitable care options and training of
alternate caregivers regarding their child‟s special
needs were a challenge. Arranging safe
alternate care caused worry and concern for
parents and a lack of suitable options resulted in
some parents receiving little respite from child
care responsibilities.
Parents‟ safety concerns presented a major
barrier to arranging alternate care for their children.
Strategies to improve options for parents
should be considered including how specialized
safety training can be provided to those working
in formal as well as informal child care settings.
Bush Battles- the challenges of providing
acute health care in rural contexts in Australia
Vicki Parker
Hunter New England Health Service
Michelle Giles
Hunter New England Area Health
Service
Glenda Parmenter
University of New England
Isabel Higgins
University of Newcastle
Penny Paliadelis
University of New England
Angela White
Hunter New England Area Health
Service
Introduction
In Australia, the rural health care environment is
characterised by increasing disadvantage in
relation to access to services and resources.
Within this context, health professionals are
challenged to provide what they feel is good
quality health care in a community of which
they are a part. This paper presents the results of
a study which aimed to:
• Identify challenges confronting
health care professionals in rural acute care
settings

• Facilitate inter-professional collaboration
in working towards improved patient
outcomes and staff participation.
Method
A mixed method approach involved a consultative,
participatory process. An initial survey was
followed by focus groups and workshops. The
target population was health care professionals
across disciplines, in rural acute care facilities
within one large Area Health Service in NSW,
Australia. Workshops facilitated interdisciplinary
collaboration to identify strategies for
addressing concerns with the aim of developing
priorities for practice change projects.
Results
Results highlighted issues to do with staffing,
isolation and communication as most significantly
impacting on staff and patient outcomes.
Access to resources and support services was
the most frequently cited challenge. Results
were consistent across professions and sites
within the Area Health service. Focus groups
identified a range of issues related to geographic
and professional isolation, working with and
apart from larger centres, generalist practice and
insufficient services and staff.
Conclusion
Findings point to the urgent need to support
clinicians through the mobilisation of strategies
that are context specific, locally based and led,
but at the same time transferrable across sites.
Interprofessional Practice- possibility or
pipedream
Vicki Parker
Hunter New England Health Service
Rebecca Mitchell
University of Newcastle
Michelle Giles
Hunter new England Area Health
Service
Recognition of the importance of interprofessional
practice in health care is growing. This
recognition is based on research that identifies
improvements in patient and service delivery
resulting from shared decision making and coordinated
activity. However, other studies identify
interprofessional teams as a site of tension
and contested authority. This paper reports the
findings drawn from a qualitative study that
examined health care professionals experiences
of being part of an inter-professional team, the
challenges as well as the triumphs.
Method
Focus groups and interviews were held with
teams and individuals who were members of an
interprofessional team in an acute care context
in a tertiary referral hospital in NSW, Australia.
Participants included nurses, doctors, physiotherapist,
speech therapists and dieticians.
Results
Participants highlighted openmindedness and
goal co-operativeness as factors that enabled
the development and ongoing functioning of the
team and consequent adoption of team identity.
Team member supported each other in dealing
with the structural barriers to team working
within the hospital environment. Tensions arose
from the discipline specific demands on individuals
that threatened the teams‟ activity. Processes
that were identified as critical to team
success were team processes, communication
and shared leadership. Although there were
often arguments within teams, individuals felt
that being able to put forward their professional
perspective increased their profile and their
sense of being valued within the organization.
Participants described having to work hard to
keep the team together.
Conclusion
Interprofessional team success is contingent on
resisting persistent destabilizing forces and
creating supportive and enabling processes.
Shifting from Critical Care to Comfort Care:
Communication between Health Care Providers
and Families
Cynthia Peden-McAlpine
University of Minnesota
Joan Liaschenko
Attention to end of life issues in critical care is a
recent phenomenon and a review of the literature
identified the major problems as the unclear
distinction between critical illness and terminal
illness and the unpredictability of timing when
the focus of care should change from critical
care goals to comfort care goals. The aim of this
study was to investigate the context of communication
surrounding trajectories of dying to
identify challenges and possible solutions to the
problems of shifting from critical care to comfort
care. Stake‟s case study method was used to
study this problem. Narrative interviews of six
cases consisting of the family and health care
providers of dying patients in ICU were completed.
Data was analyzed to illuminate patterns,
relationships, and relevant meanings. The findings
illustrated that families lack understanding
of the whole picture of the patient‟s deteriorating
condition and the prognostic implications.
This is mostly due to information received in
fragments and the stress they are experiencing.
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Even with the best information given to families
they need time to process and a comfort level
with providers to achieve consensus about the
shift from critical care to comfort care. Families
require emotional support, mediation and clarification
on an ongoing basis. Families want
information related to odds of survival and
quality of life and a rationale for the meaning of
the patient situation to the provider. Implications
include providers‟ attention to individualized
care and inclusion of family in decisionmaking
facilitating consensus between the family
and provider.
Communicating about congenital anomalies
with parents
Hagit Peres
Ashkalon College & Ben Gurion
University
Delivery of bio-medical information about
suspected congenital anomalies is always emotionally
sensitive challenge for practitioners,
which strongly impacts on parents' decisions
weather to terminate compromised pregnancies,
or build capacities to care for newborns with
severe disabilities. Tension increases tremendously
when medical practitioners deliver western-oriented
ideas while patients belong to nonwestern
minorities. The Arab-Bedouin population's
case displays language and cultural barriers,
as well as socio-political tensions inherent
challenges for obstetric-gynecologists and neonatal
staff. Sixty qualitative interviews held with
Arab-Bedouin couples who were diagnosed
with severe congenital problems are the basis
for this study. Parents interviewed recall ordeal
experiences from the moment they were informed
about their babies' compromised health
situations. Their perspectives and perceptions
teach us how mutual misunderstandings and
failure to mutually communicate ideas and
emotions leading to distrust.
Here I offer an amplification of our understanding
of these parents' perspectives by pointing on
information gaps as well as on the diverse social
and emotional reactions created in the context of
clinical perinatal sessions.
Arguably, the prominent importance of cultural
competency revealed by medical staff in each of
these distressful situations could not be overestimated.
By listening to these parents the aim here
is to further sensitize and develop the culturally
competent medical practice, hoping to improve
medical performance in ways that will minimize
parent's suffering and establish effective and
beneficial communication. Ultimately, the goal
is to maximize trust in relations between parents
and medical services at large.
Courtesy Stigma: A Hidden Health Concern
Among Frontline Service Providers to Sex
Workers?
Rachel Phillips
University of Victoria
Courtesy stigma is the public disapproval
evoked by associating with stigmatized individuals
or groups. Several studies have examined
how family members of stigmatized persons
are negatively affected by courtesy stigma,
but there has been little research examining how
workers providing frontline health and social
services to stigmatized populations might also
experience courtesy stigma. Research on the
occupational health of persons performing frontline
service work examines various sources of
workplace demands and rewards, including the
availability of public funding for the health and
social service sectors, the devaluation of feminized
forms of care-oriented work, and the
downloading of responsibility for providing care
to poorly paid or unpaid workers in the community
and home. This research project blends the
literatures on courtesy stigma and the occupational
health of frontline service workers to
understand the experiences of those providing
frontline social services to sex workers. A
mixed methods design is used to study the
workplace experiences of a small group of
workers (n=17) in a non-profit organization
providing support and educational services to
sex workers. The findings reveal that courtesy
stigma is a discernable experience among this
vulnerable group of service workers, affecting
both their work and family contexts. Courtesy
stigma played a significant role in staff perceptions
of others‟ support for themselves and their
work activities, leading to diminished opportunities
for collaborative relationships, emotional
exhaustion, altered service practices, and a low
sense of workplace accomplishment. The implications
of the findings for the literatures on
courtesy stigma and frontline service work are
considered.
'Woman centred care'? An exploration of
professional care in midwifery practice
Mari Phillips
University of Huddersfield
„Woman centred‟ care refers to a philosophy of
maternity care that makes individual women the
focus of the care provided throughout the span
of pregnancy, birth and postnatally. This philosophy
has been a central tenet of maternity
policy within the British National Health Service
since the early 1990s. Unfortunately the
policy documents that have driven the aim of

„woman centred care‟ fail to take into account
the issues and competing priorities that stakeholders
have to consider at the level of the operationalisation
of the service.
This paper reports the findings of a doctoral
study (Phillips, 2009) that explores both
women‟s and midwives‟ experiences of maternity
care over the full trajectory of maternity
provision. A modified grounded theory approach,
framed within a feminist perspective,
was used. Fieldwork was undertaken in two
phases; in phase one twelve women were interviewed
in pregnancy and after the birth. Nine
midwives were also interviewed. Preliminary
categories were identified and used to inform
phase two which included both informal, telephone
contact and in-depth interviews with five
women spanning from early pregnancy until
after the birth and included observation of their
care in labour. The midwives specifically involved
in their care were also interviewed.
The data demonstrated a continued mismatch
between the women‟s and the midwives‟ perspectives
and it was evident that despite the
policy drivers and consumerist rhetoric of
„woman centred care‟ that this was not the overriding
experience for the women who participated
in the study. I shall highlight some of the
tensions and dilemmas faced by women, midwives
and health service managers and consider
the implications for policy makers and both
maternity service and education providers.
"Under the Microscope": The Challenges,
Risks, and Responsibilities of Conducting
Health Research with Marginalized Populations.
Cheryl Pritlove
York University
Parissa Safai
York University
Qualitative approaches and research findings are
said to help dispel misconceptions about marginalized
populations by allowing such groups
to have their voices heard and stories told – thus
empowering people who lack social, political,
cultural and/or economic capital. Far too frequently
however, it is overlooked that the participant/researcher
relationship formed within
this methodological approach can be, and often
is, situated against the backdrop of broader
social power differentials (including, but not
limited to differences in income, education,
illness, sexuality, „ability‟, and gender); thus
casting doubt on the potential of qualitative
research to act as a venue of participant empowerment
rather than a site of reproduction.
Touching briefly on some of the „how to‟ issues
that arise at different stages of the research
process, such as recruiting and interviewing,
this presentation will consider the particular
methodological challenges and/or risks associated
with knowledge (and knowledge production),
researcher/participant relationships,
power, ethics, and social justice as situated
within their particular political, personal, and
relational frameworks. Specifically, the focus
of this presentation will be on my methodological
experiences and challenges as a researcher
working with low income women with cancer.
Embedded in this specific discussion will be a
broader evaluation of how well intentioned
researchers can unintentionally reproduce problematic
discourse while working with marginalized
groups and to highlight the importance of
researcher reflexivity and participatory approaches
as potential ways of negotiating such
methodological challenges.
Qualitative study on factors influencing positive
prevention among people living with
HIV/AIDS in Iran
Seyedramin Radfar
Thought,Culture and Health Institute
Pardis Nematollahi
Thought,Culture and Health Institute
Introduction: Positive prevention could be considered
as one of the main strategies that can
reduce or reverse the HIV/AIDS epidemic. This
qualitative study tried to obtain the factors that
can promote positive prevention practices
among PLWHA in Iran.
Methods: The main tool for obtaining of the
ideas was focus group discussion with men and
women that were living with HIV/AIDs in 6
provinces of Iran that had different geographical
and etnicity.64 PLWHA (16 women,48
men) in11 FGDs in 6 provinces had been interviewed
and sessions analyzed by thematic approaches.
The main themes were knowledge and
information of the participants about routes of
transmission, responsibility of participants about
other`s health and positive prevention concepts.
Results: Based on the findings the main factors
that influence positive prevention approaches
could be categorized as stigma and discrimination
( in context of family, community and
medical),disclosure barriers (pressure from
spouse, phobia of unemployment after disclosure),using
drugs and alcohol, active sex work,
low religious opinions , poor or no access to
ARV, needle and syringe programs especially in
closed settings , unmarried status, lower education
and poverty were the factors that influence
positive prevention practices.
Conclusion:
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Among the factors that mentioned above, majority
near to all of the participants believe that
stigma and discrimination, using drugs , active
sex work , low access to NSP/ARV and low
religious belief can be considered as the main
factors and it is recommended to work and
promote the situation of these fields to achieve
better positive prevention practices.
Caring TV as a client driven service design
Katariina Raij
Laurea University of Applied Sciences
We have applied Action research in developing
the CaringTV® as a two channel interactive
TV-system. It aims to develop new technology
based solutions for elderly people living at
home and for municipalities dealing with challenges
in health and social services. The CaringTV
has been developed in four different
R&D – projects with clients representing
family care givers (n=25), elderly people discharged
from hospitals (n=44) and elderly people
using services delivered by special service
houses (n=70). Action research was used as a
practical, participative, reflective and social
process. The purpose was to study elderly peopleâ€s
social reality to change it and change
reality in order to study it. The study consisted
of circles with four phases; observing, reflecting,
planning and implementing with and for
clients. We call this a client driven service design.
Findings are presented by applying Habermanâ€s
three domains of knowledge. From a
technical point of view we have the CaringTV
platform. From a practice-hermeneutic point of
view we have identified a family care giver,
different user groups, the challenges elderly
people discharged from hospitals meet at home
and an elderly person as a client in service
houses. From an emancipatory point of view
virtual, interactive support and guidance services
and participative programmes are developed
with and for elderly people to improve
their capacities. The concept of a client driven
service has been created as the indicators of
quality of life based on the elderly peopleâ€s
own conceptions. They have led to the development
of e-health services.
A poor excuse? An examination of how the
PTSD defence plays out in the Canadian
press
Tamara Reid
Simon Fraser University
Post-traumatic stress disorder (PTSD) is an
increasingly pervasive, though controversial,
diagnosis that emerged from the notion of "shell
shock" in war that is now invoked with increasing
frequency in court as a mitigating factor at
sentencing and/or as the basis for a related defence.
This project reviews the development of
the diagnostic category and controversies that
surround it and reports the results of a content
analysis of 401 newspaper articles detailing 121
unique cases in which PTSD was invoked.
Results revealed that professional controversies
surrounding PTSD have filtered into journalists‟
representations. Perceived legitimacy of the
defence hinged on simplistic conceptualizations
of the plausibility of the diagnosis, specifically,
as concerns ideas about what it means to be a
victim, and the severity of crime(s) committed.
Empathy prevails when the possibility for
trauma is obvious, and the crimes committed are
minor. The greater the heinousness of the crime,
the greater the likelihood that a PTSD defence
will be dismissed as insufficient or irrelevant.
Moreover, the author advances the position that
the offender who is linked to the PTSD diagnosis
in crime stories becomes a “face”, whose
reported biography and features contribute to
shaping the prevailing view of the problem with
which he or she is associated, subscribed to by
both the media professionals who represent
these cases and the general public who reads
about them. Hence, certain characters make bad
representatives when advocating for the acceptance
that the effects of trauma can be such that
criminal behaviour can unwittingly ensue.
Promoting Student Success in Online
Courses
Sue Robertson
California State University, Fullerton
Penny Weismuller
California State University, Fullerton
Mary Lehn-Mooney
California State University, Fullerton
Yvonne Ginez-Gonzales
Long Beach VA Medical Center
While research has identified faculty support
and availability as key student motivators and
critical to successful online learning outcomes,
specific behaviors constituting support and
availability have not been identified. This pilot
study sought to identify students‟ perspectives
of faculty behaviors supporting success, and
methods used by student-identified faculty
exemplars to promote student success.
Fifteen students who described themselves as

successful in fully online courses and the 10
faculty exemplars identified by these students
were interviewed. Interviews were audiotaped
and transcribed. Content analysis was used to
analyze data. Researchers read interviews to
obtain a sense of the whole, coded interviews
individually, then met to reach consensus on
codes and to develop categories and themes.
Students wanted to know faculty were as invested
in students‟ success as students were.
Categories around this theme were Organization,
both of the course/online environment and
how students organized their time; Communication
within the course and with the faculty;
Connection to the faculty and other students in
the course; and effective Teaching strategies
and relevant assignments. Faculty exemplars
identified the same categories but described
them from an ontologically different perspective.
Impact of family and personal history of
abused pregnant women on their coping with
current IPV
Linda Rose
Johns Hopkins University
Shreya Bhandari
Wright State University
Kristin Marcantonio
Johns Hopkins University
Linda Bullock
University of Virginia
Jackie Campbell
Johns Hopkins University
Phyllis Sharps
Johns Hopkins University
Intimate partner violence (IPV) affects 3-4
million women each year. Interventions must
consider the contexts of women‟s experiences
of abuse, how women view their situation and
what their options for responding to the abuse.
Pregnant women who are abused may have
experiences in their families of origin that influence
their views of current relationships, and
responses to abuse.
Qualitative interviews were conducted with a
subset of 37 pregnant women with a history of
IPV or current IPV, enrolled in a clinical trial.
Women were interviewed prior to giving birth
and at regular intervals for two years post delivery.
Interviews focused on family context of
abuse, response to abuse, and barriers and facilitators
to help seeking. This presentation reports
findings from baseline interviews. Interviews
were tape recorded and transcribed verbatim.
Data were analyzed using constant comparative
analysis.
Themes were: relationships with parents; witnessing
and/or experiencing abuse as a child;
foster care experiences; and parental drug abuse
and mental health concerns. Further contextual
factors were: previous abusive relationships,
“pile up” of current stressors, including financial
constraints and multiple children, and fear
and fatigue related to abuse.
These family and personal history factors may
influence women‟s ability to cope with the
current IPV, resulting in a deficit in coping
repertoires. Assessments of self-concept and
mental health should be integrated into interventions.
Past relationships and evaluation of present
circumstance reflected both a psychic fatigue
and resilience.
Meaning of Donation Experience for Living
Kidney Donors
Linda Rose
Johns Hopkins University
Laura Taylor
Johns Hopkins University
Anne Belcher
Johns Hopkins University
L. Ebony Boulware
Johns Hopkins University
Kathryn Dane
Johns Hopkins University
Sherrie Klunk
Johns Hopkins University
Christine St.Ours
Johns Hopkins University
Marie T. Nolan
Johns Hopkins University
There is an urgent need for living kidney donors,
as the shortage of organs is increasing.
Living donors are a viable option; but the need
to understand the impact of donation on the
donor is essential in order to meet their needs
for physical and psychological support.
This study explored the meaning of kidney
donation in a diverse sample of living kidney
donor candidates. Seventeen donors were interviewed
4 times from pre-donation to one year
post-donation. Interviews were transcribed
verbatim and analyzed using thematic analysis.
Data were grouped into four categories: 1)
attitudes, perceptions and emotions related to
donation; 2) motivating factors influencing
decision to donate; 3) family influence on decision
making and quality of experience; and 4)
implications for transplant care. The following
themes were identified: 1) donating is a positive
physical and emotional experience; 2) donating
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is imperative to ease the recipient‟s suffering; 3)
donating is reflective of self and/or relationship
with recipient; 4) experience is influenced by
type and quality of family involvement; and 5)
donating includes self-evaluation of immediate
recovery and long term impact.
Most participants described a positive experience,
but some donors experienced more complex
reactions and had needs for ongoing support.
The importance of relationships between
donors and recipients was significant, and the
impact of “being a donor” became a lasting
characteristic of their self-identity. This presentation
will include implications for transplant
teams.
Stories of Life and Birth: An intergenacional
study
Natália Salim
University of São Paulo
Hudson Santos Junior
University of São Paulo
Dulce Maria R. Gualda
University of São Paulo
Childbirth is an event with different meanings in
multiple socio-cultural contexts. In fact, this has
led to changes in customs and practices present
during the moment of giving birth. This goal of
this study was to understand the experiences of
childbirth and maternity from the stories of
women of different generations of a Brazilian
family who experienced childbirth from the
1940‟s up to the year 2000. This is a qualitative
study that focused on practical discussions and
feelings produced during the experience of
giving birth. Eight women, all residents of the
southern part of Sao Paulo City, participated in
this study which involved interviews that took
place in the actual residences of the participants.
A semi-open method was chosen to enable the
sharing of stories and feelings. Interviews were
recorded after receiving participants‟ authorization
and later transcribed. During the analysis
of dialogic responses, maps were elaborated
from these interviews, which allowed the viewing
of the different feelings involved in the
experience of childbirth. These feelings are
associated to family and cultural experiences,
which reveal the sharing of repertories and
various types of childbirth care throughout
generations. The uniqueness surrounding the
birth stories, allowed an understanding of the
values, deeply rooted in these experiences of
childbirth for women, and it may be said that,
these experiences of labor relations are linked to
the stories that affect what women have experienced
during their lifetime.
Practical Considerations and Patterns of
Collaboration in the Marriage Relationship
Among Persons with Disabilities
Celia Schulz
The University of Texas-Pan American
This study reports on a subset of data obtained
from a larger study. A qualitative study of persons
with disabilities was conducted to examine
the phenomenon of collaboration with others in
their lives. Participants were administered two
semi structured interviews about their experiences
with collaboration and were observed as
they collaborated with others in their lives in
two participant observation sessions. Since not
all
participants were married, data relevant to the
marriage collaboration from interviews and
participant observation sessions of a subgroup
of four married study participants were then
isolated and coded using open coding analysis.
Accuracy of data was insured through the use of
triangulation via multiple coders and member
checking. Five
overarching categories emerged. This presentation
will focus on two of these categories and
their sUniversity of British Columbiaategories:
Practical Considerations [Division of Tasks and
Roles According to Abilities; Collaboration
About the Environment; Problem Solving; and
The Use of Technology]; and Structures and
Patterns of Collaboration [Stating One‟s Needs;
Requesting Assistance With a Physical Task;
Anticipating Needs of One‟s Spouse; and Temporal
Element]. Data indicated that participants
collaborated with their spouses in a variety of
ways over time. Some unique issues in the
marriage collaboration for people with disabilities
also emerged, such as feelings of imbalance
in the contributions to the marriage regarding
physical tasks .
"Grasping the Grey": Making Meaning
about Huntington Disease Intermediate Allele
Predictive Test Results
Alicia Semaka
University of British Columbia
Lynda Balneaves
University of British Columbia
Michael Hayden
University of British Columbia
The genetics of Huntington disease (HD), an
incurable neurodegenerative disease, is often
portrayed as “black or white”; an individual is
either gene-positive or gene-negative. However,
over the last decade, HD has proven to be more
complex with a proportion of individuals receiv-

ing a “grey” genetic test result - an intermediate
allele (IA). These individuals will not develop
HD yet unusually their children remain at-risk.
The purpose of this study was to investigate
individuals‟ understanding about the clinical
implications of an IA and explore the process
they undergo when making meaning about this
result.
Using grounded-theory methodology, 28 individuals
who received an IA result from 4 genetics
clinics participated in an open-ended interview.
Many participants struggled to understand
the clinical implications and make meaning
about this result for themselves and their children.
The degree to which an individual struggled
to “grasp the grey” was influenced by their
familial experience with HD, their beliefs about
HD inheritance, and the genetic counselling
they received during their genetic testing. While
some individuals were uncertain about the
meaning of their grey result, other individuals
assigned this result either a “free & clear”; “it
could be worse”; or a “threatened future” meaning.
This is the first study to examine individual‟s
understanding of an IA and indicates that over
half of the participants were either uncertain or
had incorrect knowledge about the clinical
implications of their result. These findings will
help inform the development of genetic testing
guidelines and ensure these individuals receive
appropriate education, counselling, and support.
The Lived Experience of Latinas Who Listen
to Music for Chronic Pain
Patricia Shakhshir
Western University of Health Sciences
Chronic pain, pain that persists beyond the
expected time of recovery is difficult to manage.
Women and minorities tend to have difficulty
obtaining treatment. Women tend to be proactive
in seeking complementary alternative treatments
(CAM). Multimodal interventions of
analgesics and alternative complementary interventions
are the recommended approaches.
Listening to music is one type of complementary
intervention.
This study explored the lived experience of
Latinas as they listened to music, an intervention
for chronic pain control. The participants
were asked to follow their normal patterns,
which included taking analgesics. The participants
were interviewed and audio-recorded
three times over three visits. They kept journals
in which to write their experiences. Follow up
interviews were carried out after each journal
was analyzed. Clarification was sought during
the follow up interviews related to points that
were unclear in the journals. Ten women ages
30-50 participated. All but one of the women
identified themselves as either Mexican or
Mexican-American.
Four specific themes were derived from the
interviews and journals: 1) replacement of unpleasantness
with beauty, 2) feelings of hope
and joy 3) music as a gift from God, and 4)
music for comfort. Music has provided much
more than pain relief for these participants, it
has provided respite from a life filled with pain,
beauty, and for some, replenishment and hope.
This study may be replicated with other cultures
and/or gender.
Lessons Learned in Innovation: Role Transition
Experiences of Clinical Nurse Leaders
Rose Sherman
Florida Atlantic University
Purpose
The Clinical Nurse LeaderSM Project was initiated
by the American Association of Colleges of
Nursing in April 2004. To date, more than 100
universities/colleges in the US are participating
in the project with over 200 clinical partner.
The CNL role is the first new role proposed for
nursing since the Nurse Practitioner role was
introduced in the mid-1960s. The purpose of
this research was to explore the role transition
experiences of Clinical Nurse Leaders working
in practice settings throughout the United States.
Methodology
This was a qualitative study using an Interpretative
Phenomenological Analysis approach.
Semi-structured telephone interviews were
conducted by the investigator during 2007/2008
with 71 practicing Clinical Nurse Leaders
throughout the United States. The work was
funded by a Robert Wood Johnson Executive
Nurse Fellows grant.
Findings
Topics explored with the CNLs included what
influenced their decisions to prepare themselves
for this pioneering role, their satisfaction with
their role, educational preparation, challenges
with the role, organizational support for the role,
impact on patient outcomes and how they
viewed the future of the role. The journey for
pioneering CNLs has been challenging but most
are confident that they are having a significant
impact on patient and staff outcomes. They
view the future optimistically but are aware that
unless they can make a financial case for the
role, it may not survive in the current economic
atmosphere in the US.
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Significance
Lessons learned in innovating this new educational
program and clinical role will discussed.
Child home safety: Are we tackling a 'wicked
problem' with 'tame solutions'?
Jean Simpson
University of Otago
Rob McGee
University of Otago
Geoff Fougere
University of Otago
Chrystal Jaye
University of Otago
Unintentional injury to young children often
occurs at home. Common causes have been
identified and a few interventions proven, but
many injuries still occur that appear predictable
and preventable. The home is a complex, interactive
environment, that operates within a dynamic
social setting. Child home safety, therefore,
could be considered a „wicked problem‟.
In the 1970s Rittel and Webber coined the
phrase „wicked problems‟ to denote problems
that were not unethical, but that existed in complex
ecological systems in which social, cultural,
economic and political factors were operating
concurrently. Solving such problems by
using „tame‟ solutions that address simple
causes and their effects is not particularly effective.
The ongoing lack of success in reducing
some child home injury at least, suggests that an
analysis using a „wicked problem‟ approach
offers an alternative lens that may help find
resolutions.
In a qualitative study, child home injury was
explored using the wicked problem model.
Using data obtained from in-depth interviews
with health professionals, community family
workers and parents of young children, opinions
and experiences regarding what influenced
keeping children safe were analysed and the
wicked problem framework applied. This presentation
examines a few of the issues that
emerged as being potentially critical to keeping
children safe at home, for example, parental
fatigue and being „time poor‟. Implications for
developing and delivering effective health promotion
programmes to reduce child home injury
will be discussed.
Methodology in an ecological framework:
Hearing parents' voices on child home safety
Jean Simpson
University of Otago
Rob McGee
University of Otago
Chrystal Jaye
University of Otago
Geoff Fougere
University of Otago
Measuring mortality, morbidity or controllable
hazards, and determining risk factors are crucial
starting points for developing interventions for
child home injury. For programmes to work
effectively however, an analysis of the contextual
and personal interactions that operate in the
home environment is also important. Preventing
child injury at home is more than the implementation
of a series of interventions, it is about
safety management including coping with conflicting
behaviours and beliefs, interactions
between people and a dynamic environment.
Primary carers, usually the parents, are key
stakeholders in child safety and their perceptions,
beliefs and actions are critical for safety
management at home to be effective. Most
parents want to keep their children safe, but
unlike those who analyse at the population
level, they work at a personal level that brings
very different, but very valid, perspectives to the
problem.
Hearing the experiences, knowledge and opinions
of these key practitioners regarding what
influenced their safety management for young
children is vital for the design, development and
delivery of effective programmes to reduce
home injury to young children. How to do so
has been approached in various ways. This
qualitative study undertook a series of in-depth
interviews. This presentation describes and
discusses methodological and practical aspects
of developing the study, considerations in
choosing methods for obtaining robust qualitative
data and undertaking analyses, and issues
that emerged with drawing conclusions for the
design, development and delivery of prevention
programmes.
Awareness of dying and dying trajectories in
people with heart failure and people with
lung disease, revisiting Glaser and Strauss.
Neil Small
University of Bradford
Merryn Gott
University of Auckland
In 1965 and 1968 Glaser and Strauss published
Awareness of Dying and Time for Dying, examining
awareness contexts and temporal aspects
of work with the dying. They sought to “make
the management of dying by health professionals,
families and patients more rational and
compassionate”.
In this paper we report qualitative research on

the end-of-life care of two groups of people
living with terminal illness in the UK. One
group had a diagnosis of heart failure (40 patients
and 20 family members), the other
Chronic Obstructive Pulmonary Disease
(COPD) (21 patients, 16 family members). In
addition we undertook focus groups with 79
health care professionals involved in heart failure
care and 39 health care professionals working
with COPD.
More than 40 years after Glaser and Strauss we
identified awareness contexts that included the
closed, when the person with the illness is not
aware of the significance of their diagnosis. It
was this, with corresponding “problematic identity”
for the patient, that had been Glaser and
Strauss‟s target for change. In part this closed
awareness is a manifestation of uncertain illness
trajectories and the resulting impasse that, as
Glaser and Strauss identified, “dying must be
defined in order to be reacted to as dying”.
Our qualitative interviews with patients and
carers and focus groups with professional care
staff show the continuing resonance of Glaser
and Strauss‟s insights. Advances towards open
awareness and improvements in managing the
status passages of terminal illness have been
largely confined to cancer care.
A Qualitative Evaluation of the Pre-Release
Planning Program for HIV+ Former Georgia
State Prisoners
Donna Smith
Georgia State University
Richard Rothenberg
Georgia State University
This paper presents results from a qualitative
evaluation of the „Pre-Release Planning Program‟
(PRPP) of the Georgia Department of
Corrections. Begun in 2004, PRPP provides
comprehensive discharge planning for HIVinfected
prisoners being released from Georgia
state prisons. The program was created because
of compelling evidence that HIV+ former inmates
may not adhere to their anti-retroviral
therapeutic regimen, may practice behaviors
that place others at risk for contracting HIV
infection and may be more likely to return to
prison. With a single Pre-Release Coordinator,
PRPP currently serves only 25% of eligible
inmates state-wide; ours is the first formal
evaluation of the program. Utilizing a grounded
theory approach, we conducted 25 in-depth,
qualitative interviews with PRPP participants
who had returned to the Atlanta metropolitan
area within the previous 18 months. These
interviews provide textual 'snapshots,' illustrating
the challenges faced by all former prisoners
- challenges only exacerbated by the marginal-
ized health status and stigma experienced by
persons living with HIV/AIDS. The sense one
gets from these interviews is that of adults released
to the so-called 'free world,' but in a state
of constant tension and strain that is unsustainable.
While the PRPP program successfully
links HIV+ former Georgia state prisoners to
medical care and other basic social services
such as food stamps, participants noted repeatedly
that their greatest needs were finding transitional
housing and employment. Supporting
these needs is beyond the scope of the PRPP
program as currently structured. This evaluation
makes clear that greater institutional support
is needed for this highly disadvantaged
population of HIV+ former prisoners.
Using Institutional Ethnography to Explore
Community Treatment Orders
Nicole Snow
Centre for Nursing Studies
There is considerable debate concerning the use
of Community Treatment Orders (CTOs) in
mental health practice. CTOs involve mandated
community treatment in which individuals with
a mental illness are expected to engage in medication
or other therapy against their will
(Canadian Mental Health Association, 1998).
This study will explore the consideration and
implementation of CTOs through the use of
institutional ethnography. Developed by Dorothy
Smith, this method seeks to elucidate the
everyday life experiences that occur within an
institution. The everyday work of individuals is
influenced by the social structures and discourses
known as ruling relations inherent
within an institution. These ruling relations exist
often without people‟s overt knowledge or
awareness (Smith, 2005).
Participants in this study will include clients,
family members, staff, managers, and individuals
within the mental health courts, who have
experience with CTOs in mental health settings.
Data will be collected through interviews, observations,
and review of institutional documents.
The information obtained will be examined
for evidence of the social web of influence
that governs everyday ethical actions. These
social and ruling relations will be mapped in
accordance to their relationship to and influence
over one another. It is anticipated that the results
obtained will be of considerable interest to
practitioners, advocacy groups, families, and
individuals with mental health concerns. In
bringing these social patterns and structures to
light, there is hope that the resulting awareness
will foster a greater willingness for individuals
involved with the mental health system to ethically
engage with one another on a more mean-
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ingful level.
Phenomenological Study of Social Media
Messages from Under the Haitian Rubble
Susan Speraw
University of Tennessee-Knoxville
Maureen Baksh-Griffin
University of Tennessee-Knoxville
Suzanne Boswell
University of Tennessee-Knoxville
This research addressed gaps in understanding
of the immediate human ordeal of living
through a disaster, exploring the lived experience
of Haitian survivors of the January 2010
earthquake, and expatriates and non-Haitians
among the first responders to arrive. Applying
content analysis and phenomenological research
methods, 3602 Twitter text messages generated
on-scene and posted on the Internet to
public social networking sites, 627 blog entries,
and 176 postings on a Haiti listserv between
January 12 and February 25, 2010. This research
was determined by the University of
Tennessee Institutional Review Board to be
exempt from full board review due to the nature
of the data: social networking messages posted
in the public domain where authors had no
expectation of privacy, and wrote for the express
purpose of having their observations
broadcast to the larger world. Line-by-line
analysis of messages was conducted by the three
researchers, working independently and together
over time and numerous sessions to code and
reconfirm thematization and conclusions.
Analysis revealed trauma and poignant struggles
of people seeking to preserve dignity and find
answers to core existential questions of meaning,
death, freedom and isolation. Findings
have implications for research and training. This
is the first time social media messages have
been analyzed as a basis for planning psychosocial
interventions in disaster. Comprehensive
preparation of professionals from many disciplines
responding to disasters of catastrophic
proportions is critical, since conditions they face
may prompt existential crises of significant
proportion, whether their roles are in coordination,
direct care, or as survivors.
Unsung Heroes: Disabled Responders to the
Rescue following Hurricane Katrina
Susan Speraw
University of Tennessee-Knoxville
Deborah Persell
Arkansas State University
A phenomenological study of 12 adults with
significant disabilities illuminated their experi-
ence of responding to survivors of Hurricane
Katrina in evacuation shelters during and after
the storm. Face to face interviews 30-90 minutes
long, took place across the USA. Participants
responded to the question, When you
think about your experience responding to survivors
of Hurricane Katrina, what stands out for
you. Line by line analysis of transcripts and
development of a thematic structure of experience
was completed by researchers working in a
university interdisciplinary research group.
Member checking confirmed interpretation.
Ten participants were victim-survivors who
experienced the storm in a neighboring state less
severely impacted. Normalcy was the context of
their rescuer experience; for all participants the
storm itself and its personal impact were secondary.
In narratives, personal limitations were
minimized as factors influencing actions. Figural
to their experience was the world of possibilities,
what they could accomplish with their
talents and abilities, focusing primarily on displaced
persons who had disabilities and whose
medical necessities such as wheelchairs had
been destroyed. Getting the job of meeting
others‟ needs done, navigating environmental
and attitudinal barriers and recreating whole
lives for the people they rescued were figural.
Working with aid agencies like the Red Cross
was difficult, since most agency volunteers
staffing the shelters perceived them as unqualified
to assist. Actions of disabled participants
in a rescuer role challenge common perceptions
of them as weak, and highlight ways they can
use their expertise to respond effectively as
response team members in disaster situations.
A psychosocial rehabilitation programme for
institutionalized chronically mentally ill patients
Johanita Strumpher
Nelson Mandela Metropolitan University
Nelis van Nikerk
Kirkwood Care Cente, Life health
Care
In South Africa a few large institutions for the
care of chronically mentally ill patients still
exist. Residents consists of chronically mentally
ill patients who had been living in the
facility for a long time as well as patients admitted
from the community where there sometimes
is a lack of proper accommodation and rehabilitation-
and supportive services. These patients
tend to become institutionalized and loose their
skills for independent living. As deinstitutionalization
is a formal policy of the Department of
Health, institutions caring for the chronically
mentally ill need formal rehabilitation pro-

grammes to help patients develop the skills
necessary for community living.
A psychosocial rehabilitation programme was
developed for a 700 bed institution caring for
the chronically mentally ill. The researcher did
a needs analysis to determine residents current
skills, skills needed for community living, the
psychosocial and rehabilitation services available
to the mentally ill as well programmes that
could be adopted for rehabilitating patients. A
categorization framework was developed creating
homogeneous groups based on their potential
for rehabilitation. Programmes were designed
to meet the needs of each group, based
on intervention by multiprofessional team members.
A qualitative research design was adopted,
using the Delphi technique. Experts in mental
health care or rehabilitation were consulted, the
programme was explained and the experts were
invited to make recommendations. After three
rounds of negotiating the content, the programme
was adopted. Trustworthiness was
ensured through using an audit trail. High ethical
standards were ensured by adhering to the
principles of justice, beneficence and selfdetermination.
Power: Moral Implications in Nursing Education
Jane Sumner
LSUHSC School of Nursing
Context: Nursing is said to be a caring profession,
yet the environment of nursing education
and the external and internal pressures on it,
appear to make offering a caring education
difficult. If the art of politics is the allocation of
scarce resources, then managing scarce resources
means power and control. Those lower
in the hierarchy have to manage with what is
allocated to them. Philosophically, there are
moral and ethical issues associated with this.
With a nursing faculty crisis shortage in the US,
and pressure to increase the graduation number
of students, the internal and external pressures
on faculty and curricula are real. The ideal
taught in nursing education does not appear to
translate well into practice, thus it is timely to
examine these pressures and also how these
influence nursing education.
Questions: What knowledge should be presented
as legitimate? What would enable a
school to provide a caring curriculum that will
not lead to nurses‟ disillusionment in practice?
Theoretical Framework: Quadrangular Dialogue:
A Framework for Nursing Education
(2000).
Method: The methodological lens is critical
social theory (CST). This lens examines the
unquestioned acceptance of traditional ontology,
epistemology, and outcomes of nursing caring.
It questions the false consciousness, power, and
identifies the gaps in the traditional ethos of
nursing. Critical social theory asks, “For whom
is this true?” “Are there false assumptions?”
“Are there silences?” “What are the inadequacies?”
Fontana‟s (2004) process of CST is utilized.
Discussion: External and internal pressures will
be discussed from moral and caring perspectives.
Developing inclusive participatory approaches:
reflections on research partnerships
with 'seldom heard' older people
Denise Tanner
University of Birmingham
Jo Ellins
Health Services Management Centre
There are epistemological, ideological and
ethical arguments for the involvement of service
users and carers in health and social care research
and significant advances have been made
in this area. However, there is a tendency for
people deemed 'hard to reach' or 'difficult to
engage' to be excluded from participatory initiatives.
This paper draws on national Department of
Health-funded research, currently in progress in
England, exploring older people‟s experiences
of transitions between health and social care
services. The project is rooted in a participatory
model that embraces partnerships with older
service users and carers and key voluntary sector
and statutory agencies.
An innovative feature of the project is that it
engages with two groups of seldom heard service
users: older people from black and minority
ethnic (BME) communities and older people
with dementia. These older people are involved
in all stages of the project as „co-researchers‟
and participants.
The presentation shares insights from the project
in the following areas:
a. Practical and ethical issues involved in working
with older people from BME communities
and older people with dementia as coresearchers.
This will include discussion of
recruitment, training and support.
b. Approaches to data collection and analysis
that enable the experiences of traditionally
marginalised older people to be heard and faithfully
represented.
c. Reflections from ongoing evaluation of the
project's participatory model.
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The presentation reflects work in progress and a
critical, exploratory and reflective approach is
adopted in discussing the issues encountered
and the implications for future service development
and research.
We are what we do: how identity is constructed
through meaningful activity.
Jackie Taylor
University of Salford
Occupational therapists believe that there is a
fundamental relationship between meaningful
activities (occupations) and identity
(Christiansen, 1999, 2004) and indeed, this is
supported by the theoretical underpinnings of
action theory and symbolic interactionism. A
healthy repertoire of occupations and a resilient
sense of identity enable people to participate, to
adapt and to express themselves in society.
Previous studies have given evidence that occupations
contribute to the construction of identity
but more has yet to be learned about how this
occurs.
This paper presents the results of a study in
which narratives, extracted from interviews with
17 leisure enthusiasts, were subject to analysis
designed to interpret their meaning, and thus
their relationship with identity construction. The
leisure occupations of these enthusiasts were
taken, in this study, as exemplars of meaningful
activities in general.
The array of meanings generated from the
analysis was organised into a framework, providing
a simple structure for understanding „the
occupied self‟. The framework has three dimensions,
enabling the occupied self to be conceptualised
as located, active and changing. Each
dimension has facets which may or may not be
important in the construction of an individual‟s
unique identity.
The framework overlaps with other theories
regarding the relationship between meaningful
activity, narrative and the construction of identity,
but offers a unique perspective, which has
usefulness to those working therapeutically with
people whose identities have been disrupted or
damaged by illness, disability or other traumatic
life events.
Self-management support in interdisciplinary
primary care organizations: Contradictions
and consequences
Patricia Thille
University of Calgary
Grant Russell
Monash University
Robert Geneau
Government of Canada
Self-management support aims to empower and
prepare patients to manage their health and
health care through fostering skill development
as well as a sense of responsibility for personal
health. Proponents suggest that selfmanagement
support and traditional patient
education are complementary. The goal is systematic
referral to self-management support for
those living with chronic illnesses, with other
treating clinicians understanding and supporting
the process. We studied diabetes care in four
new, interdisciplinary primary care organizations
in Ontario (Family Health Teams) using
ethnographic methods. These organizations are
to be leaders in chronic disease management,
and have several additional supports to achieve
this goal. In this analysis, we explored the extent
to which these two forms of patient education
are complementary in Family Health
Teams. We audio-recorded sequential visits of
participating diabetic patients with a number of
clinicians over a period of three+ months. Using
both constant comparative and discourse analysis
methods, we found that registered dieticians
were those enacting self-management support
most consistently, stressing step-wise and realistic
changes in behaviour over time. However,
multiple clinicians from varying disciplines
undermined self-management support provided
by extending the discourse of responsibility to
outcomes (rather than behaviours), and limiting
opportunities for patient input into goals of care
and treatment plans. The latter pattern, observed
across the Family Health Teams, generates
mixed messages for patients about selfmanagement,
and risks reinforcing a sense of
failure. Our analysis highlights the need for
additional strategies to achieving the goal of self
-management support integration in Family
Health Teams.
Beyond Faith, Hope & Charity: Becoming a
Health Research Subject
Anne Townsend
University of British Columbia
Susan M. Cox
University of British Columbia
Paradoxically, while much research rests on
systematic evidence building, research governance
apparently does not. We know very little
about how individuals experience being human
subjects in health research. This presentation
draws on interview accounts from the first stage
of a three-phase project: ‟Centring the Human
Subject in Health Research,‟ designed to investigate
the experiences of subjects. We recruited
41 individuals (23 women, 18 men) through

multiple strategies in order to gain a heterogeneous
sample and explore diverse health research
experiences (e.g. clinical trials, qualitative studies).
Here we focus on reports of why people
took part in health research. We applied a phenomenological
approach to the data, which
illuminated the dynamic and multi-dimensional
„lived experience‟ of becoming a subject. Participants
reported a combination of circumstances
and motivations that influenced their
participation. Common factors included having
trust in the system (faith), and anticipating personal
health benefits (hope) or benefits to others
(charity). Interest, education, a sense of social
obligation, a sense of self, the practical circumstances
of daily life, and the nature of research
procedures also worked to encourage or discourage
participation. One observation was how
the relative significance of influencing factors
changed according to illness status. The
„healthy‟ typically did not take part in clinical
drug trials, whilst those reporting an illness
condition often actively sought clinical trial
participation because they considered it their
only hope of effective treatment; they felt they
had little choice. This raises concerns about the
process of free and informed consent and forms
of coercion.
Procedural Justice and decision-making in
early rheumatoid arthritis
Anne Townsend
University of British Columbia
Paul Adam
Mary Pack Program
Catherine Backman
The University of British Columbia
Susan M. Cox
University of British Columbia
Linda C Li
The University of British Columbia
Here we apply an ethical framework to interview
accounts about early experiences of Rheumatoid
Arthritis,from onset to early postdiagnosis.
We describe emerging themes from
participant accounts of the early illness trajectory
and apply the concept of procedural justice
to decision-making and associated illness actions.
In-depth interviews were conducted with
8 participants who had been diagnosed with RA
in the 12 months prior to recruitment. Highlighting
ethical considerations, which arose during
the early illness experience enhance our understanding
of the early RA experience. Individuals
described decision-making, illness actions and
the medical encounter. The process was complicated
by inadequate knowledge about early
symptoms, common-sense understandings about
the role of the GP appointment, problematic
patient-practitioner interactions and difficulties
with access to specialists. The ethical analysis
identified how procedural justice was often
compromised in the context of help seeking and
the medical encounter. For ethical healthcare
there is a need for effective patient-practitioner
communication; increased support during the
wait between primary and secondary care.
Researching research ethics: ethics & methods
in a qualitative case study
Anne Townsend
University of British Columbia
Susan M. Cox
University of British Columbia
We report on a Chronic Illness Case study
which was conducted to explore the process of
research, research participation and research
ethics. We identify and discuss issues which
surfaced in Phase II of our " Centring the Human
Subject" qualitative project, the primary
goal of which is to understand the experience of
being a research participant. In order to gain
knowledge from multiple perpectives we conducted
interviews with researchers, ethics committee
members and human subjects who had all
been involved in a Chronic Illness research
study. We conducted a total of 19 face-to-face
interviews and two focus groups to compare and
contrast accounts. The data revealed similar
issues between and within perspectives around
the importance of research and research ethics,
as wel as methodological factors. However,
there were some aspects of research participation
from the human subject perspective which
revealed new and important insights into the
experiences and expectations of research participants.
Such findings warrant further investigation
and ongoing reflection about the research
process. Of particular interest was the ways in
which ethical issues merged with methodological
features, blurring the boundaries between
ethics and method.
Unsupported Self-Management in Accounts
of Early Rheumatoid Arthritis: "I was just
left in limbo"
Anne Townsend
University of British Columbia
Paul Adam
Mary Pack Program
Catherine Backman
The University of British Columbia
Linda C Li
University of British Columbia
People self-manage all the time, but are often
unsupported. This paper‟s focus is how indi-
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viduals with early rheumatoid arthritis (RA) self
-managed illness from onset to early postdiagnosis.
People‟s self-management activities
included working to ease symptoms and continue
daily life, searching for information, and
negotiating medical encounters and the health
care system. This paper draws on the accounts
of thirty-eight participants, all of whom had a
diagnosis of RA of

Home safety for newly-arrived refugees
Merrill Turpin
The University of Queensland
Emma Campbell
AEIOU
Approximately 13 000 people obtain humanitarian
program grants for settlement in Australia
each year. Through the Integrated Humanitarian
Settlement Strategy, the Australian Government
Department of Immigration & Citizenship funds
settlement services such as on-arrival reception,
initial orientation and assistance with accommodation
and basic household goods. Promoting
safety in the home is an important aspect of
settlement work as refugees have higher rates of
emergency hospital admission than the general
population (Correa-Valez et al., 2007). As
health professionals can encounter refugees in
general and specialist health services, they need
to be aware of the home safety risks facing this
vulnerable population when making decisions
such as planning for health promotion activities
and hospital discharge.
This research aimed to elicit the perspectives of
refugee settlement workers regarding the issues
surrounding home safety for newly-arrived
refugees. Sixteen Australian settlement service
employees participated in individual interviews.
In addition, observation of a settlement worker
performing on-arrival reception and initial orientation
was also undertaken. Interviews were
audio-recorded, transcribed verbatim, combined
with fieldnotes relating to the observation session
and analysed inductively into themes.
The three themes identified were: safety issues
that workers consider, factors influencing home
safety, and the importance of sensitivity to
culture. Each theme will be discussed in this
presentation.
Correa-Valez, I., Sundararajan, V., Brown, K. &
Gifford, S.M. (2007). Hospital utilization
among people born in reugee-source countries:
An analysis of hospital admissions, Victoria,
1998-2004. Medical Journal of Australia, 186
(11), 511-580.
Best Practices in Diagrammatic Elicitation: A
Novel Approach to Data Collection
Muriah Umoquit
Cancer Care Ontario
Diagrams are often used by researchers in the
later stages of their research projects; in the
analysis or in presenting final results. Diagrams
are valued for their ability to easily summarize
complex information and facilitate deep understanding
in comparison to verbal or written text.
While often overlooked, diagrams used in the
data collection phase can offer these same benefits
to both the researcher and the participant.
Particularly important to healthcare researchers,
they can also assist in the collection of data on
complex and sensitive topics. Diagrammatic
Elicitation is a data collection method that has
research participants create an original diagram
and/or edit a researcher-prepared diagram.
This presentation draws from a multidisciplinary
systematic review of 12 traditional healthcare
and non-healthcare indexes, Google
searches and consultations with experts in the
field, as well as from practical experience from
the use of both types of diagrammatic elicitation
techniques in key informant interviews with
over 60 clinicians and senior health administrative
leaders. This presentation will discuss the
application of this novel data collection method
and the implications on data analysis. Best
practices and key methodological challenges for
both diagrammatic elicitation techniques will be
outlined and illustrated with examples. This
presentation should be helpful as an introduction
to diagrammatic elicitation and be of assistance
to healthcare researchers in considering
ways diagrammatic elicitation could be incorporated
into their qualitative research designs.
Family Members' and Critical Illness:
"Working To Get Through"
Virginia Vandall-Walker
Athabasca University
Alexander M. Clark
University of Alberta
When a relative is critically ill, the workload of
family members is augmented. They set to work
to manage the situation as best they can in order
to provide support to their loved one. What
constitutes this work?
Two investigations of nursing support
for family members of critically ill adult
patients, which included 30 participants from
three northern Alberta Canada, tertiary care
centres, revealed that to fulfill their needs in
response to the situation, these family members
engage in physical, emotional, and behavioural
work activities. Their needs and the ensuing
work to meet them are influenced most by the
intensity of their relationship to the ill relative
and by their personal resources. Family members
engage in Patient-related, Nurse/Physicianrelated,
and Self-care-related WORK in order to
access information, reassurance, respect, and
opportunities for partnering in care provision.
The grounded theory of family work pro-
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posed, entitled "Working to get through",
pushes critical care health professionals'
boundaries and challenges the paternalistic
perceptions of family member experiences with
critical illness that focus on stress and burden.
Appreciating the nature and intent of the work
of these family members and the needs that
motivate this work, can help health professionals
more effectively support family members in
meeting their needs. These findings not only
delineate the process of "Working to get
through" but as well, extend our understanding
of the breadth and depth of family members'
experiences with critical illness.
Tyranny of 'Or': Research or Dissemination?
Obligation or Exploitation? through community-academic
research
Hendricus A. Van Wilgenburg
Dalhousie University
M. Nancy Comeau
Dalhousie University
Community- academic research is often presented
and promoted as giving a voice to the
socially marginalized, stigmatized, and victimized
through effective dissemination of findings.
Yet, the focus, objective, nature of research, and
context in which the research is performed is
quite broad. Within such a wide context, it may
be helpful for researchers of Aboriginal youth
who are particularly vulnerable to harm as individuals,
and as a community because of the
extreme marginalization, stigmatization, and
victimization they have endured to better understand
exactly what ethical dissemination of
findings is. Clarification of concepts such as
“marginalization” and “stigmatization” and how
they relate to expected “obligation” and
“exploitation” within an Aboriginal research
context is important as the ideas and ideals of
appropriate inclusion and exclusion continue to
gain momentum. Such delineation would allow
researchers and Research Ethics Boards considering
the ethics of research to appreciate the
linkages of certain types of participation processes,
specific elements of the community, and
particular types of dissemination results. This
paper offers a review of a health initiative relevant
to the inclusion and dissemination of research
involving Aboriginal and non-Aboriginal
youth (aged 13-17) from 10 participating
schools, from Saskatchewan schools, Manitoba,
and Northern Quebec and presents potential
integrated matrices to guide future ethical
thought.
The Liaison Program: Supporting Knowledge
Translation and Evidence Uptake
D. Ann Vosilla
Canadian Agency for Drugs and
Technologies in Health
Differences in health service structures and
health technology capacity between Canada‟s
provinces and territories committed the Canadian
Agency for Drugs and Technologies in
Health (CADTH) to place local Liaison Officers
in participating jurisdictions to transfer knowledge.
Each Liaison Officer is CADTH‟s link with
decision makers and practitioners, facilitating
requests for information and understanding of
how to use evidence to inform decisions. This
involves engaging health care decision makers
to understand their needs and providing evidence-based
information that meets those needs
to inform decisions in health care practice.
Liaison Officers are knowledge brokers, encouraging
uptake of evidence-based resources and
innovatively work within the jurisdiction to
improve health outcomes.
Locally situated Liaison Officers meet with
practitioners across their regions, and bridge
gaps to bring like groups together to work collaboratively
on health technology questions and
responses. They provide workshops/ information
sessions, to ensure the understanding of
practice appropriate Health Technology Assessment
(HTA). Jurisdictional outreach activities
are tailored to provide appropriate support for
HTA use.
This approach has been demonstrated to be of
value to health decision makers – who receive
and provide locally relevant information, and to
CADTH, who through this locally obtained
information is better able to keep products relevant
and useful, to appropriately inform health
policy and practice decisions. This knowledge
exchange process fosters innovation and assists
in mobilizing the practical application of evidence.
As local advocates, Liaison Officers
support informed decision making and bridge
the evidence into practice gap by creating partnerships
that support knowledge dissemination
and reduce duplication.
Professionalism in a new site of nursing practice:
A study of nursing self-employment
Sarah Wall
International Institute for Qualitative
Methodology
In recent years, the health care sector has experienced
organizational restructuring, an emphasis
on economic efficiency, and the stan-

dardization and monitoring of professional
work. As a result, nurses have experienced
significant job change, job loss, and work stress.
This new health system ethos has intensified
nurses' long-standing marginalization and further
devalued their roles and contributions to the
health care endeavour. In this profoundly
changed yet persistently traditional context, a
few nurses have turned to self-employment or
independent practice to address the issues in
their employed nursing roles. These nurses now
work in a marginal space on the borders of the
institutionalized health care industry. This ethnographic
study explored the experiences of self
-employed nurses in Alberta to investigate
whether and how self-employment alters the
experience of nursing work and professionalism
and the extent to which the salient issues affecting
nurses‟ work are addressed by this unique
nursing practice arrangement. I found that this
group of nurses represents a unique perspective
on nursing practice and professionalism. Each
of the nurses were clear about the knowledge
and ethics they used in their practices and the
contributions they made as nurses. Yet, they
struggled against dominant discourses within
nursing, the health care system, and society at
large that limited the potential of their practices
and the success of their businesses. Ultimately,
however, these nurses demonstrated the possibilities
for professional growth, satisfaction, and
autonomy that can flow from attempts to push at
the boundaries of nursing practice and work
under a broader definition of health.
The AIM Study: Access, Innovation, and
Medicines - The Impact of NAFTA on Access
to Medicines in Mexico
Benjamin Warren
University of British Columbia
Introduction
Great debate has occurred over the impact of
intellectual property (IP) provisions in international
trade agreements on access to essential
medicines in developing countries. NAFTA was
the first such agreement and Mexico was the
first developing country to reform its IP system
based on treaty negotiations and subsequent
obligations.
Methods
A political economy paradigm and case study
design was chosen to base the inquiry of how
NAFTA has impacted access to medicines in
Mexico. In-depth, semi-structured interviews
were conducted with 20 key stakeholders from
government (health and economic ministries),
the pharmaceutical industry (Research-Based
and Generics), and Academia. Qualitative data
analysis was performed using NVivo 8 to code
for themes and analyze by stakeholder group.
Qualitative methodology was chosen as the best
approach to address a complex research question
that explores the public health impact of IP
provisions on access to medicines.
Results
An understanding of how given flexibilities
have been applied to promote access to medicines
is presented. Nuances in the Mexican legal
system have had both direct and indirect consequences
for accessing medicines. Formidable
macro-level procurement barriers still exist
despite pronounced economic growth over the
past two decades.
Global Health Implications
Greater attention is required on distal determinants
that are increasingly global in scope impacting
health outcomes. Such determinants
include; inadequately negotiated trade agreements
and innovation activity, both of which
create greater interdependence between people
and places around the world.
Effective Transition to Clinical Practice for
International Students undertaking the oneyear
Bachelor of Nursing course.
Anthony Welch
Queensland University of Technology
Theresa Harvey
Queensland University of Technology
Carolyn Robinson
Queensland University of Technology
In recent times there has been a considerable
increase in the number of international nurses
holding registration in their respective countries
of origin applying to undertake the Bachelor of
Nursing program in Australia.
Students entering the one year program come
from diverse cultural and linguistic backgrounds.
In recognition of the inherent difficulty
faced by some students in making the transition
to a different socio-cultural learning environment,
the School of Nursing and Midwifery has
taken the initiative of developing a teaching and
learning module to address issues involving the
experience of cultural disequilibrium and student
deficit in requisite entry level knowledge
and skills. However, even with additional assistance,
a number of international students present
as being unable to achieve the clinical standards
required and therefore, have been unsatisfactory
in their endeavours. In light of the number of
international students receiving an unsatisfac-
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tory grade in clinical practice, this study was
undertaken.
An exploratory-descriptive qualitative approach
to inquiry as proposed by Guba and Lincoln
(1985) was used for this project. Purposive data
triangulation was used to explore the phenomenon
with: current international students (10);
clinical facilitators (10); nurse academics (6);
and administrative staff from the clinical facilities
(4). The number of participants for this
study was 30. Information was gathered through
focus-groups. Analysis of data used a thematic
approach resulting in the explication of seven:
cultural conformity; Expectations; linguistic
difficulties; time preparedness; role confusion;
potential reticence; mismatch.
Social representations as subsidies for the
construction of public health policies
Mariana Winckler
USP
Guillermo Jonhson
Federal University Grande Dourados
Neusa Bloemer
Univesity of Vale do Itajaí
Public policies are guided by the premise of
meeting human needs. The study of government
policies reveals inconsistencies between its
formulation and the demands of the population.
This situation reveals itself intensively in the
field of health needs, where production of
knowledge still leaves gaps, making it imperative
to increase in the production of knowledge
and appropriate technologies. Health policies in
Brazil, established around the National Health
System, are structured under the concept of
health needs, but use in their preparation only
socio-epidemiological indicators. Therefore, this
qualitative study conducted in the city of Camboriú
(Brazil), aimed to analyze the social representations
of health needs from the perspective
of civil society organizations. Where formed as
units of analysis all the neighborhoods in the
urban area and rural, using as reference the
taxonomy of the health needs of Matsumoto
(1999), that guided the roadmap for semistructured
interviews and data collection, and
the content analysis was used as a strategy for
the apprehension of reality. On the subject of
needs the respondents indicate different meanings,
keeping close relation with the healthdisease
process and the local context. The respondents
indicate the community mobilization
as a means to achieve the unmet needs. There
was a negative view of the professionals by
users and the identification that the health practices
do not meet the need for autonomy and self
-care. It is concluded that the needs are incorpo-
rated in sociability itself and that its satisfaction
can be translated into various forms of social
formations. The analysis of social representations
of health needs was evident as an appropriate
qualitative tool for sizing the demand, as
it contemplates the subjectivity of all actors, and
subsidizes the construction of more effective
public policies, legitimizing the state as producer
of this policy.
Including Self When Researching Gendered
Violence: Enabling a Depth and Richness of
Understanding Through the Use of Sequential
Methods of Analysis.
Karen Wood
St. Thomas University
Sylvia Abonyi
University of Saskatchewan
Jennifer Poudrier
University of Saskatchewan
Background
In this paper I provide an overview
of a research project that investigated women‟s
narratives of healing from child sexual abuse
(CSA). I describe how the inclusion of my self,
as researcher, into the research process, led to
the use of two sequential methods of narrative
analysis: content and structure. I conclude that
as a result of including my self in the research
process and integrating the two distinct methods
of analyses, I achieved a unique richness and
depth of findings.
Methods
Fourteen women each told their
stories of healing from CSA. Transcripts were
analyzed first using holistic content analysis,
and then re-storied chronologically using a
problem-solution narrative approach. Emerging
themes were considered iteratively with researcher
reflections, and with literature that
drew primarily from anthropology, sociology,
and feminism.
Research Findings
In addition to documenting stories of
healing from women who were sexually abused
in childhood, the research resulted in: four
themes (naming, remembering and memory;
support; crisis and challenge; and, body); a
pattern of healing; and, a model of healing that
conveys the complexity of the healing process
by incorporating the individual, social and political
contexts of the women‟s lives.
Implications for Research
(1) When researching gendered violence,
the inclusion of the researcher may impact
decisions regarding methods of analysis.

(2) Sequential methods of narrative
analysis may make it possible to achieve a
greater depth and richness of findings.
Reducing Healthcare Associated Infections in
the Vancouver Region
Daniyal Zuberi
University of British Columbia
A shockingly high percentage of patients in
Vancouver regional hospitals and healthcare
settings become infected with preventable infections
that result in injury and death. While some
patients are infected by exposure to infected
patients or healthcare workers, others are infected
by the environment or as a result of medical
procedures, such as surgeries, ventilatorassociated
pneumonia or the insertion of catheters.
Even for those patients who survive a
healthcare associated infection, the infection can
exact a lasting toll for many of patients and the
health care system. Preventing contamination of
hospitals and other health care setting, and the
transmission of infections from healthcare
workers to patients or between patients, has the
potential to save scarce healthcare resources as
well as dramatically reduce suffering and improve
patient safety and outcomes.
This paper presents findings from qualitative
research on the effects of the privatization and
outsourcing of hospital support workers in the
Vancouver region. Based on in-depth interviews
with 70 hospital support workers, this research
revealed serious issues in terms of the cleanliness
of the hospital environment. Some of these
issues include minimal training, high turnover,
understaffing and other factors, which have
been identified in the infection control literature,
as causal factors in relation to hospital-acquired
infection rates. This paper also the preliminary
findings from digitally-recorded interviews with
leading Canadian and international infection
control experts and a diverse range of stakeholders
in the Vancouver regional health authorities,
about reducing the healthcare associated
infection rate in the Vancouver region.
Gender and Prevention of Dengue Haemmorragic
Fever at Sawojajar Village, Malang
City, East Java, Indonesia
Lilik Zuhriyah
University of Brawijaya
Enggar Fitri Loeki
University of Brawijaya
Al Rasyid Harun
University of Brawijaya
Behavioral and environmental factors play
important roles in the prevention of DHF. Larva
control conducted by jumantik has been applied
for a long time. However it does not have
satisfactory results. One of the reason of the
failure of PSN is lack of community participation.
The hypothesis that there is bias of gender
and its implication in preventing DHF need to
be studied. The aim of this study is to explore
men and women‟s opinion regarding DHF and
method of prevention. Research which was
conducted on Juli – December 2009 was qualitative
research. The population was public
figures and health caders at Kelurahan Sawojajar
Malang City. Data were collected by Focus
Group Discussion (FGD), Indepth Interview,
and Observation. Data was analyzed qualitatively
using Triangulation method. The results
show that men and women group have different
opinion about method of prevention. Men
group preferred to fogging, while women group
preferred to behavior change. Problems faced
were lack participation of some people and the
presence of empty houses or neglected lands.
Health caders expect that mosquito larva monitoring
can include the involvement of community.
And their efforts can be rewarded properly.
Mother is a person who responsible for the
cleanliness in the inside of the household while
fathers are responsible the cleanliness of the
outside. Health caders are considered to be
helpful in the monitoring of mosquito larva in
the community. However, their skill should be
improved regularly. It can be suggested to puskesmas
to approach and socialize to public figure
and provide health cader with communication
training.
Abstracts, Symposiums
Listed alphabetically by first author
Using social theory to explain health behaviours:
The Realist Complexity Approach and
research into heart disease
In this symposium we will outline a research
framework developed using critical realism and
illustrate its application in qualitative research
of health behaviours. Critical realism was developed
in philosophy but has been used to guide
theory and research in a number of disciplines
including: sociology, economics, social work,
and nursing. We present a new and useful
framework developed from critical realism to
understand health behaviours and outcomes. In
the first paper, we will briefly outline what
critical realism is and will show how the Realist
Complexity Approach draws on the work of a
number of theorists (including: Bhaskar, Lawson,
Sayer, and Pawson & Tilley). In the two
subsequent papers, we will show how the
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framework was used to inform conceptualization,
data collection, and analysis stages of a
large qualitative study to understand the factors
influencing willingness and capacity to be
physically active after a diagnosis of Coronary
Heart Disease (CHD).
i - The Realist Complexity Approach and
how it draws on critical realism
Alexander M. Clark
University of Alberta
In this paper, the nature and main tenets of the
Realist Complexity Approach will be introduced.
Briefly, critical realism is a meta-theory
that recognizes the existence of reality independent
of the individual knower. Critical realism
successfully transcends a range of historical
tensions in the social sciences. Firstly, it positions
humans as beings that have individual
agency but are also constrained by structural
factors. Secondly, it recognizes the mutual
importance and influence of personal experience
/ hermeneutical dimensions and external
social and cultural factors. Finally, it addresses
the strengths and weaknesses of positivism and
constructivism by recognizing that science is a
fallible social process while also recognizing the
objective existence and influence of objects, and
underlying powers, forces and events. The Realist
Complexity Approach was developed based
on critical realism to understand and explain
health behaviours. The approach views health
behaviours as being influenced by the complex
interplay of individual factors that affect willingness
and contextual factors that influence
capacity. Using the approach, behaviours are
viewed to be influenced via the effects of numerous
factors that act together generatively to
act as facilitators and barriers which lead to
variations in both willingness and capacity to
engage in health behaviours.
ii - Understanding agency in why people with
heart disease are active: Patients’ accounts of
facilitators and barriers
Amanda Duncan
University of Alberta
E. June Trevoy
University of Alberta
Stephanie Heath
University of Alberta
Michael Chan
Royal Alexandra Hospital
Alexander M. Clark
University of Alberta
Engaging in regular physical activity can reduce
mortality and improve quality of life in patients
with established coronary heart disease (CHD).
As part of cardiac rehabilitation, people with
CHD should receive support for regular physical
activity. But many patients do not participate
in rehabilitation or regular activity. Although
people with CHD can benefit from regular
physical activity, less is understood about factors
influencing the adoption of regular activity.
This study used the Realist Complexity Approach
to understand factors influencing willingness
and capacity to undertake regular physical
activity from the perspective of people with
CHD. The approach recognizes that individuals
with direct experience of the phenomena to be
understood have greatest insight into personal
(or „agency‟) factors influencing their behaviours.
Semi-structured home-based interviews
were conducted with 52 patients with confirmed
CHD. We found that physical activity was facilitated
by the complex interaction of personal,
body-focused, and contextual factors. Main
facilitators for regular activity were: seeing
exercise as a platform for improved health,
being embedded in supportive social contexts,
past experience with physical activity, and
having a felt sense of wellbeing when active. Of
particular importance for regular activity were
body-focused factors, where physical sensations
when undertaking activity were not feared or
avoided. For people who were moderately active
or inactive, main barriers to activity included:
fatigue, co-morbid conditions limiting
physical ability, uncomfortable symptoms when
active and a narrower sense of where physical
boundaries lay. For moderate exercisers however,
barriers were mediated enabling participants
to undertake a moderate level of physical
activity.
iii - Understanding ‘structure’ in why people
with heart disease are not active: Professional
accounts of facilitators and barriers
E. June Trevoy
University of Alberta
Alexander M. Clark
University of Alberta
We also used qualitative research guided by the
Realist Complexity Approach to investigate
health professional perspectives of how contextual
(„structural‟) factors interact to influence
activity levels in people with CHD. The approach
recognizes that professionals who work
with individuals with direct experience of phenomena
can have great insight into the structural
factors that influence behaviours. This is because
they see the nature and influence of the
factors that consistently influence behaviour(s)
across populations of these individuals. We did
semi-structured interviews with 46 key health

professionals (13 allied health, 12 nurses, 12
decision makers and 9 physicians) in Alberta,
Canada to understand their perceptions of the
factors influencing CHD patients‟ willingness
and capacity to be physically active. Participantidentified
factors and interactions were sorted
by influence on structure (capacity) or agency
(willingness). We found that with respect to
capacity, participants perceived a fast-paced,
workaholic culture with less social connectedness
as a key structural barrier to activity. The
„built environment‟ and a safe neighbourhood
were structural factors connected to political
will. Additionally, low personal income was
seen to amplify structural barriers. Interacting
with capacity factors, health professionals perceived
family, significant other, and peer group
patterns as a strong influence on personal
agency. Other personal willingness factors
included positive or negative views of exercise,
personal tendencies, priorities, values / approach
to life. Media and work setting were also perceived
to influence agency.
The synthesis of qualitative health research:
current debates and methodological developments
Methods to synthesise qualitative research began
with the recognition that providing evidence
-based health-care requires a range of evidence
beyond that provided by the „rationalist‟ model
of systematic reviewing of randomised controlled
trials. The synthesis of findings from
multiple qualitative studies can provide a range
and depth of meanings, experiences, and perspectives
of participants across health-care
contexts. Many aspects of the methods for synthesising
qualitative research are in the early
stages of development. It is unlikely that a standardised
set of procedures will ever be developed,
more probably, a „methodological palette‟
will be created from which reviewers can draw
methods relevant to the focus of their review.
The papers presented in this symposium contribute
to current debates by addressing aspects
of the synthesis of qualitative research which
require methodological development and validation:
searching for qualitative research; appraising
the quality of reporting of qualitative research;
and methods for synthesising qualitative
research.
i - The synthesis of qualitative health research:
searching for qualitative research
Kate Flemming
The University of York
The progress made in the development of approaches
to search for qualitative research is
less advanced than that for systematic reviews
of randomised controlled trials. Those developing
methods for reviewing qualitative research
have primarily concentrated on methods of
synthesis. Other elements of the review process,
including question formulation, searching and
quality appraisal have received much less attention.
Conducting a systematic search which is
reproducible and comprehensive is a distinguishing
characteristic of a systematic review;
however the role of systematic searching in the
synthesis of qualitative research is uncertain and
requires clarification.
By drawing on the author‟s own work and other
existing syntheses of qualitative research, the
presentation will seek to clarify the role that
systematic searching plays in the synthesis of
qualitative research and some of the difficulties
that are encountered in doing so. A particular
focus of the presentation will be an exploration
of the different types of methodological filters
that have been developed for searching for
qualitative research within electronic databases
and an evaluation of their success. The presentation
will also explore how well qualitative research
is indexed within databases and how
electronic searching can be complemented by
the employment of additional non-database
originated methods such as „active browsing‟
and existing knowledge.
ii - The synthesis of qualitative health research:
appraising the quality of reporting of
primary studies
Allison Tong
The Children's Hospital at Westmead
Syntheses of qualitative research typically involve
combining studies using different methods,
theoretical frameworks and conducted in
various settings. Some may contend that the
findings become decontextualized after combining
different studies. However, an assessment of
the reporting of each primary study allows
readers to make a judgment for themselves
about the trustworthiness and transferability of
the findings to their own settings.
This presentation will explore the rationale for
incorporating an appraisal of study reporting
within syntheses of qualitative research, provide
an overview of appraisal frameworks currently
used in published syntheses, and propose criteria
for assessing the reporting of qualitative
research in the context of conducting a systematic
review of qualitative research.
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The area of quality assessment is challenging
and controversial and there is little data on how
the quality of reporting reflects the robustness,
trustworthiness and transferability of the findings
of qualitative studies. We do not endeavor
to establish criteria for assessing the standard of
conduct in qualitative studies. Instead, this
presentation will focus on approaches for how
to make explicit what the authors of the primary
studies reported on.
Based on a review and comparison of quality
appraisal tools and reporting frameworks used
in published syntheses of qualitative research,
we propose a framework for assessing the comprehensiveness
of reporting of primary studies
for use when undertaking a synthesis of qualitative
research. The framework includes details
about the research team and reflexivity, study
design, context of the study, data analysis, interpretations
and reporting.
iii - The synthesis of qualitative health research:
synthesis methods and analytical
techniques
Elizabeth McInnes
Nursing Research Institute - Australian
Catholic University & SV&MHS
Synthesis methods based on qualitative methods
are evolving and are increasingly being used to
build models of evidence about patient experiences
and preferences in relation to clinical
issues. However, clarification and agreement
about the definitions, methods and analytical
techniques used for synthesizing findings from
multiple qualitative studies which use interpretative
approaches, would be useful for those
undertaking reviews and for end-users.
This presentation will explore challenges in
using qualitative synthesis techniques. These
include: defining and operationalising the various
terms and techniques associated with the
stage of synthesis; understanding what constitutes
and defines a „synthesis‟ and synthesis
outputs; considering whether different synthesis
methods and analytical techniques enable „going
beyond‟ the findings of primary studies to produce
new understandings; examining the usefulness
of the different representations of syntheses;
and identifying the synthesis outputs likely
to be most useful for health care practitioners.
Discussion will also explore if it is possible to
establish a set of core procedures for undertaking
the analysis stage of qualitative synthesis.
Reference will be made to recent published
examples which have used thematic analysis,
meta-ethnography and critical interpretive synthesis.
This exploration will assist with: establishing
where common ground and conceptual links
exist between the different analytical techniques
and for identifying approaches which might
produce outputs of most use for health care
practitioners.
Utilizing phenomenology as a novice researcher:
Staying true to method?
Three separate thesis research projects are presented
with unique patient groups and different
phenomenological approaches. Each presentation
covers the reason for choosing phenomenology,
the evolution of the method during the
project and whether each researcher would
utilize that particular phenomenological approach
again. First, the lived experience of
making decisions for women dying of advanced
cancer utilizing bracketing. Second, the experience
of living with addiction where the researcher
self-disclosed personal experience.
Third, the experience of young widows where
the researcher was participant. Researcher understanding
and application of phenomenological
method influenced the interview process and
analysis or interpretation of the data. This symposium
offers participants opportunity to discuss
how different approaches contribute to
nursing research and furthers the understanding
of phenomenological method.
i - Descriptive phenomenology: The best
methodology for the advanced cancer experience
Natasha Hubbard Murdoch
Saskatchewan Institute of Applied
Science and Technology
This thesis research explored the lived experience
of women with a known terminal cancer
diagnosis having to make decisions and the
impact of those decisions on relevant others
(family and the health care team). Research
exists on making decisions during the cancer
experience, including styles, information, technology
and influencing factors. However, a gap
exists in the literature regarding the experience
of making decisions. Conversational interviews
were conducted with five women and three
relevant others for each woman: her primary
nurse, her oncologist, and one significant other.
Participants also offered journals, emails and
letters of their memories of the experience.
Phenomenology was the best approach for this
under researched idea. This presentation uncovers
the exploration of descriptive phenomenology;
from the initial proposal defining bracketing
through the formality of data collection, the

structure of analysis (using the lived existentials
of temporality, spatiality, relationality, and
corporeality), to the writing process which
evolved out of data tables. For the women, the
data revealed four themes of the lived experience
of making decisions: 1) control, 2) influence,
3) normalcy, and 4) vulnerability. Along
with analysis, a short narrative, from the participants‟
aggregate interviews, was offered in the
writing to reveal the essence of the lived experience
in a way that the results and discussion
could not. Participants in this session are offered
opportunity to debate the comparison of descriptive
versus interpretive phenomenology
and whether descriptive was the best approach
for this topic.
ii - Researcher as study participant: A discussion
using Heuristic Inquiry
Marilee Lowe
Saskatchewan Institute of Applied
Science and Technology
The death of a spouse is a profound and lifealtering
event, and evidence supports the fact
that young women who are widowed experience
unique challenges. The purpose of studying
young widows was to understand the meaning
of spousal bereavement for individual participants.
The research tradition of phenomenology
was chosen, and the guiding question became
“what is the lived experience of spousal bereavement
for young women?” Five themes
emerged following inductive analysis of interview
transcripts conducted with five women
who were under the age of 45 at the time of
their husband‟s death: i) “Losses”; ii) “Who Am
I?”; iii) “Staying Connected through Memories”;
iv) “Living through the Firsts”; and v)
“Support Systems”.
The evolution of the understanding of phenomenology
and specifically the approach of heuristic
inquiry will form the basis of this presentation.
Traditional phenomenology requires that
the researcher separate herself from the phenomenon
in order to be able to objectively analyze
and understand the experience of the participants.
Conversely, heuristic inquiry addresses
the question from the perspective of the
researcher being intimately acquainted with the
topic and, seeking to understand one‟s own
experience; becoming a co-researcher with the
participants. This unique experience provides
for richness in understanding the phenomenon
which may not be gained by any other method
or approach. However, there are numerous
challenges which arise when the researcher is
also a study participant. This session will offer
participants the opportunity to discuss the pros
and cons of heuristic inquiry as an approach to
phenomenology.
iii - Increasing the Level of Understanding
about Phenomenon of Interest through Self-
Disclosure
Gaylene Sorochuk
Saskatchewan Institute of Applied
Science and Technology
Lacking in the gambling literature is the subjective
perspective of female gamblers‟ experience
accessing help for problem gambling. The purpose
of this thesis research was to elicit female
problem gamblers‟ perspectives on access to
services for problem gambling. A qualitative,
descriptive, exploratory study design was used.
The direct source of data and key instruments
were personal interviews, a questionnaire, and
the researcher. Through participant interviews,
increased understanding, and identification of
the facilitators and barriers experienced by the
participants when accessing services was illuminated.
Utilizing a focused interview guide ensured
a given set of topics were covered in the
interview. The questions from the interview
schedule provided a structure for guiding categorization
and subsequent analysis and interpretation
of the data.
Stigma and shame are reported issues with
female gamblers. In an effort to engage and
support participants and obtain meaningful data
with female gamblers in this study, selfdisclosure
was utilized; the researcher had accessed
Addiction Services in the past though not
related to gambling. The researcher‟s personal
and theoretical experience in the addictions field
assisted in both the closeness of the experience
and an understanding of the particular event. It
was necessary for the researcher to be open to
the perceptions of the participants rather than
attach her own meaning to the experience. This
presentation will focus on both the way in
which self disclosure aided in developing an
egalitarian relationship with participants and
measures taken to control (albeit not eliminated)
researcher bias.
Motherhood, drought and elder abuse: Stories
from three generations of women who
participate in the Australian Longitudinal
Study on Women's Health.
The Australian Longitudinal Study on Women‟s
Health (ALSWH) first collected survey data
from 42,000 participants in 1996. Surveys were
completed by women who fell into one of three
age groups: the 1973-78 cohort (aged 18-23),
the 1946-51 cohort (aged 45-50) and the 1921-
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26 cohort (aged 70-75). Participants complete
the largely quantitative survey once every three
years. At the conclusion of each survey participants
are invited to respond to the question,
“Have we missed anything?‟ The 34,315 free
text responses to this question have been analysed
by researchers using a variety of techniques
and, in addition, researchers often follow
-up quantitative findings using qualitative methods,
such as in-depth interviews. Using
ALSWH qualitative data, this symposium examines
three issues of great importance to
women‟s health: post-natal depression, the
impact of climate change and drought, and
abuse.
i - The perfect mother wouldn’t have that’:
Australian women’s experiences of motherhood
and postnatal depression.
Catherine Chojenta
University of Newcastle
Deborah Loxton
University of Newcastle
Jayne Lucke
University of Queensland
The experience of diagnosis and treatment of
PND is under-researched, and is an area currently
being reviewed and changed at policy and
clinical levels in Australia. A detailed investigation
into the thoughts, feelings and experiences
of women with PND is therefore timely, in
order to understand the underlying factors that
influence the development of PND and the
efficacy of treatment for PND. In-depth semi
structured telephone interviews were conducted
with a subsample (n=40) of women who participate
in the Australian Longitudinal Study on
Women‟s Health (ALSWH). The ALSWH is a
multi-disciplinary, nation-wide survey of the
health and wellbeing of women that has been
collecting mailed survey data since 1996. Participants
in the subsample were asked to elaborate
on their experiences of pregnancy, childbirth
and motherhood, with a focus on their
emotions during these times. Those participants
who had been diagnosed with PND described a
limited range of treatment options and support
mechanisms available to them after their diagnosis.
Many also described the guilt and shame
associated with a diagnosis of PND, and the
feelings associated with divulging this information
to other people. Many women (both those
with and without PND) also described problems
with coping in early motherhood, and particularly
highlighted stresses associated with breastfeeding.
Facilitators and barriers to treatment
access and treatment efficacy were also discussed.
The narratives collected in this project
highlight that PND is occurring in the context of
many stressful events.
ii - Narratives from women in drought
Jane Rich
University of Newcastle
Sarah Wright
University of Newcastle
Deborah Loxton
University of Newcastle
This research explores women‟s experiences of
living with drought. Drought has always been a
part of the Australian landscape, yet as climate
change occurs, projections indicate that
droughts will increase in frequency and intensity.
Despite the significance of drought in
Australia, little research has examined the psychological
consequences of drought.
This project, which is being conducted as part of
my PhD, aimed to understand the diverse ways
that drought is perceived, communicated, and
responded to, and to investigate the mental and
emotional well-being of women living with
drought in the context of ageing. The study
explores longitudinal qualitative data collected
by the ALSWH. Free text comments (N=217),
collected at five time points (1996, 1998, 2001,
2004, and 2007) from 77 women, were subjected
to a narrative analysis. These 77 women
self-identified as living with drought and its
consequences at least once during the 11 year
study period.
Findings indicated that drought is a heavy burden
for women and is at the forefront of their
lives. The drought burden has influence over a
woman‟s identity, which was challenged by
drought. However, the pressure of drought was
found to draw out strength and resilience. Parts
of Australia have been in drought for over a
decade. As such, issues involving ageing also
arose in the data. Results emphasised that the
experience of drought can not be disentangled
from the realities of gender and ageing. Findings
will contribute to the improvement and
development of policy and practice for those
affected by drought.
iii - Abuse in older age: Australian women’s
experiences of elder abuse.
Deborah Loxton
University of Newcastle
Lynette Adamson
University of Newcastle
Current literature concerned with abuse in older
age has recognised the difficulties that are en-

countered in identifying and defining elder
abuse. The majority of research in this field has
focussed on single points in time, and has
lacked the capacity to determine how these
types of events have evolved as the people
concerned have aged. Longitudinal qualitative
data collected from the ALSWH goes someway
to overcoming these challenges and provides the
opportunity for older women to discuss issues
relating to elder abuse in their own words and in
an anonymous setting. The research aimed to
identify the types of abuse that women experienced,
the context in which abusive events
occurred, and those situations where women
were the most vulnerable to abuse.
Data from 172 women who had written about
abusive experiences were subjected to content
and thematic analysis in order to meet the research
aims. Findings indicated that as women
aged they became vulnerable to increasing types
of abuse perpetrated by family, neighbours and
strangers. The onset of abuse in older age occurred
in the context of illness, caring relationships,
dependent relationships and in relationships
with health service personnel. For some
women, the abuse experienced in older age was
a continuation of abuse that had been occurring
for much of their lives. By identifying the ways
in which women speak about abusive events and
those places and times where they may become
most vulnerable, this research can contribute to
prevention of abuse in older age.
Narrative Inquiries of Life-threatening Illness
Increasing numbers of people are living with
life-threatening illnesses, including cancer, endstage
renal disease (ESRD) and HIV/AIDS,
often in the face of uncertain illness trajectories.
People with serious illness live in-between the
promise of treatment and the threat of recurrence
or progression of disease and yet this
experience is not well understood. In this symposium
we will explore findings from a CIHR
funded narrative inquiry exploring how people
living with life-threatening illness story and restor(y)
their lives. Building upon our previous
work, we will address: 1) storylines of lifethreatening
illness including findings from a
thematic analysis; 2) representational symbols
of life-threatening illness as identified by 31
participants; and 3) methodological tensions
through examination of the metonymic spaces
of narrative analysis.
i - Storylines of Life-threatening Illness
Laurene Sheilds
University of Victoria
Anita Molzahn
University of Alberta
Anne Bruce
University of Victoria
Keilli Stajduhar
University of Victoria
Kara Schick Makaroff
University of Victoria
Rosanne Beuthin
University of Victoria
The purpose of this narrative inquiry was to
explore people‟s stories of facing lifethreatening
illnesses and how liminal experiences
affect their understandings of health and
living within the context of cancer, end-stage
renal disease (ESRD) and HIV/AIDS. Thirtyone
participants took part in three in-depth
interviews over three years. Findings reveal that
people‟s experiences of illness are continually
changing. Participants make sense of the uncertainty
of life-threatening illness through narratives
that serve particular purposes at different
times. Participants use narratives to communicate
information/experience, manage the responses
of others (including health care providers),
and foreground what is important. These
narratives are rich in content and elucidate the
process of stor(y)ing and re-stor(y)ing. The
narratives also highlight the complexity and at
times ineffable nature of liminal experiences of
serious illness. From this disrupting experience,
participants encounter pivotal questions related
to meaning and purpose of life, and their own
identity within illness. This presentation will
delineate the findings from thematic analysis
and demonstrate the significance of metanarratives
(e.g. medical, survivorship, stigma of
illness and death) that shape and define people‟s
experiences. These findings challenge assumptions
that health narratives are complete, unified,
and enduring and show that narratives are
fluid, poly-vocal, and full of contradiction. The
thematic analysis portrays the multiplicity of
voices and tensions that permeate people‟s
narratives, and in this way, the thematic analysis
is dialogical and multi-layered.
ii - Representational Symbols of Lifethreatening
Illness
Kara Schick Makaroff
University of Victoria
Rosanne Beuthin
University of Victoria
Laurene Sheilds
University of Victoria
Anita Molzahn
University of Alberta
Anne Bruce
University of Victoria
Keilli Stajduhar
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University of Victoria
Research findings often rely primarily upon the
spoken and written word. Incorporation of visual
data within research may contribute understanding
of experience other than what may be
fully expressed via language. In this study,
participants were asked to bring a representational
symbol that portrayed their experiences of
living with life-threatening illnesses. In the
second interview, participants were asked to
reflect upon the meanings that the representational
symbol held for them.
Metaphoric analysis of participants‟ representational
symbols was used to understand how
participants construct and narrate un-say(able)
aspects of their illness experience. Analysis
provides insights into what is concealed and
revealed through metaphor, what is left out, how
language materializes experience, and the impact
of metaphoric language for people living
with the experience of life-threatening illness.
This method offers individuals a new or different
opportunity to tell their stories. In this presentation
we will provide examples of representational
symbols, describe the participants‟
meanings of representational symbols, and
articulate some of the strengths and challenges
of using visual analysis in qualitative research.
iii - Metonymic Spaces of Narrative Analysis
Anne Bruce
University of Victoria
Laurene Sheilds
University of Victoria
Rosanne Beuthin
University of Victoria
Kara Schick Makaroff
University of Victoria
Anita Molzahn
University of Alberta
Keilli Stajduhar
University of Victoria
The third presentation in this symposium will
explore some of the metonymic spaces in narrative
inquiry. Metonymic analysis is less commonly
used in qualitative research. This research
team uses the concept of metonymy
indicated by “( )” to address the space inbetween
opposites that are inherently associated
and yet together, open multiple meanings and
possibilities. We will specifically address four
metonymic spaces that we have encountered in
our analysis process: 1) homogeneity ( ) diversity,
2) outsider ( ) insider, 3) reader ( ) text, 4)
illuminate ( ) obscure. Homogeneity ( ) diversity
refers to the space between what is shared and
what is unique. Outsider ( ) insider refers to the
space where people, including researchers, can
have insider and outsider knowledge of the
illness experience. Reader ( ) text addresses the
interpretive process of knowing or being aware
that each of us reads text differently and that
each reading constitutes a re-stor(y)ing or reinterpretation
of the data. Illuminate ( ) obscure
relates to the dynamic nature of experience
where by focusing on any one aspect of experience
both foregrounds the experience and conceals
other aspects. From a methodological
perspective, our research team is exploring and
developing ways to portray findings that keep
the dynamic nature of text alive and portrays the
unfolding/constructing/changing nature of peoples‟
stories.
Methodological issues when conducting research
with children and adolescents
This symposium will focus on methodological
issues and challenges using different techniques
in qualitative research when conducting research
with children and adolescents in health
care. The session will consist of three linked
presentations that:
i. Provide experiences of using video technique
in observing children‟s expressions of actions.
ii. Provide experiences of using participatory
methods such as drawings and pictures to encourage
children to tell about their perceptions
on a specific theme.
iii. Provide experiences from focus group interviews
with children and adolescents.
The concluding discussion will focus on methodological
issues related to children´s competence
to bodily and verbally express their wish,
experiences, motivation and feelings, when
using these techniques. Also, research findings
from these techniques will be discussed. Furthermore,
ethical considerations and the researchers‟
interpretation of the children´s perspectives
are issues demanding reflections.
i - The use of video technique in observing
children’s expressions of actions
Maja Söderbäck
Mälardalen University
Maria Harder
Mälardalen University and Karolinska
Institutet
Video technique is found to be useful in qualitative
research when the interest is to explore
young children‟s expressions of actions in situations
where they participate as actors with parents
and health care professionals. Through this
technique the whole situation and the child´s
varying and detailed expressions are captured.
Thus the use of video provides the opportunity
to capture the child‟s subjective perspective.

The researcher‟s role is to be objective and
follow the child in the course of the situation
without interference.
Further, the video technique allows the researcher
to study a child‟s expressions several
times during the analysis, and to reflect and
validate with co-researchers. However, the
interpretation of the children's expressions of
actions needs to be guided by the intention to
understand the children‟s perspectives.
This presentation will demonstrate issues related
to the use of video technique when observing
children three to five years of age during health
visits in a Primary Child Health Care situation
and in a care procedure involving venepuncture.
Further, discussion concerning analysis of the
gathered data with respect for children´s competence
to bodily and verbally express their wish,
experiences, motivation and feelings will be
brought up.
ii - The use of drawings and pictures as participatory
methods to encourage children to
tell about their perceptions on a specific
theme
Maria Harder
Mälardalen University and Karolinska
Institutet
Karin Enskär
Jönköping University
Maja Söderbäck
Mälardalen University
The movement from doing research on children
to do research with children within the health
care area challenges researchers to use participatory
methods. The use of drawings and pictures
are such participatory methods which
allow children to share their perceptions and
experiences of a situation. Drawings and pictures
are familiar from children‟s every-daylives
and suit their competence. Furthermore,
the use of drawings and pictures facilitate the
interaction between the child and the researcher.
To let children make drawings about a specific
theme and tell about them announce the children
as experts and that their perceptions and experiences
are valuable. The use of pictures makes a
theme well-defined for the children and will
make it easier for them to associate and talk
unconstrained. The combination of various
participatory methods in one data-collection
might contribute to detailed descriptions of
children‟s perceptions about a phenomenon.
This presentation will demonstrate a combination
of participatory methods which have contributed
to grasp children‟s perceptions of various
situations as for example going through a
vaccination. The presentation will further bring
up methodological issues related to the use of
participatory methods and the analysis of grasping
children‟s perceptions with respect to their
competence.
iii - The use of focus group interviews with
children and adolescents
Marie Golsäter
Jönköping University
Karin Enskär
Jönköping University
According the Convention on the Rights of the
Child, children and adolescents have the right to
be heard in matters concerning them. Focus
group interviews is a useful way to voice children's
and adolescent's perspectives. The interaction
that occurs in a focus group can contribute
to new dimensions of a topic from the participant‟s
perspective and contributes to the
exploration of perspectives that might remain
undetected in one to-one interviews.
Focus group interviews might also encourage
children and adolescents to express their own
view instead of answering in a way they believe
the interviewer wants them to answer. One
disadvantage could be that those not comfortable
taking part in groups may choose not to
participate or might have no chance to express
their experiences.
This presentation will demonstrate the methodological
issues revealed during focus group interviews
with children and adolescents regarding
their experiences of health and life style dialogues
with the school nurse. Issues such as
performing focus groups interviews with participants
in various age groups, the size of the
group and the use of mixed or unisexual groups
will be brought up.
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Abonyi, Sylvia ... 22
Abramson, Beth ... 19
Adam, Paul ... 19, 24
Adams, Jeffery ... 22
Adams, Mary Anne ... 19
Adamson, Lynette ... 15
Ahlberg, Beth Maina ... 28
Amin, Maryam ... 31
Aminzadeh, Faranak ... 16, 29
Angus, Jan ... 19
Arthur, Anne Barbara ... 17
Ateah, Christine ... 18
Audulv, Asa ... 24
Austin, Wendy ... 14
Aveline, David ... 28
Axemo, Pia ... 28
Ayo, Nike ... 14
Babinec, Patricia ... 19
Backman, Catherine ... 19, 24, 30
Bailey, Ajay ... 29
Baksh-Griffin, Maureen ... 16
Balise, Debra ... 23
Balneaves, Lynda ... 24
Barbour, Rosaline ... 25
Barsevick, Andrea ... 29
Basnyat, Iccha ... 20
Batch, Mary ... 29
Baumbasch, Sarah ... 31
Behnia, Behnam ... 31
Belcher, Anne ... 24
Bertrand, Sharon ... 16
Beuthin, Rosanne ... 27
Bhandari, Shreya ... 17
Bharj, Kuldip ... 31
Bhattacharya, Aruna ... 14
Bishop, Danielle ... 20
Bliss, Donna ... 29
Bloemer, Neusa ... 21
Boman, Ase ... 29
QHR Author Index
Boswell, Suzanne ... 16
Botnick, Michael ... 26
Bottorff, Joan ... 20, 23
Boulware, L. Ebony ... 24
Boyce, Michelle ... 22
Bradley, Colin ... 29
Bradley, Sandra ... 27
Brady, Marian C. ... 25
Brennan, Arthur ... 23
Brown, Sally ... 22, 25, 27, 28
Bruce, Anne ... 27
Brummell, Stephen ... 27
Brussoni, Mariana ... 20, 27
Buchanan, Marla ... 21
Bullock, Linda ... 17
Butler, Mary ... 18, 28
Buxton, Jane ... 26
Callendar, Stella ... 22
Campbell, Jackie ... 17
Caplan, Wendy ... 25
Cartwright, Tina ... 29
Casey, Regina ... 30
Cecchin, Maggie ... 27
Chambers, Catherine ... 26
Chan, Michael ... 21
Chapman, Gwen E. ... 31
Charnaw-Burger, Jill ... 22, 25, 26
Cheema, Dataar Kaur ... 18
Cheng, Wen-Yun ... 21
Chepuka, Lignet ... 19
Chik, Winnie-J.H.W. ... 20, 30
Chilemba, Winnie ... 19
Chimwaza, Angela ... 19
Choe, Sukhoe ... 30
Chojenta, Catherine ... 15, 17
Chowbey, Punita ... 31
Chung, Seung Eun ... 30
Clark, Alexander M. ... 17, 18, 19, 21, 23, 25,
26

Collins, Pam ... 31
Comeau, M. Nancy ... 18, 31
Copley, Jodie ... 18
Cornett, Patricia ... 31
Coser, Larissa ... 26
Cott, Cheryl ... 22
Cox, Helen ... 15
Cox, Susan M. ... 16, 19
Crabtree, Alexis ... 26
Crepinsek, Alison ... 22, 25, 26
Crockett, Corinne ... 14
Cunningham, Colleen ... 30
Curley, Lyn ... 20
Dacher, Joan ... 22
Dahlke, Sherry ... 18, 22, 27
Dale, Craig ... 19
Dalziel, William Bill ... 16, 29
Dane, Kathryn ... 24
Dastjerdi, Fay Mahdieh ... 16, 28
Davidson, Sarah ... 18
Davis, Kristina ... 19
De Bellis, Anita ... 27
Dejman, Masoumeh ... 23
DeLuca, Jane ... 24
Dempsey-Simmons, Helen ... 30
Derrett, Sarah ... 18
Dickson, Sylvia ... 25
Dobbins, Maureen ... 17
Dobrow, Mark ... 29
Dow, Clare ... 23
Driedger, Michelle ... 26
Duncan, Amanda ... 14, 21, 23, 25
Durrant, Joan ... 18
Eaves, Yvonne ... 16
Edwards, Marie ... 18
Edwards, Nancy ... 17
Ellins, Jo ... 20
Enskar, Karin ... 24
Entwistle, Vikki ... 24
QHR Author Index
Eriksson, Elisabet ... 28
Exblad, Solvig ... 23
Fairbank, William ... 28
Ferlatte, Olivier ... 21
Ferrari, Manuela ... 15
Finegan, Barry ... 31
Finegood, Diane ... 30, 31
Flaman, Laura ... 14
Flemming, Kate ... 26
Ford, Katharine ... 17
Forgeron, Joan ... 22
Forouzan, Amenah Setareh ... 23
Forwell, Susan ... 30
Foster, Kim ... 14
Fougere, Geoff ... 27
France, Emma F. ... 23, 24
Friedrich, Jule ... 31
Fukuyama, Katherine ... 17
Garcia, Linda ... 16, 29
Garon, Maryanne ... 23
Garvin, Theresa ... 22
Gastaldo, Denise ... 26
Geneau, Robert ... 24
George, Anne ... 27
Georges, Jane ... 27
Gerrish, Kate ... 31
Giles, Michelle ... 24, 28
Ginez-Gonzales, Yvonne ... 27
Godderis, Rebecca ... 28
Goldsmith, Laurie ... 23
Golsater, Marie ... 24
Gondo, Yasuyuki ... 30
Gott, Merryn ... 27
Greeff, Minrie ... 19
Greyson, Devon ... 30
Gualda, Dulce Maria R. ... 15, 31
Guerin, Pauline ... 27
Gutteridge, Robin ... 28
Haddad, Beverley ... 28
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Hagens, Victoria ... 29
Haisma, Hinke ... 31
Hall, Julie ... 21
Hamedani, Atyeh ... 28
Hammond, Gail K. ... 31
Han, Christina ... 14
Hancock, Sara ... 16
Harder, Maria ... 24
Harun, Al Rasyid ... 23
Harvey, Theresa ... 14
Hayden, Michael ... 24
Heath, Stephanie ... 21
Hebblethwaite, Shannon ... 20
Hee, Lisa ... 29
Herring, Patti ... 27
Higginbottom, Gina ... 22, 27, 30, 31
Higgins, Isabel ... 24
Higuchi, Machiko ... 22
Hillier, Brian ... 26
Holyoke, Paul ... 19, 20, 26
Hon, Amy ... 14
Hong, Reimei ... 20
Hornsten, Asa ... 24
Houston, Patricia ... 31
Hulse, James ... 31
Hunt, Kate ... 23
Hutter, Inge ... 29, 31
Jackiewicz, Tanyana ... 15
Jardine, Cindy ... 26
Jaye, Chrystal ... 27
Jepson, Ruth ... 24
Johnson, Guillermo ... 21
Johnson, Sherrill ... 22
Johnston, Lee ... 30
Judkins-Cohn, Tanya ... 23
Jutterstrom, Lena ... 24
Kalengamaliro, Mary ... 19
Kanacki, Lana McLouth ... 27
Kang, H. Bindy K. ... 18
QHR Author Index
Kaponda, Chrissie P.N. ... 19
Kawabata, Makie ... 26
Keenan, Louanne ... 18
Kennedy, Michael ... 22
Kentenich, Herbert ... 31
Kerns, J. William ... 29
Kgositau, Mabedi ... 19
Khan, Koushambhi Basu ... 31
Khan, Shamshad ... 20
Khatun, Jahanara ... 28
Killion, Cheryl ... 18
Klubben, Laura ... 29
Klunk, Sherrie ... 24
Kol, Emre ... 17
Konradsen, Hanne ... 25
Kooienga, Sarah ... 18
Kosny, Agnieszka ... 18
Kothari, Anita ... 17
Kramer-Kile, Marnie ... 19
Krist, Alex ... 29
Kululanga, Lucy ... 19
Kureta, Yoichi ... 30
Kurtz, Donna ... 15
Kuzel, Anton ... 29
Kvern, Margie ... 31
Kwok, Cannas ... 15
Lam, Simon C. ... 20
Lampley, Tammy ... 15
Lampman, Michelle ... 29
Landreneau, Kandace ... 24
Lapum, Jennifer ... 19
Larsen, Denise ... 14, 30
Latham, Nichole ... 26
Lehn-Mooney, Mary ... 27
Levy, Jennifer ... 28
Li, Linda C. ... 19, 24
Liaschenko, Joan ... 17
Lindmark, Gunilla ... 28
Linsley, Paul ... 15

Lit, Sunjiv K. ... 18
Livingston, James ... 25
Loeki, Engar Fitri ... 23
Longo, Dan ... 29
Lopez, Karen Dunn ... 28
Lopez Huerta, Jose Alfredo ... 23
Lowe, Marilee ... 25
Loxton, Deborah ... 15, 17
Lucke, Jayne ... 15
Lui, Joyce ... 31
Luinge, Margreet ... 29
Lundman, Berit ... 24
Lupea, Ilinca ... 26
Lyckhage, Elisabeth Dahlborg ... 29
Lynan, Judith M. ... 31
Lyons, William ... 29
MacEachen, Ellen ... 18
Makaroff, Kara Schick ... 27
Makepeace-Dore, Maureen ... 30
Mann, Alexandra ... 31
Manyedi, Eva ... 19
Marcantonio, Kristin ... 17
Marshall-Lucette, Sylvie ... 14, 23
Marzolini, Susan ... 19
Masui, Yukie ... 30
Matteson, Carrie ... 30, 31
McCann, Edward ... 30
McClunie-Trust, Patricia ... 17
McCreary, Linda L. ... 19
McCrum, Carol ... 28
McDonald, Michael ... 16
McDonnell, Louise ... 25
McGee, Rob ... 27
McHugh, Sheena ... 29
McInnes, Elizabeth ... 26
McIntosh, Bonnie ... 18, 24, 27, 29
McMillan, Colleen ... 31
Merth, Thomas D. ... 31
Messecar, Deborah ... 23, 30
QHR Author Index
Metz, Stacie ... 29
Miller, Anton ... 20
Minton, Sarah ... 29
Mitchell, Rebecca ... 28
Mogale, Shirley ... 20, 25, 26, 28, 30
Moll, Laura ... 22
Molnar, Frank ... 16, 29
Molzahn, Anita ... 27
Moody, Elaine ... 17, 21, 25
Morgan, Pamela ... 31
Morgan, Steve ... 30
Morin, Heather ... 23
Mufti, Gul e Rana ... 29
Mulemi, Benson A. ... 21
Mumtaz, Zubia ... 31
Murdoch, Natasha Hubbard ... 25
Murray, Lee ... 18, 29
Myrick, Florence ... 25
Nakagawa, Takeshi ... 30
Nematollahi, Pardis ... 21
Newton, Benjamin J. ... 28
Nolan, Marie T. ... 24
Nonaka, Chiharu ... 22
Norman, Cameron ... 22, 25, 26
Norr, Kathleen F. ... 19
Noy, Smadar ... 31
Nuttgens, Simon ... 29
Nyberg, Jessie ... 15
Nykiforuk, Candace ... 14, 22, 31
O‟Brien, Beverly ... 31
O‟Donnell, Maureen ... 20
O‟Mullane, Monica ... 29
Oh, Paul ... 19
Ogrodniczuk, John ... 14
Oliffe, John L. ... 14, 18, 20, 23
Oliveira, Elaine ... 29
Olsen, Lise ... 20, 27
Oosterhoff, Alberta ... 31
Ortiz, Lecenia ... 22
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Paliadelis, Penny ... 24
Parker, Vicki ... 24, 28
Parmenter, Glenda ... 24
Parsons, Mickey ... 31
Paterson, Jan ... 27
Patterson, Jessica ... 26
Paton, Gillian ... 25
Peden-McAlpine, Cynthia ... 17, 29
Pepin, Kathleen ... 30
Peres, Hagit ... 20
Perez, Arnaldo ... 31
Perry, Ivan J. ... 29
Persell, Deborah ... 28
Philibin, Caitriona Nic ... 30
Phillips, Mari ... 22
Phillips, Rachel ... 20
Phinney, Alison ... 25
Pieper, Barbara ... 22
Ponzetti, James ... 30
Poudrier, Jennifer ... 22
Powers, Jennifer ... 17
Price, Jennifer ... 19
Pritlove, Cheryl ... 15, 19
Radfar, Seyedramin ... 21
Raij, Katariina ... 26
Raine, Kim ... 14
Raphael, Jon H. ... 28
Reeves, Scott ... 31
Reid, Tamara ... 23
Reime, Birgit ... 31
Rich, Jane ... 15
Richter, Solina ... 22
Robertson, Sue ... 27
Robinson, Carolyn ... 14
Rose, Linda ... 17, 24
Rossiter, Katherine ... 28
Roth, Patricia ... 27
Roth, Wolff-Michael ... 30
Rothenberg, Richard ... 21
QHR Author Index
Rothgang, Heinz ... 31
Rothlingova, Zuzana ... 28
Rouse, Michael ... 17
Rudman, Debbie ... 17
Rusk, Kerry ... 25
Russell, Grant ... 24
Saad, Sam ... 22, 25, 26
Saewyc, Elizabeth ... 26
Safai, Parissa ... 15
Salaway, Sarah ... 31
Salim, Natalia ... 15, 31
Salsali, Mahvash ... 31
Santos, Jr., Hudson ... 15, 31
Sarbit, Gayl ... 20
Schonfeld, Toby ... 29
Schultz, Annette ... 31
Schulz, Celia ... 22
Semaka, Alicia ... 24
Seo, Bosu ... 30
Seto, Lisa ... 19
Seymour, Jane ... 27
Shaibu, S. ... 19
Shakhshir, Patricia ... 18
Sharma, Saroo ... 31
Sharps, Phyllis ... 17
Sheftel, David ... 27
Sheilds, Laurene ... 27
Shelton, Debbie ... 20
Sherman, Rose ... 14
Shopik, Nicole ... 31
Sibbald, Shannon ... 17
Simpson, Jean ... 27
Small, Neil ... 27
Smith, Donna ... 19, 21
Smith, Jeffrey ... 29
Smitten, Jayne ... 25
Snow, Nicole ... 21
Soderback, Maja ... 24
Solorzano, Catherine ... 23

Sorochuk, Gaylene ... 25
Speraw, Susan ... 16, 28
Spiers, Jude ... 18, 22, 24, 26
Spiri, Wilza ... 29
Stajduhar, Kelli ... 27
Stege, Rachel ... 30
Steinberg, Malcolm ... 21
Stephens, Jennifer ... 17
Stevens, Elizabeth ... 29
Stewart, Sherry H. ... 31
Stewart, Valerie ... 18
St. Ours, Christine ... 24
Strumpher, Johanita ... 21
Sumner, Jane ... 27
Takahashi, Ryutaro ... 30
Takayama, Midori ... 30
Tang, Fiona W.K. ... 30
Tanner, Denise ... 20
Taylor, Darlene ... 26
Taylor, Jackie ... 16
Taylor, Laura ... 24
Thille, Patricia ... 24
Tiu, Mimi M. H. ... 30
Tong, Allison ... 26
Towell, Tony ... 29
Townsend, Anne ... 16, 19, 24
Townsend, Susan ... 16
Trevoy, E. June ... 14, 21, 23, 24, 28
Tso, Peggy ... 29
Turner, de Sales ... 14, 15
Turpin, Merrill ... 16, 18
Umoquit, Muriah ... 25, 29
Vaismoradi, Mojtaba ... 31
Vallianatos, Helen ... 14
Van Borek, Natasha ... 26
Vandall-Walker, Virginia ... 17
van Nikerk, Nelis ... 21
Van Wilgenburg, Hendricus A. ... 18, 31
Vosilla, D. Ann ... 20
QHR Author Index
Wada, Mineko ... 30
Wall, Sarah ... 16
Walsh, Matthew ... 31
Walter, Bonnie ... 27
Warren, Benjamin ... 26
Weismuller, Penny ... 27
Welch, Anthony ... 14, 20
White, Angela ... 24
White, Kate ... 15, 24
Wimberley, Paige ... 29
Winckler, Mariana ... 21
Wood, Karen ... 22
Wotherspoon, Alison ... 27
Wright, Sarah ... 15
Wright, Susan ... 19
Wyke, Sally ... 24
Yip, Andrea ... 22, 25, 26
Yonge, Olive ... 14, 25
Young, Susan ... 22
Youth Co-Researchers ... 26
Zarate, Agustin ... 23
Zuberi, Daniyal ... 18
Zuhriyah, Lilik ... 23
Zwiers, Angela ... 20, 23, 26, 30
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Forthcoming Events
TQ 2011
One week of intensive workshops on qualitative methods, techniques
and strategies. Keynote speaker. Poster session.
Thinking Qualitatively
University of Alberta - June ‘TBA’, 2011
http://www.uofaweb.ualberta.ca/iiqm/TQ2011.cfm
The International Institute for Qualitative Methodology is pleased to announce that the
11 th Thinking Qualitatively Workshop Series will be held June ‘TBA’, 2011 at the
University of Alberta, Edmonton, Canada.
This interdisciplinary educational series allows participants to engage with experts in
qualitative inquiry and learn about specific methods, techniques and approaches to
qualitative research. The academic program consists of five days of hands-on workshops
on such topics as qualitative coding and categorization, participatory action research,
discourse analysis, literature reviews, arts-based methods, poststructuralism in
qualitative research, and much more! Training sessions on qualitative analysis software
packages will also be available to participants.
This week-long event is aimed at participants from all academic disciplines and for
individuals at all stages of their research career. Individuals conducting research in
universities and colleges and/or professional settings (e.g., libraries; hospitals; government
agencies) are welcome to attend. Thinking Qualitatively includes a keynote address,
opportunities for networking, and a poster session. For a complete schedule of
workshops, including a call for poster presentations, see www.uofaweb.ualberta.ca/
iiqm/TQ2011.cfm
The Program is yet to be finalized. Details will be available at:
http://www.uofaweb.ualberta.ca/iiqm/TQ2011.cfm

Forthcoming Events
2010 SUMMER PROGRAMS
Our intensive summer school combines two popular IIQM programs
with hand-on research experience. This program is ideal
for researchers new to qualitative methods, including professionals
who do research as a component of their job, graduate students,
and seasoned researchers new to qualitative methods.
The Principles of Qualitative Inquiry
Our popular graduate-level summer course covers the basics of
qualitative research, and serves as a strong introduction to qualitative
inquiry.
Inside Analysis
Three weeks of course-work based around an ongoing qualitative
project provides a combination of practical and theoretical experience.
Thinking Qualitatively June ‘TBA,’ 2011
In this 5-day series of hands-on workshops, participants choose
workshops based on their personal needs. Major methods and
important techniques are covered, allowing participants to hone
the skills necessary to conduct a qualitative project.
NOTE: If you require work space at the Institute while you are taking
the above course/s, you must apply for residency at the Institute. The
application form and fee schedule is available on our website http://
www.iiqm.ualberta.ca
The Program is yet to be finalized. Details will be available at:
http://www.uofaweb.ualberta.ca/iiqm/education.cfm
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Forthcoming Events
IIQM DISSERTATION AWARD
The International Institute for Qualitative Methodology (IIQM), at the
University of Alberta, will annually make an award to the best doctoral
dissertation, from any academic discipline, containing research based on
qualitative methodology.
Dissertations must have been successfully defended within 18 months of
the award's submission deadline in order to be considered.
The prize consists of:
1. Publication of the dissertation according to the publication guidelines
of Left Coast Press (http://www.lcoastpress.com/), the official publisher
for the IIQM‟s Qual Press.;
2. A prize of $500.00
3. Complimentary conference registration for the Annual Advances in
Qualitative Methods Conference
For more information, including how to apply, please visit our website at:
http://www.uofaweb.ualberta.ca/iiqm/iiqmdissertation.cfm
DEADLINE OCTOBER 31, 2010

Forthcoming Events
MEMBER SCHOLARS
This application is designed for researchers, graduate students and professionals
(world-wide, in any discipline) who are interested in engaging
with qualitative scholars and would like to formalize their relationship
with the IIQM. “Member Scholars” are involved in various activities
in support of the IIQM‟s mission, such as: attending or presenting
at IIQM conferences, seminar and training events; reviewing for the
International Journal of Qualitative Methods; volunteering at IIQM
events; etc. Member Scholars serve as advocates for IIQM activities
world-wide as part of an international network of scholars committed to
excellence in qualitative research.
All applications will be reviewed by a committee comprised of IIQM
Affiliate and Distinguished Scholars; adjudication meetings are held
twice per year, so must be received by October 30th (for the fall review)
or March 30th (for the spring review). Member Scholar appointments
are open-ended, but must be renewed every three years. Individuals
must be Member Scholars for a minimum of three years before they
may be considered for IIQM “Affiliate Scholar” status.
For more information, including how to apply, please visit our website at:
http://www.uofaweb.ualberta.ca/iiqm/iiqmmemberscholars.cfm
DEADLINE OCTOBER 31, 2010
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Forthcoming Events

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