Listening to the Voices of Mothers Who Participated in a Video Feedback Intervention for Postpartum Depression.

Postpartum depression (PPD) symptoms can negatively influence mother-infant interactions. Video-Feedback Interaction Guidance for Improving Interactions Between Depressed Mothers and their Infants (VID-KIDS) is a parenting intervention that allows mothers experiencing PPD symptoms to observe and improve their interactions with their infants. VID-KIDS has also positively influenced infants' stress (cortisol) patterns. There is limited research on maternal perspectives of interventions like VID-KIDS. In this hermeneutic study, four mothers were interviewed to increase understanding of the VID-KIDS experience. Key findings included: 1) VID-KIDS provided an opportunity for mothers with PPD symptoms to positively transform their identity; 2) VID-KIDS provided a chance to witness the mother-infant relationship forming and improve maternal mental health t, and; 3) VID-KIDS provided a space for mothers to dialogue about their experience with PPD symptoms authentically. VID-KIDS promoted healing from PPD as mothers experienced a transformation in how they perceived themselves and their relationships with their infants.

Interpretive description in applied mixed methods research: Exploring issues of fit, purpose, process, context, and design.

As mixed methods research approaches become increasingly more common, it is imperative they are conducted in a thoughtful and rigorous manner to yield useful results. While researchers have begun to explore the use of various qualitative research methodologies in mixed methods research, there is a gap in literature discussing the philosophical congruence of using interpretive description in mixed method studies, and how to ensure rigor while integrating interpretive description results. Our purpose in writing this article is to discuss the issues of fit, purpose, process, context, and design when using interpretive description in mixed methods research approaches by drawing on examples from the literature. Further, we explore the contributions that interpretive description can make in a mixed methods inquiry. This article offers a first step in using a purposeful approach to mixed methods interpretive description studies to increase transparency and rigor in this relatively new methodology.

The enigma of weight: Figures, flux, and fitting in.

Purpose: In Western society, the measurement of weight is prioritized over a person's bodily experience. Hermeneutic philosopher Gadamer warned against the emphasis on measurement, rather than experience, in the medical sciences. An examination of the complexity of the experience of weight provides the opportunity to shift focus from quantifying the connection between health and weight to the experience of the person being weighed. Methods: This qualitative hermeneutic study aims to understand people's experiences of weight from the interviews of professionals (n = 7) and lay experts (n = 10). Interviews were analyzed using an interpretive hermeneutic method. Results: The interviews revealed that weight was experienced as a number imbued with meaning and bias, as a number that could be manipulated, and as a constant and anticipated bodily change. Weight change was expected and often unwelcomed, despite weight being a quality of the body that is always in flux. External measures of weight meant to monitor wellness and health inadvertently became an unhealthy fixation that prevented some participants from fully participating in life events and appreciating the stages their bodies were in. Conclusion: Weight change is a necessary condition of being human, and bodies are and will be constantly changing. To achieve health and harmony, one must fit together the acceptance of change and their bodily experience of weight. It is often the preoccupation with weight, not weight itself, that gets in the way of living.

The optics of weight: expert perspectives from the panopticon and synopticon.

Objective: That we all weigh something is a fact of life, yet the material reality of weight is refracted through multiple layers of surveillance revealing contradictions in experience and understanding, depending on one's vantage point. We explored the complexities of weight with the specific aim of furthering understanding of this multifaceted surveillance.Methods and Measures: We used hermeneutics, the philosophy and practice of interpretation, as the method of inquiry. Ten experts by experience and seven professional experts participated in interviews, which were audio- recorded, transcribed, and analyzed. Interpretations were developed through group discussions among the eight authors and reiterative writing.Results: Using the metaphor of optics, we demonstrate how the interplay of the panopticon (the few watching the many) and synopticon (the many watching the few) help us gain a deeper understanding of weight through "fitting in," being "captured by numbers," "dieting: the tyrannic tower," and "the male gaze."Conclusion: Monitoring and judging body weight have become so normative in Western society that "weight watching" practices are synonymous with good citizenship and moral character. This study offers insight about how weight is conceptualized in personal and professional contexts, with implications for body image, dieting, eating disorders, public health, and weight bias.

The impact of horizontal violence on the individual nurse: A qualitative research study.

AIM: Horizontal violence (HV) is a familiar term used in nursing. Certain populations of nurses are more susceptible to HV than others. Graduate nurses (nurses within their first 12 months of practice) are widely considered a vulnerable population in the profession and thus more at risk for HV. The purpose of this qualitative study was to explore how HV affects graduate nurses (GNs). DESIGN: Inductive thematic analysis was used in the design of this study. METHODS: Participants included eight Canadian GNs or Registered Nurses (RNs), all of whom had experience with HV in their first 12 months of practice. Data collection was done via one-on-one interviews. RESULTS: Two main themes were revealed from the data collected - Toxic Nursing Culture and Fear. Several subthemes were also identified - cycle of violence, nurses eating their young, shame, drowning, isolation and vulnerability. The findings indicate that HV is prevalent in the first year of practice and is destructive to the mental health of the individual nurse. Horizontal violence poses a serious challenge for GNs entering nursing and is often touted as the reason new nurses leave the profession altogether. CONCLUSION: This study highlighted the personal and professional challenges that are heightened for a GN when they experience HV in their first year of practice. These experiences emphasize the impact that HV can have on the mental health of nurses and their ability to deliver safe patient care.

Enduring Cell Lines: Parents' Experiences of Postmortem Tumor Banking in Childhood Cancer.

While cure rates in pediatric oncology have improved over the past 30 years, childhood cancer remains the second leading cause of death in children aged 1 to 14. Developing therapies often require using cancerous tissues, which may come from deceased donors. Tumor banks collect, store, and distribute these donated samples. While tumor banking is more common, factors that contribute to parents' decision and the impact of it on the family are not well understood. The purpose of this hermeneutic study was to understand the meaning and impact of tumor banking for parents of children who have died from cancer. Findings suggest that parents donating their child's tumors unexpectedly found a sense of meaning in their loss. They also found a legacy of their child's life; the living cells in some ways assisted the parents with grief. Aspects of this sensitive conversation and decision are discussed from the perspective of the parents' experiences.

"My Whole World Fell Apart": Parents Discovering Their Child Has Anorexia Nervosa.

This was the first study to examine the experience of parents who discover their child was living with anorexia nervosa (AN), thus fulfilling a critical gap in the eating disorder literature. Gadamerian hermeneutic inquiry was the guiding philosophy and method used to investigate this topic. Dialogues with parents revealed the ambiguity inherent within discovery; the isolation, betrayal, and loss felt by parents; and the complicated family dynamics occurring during the process of discovering one's child has AN. As such, when discoveries are made, parents play a vital role in the development and functioning of the family's response to the situation. This research offers health care providers a better understanding of the difficult times parents and caregivers experience when discovering their child has AN.

Composing Sexuality in the Midst of Adolescent Cancer.

A cancer diagnosis heralds the onset of significant life changes. The various experiences of diagnosis, treatment, and recovery from cancer during adolescence and young adulthood are complex and disruptive. Emphasis on treatment and recovery often overshadows other social and developmental imperatives for adolescents and young adults. Acknowledging, exploring, and crafting one's own sexual identity is a significant milestone achieved during this time, and it is one that is interrupted by the arrival and treatment of cancer. There is value in understanding how adolescents and young adults compose sexuality amid cancer experiences, and how this composition contributes to their ongoing stream of life experiences after recovery. As part of a larger study of sexuality and adolescent cancer, we undertook a narrative inquiry with Anna and Mark, two young adults who experienced cancer during adolescence. Over 14 months, we met with Anna and Mark, drawing on different narrative inquiry approaches to explore their past and ongoing experiences and to build negotiated stories of those experiences. We explored resonant threads between the stories, which help show the depth and complexity of sexuality as it is experienced in the midst of and after cancer. Two resonant threads are discussed: inward and outward looking, and sexuality and survival. The inquiry reveals the richness of self-composition amid competing stories of cancer treatment, disruptions to family and socialization, survivorship, what it means to be a young man or woman in the world, and the sense of a developing sexual self.

Digital Storytelling as a Psychosocial Tool for Adult Cancer Survivors.

PURPOSE: To understand the meaning and impact for adult patients with cancer (past or present) of creating a digital story related to their cancer experience. PARTICIPANTS & SETTING: 10 participants made digital stories with the help of a research assistant trained in digital storytelling. This research took place in a large, urban center in Calgary, Alberta, Canada. METHODOLOGIC APPROACH: This research was done in the tradition of philosophical hermeneutics. Ten one-on-one interviews were conducted, and data were analyzed using an interpretive qualitative methodology. FINDINGS: Findings revealed that digital stories were cathartic; reconnected individuals with family, friends, and parts of their lives that had been interrupted from cancer therapy; helped participants reflect in a way that was often described as therapeutic; and bridged communication with others about their cancer experiences. IMPLICATIONS FOR NURSING: Digital stories can be used to highlight the immense psychosocial impact of cancer and point healthcare professionals and other researchers toward creative and nontraditional ways to address this issue.

"Family Is Who They Say They Are"a: Examining the Effects of Cancer on the Romantic Partners of Adolescents and Young Adults.

In this article, we discuss a study we conducted to examine the effects of cancer on romantic partners (i.e., boyfriends and girlfriends, social/romantic/intimate partners) of adolescents and young adults experiencing, or who have experienced, cancer. In this hermeneutic study, we interviewed partners who were involved with an adolescent/young adult with cancer, a cancer survivor who was in a relationship during his treatment, and two healthcare professionals who have worked with these couples and witnessed many other situations of impact, effect, and repercussion. Out of this study, we suggest that partners are affected in many ways that can vary from estrangement, to termination of the relationship, to premature decisions about remaining in the relationship, to family disregard of the partner, and to disregard of the family due to influence of, or relationship with, the partner. We discuss these findings within the context of the larger picture of the psychosocial relational impact of cancer on members beyond those in the immediate and biological family.

Social Return on Investment: A New Approach to Understanding and Advocating for Value in Healthcare.

OBJECTIVE: To determine whether the methodology of social return on investment (SROI) could be a way in which the value of a healthcare-related program (children's cancer camp) could be captured, evaluated, and communicated. BACKGROUND: The value of healthcare goes beyond what can be captured in financial terms; however, this is the most common type of value that is measured. The SROI methodology accounts for a broader concept of value by measuring social, environmental, and economic outcomes and uses monetary values to represent them. METHODS: The steps/stages of an SROI analysis were applied to the context of a children's camp for this article. RESULTS: Applying the SROI methodology to this healthcare-related program was feasible and provided insight and understanding related to the impacts of this program. CONCLUSIONS: Because of SROI's flexibility, it is a tool that has great potential in a healthcare environment and for leaders to evaluate programmatic return on investment.

"A Tribe Apart": Sexuality and Cancer in Adolescence.

This qualitative study employed hermeneutic phenomenology and narrative inquiry to examine the topic of sexuality and adolescents with cancer from the perspectives of survivors who had experienced cancer as adolescents. This investigation examined the potentially sensitive, disquieting, and often taboo issue of sexuality in the interest of optimizing wellness in young people, and, ultimately, in the health of adults. Understanding the adolescent body as a sensitive, sexual, and developing self can enrich our understanding of adolescent cancer and promote best health care and practices, examining ways that we might mitigate the long-term effects of arrested or delayed development of sexual identity. In this article, we discuss phase 1 of the study, which used hermeneutics as the method of inquiry. Findings included a general experience of adolescents having a sense of "losing themselves" while at the same time finding themselves in a new light. Other findings include the connection between sexuality, self, and identity; the unique "tribe" of adolescents with cancer; the necessity for sexuality to take a backseat to cancer; the changing mirror images from self and others; sexuality and fertility; and, ultimately, that sexuality is a relational experience.

Stories That Heal: Understanding the Effects of Creating Digital Stories With Pediatric and Adolescent/Young Adult Oncology Patients.

The purpose of this philosophical hermeneutic study was to determine if, and understand how, digital stories might be effective therapeutic tools to use with children and adolescents/young adults (AYA) with cancer, thus helping mitigate suffering. Sixteen participants made digital stories with the help of a research assistant trained in digital storytelling and were interviewed following the completion of their stories. Findings from this research revealed that digital stories were a way to have others understand their experiences of cancer, allowed for further healing from their sometimes traumatic experiences, had unexpected therapeutic effects, and were a way to reconcile past experiences with current life. Digital stories, we conclude, show great promise with the pediatric and AYA oncology community and we believe are a way in which the psychosocial effects of cancer treatment may be addressed. Recommendations for incorporating digital stories into clinical practice and follow-up programs are offered.

"Stories Take Your Role Away From You": Understanding the Impact on Health Care Professionals of Viewing Digital Stories of Pediatric and Adolescent/Young Adult Oncology Patients.

The purpose of this philosophical hermeneutic study was to understand the effects on health care providers (HCPs) of watching digital stories made by (past and present) pediatric and adolescent/young adult (AYA) oncology patients. Twelve HCPs participated in a focus group where they watched digital stories made by pediatric/AYA oncology patients and participated in a discussion related to the impact the stories had on them personally and professionally. Findings from this research revealed that HCPs found digital stories to be powerful, therapeutic, and educational tools. Health care providers described uses for digital stories ranging from education of newly diagnosed families to training of new staff. Digital stories, we conclude, can be an efficient and effective way through which to understand the patient experience, implications from which can range from more efficient patient care delivery to decision making. Recommendations for incorporating digital storytelling into healthcare delivery are offered.

Examining the Effects of Childhood Cancer on the Parental Subsystem: Implications for Parents and Health Care Professionals-Part 3.

This article is the third part of a hermeneutic research study examining the impact of childhood cancer experiences on the parental relationship. In Part 1, we offered an exploration of the phenomenon with background literature; a description of the research question, method, and design; and finally a discussion of relationships that survived, thrived, or demised, with an emphasis on the notions of difference and trading. In Part 2, we furthered the interpretations to look at the complexities of issues such as teams, roles, focus, protection, intimacy, grieving, putting relationships on hold, and reclaiming them. In this article, we discuss the advice that the participants offered us and how that advice might have implications for other parents in similar situations and health care professionals working with families experiencing childhood cancer.

Taking One for the Team: Examining the Effects of Childhood Cancer on the Parental Subsystem-Part 2.

In this Part 2 of a three-part research paper, we further our interpretations from our hermeneutic study examining how having a child who has experienced cancer had an impact on the relationship between the parents. In Part 1, we identified the focus of the study and provided background to the topic. We also described the research question, method, and design before offering an interpretive analysis of couples whose relationships survived, thrived, or demised. In this article, we extend the interpretations under an overarching theme of "taking one for the team." Here, we discuss issues of changes in focus and roles, and the notions of tag teaming, protection, intimacy, and grieving. We examine the phenomenon of putting relationships on hold, then finding reclamation later. In Part 3, we offer implications of these findings for other parents in similar situations and for health care professionals working with these families.

Differences and Trading: Examining the Effects of Childhood Cancer on the Parental Subsystem-Part 1.

This article is the first of a three-part report of a research study that used hermeneutic inquiry to examine the effects of childhood cancer on the relationship between the parents of the child. In Part 1, we identity the topic of investigation and the relevant literature; describe the research question, method, and design; and begin our interpretations of the data with a focus on the couples who remained together and those who experienced relationship demise. In this analysis, we discovered that issues of difference and trading played a strong role in how the couples fared in their relationships. In Part 2 of this series, we focus on further interpretations, and in Part 3, we discuss the implications of the study for other parents and for health care professionals.

"It's not Just Camp!": Understanding the Meaning of Children's Cancer Camps for Children and Families.

The purpose of this philosophical hermeneutic inquiry was to understand the meaning of children's cancer camps for the child with cancer and the family. Six childhood cancer families and 5 cancer camp counselors were interviewed, in order to bring understanding to this topic. Findings from this research revealed that camp means different things for different families, and that much is at play in the cancer camp experience: the healing and developmental power of play, finding acceptance and fit, grief as something to live with versus "get over," storytelling as a means of reshaping and understanding traumatic experiences, and the solidarity of the community as one that creates intense, healing bonds. Children's cancer camps, we conclude, should be considered a necessity, versus a luxury, and could even be thought of as a psychosocial intervention for some children and families. Barriers such as structure of funding and access to resources are present and likely due to the separateness of camps from hospital programs.

Children's cancer camps: a way to understand grief differently.

A philosophical hermeneutic study was conducted as part of the first author's doctoral research to understand the meaning of children's cancer camps for the child with cancer and the family. Twenty family members from six families were interviewed in order to bring understanding to this topic. This article will detail the finding related to the experience of grief that often accompanies a cancer diagnosis, and how camp seems to allow children and families to understand their grief differently. The interesting thing about this particular cancer camp is that families of children who have died continue to attend the camp yearly, and there are events to memorialize the many children known to all the campers who no longer attend camp. This is not a grief camp but a cancer camp where grief is allowed presence as it necessarily has to in the world of childhood cancer.

Waiting to return to normal: an exploration of family systems intervention in childhood cancer.

The illness suffering of families in childhood cancer is characterized in part by a loss of family normalcy. Hermeneutic phenomenology and family process research methods were used to analyze videotaped family intervention sessions and post-intervention family/clinician interviews. Within this article, some of the findings from the larger doctoral study that focused on the illness suffering of family members and relational, family systems intervention based on the Illness Beliefs Model are described. Although the larger study included findings of family interventions that addressed several aspects of the illness suffering experienced, this article details specific findings related to the theme of the loss of family normalcy and a longing to return home. Family systems intervention practices which facilitated a lessening of illness suffering included the following: offering new interpretations of suffering within a reflecting team, articulating family strength, sensitively acknowledging the illness suffering, and eliciting the experiences of family members in a shared therapeutic conversation.