This themed collection of Age and Ageing articles includes a selection of papers published over the last 10 years which highlights the value of qualitative methodologies in health services research, particularly in understanding patient experience of health and illness and decision making about treatment and preventive care. We hope this issue will raise awareness of the scope for further contributions and encourage authors to submit papers reporting qualitative studies to the journal.
Summary of topics and themes:
In an editorial in Age and Ageing (5), we drew attention to the way in which the application of qualitative research methods within the social science disciplines of sociology, anthropology and social psychology can enrich understanding of ageing and illness: for example, through eliciting the meaning and process of ageing, health and illness from the perspective of older people; the practice of service delivery and what shapes it; and the beliefs, values and ‘taken for granted ‘knowledge that professionals may apply in their work with older people. Over the years, Age and Ageing has attracted a small but growing number of qualitative research articles around a diverse range of areas. In this themed collection we present a selection of published papers organised around several topics and overarching themes. The first themes concern aspects of older people’s subjective experience of illness and care specifically pain and its management in day to day life (8, 9) and the meaning of dignity in diverse settings (care home, end of life and among the older people generally) (7, 12, 17). Two papers explore caregiving from the perspective of those providing and receiving care, drawing attention to the emotional, relational and reciprocal features of caregiving and receiving in older age, in contrast to a view of caregiving that sees older people as ‘objects’ of care (6, 16). One further paper considers professional responses to patients’ documented decisions about refusal of treatment and the difficulty clinicians experience in implementing treatment decisions which conflict with their professional judgement (1). Read full introduction and references
The Collection:
Geriatricians’ views of advance decisions and their use in clinical care in England: qualitative study
Bond, C. J. & Lowton, K. 2011. Age & Ageing, 40, 450–456
An interview study of geriatricians’ views on advance decisions to refuse treatment and their use in decision-making in England.
Informal care at times of change in health and mobility: a qualitative study
Gooberman-Hill, R. & Ebrahim, S. 2006. Age & Ageing, 35, 261-266.
This paper questions the appropriateness of characterising the collaborative work undertaken by patients, their friends and family members in responding to the demands of illness and impaired mobility as ‘informal care’ when participants themselves assimilate this in terms of adaptation and commitment to ongoing relationships.
Living and dying with dignity in Chinese society: perspectives of older palliative care patients in Hong Kong
Ho, A. H. Y., Chan, C. L. W., Leung, P. P. Y., Chochinov, H. M., Neimeyer, R. A., Pang, S. M. C. & Tse, D. M. W. 2013. Age & Ageing, 42, 455–461
An interview study of how terminal cancer patients conceptualised the concept of ‘living and dying with dignity’ to explore the generalisability of Chochinov’s Dignity Model from Western industrial populations to Hong Kong.
‘Living within your limits’: activity restriction in older people experiencing chronic pain
Mackichan, F., Adamson, J. & Gooberman-Hill, R. 2013. Age & Ageing, 2013, 702-708.
This paper presents avoidance of activity by older people in response to pain as a rational response in the pursuit of their desire to avoid pain and maintain autonomy through avoidance of medical intervention.
Use of NSAIDs for osteoarthritis amongst older-aged primary care patients: engagement with information and perceptions of risk
Milder, T. Y., Williams, K. M., Ritchie, J. E., Lipworth, W. L. & Day, R. O. 2011. Age & Ageing, 40, 254-259.
This paper explores the understandings of risk that older-aged primary care patients have in the context of the use of oral NSAIDs to treat osteoarthritis.
Dignity and the challenge of dying in nursing homes: the residents’ view
Pleschberger, S. 2007. Age & Ageing, 36, 197-202.
An exploration of the meaning of dignity with regard to end-of-life issues from the perspective of older nursing home residents in Germany.
Caring for a dying spouse at the end of life: ‘It’s one of the things you volunteer for when you get married’: a qualitative study of the oldest carers’ experiences
Turner, M., King, C., Milligan, C., Thomas, C., Brearley, S. G., Seamark, D., Wang, X., Blake, S. & Payne, S. 2016. Age and Ageing, 45, 421-426
A qualitative interview study to elicit older people’s perspectives of dignity and its salience to their experience of medical care, decision making and self-esteem.
Dignity in older age: what do older people in the United Kingdom think?
Woolhead, G., Calnan, M., Dieppe, P. & Tadd, W. 2004. Age and Ageing, 33, 165–170
Woolhead et al identify the different facets of dignity as conceptualised by older people in terms of identity, human rights and autonomy, and the importance of professional understanding of these perspectives in the practice of patient centred care.
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