Age and Ageing themed collection of qualitative research in geriatric medicine
Age and Ageing journal is pleased to make available a free collection of qualitative research articles which we have published over the last 10 years.
This work 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 collection 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, 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 and the meaning of dignity in diverse settings (care home, end of life and among the older people generally).
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. One further paper looks at advanced care planning and 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.
The papers included in this collection illustrate the value of qualitative research in making available to clinicians insights to which they might not otherwise have access, for instance, about how patients experience and understand illness and treatment, and the reasoning and concerns which influence their often complex and shifting responses to it. Professional understanding of the divergent goals and logic underpinning clinical and lay priorities for treatment outcomes is critical in the successful implementation of health care. This is increasingly understood to depend on negotiated outcomes between patients and clinicians. In Tuckett’s terms, this involves a ‘meeting between experts’ – not in the sense that patients can, or desire to, possess knowledge and judgement equal to professionals, but rather that they have a unique and authoritative knowledge of their lived experience of illness and how this is accommodated within the goals and imperatives of complex, busy lives. Thus, while the clinical focus is on restoring function and successfully treating disease, older people may prioritise their ability to sustain social roles and obligations.
Above all, they may strive to preserve a sense of self and personal identity which the dependency of illness, age and frailty intrinsically threaten. The studies included in this collection make use of core qualitative methods of data collection (semi structured and narrative interviews, focus groups, case studies) and analysis (thematic, constant comparison, Grounded Theory, framework). However, qualitative data collection and analysis are characterised by their flexibility and methodological diversity including, for example, ethnography, participatory action research, diaries and discourse analysis of texts and images (policy, historical, media, digital). We welcome submission of papers based on qualitative research exemplifying a wide range of different topics and methodological approaches which illuminate older people’s experience of ageing, medical care and treatment, decision making and communication with health care professionals. We are particularly interested in publishing research with an international perspective and from resource poor countries, and those which offer a critical appraisal of health policy and professional practice. Dr Kristian Pollock, University of Nottingham Dr Mary Godfrey, Leeds Institute of Health Sciences
- 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.