Arab researchers encounter formidable obstacles when conducting and publishing their scientific work. We conducted semi-structured interviews with 17 Arab researchers from various Arab Middle East countries to gain a comprehensive understanding of the difficulties they face in research and publication. We analyzed the transcripts using reflexive thematic analysis. Our findings revealed several key challenges. First, Arab researchers struggle to conduct high-quality research due to limited resources, inadequate funding, and a lack of a supportive research infrastructure. Furthermore, a shortage (...) of teamwork and mentoring diminishes research productivity. Perverse promotion policies, heavy teaching loads, and low salaries force many researchers to seek external income sources, leaving them with insufficient time for research. Regarding publishing in high-impact journals, Arab researchers confront challenges existing of insufficient scientific writing skills, underrepresentation on editorial boards, and unconscious biases against researchers from economically challenged areas. Finally, achieving research integrity is closely tied to lack of access to essential resources. To address these issues, our participants proposed targeted interventions at the institutional and external levels. For example, universities can implement mentoring programs, offer workshops on scientific writing and publishing, and foster a supportive institutional culture for research. Addressing the underrepresentation of Arabic researchers on editorial boards is crucial for equity in global scientific publishing. In conclusion, acknowledging and addressing these challenges will empower Arab researchers, elevate research quality, and promote equitable global scientific collaboration. Our findings provide guidance for universities, governments, and international donors seeking to enhance research and publication practices in the Arab Middle East. (shrink)

The aim is to describe which persuasive tool from the triad of Aristotle (Ethos, Pathos and Logos) is most commonly used in editorials to convey visions and ideas in the nursing journals of the last 5 years (2014–2019). A descriptive qualitative study, based on content analysis, was performed in 2020 and summarized according to the COnsolidated criteria for REporting Qualitative research principles. Two hundred and eighty‐five editorials were included in the study, all of which were published in the (...) top‐five nursing journals, specifically, the International Journal of Nursing Studies (5‐years Journal Impact Factor [5‐Y JIF] = 5.022), the Journal of Nursing Scholarship (=3.374), the Journal of Advanced Nursing (=3.010), the Worldviews on Evidence‐Based Nursing (2.990) and the Nursing Outlook (=2.867). Logos was the most widely used tool in 148 editorials (51.9%). Ethos was used in a quarter of them (n = 72, 25.3%) and the Pathos tool was used to a similar extent (n = 65, 22.8%). Logic is the most used tool for persuasion in nursing editorials; however, nurses who would capture the attention of the nursing community by writing an editorial should also consider the profiles of the potential readers, who might be attracted in different ways by logical‐objective, ethical–moral, or emotional discourses. (shrink)

There is widespread agreement among large segments of western society that we are living in a period of hard times. At first glance such a belief might seem exceedingly odd. After all, persons in western society find themselves living in a time of unprecedented material abundance. Hunger and disease, evils all too familiar to the members of earlier generations, although far from eradicated from modern life, are plainly on the wane. Persons alive today can look forward to healthier, longer, and (...) more comfortable lives than those of their grand parents. Nevertheless, the feeling that life today is especially difficult is rampant in government, in the media, in popular books, and in academic circles. Western society is perceived in many quarters as wracked by crises of all sorts-of faith, of power, of authority, of social turmoil, of declining quality in workmanship and products, and of a general intellectual malaise afflicting both those on the Left and the Right. A tone of crisis permeates the language of public life. Editorials in major newspapers are full of dire warnings about the dangers of unbridled egoism, avarice and greed, and the risks and horrors of pollution, overpopulation, the arms race, crime, and indulgent lifestyles. (shrink)

Numerous instruments have been developed to elicit numerical values that represent the strength of preference for different health states. However, relatively few studies have attempted to analyse the reasoning processes that people employ when they are asked to answer questions based on these elicitation methods. The lottery equivalents method is a preference elicitation instrument that has recently received some attention in the literature. This study attempts a qualitative analysis of the use of this instrument on a group of 25 (...) relatively highly educated respondents. For each of three health states considered in the study, a substantial number of respondents refused to trade the chance of survival for a possible improvement in the health state. Therefore, many respondents violated an assumption that is necessary for the lottery equivalents instrument to generate cardinal health state values. These findings place a question mark against the usefulness of the lottery equivalents method, and add weight to the suspicion that ‘preferences’ are constructed according to how questions are framed. (Published Online July 31 2007). (shrink)

Qualitative longitudinal research (QLR) provides temporal understanding of the human response to health, illness, and the life course. However, little guidance is available for conducting QLR in the nursing literature. The purpose of this review is to describe the methodological status of QLR in nursing. With the assistance of a medical librarian, we conducted a thorough search circumscribed to qualitative, longitudinal nursing studies of patients’ and care‐givers’ experiences published between 2006 and 2016. The methodological quality of the 74 (...) reviewed studies varied tremendously; many reports lacked sufficient detail in reporting on sampling and attrition, retention strategies, and data collection and analysis, making it difficult for readers to evaluate the credibility and transferability of study findings. Based on the strengths and limitations of the studies reviewed and findings in the literature, we provide recommendations for enhancing the reporting of the research process as a supplement to the standards for qualitative research more broadly. These recommendations are offered in the spirit of encouraging dialogue among colleagues and assisting journal reviewers and editors in their evaluation of QLR. (shrink)

Purpose As Big Data and Artificial Intelligence (AI) proliferate, calls have emerged for ethical reflection. Ethics guidelines have played a central role in this respect. While quantitative research on the ethics guidelines of AI/Big Data has been undertaken, there has been a dearth of systematic qualitative analyses of these documents. Design/methodology/approach Aiming to address this research gap, this paper analyses 70 international ethics guidelines documents from academia, NGOs and the corporate realm, published between 2017 and 2020. Findings The (...) article presents four key findings: existing ethics guidelines (1) promote a broad spectrum of values; (2) focus principally on AI, followed by (Big) Data and algorithms; (3) do not adequately define the term “ethics” and related terms; and (4) have most frequent recourse to the values of “transparency,” “privacy,” and “security.” Based on these findings, the article argues that the guidelines corpus exhibits discernible utilitarian tendencies; guidelines would benefit from greater reflexivity with respect to their ethical framework; and virtue ethical approaches have a valuable contribution to make to the process of guidelines development. Originality/value The paper provides qualitative insights into the ethical discourse surrounding AI guidelines, as well as a concise overview of different types of operative translations of theoretical ethical concepts vis-à-vis the sphere of AI. These may prove beneficial for (applied) ethicists, developers and regulators who understand these guidelines as policy. (shrink)

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)

Qualitative studies are an important component of business ethics research. This large amount of research covers a wide array of factors and influences on ethical decision making published between 2004 and 2014. Following the methodology of past critical reviews, this work provides a synopsis of the diverse array of qualitative studies in ethical decision making within the business ethics literature. We highlight the distinct and investigative nature of qualitative research, synthesize and summarize findings, and suggest opportunities (...) for future research. We conclude with a recommendation for developing qualitative studies in business ethics and a call for an increased openness when considering this valuable and underrepresented strategy of inquiry. (shrink)

Introduction: Agricultural workers perform intense labor outside in direct sunlight and in humid environmental conditions exposing them to a high risk of heat-related illness (HRI). To implement effective cooling interventions in occupational settings, it is important to consider workers’ perceptions. To date, an analysis of agricultural workers’ experience and perception of cooling devices used in the field while working has not been published. -/- Methods: Qualitatively data from 61 agricultural workers provided details of their perceptions and experiences with cooling interventions. (...) -/- Results: The participants in the bandana group reported the bandana was practical to use at work and did not interfere with their work routine. Cooling vest group participants agreed that the vest was effective at cooling them, but the practicality of using the vest at work was met with mixed reviews. -/- Conclusion: The findings of this qualitative study support and extend existing research regarding personal cooling and heat prevention research interventions with vulnerable occupational groups. Personal cooling gear was well received and utilized by the agricultural workers. Sustainable heat prevention studies and governmental protection strategies for occupational heat stress are urgently needed to reduce the risk of heat-related morbidity, mortality, and projected climate change health impacts on outdoor workers. (shrink)

Background: Legislative changes are resulting in assisted death as an option for people at the end of life. Although nurses’ experiences and perspectives are underrepresented within broader ethical discourses about assisted death, there is a small but significant body of literature examining nurses’ experiences of caring for people who request this option. Aim: To synthesize what has been learned about nurses’ experiences of caring for patients who request assisted death and to highlight what is morally at stake for nurses who (...) undertake this type of care. Design: Qualitative meta-synthesis. Methods: Six databases were searched: CINAHL, Medline, EMBASE, Joanna Briggs Institute, PsycINFO, and Web of Science. The search was completed on 22 October 2014 and updated in February 2016. Of 879 articles identified from the database searches, 16 articles were deemed relevant based on inclusion criteria. Following quality appraisal, 14 studies were retained for analysis and synthesis. Results: The moral experience of the nurse is defined by a profound sense of responsibility, shaped by contextual forces that nurses navigate in everyday end-of-life care practice, and sustained by intra-team moral and emotional support. Discussion: The findings of this synthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The findings further demonstrate that to fully appreciate the ethics of assisted death from a nursing standpoint, it is necessary to understand the broader constraints on nurses’ moral agency that operate in everyday end-of-life care. Ethical considerations: Research ethics board approval was not required for this synthesis of previously published literature. Conclusion: In order to understand how to enact ethical practice in the area of assisted death, the moral experiences of nurses should be investigated and foregrounded. (shrink)

BackgroundIn our globalizing world, caregivers are increasingly being confronted with the challenges of providing intercultural healthcare, trying to find a dignified answer to the vulnerable situation of ethnic minority patients. Until now, international literature lacks insight in the intercultural care process as experienced by the ethnic minority patients themselves. We aim to fill this gap by analysing qualitative literature on the intercultural care encounter in the hospital setting, as experienced by ethnic minority patients.MethodsA systematic search was conducted for papers (...) published between 2000 and 2015. Analysis and synthesis were guided by the critical interpretive synthesis approach.ResultsFifty one articles were included. Four dimensions emerged, describing the intercultural care encounter as a meeting of two different cultural contexts of care, in a dynamic and circular process of balancing between the two cultural contexts, which is influenced by mediators as concepts of being human, communication, family members and the hospital’s organizational culture.ConclusionsThis review provides in-depth insight in the dynamic process of establishing intercultural care relationships in the hospital. We call for a broader perspective towards cultural sensitive care in which patients are cared for in a holistic and dignity-enhancing way. (shrink)

BackgroundResearch misconduct and questionable research practices have been the subject of increasing attention in the past few years. But despite the rich body of research available, few empirical works also include the perspectives of non-researcher stakeholders.MethodsWe conducted semi-structured interviews and focus groups with policy makers, funders, institution leaders, editors or publishers, research integrity office members, research integrity community members, laboratory technicians, researchers, research students, and former-researchers who changed career to inquire on the topics of success, integrity, and responsibilities in science. (...) We used the Flemish biomedical landscape as a baseline to be able to grasp the views of interacting and complementary actors in a system setting.ResultsGiven the breadth of our results, we divided our findings in a two-paper series with the current paper focusing on the problems that affect the integrity and research culture. We first found that different actors have different perspectives on the problems that affect the integrity and culture of research. Problems were either linked to personalities and attitudes, or to the climates in which researchers operate. Elements that were described as essential for success were often thought to accentuate the problems of research climates by disrupting research culture and research integrity. Even though all participants agreed that current research climates need to be addressed, participants generally did not feel responsible nor capable of initiating change. Instead, respondents revealed a circle of blame and mistrust between actor groups.ConclusionsOur findings resonate with recent debates, and extrapolate a few action points which might help advance the discussion. First, the research integrity debate must revisit and tackle the way in which researchers are assessed. Second, approaches to promote better science need to address the impact that research climates have on research integrity and research culture rather than to capitalize on individual researchers’ compliance. Finally, inter-actor dialogues and shared decision making must be given priority to ensure that the perspectives of the full research system are captured. Understanding the relations and interdependency between these perspectives is key to be able to address the problems of science.Study registrationhttps://osf.io/33v3m. (shrink)

Heideggerian philosophy is frequently chosen as a philosophical framing, and/or a hermeneutic analytical structure in qualitative nursing research. As Heideggerian philosophy is dense, there is merit in the development of scholarly resources that help to explain discrete Heideggerian concepts and to uncover their relevance to contemporary human experience. This paper uses a meta-synthesis methodology to pool and synthesise findings from 29 phenomenological research reports on Being-with in the nurse–patient relationship. We firstly considered and secured the most relevant Heideggerian (...) elements to nurse–patient Being-with. Under these deductive codes, we then inductively developed sub-themes that seemed to explain the multifaceted nature of Being-with, through a secondary analysis and synthesis of published data from 417 patient, carer and nurse participants. Dasein-with was enhanced when nurses had first-hand experience with a phenomenon. Nurses moved between the inauthentic they-mode, and the authentic self-mode. Through circumspection, technology and people were encountered environmentally feeding into nursing attention, assessment and communication. Nursing as a social arrangement was expressed through either leaping-in care or leaping-ahead care. There was a place for both inauthentic and authentic discourse that nurses wove through the ontic everydayness of nursing tasks. (shrink)

This paper explores the “triangulation approach” in social science research methods. Triangulation is an emerging method specifically in qualitative and multi-method studies. Researchers in the social sciences have increased their use of the triangulation approach recently due to the merits of this approach, especially to conduct in-depth studies through multiple inquiries. Simultaneously, this method has criticism and misconceptions among social researchers in terms of what it is, how it can be used, and the credibility of the findings when (...) used. Therefore, this paper analyses in depth what triangulation is, the types of triangulations and how they can be applied in the social sciences. The study basically adopted systematic literature review and used 30 articles published in scientific journals. The paper critically reviewed journal articles related to triangulation, revealed how different types of triangulation methods have been applied in the social sciences and highlighted the merits and cautions of applying this method. The paper theoretically contributes to understanding the phenomenon of the triangulation approach and how it connects with qualitative and multi-method studies. In addition, it revealed that the following data collection techniques from multiple sources can be exploited: in-depth interviews, focus group discussions, literature, documents, and surveys on the triangulation method to improve the credibility and reliability of the research. Furthermore, the study empirically contributes to social science researchers applying this approach with proper understanding. (shrink)

While a growing number of works have been published about the use of mixed methods research in nursing, scarce attention has been devoted to the issue of the quality of mixed methods within the discipline. The quality appraisal of mixed methods research poses two problems to nursing science: first, current quality criteria are not nursing‐specific and consequently, they might not facilitate the application of mixed methods research findings into nursing practice. Second, criteria were theoretically derived and as such, they (...) might not faithfully account for the decisions that nurse researchers take when appraising mixed methods research studies. This qualitative, within‐case study explored the views of nurse researchers about mixed methods research in general and, more specifically, the question of quality in mixed methods research. An international sample of 13 nurse researchers was interviewed via Skype and phone. Thematic analysis revealed that the participants favored universal, cross‐disciplinary quality criteria, and not criteria specific to the nursing discipline, and a consensual and standardized approach to appraising the quality of mixed methods research. Recommendations are put forward to strengthen the quality appraisal of mixed methods research studies by nurse researchers, as well as future works on this topic within nursing science. (shrink)

Research Ethics, Volume 18, Issue 2, Page 93-113, April 2022. Twitter is an increasingly common source of rich, personalized qualitative data, as millions of people daily share their thoughts on myriad topics. However, questions remain unclear concerning if and how to quote publicly available social media data ethically. In this study, focusing on 136 education manuscripts quoting 2667 Tweets, we look to investigate the ways in which Tweets are quoted, the ethical discussions forwarded and actions taken, and the extent (...) to which quoted Tweets are “discoverable.” A concerning result is that in almost all manuscripts, and for around half of all quoted Tweets, the original author could be identified. Drawing on our findings we share some ethical dilemmas, including those that arise from an apparent lack of understanding of the technical aspects of the platform, and offer suggestions for promoting ethically-informed practice. (shrink)

The construct of locus of control of reinforcement has generated thousands of studies since its introduction as a psychological concept by Julian Rotter. Although evidence indicates its importance for a wide range of outcomes, comparatively little research has been directed toward identification of potential developmental antecedents of internal/external expectancies. A previous review of antecedent findings called for more research to be completed, particularly using observational and/or longitudinal methodologies. The current paper summarizes and evaluates antecedent research published in the intervening (...) years since Carton and Nowicki’s review. Results largely were consistent with expectations based on Rotter’s social learning theory, although there is still a need for researchers to use observational, rather than self-report methodologies, and to include data from non-western cultures. (shrink)

Muslims are a marginal minority in Poland, but research shows that they are often subject to negative perceptions and hostility from the majority. Orientalist stereotypes about Islam and the people associated with it are widespread and often reproduced in the media. Research from North America and the European Court of Human Rights suggests that such prejudices can affect the adjudication of cases involving Muslims. It may be presumed that Poland is no exception to that, and this assumption was the starting (...) point for our empirical study. To date, there have been no studies on the perception of Muslims and Islam in the Polish legal system. This article presents the results of a qualitative thematic analysis of 57 judicial opinions issued by the common courts in Poland and published online, in which Islam or being Muslim was mentioned. The cases were categorised and texts of the judicial opinions closely analysed (with computer-assisted qualitative data analysis software) to identify recurring themes. The findings of this first exploratory study show that stereotypical representations and the “‘Othering” of Muslims do indeed occur in Polish courts, with some judges repeating Orientalist tropes that have become normalised in Polish society. (shrink)

Communities, policy actors and conservationists benefit from understanding what institutions and land management regimes promote ecosystem services like carbon sequestration and biodiversity conservation. However, the definition of success depends on local conditions. Forests’ potential carbon stock, biodiversity, and rate of recovery following disturbance are known to vary with a broad suite of factors including temperature, precipitation, seasonality, species’ traits and land use history. Methods like forest changes over time , and comparison with 'pristine' reference forests have been proposed to compare (...) the structure and biodiversity of forests in the face of underlying differences. However, data from previous visits or reference forests may be unavailable or costly to obtain. Here, we introduce a new metric of locally weighted forest inter-comparison to mitigate the above shortcomings. This method is applied to an international database of nearly 300 community forests, and compared with previously published techniques. It is particularly suited to large databases where forests may be compared among one another. Further, it avoids problematic comparisons with old-growth forests which may not resemble the goal of forest management. In most cases, the different methods produce broadly congruent results, suggesting that researchers have the flexibility to compare forest conditions using whatever type of data is available. Forest structure and biodiversity are shown to be independently measurable axes of forest condition, although users’ and foresters’ estimations of seemingly unrelated attributes are highly correlated, perhaps reflecting an underlying sentiment about forest condition. These findings contribute new tools for large-scale analysis of ecosystem condition and natural resource policy assessment. Although applied here to forestry, these techniques have broader applications to classification and evaluation problems using crowdsourced or repurposed data for which baselines or external validations are not available. (shrink)

In this paper, the authors address the perceived recent trend of funding and publishing bodies that seem to have taken a regard of qualitative research as a subordinate to, or even a subset of, quantitative research. In this reflection, they pull on insights that Hans-Georg Gadamer offered around the history of the natural and human science bifurcation, ending with a plea that qualitative research needs to be received, appraised, judged, and promoted by different lenses and criteria of (...) value. (shrink)

In recent years the literature on bioethics has begun to pose the sociological challenge of how to explore organisational processes that facilitate a systemic response to ethical concerns. The present discussion seeks to make a contribution to this important new direction in ethical research by presenting findings from an Australian pilot study. The research was initiated by the Clinical Ethics Committee of Redland Hospital at Bayside Health Service District in Queensland, Australia, and explores health professionals’ understanding of the nature (...) of ethics and their experience with ethical decision-making within an acute medical ward. This study focuses on the actual experience, understanding and attitudes of clinical professionals in a general medical ward. In particular, the discussion explores the specific findings from the study concerned with how a multi-disciplinary team of health professionals define and operationalise the notion of ethics in an acute ward hospital setting. The key issue reported is that health professionals are not only able to clearly articulate notions of ethics, but that the notions expressed by a multi-disciplinary diversity of participants share a common definitional concept of ethics as patient-centred care. The central finding is that all professional groups indicated that there is a guiding principle to address their ethical sense of the ‘good’ or the ‘ought’ and that is to act in a way that furthered the interests of patients and their families. The findings affirm the importance of a sociological perspective as a productive new direction in bioethical research. (shrink)

The physiological constraints of our neuro-sensory instrumentation limit the information we receive and from which we fashion our impressions. These limitations precede the psychological issues of data generation and analysis described by Ioannidis [1]. Scientific models widely accepted for at least 50 years [2,3] suggest that the peripheral and central nervous systems do not provide direct information about phenomena as they exist in nature. Instead, perceptible phenomena stimulate sense organs to produce nerve impulses. Sensory nerve impulses are not replicas of (...) the phenomena stimulating their production. The brain, by obscure mechanisms, then fabricates personal experience from the sensory nerve impulses. The relationship of phenomena to the brain's experiential construct is unknown. Since evidence is produced by sense organs and the brain (neither of which incorporates bona fide replicas of phenomena), all scientific conclusions are likely false in the sense that they are not based on direct knowledge of phenomena as they exist in nature. (shrink)

Using a parallel mixed-methods design, the current study examined university students’ perceptions of academic cheating through collecting and analyzing both the quantitative and qualitative data. Our quantitative findings corroborate previous research that male students have engaged more in academic cheating than females based on students’ self-reports, and that undergraduate students are less willing to discuss issues on academic cheating as compared with their graduate counterparts. Five themes emerged from the thematic analysis of the qualitative data: flexible definitions (...) for cheating, environmental promotion of cheating, the moral transgression of cheating, cheating as an ambiguous justification, and cheating as a conscious decision making process. The mixed-methods findings indicate that there is no relationship between students’ gender or classification and their endorsements of the qualitative themes. However, non-White students are more likely to endorse the theme “cheating as an ambiguous justification.” Implications for reducing and preventing academic cheating at the university level are discussed. (shrink)

Qualitative research carried out within human science must provide justification for its findings. However, the justification of empirical claims concerning human meanings has to be approached in new ways: Quantitative procedures of validation or the use of experimental control are inappropriate. Many researchers have attempted to follow Schutz's ''postulate of adequacy," which lays down as a condition of acceptability of a scientific account of human action that it be understandable by the actor in terms of commonsense interpretation of (...) everyday life. For instance, Harré suggests "validating" descriptions by ensuring that subjects of the research approve them. Against this approach, it is insisted that human science research is essentially an interpersonal process, and that therefore research activities cannot avoid such Goffmanesque features of self-presentation as resistance to being understood and eager acceptance of understanding, which are both pervasive possibilities of all social interaction. Thus, the research participant's agreement or disagreement cannot be taken as evidence as to the adequacy of a qualitative research description or interpretation. (shrink)

Qualitative fieldwork research on sensitive topics sometimes requires that interviewees be granted confidentiality and anonymity. When qualitative researchers later publish their findings, they must ensure that any statements obtained during fieldwork interviews cannot be traced back to the interviewees. Given these protections to interviewees, the integrity of the published findings cannot usually be verified or replicated by third parties, and the scholarly community must trust the word of qualitative researchers when they publish their results. This (...) trust is fundamentally abused, however, when researchers publish articles reporting qualitative fieldwork data that they never collected. Using only publicly available information, I argue that a 2017 article in an Elsevier foreign policy and international relations journal presents anonymised fieldwork interviews that could not have occurred as described. As an exercise in post-publication peer review (PPPR), this paper examines the evidence that calls into question the reliability of the putative fieldwork quotations. I show further that the 2017 article is not a unique case. The anonymity and confidentiality protections common in some areas of research create an ethical problem: the protections necessary for obtaining research data can be used as a cover to hide substandard research practices as well as research misconduct. (shrink)

Finding Your Ethical Research Self introduces novice researchers to the need for ethical reflection in practice and gives them the confidence to use their knowledge and skill when, later as researchers, they are confronted by big ethical moments in the field. -/- The 12 chapters build on each other, but not in a linear way. Core ethical concepts like consent and confidentiality once established in the early chapters are later challenged. The new focus becomes how to address qualitative research (...) ethics when confidentiality and consent take on a limited form. This approach helps students understand that the application of concepts always requires thoughtful adaptation in different contexts and the book provides guidance on how to do this. Classroom/workbook exercises develop alternative solutions to create process consent, internal confidentiality, and engage reference groups, as examples. The first eight chapters allow students to develop their ethical research self before thinking through how they might address formal ethics review. Formal ethics review is deliberately not introduced until Chapter 9. Chapter 10 offers practical help to elements of review, before Chapter 11 emphasises the key message by providing examples of researchers' dilemmas in the field using vignettes and discussion. By providing these examples, students become aware that these can arise, explore how they might arise, and recognise how they might deal with them in the moment when they are unavoidable. -/- With numerous examples of ethical dilemmas and issues and questions and exercises to encourage self-reflection, this reflexive, learn-by-doing model of research ethics will be highly useful to the novice researcher, undergraduate, and postgraduate research student. (shrink)

While the richness of Heideggerian philosophy is attractive as a healthcare research framework, its density means authors rarely utilise its fullest possibilities as an hermeneutic analytic structure. This article aims to clarify Heideggerian hermeneutic analysis by taking one discrete element of Heideggerian philosophy (Being-towards-death), and using it’s clearly defined structure to conduct a meta-synthesis of Heideggerian phenomenological studies on the experience of living with a potentially life-limiting illness. The findings richly illustrate Heidegger’s philosophy that there is either an inauthentic (...) positioning towards death, or an authentic positioning towards death with a proposition that (1) death is certain; (2) death is indefinite; (3) death is non-relational; and (4) death is not-to-be-outstripped. None of the 29 included studies on the experience of a confrontation with death fully utilised this framework, despite claiming a grounding in Heideggerian thought. This demonstrates the value in modelling how Heideggerian existential structures can be used proactively as analytical ‘hooks’ for data in research claiming a basis in this philosophy and/or method. By modelling the potential application of an important Heideggerian philosophical construct to published qualitative data, this meta-synthesis has revealed new domains and more nuanced understandings of the temporal structure of Being-towards-death. Such an approach helps to more fully unveil the existential concerns of people at the core of interpretative phenomenological enquiry and may provide a blueprint to map either primary or synthesised data to other key ontological existentials. (shrink)

BackgroundReturning neuroimaging incidental findings may create a challenge to research participants’ health literacy skills as they must interpret and make appropriate healthcare decisions based on complex radiology jargon. Disclosing IF can therefore present difficulties for participants, research institutions and the healthcare system. The purpose of this study was to identify the extent of the health literacy challenges encountered when returning neuroimaging IF. We report on findings from a retrospective survey and focus group sessions with major stakeholders involved in (...) disclosing IF.MethodsWe surveyed participants who had received a radiology report from a research study and conducted focus groups with participants, parents of child participants, Institutional Review Board members, investigators and physicians. Qualitative thematic analyses were conducted using standard group-coding procedures and descriptive summaries of health literacy scores and radiology report outcomes are examined.ResultsAlthough participants reported high health literacy skills, 67 % did not seek medical care when recommended to do so; and many participants in the focus groups disclosed they could not understand the findings described in their report. Despite their lack of understanding, participants desire to have information about their radiology results, and the investigators feel ethically inclined to return findings.ConclusionsThe language in clinically useful radiology reports can create a challenge for participants’ health literacy skills and has the potential to negatively impact the healthcare system and investigators conducting imaging research. Radiology reports need accompanying resources that explain findings in lay language, which can help reduce the challenge caused by the need to communicate incidental findings. (shrink)

Background Respect is essential to providing high quality healthcare, particularly for groups that are historically marginalized and stigmatized. While ethical principles taught to health professionals focus on patient autonomy as the object of respect for persons, limited studies explore patients’ views of respect. The purpose of this study was to explore the perspectives of a multiculturally diverse group of low-income women living with HIV (WLH) regarding their experience of respect from their medical physicians. Methods We analyzed 57 semi-structured interviews conducted (...) at HIV case management sites in South Florida as part of a larger qualitative study that explored practices facilitating retention and adherence in care. Women were eligible to participate if they identified as African American (n = 28), Hispanic/Latina (n = 22), or Haitian (n = 7). They were asked to describe instances when they were treated with respect by their medical physicians. Interviews were conducted by a fluent research interviewer in either English, Spanish, or Haitian Creole, depending on participant’s language preference. Transcripts were translated, back-translated and reviewed in entirety for any statements or comments about “respect.” After independent coding by 3 investigators, we used a consensual thematic analysis approach to determine themes. Results Results from this study grouped into two overarching classifications: respect manifested in physicians’ orientation towards the patient (i.e., interpersonal behaviors in interactions) and respect in medical professionalism (i.e., clinic procedures and practices). Four main themes emerged regarding respect in provider’s orientation towards the patient: being treated as a person, treated as an equal, treated without blame or prejudice, and treated with concern/emotional support. Two main themes emerged regarding respect as evidenced in medical professionalism: physician availability and considerations of privacy. Conclusions Findings suggest a more robust conception of what ‘respect for persons’ entails in medical ethics for a diverse group of low-income women living with HIV. Findings have implications for broadening areas of focus of future bioethics education, training, and research to include components of interpersonal relationship development, communication, and clinic procedures. We suggest these areas of training may increase respectful medical care experiences and potentially serve to influence persistent and known social and structural determinants of health through provider interactions and health care delivery. (shrink)

This paper explores the importance of hope as a determining factor for patients to participate in first-in-human trials for synthetic biology therapies. This paper focuses on different aspects of hope in the context of human health and well-being and explores the varieties of hope expressed by patients. The research findings are based on interview data collected from stable gout and diabetes patients. Three concepts of hope have emerged from the interviews: hope as certainty ; hope as reflective uncertainty ; (...) hope as self-therapy. The purpose of the paper is twofold. First, it aims to underline the significance of hope in patients’ medical decision-making, as well as the beneficence of hope for patients’ well-being, and for progress in research. Second, it shows how philosophical investigations—in particular Descartes—explore the phenomenon of hope and provide medical empirical research with profitable insights and tools. (shrink)

Editors have a responsibility to retract seriously flawed articles from their journals. However, there appears to be little consistency in journals’ policies or procedures for this. In a qualitative study, we therefore interviewed editors of science journals using semi-structured interviews to investigate their experience of retracting articles. We identified potential barriers to retraction, difficulties in the process and also sources of support and encouragement. Our findings have been used as the basis for guidelines developed by the Committee on (...) Publication Ethics. (shrink)

This study aimed to understand the preserved elements of self-identity in persons with moderate to severe dementia attributable to Alzheimer’s disease. A semi-structured interview was developed to explore the narrative self among residents with dementia in a residential care facility and residents without dementia in an independent living setting. The interviews were transcribed verbatim from audio recordings and analyzed for common themes, while being sensitive to possible differences between the groups. The participants with dementia showed evidence of self-reference even though (...) losses in explicit memory were evident. The most noticeable difference between the two groups was time frame reference. Nonetheless, all participants showed understanding of their role in relationships and exhibited concrete preferences. Our findings suggest that memory loss and other cognitive deficits associated with moderate to severe dementia do not necessarily lead to a loss of “self.”. (shrink)

Background Advances in artificial intelligence, robotics and wearable computing are creating novel technological opportunities for mitigating the global burden of population ageing and improving the quality of care for older adults with dementia and/or age-related disability. Intelligent assistive technology is the umbrella term defining this ever-evolving spectrum of intelligent applications for the older and disabled population. However, the implementation of IATs has been observed to be sub-optimal due to a number of barriers in the translation of novel applications from the (...) designing labs to the bedside. Furthermore, since these technologies are designed to be used by vulnerable individuals with age- and multi-morbidity-related frailty and cognitive disability, they are perceived to raise important ethical challenges, especially when they involve machine intelligence, collect sensitive data or operate in close proximity to the human body. Thus, the goal of this paper is to explore and assess the ethical issues that professional stakeholders perceive in the development and use of IATs in elderly and dementia care. Methods We conducted a multi-site study involving semi-structured qualitative interviews with researchers and health professionals. We analyzed the interview data using a descriptive thematic analysis to inductively explore relevant ethical challenges. Results Our findings indicate that professional stakeholders find issues of patient autonomy and informed consent, quality of data management, distributive justice and human contact as ethical priorities. Divergences emerged in relation to how these ethical issues are interpreted, how conflicts between different ethical principles are resolved and what solutions should be implemented to overcome current challenges. Conclusions Our findings indicate a general agreement among professional stakeholders on the ethical promises and challenges raised by the use of IATs among older and disabled users. Yet, notable divergences persist regarding how these ethical challenges can be overcome and what strategies should be implemented for the safe and effective implementation of IATs. These findings provide technology developers with useful information about unmet ethical needs. Study results may guide policy makers with firsthand information from relevant stakeholders about possible solutions for ethically-aligned technology governance. (shrink)

The ethical principle of ‘respect for persons’ in clinical research has traditionally focused on protecting individuals’ autonomy rights, but respect for participants also includes broader, although less well understood, ethical obligations to regard individuals’ rights, needs, interests and feelings. However, there is little empirical evidence about how to effectively convey respect to potential and current participants. To fill this gap, we conducted exploratory, qualitative interviews with participants in a clinical genomics implementation study. We interviewed 40 participants in English or (...) Spanish about their experiences with respect in the study and perceptions of how researchers in a hypothetical observational study could convey respect or a lack thereof. Most interviewees were female, identified as Hispanic/Latino or non-Hispanic white, reported annual household income under US$60 000 and did not have a Bachelor’s degree ; 30% had limited health literacy. We identified four key domains for demonstrating respect: personal study team interactions, with an emphasis on empathy, appreciation and non-judgment; study communication processes, including following up and sharing results with participants; inclusion, particularly ensuring materials are understandable and procedures are accessible; and consent and authorisation, including providing a neutral informed consent and keeping promises regarding privacy protections. While the experience of respect is inherently subjective, these findings highlight four key domains that may meaningfully demonstrate respect to potential and current research participants. Further empirical and normative work is needed to substantiate these domains and evaluate how best to incorporate them into the practice of research. (shrink)

Imagination is extremely important for science, yet very little is known about how scientists actually use it. Are scientists taught to imagine? What do they value imagination for? How do social and disciplinary factors shape it? How is the labor of imagining distributed? These questions should be high priority for anyone who studies or practices science, and this paper argues that the best methods for addressing them are qualitative. I summarize a few preliminary findings derived from recent interview-based (...) and observational qualitative studies that I have performed. These finding include: (i) imagination is only valued for use in addressing maximally specific problems, and only when all else fails; (ii) younger scientists and scientists who are members of underrepresented groups express less positive views about imagination in general, and have less confidence in their own imaginations; (iii) while scientists seem to employ various epistemological frameworks to evaluate imaginings, overall they appear to be epistemic consequentialists about imagination, and this holds also for their evaluations of the tools they use to extend the power of their imaginations. I close by discussing the epistemic and ethical consequences of these findings, and then suggesting a few research avenues that could be explored next as we move forward in the study of scientific imagination. (shrink)

Published data and studies on research misconduct, which focuses on researchers in Malaysia, is still lacking, therefore, we decided that this was an area for investigation. This study provides qualitative results for the examined issues through series of in-depth interviews with 21 researchers and lecturers in various universities in Malaysia. The aims of this study were to investigate the researchers’ opinions and perceptions regarding what they considered to be research misconduct, their experience with such misconduct, and the factors that (...) contribute to research misconduct. Our findings suggest that the most common research misconducts that are currently being witnessed in Malaysian universities are plagiarism and authorship disputes, however, researchers seldom report incidents of research misconduct because it takes too much time, effort and work to report them, and some are just afraid of repercussions when they do report it. This suggests possible loopholes in the monitoring system, which may allow some researchers to bypass it and engage in misconduct. This study also highlights the structural and individual factors as the most influential factors when it comes to research misconduct besides organizational, situational and cultural factors. Finally, this study highlights the concerns of all participants regarding the ‘publish or perish’ pressure that they believe would lead to a hostile working environment, thus enhancing research misconduct, as researchers tend to think about their own performance rather than that of whole team or faculty. Consequently this weakens the interpersonal relationships among researchers, which may compromise the teaching and supervision of junior researchers and research students. (shrink)

In this paper the use value of qualitative research findings to nurses in practice is questioned. More precisely it is argued that, insofar as action follows belief then, in all but the rarest of cases, the beliefs that nurses in practice can justifiably derive from or form on the basis of qualitative research findings do not sanction action in the world and the assumption, apparently widely held, that qualitative research can as evidence productively inform practice (...) collapses. If qualitative research does not have a substantive action guiding potential then, in consequence, three conclusions are permitted. First, regarding the requirement that nurses ground actions on evidence, regulators should redraft methodologically neutral or permissive guidelines to specify the sorts of research evidence that can serve this function. Second, qualitative methodologies should receive less prominence in nurse education programmes. Third, qualitative researchers should make it clear that their work cannot inform practice. Alternatively, if this claim is advanced the process by which this is to be achieved should be explicitly stated. (shrink)

This qualitative social scientific study explores professional texts of healthcare ethics to understand the ways in which ethical professionalism in medicine and nursing are culturally constructed in Finland. Two books in ethics, published by Finnish national professional organizations—one for nurses and one for physicians—were analyzed with the method of critical discourse analysis. Codes of ethics for each profession were also scrutinized. Analysis of the texts sought to reveal what is taken for granted in the texts as well as to (...) speculate what appeared to be relegated to the margins of the texts or left entirely invisible. Physicians’ ethics was discovered to emphasize objectivity and strong group membership as a basis for ethical professionalism. The discourses identified in the physicians’ ethics guidebook were universal ethics, reductionism, non-subjectivity, and threat. Nursing ethics was discovered to highlight reflectivity as its central focus. This idea of reflectivity was echoed in the identified discourses: local ethics, enlightenment, and moral agency. The analysis exposes a cultural gap between the ethics discourses of medicine and nursing. More work is needed to bridge ethics discourses in Finland in a way that can support healthcare professionals to find common ground and to foster inclusivity in ethical dialogue. Further development of bioethical practices is suggested as a potential way forward. (shrink)

Incidental findings and secondary findings, being results that are unrelated to the diagnostic question, are the subject of an important debate in the practice of clinical genomic medicine. Arguments for reporting these results or not doing so typically relate to the principles of autonomy, non-maleficence and beneficence. However, these principles frequently conflict and are insufficient by themselves to come to a conclusion. This study investigates empirically how ethical principles are considered when actually reporting IFs or SFs and how (...) value conflicts are weighed. A qualitative focus group study has been undertaken, including a multidisciplinary group of professionals from Belgian centres for medical genetics. The data were analysed thematically. All eight Belgian centres participated in this study. Ethical values were frequently referred to for disclosure policies on IFs and SFs. Participants invoked respect for patient autonomy to support the disclosure of IFs and opt-out options for IFs and SFs, non-maleficence for the professional delineation of reportable IFs and opt-out options for IFs and SFs and beneficence for the mandatory reporting of actionable IFs, the delineation of reportable IFs and a current decline of actively pursued SFs. Professional assumptions about patients’ genetic literacy were an important factor in the weighing of values. In line with the traditional bioethical discourse, the mandatory reporting of actionable IFs might be interpreted as a “technological, soft paternalism”. Restricting patients’ choices might be acceptable, but then its motives should be valid and its beneficent outcomes highly plausible. Hence, the presuppositions of technological, soft paternalism - patients’ inability to make informed decisions, normative rationality, the efficacy of beneficent outcomes and the delineated spectrum of beneficence - should be approached critically. Moreover, distributive justice should be considered an important value in the delineation of the current scope of the ethical debate on IFs and SFs. This study of guiding values may stimulate the debate on the ethical grounds for a solid policy on IFs and SFs internationally. (shrink)

This study explores how qualitative health researchers navigate the demands of medical research ethics committees in Germany where qualitative research is subject to approval only when it is conducted in medical contexts. We present the results of a grounded theory study to investigate qualitative health researchers’ experiences with procedural ethics and the strategies they adopt to navigate its demands. Our analysis revealed six dimensions of experience and three strategies adopted by researchers to navigate the demands of medical (...) research ethics committees. All participants agreed that research ethics is of high importance in qualitative health research, but strategies to navigate the demands of medical research ethics committees ranged from avoiding, and adapting, to transforming the procedures of ethics review. Based on our findings, we provide recommendations for improving the ethics review of qualitative health research. (shrink)

The increasing integration of Machine Learning (ML) techniques into clinical care, driven in particular by Deep Learning (DL) using Artificial Neural Nets (ANNs), promises to reshape medical practice on various levels and across multiple medical fields. Much recent literature examines the ethical consequences of employing ML within medical and psychiatric practice but the potential impact on psychiatric diagnostic systems has so far not been well-developed. In this article, we aim to explore the challenges that arise from the recent use of (...) ANNs for the old problems of psychiatric nosology. To enable an empirically supported critical reflection on the topic, we conducted semi-structured qualitative interviews with Swiss and German experts in computational psychiatry. Here, we report our findings structured around two themes, namely (1) the possibility of using ML for defining or refining of psychiatric classification, and (2) the desirability of employing ML for psychiatric nosology. We discuss these themes by relating them to recent debates about network theory for psychiatric nosology and show why empirical research in the field should critically reflect on its contribution to psychopathology research. In sum, we argue that beyond technical, regulatory, and ethical challenges, philosophical reflection is crucial to harness the potential of ML in psychiatry. (shrink)

First published in 1914 and reissued with a new introduction in 1992, _Work and Wealth _is a seminal vision of Hobson's liberal utopian ideals, which desired to demonstrate how economic and social reform could transform existing society into one in which the majority of the population, as opposed to a small elite, could find fulfillment. Hobson attacked conventional economic wisdom which made a division between the cost of production and the utility derived from consumption. Far from being necesarily arduous, Hobson (...) argued that work had the potential to bring about immense utility and enrichment. The qualitative, humanist work argues in favour of a new form of capitalism to minimise cost and maximise utility. (shrink)

Background: In the last two decades, nursing authors have published ethical analyses of palliative sedation—an end-of-life care practice that also receives significant attention in the broader medical and bioethics literature. This nursing literature is important, because it contributes to disciplinary understandings about nursing values and responsibilities in end-of-life care. Research aim: The purpose of this project is to review existing nursing ethics literature about palliative sedation, and to analyze how nurses’ moral identities are portrayed within this literature. Research design: We (...) reviewed discussion papers, written by nurses about the ethics of palliative sedation, which were cited in MEDLINE, CINAHL, Nursing and Allied Health, or Philosopher’s Index (search date March 2018). Twenty-one papers met selection criteria. We performed a comprehensive review and analysis (using the Qualitative Analysis Guide of Leuven), of the values, responsibilities, and relationships reflected in authors’ portrayal of the nursing role. Findings: Two different tones are apparent in the extant nursing ethics literature. One is educational, while the other is critically reflective. Irrespective of tone, all authors agree on the alleviation of suffering as a fundamental nursing responsibility. However, they differ in their analysis of this responsibility in relation to other values in end-of-life care, including those that depend on consciousness. Finally, authors emphasize the importance of subjective and experience-based understandings of palliative sedation, which they argue as depending on nurses’ proximity to patients and families in end-of-life care. Discussion and conclusion: Based on our findings, we develop three recommendations for future writing by nurses about palliative sedation. These relate to the responsibility of recognizing how consciousness might matter in (some) peoples’ moral experiences of death and dying, to the importance of moral reflectiveness in nursing practice, and to the value of a relational approach in conceptualizing the nursing ethics of palliative sedation. (shrink)

This paper offers a defense of ‘publishing without belief’ (PWB) – the view that authors are not required to believe what they publish. I address objections to the view ranging from outright denial and advocacy of a belief norm for publication, to a modified version that allows for some cases of PWB but not others. I reject these modifications. In doing so, I offer both an alternative story about the motivations for PWB and a diagnosis of the disagreement over (...) its permissibility. The original defense focused on consequentialist reasons for allowing PWB, offering mostly defensive arguments against potential criticisms. But I argue that once we shift our focus to the reasons why authors might be prone to PWB, we see a difference in two types of motivation: whereas I imagine PWB as arising from underconfident agents, critics point to cagey or nefarious authorial practices, or authors’ failure to clarify their own degrees of belief. Underlying the debate over norms of philosophical publishing, we find two different conceptions of philosophy itself. (shrink)

Introduction: Vulnerability is a poorly understood concept in research ethics, often aligned to autonomy and consent. A recent addition to the literature represents a taxonomy of vulnerability developed by Kipnis, but this refers to the conduct of clinical trials rather than qualitative research, which may raise different issues. Aim: To examine issues of vulnerability in cancer and palliative care research obtained through qualitative interviews. Method: Secondary analysis of qualitative data from 26 black Caribbean and 19 white British (...) patients with advanced cancer. Results: Four domains of vulnerability derived from Kipnis’s taxonomy were identified and included: (i) communicative vulnerability, represented by participants impaired in their ability to communicate because of distressing symptoms; (ii) institutional vulnerability, which referred to participants who existed under the authority of others—for example, in hospital; (iii) deferential vulnerability, which included participants who were subject to the informal authority or the independent interests of others; (iv) medical vulnerability, which referred to participants with distressing medical conditions; and (v) social vulnerability, which included participants considered to belong to an undervalued social group. Participants from both ethnic groups populated all these domains, but those who were black Caribbean were more present among the socially vulnerable. Conclusions: Current classifications of vulnerability require reinterpretation when applied to qualitative research at the end of life. We recommend that researchers and research ethics committees reconceptualise vulnerability using the domains identified in this study and consider the research context and interviewers’ skills. (shrink)

BackgroundMental health professionals (MHP) working in court-mandated treatment settings face ethical dilemmas due to their dual role in assuring their patient’s well-being while guaranteeing the security of the population. Clear practical guidelines to support these MHPs’ decision-making are lacking, amongst others, due to the ethical conflicts within this field. This qualitative interview study contributes to the much-needed empirical research on how MHPs resolve these ethical conflicts in daily clinical practice. Methods31 MHPs working in court-mandated treatment settings were interviewed. The (...) interviews were semi-structured and our in-depth analysis followed the thematic analysis approach.ResultsWe first outline how mental health professionals perceive their dual loyalty conflict and how they describe their affiliations with the medical and the justice system. Our findings indicate that this positioning was influenced by situational factors, drawing the MHPs at times closer to the caring or controlling poles. Second, our results illustrate how participating MHPs solve their dual loyalty conflict. Participants considered central to motivate the patient, to see the benefits of treatment and its goals. Further, transparent communication with patients and representatives of the justice system was highlighted as key to develop a trustful relationship with the patient and to manage the influences from the different players involved. ConclusionsEven though individual positioning and opinions towards dealing with the influences of the justice system varied, the results of our research show that, in spite of varying positions, the underlying practice is not very different across participating MHPs. Several techniques that allow developing a high-quality therapeutic alliance with the patient are key elements of general psychotherapy. Transparency appears as the crucial factor when communicating with the patient and with representatives of the justice system. More specifically, patients need to be informed since the beginning of therapy about the limits of medical confidentiality. It is also recommended to develop guidelines that define the level of detailed information that should be disclosed when communicating with the authorities of the justice system. (shrink)

Despite research supporting the efficacy of family therapy for adolescent depression, little research has been done to clarify the therapeutic variables that Chinese families with depressed adolescents consider helpful in family therapy. This study explored Chinese depressed adolescents’ and their parents’ perceptions of the factors promoting improvement in family therapy. Twelve Chinese families with one adolescent child fulfilling the criteria for major depressive disorder were recruited. A total of 134 family therapy sessions were conducted by 4 therapists. After therapy, semi-structured (...) interviews about the clients’ perceptions of the helpful and effective aspects of therapy were conducted. Thematic analysis was used to analyze the transcribed dialogues. Five overarching themes emerged: factors supporting therapeutic alliance formation, the therapist’s systemic attitude, systemic therapy direction, effective systemic therapy techniques and strategies for dealing with current issues. A trustworthy therapy alliance with a competent and supportive therapist helped depressed adolescents improve by facilitating the expression of their emotions; exploring family interactions, beliefs and emotion flows related to their symptoms; promoting their self-development; and activating their resources. The families valued the respectfulness of the therapists and their collaborative and nonauthoritative approach. Adolescents’ academic difficulties and crises received special attention. The possible clinical implementations of our findings in the design of family therapy strategies for depressed Chinese adolescents are discussed. (shrink)