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This analysis was conducted to understand the nuanced and underlying benefits and challenges of an experiential educational intervention for DNP students learning how neighborhoods and health disparities may be related. Poor social and environmental conditions in many low-income urban neighborhoods are linked to deleterious health outcomes. Many of the structural and political influences are unknown to health providers, which can inhibit their understanding of the social effects on health. One aspect of a new DNP social determinants of health curriculum is a guided community bus tour in economically disadvantaged neighborhoods to enhance understanding of health disparities. A concurrent mixed methods design, including comparison surveys and thematic analysis, was used to analyze student responses to the experiential educational intervention. A community-based bus tour implemented in socially disadvantaged neighborhoods in an urban environment was the study focus. New DNP students (n=91) in a midwestern university introductory course agreed to provide feedback following an experiential learning activity. The analysis of responses to the educational intervention was completed using a systematic thematic analysis alongside descriptive statistics and paired t-tests in a convergent mixed methods analytical approach to answer the research aim. Students expressed confidence in naming and addressing health disparities after the bus tour activity. Analysis showed: (a) A visual tour can impact new learning, (b) Policy can explain inequity and is new to students, (c) Students do not well articulate racial disparities and (d) Understanding racial history requires attention and conversation. A community bus tour met our expectations for teaching DNP students concepts related to health disparities as it illustrated real-life situations in actual neighborhoods. However, there were unusual student responses that prompted us to reflect on the activity and consider improvements. More emphasis needs to be placed on cultural wealth and on discussion planning for such experiences. Our results lay the groundwork for curriculum development. Setting goals and targets in line with the 2022 CDC’s Core Health Equity Science and Implementation Strategy is essential. •An experiential bus tour provided a stark recognition of poverty for some but a daily reality for others.•Teaching about health disparities requires attention to cultural challenges as well as cultural wealth.•Implicit bias is a common risk in educational design that can be mitigated.•Reflective and experiential educational practices like bus tours, should lead to actionable community intervention strategies.

This article describes, exemplifies and discusses the use of the philosophical hermeneutic interview and its distinguishing characteristics. Excerpts of interviews from a philosophical hermeneutic study are used to show how this particular phenomenological tradition is applied to research inquiry. The purpose of the article is to lay out the foundational background for philosophical hermeneutics in a way that clarifies its unique approach to interviewing and its usefulness for advancing health care knowledge. Implications for health care research and practice are addressed.

Climate change is a public health threat on a global scale. Over the last two decades, research has uncovered the myriad health effects of climate change and its associated costs. The literature is also beginning to show the direct and indirect effects of climate change to be an indicator of increased adverse mental health outcomes including excessive worry, anxiety, grief, and post-traumatic stress disorder. The development of scales to measure some of these effects in adult populations has shown the critical need to understand the various ways climate change affects mental well-being in adolescent populations who are at a critical juncture in psychological development. The purposes of this study were to understand the lived experience of adolescents who are concerned about climate change and uncover the meaning of climate change concern for adolescents as informed by emerging patterns. This study utilized Hermeneutic Phenomenology as a philosophical foundation and methodological approach for data retrieval and analysis. An interview-based approach with a purposeful sample (n = 11, aged 12–17 years) revealed the multi-layered elements of climate change concern and its effects. Three patterns emerged: Climate Change as a Temporal Threat and Pressure, Awareness and Concern as a Continuum, and Experiencing Concern and Making Meaning. These findings may now inform interdisciplinary knowledge on upstream mitigation efforts and the promotion of positive outcomes relating to climate change. The need for focused educational attention to adolescent behaviors and concerns is explicated and exemplified.

China employed a unique volunteerism system where health care providers outside of Hubei Province, the epicentre, travelled to reverse the devastation wrought by coronavirus disease 2019 (COVID-19) at its global onset. The aim is to study the unique circumstances of Chinese volunteerism in the context of continuing pandemic threats, specifically exploring the experiences of 20 Chinese nurse and physician volunteers fighting COVID-19 during the outbreak. Interviews were done through video calling. Using content analysis with a hermeneutic perspective, emerging patterns showed the ways in which China's particular manifestation of volunteerism teaches us how to engage global threats of this nature. The overarching lesson, For the Good of the People, was manifested in several dynamic and overlapping themes: 1) Reaching for Professional Standards Even in Crisis; 2) Constantly Caring Through Failures and Successes; and 3) Holding Fast to the Common Good. The devastation was met by the resilience of volunteers, who overcame profound challenges managing patient care. Volunteerism required sacrifice and tremendous support in the form of training and administrative direction, family support, and peer collaboration. Volunteers' physical and psychosocial wellbeing was a priority. Recognizing the representative themes can help societies plan for continuing and future events.

Background The purpose of this article is to engage clinicians in a dialogue about ideas on how to provide more specific, contextually relevant, practical and culturally tailored diabetes self-management recommendations as suggested by Mexican-American women diagnosed with type 2 diabetes. Current diabetes self-management recommendations, targeting Mexican Americans in particular, remain largely broad (“reduce your calorie intake” or “cut back on carbs”), overly ambitious (“stop eating tortillas”), and relatively ineffective (Svedbo Engström et al., BMJ Open 6(3):e010249, 2016; Johansson et al., Int J Qual Stud Health Well-being 11, 2016; Oomen et al., The Diabetes Educ 25:220-225, 1999; Franek, Ont Health Technol Assess Ser 13(9):1-60, 2013; Purnell et al. Patient 9:349, 2016). Methods A secondary and focused analysis ( N  = 12) was performed on data gathered from a larger qualitative study ( N  = 16), which explored diabetes among Mexican-American women residing in rural South Texas. Results Findings from the secondary analysis were that study informants elicited more realistic or contextually relevant, specific self-management strategies that reflected the cognitive, emotive, and behavioral areas but were reframed within the context of the Mexican-American culture. Self-management strategies fell into the categories of: (a) environmental controls, (b) avoiding overeating, (c) lifestyle changes, (d) cooking tips, and (e) active self-management. Conclusions Diabetes remains a serious health threat to Mexican Americans, women in particular. Few individuals attain glycemic control, likely due in part to the disconnect between global and non-contextual self-management recommendations offered by health care providers and the need for more detailed and realistic guidance required for the day-to-day self-management of diabetes.

This multimethod, qualitative study provides results for educators of nursing doctoral students to consider. Combining the expertise of an empirical analytical researcher (who uses statistical methods) and an interpretive phenomenological researcher (who uses hermeneutic methods), a course was designed that would place doctoral students in the midst of multiparadigmatic discussions while learning fundamental research methods. Field notes and iterative analytical discussions led to patterns and themes that highlight the value of this innovative pedagogical application. Using content analysis and interpretive phenomenological approaches, together with one of the students, data were analyzed from field notes recorded in real time over the period the course was offered. This article describes the course and the study analysis, and offers the pedagogical experience as transformative. A link to a sample syllabus is included in the article. The results encourage nurse educators of doctoral nursing students to focus educational practice on multiple methodological perspectives. [This multimethod, qualitative study provides results for educators of nursing doctoral students to consider. Combining the expertise of an empirical analytical researcher (who uses statistical methods) and an interpretive phenomenological researcher (who uses hermeneutic methods), a course was designed that would place doctoral students in the midst of multiparadigmatic discussions while learning fundamental research methods. Field notes and iterative analytical discussions led to patterns and themes that highlight the value of this innovative pedagogical application. Using content analysis and interpretive phenomenological approaches, together with one of the students, data were analyzed from field notes recorded in real time over the period the course was offered. This article describes the course and the study analysis, and offers the pedagogical experience as transformative. A link to a sample syllabus is included in the article. The results encourage nurse educators of doctoral nursing students to focus educational practice on multiple methodological perspectives. [ J Nurs Educ. 2014;53(12):673–677.]

Interpretive methodologies require a level of introspection and engagement that is different from that used in empirical and analytical methodologies. The use of multiple interpretive methodologies to explore a phenomenon, in the context of a single study, is a unique perspective for undertaking qualitative research. The purpose of this article is to illustrate the synergistic nature of combining interpretive methodologies to capture multiple facets of a phenomenon. We used two different philosophical orientations, Heideggerian hermeneutic phenomenology and Foucauldian discourse analysis not only to describe the differences in research questions, methods, and analyses, but also to illustrate the added insight gained from a multiple-methodological approach. The differences between interpretive methodologies, as well as the analytic value of this innovative approach, are nuanced and are best demonstrated through the analysis of an exemplar transcript using both methodologies. Although subtle methodological differences exist, the interpretations combined create a deepening understanding of the phenomenon. Awareness of how each interpretive tradition influences the language around the research question, the data collection and analysis, and overall integrity of the level of inquiry is crucial to maintaining a rigor in both traditions, yet recognition of multiple “truths” allows for a more holistic representation to be created.

The number of RN-to-baccalaureate nursing (BSN) programs is increasing; however, nurses continue to voluntarily withdraw at higher rates than expected. A Heideggerian hermeneutic approach was used to interpret the meaning of the experience of RNs, who voluntarily withdraw from their baccalaureate nursing programs. The research aims were to generate a comprehensive understanding of (a) the experiences of RN-to-BSN noncompleters, (b) the meaning noncompleters ascribe to the experience of dropping out, and (c) the interplay between factors that influence dropout decisions. Two overarching patterns of understanding emerged: Withdrawing as Revisiting Failure, and Withdrawing as Impasse: On One Side of the Divide. The factors that influence whether an RN finishes a baccalaureate nursing program are many, but the effect on dignity and well-being are immeasurable. Voluntary withdrawal from an RN-to-BSN program leaves nurses professionally place-bound, affecting not only the individual nurse but also the profession. [J Nurs Educ. 2017;56(5):260-265.].

Background The growth of patient, community and population-centred nursing research is a rationale for the use of research methods that can examine complex healthcare issues, not only from a biophysical perspective, but also from cultural, psychosocial and political viewpoints. This need for multiple perspectives requires mixed-methods research. Philosophy and practicality are needed to plan, conduct, and make mixed-methods research more broadly accessible to the health sciences research community. The traditions and dichotomy between qualitative and quantitative research makes the application of mixed methods a challenge. Aim To propose an integrated model for a research project containing steps from start to finish, and to use the unique strengths brought by each approach to meet the health needs of patients and communities. Discussion Mixed-methods research is a practical approach to inquiry, that focuses on asking questions and how best to answer them to improve the health of individuals, communities and populations. An integrated model of research begins with the research question(s) and moves in a continuum. The lines dividing methods do not dissolve, but become permeable boundaries where two or more methods can be used to answer research questions more completely. Rigorous and expert methodologists work together to solve common problems. Conclusion Mixed-methods research enables discussion among researchers from varied traditions. There is a plethora of methodological approaches available. Combining expertise by communicating across disciplines and professions is one way to tackle large and complex healthcare issues. Implications for practice The model presented in this paper exemplifies the integration of multiple approaches in a unified focus on identified phenomena. The dynamic nature of the model signals a need to be open to the data generated and the methodological directions implied by findings.