qualitative research abstracts

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GUIDANCE ON SUBMISSION OF QUALITATIVE RESEARCH ABSTRACTS

General guidance

Authors should refer to the general information and guidelines contained in the Society’s “Guidance for Submission of Abstracts”. The general guidance therein applies to qualitative research abstracts. This includes the maximum permitted limit of 250 words, and the instruction that abstracts should be structured. In keeping with all submissions to the Society, subsequent presentation must reflect and elaborate on the abstract. Research studies or findings not referred to in the abstract should not be presented.

This document contains specific guidance on the content of qualitative research abstracts.

How guidance on content is to be applied by authors and Council.

Council recognises that the nature of qualitative research makes its comprehensive communication within short abstracts a challenge.  Therefore, whilst the key areas to be included within abstracts are set out below, it is recognised that emphasis on each area will vary in different cases, and that not every listed sub-area will be covered.  Certain elements are likely to receive greater attention at the time of presentation than within the abstract.  In particular, presentation of the paper should include sufficient empirical data to allow judgement of the conclusions drawn.

Content of abstracts

• Research question/objective and design: clear statement of the research question/objective and its relevance. Methodological or theoretical perspectives should be clearly outlined.
• Population and sampling: who the subjects were and what sampling strategies were used .
• Methods of data collection: clear exposition of data collection: access, selection, method of collection, type of data, relationship of researcher to subjects/setting (what data were collected, from where/whom, by whom)
• Quality of data and analysis: strategies to enhance quality of data analysis e.g. triangulation, respondent validation; and to enhance validity e.g. attention to negative cases, consideration of alternative explanations, team analysis, peer review panels
• Application of critical thinking to analysis: attention to the influence of the researcher on data collected and on analysis. Critical approach to the status of data collected
• Theoretical and empirical context: evidence that design and analysis take into account and add to previous knowledge
• Conclusions: justified in relation to data collected, sufficient original data presented to substantiate interpretations, reasoned consideration of transferability  to groups/settings beyond those studied

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Writing an Abstract for Your Research Paper

Definition and Purpose of Abstracts

An abstract is a short summary of your (published or unpublished) research paper, usually about a paragraph (c. 6-7 sentences, 150-250 words) long. A well-written abstract serves multiple purposes:

• an abstract lets readers get the gist or essence of your paper or article quickly, in order to decide whether to read the full paper;
• an abstract prepares readers to follow the detailed information, analyses, and arguments in your full paper;
• and, later, an abstract helps readers remember key points from your paper.

It’s also worth remembering that search engines and bibliographic databases use abstracts, as well as the title, to identify key terms for indexing your published paper. So what you include in your abstract and in your title are crucial for helping other researchers find your paper or article.

If you are writing an abstract for a course paper, your professor may give you specific guidelines for what to include and how to organize your abstract. Similarly, academic journals often have specific requirements for abstracts. So in addition to following the advice on this page, you should be sure to look for and follow any guidelines from the course or journal you’re writing for.

The Contents of an Abstract

Abstracts contain most of the following kinds of information in brief form. The body of your paper will, of course, develop and explain these ideas much more fully. As you will see in the samples below, the proportion of your abstract that you devote to each kind of information—and the sequence of that information—will vary, depending on the nature and genre of the paper that you are summarizing in your abstract. And in some cases, some of this information is implied, rather than stated explicitly. The Publication Manual of the American Psychological Association , which is widely used in the social sciences, gives specific guidelines for what to include in the abstract for different kinds of papers—for empirical studies, literature reviews or meta-analyses, theoretical papers, methodological papers, and case studies.

Here are the typical kinds of information found in most abstracts:

• the context or background information for your research; the general topic under study; the specific topic of your research
• the central questions or statement of the problem your research addresses
• what’s already known about this question, what previous research has done or shown
• the main reason(s) , the exigency, the rationale , the goals for your research—Why is it important to address these questions? Are you, for example, examining a new topic? Why is that topic worth examining? Are you filling a gap in previous research? Applying new methods to take a fresh look at existing ideas or data? Resolving a dispute within the literature in your field? . . .
• your research and/or analytical methods
• your main findings , results , or arguments
• the significance or implications of your findings or arguments.

Your abstract should be intelligible on its own, without a reader’s having to read your entire paper. And in an abstract, you usually do not cite references—most of your abstract will describe what you have studied in your research and what you have found and what you argue in your paper. In the body of your paper, you will cite the specific literature that informs your research.

When to Write Your Abstract

Although you might be tempted to write your abstract first because it will appear as the very first part of your paper, it’s a good idea to wait to write your abstract until after you’ve drafted your full paper, so that you know what you’re summarizing.

What follows are some sample abstracts in published papers or articles, all written by faculty at UW-Madison who come from a variety of disciplines. We have annotated these samples to help you see the work that these authors are doing within their abstracts.

Choosing Verb Tenses within Your Abstract

The social science sample (Sample 1) below uses the present tense to describe general facts and interpretations that have been and are currently true, including the prevailing explanation for the social phenomenon under study. That abstract also uses the present tense to describe the methods, the findings, the arguments, and the implications of the findings from their new research study. The authors use the past tense to describe previous research.

The humanities sample (Sample 2) below uses the past tense to describe completed events in the past (the texts created in the pulp fiction industry in the 1970s and 80s) and uses the present tense to describe what is happening in those texts, to explain the significance or meaning of those texts, and to describe the arguments presented in the article.

The science samples (Samples 3 and 4) below use the past tense to describe what previous research studies have done and the research the authors have conducted, the methods they have followed, and what they have found. In their rationale or justification for their research (what remains to be done), they use the present tense. They also use the present tense to introduce their study (in Sample 3, “Here we report . . .”) and to explain the significance of their study (In Sample 3, This reprogramming . . . “provides a scalable cell source for. . .”).

Sample Abstract 1

From the social sciences.

Reporting new findings about the reasons for increasing economic homogamy among spouses

Gonalons-Pons, Pilar, and Christine R. Schwartz. “Trends in Economic Homogamy: Changes in Assortative Mating or the Division of Labor in Marriage?” Demography , vol. 54, no. 3, 2017, pp. 985-1005.

Sample Abstract 2

From the humanities.

Analyzing underground pulp fiction publications in Tanzania, this article makes an argument about the cultural significance of those publications

Emily Callaci. “Street Textuality: Socialism, Masculinity, and Urban Belonging in Tanzania’s Pulp Fiction Publishing Industry, 1975-1985.” Comparative Studies in Society and History , vol. 59, no. 1, 2017, pp. 183-210.

Sample Abstract/Summary 3

From the sciences.

Reporting a new method for reprogramming adult mouse fibroblasts into induced cardiac progenitor cells

Lalit, Pratik A., Max R. Salick, Daryl O. Nelson, Jayne M. Squirrell, Christina M. Shafer, Neel G. Patel, Imaan Saeed, Eric G. Schmuck, Yogananda S. Markandeya, Rachel Wong, Martin R. Lea, Kevin W. Eliceiri, Timothy A. Hacker, Wendy C. Crone, Michael Kyba, Daniel J. Garry, Ron Stewart, James A. Thomson, Karen M. Downs, Gary E. Lyons, and Timothy J. Kamp. “Lineage Reprogramming of Fibroblasts into Proliferative Induced Cardiac Progenitor Cells by Defined Factors.” Cell Stem Cell , vol. 18, 2016, pp. 354-367.

Sample Abstract 4, a Structured Abstract

Reporting results about the effectiveness of antibiotic therapy in managing acute bacterial sinusitis, from a rigorously controlled study

Note: This journal requires authors to organize their abstract into four specific sections, with strict word limits. Because the headings for this structured abstract are self-explanatory, we have chosen not to add annotations to this sample abstract.

Wald, Ellen R., David Nash, and Jens Eickhoff. “Effectiveness of Amoxicillin/Clavulanate Potassium in the Treatment of Acute Bacterial Sinusitis in Children.” Pediatrics , vol. 124, no. 1, 2009, pp. 9-15.

“OBJECTIVE: The role of antibiotic therapy in managing acute bacterial sinusitis (ABS) in children is controversial. The purpose of this study was to determine the effectiveness of high-dose amoxicillin/potassium clavulanate in the treatment of children diagnosed with ABS.

METHODS : This was a randomized, double-blind, placebo-controlled study. Children 1 to 10 years of age with a clinical presentation compatible with ABS were eligible for participation. Patients were stratified according to age (<6 or ≥6 years) and clinical severity and randomly assigned to receive either amoxicillin (90 mg/kg) with potassium clavulanate (6.4 mg/kg) or placebo. A symptom survey was performed on days 0, 1, 2, 3, 5, 7, 10, 20, and 30. Patients were examined on day 14. Children’s conditions were rated as cured, improved, or failed according to scoring rules.

RESULTS: Two thousand one hundred thirty-five children with respiratory complaints were screened for enrollment; 139 (6.5%) had ABS. Fifty-eight patients were enrolled, and 56 were randomly assigned. The mean age was 6630 months. Fifty (89%) patients presented with persistent symptoms, and 6 (11%) presented with nonpersistent symptoms. In 24 (43%) children, the illness was classified as mild, whereas in the remaining 32 (57%) children it was severe. Of the 28 children who received the antibiotic, 14 (50%) were cured, 4 (14%) were improved, 4(14%) experienced treatment failure, and 6 (21%) withdrew. Of the 28children who received placebo, 4 (14%) were cured, 5 (18%) improved, and 19 (68%) experienced treatment failure. Children receiving the antibiotic were more likely to be cured (50% vs 14%) and less likely to have treatment failure (14% vs 68%) than children receiving the placebo.

CONCLUSIONS : ABS is a common complication of viral upper respiratory infections. Amoxicillin/potassium clavulanate results in significantly more cures and fewer failures than placebo, according to parental report of time to resolution.” (9)

Some Excellent Advice about Writing Abstracts for Basic Science Research Papers, by Professor Adriano Aguzzi from the Institute of Neuropathology at the University of Zurich:

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• USC Libraries
• Research Guides

Organizing Your Social Sciences Research Paper

• 3. The Abstract
• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
• Glossary of Research Terms
• Reading Research Effectively
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Applying Critical Thinking
• Choosing a Title
• Making an Outline
• Paragraph Development
• Research Process Video Series
• Executive Summary
• The C.A.R.S. Model
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
• Content Alert Services
• Evaluating Sources
• Primary Sources
• Secondary Sources
• Tiertiary Sources
• Scholarly vs. Popular Publications
• Qualitative Methods
• Quantitative Methods
• Insiderness
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Writing Concisely
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
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An abstract summarizes, usually in one paragraph of 300 words or less, the major aspects of the entire paper in a prescribed sequence that includes: 1) the overall purpose of the study and the research problem(s) you investigated; 2) the basic design of the study; 3) major findings or trends found as a result of your analysis; and, 4) a brief summary of your interpretations and conclusions.

Writing an Abstract. The Writing Center. Clarion University, 2009; Writing an Abstract for Your Research Paper. The Writing Center, University of Wisconsin, Madison; Koltay, Tibor. Abstracts and Abstracting: A Genre and Set of Skills for the Twenty-first Century . Oxford, UK: Chandos Publishing, 2010;

Importance of a Good Abstract

Sometimes your professor will ask you to include an abstract, or general summary of your work, with your research paper. The abstract allows you to elaborate upon each major aspect of the paper and helps readers decide whether they want to read the rest of the paper. Therefore, enough key information [e.g., summary results, observations, trends, etc.] must be included to make the abstract useful to someone who may want to examine your work.

How do you know when you have enough information in your abstract? A simple rule-of-thumb is to imagine that you are another researcher doing a similar study. Then ask yourself: if your abstract was the only part of the paper you could access, would you be happy with the amount of information presented there? Does it tell the whole story about your study? If the answer is "no" then the abstract likely needs to be revised.

Farkas, David K. “A Scheme for Understanding and Writing Summaries.” Technical Communication 67 (August 2020): 45-60;  How to Write a Research Abstract. Office of Undergraduate Research. University of Kentucky; Staiger, David L. “What Today’s Students Need to Know about Writing Abstracts.” International Journal of Business Communication January 3 (1966): 29-33; Swales, John M. and Christine B. Feak. Abstracts and the Writing of Abstracts . Ann Arbor, MI: University of Michigan Press, 2009.

Structure and Writing Style

I.  Types of Abstracts

To begin, you need to determine which type of abstract you should include with your paper. There are four general types.

Critical Abstract A critical abstract provides, in addition to describing main findings and information, a judgment or comment about the study’s validity, reliability, or completeness. The researcher evaluates the paper and often compares it with other works on the same subject. Critical abstracts are generally 400-500 words in length due to the additional interpretive commentary. These types of abstracts are used infrequently.

Descriptive Abstract A descriptive abstract indicates the type of information found in the work. It makes no judgments about the work, nor does it provide results or conclusions of the research. It does incorporate key words found in the text and may include the purpose, methods, and scope of the research. Essentially, the descriptive abstract only describes the work being summarized. Some researchers consider it an outline of the work, rather than a summary. Descriptive abstracts are usually very short, 100 words or less. Informative Abstract The majority of abstracts are informative. While they still do not critique or evaluate a work, they do more than describe it. A good informative abstract acts as a surrogate for the work itself. That is, the researcher presents and explains all the main arguments and the important results and evidence in the paper. An informative abstract includes the information that can be found in a descriptive abstract [purpose, methods, scope] but it also includes the results and conclusions of the research and the recommendations of the author. The length varies according to discipline, but an informative abstract is usually no more than 300 words in length.

Highlight Abstract A highlight abstract is specifically written to attract the reader’s attention to the study. No pretense is made of there being either a balanced or complete picture of the paper and, in fact, incomplete and leading remarks may be used to spark the reader’s interest. In that a highlight abstract cannot stand independent of its associated article, it is not a true abstract and, therefore, rarely used in academic writing.

II.  Writing Style

Use the active voice when possible , but note that much of your abstract may require passive sentence constructions. Regardless, write your abstract using concise, but complete, sentences. Get to the point quickly and always use the past tense because you are reporting on a study that has been completed.

Abstracts should be formatted as a single paragraph in a block format and with no paragraph indentations. In most cases, the abstract page immediately follows the title page. Do not number the page. Rules set forth in writing manual vary but, in general, you should center the word "Abstract" at the top of the page with double spacing between the heading and the abstract. The final sentences of an abstract concisely summarize your study’s conclusions, implications, or applications to practice and, if appropriate, can be followed by a statement about the need for additional research revealed from the findings.

Composing Your Abstract

Although it is the first section of your paper, the abstract should be written last since it will summarize the contents of your entire paper. A good strategy to begin composing your abstract is to take whole sentences or key phrases from each section of the paper and put them in a sequence that summarizes the contents. Then revise or add connecting phrases or words to make the narrative flow clearly and smoothly. Note that statistical findings should be reported parenthetically [i.e., written in parentheses].

Before handing in your final paper, check to make sure that the information in the abstract completely agrees with what you have written in the paper. Think of the abstract as a sequential set of complete sentences describing the most crucial information using the fewest necessary words. The abstract SHOULD NOT contain:

• A catchy introductory phrase, provocative quote, or other device to grab the reader's attention,
• Lengthy background or contextual information,
• Redundant phrases, unnecessary adverbs and adjectives, and repetitive information;
• Acronyms or abbreviations,
• References to other literature [say something like, "current research shows that..." or "studies have indicated..."],
• Using ellipticals [i.e., ending with "..."] or incomplete sentences,
• Jargon or terms that may be confusing to the reader,
• Citations to other works, and
• Any sort of image, illustration, figure, or table, or references to them.

Abstract. Writing Center. University of Kansas; Abstract. The Structure, Format, Content, and Style of a Journal-Style Scientific Paper. Department of Biology. Bates College; Abstracts. The Writing Center. University of North Carolina; Borko, Harold and Seymour Chatman. "Criteria for Acceptable Abstracts: A Survey of Abstracters' Instructions." American Documentation 14 (April 1963): 149-160; Abstracts. The Writer’s Handbook. Writing Center. University of Wisconsin, Madison; Hartley, James and Lucy Betts. "Common Weaknesses in Traditional Abstracts in the Social Sciences." Journal of the American Society for Information Science and Technology 60 (October 2009): 2010-2018; Koltay, Tibor. Abstracts and Abstracting: A Genre and Set of Skills for the Twenty-first Century. Oxford, UK: Chandos Publishing, 2010; Procter, Margaret. The Abstract. University College Writing Centre. University of Toronto; Riordan, Laura. “Mastering the Art of Abstracts.” The Journal of the American Osteopathic Association 115 (January 2015 ): 41-47; Writing Report Abstracts. The Writing Lab and The OWL. Purdue University; Writing Abstracts. Writing Tutorial Services, Center for Innovative Teaching and Learning. Indiana University; Koltay, Tibor. Abstracts and Abstracting: A Genre and Set of Skills for the Twenty-First Century . Oxford, UK: 2010; Writing an Abstract for Your Research Paper. The Writing Center, University of Wisconsin, Madison.

Writing Tip

Never Cite Just the Abstract!

Citing to just a journal article's abstract does not confirm for the reader that you have conducted a thorough or reliable review of the literature. If the full-text is not available, go to the USC Libraries main page and enter the title of the article [NOT the title of the journal]. If the Libraries have a subscription to the journal, the article should appear with a link to the full-text or to the journal publisher page where you can get the article. If the article does not appear, try searching Google Scholar using the link on the USC Libraries main page. If you still can't find the article after doing this, contact a librarian or you can request it from our free i nterlibrary loan and document delivery service .

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The Oxford Handbook of Qualitative Research

Patricia Leavy Independent Scholar Kennebunk, ME, USA

A newer edition of this book is available.

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This handbook provides a broad introduction to qualitative research to those with little to no background in the subject while simultaneously providing substantive contributions to the field that will be of interest to even the most experienced researchers. The first two sections explore the history of qualitative research, ethical perspectives, and philosophical/theoretical approaches. The next three sections focus on the major methods of qualitative practice, as well as on newer approaches (such as arts-based research and internet research); area studies often excluded (such as museum studies and disaster studies); and mixed methods and participatory methods (such as community-based research). The next section covers key issues including data analysis, interpretation, writing, and assessment. The final section offers a commentary about politics and research and the move toward public scholarship. The Oxford Handbook of Qualitative Research is intended for students of all levels, faculty, and researchers across the social sciences.

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Qualitative Research

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• Description
• Aims and Scope
• Editorial Board
• Abstracting / Indexing
• Submission Guidelines

Qualitative Research  publishes papers with a clear methodological focus. We invite scholarship that has multi-disciplinary appeal, that debates and enlivens qualitative methods, and that pushes at the boundaries of established ways of doing qualitative research. We are interested in papers that are attentive to a wide audience, that are alive to new and diverse ways of thinking about qualitative methods, and that contribute to discussions within the pages of this journal. These discussions can be brought to life through empirical studies and research encounters, but we do not accept papers that focus on reporting the findings from qualitative research studies.

We see our journal as contributing to the community of academics across different fields who use qualitative methods as a way of making sense of the world. We understand methods and methodology as a practice and as a perspective, and welcome contributions that reflect on and critically engage with both aspects.  Qualitative Research is a space where ideas and understandings are used to open up methodological issues for reflection and debate, and we work hard to provide a supportive environment to foster this ethos.

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Manuscript Submission Guidelines: Qualitative Research

This Journal is a member of the Committee on Publication Ethics

Please read the guidelines below then visit the Journal’s submission site http://mc.manuscriptcentral.com/qrj  to upload your manuscript. Please note that manuscripts not conforming to these guidelines may be returned.

Only manuscripts of sufficient quality that meet the aims and scope of Qualitative Research will be reviewed.

There are no fees payable to submit or publish in this Journal. Open Access options are available - see section 3.3 below.

As part of the submission process you will be required to warrant that you are submitting your original work, that you have the rights in the work, and that you have obtained and can supply all necessary permissions for the reproduction of any copyright works not owned by you, that you are submitting the work for first publication in the Journal and that it is not being considered for publication elsewhere and has not already been published elsewhere. Please see our guidelines on prior publication and note that the journal may accept submissions of papers that have been posted on pre-print servers; please alert the Editorial Office when submitting (contact details are at the end of these guidelines) and include the DOI for the preprint in the designated field in the manuscript submission system. Authors should not post an updated version of their paper on the preprint server while it is being peer reviewed for possible publication in the journal. If the article is accepted for publication, the author may re-use their work according to the journal's author archiving policy. If your paper is accepted, you must include a link on your preprint to the final version of your paper.

• What do we publish? 1.1 Aims & Scope 1.2 Article types 1.3 Writing your paper
• Editorial policies 2.1 Peer review policy 2.2 Authorship 2.3 Acknowledgements 2.4 Funding 2.5 Declaration of conflicting interests 2.6 Research Data
• Publishing policies 3.1 Publication ethics 3.2 Contributor's publishing agreement 3.3 Open access and author archiving
• Preparing your manuscript 4.1 Formatting 4.2 Artwork, figures and other graphics 4.3 Supplemental material 4.4 Reference style 4.5 English language editing services
• Submitting your manuscript 5.1 ORCID 5.2 Information required for completing your submission 5.3 Permissions
• On acceptance and publication 6.1 Sage Production 6.2 Online First publication 6.3 Access to your published article 6.4 Promoting your article
• Further information

1. What do we publish?

1.1 Aims & Scope

Qualitative Research publishes papers with a clear methodological focus. We invite scholarship that has multi-disciplinary appeal, that debates and enlivens qualitative methods, and that pushes at the boundaries of established ways of doing qualitative research. We are interested in papers that are attentive to a wide audience, that are alive to new and diverse ways of thinking about qualitative methods, and that contribute to discussions within the pages of this journal. These discussions can be brought to life through empirical studies and research encounters, but we do not accept papers that focus on reporting the findings from qualitative research studies.

We see our journal as contributing to the community of academics across different fields who use qualitative methods as a way of making sense of the world. We understand methods and methodology as a practice and as a perspective, and welcome contributions that reflect on and critically engage with both aspects. QR is a space where ideas and understandings are used to open up methodological issues for reflection and debate, and we work hard to provide a supportive environment to foster this ethos.

1.2 Article Types

Qualitative Research publishes articles, notes and reviews. Most of our submissions follow formal academic publishing guidelines, but we welcome creative and imaginative ways to explore qualitative methods and are open to conversations about the format and presentation of submissions.

We publish articles that are original, critical and creative engagements with qualitative methods. Articles must have a clear methodological focus, and not simply present findings from qualitative studies. They should be between 7,500 and 8,500 words, excluding references. Any articles that fall below or above that range will be returned.

Notes is a new format for short, engaging and imaginative submissions. It offers a more playful space for critical reflection on the craft of qualitative research. Authors are encouraged to experiment with styles of writing, and submissions can take the form of stories, anecdotes, or lessons that impart original methodological insights. Submissions should be between 2,000 and 4,000 words, excluding references.

Reviews are an important contribution to Qualitative Research. We welcome proposals that connect with the aims and the scope of our journal by offering reflective readings of key contributions to methodological debates and discussions in qualitative research. Specifically, we invite traditional book reviews that critically engage with titles and identify connections to wider literature, as well as provide a more descriptive account of content. Here, reviewers should not be afraid to (kindly) consider the significance and clarity of the contribution.

While our book reviews are usually around 800 to 1000 words and tend to focus on a single title, we also welcome longer review essays that explore two or three publications. If you would like to submit a proposal for a book review on the latest contribution or a classic of the genre, please get in touch with the editors, [email protected] . Your proposal should include a statement on why you would like to review the title(s) and how the piece relates to your own interests and expertise.

Beyond the traditional book review, we also invite reviews of events, cultural artifacts, and other dissemination platforms. Here we welcome reviews of relevant conferences and colloquia, podcasts and radio programmes, novels, and documentary series. As with the book review, the word count should be 800 to 1000 words and explicitly relate to how the event/artifact furthers debates in qualitative research. Again, please contact the editors at [email protected] with an outline of your proposal.

Please note that Qualitative Research does not accept unsolicited reviews.

1.3 Writing your paper

The Sage Author Gateway has some general advice and on  how to get published , plus links to further resources. Sage Author Services also offers authors a variety of ways to improve and enhance their article including English language editing, plagiarism detection, and video abstract and infographic preparation.

1.3.1 Make your article discoverable

For information and guidance on how to make your article more discoverable, visit our Gateway page on How to Help Readers Find Your Article Online

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2. Editorial policies

2.1 Peer review policy

Sage does not permit the use of author-suggested (recommended) reviewers at any stage of the submission process, be that through the web-based submission system or other communication. Reviewers should be experts in their fields and should be able to provide an objective assessment of the manuscript. Our policy is that reviewers should not be assigned to a paper if:

•  The reviewer is based at the same institution as any of the co-authors

•  The reviewer is based at the funding body of the paper

•  The author has recommended the reviewer

•  The reviewer has provided a personal (e.g. Gmail/Yahoo/Hotmail) email account and an institutional email account cannot be found after performing a basic Google search (name, department and institution). 

2.2 Authorship

All parties who have made a substantive contribution to the article should be listed as authors. Principal authorship, authorship order, and other publication credits should be based on the relative scientific or professional contributions of the individuals involved, regardless of their status. For any multiple-authored publication that substantially derives from the student’s dissertation or thesis the student should normally be named as first author.

        Please note that AI chatbots, for example ChatGPT, should not be listed as authors. For more information see the policy on Use of ChatGPT and generative AI tools .

2.3 Acknowledgements

All contributors who do not meet the criteria for authorship should be listed in an Acknowledgements section. Examples of those who might be acknowledged include a person who provided purely technical help, or a department chair who provided only general support.

2.3.1 Third party submissions

Where an individual who is not listed as an author submits a manuscript on behalf of the author(s), a statement must be included in the Acknowledgements section of the manuscript and in the accompanying cover letter. The statements must:

• Disclose this type of editorial assistance – including the individual’s name, company and level of input
• Identify any entities that paid for this assistance
• Confirm that the listed authors have authorized the submission of their manuscript via third party and approved any statements or declarations, e.g. conflicting interests, funding, etc.

Where appropriate, Sage reserves the right to deny consideration to manuscripts submitted by a third party rather than by the authors themselves .

2.4 Funding

Qualitative Research requires all authors to acknowledge their funding in a consistent fashion under a separate heading.  Please visit the Funding Acknowledgements  page on the Sage Journal Author Gateway to confirm the format of the acknowledgment text in the event of funding, or state that: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. 

2.5 Declaration of conflicting interests

Qualitative Research encourages authors to include a declaration of any conflicting interests and recommends you review the good practice guidelines on the Sage Journal Author Gateway

2.6 Research Data

At Sage we are committed to facilitating openness, transparency and reproducibility of research. Where relevant, the journal encourages authors to share their research data in a suitable public repository subject to ethical and methodological considerations and where data is included, to add a data accessibility statement in their manuscript file. Authors should also follow data citation principles. For more information please visit the Sage Author Gateway , which includes information about Sage’s partnership with the data repository Figshare. For more information, including FAQs please visit the Sage Research Data policy pages .

We acknowledge this practice is not always relevant or appropriate for ethically sound qualitative inquiry, and so would encourage you to consider the unfolding ethical, legal and moral obligations linked to your research data on a case by case basis.

3. Publishing Policies

3.1 Publication ethics

Sage is committed to upholding the integrity of the academic record. We encourage authors to refer to the Committee on Publication Ethics’ International Standards for Authors  and view the Publication Ethics page on the  Sage Author Gateway .

3.1.1 Plagiarism

Qualitative Research and Sage take issues of copyright infringement, plagiarism or other breaches of best practice in publication very seriously. We seek to protect the rights of our authors and we always investigate claims of plagiarism or misuse of published articles. Equally, we seek to protect the reputation of the journal against malpractice. Submitted articles may be checked with duplication-checking software. Where an article, for example, is found to have plagiarised other work or included third-party copyright material without permission or with insufficient acknowledgement, or where the authorship of the article is contested, we reserve the right to take action including, but not limited to: publishing an erratum or corrigendum (correction); retracting the article; taking up the matter with the head of department or dean of the author's institution and/or relevant academic bodies or societies; or taking appropriate legal action.

3.1.2 Prior publication

If material has been previously published it is not generally acceptable for publication in a Sage journal. However, there are certain circumstances where previously published material can be considered for publication. Please refer to the guidance on the Sage Author Gateway  or if in doubt, contact the Editor at the address given below.

3.2 Contributor's publishing agreement

Before publication, Sage requires the author as the rights holder to sign a Journal Contributor’s Publishing Agreement. Sage’s Journal Contributor’s Publishing Agreement is an exclusive licence agreement which means that the author retains copyright in the work but grants Sage the sole and exclusive right and licence to publish for the full legal term of copyright. Exceptions may exist where an assignment of copyright is required or preferred by a proprietor other than Sage. In this case copyright in the work will be assigned from the author to the society. For more information please visit the  Sage Author Gateway

3.3 Open access and author archiving

Qualitative Research offers optional open access publishing via the Sage Choice programme and Open Access agreements, where authors can publish open access either discounted or free of charge depending on the agreement with Sage. Find out if your institution is participating by visiting Open Access Agreements at Sage . For more information on Open Access publishing options at Sage please visit Sage Open Access . For information on funding body compliance, and depositing your article in repositories, please visit Sage’s Author Archiving and Re-Use Guidelines and Publishing Policies .

4. Preparing your manuscript for submission

4.1 Formatting

• Attach to every submission a letter confirming that all authors have agreed to the submission and that the article is not currently being considered for publication by any other journal.
• Include a title page with full title and subtitle (if any). For the purposes of blind refereeing, full name of each author with current affiliation and full address/phone/fax/email details plus short biographical note should be supplied on a separate sheet. The editors will not inspect the manuscript until this information is given.
• Also for the purposes of blind refereeing, authors should replace all self-citations in the text and reference list with anonymous citations, in the style (Author, 2009), etc.
• Any citation that includes any of the authors should be replaced with (Author A and others, 2003) in the text, and in the reference list at 'Au' put 'Author A and others (2003), details withheld for peer review' followed by Author B and others, if necessary.
• Abstract of 100-150 words.
• Up to 10 key words.
• All authors must provide a full word count for their paper. The minimum word count is 7500 and the maximum is 8500 words excluding all references. Papers under the minimum and over the maximum word count will be unsubmitted.
• The journal uses notes where necessary. Historical, documentary or archival sources should be cited in endnotes. Discursive endnotes are also allowed. Endnotes are signalled in the text by superscript numbers.
• References in both the text and in any endnotes should follow Sage Harvard style. References are cited in the text thus: (author, date: page).
• An alphabetical References section should follow the text (and endnotes, if any) using the Sage Harvard system.
• All artwork, graphics, line diagrams and photographs are termed 'Figures' and should be referred to as such in the manuscript. They should be numbered consecutively. All figures should have short descriptive captions at the end of the document.
• Articles must be written in English. Use a clear, readable style, avoiding jargon. If technical terms or acronyms must be included, define them when first used.
• Non-discriminatory language is mandatory
• UK or US spellings may be used with '-ize' spellings as given in the Oxford English Dictionary (e.g. organize, recognize).
• Use single quotation marks with double quotes inside single quotes.
• Dates should be presented in the form 1 May 2010. Do not use points in abbreviations, contractions or acronyms (e.g. AD, USA, Dr, PhD)
• Qualitative Research adheres to the Sage Harvard reference style. View the Sage Harvard guidelines to ensure your manuscript conforms to this reference style.
• If you use EndNote to manage references, you can download the Sage Harvard EndNote output file .

4.2 Artwork, figures and other graphics

Qualitative Research welcomes the inclusion of figures. There is no word count equivalent for figures, but images should be carefully selected and will be reviewed for their quality and suitability. 

For guidance on the preparation of illustrations, pictures and graphs in electronic format, please visit Sage’s Manuscript Submission Guidelines .   

Figures supplied in colour will appear in colour online regardless of whether or not these illustrations are reproduced in colour in the printed version. For specifically requested colour reproduction in print, you will receive information regarding the costs from Sage after receipt of your accepted article.

4.3 Supplemental material

This journal does not currently accept supplemental files.

4.4 Reference style

Qualitative Research adheres to the Sage Harvard reference style. View the Sage Harvard  guidelines to ensure your manuscript conforms to this reference style.

If you use EndNote    to manage references, you can download the  Sage Harvard EndNote output file ..

4.5 English language editing services

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About Journal

American Journal of Qualitative Research (AJQR)  is a quarterly peer-reviewed academic journal that publishes qualitative research articles from a number of social science disciplines such as psychology, health science, sociology, criminology, education, political science, and administrative studies. The journal is an international and interdisciplinary focus and greatly welcomes papers from all countries. The journal offers an intellectual platform for researchers, practitioners, administrators, and policymakers to contribute and promote qualitative research and analysis.

ISSN: 2576-2141

Call for Papers- American Journal of Qualitative Research

American Journal of Qualitative Research (AJQR) welcomes original research articles and book reviews for its next issue. The AJQR is a quarterly and peer-reviewed journal published in February, May, August, and November.

We are seeking submissions for a forthcoming issue published in February 2024. The paper should be written in professional English. The length of 6000-10000 words is preferred. All manuscripts should be prepared in MS Word format and submitted online: https://www.editorialpark.com/ajqr

For any further information about the journal, please visit its website: https://www.ajqr.org

Submission Deadline: November 15, 2023

Announcement 

Dear AJQR Readers, 

Due to the high volume of submissions in the American Journal of Qualitative Research , the editorial board decided to publish quarterly since 2023.

Volume 8, Issue 2

Current issue - in progress.

The COVID-19 pandemic has highlighted and exacerbated the difficult juggling act women in the U.S. have to do between parenting their children and working outside the home. The pandemic has also led to a decline in maternal mental health, particularly among mothers with young children, mothers of color, and those with previous mental health issues. The authors noted these experiences in their own lives as mothers with children and observed them in the lives of the women around them. These observations informed the design of this narrative inquiry study, in which we used semi-structured interviews to explore mothers’ shifting ideas and experiences of mothering, work, and family life during a global pandemic. We used creative analytic practice (CAP) to compose reflexive researcher conversations around the interview data that enabled us to highlight nuances in the data, show more transparently our meaning-making, make visible our researcher subjectivities, show uncertainties about aspects of data interpretation, and create a more accessible data representation.

Keywords: Mothering, COVID-19 pandemic, U.S. women, Narrative inquiry, Creative analytic practice.

The COVID-19 pandemic put France’s healthcare system under extreme tension and led to significant levels of stress among healthcare professionals in general and nurses in particular. Research has shown how these elements affected nurses’ physical and psychological health and manifested as insomnia, anxiety, and depressive syndromes. The present qualitative study aimed to explore the lived experiences of France’s nurses as a function of their level of exposure to the virus and whether they worked in the hospital sector or practiced privately in the community during the pandemic’s first wave. It also sought to describe the resources nurses used to maintain their overall health. We administered 19 qualitative interviews to 19 nurses in the autumn of 2021. The present study revealed that nurses were subjected to significant stress during the pandemic. Our data analysis enabled us to draw out three principal themes: 1) Being on the edge in stormy period ; 2) Personal impact on several levels and 3) Floating together and learning. There were no significant differences between the groups that were subjected to different levels of exposure to COVID-19. All the groups were affected by the pandemic that struck a healthcare system that was already systematically fragile. Nurses were severely tested by the COVID-19 pandemic, but their consciousness of the importance of their role grew, despite questioning what meaning there was to their profession, perhaps even to their lives . The trauma still felt fresh 18 months later, during the interviews, and this cannot be ignored in future healthcare policymaking .

Keywords: COVID-19, nurses, salutogenesis, stressors, health resources.

Annual mammography screening is recommended by the US Preventive Services Task Force (USPSTF) and American Cancer Society (ACS) to reduce mortality through early detection of breast cancer. In rural Appalachia, rates of later-stage breast cancer incidence and mortality are higher than national averages. We explored the ways that providers and staff at breast cancer screening facilities employed novel approaches to overcome patient- and facility-level barriers to access to breast cancer screening in the Appalachian region. We conducted 23 semi-structured interviews with 28 clinical providers and staff of breast health facilities in Appalachia. Themes reflect how limiting features of breast screening facilities influenced access to care; the way patient-level barriers presented challenges to access to breast screening; and that external and regulatory forces presented obstacles to access to care. In addition, the unique geographical and geographical attributes of the Appalachian region shaped access and adherence to mammography screening recommendations. Thematic findings highlight that facilities implemented patient-centered strategies to overcome access-related barriers. Results may inform the ways breast cancer screening facilities address suboptimal access to breast health screening. They may also inform future resource allocations to enable facilities to reach breast cancer screening performance goals.

Keywords: rural health, breast cancer, preventive health care, women’s health.

Paternal parenting affects child development; hence, the father’s absence has a deleterious effect on the male child. The literature on parenting shows limited focus on how parenting impacts children by gender. This qualitative hermeneutic phenomenological study investigated the key question, “How does a father’s absence during childhood influence a man’s subsequent parenting of his son(s)?” An integrated theoretical framework was used to guide the study: Parenting Style Theory, Social-Cognitive Theory, and Bioecological Systems Theory. Nine Trinidadian males aged 20 to 35 years who were parenting sons were recruited to participate using snowball sampling. Data on men’s adverse childhood experiences were gathered using semi-structured interviews. Content and thematic analyses were done using DELVE software. Key findings include the influence of stereotypical cultural constructs, the church’s critical role in addressing childhood trauma, the transmission of father absence across generations, and the relationship between neurodevelopment and adverse childhood experiences. Implications of these findings will benefit child and adolescent advocacy, inform policymaking, aid professional intervention in mental health and education, and strengthen familial systems and ecclesiastical contexts. Future research should explore the lived experiences of men who crave emotional connection with their sons yet struggle with the stereotypical cultural perception of manhood.

Keywords: father absence, brain development, childhood trauma, intergenerational, the transmission of behavior.

The purpose of this qualitative transcendental phenomenological study was to understand the essence of the shared lived experiences of undergraduate college students with anxiety disorders at two universities in the Southeastern United States. Ellis’s cognitive theory, rational emotive behavior therapy, guided the study which took place at a mid-sized, public nonsectarian university and a small, private liberal arts college. The central research question elicited rich data regarding the shared lived experiences of the study participants. The four research sub-questions address participants’ perceptions regarding the impact of their disorders on their lifestyles and academic performance. A purposeful criterion sample was used to select the participants who completed a questionnaire, open-ended individual interviews, a single focus group interview, and participant journals. Phenomenological reduction was used to create a composite integration of meaning and the essence of the lived experience of the participants. Data results identified five themes: (a) social fears, (b) stressor issues, (c) generational issues, (d) academic performance barriers, and (e) institutional education and accommodation preferences.

Keywords: Alexithymia, anxiety, disorder, qualitative, stressors

School shootings are traumatic events that can lead to anxiety, depression, and post-traumatic stress disorder among students who experience these events. It is important to find effective strategies to help students cope with their return to school, as well as their anxiety and stress levels while on campus. There exists a gap in the literature on the effects of therapy dogs on students who have witnessed a school shooting. This current study used a retrospective mixed-methods survey that was sent to recent graduates of Marjory Stoneman Douglas High School (located in Parkland, Florida) who witnessed the February 2018 shooting. Data were collected to assess how the therapy dogs affected students' willingness to return to school and their stress/anxiety levels while on campus. Identified themes indicated that the therapy dogs helped with anxiety levels, stress levels, and overall moods of Marjory Stoneman Douglas High School students. These findings provide important implications for community leaders and school administrators who want to promote healing and well-being in a community that has experienced violence.

Keywords: Therapy dog, school shooting, community violence.

Identifying the relation between the processes of programming and foreign language writing may lead to new directions for programming language and natural language focused instructional design. The present qualitative case study supported by quantitative data investigated foreign language writing experiences of computer engineering students taking an object-oriented programming course. Forty-five sophomores learning programming and academic English simultaneously in a foundation university in Ankara, Turkey, were selected purposefully for the case study. There were two data sources (students’ opinions and documents) and three data collection tools (a semi-structured interview, a short diary, and a composition. In terms of the findings of the research, four themes were obtained; however, only the use of metacognitive strategies will be explained in detail due to the length of the study. Participants stated that they feel the positive effects of programming experience on the use of self-evaluation strategy and that there are similarities and differences between the processes of programming and foreign language writing. Participants’ views on the effect of programming on foreign language writing did not differ according to their writing and programming performance scores. Participants stated that programming experience may have an effect on the use of metacognitive language learning strategies in the writing process. Upon analyzing participants’ comments, it is understood that programming experience does not hinder the use of metacognitive strategies but has a role in supporting and reinforcing their use. It is suggested that multiple case studies be done for similar views on the effects of programming and that each finding be proven by quantitative studies.

Keywords: programming, foreign language writing, metacognitive strategies.

The significance of participatory decision-making in educational institutions is widely acknowledged as essential in school management and administration. This study aimed to determine how involved teachers are in making decisions in their schools and what role they think they play in shaping different parts of school policies and procedures. It also looked at their perspectives on how decisions made by others are carried out in schools. Semi-structured interviews with 10 secondary school teachers focused on teachers' role in decision-making related to their routine school tasks, strategic decision-making, participatory role in making school decisions, and their willingness to participate in decision-making. This study showed that teachers' low participation is attributed to their shared desire to be involved in school management and administration-related decisions. Teachers expressed that participatory school-based decision-making can promote collaboration and collectivism among the school staff, and it plays a significant role in shaping their work satisfaction and motivation. By gaining insights into teachers' perspectives, this study aims to contribute to the broader understanding of participatory school decision-making in the Rwandan secondary education system and communicate potential improvements for fostering a more collaborative and inclusive educational environment.

Keywords: teachers’ perceptions, qualitative research, decision-making, secondary schools.

One of the major inefficiencies in qualitative research is the accuracy and timeliness of transcribing audio files into analyzable text. However, researchers may now have the ability to leverage artificial intelligence to increase research efficiency through Chat GPT. As a result, this study performs feasibility and accuracy testing of Chat GPT versus human transcription to compare accuracy and timeliness. Results suggest that by using specific commands, Chat GPT can clean interview transcriptions in seconds with a <1% word error rate and near 0% syntactic error rate. Implications for research and ethics are addressed.

Keywords: Chat GPT, artificial intelligence, qualitative research, educational research, transcription

Alcohol misuse on college campuses has been shown to be the cause of physical, socio-emotional, and academic harms. Alcohol is also an issue at Gallaudet University but there is a gap in the literature describing this phenomenon. Using the social ecological model, this qualitative case study explored student perceptions and experiences with alcohol use through interviews with 24 deaf and hard of hearing college students at Gallaudet University. The main themes included: something to do, isolation, coping, communication, “playing catch up with life,” belonging, peer pressure, and university dynamics. The results of this study supported the research on alcohol use in the college environment, showing these themes to also be true at Gallaudet University. As a result, researchers recommend for Gallaudet University and other institutions use the education and interventions shown to be effective in the College Alcohol Intervention Matrix with deaf and hard of hearing students. Researchers also identified themes that were divergent from general college students and specific to the experience of being deaf and hard of hearing. This study highlighted the interpersonal level impact and importance of communication with alcohol and related harms. Researchers recommend further research on the spectrum of communication isolation on alcohol use, related harms, and the social-ecological impact of these experiences. In addition, researchers recommend programming and services to specifically address the issues that occur as a result of isolation, coping challenges, desire to belong, susceptibility to peer pressure, and wanting to catch up on life. It is hoped that the insights gained from this study will be used to inform interventions for deaf and hard of hearing college students, to reduce alcohol misuse, and thus to impact positive change.

Keywords: Deaf, hard of hearing, alcohol, college, university, isolation.

The Dissertation Abstract: 101

How to write a clear & concise abstract (with examples).

By:   Madeline Fink (MSc) Reviewed By: Derek Jansen (MBA)   | June 2020

So, you’ve (finally) finished your thesis or dissertation or thesis. Now it’s time to write up your abstract (sometimes also called the executive summary). If you’re here, chances are you’re not quite sure what you need to cover in this section, or how to go about writing it. Fear not – we’ll explain it all in plain language , step by step , with clear examples .

Overview: The Dissertation/Thesis Abstract

• What exactly is a dissertation (or thesis) abstract
• What’s the purpose and function of the abstract
• Why is the abstract so important
• How to write a high-quality dissertation abstract
• Example/sample of a quality abstract
• Quick tips to write a high-quality dissertation abstract

What is an abstract?

Simply put, the abstract in a dissertation or thesis is a short (but well structured) summary that outlines the most important points of your research (i.e. the key takeaways). The abstract is usually 1 paragraph or about 300-500 words long (about one page), but but this can vary between universities.

A quick note regarding terminology – strictly speaking, an abstract and an executive summary are two different things when it comes to academic publications. Typically, an abstract only states what the research will be about, but doesn’t explore the findings – whereas an executive summary covers both . However, in the context of a dissertation or thesis, the abstract usually covers both, providing a summary of the full project.

In terms of content, a good dissertation abstract usually covers the following points:

• The purpose of the research (what’s it about and why’s that important)
• The methodology (how you carried out the research)
• The key research findings (what answers you found)
• The implications of these findings (what these answers mean)

We’ll explain each of these in more detail a little later in this post. Buckle up.

What’s the purpose of the abstract?

A dissertation abstract has two main functions:

The first purpose is to  inform potential readers  of the main idea of your research without them having to read your entire piece of work. Specifically, it needs to communicate what your research is about (what were you trying to find out) and what your findings were . When readers are deciding whether to read your dissertation or thesis, the abstract is the first part they’ll consider. 

The second purpose of the abstract is to  inform search engines and dissertation databases  as they index your dissertation or thesis. The keywords and phrases in your abstract (as well as your keyword list) will often be used by these search engines to categorize your work and make it accessible to users. 

Simply put, your abstract is your shopfront display window – it’s what passers-by (both human and digital) will look at before deciding to step inside. 

Why’s it so important?

The short answer – because most people don’t have time to read your full dissertation or thesis! Time is money, after all…

If you think back to when you undertook your literature review , you’ll quickly realise just how important abstracts are! Researchers reviewing the literature on any given topic face a mountain of reading, so they need to optimise their approach. A good dissertation abstract gives the reader a “TLDR” version of your work – it helps them decide whether to continue to read it in its entirety. So, your abstract, as your shopfront display window, needs to “sell” your research to time-poor readers.

You might be thinking, “but I don’t plan to publish my dissertation”. Even so, you still need to provide an impactful abstract for your markers. Your ability to concisely summarise your work is one of the things they’re assessing, so it’s vital to invest time and effort into crafting an enticing shop window.  

A good abstract also has an added purpose for grad students . As a freshly minted graduate, your dissertation or thesis is often your most significant professional accomplishment and highlights where your unique expertise lies. Potential employers who want to know about this expertise are likely to only read the abstract (as opposed to reading your entire document) – so it needs to be good!

Think about it this way – if your thesis or dissertation were a book, then the abstract would be the blurb on the back cover. For better or worse, readers will absolutely judge your book by its cover .

How to write your abstract

As we touched on earlier, your abstract should cover four important aspects of your research: the purpose , methodology , findings , and implications . Therefore, the structure of your dissertation or thesis abstract needs to reflect these four essentials, in the same order.  Let’s take a closer look at each of them, step by step:

Step 1: Describe the purpose and value of your research

Here you need to concisely explain the purpose and value of your research. In other words, you need to explain what your research set out to discover and why that’s important. When stating the purpose of research, you need to clearly discuss the following:

• What were your research aims and research questions ?
• Why were these aims and questions important?

It’s essential to make this section extremely clear, concise and convincing . As the opening section, this is where you’ll “hook” your reader (marker) in and get them interested in your project. If you don’t put in the effort here, you’ll likely lose their interest.

Step 2: Briefly outline your study’s methodology

In this part of your abstract, you need to very briefly explain how you went about answering your research questions . In other words, what research design and methodology you adopted in your research. Some important questions to address here include:

• Did you take a qualitative or quantitative approach ?
• Who/what did your sample consist of?
• How did you collect your data?
• How did you analyse your data?

Simply put, this section needs to address the “ how ” of your research. It doesn’t need to be lengthy (this is just a summary, after all), but it should clearly address the four questions above.

Need a helping hand?

Step 3: Present your key findings

Next, you need to briefly highlight the key findings . Your research likely produced a wealth of data and findings, so there may be a temptation to ramble here. However, this section is just about the key findings – in other words, the answers to the original questions that you set out to address.

Again, brevity and clarity are important here. You need to concisely present the most important findings for your reader.

Step 4: Describe the implications of your research

Have you ever found yourself reading through a large report, struggling to figure out what all the findings mean in terms of the bigger picture? Well, that’s the purpose of the implications section – to highlight the “so what?” of your research. 

In this part of your abstract, you should address the following questions:

• What is the impact of your research findings on the industry /field investigated? In other words, what’s the impact on the “real world”. 
• What is the impact of your findings on the existing body of knowledge ? For example, do they support the existing research?
• What might your findings mean for future research conducted on your topic?

If you include these four essential ingredients in your dissertation abstract, you’ll be on headed in a good direction.

Example: Dissertation/thesis abstract

Here is an example of an abstract from a master’s thesis, with the purpose , methods , findings , and implications colour coded.

The U.S. citizenship application process is a legal and symbolic journey shaped by many cultural processes. This research project aims to bring to light the experiences of immigrants and citizenship applicants living in Dallas, Texas, to promote a better understanding of Dallas’ increasingly diverse population. Additionally, the purpose of this project is to provide insights to a specific client, the office of Dallas Welcoming Communities and Immigrant Affairs, about Dallas’ lawful permanent residents who are eligible for citizenship and their reasons for pursuing citizenship status . The data for this project was collected through observation at various citizenship workshops and community events, as well as through semi-structured interviews with 14 U.S. citizenship applicants . Reasons for applying for U.S. citizenship discussed in this project include a desire for membership in U.S. society, access to better educational and economic opportunities, improved ease of travel and the desire to vote. Barriers to the citizenship process discussed in this project include the amount of time one must dedicate to the application, lack of clear knowledge about the process and the financial cost of the application. Other themes include the effects of capital on applicant’s experience with the citizenship process, symbolic meanings of citizenship, transnationalism and ideas of deserving and undeserving surrounding the issues of residency and U.S. citizenship. These findings indicate the need for educational resources and mentorship for Dallas-area residents applying for U.S. citizenship, as well as a need for local government programs that foster a sense of community among citizenship applicants and their neighbours.

Practical tips for writing your abstract

When crafting the abstract for your dissertation or thesis, the most powerful technique you can use is to try and put yourself in the shoes of a potential reader. Assume the reader is not an expert in the field, but is interested in the research area. In other words, write for the intelligent layman, not for the seasoned topic expert. 

Start by trying to answer the question “why should I read this dissertation?”

Remember the WWHS.

Make sure you include the  what , why ,  how , and  so what  of your research in your abstract:

• What you studied (who and where are included in this part)
• Why the topic was important
• How you designed your study (i.e. your research methodology)
• So what were the big findings and implications of your research

Keep it simple.

Use terminology appropriate to your field of study, but don’t overload your abstract with big words and jargon that cloud the meaning and make your writing difficult to digest. A good abstract should appeal to all levels of potential readers and should be a (relatively) easy read. Remember, you need to write for the intelligent layman.

Be specific.

When writing your abstract, clearly outline your most important findings and insights and don’t worry about “giving away” too much about your research – there’s no need to withhold information. This is the one way your abstract is not like a blurb on the back of a book – the reader should be able to clearly understand the key takeaways of your thesis or dissertation after reading the abstract. Of course, if they then want more detail, they need to step into the restaurant and try out the menu.

Psst... there’s more!

This post was based on one of our popular Research Bootcamps . If you're working on a research project, you'll definitely want to check this out ...

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19 Comments

This was so very useful, thank you Caroline.

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This was really useful in writing the abstract for my dissertation. Thank you Caroline.

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I am so grateful for the tips. I am very optimistic in coming up with a winning abstract for my dessertation, thanks to you.

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Introduction to qualitative research methods – Part I

Shagufta bhangu.

Department of Global Health and Social Medicine, King's College London, London, United Kingdom

Fabien Provost

Carlo caduff.

Qualitative research methods are widely used in the social sciences and the humanities, but they can also complement quantitative approaches used in clinical research. In this article, we discuss the key features and contributions of qualitative research methods.

INTRODUCTION

Qualitative research methods refer to techniques of investigation that rely on nonstatistical and nonnumerical methods of data collection, analysis, and evidence production. Qualitative research techniques provide a lens for learning about nonquantifiable phenomena such as people's experiences, languages, histories, and cultures. In this article, we describe the strengths and role of qualitative research methods and how these can be employed in clinical research.

Although frequently employed in the social sciences and humanities, qualitative research methods can complement clinical research. These techniques can contribute to a better understanding of the social, cultural, political, and economic dimensions of health and illness. Social scientists and scholars in the humanities rely on a wide range of methods, including interviews, surveys, participant observation, focus groups, oral history, and archival research to examine both structural conditions and lived experience [ Figure 1 ]. Such research can not only provide robust and reliable data but can also humanize and add richness to our understanding of the ways in which people in different parts of the world perceive and experience illness and how they interact with medical institutions, systems, and therapeutics.

Examples of qualitative research techniques

Qualitative research methods should not be seen as tools that can be applied independently of theory. It is important for these tools to be based on more than just method. In their research, social scientists and scholars in the humanities emphasize social theory. Departing from a reductionist psychological model of individual behavior that often blames people for their illness, social theory focuses on relations – disease happens not simply in people but between people. This type of theoretically informed and empirically grounded research thus examines not just patients but interactions between a wide range of actors (e.g., patients, family members, friends, neighbors, local politicians, medical practitioners at all levels, and from many systems of medicine, researchers, policymakers) to give voice to the lived experiences, motivations, and constraints of all those who are touched by disease.

PHILOSOPHICAL FOUNDATIONS OF QUALITATIVE RESEARCH METHODS

In identifying the factors that contribute to the occurrence and persistence of a phenomenon, it is paramount that we begin by asking the question: what do we know about this reality? How have we come to know this reality? These two processes, which we can refer to as the “what” question and the “how” question, are the two that all scientists (natural and social) grapple with in their research. We refer to these as the ontological and epistemological questions a research study must address. Together, they help us create a suitable methodology for any research study[ 1 ] [ Figure 2 ]. Therefore, as with quantitative methods, there must be a justifiable and logical method for understanding the world even for qualitative methods. By engaging with these two dimensions, the ontological and the epistemological, we open a path for learning that moves away from commonsensical understandings of the world, and the perpetuation of stereotypes and toward robust scientific knowledge production.

Developing a research methodology

Every discipline has a distinct research philosophy and way of viewing the world and conducting research. Philosophers and historians of science have extensively studied how these divisions and specializations have emerged over centuries.[ 1 , 2 , 3 ] The most important distinction between quantitative and qualitative research techniques lies in the nature of the data they study and analyze. While the former focus on statistical, numerical, and quantitative aspects of phenomena and employ the same in data collection and analysis, qualitative techniques focus on humanistic, descriptive, and qualitative aspects of phenomena.[ 4 ]

For the findings of any research study to be reliable, they must employ the appropriate research techniques that are uniquely tailored to the phenomena under investigation. To do so, researchers must choose techniques based on their specific research questions and understand the strengths and limitations of the different tools available to them. Since clinical work lies at the intersection of both natural and social phenomena, it means that it must study both: biological and physiological phenomena (natural, quantitative, and objective phenomena) and behavioral and cultural phenomena (social, qualitative, and subjective phenomena). Therefore, clinical researchers can gain from both sets of techniques in their efforts to produce medical knowledge and bring forth scientifically informed change.

KEY FEATURES AND CONTRIBUTIONS OF QUALITATIVE RESEARCH METHODS

In this section, we discuss the key features and contributions of qualitative research methods [ Figure 3 ]. We describe the specific strengths and limitations of these techniques and discuss how they can be deployed in scientific investigations.

Key features of qualitative research methods

One of the most important contributions of qualitative research methods is that they provide rigorous, theoretically sound, and rational techniques for the analysis of subjective, nebulous, and difficult-to-pin-down phenomena. We are aware, for example, of the role that social factors play in health care but find it hard to qualify and quantify these in our research studies. Often, we find researchers basing their arguments on “common sense,” developing research studies based on assumptions about the people that are studied. Such commonsensical assumptions are perhaps among the greatest impediments to knowledge production. For example, in trying to understand stigma, surveys often make assumptions about its reasons and frequently associate it with vague and general common sense notions of “fear” and “lack of information.” While these may be at work, to make such assumptions based on commonsensical understandings, and without conducting research inhibit us from exploring the multiple social factors that are at work under the guise of stigma.

In unpacking commonsensical understandings and researching experiences, relationships, and other phenomena, qualitative researchers are assisted by their methodological commitment to open-ended research. By open-ended research, we mean that these techniques take on an unbiased and exploratory approach in which learnings from the field and from research participants, are recorded and analyzed to learn about the world.[ 5 ] This orientation is made possible by qualitative research techniques that are particularly effective in learning about specific social, cultural, economic, and political milieus.

Second, qualitative research methods equip us in studying complex phenomena. Qualitative research methods provide scientific tools for exploring and identifying the numerous contributing factors to an occurrence. Rather than establishing one or the other factor as more important, qualitative methods are open-ended, inductive (ground-up), and empirical. They allow us to understand the object of our analysis from multiple vantage points and in its dispersion and caution against predetermined notions of the object of inquiry. They encourage researchers instead to discover a reality that is not yet given, fixed, and predetermined by the methods that are used and the hypotheses that underlie the study.

Once the multiple factors at work in a phenomenon have been identified, we can employ quantitative techniques and embark on processes of measurement, establish patterns and regularities, and analyze the causal and correlated factors at work through statistical techniques. For example, a doctor may observe that there is a high patient drop-out in treatment. Before carrying out a study which relies on quantitative techniques, qualitative research methods such as conversation analysis, interviews, surveys, or even focus group discussions may prove more effective in learning about all the factors that are contributing to patient default. After identifying the multiple, intersecting factors, quantitative techniques can be deployed to measure each of these factors through techniques such as correlational or regression analyses. Here, the use of quantitative techniques without identifying the diverse factors influencing patient decisions would be premature. Qualitative techniques thus have a key role to play in investigations of complex realities and in conducting rich exploratory studies while embracing rigorous and philosophically grounded methodologies.

Third, apart from subjective, nebulous, and complex phenomena, qualitative research techniques are also effective in making sense of irrational, illogical, and emotional phenomena. These play an important role in understanding logics at work among patients, their families, and societies. Qualitative research techniques are aided by their ability to shift focus away from the individual as a unit of analysis to the larger social, cultural, political, economic, and structural forces at work in health. As health-care practitioners and researchers focused on biological, physiological, disease and therapeutic processes, sociocultural, political, and economic conditions are often peripheral or ignored in day-to-day clinical work. However, it is within these latter processes that both health-care practices and patient lives are entrenched. Qualitative researchers are particularly adept at identifying the structural conditions such as the social, cultural, political, local, and economic conditions which contribute to health care and experiences of disease and illness.

For example, the decision to delay treatment by a patient may be understood as an irrational choice impacting his/her chances of survival, but the same may be a result of the patient treating their child's education as a financial priority over his/her own health. While this appears as an “emotional” choice, qualitative researchers try to understand the social and cultural factors that structure, inform, and justify such choices. Rather than assuming that it is an irrational choice, qualitative researchers try to understand the norms and logical grounds on which the patient is making this decision. By foregrounding such logics, stories, fears, and desires, qualitative research expands our analytic precision in learning about complex social worlds, recognizing reasons for medical successes and failures, and interrogating our assumptions about human behavior. These in turn can prove useful in arriving at conclusive, actionable findings which can inform institutional and public health policies and have a very important role to play in any change and transformation we may wish to bring to the societies in which we work.

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• Open access
• Published: 13 May 2024

Patient medication management, understanding and adherence during the transition from hospital to outpatient care - a qualitative longitudinal study in polymorbid patients with type 2 diabetes

• Léa Solh Dost   ORCID: orcid.org/0000-0001-5767-1305 1 , 2 ,
• Giacomo Gastaldi   ORCID: orcid.org/0000-0001-6327-7451 3 &
• Marie P. Schneider   ORCID: orcid.org/0000-0002-7557-9278 1 , 2  

BMC Health Services Research volume  24 , Article number:  620 ( 2024 ) Cite this article

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Metrics details

Continuity of care is under great pressure during the transition from hospital to outpatient care. Medication changes during hospitalization may be poorly communicated and understood, compromising patient safety during the transition from hospital to home. The main aims of this study were to investigate the perspectives of patients with type 2 diabetes and multimorbidities on their medications from hospital discharge to outpatient care, and their healthcare journey through the outpatient healthcare system. In this article, we present the results focusing on patients’ perspectives of their medications from hospital to two months after discharge.

Patients with type 2 diabetes, with at least two comorbidities and who returned home after discharge, were recruited during their hospitalization. A descriptive qualitative longitudinal research approach was adopted, with four in-depth semi-structured interviews per participant over a period of two months after discharge. Interviews were based on semi-structured guides, transcribed verbatim, and a thematic analysis was conducted.

Twenty-one participants were included from October 2020 to July 2021. Seventy-five interviews were conducted. Three main themes were identified: (A) Medication management, (B) Medication understanding, and (C) Medication adherence, during three periods: (1) Hospitalization, (2) Care transition, and (3) Outpatient care. Participants had varying levels of need for medication information and involvement in medication management during hospitalization and in outpatient care. The transition from hospital to autonomous medication management was difficult for most participants, who quickly returned to their routines with some participants experiencing difficulties in medication adherence.

Conclusions

The transition from hospital to outpatient care is a challenging process during which discharged patients are vulnerable and are willing to take steps to better manage, understand, and adhere to their medications. The resulting tension between patients’ difficulties with their medications and lack of standardized healthcare support calls for interprofessional guidelines to better address patients’ needs, increase their safety, and standardize physicians’, pharmacists’, and nurses’ roles and responsibilities.

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Introduction

Continuity of patient care is characterized as the collaborative engagement between the patient and their physician-led care team in the ongoing management of healthcare, with the mutual objective of delivering high-quality and cost-effective medical care [ 1 ]. Continuity of care is under great pressure during the transition of care from hospital to outpatient care, with a risk of compromising patients’ safety [ 2 , 3 ]. The early post-discharge period is a high-risk and fragile transition: once discharged, one in five patients experience at least one adverse event during the first three weeks following discharge, and more than half of these adverse events are drug-related [ 4 , 5 ]. A retrospective study examining all discharged patients showed that adverse drug events (ADEs) account for up to 20% of 30-day hospital emergency readmissions [ 6 ]. During hospitalization, patients’ medications are generally modified, with an average of nearly four medication changes per patient [ 7 ]. Information regarding medications such as medication changes, the expected effect, side effects, and instructions for use are frequently poorly communicated to patients during hospitalization and at discharge [ 8 , 9 , 10 , 11 ]. Between 20 and 60% of discharged patients lack knowledge of their medications [ 12 , 13 ]. Consideration of patients’ needs and their active engagement in decision-making during hospitalization regarding their medications are often lacking [ 11 , 14 , 15 ]. This can lead to unsafe discharge and contribute to medication adherence difficulties, such as non-implementation of newly prescribed medications [ 16 , 17 ].

Patients with multiple comorbidities and polypharmacy are at higher risk of ADE [ 18 ]. Type 2 diabetes is one of the chronic health conditions most frequently associated with comorbidities and patients with type 2 diabetes often lack care continuum [ 19 , 20 , 21 ]. The prevalence of patients hospitalized with type 2 diabetes can exceed 40% [ 22 ] and these patients are at higher risk for readmission due to their comorbidities and their medications, such as insulin and oral hypoglycemic agents [ 23 , 24 , 25 ].

Interventions and strategies to improve patient care and safety at transition have shown mixed results worldwide in reducing cost, rehospitalization, ADE, and non-adherence [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. However, interventions that are patient-centered, with a patient follow-up and led by interprofessional healthcare teams showed promising results [ 34 , 35 , 36 ]. Most of these interventions have not been implemented routinely due to the extensive time to translate research into practice and the lack of hybrid implementation studies [ 37 , 38 , 39 , 40 , 41 ]. In addition, patient-reported outcomes and perspectives have rarely been considered, yet patients’ involvement is essential for seamless and integrated care [ 42 , 43 ]. Interprofessional collaboration in which patients are full members of the interprofessional team, is still in its infancy in outpatient care [ 44 ]. Barriers and facilitators regarding medications at the transition of care have been explored in multiple qualitative studies at one given time in a given setting (e.g., at discharge, one-month post-discharge) [ 8 , 45 , 46 , 47 , 48 ]. However, few studies have adopted a holistic methodology from the hospital to the outpatient setting to explore changes in patients’ perspectives over time [ 49 , 50 , 51 ]. Finally, little is known about whether, how, and when patients return to their daily routine following hospitalization and the impact of hospitalization weeks after discharge.

In Switzerland, continuity of care after hospital discharge is still poorly documented, both in terms of contextual analysis and interventional studies, and is mainly conducted in the hospital setting [ 31 , 35 , 52 , 53 , 54 , 55 , 56 ]. The first step of an implementation science approach is to perform a contextual analysis to set up effective interventions adapted to patients’ needs and aligned to healthcare professionals’ activities in a specific context [ 41 , 57 ]. Therefore, the main aims of this study were to investigate the perspectives of patients with type 2 diabetes and multimorbidities on their medications from hospital discharge to outpatient care, and on their healthcare journey through the outpatient healthcare system. In this article, we present the results focusing on patients’ perspectives of their medications from hospital to two months after discharge.

Study design

This qualitative longitudinal study, conducted from October 2020 to July 2021, used a qualitative descriptive methodology through four consecutive in-depth semi-structured interviews per participant at three, 10-, 30- and 60-days post-discharge, as illustrated in Fig.  1 . Longitudinal qualitative research is characterized by qualitative data collection at different points in time and focuses on temporality, such as time and change [ 58 , 59 ]. Qualitative descriptive studies aim to explore and describe the depth and complexity of human experiences or phenomena [ 60 , 61 , 62 ]. We focused our qualitative study on the 60 first days after discharge as this period is considered highly vulnerable and because studies often use 30- or 60-days readmission as an outcome measure [ 5 , 63 ].

This qualitative study follows the Consolidated Criteria for Reporting Qualitative Research (COREQ). Ethics committee approval was sought and granted by the Cantonal Research Ethics Commission, Geneva (CCER) (2020 − 01779).

Recruitment took place during participants’ hospitalization in the general internal medicine divisions at the Geneva University Hospitals in the canton of Geneva (500 000 inhabitants), Switzerland. Interviews took place at participants’ homes, in a private office at the University of Geneva, by telephone or by secure video call, according to participants’ preference. Informal caregivers could also participate alongside the participants.

Study flowchart

Researcher characteristics

All the researchers were trained in qualitative studies. The diabetologist and researcher (GG) who enrolled the patients in the study was involved directly or indirectly (advice asked to the Geneva University Hospital diabetes team of which he was a part) for most participants’ care during hospitalization. LS (Ph.D. student and community pharmacist) was unknown to participants and presented herself during hospitalization as a “researcher” and not as a healthcare professional to avoid any risk of influencing participants’ answers. This study was not interventional, and the interviewer (LS) invited participants to contact a healthcare professional for any questions related to their medication or medical issues.

Population and sampling strategy

Patients with type 2 diabetes were chosen as an example population to describe polypharmacy patients as these patients usually have several health issues and polypharmacy [ 20 , 22 , 25 ]. Inclusions criteria for the study were: adult patients with type 2 diabetes, with at least two other comorbidities, hospitalized for at least three days in a general internal medicine ward, with a minimum of one medication change during hospital stay, and who self-managed their medications once discharged home. Exclusion criteria were patients not reachable by telephone following discharge, unable to give consent (patients with schizophrenia, dementia, brain damage, or drug/alcohol misuse), and who could not communicate in French. A purposive sampling methodology was applied aiming to include participants with different ages, genders, types, and numbers of health conditions by listing participants’ characteristics in a double-entry table, available in Supplementary Material 1 , until thematic saturation was reached. Thematic saturation was considered achieved when no new code or theme emerged and new data repeated previously coded information [ 64 ]. The participants were identified if they were hospitalized in the ward dedicated to diabetes care or when the diabetes team was contacted for advice. The senior ward physician (GG) screened eligible patients and the interviewer (LS) obtained written consent before hospital discharge.

Data collection and instruments

Sociodemographic (age, gender, educational level, living arrangement) and clinical characteristics (reason for hospitalization, date of admission, health conditions, diabetes diagnosis, medications before and during hospitalization) were collected by interviewing participants before their discharge and by extracting participants’ data from electronic hospital files by GG and LS. Participants’ pharmacies were contacted with the participant’s consent to obtain medication records from the last three months if information regarding medications before hospitalization was missing in the hospital files.

Semi-structured interview guides for each interview (at three, 10-, 30- and 60-days post-discharge) were developed based on different theories and components of health behavior and medication adherence: the World Health Organization’s (WHO) five dimensions for adherence, the Information-Motivation-Behavioral skills model and the Social Cognitive Theory [ 65 , 66 , 67 ]. Each interview explored participants’ itinerary in the healthcare system and their perspectives on their medications. Regarding medications, the following themes were mentioned at each interview: changes in medications, patients’ understanding and implication; information on their medications, self-management of their medications, and patients’ medication adherence. Other aspects were mentioned in specific interviews: patients’ hospitalization and experience on their return home (interview 1), motivation (interviews 2 and 4), and patient’s feedback on the past two months (interview 4). Interview guides translated from French are available in Supplementary Material 2 . The participants completed self-reported and self-administrated questionnaires at different interviews to obtain descriptive information on different factors that may affect medication management and adherence: self-report questionnaires on quality of life (EQ-5D-5 L) [ 68 ], literacy (Schooling-Opinion-Support questionnaire) [ 69 ], medication adherence (Adherence Visual Analogue Scale, A-VAS) [ 70 ] and Belief in Medication Questionnaire (BMQ) [ 71 ] were administered to each participant at the end of selected interviews to address the different factors that may affect medication management and adherence as well as to determine a trend of determinants over time. The BMQ contains two subscores: Specific-Necessity and Specific-Concerns, addressing respectively their perceived needs for their medications, and their concerns about adverse consequences associated with taking their medication [ 72 ].

Data management

Informed consent forms, including consent to obtain health data, were securely stored in a private office at the University of Geneva. The participants’ identification key was protected by a password known only by MS and LS. Confidentiality was guaranteed by pseudonymization of participants’ information and audio-recordings were destroyed once analyzed. Sociodemographic and clinical characteristics, medication changes, and answers to questionnaires were securely collected by electronic case report forms (eCRFs) on RedCap®. Interviews were double audio-recorded and field notes were taken during interviews. Recorded interviews were manually transcribed verbatim in MAXQDA® (2018.2) by research assistants and LS and transcripts were validated for accuracy by LS. A random sample of 20% of questionnaires was checked for accuracy for the transcription from the paper questionnaires to the eCRFs. Recorded sequences with no link to the discussed topics were not transcribed and this was noted in the transcripts.

Data analysis

A descriptive statistical analysis of sociodemographic, clinical characteristics and self-reported questionnaire data was carried out. A thematic analysis of transcripts was performed, as described by Braun and Clarke [ 73 ], by following six steps: raw data was read, text segments related to the study objectives were identified, text segments to create new categories were identified, similar or redundant categories were reduced and a model that integrated all significant categories was created. The analysis was conducted in parallel with patient enrolment to ensure data saturation. To ensure the validity of the coding method, transcripts were double coded independently and discussed by the research team until similar themes were obtained. The research group developed and validated an analysis grid, with which LS coded systematically the transcriptions and met regularly with the research team to discuss questions on data analysis and to ensure the quality of coding. The analysis was carried out in French, and the verbatims of interest cited in the manuscript were translated and validated by a native English-speaking researcher to preserve the meaning.

In this analysis, we used the term “healthcare professionals” when more than one profession could be involved in participants’ medication management. Otherwise, when a specific healthcare professional was involved, we used the designated profession (e.g. physicians, pharmacists).

Patient and public involvement

During the development phase of the study, interview guides and questionnaires were reviewed for clarity and validity and adapted by two patient partners, with multiple health conditions and who experienced previously a hospital discharge. They are part of the HUG Patients Partners + 3P platform for research and patient and public involvement.

Interviews and participants’ descriptions

A total of 75 interviews were conducted with 21 participants. In total, 31 patients were contacted, seven refused to participate (four at the project presentation and three at consent), two did not enter the selection criteria at discharge and one was unreachable after discharge. Among the 21 participants, 15 participated in all interviews, four in three interviews, one in two interviews, and one in one interview, due to scheduling constraints. Details regarding interviews and participants characteristics are presented in Tables  1 and 2 .

The median length of time between hospital discharge and interviews 1,2,3 and 4 was 5 (IQR: 4–7), 14 (13-20), 35 (22-38), and 63 days (61-68), respectively. On average, by comparing medications at hospital admission and discharge, a median of 7 medication changes (IQR: 6–9, range:2;17) occurred per participant during hospitalization and a median of 7 changes (5–12) during the two months following discharge. Details regarding participants’ medications are described in Table  3 .

Patient self-reported adherence over the past week for their three most challenging medications are available in Supplementary Material 3 .

Qualitative analysis

We defined care transition as the period from discharge until the first medical appointment post-discharge, and outpatient care as the period starting after the first medical appointment. Data was organized into three key themes (A. Medication management, B. Medication understanding, and C. Medication adherence) divided into subthemes at three time points (1. Hospitalization, 2. Care transition and 3. Outpatient care). Figure  2 summarizes and illustrates the themes and subthemes with their influencing factors as bullet points.

Participants’ medication management, understanding and adherence during hospitalization, care transition and outpatient care

A. Medication management

A.1 medication management during hospitalization: medication management by hospital staff.

Medications during hospitalization were mainly managed by hospital healthcare professionals (i.e. nurses and physicians) with varying degrees of patient involvement: “At the hospital, they prepared the medications for me. […] I didn’t even know what the packages looked like.” Participant 22; interview 1 (P22.1) Some participants reported having therapeutic education sessions with specialized nurses and physicians, such as the explanation and demonstration of insulin injection and glucose monitoring. A patient reported that he was given the choice of several treatments and was involved in shared decision-making. Other participants had an active role in managing and optimizing dosages, such as rapid insulin, due to prior knowledge and use of medications before hospitalization.

A.2 Medication management at transition: obtaining the medication and initiating self-management

Once discharged, some participants had difficulties obtaining their medications at the pharmacy because some medications were not stored and had to be ordered, delaying medication initiation. To counter this problem upstream, a few participants were provided a 24-to-48-hour supply of medications at discharge. It was sometimes requested by the patient or suggested by the healthcare professionals but was not systematic. The transition from medication management by hospital staff to self-management was exhausting for most participants who were faced with a large amount of new information and changes in their medications: “ When I was in the hospital, I didn’t even realize all the changes. When I came back home, I took away the old medication packages and got out the new ones. And then I thought : « my God, all this…I didn’t know I had all these changes » ” P2.1 Written documentation, such as the discharge prescription or dosage labels on medication packages, was helpful in managing their medication at home. Most participants used weekly pill organizers to manage their medications, which were either already used before hospitalization or were introduced post-discharge. The help of a family caregiver in managing and obtaining medications was reported as a facilitator.

A.3 Medication management in outpatient care: daily self-management and medication burden

A couple of days or weeks after discharge, most participants had acquired a routine so that medication management was less demanding, but the medication burden varied depending on the participants. For some, medication management became a simple action well implemented in their routine (“It has become automatic” , P23.4), while for others, the number of medications and the fact that the medications reminded them of the disease was a heavy burden to bear on a daily basis (“ During the first few days after getting out of the hospital, I thought I was going to do everything right. In the end, well [laughs] it’s complicated. I ended up not always taking the medication, not monitoring the blood sugar” P12.2) To support medication self-management, some participants had written documentation such as treatment plans, medication lists, and pictures of their medication packages on their phones. Some participants had difficulties obtaining medications weeks after discharge as discharge prescriptions were not renewable and participants did not see their physician in time. Others had to visit multiple physicians to have their prescriptions updated. A few participants were faced with prescription or dispensing errors, such as prescribing or dispensing the wrong dosage, which affected medication management and decreased trust in healthcare professionals. In most cases, according to participants, the pharmacy staff worked in an interprofessional collaboration with physicians to provide new and updated prescriptions.

B. Medication understanding

B.1 medication understanding during hospitalization: new information and instructions.

The amount of information received during hospitalization varied considerably among participants with some reporting having received too much, while others saying they received too little information regarding medication changes, the reason for changes, or for introducing new medications: “They told me I had to take this medication all my life, but they didn’t tell me what the effects were or why I was taking it.” P5.3

Hospitalization was seen by some participants as a vulnerable and tiring period during which they were less receptive to information. Information and explanations were generally given verbally, making it complicated for most participants to recall it. Some participants reported that hospital staff was attentive to their needs for information and used communication techniques such as teach-back (a way of checking understanding by asking participants to say in their own words what they need to know or do about their health or medications). Some participants were willing to be proactive in the understanding of their medications while others were more passive, had no specific needs for information, and did not see how they could be engaged more.

B.2 Medication understanding at transition: facing medication changes

At hospital discharge, the most challenging difficulty for participants was to understand the changes made regarding their medications. For newly diagnosed participants, the addition of new medications was more difficult to understand, whereas, for experienced participants, changes in known medications such as dosage modification, changes within a therapeutic class, and generic substitutions were the most difficult to understand. Not having been informed about changes caused confusion and misunderstanding. Therefore, medication reconciliation done by the patient was time-consuming, especially for participants with multiple medications: “ They didn’t tell me at all that they had changed my treatment completely. They just told me : « We’ve changed a few things. But it was the whole treatment ». ” P2.3 Written information, such as the discharge prescription, the discharge report (brief letter summarizing information about the hospitalization, given to the patient at discharge), or the label on the medication box (written by the pharmacist with instructions on dosage) helped them find or recall information about their medications and diagnoses. However, technical terms were used in hospital documentations and were not always understandable. For example, this participant said: “ On the prescription of valsartan, they wrote: ‘resume in the morning once profile…’[once hypertension profile allows]… I don’t know what that means.” P8.1 In addition, some documents were incomplete, as mentioned by a patient who did not have the insulin dosage mentioned on the hospital prescription. Some participants sought help from healthcare professionals, such as pharmacists, hospital physicians, or general practitioners a few days after discharge to review medications, answer questions, or obtain additional information.

B.3 Medication understanding in the outpatient care: concerns and knowledge

Weeks after discharge, most participants had concerns about the long-term use of their medications, their usefulness, and the possible risk of interactions or side effects. Some participants also reported having some lack of knowledge regarding indications, names, or how the medication worked: “I don’t even know what Brilique® [ticagrelor, antiplatelet agent] is for. It’s for blood pressure, isn’t it?. I don’t know.” P11.4 According to participants, the main reasons for the lack of understanding were the lack of information at the time of prescribing and the large number of medications, making it difficult to search for information and remember it. Participants sought information from different healthcare professionals or by themselves, on package inserts, through the internet, or from family and friends. Others reported having had all the information needed or were not interested in having more information. In addition, participants with low medication literacy, such as non-native speakers or elderly people, struggled more with medication understanding and sought help from family caregivers or healthcare professionals, even weeks after discharge: “ I don’t understand French very well […] [The doctor] explained it very quickly…[…] I didn’t understand everything he was saying” P16.2

C. Medication adherence

C.2 medication adherence at transition: adopting new behaviors.

Medication adherence was not mentioned as a concern during hospitalization and a few participants reported difficulties in medication initiation once back home: “I have an injection of Lantus® [insulin] in the morning, but obviously, the first day [after discharge], I forgot to do it because I was not used to it.” P23.1 Participants had to quickly adopt new behaviors in the first few days after discharge, especially for participants with few medications pre-hospitalization. The use of weekly pill organizers, alarms and specific storage space were reported as facilitators to support adherence. One patient did not initiate one of his medications because he did not understand the medication indication, and another patient took her old medications because she was used to them. Moreover, most participants experienced their hospitalization as a turning point, a time when they focused on their health, thought about the importance of their medications, and discussed any new lifestyle or dietary measures that might be implemented.

C.3 Medication adherence in outpatient care: ongoing medication adherence

More medication adherence difficulties appeared a few weeks after hospital discharge when most participants reported nonadherence behaviors, such as difficulties implementing the dosage regimen, or intentionally discontinuing the medication and modifying the medication regimen on their initiative. Determinants positively influencing medication adherence were the establishment of a routine; organizing medications in weekly pill-organizers; organizing pocket doses (medications for a short period that participants take with them when away from home); seeking support from family caregivers; using alarm clocks; and using specific storage places. Reasons for nonadherence were changes in daily routine; intake times that were not convenient for the patient; the large number of medications; and poor knowledge of the medication or side effects. Healthcare professionals’ assistance for medication management, such as the help of home nurses or pharmacists for the preparation of weekly pill-organizers, was requested by participants or offered by healthcare professionals to support medication adherence: “ I needed [a home nurse] to put my pills in the pillbox. […] I felt really weak […] and I was making mistakes. So, I’m very happy [the doctor] offered me [home care]. […] I have so many medications.” P22.3 Some participants who experienced prehospitalization non-adherence were more aware of their non-adherence and implemented strategies, such as modifying the timing of intake: “I said to my doctor : « I forget one time out of two […], can I take them in the morning? » We looked it up and yes, I can take it in the morning.” P11.2 In contrast, some participants were still struggling with adherence difficulties that they had before hospitalization. Motivations for taking medications two months after discharge were to improve health, avoid complications, reduce symptoms, reduce the number of medications in the future or out of obligation: “ I force myself to take them because I want to get to the end of my diabetes, I want to reduce the number of pills as much as possible.” P14.2 After a few weeks post-hospitalization, for some participants, health and illness were no longer the priority because of other life imperatives (e.g., family or financial situation).

This longitudinal study provided a multi-faceted representation of how patients manage, understand, and adhere to their medications from hospital discharge to two months after discharge. Our findings highlighted the varying degree of participants’ involvement in managing their medications during their hospitalization, the individualized needs for information during and after hospitalization, the complicated transition from hospital to autonomous medication management, the adaptation of daily routines around medication once back home, and the adherence difficulties that surfaced in the outpatient care, with nonadherence prior to hospitalization being an indicator of the behavior after discharge. Finally, our results confirmed the lack of continuity in care and showed the lack of patient care standardization experienced by the participants during the transition from hospital to outpatient care.

This in-depth analysis of patients’ experiences reinforces common challenges identified in the existing literature such as the lack of personalized information [ 9 , 10 , 11 ], loss of autonomy during hospitalization [ 14 , 74 , 75 ], difficulties in obtaining medication at discharge [ 11 , 45 , 76 ] and challenges in understanding treatment modifications and generics substitution [ 11 , 32 , 77 , 78 ]. Some of these studies were conducted during patients’ hospitalization [ 10 , 75 , 79 ] or up to 12 months after discharge [ 80 , 81 ], but most studies focused on the few days following hospital discharge [ 9 , 11 , 14 , 82 ]. Qualitative studies on medications at transition often focused on a specific topic, such as medication information, or a specific moment in time, and often included healthcare professionals, which muted patients’ voices [ 9 , 10 , 11 , 47 , 49 ]. Our qualitative longitudinal methodology was interested in capturing the temporal dynamics, in-depth narratives, and contextual nuances of patients’ medication experiences during transitions of care [ 59 , 83 ]. This approach provided a comprehensive understanding of how patients’ perspectives and behaviors evolved over time, offering insights into the complex interactions of medication management, understanding and adherence, and turning points within their medication journeys. A qualitative longitudinal design was used by Fylan et al. to underline patients’ resilience in medication management during and after discharge, by Brandberg et al. to show the dynamic process of self-management during the 4 weeks post-discharge and by Lawton et al. to examine how patients with type 2 diabetes perceived their care after discharge over a period of four years [ 49 , 50 , 51 ]. Our study focused on the first two months following hospitalization and future studies should focus on following discharged and at-risk patients over a longer period, as “transitions of care do not comprise linear trajectories of patients’ movements, with a starting and finishing point. Instead, they are endless loops of movements” [ 47 ].

Our results provide a particularly thorough description of how participants move from a state of total dependency during hospitalization regarding their medication management to a sudden and complete autonomy after hospital discharge impacting medication management, understanding, and adherence in the first days after discharge for some participants. Several qualitative studies have described the lack of shared decision-making and the loss of patient autonomy during hospitalization, which had an impact on self-management and created conflicts with healthcare professionals [ 75 , 81 , 84 ]. Our study also highlights nuanced patient experiences, including varying levels of patient needs, involvement, and proactivity during hospitalization and outpatient care, and our results contribute to capturing different perspectives that contrast with some literature that often portrays patients as more passive recipients of care [ 14 , 15 , 74 , 75 ]. Shared decision-making and proactive medication are key elements as they contribute to a smoother transition and better outcomes for patients post-discharge [ 85 , 86 , 87 ].

Consistent with the literature, the study identifies some challenges in medication initiation post-discharge [ 16 , 17 , 88 ] but our results also describe how daily routine rapidly takes over, either solidifying adherence behavior or generating barriers to medication adherence. Participants’ nonadherence prior to hospitalization was a factor influencing participants’ adherence post-hospitalization and this association should be further investigated, as literature showed that hospitalized patients have high scores of non-adherence [ 89 ]. Mortel et al. showed that more than 20% of discharged patients stopped their medications earlier than agreed with the physician and 25% adapted their medication intake [ 90 ]. Furthermore, patients who self-managed their medications had a lower perception of the necessity of their medication than patients who received help, which could negatively impact medication adherence [ 91 ]. Although participants in our study had high BMQ scores for necessity and lower scores for concerns, some participants expressed doubts about the need for their medications and a lack of motivation a few weeks after discharge. Targeted pharmacy interventions for newly prescribed medications have been shown to improve medication adherence, and hospital discharge is an opportune moment to implement this service [ 92 , 93 ].

Many medication changes were made during the transition of care (a median number of 7 changes during hospitalization and 7 changes during the two months after discharge), especially medication additions during hospitalization and interruptions after hospitalization. While medication changes during hospitalization are well described, the many changes following discharge are less discussed [ 7 , 94 ]. A Danish study showed that approximately 65% of changes made during hospitalization were accepted by primary healthcare professionals but only 43% of new medications initiated during hospitalization were continued after discharge [ 95 ]. The numerous changes after discharge may be caused by unnecessary intensification of medications during hospitalization, delayed discharge letters, lack of standardized procedures, miscommunication, patient self-management difficulties, or in response to an acute situation [ 96 , 97 , 98 ]. During the transition of care, in our study, both new and experienced participants were faced with difficulties in managing and understanding medication changes, either for newly prescribed medication or changes in previous medications. Such difficulties corroborate the findings of the literature [ 9 , 10 , 47 ] and our results showed that the lack of understanding during hospitalization led to participants having questions about their medications, even weeks after discharge. Particular attention should be given to patients’ understanding of medication changes jointly by physicians, nurses and pharmacists during the transition of care and in the months that follow as medications are likely to undergo as many changes as during hospitalization.

Implication for practice and future research

The patients’ perspectives in this study showed, at a system level, that there was a lack of standardization in healthcare professional practices regarding medication dispensing and follow-up. For now, in Switzerland, there are no official guidelines on medication prescription and dispensation during the transition of care although some international guidelines have been developed for outpatient healthcare professionals [ 3 , 99 , 100 , 101 , 102 ]. Here are some suggestions for improvement arising from our results. Patients should be included as partners and healthcare professionals should systematically assess (i) previous medication adherence, (ii) patients’ desired level of involvement and (iii) their needs for information during hospitalization. Hospital discharge processes should be routinely implemented to standardize hospital discharge preparation, medication prescribing, and dispensing. Discharge from the hospital should be planned with community pharmacies to ensure that all medications are available and, if necessary, doses of medications should be supplied by the hospital to bridge the gap. A partnership with outpatient healthcare professionals, such as general practitioners, community pharmacists, and homecare nurses, should be set up for effective asynchronous interprofessional collaboration to consolidate patients’ medication management, knowledge, and adherence, as well as to monitor signs of deterioration or adverse drug events.

Future research should consolidate our first attempt to develop a framework to better characterize medication at the transition of care, using Fig. 2   as a starting point. Contextualized interventions, co-designed by health professionals, patients and stakeholders, should be tested in a hybrid implementation study to test the implementation and effectiveness of the intervention for the health system [ 103 ].

Limitations

This study has some limitations. First, the transcripts were validated for accuracy by the interviewer but not by a third party, which could have increased the robustness of the transcription. Nevertheless, the interviewer followed all methodological recommendations for transcription. Second, patient inclusion took place during the COVID-19 pandemic, which may have had an impact on patient care and the availability of healthcare professionals. Third, we cannot guarantee the accuracy of some participants’ medication history before hospitalization, even though we contacted the participants’ main pharmacy, as participants could have gone to different pharmacies to obtain their medications. Fourth, our findings may not be generalizable to other populations and other healthcare systems because some issues may be specific to multimorbid patients with type 2 diabetes or to the Swiss healthcare setting. Nevertheless, issues encountered by our participants regarding their medications correlate with findings in the literature. Fifth, only 15 out of 21 participants took part in all the interviews, but most participants took part in at least three interviews and data saturation was reached. Lastly, by its qualitative and longitudinal design, it is possible that the discussion during interviews and participants’ reflections between interviews influenced participants’ management, knowledge, and adherence, even though this study was observational, and no advice or recommendations were given by the interviewer during interviews.

Discharged patients are willing to take steps to better manage, understand, and adhere to their medications, yet they are also faced with difficulties in the hospital and outpatient care. Furthermore, extensive changes in medications not only occur during hospitalization but also during the two months following hospital discharge, for which healthcare professionals should give particular attention. The different degrees of patients’ involvement, needs and resources should be carefully considered to enable them to better manage, understand and adhere to their medications. At a system level, patients’ experiences revealed a lack of standardization of medication practices during the transition of care. The healthcare system should provide the ecosystem needed for healthcare professionals responsible for or involved in the management of patients’ medications during the hospital stay, discharge, and outpatient care to standardize their practices while considering the patient as an active partner.

Data availability

The anonymized quantitative survey datasets and the qualitative codes are available in French from the corresponding author on reasonable request.

Abbreviations

adverse drug events

Adherence Visual Analogue Scale

Belief in Medication Questionnaire

Consolidated Criteria for Reporting Qualitative Research

case report form

standard deviation

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Acknowledgements

The authors would like to thank all the patients who took part in this study. We would also like to thank the Geneva University Hospitals Patients Partners + 3P platform as well as Mrs. Tourane Corbière and Mr. Joël Mermoud, patient partners, who reviewed interview guides for clarity and significance. We would like to thank Samuel Fabbi, Vitcoryavarman Koh, and Pierre Repiton for the transcriptions of the audio recordings.

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LS, GG, and MS conceptualized and designed the study. LS and GG screened and recruited participants. LS conducted the interviews. LS, GG, and MS performed data analysis and interpretation. LS drafted the manuscript and LS and MS worked on the different versions. MS and GG approved the final manuscript.

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Solh Dost, L., Gastaldi, G. & Schneider, M. Patient medication management, understanding and adherence during the transition from hospital to outpatient care - a qualitative longitudinal study in polymorbid patients with type 2 diabetes. BMC Health Serv Res 24 , 620 (2024). https://doi.org/10.1186/s12913-024-10784-9

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