This paper is critical review of qualitative research on the influence of socio-cultural aspects on tuberculosis-related stigma among non-affected persons. The study is conducted with Haitians living in Florida, United States, and in Haiti. The paper provides a critical and analytical review of the purpose of the study, the study design, theory that guided the research, the methodology, instruments used and the data analysis procedures, limitations of the study and strengths of the research. The paper also reviews the implications of the findings of the study, applicability and the ethical considerations involved in this research.
Qualitative Nursing Research on Haitians
This paper is a review of qualitative research conducted on the Haitian population in two contexts; Haiti and South Florida in U.S.A. The paper provides a critical review of the purpose of the study, the study design, theory that guided the research, the methodology, instruments used and the data analysis procedures, limitations of the study and strengths of the research. The paper also reviews the implications of the findings of the study, its applicability and the ethical considerations.
The purpose of this study was to investigate how socio-cultural contexts influence perceived components of tuberculosis-related stigma in non-affected persons (Jeannine, ladys, Kelly, Michael, Yiliang, & Mitchell, 2010). The research adopted qualitative research design. Specifically, this research was comparative in nature since it involved comparison of tuberculosis-related stigma in two socio-cultural contexts. The study was two-phased and used the methods of cultural epidemiology.
The research instruments that the study used included stigma scales which collected data on stigmatizing aspects of tuberculosis, focus group discussion guides which helped in directing discussions in the focus groups, and interview guides, which were used to collect data from the key informants (Jeannine et al, 2010). The methodology adopted was that of a comparative study or comparative analysis of the Haitians in the two socio-cultural contexts. Being a qualitative study, the researchers applied methods of cultural epidemiology collect ethnographic data on the cultural contexts and components of tuberculosis-related stigma. The theory that guided the study was ground theory.
The data analysis procedures that this study applied were guided, to large extent, by the nature of the design (Jeannine et al, 2010). Since this was a qualitative study, appropriate procedures for measuring qualitative data were necessary. The thematic analysis focused on tuberculosis stigma components that were expressed and captured in the interviews, focus group discussions. The use of observation revealed the distinctive emphases of tuberculosis stigma among Haitians in South Florida, U.S.A and in Haiti. Factor analysis was used to analyze the stigma scale scores and helped in confirming the thematic differences revealed by the analysis of and finding from the ethnographic data (Jeannine et al, 2010).
The findings of the study matched its objectives. The study results indicated that socio-cultural context of Haitians influenced the perceived tuberculosis-related stigma of non-affected persons. For example, the study found political and economic factors helped in shaping the meaning and the experiences of tuberculosis-related illnesses (Jeannine et al, 2010). The study also revealed that tuberculosis stigma among Haitians in South Florida integrated aspects of their identity as a negatively-stereotyped minority group with a larger, racially segregated society. The study thus confirmed that tuberculosis-associated stigma was influenced by socio-cultural aspects of the victims. These include politics, economic status, institutional policies, and structures for delivering health services (Juniarti and Evans, 2011). The tuberculosis stigma among the immigrant communities was also found to be compounded by the racial stereotypes and prejudicial perceptions immigrant communities by the natives.
In Haiti, tuberculosis stigma was significantly associated and compounded by poverty, malnutrition, and HIV/AIDS infections (Jeannine et al, 2010). The study thus confirmed that tuberculosis-associated stigma was influenced by socio-cultural aspects of the victims. These include politics, economic status, institutional policies, and structures for delivering health services (Juniarti and Evans, 2011).
This study was thus timely and instrumental in influencing and informing policy makers in the health service delivery to formulate policies that will be favorable to the already tuberculosis-stigmatized immigrant communities. Such policies should thus build structures for improved accessibility and effectiveness of healthcare services for the immigrant and minority communities. The ethical considerations included confidential treatment of the data collected from the participants. They were assured that the data will be used purely for the purposes of the study. Besides, all the participants were recruited after voluntary acceptance and informed consent was secured by the researchers. The study also informed the participants of the potential benefits of voluntary participation in the study. The researcher, therefore, explained to the participants that what the researchers were interested in was collection of data that can then be used to recommend policy legislations that will improve the welfare of the participants.
The strength of this study is in the way it accurately applied qualitative design in terms of data collection tools, data analysis and presentation of the findings. However, the weaknesses of this study are the limitations that are common with qualitative research and its design (Rahill, Rosa & Edwards, 2012; Thorne, 2011). This study can be biased since it does not allow for random sampling of the participants. Thus inferential analysis becomes challenging and thus external validity might be difficult to achieve (Polit & Beck, 2010).
This study was largely objective. Its limitations create room for further studies that apply both qualitative and quantitative designs so as to enhance triangulation and limitation of the weaknesses associated with qualitative research designs. Thus, more studies should be conducted, especially focusing on the context specific tuberculosis-related stigma and the possible interventions that are relevant to such specific contexts.
In conclusion, this study applied qualitative techniques that are relevant to any qualitative research. In the general evaluation, the study was able to meet its objectives through the methods proposed and used in the development and implementation of the planned study. Although there may be some limitations, the study displayed a significant operationalization of the of the conventional qualitative study methods. The strengths, by far surpasses the weaknesses that a critical analysis of the study can cite. The areas of weaknesses can thus be used for future research improvement.
Jeannine, C., ladys, M., Kelly, S.M., Michael, L., Yiliang, Z. & Mitchell, W. (2010).”Structural forces and the production of TB-related stigma among Haitians in two contexts”. Social Science and Medicine 71, (8):1409-1417.
Juniarti, N. and Evans, D. (2011). “A qualitative review: the stigma of tuberculosis”. Journal of Clinical Nursing, 20: 1961-1970.
Polit, D.F.& Beck, C.T. (2010). “Generalization in quantitative and qualitative research: Myths and strategies”. International Journal of Nursing Studies, 47 (11): 1451-1458
Rahill, G. J., Rosa, M. D., & Edwards, B. (2012). “Insights and Practical Strategies for Health Research Among Haitian Immigrants: Lessons Learned From the Miami-Dade Picuriste Study”. Journal of Immigrant & Refugee Studies, 10 (1): 1961-1970.
Thorne, S. (2011). “Toward methodological emancipation in applied health research”. Qualitative Health Research, 21(4): 443-453.