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Characteristics of coders
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There is a growing awareness and interest in the development of culturally competent health knowledge. Drawing on experience using a qualitative approach to elicit information from Mandarin- or Cantonese-speaking participants for a colorectal cancer prevention study, the authors describe lessons learned through the analysis process. These lessons i...
Citations
... Correspondingly, it is preferable to avoid (or minimise) linguistic and cultural barriers between participants, the moderator, and/or, subsequently, the researchers (involved in the analytical cycle). It is recognised that translation and other language assistance can be sources of inaccuracy or misinterpretation in cross-language research (Tsai et al. 2004;Wallin & Ahlstrom 2006). ...
... Finally, the data collected from the participants were analyzed using Collaizzi's Phenomenological methodology, a method that ensures the credibility and reliability of the study results. (Tsai, 2004) Collaizzi's Phenomenological methodology helps in exploring the fundamental structure of an experience explored in a clear and logical way. ...
Back ground / Purpose Breast cancer is now the most common cancer among women in most urban areas in India and the second most common in the rural areas. The aim of the study was to examine the lived experiences of rural women with low socioeconomic backgrounds who have undergone mastectomies for breast cancer. Method: Using a phenomenological method, semi-structured interviews were conducted that asked about knowledge, challenges, coping and spirituality with 23 rural women from low socioeconomic status and agricultural backgrounds. The interviews were analyzed for themes that described their experiences. Several themes emerged from the data. These included ignorance about the disease, feelings of guilt, financial crisis, fear of change in intimate relationships, importance of spirituality, poor support systems and financial hardship. Conclusion: In India, there are very few cancer studies on rural populations yet the incidence of cancer in this population is increasing. Future studies need to focus on the rural population in order to educate them about the disease and to assist access to treatment, and psychological support. Emotional distress and lack of knowledge could be addressed by psychosocial education. Community based approaches are needed to develop culturally appropriate interventions empowering the women and enhancing their self-efficacy.
... Those the core writing team for this article, (MDC, DØ, PD, SS) are either native Danish speakers or lived in Denmark for more than 10 years and consider themselves able to handle the Danish transcripts and able to translate them into English for further processing. During the data processing, all researchers discussed the interpretation of the findings repeatedly, to reduce the challenges that lie in working in several languages [19,20]. Table 1 provides an overview of the analysis steps. ...
Background: Simulation-based learning (SBL), used for achieving various learning goals, is spreading around the world. However, it is still open, to what extend SBL needs to be adapted to local cultures. This study aimed to explore how various stakeholder groups perceive what constitutes a competent simulation facilitator across three different countries.
Methods: We conducted an interview study with learners, facilitators, and facilitator trainers. Semi-structured interviews with 75 participants underwent content analysis. Participants were recruited from Denmark, Korea, and Australia. Interviews focused on characteristics of simulation faculty, as well as educational behaviours. Interviews were audio-recorded, translated to English, transcribed, and content analysed by inductively developing codes using the Nvivo software. In the first coding round, each interview was treated separately. In the analysis round, the individual codes between countries and stakeholder groups were compared to identify similarities and differences.
Results: Our study shows high demands for the simulation facilitator role. A competent simulation facilitator should possess the following characteristics: (1) subject matter expertise, (2) personal approach and traits, (3) self-awareness and reflection, and (4) communication skills. Educational behaviours comprised (1) supporting a safe learning environment, 2) working goal-oriented with the course, (3) engaging before the course with preparation, (4) leading scenarios, and (5) facilitating debriefings. Comparative analysis showed similar wishes towards simulation facilitators from the different stakeholders in different countries, though the same terms might mean different details in the various settings.
Conclusions: These findings offer guidance for learning needs analysis and the establishment of faculty development programmes. The study also shows that the personal characteristics are an important aspect of the facilitator role above and beyond displaying educational behaviours.
... Language is not only a technical means of communication but also an important factor in conveying values and beliefs which include cultural meanings (Temple, 2002). The accuracy of cross-cultural qualitative research is therefore threatened if the researcher(s) are not able to speak the local language (Tsai et al., 2004). Even if there are local translators, the risk of misunderstanding an informant's responses is still high, and the meaning of the data may not be accurately captured (Chiumento et al., 2018). ...
With the development of globalization and the mobility of academics, there is an increasing opportunity for cooperation in intercultural research. This however raises questions about the advantages and disadvantages of being a cultural insider and outsider in such an endeavour. This paper considers the methodological complexities of intercultural research revealed during the collaborative research undertaken in rural China by the two authors, one English and one Chinese. Questions emerged about how to maintain objectivity, integrity, and confidentiality within intercultural settings. As such, it provides many useful insights for researchers carrying out collaborative research in intercultural settings, whether as an insider or outsider. This study also contributes to the English literature on methodological studies in rural China.
... During the analysis and interpretation stages of qualitative research, power differentials as well as language differences can create a challenge for validity (Hennink, 2008). Translation, for example, can pose a major threat to validity given difficulties in conveying cultural and language nuances (Esposito, 2001;Tsai et al., 2004;Wong & Poon, 2010). ...
... While there is a growing literature addressing frameworks for equitable collaboration between academic researchers and community partners (Pratt, 2021), less is known about how researchers themselves can form and maintain meaningful transnational collaborations. The small existing literature has focused primarily on translation and language challenges (Chiumento et al., 2018;Tsai et al., 2004), working with cultural brokers (Hennink, 2008), and positionality of research team members (Coloma, 2008). However, guidance for transnational teams that encompasses all aspects of the research endeavor, from formation of the team to dissemination of the findings, to our knowledge, has not been provided (Liamputtong, 2010). ...
... By removing coding silos (i.e., coding teams assigned by language only, Thai or English), this approach was better able to illuminate cultural nuances, address coding discrepancies more efficiently, and bring forward discussions around the complex nature of well-being and how it was manifested in the data. This approach also addresses recommendations in the literature for including insiders and outsiders as coders to ensure accurate interpretation of participants' narratives (Suwankhong & Liamputtong, 2015;Tsai et al., 2004;Wong & Poon, 2010). While our approach has several strengths and opportunities to enhance rigor in analysis and interpretation, this approach also has challenges and limitations including being labor and time intensive in nature. ...
Qualitative scholars are increasingly engaged in global research where members of the research team are from different countries and cultures and have different primary languages. However, in-depth descriptions of how to work as a transnational team successfully and rigorously are scarce. Using a collaboration between Stanford University in the US and Chulalongkorn University in Thailand as a case example, we present the nuances and challenges experienced in this research collaboration, as well as the strategies employed to optimize the validity and reliability of the study findings. While we started our data analysis following a more typical qualitative analysis path, shortcomings of this approach brought us to explore an alternative, involving data review and coding by transnational coding sub-teams. This approach was better able to illuminate cultural nuances, address coding discrepancies, and bring forward discussions to enhance interpretation and validity of findings. We describe our collaborative and iterative approach, and highlight methodological implications around team composition, language nuances and translation challenges, our coding process involving transnational coding sub-teams, and important considerations for managing team dynamics (e.g., power and hierarchy) and the partnership process and engagement over time. Moreover, we highlight the benefits of integrating insiders and outsiders throughout the research process, from data collection to coding and interpretation. Our process can serve as a model for similar transnational teams seeking ways to fully benefit from cross-cultural research collaborations.
... Several meetings among the research team were held to review data analysis, nascent themes and the need for further data collection. N.B. also discussed data interpretation with language interpreters and bilingual research assistants to add cultural context and minimise misinterpretation (Tsai et al., 2004). ...
Objective
In low tuberculosis (TB) incidence countries, linguistic and cultural dissonance between families experiencing infectious TB and TB health care providers is a barrier to effective communication and successful treatment. The purpose of this research was to explore infectious TB education and counselling from the perspective of patients and family members who are foreign-born.
Design/Setting
One component of a multiphase, qualitative case study conducted in Calgary, a large city in western Canada.
Method
Data were collected through semi-structured interviews, chart review and field notes and analysed thematically. Eight families were represented in the 6 patient and 13 family member participants who had recently experienced infectious TB.
Results
Three themes were generated from the data: ‘learning about TB from many sources’, ‘reassurance and connection’ and ‘missing information’. Participants described learning about TB in different ways, feeling reassured once they knew more and sharing information with others. Overall, participants expressed satisfaction with education and counselling received. However, there were indications that communication problems had occurred. Participants asked questions during the interview, described areas of lingering confusion and shared TB-related behaviours incongruent with medical understanding. Knowledge gaps often increased isolation.
Conclusion
Gaps in infectious TB education and counselling have negative impacts on patient and family member well-being. Education and counselling can be improved using multiple modes of communication, proactively addressing common misperceptions and reducing barriers to patient participation. Improvements could empower families to better manage their own experience and share accurate TB information with their communities.
... Even if they are included, cross-cultural researchers often contribute only to certain phases of research, such as recruitment or interviewing, rather than the development of study design, choice of data collection instruments, and other conceptual and methodological phases (Berman & Tyyska, 2011). As a result, cross-cultural researchers often have limited methodological guidance (Tsai et al., 2004). ...
While a growing body of research has examined immigrants' health generally, less is known specifically about the impact of immigration policy on the health of Chinese immigrants, the second-largest foreign-born population in the United States. This is due, in part, to the lack of methodologically well-trained, cross-cultural researchers who have both the cultural and linguistic expertise and health knowledge to engage with Chinese immigrant populations. This paper addresses this gap by examining Chinese cross-cultural researchers' roles in the qualitative phase of the Research on ImmiGrant HealTh and State policy (RIGHTS) project, which sought to assess how immigration policies shaped Chinese and other immigrants' experiences in healthcare and other related sectors in California. We used reflexivity to assess Chinese cross-cultural researchers' posi-tionality of insiderness and outsiderness and its influence on the process of data collection (i.e., recruitment, conducting interviews, transcription, and translation). Our reflexivity guides the assessment of the opportunities (e.g., expanding the recruitment pool, engaging participants more effectively in interviews, ensuring data integrity, and discussing heterogeneity within the Chinese immigrant community) and challenges (e.g., the difficulty of recruiting low-income and undocumented immigrants, addressing participants' in-depth thoughts, the time-consuming nature of transcription and translation, and the assessment of power dynamics) in conducting immigrant health research with the Chinese community. These results highlight the need for cross-cultural researchers to help build trusting relationships with ethnic-minority communities, thus gaining new insights and advancing knowledge within the field of ethnic minority health research. These insights can guide future investigations of Chinese and other immigrant communities as research on immigration policy and health expands.
... Third, they must make culturally-sensitive decisions around how rapport-building, positionality, and reflexivity will be navigated at each site (Mendenhall, 2019;Manohar et al., 2017;Pacheco-Vega, 2020;Suwankhong & Liamputtong, 2015). Then, to perform cross-cultural analyses, researchers must produce meaningful translations that require careful translation and back-translation (Behr, 2017;Choi et al., 2012;Hennink, 2008;Regmi et al., 2010;Tsai et al., 2004). Finally, researchers must make complex and intersecting analytic decisions about how to compare texts generated across research groups (Quintanilha et al., 2015;Wendt, 2020). ...
In recent years, there has been a florescence of cross-cultural research using ethnographic and qualitative data. This cutting-edge work confronts a range of significant methodological challenges, but has not yet addressed how thematic analysis can be modified for use in cross-cultural ethnography. Thematic analysis is widely used in qualitative and mixed-methods research, yet is not currently well-adapted to cross-cultural ethnographic designs. We build on existing thematic analysis techniques to discuss a method to inductively identify metathemes (defined here as themes that occur across cultures). Identifying metathemes in cross-cultural research is important because metathemes enable researchers to use systematic comparisons to identify significant patterns in cross-cultural datasets and to describe those patterns in rich, contextually-specific ways. We demonstrate this method with data from a collaborative cross-cultural ethnographic research project (exploring weight-related stigma) that used the same sampling frame, interview protocol, and analytic process in four cross-cultural research sites in Samoa, Paraguay, Japan, and the United States. Detecting metathemes that transcend data collected in different languages, cultures, and sites, we discuss the benefits and challenges of qualitative metatheme analysis.
... Translation serves as an important educational tool for health education and health promotion among multilingual and multicultural populations [1][2][3]. Health literacy research shows that improving the linguistic accessibility and understandability of health translations can have an important impact on the uptake of health recommendations by medical professionals and health authorities [4]. Current approaches to multicultural health resource evaluation are chiefly qualitative and use clinically developed guidelines or the judgement of health professionals [5,6]. ...
Background
Linguistic accessibility has an important impact on the reception and utilization of translated health resources among multicultural and multilingual populations. Linguistic understandability of health translation has been understudied.
Objective
Our study aimed to develop novel machine learning models for the study of the linguistic accessibility of health translations comparing Chinese translations of the World Health Organization health materials with original Chinese health resources developed by the Chinese health authorities.
Methods
Using natural language processing tools for the assessment of the readability of Chinese materials, we explored and compared the readability of Chinese health translations from the World Health Organization with original Chinese materials from the China Center for Disease Control and Prevention.
ResultsA pairwise adjusted t test showed that the following 3 new machine learning models achieved statistically significant improvement over the baseline logistic regression in terms of area under the curve: C5.0 decision tree (95% CI –0.249 to –0.152; P
... Conducting cross-cultural and cross-language research can be challenging, and the person interviewed might not trust a stranger or worry about the confidentiality of the interview ( Wallin and Ahlström, 2006 ). Moreover, barriers related to culture or language may constrain an interviewer in the encounter with a person with an immigrant background ( Tsai et al., 2004 ). ...
Objective:
To explore Somali women's experiences of antenatal care in Norway.
Design:
A qualitative study based on individual semi-structured interviews conducted either face-to-face or over the phone.
Setting:
Norway.
Participants:
Eight Somali-born women living in Norway.
Key findings:
Four themes were generated from the analysis. From their experiences of antenatal care in Norway, the Somali women described: 1) when care was provided in a way that gained their trust, they made better use of the available health services, 2) the importance of continuity of care and of sharing commonalities with the caregiver, 3) a need for accessible information, specifically tailored to the needs of Somali women and 4) how culturally insensitive caregivers had a negative impact on the quality of care.
Conclusion and implications for practice:
The Somali women in this study were grateful for the care provided, although the quality of antenatal care did not always meet their needs. This study should serve as a reminder of the importance of establishing trust between the pregnant woman and the caregiver, strengthening interpretation services and assuring tailored information is available to Somali women at an early stage. The findings further suggest that antenatal care for Somali women may be improved by offering continuity of care and improving clinical and cultural skills in clinicians. Suggestions for practice, and future research, include initiating group antenatal care especially tailored to Somali women.
