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Snowball Sampling: A Purposeful Method of Sampling in Qualitative Research

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DOI:10.5812/sdme.67670

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Authors:

Mahin Naderifar

Zabol University Of Medical Sciences

Hamideh Goli

Sabzevar University of Medical Sciences

Fereshteh Ghaljaei

Zahedan University of Medical Sciences

Background and Objectives Snowball sampling is applied when samples with the target characteristics are not easily accessible. This research describes snowball sampling as a purposeful method of data collection in qualitative research. Methods This paper is a descriptive review of previous research papers. Data were gathered using English keywords, including “review,” “declaration,” “snowball,” and “chain referral,” as well as Persian keywords that are equivalents of the following: “purposeful sampling,” “snowball,” “qualitative research,” and “descriptive review.” The databases included Google Scholar, Scopus, Irandoc, ProQuest, Science Direct, SID, MagIran, Medline, and Cochrane. The search was limited to Persian and English articles written between 2005 and 2013. Results The preliminary search yielded 433 articles from PubMed, 88 articles from Scopus, 1 article from SID, and 18 articles from MagIran. Among 125 articles, methodological and non-research articles were omitted. Finally, 11 relevant articles, which met the criteria, were selected for review. Conclusions Different methods of snowball sampling can be applied to facilitate scientific research, provide community-based data, and hold health educational programs. Snowball sampling can be effectively used to analyze vulnerable groups or individuals under special care. In fact, it allows researchers to access susceptible populations. Thus, it is suggested to consider snowball sampling strategies while working with the attendees of educational programs or samples of research studies.

. General Data Gathered from the Selected Articles on the Snowball Sampling Method

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Strides Dev Med Educ. 2017 September; 14(3):e67670.

Published online 2017 September 30.

doi: 10.5812/sdme.67670.

Research Article

Snowball Sampling: A Purposeful Method of Sampling in Qualitative

Research

Mahin Naderifar,1Hamideh Goli,2and Fereshteh Ghaljaie3,*

1Department of Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, IR Iran

2Department of Nursing, Faculty of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran

3Community Nursing Research Center, Faculty of Nursing and Midwifery,Zahedan University of Medical Sciences, Zahedan, Iran

*Corresponding author: Fereshteh Ghaljaie, Community Nursing Research Center, Faculty of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran.

E-mail: ghaljaei_f@yahoo.com

Received 2016 November 29; Revised 2017 May 03; Accepted 2017 June 25.

Abstract

Background and Objectives: Snowball sampling is applied when samples with the target characteristics are not easily accessible.

This research describes snowball sampling as a purposeful method of data collection in qualitative research.

Methods: This paper is a descriptive review of previous research papers. Data were gathered using English keywords, including “re-

view,” “declaration,” “snowball,” and “chain referral,” as well as Persian keywords that are equivalents of the following: “purposeful

sampling,” “snowball,” “qualitative research,” and “descriptive review.” The databases included Google Scholar,Scopus, Irandoc, Pro-

Quest, Science Direct, SID, MagIran, Medline, and Cochrane. The search was limited to Persian and English articles written between

2005 and 2013.

Results: The preliminary search yielded 433 articles from PubMed, 88 articles from Scopus, 1 article from SID, and 18 articles from

MagIran. Among 125 articles, methodological and non-research articles were omitted. Finally, 11 relevant articles, which met the

criteria, were selected for review.

Conclusions: Diﬀerent methods of snowball sampling can be applied to facilitate scientiﬁc research, provide community-based

data, and hold health educational programs. Snowball sampling can be eﬀectively used to analyze vulnerable groups or individ-

uals under special care. In fact, it allows researchers to access susceptible populations. Thus, it is suggested to consider snowball

sampling strategies while working with the attendees of educational programs or samples of research studies.

Keywords: Purposeful Sampling, Snowball, Qualitative Research, Descriptive Review

1. Background

Qualitative research is an organized method of de-

scribing people’s experiences and internal feelings (1). It

can be said that qualitative research provides a thorough

and deep overview of a phenomenon through data col-

lection and presents a rich description using a ﬂexible

method of research. In this method, qualitative informa-

tion, which is gathered in the form of non-numerical data,

is presented (2).

There are diﬀerent methods to collect the required

data, including interviews, observations, focus groups,

narratives, notes, reports, and review of archives. The

researcher chooses the information with respect to the

questions, sensitivity of the subject, research samples, and

availability of resources (3). To determine the characteris-

tics of a community, it is possible to gather data by sam-

pling or census reports.

Sampling is the process of choosing a part of the popu-

lation to represent the whole. If the researcher considers a

part of the population as a representation of the whole, the

analysis will be more comprehensive (4). In many research

studies, factors such as lack of human resources, lack of

precision, high expenses, inadequate equipment, and pop-

ulation dispersion prevent researchers from studying the

entire population. In this case, it is preferable to study only

a part of the population (5).

Researchers should plan the sampling process and de-

termine the method of study. Sampling is performed in

two general ways: probability and nonprobability. In prob-

ability sampling methods, the rules of probability are ap-

plied, and as their main feature, each sample has a chance

to be selected. In these methods, the researcher’s opin-

ion or community members do not inﬂuence the selection

of samples. The selected sample is a representative of the

population, and the researcher can generalize the ﬁndings

to the whole population. Probability sampling methods

include simple random sampling, systematic sampling,

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Naderifar M et al.

stratiﬁed sampling, and cluster sampling.

On the other hand, nonprobability methods of sam-

pling involve samples that are available to the researcher

or are selected by the researcher. In these methods, not ev-

eryone has an equal chance of being selected, and it is not

clear who will be included in the ﬁnal sample. Regarding

the sampling method, generalization of the ﬁndings to the

entire population is not clear either, and one cannot calcu-

late the rate of error in the sampling. Diﬀerent methods of

nonprobability sampling include convenience, purpose-

ful, and quota sampling. In quantitative research, proba-

bility sampling is normally applied, whereas in qualitative

research, nonprobability sampling is selected (1).

The convenience sampling method includes members

of the population who are available to the researcher. For

instance, a lecturer who distributes questionnaires among

students has in fact used this method. Asking questions

from passers-by on the street is another example of this

method of sampling. This method is also called “acciden-

tal sampling” (1). Snowball sampling is a convenience sam-

pling method. This method is applied when it is diﬃ-

cult to access subjects with the target characteristics. In

this method, the existing study subjects recruit future sub-

jects among their acquaintances. Sampling continues un-

til data saturation (6).

As stated by Polit-O’Hara and Beck, this method, which

is also called the “chain method,” is eﬃcient and cost-

eﬀective to access people who would otherwise be very

diﬃcult to ﬁnd. In this method, the researcher asks the

ﬁrst few samples, who are usually selected via convenience

sampling, if they know anyone with similar views or situ-

ations to take part in the research. The snowball method

not only takes little time but also provides the researcher

with the opportunity to communicate better with the sam-

ples, as they are acquaintances of the ﬁrst sample, and the

ﬁrst sample is linked to the researcher (7). This type of net-

working is particularly useful for ﬁnding people who are

not willing to reveal their identities (e.g., addicts and crim-

inals) (4).

In another deﬁnition, snowball sampling may be less

reliant on a reference sample, but it is still suitable to ﬁnd

unattainable populations. For example, when the research

is aimed at a group of illegal immigrants or addicts, meet-

ing the ﬁrst group of samples will probably lead to other

samples; thus, the study sample grows like a rolling snow-

ball (5).

Generally, snowball sampling is a gradual process, and

time inﬂuences the selection of samples. Sampling usu-

ally continues until data saturation. On the other hand,

convenience sampling is the weakest method of sampling.

The risk of bias is low when the population is homoge-

neous in terms of the target characteristic under question,

whereas in nonhomogeneous populations, this method of

sampling has a higher risk of error (1).

In recent decades, qualitative research has become

more popular in nursing studies. Despite the growing

body of qualitative research in the past few decades, there

have been debates about these types of studies due to lack

of detailed information on the methods and processes.

Most published qualitative papers do not provide enough

information about the characteristics of the samples, re-

search, and sampling methods. In qualitative research,

sampling is determined by the type of research, while most

published literature has not determined the type of re-

search (8).

Consecutive sampling is one method of purposeful

sampling in qualitative research. In this method, instead

of selecting a ﬁxed sample, every subject who meets the cri-

teria is selected until the required sample size is achieved.

This method is classiﬁed into three types, one of which is

snowball sampling. This type of sampling is a nonprob-

ability method, which involves random selection of sub-

jects. This method is most eﬀective when the members

of the population are not easily accessible (e.g., homeless

people, illegal immigrants, and addicts). The researcher

ﬁrst identiﬁes a group of people, and after gathering data,

he/she asks them to recommend similar cases for the study.

The purpose of qualitative research is to gain a deeper

understanding of a phenomenon, rather than to general-

izing the ﬁndings. Therefore, careful selection of research

samples can help us conduct a more thorough evaluation.

The purpose of this study was to review the available qual-

itative research in nursing, which applied the snowball

sampling method.

2. Methods

This research is a thorough and descriptive review of

the snowball sampling method, based on articles pub-

lished in national and international journals, as well as dis-

sertations. The articles were selected from Cochrane, Pro-

Quest, Science Direct, SID, MagIran, Medline, Irandoc, Sco-

pus, and Google Scholar databases in both Persian and En-

glish languages between 2005 and 2013. Data were gath-

ered using English keywords, including “review,” “declara-

tion,” “snowball,” and “chain referral,” as well as Persian

keywords that are equivalents of the following: “purpose-

ful sampling,” “snowball,” “qualitative research,” and “de-

scriptive review.”

First, all articles related to qualitative research in Iran

were gathered. The articles, which contained the afore-

mentioned keywords in the abstract, were included in our

preliminary list, while the rest of the articles were dis-

carded. Then, a checklist was used to document all the

2Strides Dev Med Educ. 2017; 14(3):e67670.

Naderifar M et al.

required information, including the title, location, time,

scope, and method of sampling; this checklist was used for

the ﬁnal evaluation. Two individuals separately searched

and gathered the data.

3. Results

In the preliminary search, 423 articles from PubMed,

88 articles from Scopus, 1 article from SID, and 18 articles

from MagIran were selected. Dissertations approved be-

tween 2005 and 2013 were also reviewed. After limiting the

search to articles with full text, the total number of the ar-

ticles reached 125. In addition, dissertations that were not

available to the researchers were eliminated.

The remaining articles were reviewed, and those with

a theoretical framework, as well as non-research articles,

were omitted. Finally, 11 articles were found eligible for the

review and were selected for their relevance to the purpose

of this study. The methods and content of these papers

were thoroughly reviewed to determine the characteristics

of snowball sampling and methods of implementation (Ta-

ble 1).

4. Discussion and Conclusions

One main challenge of qualitative research is selecting

the samples, determining the suﬃcient sample size, and

explaining the sampling procedure. Although many quali-

tative research experts believe that data saturation is a sub-

jective phenomenon, there is also the view that more ob-

servations and interviews do not aﬀect the interpretation

of the results.

Review of the literature showed that a few research

studies have accurately explained the snowball sampling

method. In most of them, the main method of sampling

was suﬃcient, and they have not presented clear expla-

nations about its implementation. On the other hand, in

some studies, the snowball sampling method did not suf-

ﬁce and was only used to complete the data. It should be

mentioned that the snowball sampling method is fully ex-

plained in only one study, which has fully clariﬁed its dif-

ferent aspects.

Diﬀerent variations of snowball sampling can be ap-

plied in the development of community-based informa-

tion, dissemination eﬀorts related to health education pro-

grams, and research studies. These methods can be eﬀec-

tively used to choose samples from fragile populations or

people under specialized care. Adaptation of the snowball

sampling method helps researchers gain access to the tar-

get population.

Adaptations of snowball sampling strategies should be

considered when recruiting participants for educational

programs or research studies. In snowball sampling, the

fragile population is selected in a social context and in a

multi-stage process. After gaining access to the prelimi-

nary samples, the samples begin to introduce other people

to take part in the research. This process will continue in

a semi-automatic and chain-like manner until data satura-

tion (9).

Nurses have diﬀerent responsibilities, including clini-

cal care, education, and research. In many cases, it is dif-

ﬁcult to identify or contact care-seekers. Human immun-

odeﬁciency virus (HIV) positive patients, abused women,

drug addicts, sex workers, and people with homosexual

or asexual tendencies are examples of these fragile popu-

lations (10). The snowball sampling method has been de-

rived from diﬀerent concepts of social marketing. How-

ever, people who are involved in research studies and have

educational opportunities should always consider individ-

ual rights and privacy.

Snowball sampling is a method of gathering informa-

tion to access speciﬁc groups of people. The advantages

and limitations of this research method should be eval-

uated to select the best strategy. A researcher aiming to

perform health interventions should consider people’s pri-

vacy concerns (both for preliminary samples and samples

in the target community). Additionally, anonymity and

conﬁdentiality of the data should be guaranteed by the re-

searcher (11).

The limitations of this study, which are mostly related

to its design (review study), include lack of homogeneity in

the measurement methods and lack of explanation about

the exact sampling method in most papers. Researchers

interested in qualitative research are recommended to

choose a method of sampling that is not only more accu-

rate but also saves time and money.

Supplementary Material

Supplementary material(s) is available here [To read

supplementary materials, please refer to the journal web-

site and open PDF/HTML].

Acknowledgments

The researchers would like to thank our research col-

leagues in Zabol University of Medical Sciences and Za-

hedan University of Medical Sciences, for their coopera-

tion.

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4Strides Dev Med Educ. 2017; 14(3):e67670.

Naderifar M et al.

Table1. General Data Gathered from the Selected Articles on the Snowball Sampling Method

Reference Title Data Collection Method Findings

Walsh et al. (12)Attitudes and subjective norms:

Determinants of parents’ intentions to

reduce childhood fever with

medications

Three methods: newspaper

advertisement, face-to-face interview,

and snowball sampling

The snowball method was implemented

by a network of researchers and

respondents. All the attendees were

given a package containing an

introduction letter, information

overview sheet, questionnaire, and

return envelope. After completing the

forms, the information was collected.

Charkazi et al. (13)Explaining smoking among students at

Golestan University of Medical Sciences

based on BASNEF model

Snowball sampling (The researcher

identiﬁed some smoking students, and

after explaining the purpose of the study

and obtaining oral consent, they were

asked to introduce some other smoker

students to recruit a larger sample.)

Abstract norms and enabling factors are

among the most important factors in

smoking. Therefore, these points should

be considered for preventing and

organizing recovery programs.

Heshmati Nabavi et al. (14)Barrier to forming and implementing

academic service partnership in

nursing: A qualitative study

Purposeful sampling, snowball

sampling, and interview (First,

purposeful sampling was applied, and

then more samples were identiﬁed

using the snowball method. This process

continued until data saturation.)

The identiﬁed themes were

“organizational divergence,” “invisible

wall,” and “overemphasis on theoretical

knowledge.” The most important

barriers impeding cooperation between

educational and clinical institutes are

ambiguities in the organizational

structure of institutes, responsibilities

of employees of each institute in

relation to others, overemphasis on

theoretical knowledge, and ignoring of

practical knowledge and clinical

performance of nurses. Development of

academic service partnership can be

facilitated by deﬁning a formal

organizational relationship between

academic and service institutes,

clarifying roles and responsibilities of

each institute regarding clinical

education, deﬁning clinical practice

roles for nursing faculty members, and

emphasizing the importance of nursing

clinical practice.

Swallow et al. (15)Pan-Britain, mixed-methods study of

multidisciplinary teams teaching

parents to manage children’s long-term

kidney conditions at home: Study

protocol

Purposeful sampling was applied

considering the child’s age, diagnosis,

ethnicity,and need for clinical care.

Snowball sampling was implemented to

identify staﬀ members who were

involved in the care of the child.

It is essential to educate the parents on

long-term care for children at home. It is

also essential to understand that parents

of children with chronic renal diseases

need to receive specialized education.

Sasson et al. (16)A qualitative study to identify barriers to

local implementation of pre-hospital

termination of resuscitation protocols

First, a focus group was determined, and

then using snowball sampling, more

samples entered the study. Emergency

room doctors, paramedics, emergency

room authorities, and nurses were also

invited.

A method Focus group was used instead

of a response package to have a better

understanding of how emergency

systems manage resuscitation protocols

and which practical factors impede the

implementation of resuscitation

protocols.

Zaghloul and Alsokair (17)Constructing a nurse appraisal form: A

Delphi technique study

Delphi technique and snowball

sampling method

A standardized nurse appraisal form was

designed and implemented in the

hospitals of the eastern states of Saudi

Arabia, which are covered by health

organizations. The nurses’ ideas about

the appraisal form were used to

determine diﬀerent aspects of a nurse’s

performance. In each hospital, the ﬁrst

head nurse was introduced to other

head nurses to participate in the study.

This process continued until enough

head nurses and supervisors were

recruited.

Strides Dev Med Educ. 2017; 14(3):e67670. 5

Naderifar M et al.

Zareipour et al. (18)Eﬀective factors on smoking based on

BASNEF model in male students in

Tehran Medical Sciences University in

2009

Snowball sampling method (The

researcher met a smoking person, and

after attaining oral consent, he was

asked to complete a questionnaire.

Then, he was asked to invite other

smoker friends to take part in the study.

The researcher recruited the samples

and collected the questionnaires.)

Based on this model, the importance of

normative, enabling, and observational

factors in smoking behaviors was

determined, and the need for

authorities’ attention was highlighted.

Improvement of social and life skills,

including resistance against peer

pressure (saying “no”), and of the sense

of responsibility and self-conﬁdence in

the youth can be eﬀective. The youth

smoke out of fear of humiliation and

shame. However, through building

conﬁdence, they can inﬂuence their

peers.

Lagu et al. (19)Content of weblogs written by health

professionals

Modiﬁed snowball sampling method The domain and content of medical

weblogs were reviewed to determine

how much the writer of these posts had

revealed facts about the patient,

breached the doctor-patient

conﬁdentiality,or outlined the

shortcomings of care for the patient. The

researchers deﬁned medical weblogs as

web pages, which have medical content

and are written by healthcare

professionals. Weblogs are a developing

part of the medical profession’s public

face. In these weblogs, doctors and

nurses can share their opinions.

However, they can also jeopardize their

career by revealing conﬁdential

information in their content.

Schreiber and MacDonald (20)Keeping vigil over the profession: A

grounded theory of the context of nurse

anesthesia practice

Purposeful and snowball sampling

methods

Management of registered anesthesia

nurses in diﬀerent cultural-political

backgrounds of patient care was

studied. The grounded theory was used

to observe the performance of

registered and certiﬁed anesthetic

nurses. The grounded theory was used

to ﬁnd procedures in diﬀerent social

backgrounds. The grounded theory was

used since the researchers were

interested to show the process using

which the nurses performed their role.

Mishima et al. (21)Assistance in family health from the

perspective of users

Snowball sampling method (chain

sampling) according to the location of

the original interviewed group that met

the inclusion criteria

Family health services were evaluated

from the perspective of clients in San

Paolo and Riviera Porto, Brazil, in a wide

range of primary healthcare services

and specialized care services at diﬀerent

levels.

Cataldo and Malone (22)False promises: The tobacco industry,

“low-tar” cigarettes, and older smokers

Snowball sampling The role of tobacco industries in

marketing and damage from tobacco

addiction were assessed among old

smokers and infants. The researcher

sought to ﬁnd documents from the

tobacco industry,which was

unsuccessful.

Sadler et al. (9)Recruiting hard-to-reach United States

population sub-groups via adaptations

of snowball sampling strategy

Snowball sampling to recruit subgroups

that were not easily accessible

Variations of the snowball sampling

strategy can be applied in the

development of community-based

information, health education

programs, and research studies. This

strategy is eﬀective in enlisting the

involvement of members from

vulnerable populations. These strategies

ﬁnd individuals, who have the desired

characteristics, and use that person’s

social networks to recruit similar

subjects in a multi-stage process. This

semi-automatic process continues until

enough samples have been recruited.

6Strides Dev Med Educ. 2017; 14(3):e67670.

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Jan 2025
HUM ECOL

Within the legacy of environmental injustices in South Africa, this study explores the role of community-based wildlife tourism (CBWT) in promoting equitable land management. We discuss whether community-based initiatives, specifically related to tourism, can provide lasting structural benefits to local communities. Utilizing the environmental justice (EJ) framework, we conducted a qualitative case study involving semi-structured interviews with 23 participants involving the Wild Olive Tree Camp, a CBWT enterprise in the Kruger to Canyons Biosphere Region in South Africa. By analyzing the neoliberal approach to environmental resources for tourism, we demonstrate that while CBWT might benefit local communities in the short term, it risks perpetuating neocolonial structures and dependencies in the long term. This study underscores the need to acknowledge historical trauma stemming from segregation and apartheid and advocates for the restructuring of power imbalances in tourism management while promoting equitable access to knowledge and land rights. This study contributes to the EJ scholarship by contextualizing these issues within the historical reality of the region.

Exploring the Experiences of Doctoral Student Mothers: A Comparative Study of Kazakhstan and Uzbekistan

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Jan 2025

Naureen Durrani

This study addresses the research gap on doctoral student mothers (DSMs) in Central Asia by examining the experiences of 15 DSMs in Kazakhstan and Uzbekistan as they navigate multiple roles. Drawing on Butler’s theory of gender and O’Reilly’s maternal theory, qualitative online interviews reveal common challenges in balancing motherhood, spousal duties, academic pursuits, and kelin (a bride or a daughter-in-law at husband’s parental home) roles, leading to feelings of guilt and inadequacy. Gender norms, lack of support, financial constraints, and negative perceptions from supervisors hinder DSMs’ academic progress, highlighting the importance of extended study timelines, supportive supervisors, and understanding institutions. Coping strategies, including support from family and peers, and self-motivation, are crucial in addressing the mental health impact of these challenges. Contrasts in experiences between Kazakhstani and Uzbekistani DSMs are evident, with Uzbekistani DSMs facing greater pressure as kelins, limited spousal support and mobility challenges to field sites, and encountering more institutional biases compared to their Kazakhstani counterparts. The study advocates for broader implications to promote equitable opportunities for DSMs in the region.

Understanding Burnout among Surgical residents: a mixed method study

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Full-text available

Jan 2025

Burnout is a complex condition that can strangely affect individuals in healthcare professions, such as surgeons and surgical residents. This study aimed to assess burnout and better explain the concept of burnout in surgical residents and the clarification strategies they take with this phenomenon to solve this problem. This mixed methods study was conducted at Shiraz University of Medical Sciences in 2022–2023 with two quantitative and qualitative phases. The statistical population included 114 surgical residents. The census sampling method was used in the quantitative and purposefully in the qualitative phases. The tool of the study was a 22-item Maslach Burnout Inventory-Student Survey questionnaire. Results showed that 27.27% of the residents had no academic burnout, but most 62.73% experienced a moderate level of academic burnout; also, 10% were in mild and severe burnout levels. In the qualitative phase of the study, 1047 codes were extracted after data analysis. The results showed three themes (and nine sub-themes) that emerged from the data analysis: A) Experienced burnout, B) Coping strategies, and C) Proposed strategies to reduce academic burnout. There was a remarkable incidence of burnout in surgical residents, which was higher than predicted. Although academic burnout is not the only factor affecting the residents ' academic decline, it is one of the most essential and significant factors that threaten residents’ motivation and academic performance. The evidence from the current research shows that educational managers and stakeholders should examine the consequences of academic burnout in residents to solve their problems in the current situation through some interventions.

Characterizing Network Structure of Anti-Trans Actors on TikTok

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Full-text available

Jan 2025

The recent proliferation of short form video social media sites such as TikTok has been effectively utilized for increased visibility, communication, and community connection amongst trans/nonbinary creators online. However, these same platforms have also been exploited by right-wing actors targeting trans/nonbinary people, enabling such anti-trans actors to efficiently spread hate speech and propaganda. Given these divergent groups, what are the differences in network structure between anti-trans and pro-trans communities on TikTok, and to what extent do they amplify the effects of anti-trans content? In this paper, we collect a sample of TikTok videos containing pro and anti-trans content, and develop a taxonomy of trans related sentiment to enable the classification of content on TikTok, and ultimately analyze the reply network structures of pro-trans and anti-trans communities. In order to accomplish this, we worked with hired expert data annotators from the trans/nonbinary community in order to generate a sample of highly accurately labeled data. From this subset, we utilized a novel classification pipeline leveraging Retrieval-Augmented Generation (RAG) with annotated examples and taxonomy definitions to classify content into pro-trans, anti-trans, or neutral categories. We find that incorporating our taxonomy and its logics into our classification engine results in improved ability to differentiate trans related content, and that Results from network analysis indicate many interactions between posters of pro-trans and anti-trans content exist, further demonstrating targeting of trans individuals, and demonstrating the need for better content moderation tools

Collaborative Music Therapy and Speech-Language Pathology for Pediatric Acquired Communication Impairments: A Phenomenological International Perspective

Article

Nov 2024

The partnership between music therapy and speech-language pathology is gaining recognition as an effective approach in the rehabilitation of young children with acquired communication impairments (ACIs). Yet, there remains a notable gap in understanding the distinctive contributions and challenges inherent in this collaborative practice. This study explored the perspectives of music therapists (MTs) and speech-language pathologists (SLPs) regarding the unique role of this collaborative effort, the elements of successful collaboration, and the methods implemented by clinicians to evaluate outcomes. Semi-structured interviews were conducted with nine pairs of MTs and SLPs in rehabilitation facilities across seven countries. These interviews were analyzed thematically using Van Manen’s approach to hermeneutic phenomenology. Three themes arose from the data: (a) the role of collaborative music therapy and speech-language pathology, (b) building blocks of successful collaboration, and (c) evaluating collaborative practices. This collaboration fosters a unified strategy aimed at achieving shared language and communication goals. By combining their distinct expertise, MTs and SLPs can address the complex and varied needs of children with ACIs more effectively. However, further research is essential to comprehensively understand the functional outcomes arising from such collaborative endeavors in pediatric ACIs. This is crucial for validating the efficacy and significance of this approach in bolstering language and communication skills and advocating for its wider integration within rehabilitation services.

A Case Study on Representativeness Heuristic in Employed and Unemployed Women in Turkey

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Full-text available

Jan 2022

This study discusses whether decisions made under uncertain conditions are affected by the representativeness heuristic regarding employed and unemployed women. For this purpose, we investigated whether female physicians and housewives use prior information when making predictions. The study's main purpose is to understand women's disadvantaged position in the labor market. The study’s main contribution to the literature is to explore the effect of the representativeness heuristic on women’s deviations from rationality. To measure the representativeness heuristic, 14 questions were asked of 428 employed and unemployed women through an online survey. Our results were consistent with the literature, and we concluded that decisions made under uncertain conditions are influenced by the representativeness heuristic, resulting in deviations from rationality.

What Makes a Youth Study Travel Product Popular in China? An Enquiry from the Perspective of Industry Suppliers

Article

Jan 2025

Bridging Scholarship and Practice in Higher Education: Fostering Innovative Research and Enhancing Teaching

Book

Jan 2025

Sam Illingworth

Place Iteration and Integration: How Digital Nomads Navigate the Mobile Worker Paradox

Article

Dec 2024
ADMIN SCI QUART

To access the benefits of mobility, digital nomads regularly disconnect from their physical locations, which should prevent them from forming a sense of place. Yet, they need this sense of place to work effectively and continue to work as digital nomads. Identifying this tension between mobility and work as the mobile worker paradox, we conduct a qualitative analysis of 73 interviews with 67 digital nomads and advance a theoretical model showing two paths by which digital nomads navigate this paradox. As digital nomads initially move to a new location, they experience placelessness—enjoying freedom and being burdened by the lack of structure. They use their freedom for nonwork adventures, and they address burdens via work placemaking, resulting in placefulness, which is a deep connection to their physical location. We find that digital nomads interpret placefulness differently according to their degree of wanderlust, which determines whether they navigate the mobile worker paradox through place iteration or place integration. Challenging the idea that mobility and a sense of place are incompatible, this study enhances our understanding of digital nomads and mobile workers broadly, and it contributes to the literatures on place, paradox, and flexible work. It also invites further research on hybrid workers, the importance of wanderlust in contemporary work arrangements, and the career implications of place iteration and place integration.

Pan-Britain, mixed-methods study of multidisciplinary teams teaching parents to manage children's long-term kidney conditions at home: Study protocol

Article

Full-text available

Feb 2012
BMC HEALTH SERV RES

Care of children and young people (children) with long-term kidney conditions is usually managed by multidisciplinary teams. Published guidance recommends that whenever possible children with long-term conditions remain at home, meaning parents may be responsible for performing the majority of clinical care-giving. Multidisciplinary team members, therefore, spend considerable time promoting parents' learning about care-delivery and monitoring care-giving. However, this parent-educative aspect of clinicians' role is rarely articulated in the literature so little evidence exists to inform professionals' parent-teaching interventions. This ongoing study addresses this issue using a combination of quantitative and qualitative methods involving the twelve children's kidney units in England, Scotland and Wales. Phase I involves a survey of multidisciplinary team members' parent-teaching interventions using:i) A telephone-administered questionnaire to determine: the numbers of professionals from different disciplines in each team, the information/skills individual professionals relay to parents and the teaching strategies/interventions they use. Data will be managed using SPSS to produce descriptive statisticsii) Digitally-recorded, qualitative group or individual interviews with multidisciplinary team members to explore their accounts of the parent-teaching component of their role. Interviews will be transcribed anonymously and analysed using Framework Technique. Sampling criteria will be derived from analysis to identify one/two unit(s) for subsequent in-depth studyPhase II involves six prospective, ethnographic case-studies of professional-parent interactions during parent-teaching encounters. Parents of six children with a long-term kidney condition will be purposively sampled according to their child's age, diagnosis, ethnicity and the clinical care-giving required; snowball sampling will identify the professionals involved in each case-study. Participants will provide signed consent; data gathering will involve a combination of: minimally-obtrusive observations in the clinical setting and families' homes; de-briefing interviews with participants to obtain views on selected interactions; focussed 'verbatim' field-notes, and case-note reviews. Data gathering will focus on communication between parents and professionals as parents learn care-giving skills and knowledge. Interviews will be digitally recorded and transcribed anonymously. This study involves an iterative-inductive approach and will provide a unique, detailed insight into the social context in which professionals teach and parents learn; it will inform professionals' parent-educative roles, educational curricula, and health care policy.

Content of Weblogs Written by Health Professionals

Article

Full-text available

Oct 2008
J GEN INTERN MED

Medical weblogs ("blogs") have emerged as a new connection between health professionals and the public. To examine the scope and content of medical blogs and approximate how often blog authors commented about patients, violated patient privacy, or displayed a lack of professionalism. We defined medical blogs as those that contain some medical content and were apparently written by physicians or nurses. We used the Google search term "medical blog" to begin a modified snowball sampling method to identify sites posting entries from 1/1/06 through 12/14/06. We reviewed five entries per blog, categorizing content and characteristics. We identified 271 medical blogs. Over half (56.8%) of blog authors provided sufficient information in text or image to reveal their identities. Individual patients were described in 114 (42.1%) blogs. Patients were portrayed positively in 43 blogs (15.9%) and negatively in 48 blogs (17.7%). Of blogs that described interactions with individual patients, 45 (16.6%) included sufficient information for patients to identify their doctors or themselves. Three blogs showed recognizable photographic images of patients. Healthcare products were promoted, either by images or descriptions, in 31 (11.4%) blogs. Blogs are a growing part of the public face of the health professions. They offer physicians and nurses the opportunity to share their narratives. They also risk revealing confidential information or, in their tone or content, risk reflecting poorly on the blog authors and their professions. The health professions should assume some responsibility for helping authors and readers negotiate these challenges.

Constructing a nurse appraisal form: A Delphi technique study

Article

Full-text available

Feb 2008

The study was conducted with the aim to construct a unified nurse appraisal format to be used at hospitals performing under different healthcare organizations in the Eastern Province in the Kingdom of Saudi Arabia. The study included hospitals representing different healthcare organizations within the Eastern Province. The target population included Hospital head nurses and nurse supervisors and the snowball sampling technique was employed to select the panel subjects. The final draft resulted into the agreed upon performance dimensions which included namely; quality standards, work habits, supervision/leadership, staff relations and interpersonal skills, attendance and punctuality, problem solving, oral communication, productivity results, coordination, innovation, record keeping. Nurse managers have to continuously assess competence of practicing nurses to assure qualified and safe patient care. A nurse appraisal form was constructed concurrently with this study results and was proposed to be used at all Eastern Region hospitals. This study is considered an initial step for further efforts and studies to be conducted to reach both national and international nursing appraisal dimensions and unify them for the sake of best health promotion.

Recruiting hard-to-reach United States population sub-groups via adaptations of snowball sampling strategy

Article

Full-text available

Sep 2010
NURS HEALTH SCI

Nurse researchers and educators often engage in outreach to narrowly defined populations. This article offers examples of how variations on the snowball sampling recruitment strategy can be applied in the creation of culturally appropriate, community-based information dissemination efforts related to recruitment to health education programs and research studies. Examples from the primary author's program of research are provided to demonstrate how adaptations of snowball sampling can be used effectively in the recruitment of members of traditionally underserved or vulnerable populations. The adaptation of snowball sampling techniques, as described in this article, helped the authors to gain access to each of the more-vulnerable population groups of interest. The use of culturally sensitive recruitment strategies is both appropriate and effective in enlisting the involvement of members of vulnerable populations. Adaptations of snowball sampling strategies should be considered when recruiting participants for education programs or for research studies when the recruitment of a population-based sample is not essential.

Keeping vigil over the profession: A grounded theory of the context of nurse anaesthesia practice

Article

Full-text available

Jul 2010
BMC Nurs

Background Nurse anaesthetists in the US have faced continued, repeated challenges to their profession. Regardless, they have met these challenges and have established themselves as major anaesthesia care providers. In this paper we address the research question: How do certified registered nurse anaesthetists (CRNAs) manage the socio-political context in which they provide care for their patients? Methods Grounded theory was used to explore how nurse anaesthetists protect and promote their profession. Purposive, snowball, and theoretical sampling was used and data were collected through participant observation and interviews conducted at a conference of the professional association, an educational program, by telephone, email exchanges, and time spent in operating rooms and an outpatient surgical clinic. Analysis included coding at increasingly abstract levels and constant comparison. Results The basic social process identified was Keeping Vigil Over the Profession, which explains how nurse anaesthetists protect and promote their profession. It is comprised of three contextual categories: Establishing Public Credibility through regulatory and educational standards, Political Vigilance and taking action in governmental and policy arenas, and Tending the Flock through a continuous information loop between local and administrative/political levels. Conclusions From our study of the context of nurse anaesthesia practice, it is clear that CRNAs are dedicated to protecting their ability to provide high quality patient care by maintaining constant vigilance over their profession.

Assistance in Family Health From the Perspective of Users

Article

Full-text available

May 2010
REV LAT-AM ENFERM

This descriptive exploratory study analyzed user satisfaction with the care received at a Family Health Unit in Ribeirão Preto, Brazil. In total, 40 users from families registered in the FHU were selected, using key informants and the snowball sampling technique, and interviewed. Thematic content analysis was used to analyze the empirical material. Interviewees were mostly female, over 50 years, resident in the catchment area of the unit for 10-30 years, had incomplete primary education and also did not perform work outside the home. The analysis identified three themes: access, team-user interaction and organization of work in the FHU. The subjects of this study expressed satisfaction with the accessibility provided together with the caring attention given to them, marked by a team-user interaction that takes place in a friendly and patience manner. Although not totally satisfied, the majority of users would recommend the health service to someone due to its quality.

A Qualitative Study to Identify Barriers to Local Implementation of Prehospital Termination of Resuscitation Protocols

Article

Full-text available

Jul 2009

Despite the existence of national American Heart Association guidelines and 2 termination-of-resuscitation (TOR) rules for ceasing efforts in refractory out-of-hospital cardiac arrest, many emergency medical services agencies in the United States have adopted their own local protocols. Public policies and local perceptions may serve as barriers or facilitators to implementing national TOR guidelines at the local level. Three focus groups, lasting 90 to 120 minutes, were conducted at the National Association of Emergency Medical Services Physicians meeting in January 2008. Snowball sampling was used to recruit participants. Two reviewers analyzed the data in an iterative process to identify recurrent and unifying themes. We identified 3 distinct groups whose current policies or perceptions may impede efforts to adopt national TOR guidelines: payers who incentivize transport; legislators who create state mandates for transport and allow only narrow use of do-not-resuscitate orders; and communities where cultural norms are perceived to impede termination of resuscitation. Our participants suggested that national organizations, such as the American Heart Association and American College of Emergency Physicians, may serve as potential facilitators in addressing these barriers by taking the lead in asking payers to change reimbursement structures; encouraging legislators to revise laws to reflect the best available medical evidence; and educating the public that rapid transport to the hospital cannot substitute for optimal provision of prehospital care. We have identified 3 influential groups who will need to work with national organizations to overcome current policies or prevailing perceptions that may impede implementing national TOR guidelines.

Attitudes and subjective norms: Determinants of parents' intentions to reduce childhood fever with medications

Article

Full-text available

Nov 2008

Fever is a natural protective response of the host organism. Mild to moderate fevers, up to 40.0ºC, have immunological benefits and do not need to be reduced. However, parents regularly reduce fever with medications to prevent perceived harmful outcomes. This study identified the determinants of parents’ intentions to reduce childhood fever with medications. A community-based crossectional survey was conducted with 391 Australian parents of children aged between 6-months and 5-years. Recruitment was through advertising, face-to-face, and snowball methods. The survey targeted constructs of the Theory of Planned Behavior: attitudes, subjective norms, perceived behavioral control, intentions and previously identified background factors. Structural equation modeling identified 69% of the variance in intentions. The strongest influences were from non-scientifically based attitudes (phobic) (β=.55) and subjective norms (husband/partner and doctors) (β=.36). Attitudes (β=.69) and subjective norms (β=.52) were strongly determined by child medication behaviour (whether the child took medications easily when febrile) which had a total effect on intentions of β=.66. Perceived control, education and number of children had minimal influence on intentions. There is an urgent need for 1) the education of both parents in the benefits of fever and 2) for doctors to consistently provide parents with evidence-based information.

Effective factors on smoking base on BASNEF model n male students in Tehran medical sciences university in 2009

Article

Jan 2011

Background & Aims: Smoking as a health risk behavior endangers not only the individual but also community health and is one of the preventable causes of death. This risk behavior is growing among educated young people. This study was aimed to investigate effective factors leading to smoking based on BASNEF Model in male students in Tehran Medical Sciences University in 2009. Materials & Methods: This descriptive analytical study was performed on 200 male students that were selected by snowball sampling method. The data were collected using a questionnaires based on BASNEF Model. The data were analyzed by Chi-square tests, and Pearson correlation coefficient. Results: The survey results showed that the most frequent causes of smoking were easy access to cigarettes (80%) and peers smoking (82%). Considering the attitude of the samples 33.5% had a positive, 19.5% neutral and 47% had a negative attitude toward smoking. There was a significant association between positive attitude to smoking and students’ years of study or parental education. There also was a significant relationship between age at onset of smoking with either parents or peers smoking. There was a relationship between low price cigarettes and the number of cigarettes smoked per day. The average number of cigarettes smoked per day and students age and cigar costs per month showed a positive correlation. Conclusion: The importance of attitudes, subjective norms, and factors affecting smoking are highlighted in the study and health officials must urge to pursue structural interventions to prevent them.

The Practice of Nursing Research

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