Quantitizing findings from qualitative studies for integration in mixed methods reviewing.
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ABSTRACT:
SUBMITTER: van Grootel L
PROVIDER: S-EPMC7317911 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundHospice-at-home aims to enable patients approaching end-of-life to die at home and support their carers. A wide range of different service models exists but synthesised evidence on how best to support family carers to provide sustainable end-of-life care at home is limited.AimTo explore what works best to promote family carers' experiences of hospice-at-home.DesignRealist evaluation with mixed methods. This paper focuses on qualitative interviews with carers (to gain their perspective and as proxy for patients) and service providers from 12 case study sites in England. Interviews were coded and programme theories were refined by the research team including two public members.Setting/participantsInterviews with carers (involved daily) of patients admitted to hospice-at-home services (n = 58) and hospice-at-home staff (n = 78).ResultsPost bereavement, 76.4% of carers thought that they had received as much help and support as they needed and most carers (75.8%) rated the help and support as excellent or outstanding. Of six final programme theories capturing key factors relevant to providing optimum services, those directly relevant to carer experiences were: integration and co-ordination of services; knowledge, skills and ethos of hospice staff; volunteer roles; support directed at the patient-carer dyad.ConclusionsCarers in hospice-at-home services identified care to be of a higher quality than generic community services. Hospice staff were perceived as having 'time to care', communicated well and were comfortable with dying and death. Hands-on care was particularly valued in the period close to death.
| S-EPMC10657508 | biostudies-literature
Project description:Mixed methods research offers powerful tools for investigating complex processes and systems in health and health care. This article describes integration principles and practices at three levels in mixed methods research and provides illustrative examples. Integration at the study design level occurs through three basic mixed method designs-exploratory sequential, explanatory sequential, and convergent-and through four advanced frameworks-multistage, intervention, case study, and participatory. Integration at the methods level occurs through four approaches. In connecting, one database links to the other through sampling. With building, one database informs the data collection approach of the other. When merging, the two databases are brought together for analysis. With embedding, data collection and analysis link at multiple points. Integration at the interpretation and reporting level occurs through narrative, data transformation, and joint display. The fit of integration describes the extent the qualitative and quantitative findings cohere. Understanding these principles and practices of integration can help health services researchers leverage the strengths of mixed methods.
| S-EPMC4097839 | biostudies-other
Project description:Abstract Background and Objectives The aging population places increasing demands on our healthcare system. Mobile health offers the potential to reduce this burden. The aim of this systematic review is to thematically synthesize qualitative evidence of older adults’ user engagement toward mobile health, and to generate relevant recommendations for intervention developers. Research Design and Methods A systematic literature search was performed in Medline, Embase, and Web of Science electronic databases from inception until February 2021. Papers on qualitative and mixed-methods studies that investigated older adults’ user engagement with a mobile health intervention were included. Relevant data were extracted and analyzed using thematic analysis. The Critical Appraisal Skills Program Qualitative Checklist was used to assess the quality of the included studies. Results Thirty-two articles were deemed eligible for inclusion in the review. Three overarching analytical themes emerged from the 25 descriptive themes generated by the line-by-line coding: the limited capabilities, the prerequisite of motivation, and the importance of social support. Discussion and Implications Successful development and implementation of future mobile health intervention for older adults will be challenging given the physical and psychological limitations and motivational barriers that older adults experience. Design adaptations and well-thought-out blended alternatives (i.e., combining mobile health with face-to-face support) might be potential solutions to improve older adults’ user engagement with mobile health interventions.
| S-EPMC10053647 | biostudies-literature
Project description:BACKGROUND:In remote rural Tanzania, the rate of linkage into HIV care was estimated at 28% in 2014. This study explored facilitators and barriers to linkage to HIV care at individual/patient, health care provider, health system, and contextual levels to inform eventual design of interventions to improve linkage to HIV care. METHODS:We conducted a descriptive qualitative study nested in a cohort study of 1012 newly diagnosed HIV-positive individuals in Mbeya region between August 2014 and July 2015. We conducted 8 focus group discussions and 10 in-depth interviews with recently diagnosed HIV-positive individuals and 20 individual interviews with healthcare providers. Transcripts were analyzed inductively using thematic content analysis. The emergent themes were then deductively fitted into the four level ecological model. RESULTS:We identified multiple factors influencing linkage to care. HIV status disclosure, support from family/relatives and having symptoms of disease were reported to facilitate linkage at the individual level. Fear of stigma, lack of disclosure, denial and being asymptomatic, belief in witchcraft and spiritual beliefs were barriers identified at individual's level. At providers' level; support and good patient-staff relationship facilitated linkage, while negative attitudes and abusive language were reported barriers to successful linkage. Clear referral procedures and well-organized clinic procedures were system-level facilitators, whereas poorly organized clinic procedures and visit schedules, overcrowding, long waiting times and lack of resources were reported barriers. Distance and transport costs to HIV care centers were important contextual factors influencing linkage to care. CONCLUSION:Linkage to HIV care is an important step towards proper management of HIV. We found that access and linkage to care are influenced positively and negatively at all levels, however, the individual-level and health system-level factors were most prominent in this setting. Interventions must address issues around stigma, denial and inadequate awareness of the value of early linkage to care, and improve the capacity of HIV treatment/care clinics to implement quality care, particularly in light of adopting the 'Test and Treat' model of HIV treatment and care recommended by the World Health Organization.
| S-EPMC6451278 | biostudies-literature
Project description:ObjectivesMindfulness-based cognitive therapy (MBCT) is effective in treating psychosocial comorbidities in inflammatory bowel disease (IBD); however, there have been no qualitative studies of MBCT experiences among youth with IBD. We aimed to examine the experiences of youth with IBD and depression who completed an adapted MBCT group programme, and the impact of common psychotherapy and group factors.DesignThis mixed method qualitative study, nested within a randomised controlled trial (RCT) of MBCT for youth with IBD, employed thematic analysis of qualitative data from three focus groups and open-ended survey questions.SettingThe study was conducted in the outpatient department of a tertiary hospital for young adults in Brisbane, Australia.ParticipantsOut of sixty-four adolescents and young adults recruited to the RCT of MBCT for youth with IBD and depression, 29 completed the MBCT evaluation survey and 19 attended the focus groups.ResultsFour key themes emerged: 'connectedness and shared understanding', 'growing in wisdom', 'therapeutic alliance' and 'barriers to mindfulness practice'. Participants described MBCT experiences as healing and transformative with the themes of connectedness, growing in wisdom and therapeutic alliance laying the foundation for therapeutic change. Main barriers included fatigue, depression, time and travel constraints.ConclusionsThe study identified key themes facilitating the process of therapeutic change within the MBCT programme for youth with IBD and elucidated common and group psychotherapy factors underlying the key themes. Participants perceived connecting with peers as essential for learning mindfulness skills which in turn strengthened the connection. Study findings will facilitate interpretation of the results of the RCT of MBCT in youth with IBD and inform the design of future studies of MBCT in this cohort.Trial registration numberACTRN12617000876392; Results.
| S-EPMC7643511 | biostudies-literature
Project description:BackgroundOver the past 50 years, the content and structure of antenatal education classes have varied to reflect social norms of the time, the setting and context in which they have been held and who has facilitated them. In recent times, antenatal and parenting education classes have become a smorgasbord of information, offering a range of diverse content. Where and how parents-to-be may access formal antenatal and parenting education classes are also varied. Even before the lockdown challenges of the Covid-19 pandemic, many antenatal and parenting education classes had become available and accessible online. While the flexibility and accessibility of this option are apparent, scant research to date has reported on parents' experiences of undertaking online antenatal education.ObjectivesThe objectives of this study were to explore new parents' experiences of engaging in online antenatal education, and to discover how consumers of online antenatal education perceive it should be designed and delivered.Design/methodsA mixed-methods design was used for this study, which was conducted with 294 past enrolees in a range of online antenatal and early parenting education programmes delivered by one private provider in Australia. The past enrolees were invited to participate in the study by email, wherein a link to an online information sheet and survey containing closed- and open-ended questions was provided. The responses to the open-ended questions that are reported in this article were analysed using a thematic approach that involved coding, sub-categorizing and then categorizing the data.ResultsA total of 108 participants provided qualitative data about the delivery and design of online antenatal education and information. The data were captured in three themes: video control and content, accessibility and pre-/intra-programme support.ConclusionsThe results of this study provide important insights for the development of online antenatal education programmes and courses that will be of interest to antenatal educators, maternity services and maternity care policy developers. Specifically, millennial parents want trustworthy and accurate antenatal education that is delivered in a framework that aligns with and builds on adult-learning principles. The diversity of families and of expectant parents' learning styles is also important to recognize in antenatal education curricula.
| S-EPMC9880454 | biostudies-literature
Project description:ObjectivesThis study compares rapid and traditional analyses of a UK health service evaluation dataset to explore differences in researcher time and consistency of outputs.DesignMixed methods study, quantitatively and qualitatively comparing qualitative methods.SettingData from a home birth service evaluation study in a hospital in the English National Health Service, which took place between October and December 2014. Two research teams independently analysed focus group and interview transcript data: one team used a thematic analysis approach using the framework method, and the second used rapid analysis.ParticipantsHome birth midwives (6), midwifery support workers (4), commissioners (4), managers (6), and community midwives (12) and a patient representative (1) participated in the original study.Primary outcome measuresTime taken to complete analysis in person hours; analysis findings and recommendations matched, partially matched or not matched across the two teams.ResultsRapid analysis data management took less time than thematic analysis (43 hours?vs 116.5?hours). Rapid analysis took 100?hours, and thematic analysis took 126.5?hours in total, with interpretation and write up taking much longer in the rapid analysis (52 hours?vs 8?hours). Rapid analysis findings overlapped with 79% of thematic analysis findings, and thematic analysis overlapped with 63% of the rapid analysis findings. Rapid analysis recommendations overlapped with 55% of those from the thematic analysis, and thematic analysis overlapped with 59% of the rapid analysis recommendations.ConclusionsRapid analysis delivered a modest time saving. Excessive time to interpret data in rapid analysis in this study may be due to differences between research teams. There was overlap in outputs between approaches, more in findings than recommendations. Rapid analysis may have the potential to deliver valid, timely findings while taking less time. We recommend further comparisons using additional data sets with more similar research teams.
| S-EPMC6194404 | biostudies-literature
Project description:ObjectivesTo explore the potential impacts of introducing General Practitioners into Emergency Departments (GPED) from the perspectives of service leaders, health professionals and patients. These 'expectations of impact' can be used to generate hypotheses that will inform future implementations and evaluations of GPED.DesignQualitative study consisting of 228 semistructured interviews.Setting10 acute National Health Service (NHS) hospitals and the wider healthcare system in England. Interviews were undertaken face to face or via telephone. Data were analysed thematically.Participants124 health professionals and 94 patients and carers. 10 service leaders representing a range of national organisations and government departments across England (eg, NHS England and Department of Health) were also interviewed.ResultsA range of GPED models are being implemented across the NHS due to different interpretations of national policy and variation in local context. This has resulted in stakeholders and organisations interpreting the aims of GPED differently and anticipating a range of potential impacts. Participants expected GPED to affect the following areas: ED performance indicators; patient outcome and experience; service access; staffing and workforce experience; and resources. Across these 'domains of influence', arguments for positive, negative and no effect of GPED were proposed.ConclusionsEvaluating whether GPED has been successful will be challenging. However, despite uncertainty surrounding the direction of effect, there was agreement across all stakeholder groups on the areas that GPED would influence. As a result, we propose eight domains of influence that will inform our subsequent mixed-methods evaluation of GPED.Trial registration numberISRCTN51780222.
| S-EPMC8149439 | biostudies-literature
Project description:Incorporating generative artificial intelligence (GAI) in education has become crucial in contemporary educational environments. This research article thoroughly investigates the ramifications of implementing GAI in the higher education context of Saudi Arabia, employing a blend of quantitative and qualitative research approaches. Survey-based quantitative data reveals a noteworthy correlation between educators' awareness of GAI and the frequency of its application. Notably, around half of the surveyed educators are at stages characterized by understanding and familiarity with GAI integration, indicating a tangible readiness for its adoption. Moreover, the study's quantitative findings underscore the perceived value and ease associated with integrating GAI, thus reinforcing the assumption that educators are motivated and inclined to integrate GAI tools like ChatGPT into their teaching methodologies. In addition to the quantitative analysis, qualitative insights from in-depth interviews with educators unveil a rich tapestry of perspectives. The qualitative data emphasizes GAI's role as a catalyst for collaborative learning, contributing to professional development, and fostering innovative teaching practices.
| S-EPMC10909195 | biostudies-literature
Project description:ObjectivesFinancial incentives are recommended by the UK's National Institute for Health and Care Excellence to aid smoking cessation in pregnancy. However, little is known about how implementation contexts might impact on their effectiveness. Variations in smoking cessation support (usual care) for pregnant women who smoke were examined qualitatively as part of a prospective process evaluation of the Cessation in Pregnancy Incentives Trial (CPIT III).DesignLongitudinal case studies of five CPIT III trial sites informed by realist evaluation.SettingA stop smoking service (SSS) serving a maternity hospital constituted each case study, located in three UK countries.ParticipantsData collection included semistructured interviews with trial participants (n=22), maternity (n=12) and SSS staff (n=17); and site observations and perspectives recorded in fieldnotes (n=85).ResultsCessation support (usual care) for pregnant women varied in amount, location, staff capacity, flexibility and content across sites. SSS staff capacity was important to avoid gaps in support. Colocation and good working relationships between maternity and SSS professionals enabled prioritisation and reinforced the importance of smoking cessation. Sites with limited use of carbon monoxide (CO) monitoring reduced opportunities to identify smokers while inconsistency around automatic referral processes prevented the offer of cessation support. SSS professionals colocated within antenatal clinics were available to women they could not otherwise reach. Flexibility around location, timing and tailoring of approaches for support, facilitated initial and sustained engagement and reduced the burden on women.ConclusionsTrial sites faced varied barriers and facilitators to delivering cessation support, reflecting heterogeneity in usual care. If financial incentives are more effective with concurrent smoking cessation support, sites with fewer barriers and more facilitators regarding this support would be expected to have more promising trial outcomes. Future reporting of trial outcomes will assist in understanding incentives' generalisability across a wide range of usual care settings.Trial registration numberISRCTN15236311.
| S-EPMC9730354 | biostudies-literature