Journal articles on the topic 'Concurrent mixed methods design'
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Hou, Su-I. "Mixed Methods Evaluation - A Chinese Cancer Screening Program." Innovation in Aging 4, Supplement_1 (December 1, 2020): 816. http://dx.doi.org/10.1093/geroni/igaa057.2970.
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Abstract This paper introduces the rapidly growing modern mixed methods research (MMR) and its application in a Chinese cancer screening program. While some previous researchers have incorporated quantitative and qualitative data in research, recent mixed methods developments have provided significant clarity that can guide those new to the MMR field. Understanding the context for using MMR and examining a complex mixed methods evaluation study in Taiwan can help illustrate opportunities for and application of mixed methods in Asians. The Taiwan Cervical Cancer Screening Education Program is used as an exemplar of a multi-phase complex mixed methods evaluation study showcasing various MMR designs. These include an exploratory sequential design to develop culturally sensitive study instrument, iterative concurrent and sequential mixed methods for intervention mapping, and an embedded mixed methods evaluation design to assess impact. Visual diagrams are introduced to facilitate communication of mixed methods design procedures and products in each phase.
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Alavi, Hamed, and Patrycja Hąbek. "Addressing Research Design Problem in Mixed Methods Research." Management Systems in Production Engineering 21, no. 1 (March 1, 2016): 62–66. http://dx.doi.org/10.2478/mspe-10-01-2016.
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Abstract Alongside other disciplines in social sciences, management researchers use mixed methods research more and more in conduct of their scientific investigations. Mixed methods approach can also be used in the field of production engineering. In comparison with traditional quantitative and qualitative research methods, reasons behind increasing popularity of mixed research method in management science can be traced in different factors. First of all, any particular discipline in management can be theoretically related to it. Second is that concurrent approach of mixed research method to inductive and deductive research logic provides researchers with opportunity to generate theory and test hypothesis in one study simultaneously. In addition, it provides a better justification for chosen method of investigation and higher validity for obtained answers to research questions. Despite increasing popularity of mixed research methods among management scholars, there is still need for a comprehensive approach to research design typology and process in mixed research method from the perspective of management science. The authors in this paper try to explain fundamental principles of mixed research method, its typology and different steps in its design process.
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Shannonhouse, Laura, Sejal Barden, Eric Jones, Laura Gonzalez, and Arthur Murphy. "Secondary Traumatic Stress for Trauma Researchers: A Mixed Methods Research Design." Journal of Mental Health Counseling 38, no. 3 (July 1, 2016): 201–16. http://dx.doi.org/10.17744/mehc.38.3.02.
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Forty-nine infants and toddlers were killed and 93 others were injured in the ABC Day Care Center fire disaster in Hermosillo, Mexico. This study describes the experiences of ten mental health professionals who researched the community-scale grief and provided clinical services to the parents and caregivers of the affected children. A concurrent triangulation mixed-methods approach was used to quantitatively measure and qualitatively understand the secondary traumatic stress (STS) of the responding professionals. Results indicated that experiences of STS decreased with time and debriefing, however, the responding professionals who were more directly connected to the trauma and those who worked with parents who lost their children displayed an enduring impact of STS. Coping strategies and gender expectations are considered in a discussion of debriefing in the specific cultural context of Northwestern Mexico.
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Smith, Thomas M., Marisa Cannata, and Katherine Taylor Haynes. "Reconciling Data from Different Sources: Practical Realities of Using Mixed Methods to Identify Effective High School Practices." Teachers College Record: The Voice of Scholarship in Education 118, no. 7 (July 2016): 1–34. http://dx.doi.org/10.1177/016146811611800705.
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Background/Context Mixed methods research conveys multiple advantages to the study of complex phenomena and large organizations or systems. The benefits are derived from drawing on the strengths of qualitative methods to answer questions about how and why a phenomenon occurs and those of quantitative methods to examine how often a phenomenon occurs and establish generalizable, empirical associations between variables and outcomes. Though the literature offers many strategies, designing mixed methods research can be challenging in large scale projects when trying to balance reliability, validity, and generalizability. By supporting the findings with multiple forms of evidence mixed methods designs lend greater validity than mono-method ones. However to draw on the comparative advantages of these two paradigms, researchers must grapple with the challenges of working with more than one method. Focus of Study This paper discusses the benefits and challenges of collecting and interpreting mixed methods data in a large scale research and development project. Drawing on existing frameworks, we refect on our strategies of mixed methods design, data collection, and analysis. We discuss the quandaries faced by researchers when discrepant findings emerge. Research Design The data come from a large, mixed methods case study focused on the practices that explain why some high schools in large urban districts are particularly effective at serving low income students, minority students, and English language learners. Undertaken in several phases, the work included sequential and concurrent designs. Incorporating a sequential explanatory design element, we first used quantitative data to identify schools in the district that were more and less effective at improving student achievement in English/language arts, mathematics, and science. We then used a combination of interviews, focus groups, surveys, classroom observations, and district administrative data—in a concurrent design—to try to understand what differentiated between the most and least effective schools in the district. Conclusions Based on our analyses, we provide examples of when mixed methods data converge, when they diverge but are complementary, and when they diverge and introduce a methodological quandary for researchers who must confront seemingly discrepant findings. In so doing, we discuss the tradeoffs encountered between the study design and the implications as we confronted them during analysis and suggest ways to balance the methodological demands of complex research studies. Seemingly discrepant findings, while challenging to reconcile, when considered for their potential complementarity, actually lead to a more complete understanding of the phenomena under study.
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Leech, Nancy L., Kathleen M. T. Collins, Qun G. Jiao, and Anthony J. Onwuegbuzie. "Mixed Research in Gifted Education." Journal for the Education of the Gifted 34, no. 6 (November 4, 2011): 860–75. http://dx.doi.org/10.1177/0162353211425095.
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The purpose of this study was to identify the prevalence of mixed research techniques in empirical studies published in gifted education journals. During Phase 1, empirical full-text databases and relevant electronic bibliographic databases related to gifted education were searched during a time span of 10 to 18 years, resulting in the identification of 32 mixed research studies. During Phase 2, frequency data were compiled detailing the types of methods (quantitative, qualitative, mixed) implemented in empirical studies published in three leading gifted education research journals covering the time span of 5 years. A sequential mixed analysis was conducted on Phase 2 data, and results indicated that authors of empirical research articles utilized primarily quantitative methods. Among the 19 studies identified as mixed research, 5 utilized a mixed design that was categorized as a partially mixed, concurrent, dominant status design.
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Stewart, William H. "Seoul Destination: A Mixed-methods Study of a Korean University." FIRE: Forum for International Research in Education 6, no. 3 (October 19, 2020): 58–82. http://dx.doi.org/10.32865/fire202063220.
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The number of international students studying in the Republic of Korea has increased tremendously over the last 20 years, marking a change in regional student mobility trends. While most international degree students tend to originate in countries in Asia, signifying regionalization versus internationalization, exchange students are diverse by nationality/ region. This concurrent nested mixed-methods study sought to investigate the pull factors of a Korean university among exchange students. 564 students completed an electronic questionnaire and through on campus interviews. Quantitative results suggested that exchange students found characteristics about Korea attractive (e.g., K-pop) as well as wanting international and/or cross-cultural experiences, to be the most appealing. 10 students participated in interviews, and findings showed that students became interested in Korea by exposure to popular media, as well as wanting a diverse, international study environment. The implications of these findings are discussed in terms of university inbound program promotion/marketing and program design/development for short-term mobility, along with areas for future research.
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Bartlam, Bernadette, Jacqueline Waterfield, Annette Bishop, Melanie A. Holden, Panos Barlas, Khaled M. Ismail, Christine Kettle, and Nadine E. Foster. "The Role of Qualitative Research in Clinical Trial Development: The EASE Back Study." Journal of Mixed Methods Research 12, no. 3 (July 13, 2016): 325–43. http://dx.doi.org/10.1177/1558689816656740.
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This article outlines the rationale for adopting a mixed methods approach within randomized controlled trials (RCTs) and explores challenges associated in doing so. Taking the example of the EASE Back feasibility and pilot study ( Evaluating Acupuncture and Standard care for pregnant wom En with BACK pain: ISRCTN49955124), we detail why and how we operationalized a concurrent-sequential mixed methods research design. We present key findings from the exploratory research (focus groups and interviews) and explain how these were integrated with descriptive findings (a national survey of physical therapists) in order to inform and refine the design of the explanatory phase (the pilot RCT). We conclude with a discussion of lessons learned and implications for future research design and conduct.
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Martin, Rosemarie, Augustine W. Kang, Audrey A. DeBritz, Mary R. Walton, Ariel Hoadley, Courtney DelaCuesta, and Linda Hurley. "Medication for Opioid Use Disorder Service Provision and Telephone Counseling: A Concurrent Mixed-Methods Approach." International Journal of Environmental Research and Public Health 18, no. 11 (June 7, 2021): 6163. http://dx.doi.org/10.3390/ijerph18116163.
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Using quantitative and qualitative evidence, this study triangulates counselors’ perspectives on the use of telemedicine in the context of Opioid Use Disorder (OUD) treatment. A concurrent mixed-methods design examined counselors’ experiences with telephone counseling during the COVID-19 pandemic. N = 42 counselors who provided OUD counseling services completed a close-ended, quantitative survey examining their experiences in addressing clients’ anxiety, depression, anger, substance use, therapeutic relationship, and substance use recovery using telephone counseling. The survey also assessed comfort, convenience, and satisfaction with telephone counseling. Counselors also completed open-ended responses examining satisfaction, convenience, relationship with patients, substance use, and general feedback with telephone counseling. The synthesis of quantitative and qualitative evidence indicated that a majority of counselors had positive experiences with using telephone counseling to provide services to clients undergoing OUD treatment. Convenience, greater access to clients, and flexibility were among the reasons cited for their positive experience. However, counselors also expressed that the telephone counseling was impersonal, and that some clients may have difficulties accessing appropriate technology for telehealth adoption. Findings suggest that further research with counselors is needed to identify the key elements of an effective integration of telephone counseling with traditional in-person treatment approaches in the post-pandemic era.
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Al-Yateem, Nabeel, Muhammad Arsyad Subu, Arwa Al-Shujairi, Intima Alrimawi, Hend Mohd Ali, Khadija Hasan, Nawal Peer Dad, and Maria Brenner. "Coping among adolescents with long-term health conditions: a mixed-methods study." British Journal of Nursing 29, no. 13 (July 9, 2020): 762–69. http://dx.doi.org/10.12968/bjon.2020.29.13.762.
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Background: Adolescents with long-term health conditions may be at risk of developing psychological comorbidities and adopting ineffective coping mechanisms if they are not adequately supported at home or school. Aim: To understand the strategies adolescents use when dealing with challenging health situations, and gain an in-depth understanding of the characteristics of their preferred care environment if they have unexpected health crises. Design: The study used a concurrent mixed-methods design, with data gathered between January and May 2019. Descriptive and non-parametric tests were used to analyse quantitative and qualitative data. Results: ‘Problem-focused disengagement’ was the most-often used coping strategy. The second and third most common strategies were ‘problem-focused engagement’ and ‘emotion-focused engagement’. Finally, girls tended to adopt more negative coping strategies than boys. The analysis revealed that most adolescents preferred home over school as the care environment because these caring agents were close and available, knew how to care for them and had the resources to provide or access care, and listened and understood them. Conclusion: Adolescents adopted disengagement and negative coping strategies early in their attempts to cope with stressful events before adopting more positive strategies. This is alarming, especially as school health services are not sufficiently supportive of adolescents at times of stress and illness. Adolescents often perceive school providers as unavailable and lacking knowledge about their health needs.
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Saunders, Mark Nk, and Adrian Thornhill. "Researching sensitively without sensitizing: Using a card sort in a concurrent mixed methods design to research trust and distrust." International Journal of Multiple Research Approaches 5, no. 3 (December 2011): 334–50. http://dx.doi.org/10.5172/mra.2011.5.3.334.
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Arumugam, Pathman, Tengku Alina Tengku Ismail, Aziah Daud, Kamarul Imran Musa, Noor Aman A. Hamid, Shaiful Bahari Ismail, and Zakiah Mohd Said. "Treatment-Seeking Behavior Among Male Civil Servants in Northeastern Malaysia: A Mixed-Methods Study." International Journal of Environmental Research and Public Health 17, no. 8 (April 15, 2020): 2713. http://dx.doi.org/10.3390/ijerph17082713.
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Background: Men’s health in Malaysia is slowly gaining more attention, but minimal research has examined how Malaysian men behave and seek treatment. While few studies have investigated men’s treatment-seeking behavior (TSB), those that have been conducted seem to be inconclusive and tend to yield contradictory findings. Objectives: This paper aims to determine the proportion of inappropriate TSB and to explore in-depth treatment-seeking behavior among male civil servants in northeastern Malaysia. Methods: This paper adopted a mixed-methods approach, specifically a concurrent parallel study design. A quantitative study using a self-administered questionnaire was performed to identify the proportion of appropriate and inappropriate TSB among male civil servants in northeastern Malaysia. Concurrently, a qualitative study was conducted involving six focus group discussion sessions, and the results of both parts were integrated to provide a detailed explanation of TSB among the participants. Results: A total of 381 participants were involved in the quantitative study, yielding a response rate of 94.8%; 246 (64.6%) engaged in inappropriate TSB. Some of the reported morbidities among the participants were hypertension (26.5%) and diabetes mellitus (26.2%). From the qualitative study, a main theme related to TSB emerged with several sub-themes, which were health literacy, stage of seeking treatment, preference for alternative treatment, perceived threat of illness, self-treatment, and the influence of family members and others. Conclusions: TSB among male civil servants in northeastern Malaysia is poor, and the factors contributing to it are multidimensional. This study has provided new valuable evidence on men’s TSB in northeastern Malaysia. The findings can be used to facilitate and improve current policies and the implementation of men’s health services throughout the country.
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Liu, Wei, Beverley Sparks, and Alexandra Coghlan. "Fun, inspiration and discovery: from momentary experiences to overall evaluations." International Journal of Contemporary Hospitality Management 29, no. 7 (July 10, 2017): 1937–55. http://dx.doi.org/10.1108/ijchm-12-2015-0735.
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Purpose This paper aims to use a concurrent mixed method approach to explore the key variables that can influence customer experience at a food and wine event. Design/methodology/approach A concurrent mixed methods approach, using a participant-generated image (PGI) method, together with a recall survey, provided images with associated narratives, descriptive statistics, correlations and hierarchical multiple regression analysis to explore how attendees appraise their experiences based on their goals and the link between experience appraisals and overall evaluations. Findings Through the PGI method (N = 25), the authors determined that customer experience at the event could be viewed as a hierarchical model, comprising a fundamental sensory experience together with three higher-order customer experience components (fun, discovery and inspiration). A separate concurrent recall study (N = 598) demonstrated the relationship between the same four customer experience components and overall satisfaction as well as recommendation and repeat visitation. Practical implications The results suggest that to promote positive customer experiences, along with the product of the event itself, event managers should focus on activity programs that are fun, inspirational and novel, as well as sensory. Originality/value This study focuses on a single case study of an event to examine and extend our understanding of customer experience. The use of a concurrent mixed methods approach provides us with different types of data from two separate samples of participants. By integrating data from each study the authors are able to build a conceptual model of the salient dimensions of customer experience and then quantitatively analyze how these salient dimensions are related to outcome variables.
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Lohmann, Julia, Stephan Brenner, Jean-Louis Koulidiati, Serge M. A. Somda, Paul Jacob Robyn, and Manuela De Allegri. "No impact of performance-based financing on the availability of essential medicines in Burkina Faso: A mixed-methods study." PLOS Global Public Health 2, no. 3 (March 23, 2022): e0000212. http://dx.doi.org/10.1371/journal.pgph.0000212.
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Access to safe, effective, and affordable essential medicines (EM) is critical to quality health services and as such has played a key role in innovative health system strengthening approaches such as Performance-based Financing (PBF). Available literature indicates that PBF can improve EM availability, but has not done so consistently in the past. Qualitative explorations of the reasons are yet scarce. We contribute to expanding the literature by estimating the impact of PBF on EM availability and stockout in Burkina Faso and investigating mechanisms of and barriers to change. The study used an explanatory mixed methods design. The quantitative study component followed a quasi-experimental design (difference-in-differences), comparing how EM availability and stockout had changed three years after implementation in 12 PBF and in 12 control districts. Qualitative data was collected from purposely selected policy and implementation stakeholders at all levels of the health system and community, using in-depth interviews and focus group discussions, and explored using deductive coding and thematic analysis. We found no impact of PBF on EM availability and stockouts in the quantitative data. Qualitative narratives converge in that EM supply had increased as a result of PBF, albeit not fully satisfactorily and sustainably so. Reasons include persisting contextual challenges, most importantly a public medicine procurement monopoly; design challenges, specifically a disconnect and disbalance in incentive levels between service provision and service quality indicators; implementation challenges including payment delays, issues around performance verification, and insufficient implementation of activities to strengthen stock management skills; and concurrently implemented policies, most importantly a national user fee exemption for children and pregnant women half way through the impact evaluation period. The case of PBF and EM availability in Burkina Faso illustrates the difficulty of incentivizing and effecting holistic change in EM availability in the presence of strong contextual constraints and powerful concurrent policies.
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Schiffelbein, Jenna E., Kathleen L. Carluzzo, Rian M. Hasson, Jennifer A. Alford-Teaster, Inger Imset, and Tracy Onega. "Barriers, Facilitators, and Suggested Interventions for Lung Cancer Screening Among a Rural Screening-Eligible Population." Journal of Primary Care & Community Health 11 (January 2020): 215013272093054. http://dx.doi.org/10.1177/2150132720930544.
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Introduction: Rural areas are disproportionally affected by lung cancer late-stage incidence and mortality. Lung cancer screening (LCS) is recommended to find lung cancer early and reduce mortality, yet uptake is low. The purpose of this study was to elucidate the barriers to, facilitators of, and suggested interventions for increasing LCS among a rural screening-eligible population using a mixed methods concurrent embedded design study. Methods: Qualitative and quantitative data were collected from rural-residing adults who met the eligibility criteria for LCS but who were not up-to-date with LCS recommendations. Study participants (n = 23) took part in 1 of 5 focus groups and completed a survey. Focus group discussions were recorded, transcribed, and coded through a mixed deductive and inductive approach. Survey data were used to enhance and clarify focus group results; these data were integrated in the design and during analysis, in accordance with the mixed methods concurrent embedded design approach. Results: Several key barriers to LCS were identified, including an overall lack of knowledge about LCS, not receiving information or recommendation from a health care provider, and lack of transportation. Key facilitators were receiving a provider recommendation and high motivation to know the screening results. Participants suggested that LCS uptake could be increased by addressing provider understanding and recommendation of LCS and conducting community outreach to promote LCS awareness and access. Conclusion: The results suggest that the rural screening-eligible population is generally receptive to LCS. Patient-level factors important to getting this population screened include knowledge, transportation, motivation to know their screening results, and receiving information or recommendation from a provider. Addressing these factors may be important to increase rural LCS uptake.
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Estrada Molina, Odiel. "The Effects of WhatsApp and Telegram on Student Engagement: An Analysis from the Mixed-Methods Approach." Education Research International 2022 (July 13, 2022): 1–14. http://dx.doi.org/10.1155/2022/2881404.
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One of the most studied variables in virtual online education is engagement because it contributes to retention and academic performance. Several studies show that the didactic design of the virtual course, the role of the teacher, interactivity, interaction, time spent in the virtual environment, and the use of digital social networks increase engagement. However, there is a lack of research that compares which of the two digital social networks, WhatsApp or Telegram, promotes higher levels of engagement. This study’s objective is to analyze the effect of the educational use of Telegram on student engagement. An experiment (pretest and posttest with a control group) is designed using a mixed-methods approach based on a convergent or concurrent triangulation design. The study populations (coincides with the sample) are those enrolled (n = 229) in the six editions of a virtual postgraduate course. The techniques used for data analysis were scatter plots, content analysis of teachers’ narratives, and statistical methods. The triangulation of the quantitative and qualitative results confirms that the educational use of digital social networks promotes engagement in all experimental groups (use of the virtual learning environment and Telegram) obtaining greater significant differences than in the control groups. It is concluded that the use of the following Telegram functionalities, chat groups, peer assessments, support for various types of online interaction, the exchange of digital media, and the design of surveys contributed, under the guidance of teachers, is to increase the student’s engagement.
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Park, Eunhee, and Yu-Ping Chang. "Using Digital Media to Empower Adolescents in Smoking Prevention: Mixed Methods Study." JMIR Pediatrics and Parenting 3, no. 1 (March 31, 2020): e13031. http://dx.doi.org/10.2196/13031.
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Background There is a critical need for effective health education methods for adolescent smoking prevention. The coproduction of antismoking videos shows promising results for adolescent health education. Objective This study explored the feasibility of a smoking prevention program using the coproduction of antismoking videos in order to empower adolescents in smoking prevention and tobacco control. A smoking prevention program based on coproduction of antismoking videos over eight sessions was implemented in a low-income neighborhood. Methods A mixed methods design with a concurrent embedded approach was used. In total, 23 adolescents participated in the program. During the prevention program, small groups of participants used video cameras and laptops to produce video clips containing antismoking messages. Quantitative data were analyzed using the Wilcoxon signed-rank test to examine changes in participants’ psychological empowerment levels between pre- and postintervention; qualitative interview data were analyzed using content analysis. Results Pre- and postcomparison data revealed that participants’ psychological empowerment levels were significantly enhanced for all three domains—intrapersonal, interactional, and behavioral—of psychological empowerment (P<.05). Interviews confirmed that the coproduction of antismoking videos is feasible in empowering participants, by supporting nonsmoking behaviors and providing them with an opportunity to help build a smoke-free community. Conclusions Both quantitative and qualitative data supported the feasibility of the coproduction of antismoking videos in empowering adolescents in smoking prevention. Coproduction of antismoking videos with adolescents was a beneficial health education method.
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Güeita-Rodríguez, Javier, Anna Ogonowska-Slodownik, Natalia Morgulec-Adamowicz, Mar Lledó Martín-Prades, Juan Nicolás Cuenca-Zaldívar, and Domingo Palacios-Ceña. "Effects of Aquatic Therapy for Children with Autism Spectrum Disorder on Social Competence and Quality of Life: A Mixed Methods Study." International Journal of Environmental Research and Public Health 18, no. 6 (March 18, 2021): 3126. http://dx.doi.org/10.3390/ijerph18063126.
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Autism Spectrum Disorder (ASD) is a constellation of social deficits and repetitive sensory-motor behaviours. Aquatic therapy (AT) may be effective in improving the social interactions and behaviours in children with ASD. The objective of this study was to evaluate the effects of an AT program on social competence and quality of life and to understand participant’s experiences related to the intervention by obtaining qualitative data. A mixed methods intervention study was conducted among 6 children with ASD and their parents, with two research phases in a concurrent embedded design (an aquatic intervention as the quantitative design and a qualitative design in second step). The intervention and qualitative design followed international guidelines and were integrated into the method and reporting subheadings. Significant improvement was observed in the physical competence (p = 0.026) and important improvements in school functioning and aquatic skills, with no adverse events. Qualitative findings described: the meaning of AT intervention, patterns of behaviour and activities changes, social communication and social interaction. The aquatic intervention showed positive results for the social and physical competence, with elements of discordance, expansion, and confirmation between quantitative and qualitative results.
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Gander, Michelle. "Professional staff in universities: Career needs, values, attitudes and behaviours." Australian Journal of Career Development 27, no. 3 (September 24, 2018): 160–71. http://dx.doi.org/10.1177/1038416218775746.
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This article outlines a concurrent complementarity, mixed methods research design to explore the careers of university professional staff through the application of a contemporary career profile framework. Two hundred and twenty-six participants from Australia and the UK completed a multi-method questionnaire. Integration occurred at three points: the conceptualisation stage using a multi-method instrument; the experiential stage where the quantitative data results acted as a priori themes for the theoretical thematic analysis; and the inferential stage where both convergent and divergent triangulation of the results took place to provide a broader and deeper understanding of the phenomenon under study. This methodological design aims to demonstrate the usefulness of mixed methods in carrying out careers research. The findings extend the career profile theory by highlighting individual needs, related behaviours and outcomes and by suggesting that there are various psychological mechanisms acting to drive career behaviours.
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Zhou, Zhichun, David Burrell McAdam, Deborah Ann Napolitano, and Kathryn Douthit. "Shining a Light on the Challenging Behaviors of Adolescents with Comorbid Diagnoses: Use of Pictorial Concurrent Operant Preference Assessment." Children 8, no. 8 (August 8, 2021): 683. http://dx.doi.org/10.3390/children8080683.
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Currently, there are no published studies that have used the concurrent operant preference assessment procedure to identify functions of challenging behaviors displayed by individuals with comorbid diagnoses. Four participants (aged 11–16 years) with comorbid diagnoses who displayed multiple challenging behaviors were referred to this study. We modified the standard concurrent operant preference assessment and used the new modified version, the pictorial concurrent operant preference assessment, to identify the functions of the challenging behaviors. Utilizing the triangulation mixed-methods design, we compared the indirect functional behavioral assessment (FBA) and the direct FBA with the pictorial concurrent operant preference assessment. The results obtained successfully demonstrated the concordance among these assessments in identifying the behavioral function for each participant. The results further showed that (1) the preferences served the same functional effects on both the challenging behaviors and the adaptive behaviors and (2) the pictorial concurrent operant preference assessment can be used independently to identify potential behavioral function and to specify the reinforcing potency of each behavioral function. The significance of the study results, limitations of this study, and directions for future research and clinical practice are discussed.
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Sebastian, Perumbilly A., and Anderson A. Stephen. "Substance Abuse Prevention: Perspectives from India’s Addiction Treatment Professionals." Artha - Journal of Social Sciences 14, no. 2 (April 1, 2015): 9. http://dx.doi.org/10.12724/ajss.33.2.
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This article is focused on substance abuse prevention from the perspective of India. Research participants were 112 substance addiction treatment professionals associated with government approved addiction treatment centres in India. They were called from 26 Indian states and 4 union territories in India. Data were collected through a survey instrument using a mixed-methods research design with a focus on concurrent strategies. Participants provided practical recommendations for creating public awareness systemically, concurrently and consistently through a prevention agenda focusing on important social sectors such as schools, employment settings, religious/spiritual settings, and at local, state and national domains of India. This study concludes that creating massive awareness campaigns simultaneously and consistently over long periods of time in all these sectors of the society will facilitate systemic change at the macro-level. Findings have practical implications for policymakers everywhere working towards preventing substance abuse.
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Arreola Gurrola, Sergio, and Claudia Estela Saldaña Durán. "diagnóstico de competitividad del sector de mezcal de Durango, México." Revista Relayn - Micro y Pequeñas empresas en Latinoamérica 4, no. 3 (October 1, 2020): 16–27. http://dx.doi.org/10.46990/relayn.2020.4.3.36.
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El objetivo del presente trabajo fue desarrollar un diagnóstico de la competitividad del clúster de mezcal de Durango. Se utilizó un diseño concurrente de métodos mixtos, en el enfoque cualitativo se usó un diseño fenomenológico y en el cuantitativo un cuestionario adaptado. Resultando que cuatro fuerzas competitivas (la amenaza de nuevos competidores, amenaza de productos sustitos, poder negociador de los compradores y la rivalidad de la industria) erosionan el valor que pueden generar las empresas en el sector de mezcal en Durango, así mismo se hallaron tres grupos estratégicos que difieren en sus indicadores de competitividad. Abstract The objective of this work was to develop a diagnosis of the competitiveness of theDurango mezcal cluster. A concurrent design of mixed methods was used, thequalitative approach used a phenomenological design and in quantitative an adaptedquestionnaire. It turns out that four competitive forces (the threat of new competitors,threat of substitute products, buyer trading power and industry rivalry) erode the valuethat companies can generate in the mezcal sector in Durango, as well as threestrategic groups that differ in their competitiveness indicators.
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Kiperman, Sarah, Hannah L. Schacter, Margaret Judge, and Gabriel DeLong. "LGBTQ+ Youth’s Identity Development in the Context of Peer Victimization: A Mixed Methods Investigation." International Journal of Environmental Research and Public Health 19, no. 7 (March 25, 2022): 3921. http://dx.doi.org/10.3390/ijerph19073921.
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Research rarely explores LGBTQ+ youth bullying in the context of culture-specific outcomes (e.g., LGBTQ+ identity development) and what can mitigate the impact of peer stressors. This study used a concurrent mixed methods design to explore how experiences of peer victimization predicted LGBTQ+ youth’s identity development (i.e., stigma sensitivity, concealment motivation, and difficult process) and whether social support and outness served as protective, moderating factors. The mixed methods approach provides a culture-specific context via qualitative inquiry to inform whether the quantitative findings align with how youth qualitatively discuss their experience of peer victimization, negative outcomes, and social support. Our sample consisted of 349 LGBTQ+ youth 14–17 years old who completed a survey (quantitative sample) and a subset of 39 LGBTQ+ youth who completed a semi-structured interview (qualitative sample). Our quantitative findings indicated that greater overall peer victimization was positively related to LGBIS-revised subscales of stigma sensitivity, concealment motivation, and difficult process, where both outness and social support moderated such relations. Qualitatively, victimized youth also reported stigma sensitivity and concealment motivation while also endorsing how being out and having a support system played a role in their experience of being victimized. These qualitative findings align with our quantitative findings that classmate support mitigated the effects of peer victimization on the difficulty of coming out. Implications for practitioners and researchers are provided.
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BOZKURT, Bayram, and Halil İbrahim AKTAŞ. "The Examination of Teachers’ Perceptions Relating to Job Satisfaction: A Mixed-Method Study." International Journal of Psychology and Educational Studies 9 (October 23, 2022): 841–55. http://dx.doi.org/10.52380/ijpes.2022.9.4.704.
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This study aimed to examine the perceptions of job satisfaction of teachers working in public schools. A concurrent design is one of the mixed methods research designs where qualitative and quantitative research methods are used together. The research was designed with the phenomenology pattern, one of the qualitative research designs, and the hatch pattern, which is one of the quantitative research types. The data in the qualitative part of the research were analyzed by content analysis method. The data in the quantitative part was analyzed with statistical methods such as mean and standard deviation. While the sample of the quantitative part consists of 324 teachers, in the qualitative part, 43 teachers determined from the same sample constitute the study group. The quantitative results showed that the teachers had a high level of internal satisfaction and a moderate external satisfaction perception. It has been concluded that teachers have a medium level of job satisfaction perception in all job satisfaction. The qualitative results revealed that the teachers had negative views on social prestige, adequate pay, being appreciated by the manager, and positive views on being satisfied with the workplace, being satisfied with the manager, and feeling conscientious about their work. It is expected that the research results will provide data for both policymakers in education and school administrators who affect teacher job satisfaction in practice.
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Chu, Shao-Yin, Chin-Chen Wen, and Chun-Ying Weng. "Gender Differences in Caring for Children with Genetic or Rare Diseases: A Mixed-Methods Study." Children 9, no. 5 (April 27, 2022): 627. http://dx.doi.org/10.3390/children9050627.
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As a factor in parenting stress, gender differences in caring for children with genetic or rare diseases warrant research attention; therefore, this study explored gender differences in parenting stress, health outcomes, and illness perceptions among caregivers of pediatric genetic or rare disease populations to improve the understanding of such gender differences. Applying a concurrent triangulation mixed-methods design, we conducted a questionnaire survey to assess study measures for 100 family caregivers (42 men and 58 women), which included a free-text response item to probe caregivers’ subjective perceptions of the children’s illness. The gender differences hypothesis was tested with statistics and the qualitative data about illness perception was analyzed by directed content analysis. Most female caregivers served as the primary caregivers and provided more caregiving, while they experienced significantly increased levels of parenting stress and depressive symptoms compared with male caregivers. Female caregivers perceived the conditions of their children’s diseases to be highly symptomatic, with negative consequences and requiring disease control. By contrast, male caregivers had stronger perceptions regarding the negative effects of the disease on the children’s quality of life. The gender discrepancy in viewpoints of illness perception sequence may contribute to female caregivers’ higher levels of stress and depressive symptoms than males.
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Acosta, Imee Colonia, and Alexander S. Acosta. "Resilience is the Key: A Concurrent Mixed Methods Study on Surviving the Challenges of COVID-19 among Philippine Schools Overseas." International Journal of Research in Education and Science 8, no. 3 (August 26, 2022): 559–75. http://dx.doi.org/10.46328/ijres.2863.
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The COVID-19 pandemic has brought unprecedented challenges among schools across the globe, including the Philippine Schools Overseas (PSOs). Using a convergent mixed methods design, this study investigated the perceptions, views and experiences of the respondents to the unexpected occurrence of COVID 19. In this approach, quantitative and qualitative data collection techniques were used in parallel with each other. Datasets were analyzed separately and merged at the point of integration where they are arrayed side-by-side and by using a joint display. A total of eighty-eight participants from PSOs participated the survey, and nine respondents participated in the phenomenological interviews. The chi-square analysis revealed non-significant association between the respondents’ designation and their perceptions to surviving the challenges of COVID-19 in relation to challenges encountered, learning continuity, health and safety protocols, and lessons learned. Qualitative findings revealed that mitigating the challenges, pursuing learning continuity, observing stricter health and safety protocols, and learning from experiences are the best approaches to survive the challenges. The direct comparison of the quantitative and qualitative results allowed us to draw meta-inferences which were classified as confirming and expanding. The mixed methods analyses illuminated the overall aspects of how schools survived the COVID-19 challenges, thus creating a more complete picture of the phenomenon under study.
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Morrison Small, Marilyn, Jascinth Lindo, Joyette Aiken, and Claudette Chin. "Lateral violence among nurses at a Jamaican hospital : a mixed methods study." International Journal of Advanced Nursing Studies 6, no. 2 (October 10, 2017): 85. http://dx.doi.org/10.14419/ijans.v6i2.8264.
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Purpose: In many first-world settings, lateral violence among nurses is pervasive and has been associated with deleterious psychological effects, high staff turnover and negative patient outcomes. This study explored lateral violence among nurses at a Jamaican hospital.Methods: A fixed concurrent QUAN= QUAL mixed method study design was employed. Data were gathered from 114 registered nurses using the 38-item Briles’ Sabotage Savvy self-administered questionnaire and two focus group discussions.Results: Exposure to lateral violence was reported by 96% of participants, and 3/4 rated the exposure as moderate to severe. Nurse Managers were the main perpetrators of lateral violence (63%). Lateral violence created a hostile environment, and half of the nurses surveyed indicated an intent to resign. These survey findings were supported by the focus group discussions which yielded themes inclusive of professional disengagement and erosion of team work.Conclusion: The high levels of lateral violence reported in this study indicates an urgent need for the implementation of appropriate workplace violence policies. Reported threats to the healthcare system included poor staff retention and professional disengagement.Highlights:Lateral violence among nurses is one of the most damaging issues affecting the progress of the nursing profession and is well studied in the developed world.The attributes of the phenomenon of lateral violence in a low and middle-income country are described in this paper.Exposure to lateral violence was reported by 96% of participants, forms of lateral violence appeared to be mainly verbal or emotional and nurse managers were the major perpetrators.Assimilated behavior in response to lateral violence among the nurses included professional disengagement, retaliation, avoidance and intent to resign.The pervasiveness of lateral violence among the nurses studied indicates the need to implement appropriate workplace violence policies.
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Kenny, Lorna, Kevin Moore, Clíona O' Riordan, Siobhan Fox, John Barton, Salvatore Tedesco, Marco Sica, et al. "The Views and Needs of People With Parkinson Disease Regarding Wearable Devices for Disease Monitoring: Mixed Methods Exploration." JMIR Formative Research 6, no. 1 (January 6, 2022): e27418. http://dx.doi.org/10.2196/27418.
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Background Wearable devices can diagnose, monitor, and manage neurological disorders such as Parkinson disease. With a growing number of wearable devices, it is no longer a case of whether a wearable device can measure Parkinson disease motor symptoms, but rather which features suit the user. Concurrent with continued device development, it is important to generate insights on the nuanced needs of the user in the modern era of wearable device capabilities. Objective This study aims to understand the views and needs of people with Parkinson disease regarding wearable devices for disease monitoring and management. Methods This study used a mixed method parallel design, wherein survey and focus groups were concurrently conducted with people living with Parkinson disease in Munster, Ireland. Surveys and focus group schedules were developed with input from people with Parkinson disease. The survey included questions about technology use, wearable device knowledge, and Likert items about potential device features and capabilities. The focus group participants were purposively sampled for variation in age (all were aged >50 years) and sex. The discussions concerned user priorities, perceived benefits of wearable devices, and preferred features. Simple descriptive statistics represented the survey data. The focus groups analyzed common themes using a qualitative thematic approach. The survey and focus group analyses occurred separately, and results were evaluated using a narrative approach. Results Overall, 32 surveys were completed by individuals with Parkinson disease. Four semistructured focus groups were held with 24 people with Parkinson disease. Overall, the participants were positive about wearable devices and their perceived benefits in the management of symptoms, especially those of motor dexterity. Wearable devices should demonstrate clinical usefulness and be user-friendly and comfortable. Participants tended to see wearable devices mainly in providing data for health care professionals rather than providing feedback for themselves, although this was also important. Barriers to use included poor hand function, average technology confidence, and potential costs. It was felt that wearable device design that considered the user would ensure better compliance and adoption. Conclusions Wearable devices that allow remote monitoring and assessment could improve health care access for patients living remotely or are unable to travel. COVID-19 has increased the use of remotely delivered health care; therefore, future integration of technology with health care will be crucial. Wearable device designers should be aware of the variability in Parkinson disease symptoms and the unique needs of users. Special consideration should be given to Parkinson disease–related health barriers and the users’ confidence with technology. In this context, a user-centered design approach that includes people with Parkinson disease in the design of technology will likely be rewarded with improved user engagement and the adoption of and compliance with wearable devices, potentially leading to more accurate disease management, including self-management.
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Moreno-Mulet, Cristina, Noemí Sansó, Alba Carrero-Planells, Camelia López-Deflory, Laura Galiana, Patricia García-Pazo, Maria Magdalena Borràs-Mateu, and Margalida Miró-Bonet. "The Impact of the COVID-19 Pandemic on ICU Healthcare Professionals: A Mixed Methods Study." International Journal of Environmental Research and Public Health 18, no. 17 (September 1, 2021): 9243. http://dx.doi.org/10.3390/ijerph18179243.
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The large numbers of patients admitted to intensive care units due to COVID-19 has had a major impact on healthcare professionals. The incidence of mental health disorders among these professionals has increased considerably and their professional quality of life has suffered during the pandemic. This study aims to explore the impact of the provision of COVID-19 patient care on ICU healthcare professionals. A mixed methods study with an exploratory concurrent design was conducted between June and November 2020 in the Balearic Islands, Spain. Data were collected using a self-report online survey (n = 122) based on three validated questionnaires, and individual semi-structured in-depth online interviews (n = 11). Respondents scored 2.5 out of 5 on the moral distress scale, moderate/high on the compassion satisfaction scale, and moderate on the burnout and compassion fatigue subscales. Age was significantly and negatively related to professional quality of life but was positively related to workload and unavailability of protective equipment. Three main groups of themes relating to the impact of the pandemic emerged from the in-depth interviews: (a) clinical, (b) professional, and (c) personal and family impacts in the two waves. ICU healthcare professionals should be viewed as second victims of the COVID-19 pandemic as they have suffered significant psychological, professional, and moral harm.
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Scholz Mellum, Jean, Donna Martsolf, Greer Glazer, Grant Martsolf, and Barbara Tobias. "A mixed methods study of the experience of older adults with multimorbidity in a Care Coordination Program." International Journal of Care Coordination 21, no. 1-2 (March 7, 2018): 36–46. http://dx.doi.org/10.1177/2053434518762593.
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Introduction Care Coordination Programs are designed to streamline services for older adults with multimorbidity. The Triple Aim, a conceptual model for the design and evaluation of healthcare models, stipulates that a balance of three aims—reducing costs, improving population health, and improving patient experience—are needed for high-quality, value-based care. Research is beginning to show that coordinating care across the continuum of care reduces costs and improves the health of the multimorbid older adult population. Yet little is known about older adults’ experience of care and their overall assessment of interactions with healthcare providers across the length of time of these interactions in a Care Coordination Program. Methods To gain a deeper understanding of older adults’ experience with a Care Coordination Program, this concurrent mixed methods research study analyzed 201 older adults’ assessment of their chronic illness care using the Patient Assessment of Chronic Illness Care (PACIC+). A subset of 30 older adults also participated in a telephone interview to collect qualitative data. Results The experience of older adults with multimorbidity in a Care Coordination Program was related to two factors: (1) professional actions and (2) professional attitudes. Actions that improved patients’ experience of care were communication, coordination, and addressing fundamental problems. Professional attitudes that improved their experience of care included being compassionate, knowledgeable and professional, mutually respectful, and positive and encouraging. Discussion To improve patient experience, Care Coordination Programs must design and measure their efforts related to the actions and the attitudes of their care team, especially primary care physicians and care coordinators.
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Reszel, Jessica, Joan van den Hoek, Tram Nguyen, Gayatri Aravind, Mark T. Bayley, Marie-Louise Bird, Kate Edwards, et al. "The Stroke Recovery in Motion Implementation Planner: Mixed Methods User Evaluation." JMIR Formative Research 6, no. 7 (July 29, 2022): e37189. http://dx.doi.org/10.2196/37189.
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Background As more people are surviving stroke, there is a growing need for services and programs that support the long-term needs of people living with the effects of stroke. Exercise has many benefits; however, most people with stroke do not have access to specialized exercise programs that meet their needs in their communities. To catalyze the implementation of these programs, our team developed the Stroke Recovery in Motion Implementation Planner, an evidence-informed implementation guide for teams planning a community-based exercise program for people with stroke. Objective This study aimed to conduct a user evaluation to elicit user perceptions of the usefulness and acceptability of the Planner to inform revisions. Methods This mixed methods study used a concurrent triangulation design. We used purposive sampling to enroll a diverse sample of end users (program managers and coordinators, rehabilitation health partners, and fitness professionals) from three main groups: those who are currently planning a program, those who intend to plan a program in the future, and those who had previously planned a program. Participants reviewed the Planner and completed a questionnaire and interviews to identify positive features, areas of improvement, value, and feasibility. We used descriptive statistics for quantitative data and content analysis for qualitative data. We triangulated the data sources to identify Planner modifications. Results A total of 39 people participated in this study. Overall, the feedback was positive, highlighting the value of the Planner’s comprehensiveness, tools and templates, and real-world examples. The identified areas for improvement included clarifying the need for specific steps, refining navigation, and creating more action-oriented content. Most participants reported an increase in knowledge and confidence after reading the Planner and reported that using the resource would improve their planning approach. Conclusions We used a rigorous and user-centered process to develop and evaluate the Planner. End users indicated that it is a valuable resource and identified specific changes for improvement. The Planner was subsequently updated and is now publicly available for community planning teams to use in the planning and delivery of evidence-informed, sustainable, community-based exercise programs for people with stroke.
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Hatta, Taichi, Keiichi Narita, Kazuhiro Yanagihara, Hiroshi Ishiguro, Toshinori Murayama, and Masayuki Yokode. "Crossover Mixed Analysis in a Convergent Mixed Methods Design Used to Investigate Clinical Dialogues About Cancer Treatment in the Japanese Context." Journal of Mixed Methods Research 14, no. 1 (August 19, 2018): 84–109. http://dx.doi.org/10.1177/1558689818792793.
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The convergent mixed methods design is a common mixed methods research strategy; however, a challenge arises when data are collected concurrently but not analyzed completely independently due to overlapping research aims or certain styles of reasoning. The aims of this study were to (1) implement a crossover-tracks analysis in a convergent design wherein qualitative and quantitative strands were intertwined and informed each other and (2) examine a working hypothesis about the relationship between temporal change in clinical dialogues to examine the strength of patients’ motivation to participate in a clinical consultation. Using hypothetico-deductive method, the dynamic analytical approach shifted between inductive and deductive approaches. The qualitative and quantitative results were merged, and a joint-display depicted the relation for the final interpretation.
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Parker, Nathan H., Rebecca E. Lee, Daniel P. O’Connor, An Ngo-Huang, Maria Q. B. Petzel, Keri Schadler, Xuemei Wang, et al. "Supports and Barriers to Home-Based Physical Activity During Preoperative Treatment of Pancreatic Cancer: A Mixed-Methods Study." Journal of Physical Activity and Health 16, no. 12 (December 1, 2019): 1113–22. http://dx.doi.org/10.1123/jpah.2019-0027.
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Background: Physical activity and exercise appear to benefit patients receiving preoperative treatment for cancer. Supports and barriers must be considered to increase compliance with home-based exercise prescriptions in this setting. Such influences have not been previously examined. Methods: The authors used quantitative and qualitative methods to examine potential physical activity influences among patients who were prescribed home-based aerobic and strengthening exercises concurrent with preoperative chemotherapy or chemoradiation for pancreatic cancer. Physical activity was measured using exercise logs and accelerometers. Social support for exercise and perceived neighborhood walkability were measured using validated surveys. Relationships between influences and physical activity were evaluated using linear regression analyses and qualitative interviews. Results: Fifty patients received treatment for a mean of 16 (9) weeks prior to planned surgical resection. Social support from friends and neighborhood esthetics were positively associated with physical activity (P < .05). In interviews, patients confirmed the importance of these influences and cited encouragement from health care providers and desire to complete and recover from treatment as additional motivators. Conclusions: Interpersonal and environmental motivators of exercise and physical activity must be considered in the design of future home-based exercise interventions designed for patients receiving preoperative therapy for cancer.
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Liu, Qi, Margaret Jones, and Clare Hocking. "Describing and measuring the ‘switch-on’ effect in people with dementia who participate in cognitive stimulation therapy: A mixed methods study." British Journal of Occupational Therapy 83, no. 5 (January 30, 2020): 316–25. http://dx.doi.org/10.1177/0308022619899301.
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Introduction Cognitive stimulation therapy is an evidence-based group intervention for promoting cognition and quality of life in people with dementia. This New Zealand study aimed to describe and measure the ‘switch-on’ effect, a recently reported benefit involving enhanced participation. Method A convergent parallel mixed methods design was implemented. Interviews guided by qualitative descriptive methodology were conducted with four community-dwelling men with mild dementia and their wives, before, during and after cognitive stimulation therapy. Concomitantly, participants with dementia were scored on the Volitional Questionnaire following a single-subject A–B design. Qualitative and quantitative data were analysed using NVivo-assisted thematic analysis and descriptive statistics respectively and conjointly. Findings ‘Switch-on’ was found to be multi-dimensional in nature, with increased engagement and expanded scope in Doing, Feeling, Relating, and Thinking and Reflecting. ‘Switch-on’ occurred with a noticeable onset within 3 weeks, which was sustained and consolidated towards completion of cognitive stimulation therapy in both group and home environments. Three men showed concurrent improvements on the achievement sub-scale of the Volitional Questionnaire. However, the measure did not effectively capture ‘switch-on’ due to its ceiling effect. Conclusion Findings about ‘switch-on’ suggest broader, under-researched benefits of cognitive stimulation therapy that merit further exploration from an occupational therapy perspective.
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Azanaw, Abrham, Melaku Birhanu Alemu, Mezgebu Yitayal, and Andualem Yalew Aschalew. "Evaluation of the pediatric antiretroviral therapy service in Gondar city public health facilities—A case study design with mixed methods." PLOS ONE 17, no. 12 (December 30, 2022): e0279890. http://dx.doi.org/10.1371/journal.pone.0279890.
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Background The pediatric antiretroviral therapy (ART) service is introduced to save lives, restore mental and physical functions, and improve the quality of life of children living with HIV/AIDS. This evaluation aimed to assess the implementation status of the pediatric ART service provision in Gondar city administration health facilities to promote evidence-based decision-making for program improvement. Methods An institutional-based single case-study design with concurrent mixed methods were applied. The service was evaluated by the availability of essential resources, compliance of health providers with the standard guideline, and caregivers’ satisfaction dimensions. Document review, key informant interviews, observations, and interviewer-administered exit-interview were conducted. The quantitative data were analyzed in descriptive and analytical, while the qualitative data were transcribed, translated, and thematically analyzed. A logistic regression analysis was performed to identify factors associated with caregivers’ satisfaction. Results The overall implementation of pediatric ART service was 75.32%. The availability, compliance, and satisfaction were 68.96%, 74.44%, and 84.64%, respectively. Trained healthcare professionals, essential ART drugs, registers, and basic laboratory diagnostic equipment were reasonably available. However, the lack of opportunistic infection medications and adequate rooms were significant gaps in service provision. Respondents noted a shortage of drugs and rooms for consultation and service provision. Short travel distance (AOR = 2.87), low viral load (AOR = 3.15), and sex of caregivers (AOR = 4.98) were significantly associated with good satisfaction. Conclusions The overall implementation of pediatric ART service is well based on the pre-determined judgment criteria. The health facilities and policymakers are advised to focus on availing medications to treat opportunistic infections and expanding the health facility to have enough space for consultation and service provision. Furthermore, particular emphasis should be given to caregivers who come from long distances and patients with a high viral load to increase caregivers’ satisfaction.
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Gaias, Larissa M., Manuela Jimenez, Tashia Abry, Kristen L. Granger, and Michelle Taylor. "Kindergarten Teachers’ Instructional Priorities Misalignment and Job Satisfaction: A Mixed Methods Analysis." Teachers College Record: The Voice of Scholarship in Education 120, no. 12 (December 2018): 1–38. http://dx.doi.org/10.1177/016146811812001206.
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Background Instructional priority misalignment—the difference between how much time teachers would ideally spend on certain subjects/skills compared with how much time teachers actually spend on certain subjects/skills—is a novel measure addressing aspects of teacher autonomy that could have implications for job satisfaction. This misalignment may be particularly salient for kindergarten teachers, who have experienced recent shifts in instructional priorities as standards-based academic learning has been increasingly integrated into the classrooms of our youngest students. Thus, misalignment in teachers’ instructional priorities regarding Common Core academic topics (math, English) and socio-emotional learning skills may be especially important for kindergarten teachers’ job satisfaction. Research Questions (a) To what extent do teachers experience misalignment between their ideal and actualized instructional priorities in Common Core and socio-emotional domains? (b) Is misalignment in Common Core and socio-emotional domains related to teacher job satisfaction? (c) Which perceptions of the teaching profession contribute to job satisfaction for kindergarten teachers who report high misalignment but high job satisfaction? (d) How do their responses compare with the responses of teachers who report high misalignment but low job satisfaction? Setting and Participants A total of 911 kindergarten teachers (99% female, 83% Caucasian) from the state of Arizona participated in the study. At the time of data collection, Arizona had adapted the Common Core standards for math and literacy but had not implemented socio-emotional standards for kindergarten. Research Design Participants completed a survey in which they reported on their ideal and actual instructional priorities, their job satisfaction, and why they felt satisfied or unsatisfied with the profession. Data Collection and Analysis We used mixed methodology with concurrent data collection but sequential data analysis to answer our research questions. Findings/Results In the quantitative phase (Phase 1), we found that teachers experienced significant misalignment between their ideal and actual instructional priorities regarding socio-emotional development priorities, but not regarding Common Core academics. Additionally, a logistic regression demonstrated that for both domains of instruction, misalignment negatively predicted job satisfaction. Qualitatively, highly misaligned teachers who reported higher job satisfaction levels more often described psychological well-being, positive student characteristics, and the ability to tend to the needs of their family and friends as reasons for their job satisfaction than highly misaligned teachers with lower job satisfaction. Conclusions The present study has implications for teacher training, recruitment, and professional development aimed at supporting job satisfaction in kindergarten teachers.
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Chicoine, Gabrielle, José Côté, Jacinthe Pepin, Pierre Pluye, Louise Boyer, Guillaume Fontaine, Geneviève Rouleau, Simon Dubreucq, and Didier Jutras-Aswad. "Impact of a videoconferencing educational programme for the management of concurrent disorders on nurses’ competency development and clinical practice: protocol for a convergent mixed methods study." BMJ Open 11, no. 3 (March 2021): e042875. http://dx.doi.org/10.1136/bmjopen-2020-042875.
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IntroductionExtension for Community Healthcare Outcomes (Project ECHO©) is an innovative model for continuing professional development that uses videoconferencing technology to support and train general practitioners remotely. The model has been replicated to a variety of settings and locations for capacity building in healthcare professionals caring for patients with chronic and complex health conditions. Limited research has been conducted so far on the impact of ECHO in the field of concurrent mental health and substance use disorders (ie, concurrent disorders (CDs)). Therefore, this mixed methods study aims to develop a comprehensive understanding of an ECHO programme impact for CD management on nurses’ competency development and clinical practice.Methods and analysisThe proposed mixed methods study, based on a convergent parallel design, will be conducted in the province of Quebec, Canada, to collect, analyse and interpret quantitative (QUAN) and qualitative (QUAL) data from a specific ECHO Program on CDs. In the QUAN component, an observational prospective cohort study will be conducted over a 12-month period. All nurses who participated in the programme between 2018 and 2020 and who consent to research will be recruited to collect data on the extent of their learning and practice outcomes at three time points. Alongside the surveys, nurses will be invited to participate in individual semistructured interviews. In-depth QUAL data will be subjected to a thematic analysis and will assist in exploring how and in which conditions nurses developed and mobilised their competencies in clinical practice. A comparison-of-results strategy will be used in the final integration component of the study.Ethics and disseminationThis study protocol was approved by the Ethics Committee of the Université de Montréal Hospital Center (#19.295) and the Université de Montréal Ethics Committee (CERSES-20–017 R). We aim to disseminate the findings through international academic conferences, international peer-reviewed journals and professional media.
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Bellass, Sue, Johanna Taylor, Lu Han, Stephanie L. Prady, David Shiers, Rowena Jacobs, Richard Ian Gregory Holt, et al. "Exploring Severe Mental Illness and Diabetes: Protocol for a Longitudinal, Observational, and Qualitative Mixed Methods Study." JMIR Research Protocols 8, no. 9 (September 6, 2019): e13407. http://dx.doi.org/10.2196/13407.
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Background The average life expectancy for people with a severe mental illness (SMI) such as schizophrenia or bipolar disorder is 15 to 20 years less than that for the population as a whole. Diabetes contributes significantly to this inequality, being 2 to 3 times more prevalent in people with SMI. Various risk factors have been implicated, including side effects of antipsychotic medication and unhealthy lifestyles, which often occur in the context of socioeconomic disadvantage and health care inequality. However, little is known about how these factors may interact to influence the risk of developing diabetes and poor diabetic outcomes, or how the organization and provision of health care may contribute. Objective This study aims to identify the determinants of diabetes and to explore variation in diabetes outcomes for people with SMI. Methods This study will employ a concurrent mixed methods design combining the interrogation of electronic primary care health records from the Clinical Practice Research Datalink (CPRD GOLD) with qualitative interviews with adults with SMI and diabetes, their relatives and friends, and health care staff. The study has been funded for 2 years, from September 2017 to September 2019, and data collection has recently ended. Results CPRD and linked health data will be used to explore the association of sociodemographics, illness, and health care–related factors with both the development and outcomes of type 2 diabetes in people with SMI. Experiences of managing the comorbidity and accessing health care will be explored through qualitative interviews using topic guides informed by evidence synthesis and expert consultation. Findings from both datasets will be merged to develop a more comprehensive understanding of diabetes risks, interventions, and outcomes for people with SMI. Findings will be translated into recommendations for interventions and services using co-design workshops. Conclusions Improving diabetes outcomes for people with SMI is a high-priority area nationally and globally. Understanding how risk factors combine to generate high prevalence of diabetes and poor diabetic outcomes for this population is a necessary first step in developing health care interventions to improve outcomes for people with diabetes and SMI. Trial Registration ClinicalTrials.gov NCT03534921; https://clinicaltrials.gov/ct2/show/NCT03534921
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Allegri, Manuela De, Swati Srivastava, Christoph Strupat, Stephan Brenner, Divya Parmar, Diletta Parisi, Caitlin Walsh, et al. "Mixed and Multi-Methods Protocol to Evaluate Implementation Processes and Early Effects of the Pradhan Mantri Jan Arogya Yojana Scheme in Seven Indian States." International Journal of Environmental Research and Public Health 17, no. 21 (October 26, 2020): 7812. http://dx.doi.org/10.3390/ijerph17217812.
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In September 2018, India launched Pradhan Mantri Jan Arogya Yojana (PM-JAY), a nationally implemented government-funded health insurance scheme to improve access to quality inpatient care, increase financial protection, and reduce unmet need for the most vulnerable population groups. This protocol describes the methodology adopted to evaluate implementation processes and early effects of PM-JAY in seven Indian states. The study adopts a mixed and multi-methods concurrent triangulation design including three components: 1. demand-side household study, including a structured survey and qualitative elements, to quantify and understand PM-JAY reach and its effect on insurance awareness, health service utilization, and financial protection; 2. supply-side hospital-based survey encompassing both quantitative and qualitative elements to assess the effect of PM-JAY on quality of service delivery and to explore healthcare providers’ experiences with scheme implementation; and 3. process documentation to examine implementation processes in selected states transitioning from either no or prior health insurance to PM-JAY. Descriptive statistics and quasi-experimental methods will be used to analyze quantitative data, while thematic analysis will be used to analyze qualitative data. The study design presented represents the first effort to jointly evaluate implementation processes and early effects of the largest government-funded health insurance scheme ever launched in India.
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Ayers, Britni L., Cari A. Bogulski, Lauren Haggard-Duff, Aline Andres, Elisabet Børsheim, and Pearl A. McElfish. "Documenting and characterising gestational weight gain beliefs and experiences among Marshallese pregnant women in Arkansas: a protocol for a longitudinal mixed-methods study." BMJ Open 10, no. 9 (September 2020): e037219. http://dx.doi.org/10.1136/bmjopen-2020-037219.
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IntroductionArkansas has the largest population of Marshallese Pacific Islanders residing in the continental USA. The Marshallese have higher rates of obesity, type 2 diabetes, pre-term births, low birthweight babies, infant mortality, and inadequate or no prenatal care. Despite the high rates of cardiometabolic and maternal and child health disparities among Marshallese, there are no studies documenting gestational weight gain or perceptions about gestational weight gain among the Marshallese population residing in the USA.Methods and analysisThis paper describes the protocol of a mixed-methods concurrent triangulation longitudinal study designed to understand gestational weight gain in Marshallese women. The mixed-methods design collects qualitative and quantitative data during simultaneous data collection events, at both first and third trimester, and then augments that data with postpartum data abstraction. Quantitative and qualitative data will be analysed separately and then synthesised during the interpretation phase.Ethics and disseminationThe study used a community engaged approach approved by the University of Arkansas for Medical Sciences Institutional Review Board (#228023). The research team will disseminate results to study participants, research stakeholders (clinics, faith-based organisations and community-based organisation), the broader Marshallese community and fellow researchers. Results will be disseminated to study participants through a one-page summary that show the aggregated research results using plain language and infographics.
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Rennick, Janet, Francine Buchanan, Eyal Cohen, Franco Carnevale, Karen Dryden-Palmer, Patricia Fontela, Hema Patel, Saleem Razack, Isabelle St-Sauveur, and Susan Law. "TOwards enhancing Paediatric Intensive Care for Children with Medical Complexity (ToPIC CMC): a mixed-methods study protocol using Experience-based Co-design." BMJ Open 12, no. 9 (September 2022): e066459. http://dx.doi.org/10.1136/bmjopen-2022-066459.
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IntroductionAdvances in medical technology and postoperative care have led to increased survival of children with medical complexity (CMC). Parents of CMC develop substantial caregiver expertise and familiarity with paediatric intensive care unit (PICU) staff and treatment procedures which may give rise to tensions regarding respective roles, caretaking preferences, treatment goals and expected outcomes. A therapeutic alliance built through strong partnerships constitutes the foundation of patient and family-centred care (PFCC), contributing to improvements in experiences and outcomes. Yet acute care settings continue to struggle with integrating PFCC into practice. This study aims to enhance PFCC for CMC in the PICU using an innovative approach to integrated knowledge translation.MethodsA mixed-method concurrent triangulation design will be used to develop, implement and evaluate PFCC practice changes for CMC in the PICU. Qualitative data will be collected using an Experience-based Co-design (EBCD) approach. Parents, CMC and staff will reflect on their PICU care experiences (stages 1 and 2), identify priorities for improvement (stage 3), devise strategies to implement changes (stage 4), evaluate practice changes and study process, and disseminate findings (stage 5). The quantitative arm will consist of a prepractice and postpractice change evaluation, compared with a control site. Analysis of qualitative and quantitative data will provide insights regarding the impact of PICU practice changes on PFCC.Ethics and disseminationThe McGill University Health Centre Research Ethics Board (Ref. #2019-5021) and the Hospital for Sick Children Research Ethics Board (Ref. #1000063801) approved the study. Knowledge users and researchers will be engaged as partners throughout the study as per our participatory approach. Knowledge products will include a short film featuring themes and video/audio clips from the interviews, recommendations for improvements in care, and presentations for healthcare leaders and clinical teams, in addition to traditional academic outputs such as conference presentations and publications.
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Hashish, E. Abou, and HM Ashour. "Determinants and mitigating factors of the brain drain among Egyptian nurses: a mixed-methods study." Journal of Research in Nursing 25, no. 8 (September 24, 2020): 699–719. http://dx.doi.org/10.1177/1744987120940381.
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Background A brain drain is a migration of employees in their quest for an improved level of living conditions, better earnings, access to advanced technology and secure political conditions in diverse places worldwide. The brain drain of nurses is an ongoing phenomenon that impacts the quality and quantity of the nursing workforce and affects the quality of care. The nurses' brain drain is commonly known as a result of the interplay of many factors. So, identification of these factors and how to manage them is a timely topic in nursing research. Aims This study aims to investigate determinants of the nurses' brain drain and mitigating factors from nurses' perspectives in Egypt. Methods Mixed-methods research was conducted using a concurrent triangulation design. A sample of 325 nurses who were working at an Egyptian university hospital answered a brain drain questionnaire while the qualitative investigation was guided by a semi-structured interview with a purposive sample of 35 nurses to elicit exploratory perspectives on factors causing brain drain and mitigation strategies. Results were analysed using inferential statistics and thematic data analysis. Results Both push and pull factors can predict about 99.6% and 97.5% of the nurses’ brain drain, respectively. Seven themes were derived from the qualitative content analysis, and six themes were categorised under ‘push-pull’ factors. In addition, the ‘mitigating factors theme’ was identified with five sub-factors as possible solutions. Economic and work environment reasons were reported as the most influential for nurses’ brain drain. Conclusions Policymakers could use the identified factors from quantitative and qualitative data for creating a system that would improve nurses' conditions and policies, and prevent nurses' migration. Nursing leaders have a significant role with non-remuneration strategies in retaining nurses through creating an empowering work environment. In addition, shared governance, a strong nursing syndicate role and professorial marketing would be essential mitigating factors for the nurses' brain drain.
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Mekuria, Banchirega, Gebremedhin Beedemariam Gebretekle, Tamerat Bekele, Mesfin Negussie, Melaku Kifle, and Teferi Gedif Fenta. "Bacterial resistance to fluoroquinolones and contributing factors in Addis Ababa, Ethiopia: a mixed methods study." Ethiopian Pharmaceutical Journal 34, no. 1 (June 19, 2019): 61–72. http://dx.doi.org/10.4314/epj.v34i1.6.
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Fluoroquinolones are widely used globally and there is a growing trend of resistance to these agents. However, there is scanty information in Ethiopia and this study aimed to assess the level of bacterial resistance to fluoroquinolones and identify contributing factors in Addis Ababa, Ethiopia. Concurrent mixed methods study design was used. Records (January 2013 to December 2016) of the Microbiology Laboratory of International Clinical Laboratories were retrospectively reviewed. In addition, qualitative interviews were conducted with purposively selected 20 prescribers’ and dispensers’ to explore perceived contributing factors to resistance. Descriptive statistics was used to summarize the data and possible association was explored using multivariable logistic regression. Qualitative data was analyzed using thematic analysis. A total of 7,889 bacterial isolates were identified from 4,310 patients. The overall resistance of bacterial isolates to fluoroquinolones was 42.5% and the highest resistance was to nalidixic acid (63.3%). Enterococci and Escherichia coli developed high level of resistance to ciprofloxacin and norfloxacin; while Enterococci had higher resistant to nalidixic acid (77.8%). Resistance to fluoroquinolones was 5-times more likely in patients aged ≥ 60 years than those < 15 years old (AOR = 5.63, 95% CI: 4.71, 6.73). Resistance to fluoroquinolones increased from 40.4% in 2013 to 49.0% in 2015 but declined to 46.3% in 2016. Respondents of the qualitative interviews suggested that injudicious prescribing due to lack of institutional antibiogram and inadequate knowledge, nonprescription sales of antibiotics and/or patient hording and sharing practices contributed for the high level of fluoroquinolone resistance. The study showed a high level of bacterial resistance to fluoroquinolones. Patients’ age and year of testing were significantly associated with resistance. Moreover, inappropriate prescribing practice, illegal over-the-counter sales as well as their unreasonable use by patients were key drivers to the problem. This calls for the strict regulation of non-prescription sales of antibiotics, public awareness creation and development of local antibiogram to guide prescribing. Keywords: fluoroquinolones, bacterial resistance, qualitative interview, enterococci, Escherichia coli
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Costigan, Jennifer, Sue S. Feldman, and Mark Lemak. "Assessment of Patient Satisfaction With Dermatology Clinics According to Clinic Type: Mixed Methods Study." JMIR Dermatology 3, no. 1 (May 12, 2020): e17171. http://dx.doi.org/10.2196/17171.
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Background Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey responses are considered significant indicators of the quality of care and patient satisfaction. There is a pressing need to improve patient satisfaction rates as CAHPS survey responses are considered when determining the amount a facility will be reimbursed by the Centers of Medicare and Medicaid each year. Low overall CAHPS scores for an academic medical center’s dermatology clinics were anecdotally attributed to clinic type. However, it was unclear whether clinic type was contributing to the low scores or whether there were other factors. Objective This study aimed to determine where the efforts of patient satisfaction improvement should be focused for two different types of dermatology clinics (private and rapid access clinics). Methods This study used a concurrent mixed methods design. Secondary data derived from the University of Alabama at Birmingham Hospital’s Press Ganey website were analyzed for clinic type comparisons and unstructured data were qualitatively analyzed to further enrich the quantitative findings. The University of Alabama at Birmingham Hospital is an academic medical center. The data were analyzed to determine the contributors responsible for each clinic not meeting national benchmarks. Thereafter, a review of these contributing factors was further performed to assess the difference in CAHPS scores between the private and rapid access clinics to determine if clinic type was a contributing factor to the overall scores. Results The data sample included 821 responses from May 2017 to May 2018. Overall, when both private clinics and rapid access clinics were viewed collectively, majority of the patients reported stewardship of patient resources as the most poorly rated factor (367/549, 66.8%) and physician communication quality as the most positively rated factor (581/638, 91.0%). However, when private clinics and rapid access clinics were viewed individually, rapid access clinics contributed slightly to the overall lower dermatology scores at the academic medical center. Conclusions This study determined that different factors were responsible for lower CAHPS scores for the two different dermatology clinics. Some of the contributing factors were associated with the mission of the clinic. It was suspected that the mission had not been properly communicated to patients, leading to misaligned expectations of care at each clinic.
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Zhang, Xiuyuan, Paul A. McDermott, John W. Fantuzzo, and Vivian L. Gadsden. "Longitudinal Stability of IRT and Equivalent-Groups Linear and Equipercentile Equating." Psychological Reports 113, no. 1 (August 2013): 291–313. http://dx.doi.org/10.2466/03.10.pr0.113x11z6.
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A multiscale criterion-referenced test that featured two presumably equivalent forms (A and B), was administered to 1,667 Head Start children at each of four points over an academic year. Using a randomly equivalent groups design, three equating methods were applied: common-item IRT equating using concurrent calibration, linear transformation, and equipercentile transformation. The methods were compared by examining mean score differences, weighted mean squared difference, and Kolmogorov's D statistics for each subscale. The results indicated that over time the IRT equating method and conventional equating methods exhibited different patterns of discrepancy between the two test forms. IRT equating yielded marginally smaller form-to-form mean score differences and generated slightly f ewer distributional discrepancies between Forms A and B than both linear and equipercentile equating. However, the results were mixed indicating that more studies are needed to provide additional information on the relative merits and weaknesses of each approach.
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Kadir, Abdul, Rochmad Rochmad, and Iwan Junaedi. "Mathematical Connection Ability of Grade 8th Students’ in terms of Self-Concept in Problem Based Learning." Journal of Primary Education 9, no. 3 (May 31, 2020): 258–66. http://dx.doi.org/10.15294/jpe.v9i3.37547.
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MMathematical connections ability is a demand in mathematics education to develop mathematical ideas and problem-solving in one another. This study aims to find mathematical connection ability patterns in terms of self-concept. The research method used is mixed methods with concurrent embedded design, quantitative research analysis using true experimental design, while qualitative research analysis uses the Miles and Huberman model. The population in this study was eighth-grade students of SMP Negeri 13 Semarang, Indonesia, and sampling was done by random sampling technique. The results showed that the mathematical connection ability pattern in terms of mathematical self-concepts is diverse. It is found that there were two patterns of mathematical connection ability in subjects with high self-concept. In subjects with moderate self-concept, three patterns of mathematical connection ability subjects with low self-concept, three patterns of mathematical connection ability are found
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Moore, Corey L., Edward O. Manyibe, Fariborz Aref, and Andre L. Washington. "Research Capacity Building: A Historically Black College/University-Based Case Study of a Peer-to-Peer Mentor Research Team Model." Rehabilitation Research, Policy, and Education 31, no. 3 (September 2017): 283–308. http://dx.doi.org/10.1891/2168-6653.31.3.283.
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Purpose: To evaluate a peer-to-peer mentor research team model (PPMRTM) in building investigators’ research skills (i.e., research methods and grant writing) at a historically Black college/university (HBCU) in the United States. Method: Three different theories (i.e., planned change, critical mass, and self-efficacy), contemporary study findings, and our personal experiences as HBCU-based investigators provided a useful framework for developing the PPMRTM and corresponding intervention components. Three faculty members (herein referred to as fellows) and 5 mentors participated in the study. A concurrent equal status mixed methods design was used to triangulate data collected from 2 different sources: (a) a mixed methods (i.e., qualitative and quantitative) Web-based survey and (b) telephone interviews. The data were analyzed using SPSS Version 22 and NVivo Version 10.0. Results: The findings indicated that mentors and fellows were satisfied with the mentorship relationship, the program design, and its processes. Fellows submitted, for the first time in their career, a research proposal to the National Institute on Disability, Independent Living, and Rehabilitation Research Minority Serving Institution-Field Initiated Program (Catalog of Federal Domestic Assistance [CFDA 84.133]; G-4 research or G-5 development) for competitive funding consideration. This was a core goal of the program. They also indicated that their confidence to conduct research improved. Conclusions: The results suggest that the PPMRTM could represent a promising conceptual framework for conducing mentorship at HBCUs and other minority-serving institutions to improve early career research scientists’ research skills.
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DEVIANA, DEVIANA, and I. NYM BAGUS PRAMARTHA. "PENGARUH PEMBELAJARAN ICI TERHADAP KEMAMPUAN REPRESENTASI MATEMATIS SISWA DITINJAU DARI GAYA KOGNITIF." E-Jurnal Matematika 9, no. 1 (January 31, 2020): 51. http://dx.doi.org/10.24843/mtk.2020.v09.i01.p278.
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The purpose of this research is to find out : (1) the effect ICI model for attitude and ability of mathematical representation in terms of student's cognitive (2) how the model of learning ICI can affect the attitude and the ability of mathematical representation in terms of students' cognitive. The research type is a combination of research using concurrent embedded design with mixed methods. Then, quantitative methods use post test design only control group design and analyzed using MANCOVA while qualitative method using descriptive research with data reduction, data presentation and verification. The results showed that: (1) learning with the ICI Model has a positive effect on Attitude and Ability of Mathematical Representation Viewed From Student Cognitive Styles on Line and Corner Material Class (? = 30.319, p> 0.05 ), (2) Students with FI cognitive style tend to have fulfilled three components of attitude and stages of mathematical representation; students with cognitive style field dependent tend not to be able to show attitude that refers to the three components of mathematical attitudes and have been able to understand the problems but in representing less and not yet able to complete the solution of the problems given.
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Schunko, Christoph, and Christian Vogl. "Is the Commercialization of Wild Plants by Organic Producers in Austria Neglected or Irrelevant?" Sustainability 10, no. 11 (October 31, 2018): 3989. http://dx.doi.org/10.3390/su10113989.
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European countries are split over the appreciation of wild berries, fruits, mushrooms, and herbs. While some countries provide public statistics on wild plants, others seem to neglect wild plant gathering and commercialization. In this study, we aimed to understand if wild plant commercialization is neglected or irrelevant in Austria, a country that does not provide statistics. We focus on organic producers, because organic certification of wild plant gathering might have potential for countering frequent concerns about commercial gathering, including destructive gathering and overharvesting. Using a mixed-methods approach with a concurrent triangulation design, databases of six organic certification bodies were analysed concurrently with semi-structured expert interviews of their representatives. We found that organic certification for gathering was issued to 1.5% of organic producers in the year 2016 in Austria and is relevant for three distinct gatherer types: regular, diversified, and single-plant gatherers. Organic gathering is most frequently part of agricultural or horticultural farms and rarely an isolated commercial activity. It is related to mixed farming, deepening on-farm diversification, and contributes to maintaining traditions, as well as the local socio-ecological memory of wild plant products. Organic wild plants are directly marketed to consumers as traditional and innovative products, but also supplied to mass markets. We conclude that from a socio-cultural perspective and a focus on regional economies, organic gathering is neglected in Austria, whereas from an income perspective, wild plant gathering seems to be indeed relevant for few organic producers, although exhibiting potential.
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Palmer Kelly, Elizabeth, Julia L. Agne, and Timothy M. Pawlik. "Exploring the perception of survivors on the bidirectional impact between cancer and their social contexts: A mixed-methods approach." Palliative and Supportive Care 17, no. 6 (March 7, 2019): 668–76. http://dx.doi.org/10.1017/s1478951519000038.
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AbstractObjectiveThe purpose of the current study was to use a mixed-methods approach to assess the perspective of cancer survivors on the bidirectional impact between cancer and their social contexts.MethodA fixed concurrent triangulation mixed-methods survey design was used with open- and closed-ended questions that were predetermined and administered to participants. Quantitative items included demographic questions and the Life Impact Checklist. Qualitative questions were designed to explore the bidirectional impact between the patient and specific contexts including spirituality/faith, the spousal/partner relationship, and the family. A cross-sectional descriptive approach was used to evaluate the quantitative items and the constant comparative method guided the analysis of open-ended questions.ResultAmong 116 participants (mean age 58.4 years), the majority were female (66.7%) with breast cancer (27.9%). Nearly one-half the respondents endorsed a positive impact of cancer on their spirituality/faith, but qualitative results suggested less of a bidirectional impact. The importance of the spouse/partner during the cancer experience was emphasized, including the subthemes of instrumental and emotional support; however, there was often a negative impact of cancer on the spouse/partner relationship, including sexual functioning. Survivors indicated family members provided instrumental and emotional support, but not as regularly or directly as a spouse/partner.Significance of resultsSocial contexts are important among cancer survivors, with many cancer survivors relying more on their spouse/partner than other family members for support. The cancer experience is stressful not only for survivors, but also for individuals in their social contexts and relationships.
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Starr, Lauren, Karla Washington, Miranda McPhillips, George Demiris, and Debra Parker Oliver. "IT WAS TERRIBLE, I DIDN'T SLEEP FOR TWO YEARS: A MIXED-METHODS EXPLORATION OF SLEEP AMONG HOSPICE FAMILY CAREGIVERS." Innovation in Aging 6, Supplement_1 (November 1, 2022): 289. http://dx.doi.org/10.1093/geroni/igac059.1149.
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Abstract Due to overnight caregiving demands and inadequate social support, over 1.2 million hospice family caregivers in the U.S. and millions more worldwide are at risk of poor sleep and resulting negative effects on health. Sleep problems are a modifiable source of global health inequities. The purpose of this study was to describe hospice family caregiver sleep experiences, efforts to improve sleep, and effects of sleep. Developed using the Symptom Management Model, this mixed methods study featured a concurrent nested design prioritizing qualitative reflexive thematic analysis. In 2021, 47 family caregivers of hospice care-recipients from two randomized clinical trials in the United States (NCT03712410, NCT02929108) were interviewed. Sleep-related questions from PHQ-9 and GAD-7, and self-rated health and energy were administered at baseline. Three themes emerged: quality of sleep, factors influencing sleep, and effects of sleep. Hospice family caregivers commonly experienced “interrupted” sleep with frequent night-waking due to “on-call” “vigilance” and anxiety overnight and, sometimes, in bereavement. Negative effects included exhaustion, mental and physical health decline, and reduced performance. 72.5% described sleep quality as “fair” or “poor.” At baseline, 35.5% of caregivers were bothered by trouble falling asleep, staying asleep, or sleeping too much at least “more than half the days” in a week. Caregivers were reluctant to take sleep medications. Over half quit jobs or reduced work hours to provide care; few reported adequate support. Hospice family caregivers commonly experience disordered sleep with negative effects. Clinicians must assess sleep, offer tailored sleep interventions, and provide more supports to hospice family caregivers.