Barriers to completing the 4AT for delirium and its clinical implementation in two hospitals: a mixed-methods study

Life Issues ◽

Conventional Content Analysis ◽

End Of Life Issues ◽

Qualitative Phase ◽

Acute Admissions

Abstract Purpose To assess the clinical implementation and barriers to completing the 4AT for delirium in general medical and geriatric patients over 75 years upon admission to Wellington and Kenepuru Hospitals during the first eight months of 2017, 2018 and 2019. Methods Retrospective data from electronic health records were analysed using an explanatory-sequential mixed-methods approach. The initial quantitative phase measured doctors’ adherence to the 4AT and the rate of positive 4ATs (≥ 4). The subsequent qualitative phase identified doctors’ main reasons for omitting the 4AT through conventional content analysis. Results The quantitative population included 7799 acute admissions (mean age 84, 58.2% female). There was good clinical implementation of the 4AT, evidenced by an overall adherence rate of 83.2% and a rate of positive 4ATs of 14.8% that is in keeping with expected delirium rates in similar settings. The qualitative sample consisted of 875 acute admissions (mean age 84, 56.3% female) with documented reasons for omitting the 4AT. The main barriers to completing the 4AT were: reduced patient alertness, communication barriers (language, deafness, aphasia and dysarthria), prioritising patients’ wellness and comfort (addressing critical illnesses, symptoms, end-of-life issues and promoting sleep), pre-existing cognitive disorders, and unstructured delirium assessments. Conclusion Adherence to the 4AT was high and sustainable in both hospitals. Most barriers to completing the 4AT were potentially avoidable. Education about the 4AT in relation to these barriers may improve its implementation.

Applicability and Clinical Utility of the Client-Centred Strategies Framework

Canadian Journal of Occupational Therapy ◽

10.1177/000841740807500512 ◽

2008 ◽

Vol 75 (5) ◽

pp. 288-300 ◽

Cited By ~ 22

Author(s):

Gayle Restall ◽

Jacquie Ripat

Keyword(s):

Mixed Methods ◽

Community Organizing ◽

Clinical Utility ◽

Political Action ◽

Occupational Therapists ◽

Daily Practice ◽

Multiple Factors ◽

Implementing Strategies ◽

Background. The Client-centred Strategies Framework consists of strategies for facilitating therapists' application of client-centred approaches.Purpose. The purpose of this study was to explore the application of the strategies and the utility of the framework to implement client-centred approaches.Methods. The study used a sequential mixed-methods procedure. The quantitative phase consisted of a survey of 230 Canadian occupational therapists. The qualitative phase consisted of telephone focus groups with a sample of 14 Canadian respondents to the initial survey.Findings. Results indicated that occupational therapists experience challenges in implementing strategies, particularly related to community organizing, coalition advocacy, and political action. Therapists identified multiple factors that influenced the implementation of strategies and ways of incorporating strategies into daily practice. The Client-centred Strategies Framework was viewed as a useful tool for increasing dialogue about occupational therapists' role in client-centred practice.Implications. The results of this study encourage an expanded view of client-centred strategies and the application of strategies to daily practice.

An Exploratory Sequential Mixed Methods Approach to Understanding Researchers’ Data Management Practices at UVM: Findings from the Qualitative Phase

Journal of eScience Librarianship ◽

10.7191/jeslib.2017.1097 ◽

2017 ◽

Vol 6 (1) ◽

pp. e1097

Author(s):

Elizabeth Berman ◽

Keyword(s):

Mixed Methods ◽

Data Management ◽

Management Practices ◽

Mixed Methods Approach ◽

Proses Penalaran Kuantitatif Menggunakan Kerangka Referensi Siswa Ditinjau Dari Gender

Jurnal Ilmiah Soulmath Jurnal Edukasi Pendidikan Matematika ◽

10.25139/smj.v9i2.3940 ◽

2022 ◽

Vol 9 (2) ◽

pp. 175-194

Author(s):

Dedi Rahman Siolimbona ◽

Mega Teguh Budiarto ◽

A'yunin Sofro

Keyword(s):

Mixed Methods ◽

Statistical Tests ◽

Female Students ◽

Frame Of Reference ◽

Quantitative Reasoning ◽

Male Students ◽

Male And Female ◽

Quantitative Phase ◽

Abstract The results of previous studies showed that the ratio of the differences in the level of quantitative reasoning abilities between male students and female students was quite significant. While the frame of reference refers to a series of mental actions through which individuals can regulate the processes and products of quantitative reasoning. Therefore, there are two main objectives of this study, namely to show whether or not there are differences in quantitative reasoning products using a frame of reference between male and female students, then to describe the process of quantitative reasoning using a frame of reference between male and female students. Using Sequential Mixed Methods, this study examined 58 students of class VIII junior high school. The research was conducted in two phases, namely the quantitative phase which included statistical data analysis using the Mann Withney Test to determine whether there were differences in the product of quantitative reasoning using the frame of reference for male and female students. Then the qualitative phase includes a description of the quantitative reasoning process using a frame of reference for male and female students. The results of the study stated that there were differences in the product of quantitative reasoning between male and female students. This is indicated by the results of statistical tests in the quantitative phase, while the qualitative phase found that male students were able to analyze the formulas that were determined according to the results of their own interpretation of the information provided implicitly or explicitly in the questions compared to female students. Keywords: Quantitative Reasoning, Frame of Reference, Gender Abstrak Hasil penelitian sebelumnya menunjukan rasio perbedaan tingkat kemampuan penalaran kuantitatif antara siswa laki-laki dan siswa perempuan yang cukup signifikan. Sedang kerangka referensi merujuk pada serangkaian tindakan mental yang melaluinya individu dapat mengatur proses dan produk dari penalaran kuantitatif. Oleh karenanya, ada dua tujuan utama dari penelitian ini, yaitu menunjukkan ada atau tidak-nya perbedaan produk penalaran kuantitatif menggunakan kerangka referensi antara siswa laki-laki dan perempuan, selanjutnya mendeskripsikan proses penalaran kuantitatif menggunakan kerangka referensi antara siswa laki-laki dan perempuan. Menggunakan Sequential Mixed Methods penelitian ini mengkaji 58 orang siswa kelas VIII SMP. Penelitian dilakukan dengan dua fase, yaitu fase kuantitatif meliputi analisis data statistik menggunakan uji Mann Withney Test untuk mengetahui adakah perbedaan produk penalaran kuantitatif menggunakan kerangka referensi siswa laki-laki dan perempuan. selanjutnya fase kualitatif meliputi, deskripsi proses penalaran kuantitatif menggunakan kerangka referensi siswa laki-laki dan perempuan. Hasil penelitian menyatakan ada perbedaan produk penalaran kuantitatif antara siswa laki-laki dan perempuan. Hal ini ditunjukkan oleh hasil uji statistik pada fase kuantitatif, sedangkan fase kualitatif menemukan bahwa siswa laki-laki lebih dapat menganalisis rumus/formula yang ditentukan menurut hasil interpretasinya sendiri terhadap informasi yang diberikan secara implisit maupun eksplisit dalam soal disbanding siswa perempuan. Kata Kunci: Penalaran Kuantitatif, Kerangka Referensi, Gender.

Understanding and scaffolding Danish schoolteachers’ motivation for using classroom-based physical activity: study protocol for a mixed methods study

BMJ Open ◽

10.1136/bmjopen-2017-019857 ◽

2018 ◽

Vol 8 (3) ◽

pp. e019857 ◽

Cited By ~ 3

Author(s):

Louise Stjerne Knudsen ◽

Thomas Skovgaard ◽

Thomas Bredahl

Keyword(s):

Physical Activity ◽

Mixed Methods ◽

Natural Setting ◽

Quantitative Phase ◽

Positive Effects ◽

Registration Number ◽

Need For Support ◽

Amount Of Knowledge ◽

IntroductionThe benefits of physical activity for children’s health, both mental and physical, and its positive effects on academic achievement are well established. Research also emphasises that schools could provide a natural setting for regular physical activity. There is, however, a limited amount of knowledge about teachers’ views when it comes to integrating physical activity as part of teaching. The aim of this study is to understand teachers’ motivation for integrating physical activity as part of teaching and to assess their need for guidance and support.Methods and analysisThe study uses an explanatory sequential mixed-methods design. Schools from across Denmark are included in the sample. The design comprises two separated phases—a quantitative and qualitative phase. The quantitative phase is guided by the self-determination theory where teachers’ motivation will be measured using the Work Task Motivation Scale for Teachers. The theory of scaffolding guides the qualitative phase, which consists of in-depth interviews with participants selected from the quantitative phase based on levels of motivation and on demographic information. In accordance with the study aims, the analysis of data will identify teachers’ internal and external levels of motivation. The purpose of the qualitative phase is to enhance understanding of teachers’ motivation and of their need for support in the use of physical activity in teaching.Ethics and disseminationAll relevant ethics approvals have been acquired. All participants in this study will provide written informed consent prior to data collection. All data emerging from the quantitative and qualitative phase will be anonymised for analysis. Ethics approval was requested from the Regional Committee on Health Research Ethics for Southern Denmark approval ID S-20162000–40 and the Danish Data Protection Agency approval ID 16/15491). The study was deemed not notifiable by both authorities.Trial registration numberNCT02894346; Pre-results.