scholarly journals Patient perceptions of receiving test results via online portals: a mixed-methods study

2017 ◽  
Vol 25 (4) ◽  
pp. 440-446 ◽  
Author(s):  
Traber D Giardina ◽  
Jessica Baldwin ◽  
Daniel T Nystrom ◽  
Dean F Sittig ◽  
Hardeep Singh
Keyword(s):  
Mixed Methods ◽  
Negative Emotions ◽  
Structured Interview ◽  
Mixed Methods Study ◽  
Test Results ◽  
Policy And Practice ◽  
Online Test ◽  
National Guidance ◽  
Semistructured Interviews ◽  
Test Result

Abstract Objective Online portals provide patients with access to their test results, but it is unknown how patients use these tools to manage results and what information is available to promote understanding. We conducted a mixed-methods study to explore patients’ experiences and preferences when accessing their test results via portals. Materials and Methods We conducted 95 interviews (13 semistructured and 82 structured) with adults who viewed a test result in their portal between April 2015 and September 2016 at 4 large outpatient clinics in Houston, Texas. Semistructured interviews were coded using content analysis and transformed into quantitative data and integrated with the structured interview data. Descriptive statistics were used to summarize the structured data. Results Nearly two-thirds (63%) did not receive any explanatory information or test result interpretation at the time they received the result, and 46% conducted online searches for further information about their result. Patients who received an abnormal result were more likely to experience negative emotions (56% vs 21%; P = .003) and more likely to call their physician (44% vs 15%; P = .002) compared with those who received normal results. Discussion Study findings suggest that online portals are not currently designed to present test results to patients in a meaningful way. Patients experienced negative emotions often with abnormal results, but sometimes even with normal results. Simply providing access via portals is insufficient; additional strategies are needed to help patients interpret and manage their online test results. Conclusion Given the absence of national guidance, our findings could help strengthen policy and practice in this area and inform innovations that promote patient understanding of test results.

scholarly journals Does Quantitative Research in Child Maltreatment Tell the Whole Story? The Need for Mixed-Methods Approaches to Explore the Effects of Maltreatment in Infancy

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Samuel Glass ◽  
Ruchika Gajwani ◽  
Fiona Turner-Halliday
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Child Maltreatment ◽  
Quantitative Research ◽  
Qualitative Data ◽  
Quantitative Measurement ◽  
Social Care ◽  
Mixed Methods Study ◽  
Semistructured Interviews ◽  
Qualitative Exploration

Background and Aims.Research on child maltreatment has largely overlooked the under-five age group and focuses primarily on quantitative measurement. This mixed-methods study of maltreated children (N=92) entering care (age 6–60 months) combines a quantitative focus on the associations between care journey characteristics and mental health outcomes with a qualitative exploration of maltreatment in four different families.Methods.Care journey data was obtained from social care records; mental health and attachment assessments were carried out following entry to care; qualitative data comprised semistructured interviews with professionals, foster carers, and parents.Results.Significant associations were found between suspected sexual abuse and increased DAI inhibited attachment symptoms (p=0.001) and between reported domestic violence and decreased DAI inhibited (p=0.016) and disinhibited (p=0.004) attachment symptoms. Qualitative results: two themes demonstrate the complexity of assessing maltreatment: (1) overlapping maltreatment factors occur in most cases and (2) maltreatment effects may be particularly challenging to isolate. Conclusions.Qualitative exploration has underscored the complexity of assessing maltreatment, indicating why expected associations were not found in this study and posing questions for the quantitative measurement of maltreatment in general. We therefore suggest a new categorisation of maltreatment and call for the complimentary research lenses of further mixed-methods approaches.

scholarly journals Legacy Beliefs Across Generations: Comparing Views of Older Parents and Their Adult Children

2018 ◽  
Vol 88 (2) ◽  
pp. 168-186
Author(s):  
Thomas M. Meuser ◽  
Thuli G. Mthembu ◽  
Brianne L. Overton ◽  
Nicolette V. Roman ◽  
Rebecca D. Miller ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Adult Child ◽  
Structured Interview ◽  
The Self ◽  
Mixed Methods Study ◽  
Mutual Understanding ◽  
New Approach ◽  
Older Parents ◽  
Parents And Children ◽  
Intention To Continue

This mixed-methods study examined legacy beliefs (i.e., anticipated remembrances and linkages to the self after death) as understood in 14 older parent and adult child pairs. This work validates and expands on a 2005 typology of legacy beliefs from gerontologists, Elizabeth Hunter and Graham Rowles. A structured interview was administered separately to parents and children, coded for legacy examples (i.e., those unique to the parent, overlapping, unique to the child), and analyzed with respect to expectations of similarity reported by each participant. Most predicted moderate to high overlap in mutual understanding of parent legacy. This was not the case, as there were far more unique legacy examples given than shared. Pairs agreed least with respect to material legacies, with half showing no agreement. All reported finding the structured discussion of legacy to be beneficial, with some indicating an intention to continue these discussions further. This work may constitute a new approach to intervention.

scholarly journals Factors Affecting Definitions of and Approaches to Integrative Medicine: A Mixed Methods Study Examining China’s Integrative Medicine Development

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Weijun Zhang ◽  
Sonya E. Pritzker ◽  
Ka-Kit Hui
Keyword(s):  
Mixed Methods ◽  
Integrative Medicine ◽  
Mixed Methods Study ◽  
Working Environment ◽  
Snowball Sampling ◽  
Key Factors ◽  
Factors Affecting ◽  
Education Practice ◽  
Key Characteristics ◽  
Semistructured Interviews

Aim. This study identifies existing definitions and approaches among China’s integrative medicine (IM) experts and examines relationships with key characteristics distinguishing individual experts.Methods. Snowball sampling was used to select 73 IM experts for semistructured interviews. In this mixed methods study, we first identified definitions and approaches through analyzing core statements. Four key factors, including age, education, practice type, and working environment, were then chosen to evaluate the associations with the definitions.Results. Four unique definitions were identified, including IM as a “new medicine” (D1), as a combination of western medicine (WM) and Chinese medicine (CM) (D2), as a modernization of CM (D3), and as a westernization of CM (D4). D4 was mostly supported by those working in WM organizations, while D3 was more prominent from individuals working in CM organizations (P=0.00004). More than 64% clinicians had D2 while only 1 (5.9%) nonclinician had D2. Only 1 clinician (1.8%) had D4 while almost 30% nonclinicians had D4 (P=0.0001). Among nonclinicians working in WM organizations, 83.3% of them had D4 (P=0.001).Conclusion. Findings indicate that institutional structure and practice type are factors affecting IM approaches. These results carry implications for the ways in which western countries move forward with the definition and implementation of IM.

scholarly journals ‘Maybe we can turn the tide’: an explanatory mixed-methods study to understand how knowledge brokers mobilise health evidence in low- and middle-income countries

2019 ◽  
Author(s):  
Theresa C. Norton ◽  
Daniela C. Rodriguez ◽  
Catherine Howell ◽  
Charlene Reynolds ◽  
Sara Willems
Keyword(s):  
Mixed Methods ◽  
Online Survey ◽  
Newborn Health ◽  
Mixed Methods Study ◽  
Promising Practices ◽  
Policy And Practice ◽  
Middle Income ◽  
Middle Income Countries ◽  
Knowledge Brokers ◽  
Low And Middle Income

Background: Little is known about how knowledge brokers (KBs) operate in low- and middle-income countries (LMICs) to translate evidence for health policy and practice. These intermediaries facilitate relationships between evidence producers and users to address public health issues.<br />Aims and objectives: To increase understanding, a mixed-methods study collected data from KBs who had acted on evidence from the 2015 Global Maternal Newborn Health Conference in Mexico.<br />Methods: Of the 1000 in-person participants, 252 plus 72 online participants (n=324) from 56 countries completed an online survey, and 20 participants from 15 countries were interviewed. Thematic analysis and application of knowledge translation (KT) theory explored factors influencing KB actions leading to evidence uptake. Descriptive statistics of respondent characteristics were used for cross-case comparison.Findings: Results suggest factors supporting the KB role in evidence uptake, which include active relationships with evidence users through embedded KB roles, targeted and tailored evidence communication to fit the context, user receptiveness to evidence from a similar country setting, adaptability in the KB role, and action orientation of KBs.<br />Discussion and conclusions: Initiatives to increase evidence uptake in LMICs should work to establish supportive structures for embedded KT, identify processes for ongoing cross-country learning, and strengthen KBs already showing effectiveness in their roles.<br /><br />key messages<br /><br /><ol><li>Little is known about how knowledge brokers mobilise evidence in low- and middle-income countries.</li><br /><li>A multi-country study of knowledge brokers identified promising practices for evidence uptake.</li><br /><li>Embedded brokers who adapted messaging and evidence to context in active relationships worked well.</li><br /><li>Capacity building should use KB promising practices and facilitate multi-country evidence exchange.</li></ol>

scholarly journals Clinician Perspectives and Design Implications in Using Patient-Generated Health Data to Improve Mental Health Practices: Mixed Methods Study

10.2196/18123 ◽  
2020 ◽  
Vol 4 (8) ◽  
pp. e18123
Author(s):  
Danny T Y Wu ◽  
Chen Xin ◽  
Shwetha Bindhu ◽  
Catherine Xu ◽  
Jyoti Sachdeva ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Collaborative Care ◽  
Mobile Apps ◽  
Data Interpretation ◽  
Health Data ◽  
Design Guidelines ◽  
Mixed Methods Study ◽  
Semistructured Interviews ◽  
Mhealth Apps

Background Patient-generated health data (PGHD) have been largely collected through mobile health (mHealth) apps and wearable devices. PGHD can be especially helpful in mental health, as patients’ illness history and symptom narratives are vital to developing diagnoses and treatment plans. However, the extent to which clinicians use mental health–related PGHD is unknown. Objective A mixed methods study was conducted to understand clinicians’ perspectives on PGHD and current mental health apps. This approach uses information gathered from semistructured interviews, workflow analysis, and user-written mental health app reviews to answer the following research questions: (1) What is the current workflow of mental health practice and how are PGHD integrated into this workflow, (2) what are clinicians’ perspectives on PGHD and how do they choose mobile apps for their patients, (3) and what are the features of current mobile apps in terms of interpreting and sharing PGHD? Methods The study consists of semistructured interviews with 12 psychiatrists and clinical psychologists from a large academic hospital. These interviews were thematically and qualitatively analyzed for common themes and workflow elements. User-posted reviews of 56 sleep and mood tracking apps were analyzed to understand app features in comparison with the information gathered from interviews. Results The results showed that PGHD have been part of the workflow, but its integration and use are not optimized. Mental health clinicians supported the use of PGHD but had concerns regarding data reliability and accuracy. They also identified challenges in selecting suitable apps for their patients. From the app review, it was discovered that mHealth apps had limited features to support personalization and collaborative care as well as data interpretation and sharing. Conclusions This study investigates clinicians’ perspectives on PGHD use and explored existing app features using the app review data in the mental health setting. A total of 3 design guidelines were generated: (1) improve data interpretation and sharing mechanisms, (2) consider clinical workflow and electronic health record integration, and (3) support personalized and collaborative care. More research is needed to demonstrate the best practices of PGHD use and to evaluate their effectiveness in improving patient outcomes.

scholarly journals Successful Negotiation of Goal Conflict between Romantic Partners Predicts Better Goal Outcomes During COVID-19: A Mixed Methods Study

2020 ◽  
Author(s):  
Laura Marika Vowels ◽  
Katherine Carnelley ◽  
Rachel Francois-Walcott
Keyword(s):  
Mixed Methods ◽  
Daily Diary ◽  
Extended Period ◽  
Structured Interview ◽  
Romantic Partners ◽  
Mixed Methods Study ◽  
Goal Conflict ◽  
Emotional Needs ◽  
Interdependence Theory ◽  
Conflict Strategies

Interdependence theory suggests that romantic partners become more interdependent as they spend more time together. Due to COVID-19, partners have been together for an extended period while coping with demands caused by the pandemic. This is likely to lead to instances of conflict between partners’ goals. Goal conflict is damaging for relationships as it continuously tests the commitment between partners. In a concurrent mixed-methods study, we investigated whether (negotiation of) goal conflict was associated with goal outcomes (progress, confidence, motivation) and what strategies partners used during the pandemic to negotiate goal conflict. Quantitative participants (n = 200) completed a daily diary for a week and weekly longitudinal reports for a month and qualitative participants (n = 48) attended a semi-structured interview. Results showed that higher goal conflict was associated with lower goal outcomes, and successful negotiation of goal conflict was associated with better goal outcomes. Qualitative analyses identified three conflict strategies (compromise, integration, concession). Conversations focused on both practical and emotional needs and included respectful communication and space from conflict (timeout or avoidance). The mixed-methods results suggest that goal conflict was relatively low during the pandemic and participants were often able to negotiate goal conflict resulting in better goal outcomes.

scholarly journals Transforming training into practice with the conflict management framework: a mixed methods study

2021 ◽  
Vol 5 (1) ◽  
pp. e001088
Author(s):  
Oscar Lyons ◽  
Liz Forbat ◽  
Esse Menson ◽  
Julia C Chisholm ◽  
Kate Pryde ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Conflict Management ◽  
Management Training ◽  
Mixed Methods Study ◽  
Post Intervention ◽  
Management Framework ◽  
Semistructured Interviews ◽  
Conflict Management Training ◽  
Effective Adjunct ◽  
And Training

ObjectiveTo implement and evaluate the use of the conflict management framework (CMF) in four tertiary UK paediatric services.DesignMixed methods multisite evaluation including prospective pre and post intervention collection of conflict data alongside semistructured interviews.SettingEight inpatient or day care wards across four tertiary UK paediatric services.InterventionsThe two-stage CMF was used in daily huddles to prompt the recognition and management of conflict.ResultsConflicts were recorded for a total of 67 weeks before and 141 weeks after implementation of the CMF across the four sites. 1000 episodes of conflict involving 324 patients/families across the four sites were recorded. After implementation of the CMF, time spent managing episodes of conflict around the care of a patient was decreased by 24% (p<0.001) (from 73 min to 55 min) and the estimated cost of this staff time decreased by 20% (p<0.02) (from £26 to £21 sterling per episode of conflict). This reduction occurred despite conflict episodes after implementation of the CMF having similar severity to those before implementation. Semistructured interviews highlighted the importance of broad multidisciplinary leadership and training to embed a culture of proactive and collaborative conflict management.ConclusionsThe CMF offers an effective adjunct to conflict management training, reducing time spent managing conflict and the associated staff costs.

scholarly journals Physical Activity and the Menstrual Cycle: A Mixed-Methods Study of Women’s Experiences

2021 ◽  
Vol 29 (1) ◽  
pp. 47-58
Author(s):  
Petra V. Kolić ◽  
David T. Sims ◽  
Kirsty Hicks ◽  
Laura Thomas ◽  
Christopher I. Morse
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Menstrual Cycle ◽  
Physical Symptoms ◽  
Mixed Methods Study ◽  
Mixed Methods Design ◽  
Online Questionnaire ◽  
Societal Norms ◽  
Menstrual Symptoms ◽  
Semistructured Interviews

The menstrual cycle is an important biological process in women that is associated with a range of physical symptoms, which can shape how women think, feel, and participate in activities of daily life. This study employed a mixed-methods design to investigate adult women’s physical activity throughout the menstrual cycle. One hundred and twenty-eight participants completed an online questionnaire that explored events of the menstrual cycle (e.g., bleeding, pain, fatigue) and physical activity. Semistructured interviews with 21 questionnaire respondents unpacked individual experiences of physical activity throughout the menstrual cycle. From the questionnaire data, 44 participants were categorized as avoiders and 84 as nonavoiders of physical activity due to menstrual events. Avoiders of physical activity reported longer periods, heavier menstrual flow, and higher levels of fatigue and pain compared with nonavoiders. Interviews revealed that avoidance of physical activity ranged from complete avoidance to adaptation (e.g., types of exercise). Reasons for avoidance and adaptation of physical activity included menstrual symptoms, personal thoughts, and concerns about other people’s views of the period. The present study findings emphasize the importance of not only evaluating prevalent physical symptoms, but also unpacking women’s individual perspectives and established societal norms to better understand and normalize physical activity throughout the menstrual cycle.

scholarly journals Implications of a Multicomponent Sleep Program After Brain Injury: A Mixed-Methods Study

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512505214p1-7512505214p1
Author(s):  
Brandi Fulwider
Keyword(s):  
Mixed Methods ◽  
Brain Injury ◽  
Research Study ◽  
Mixed Methods Study ◽  
Occupational Performance ◽  
Semistructured Interviews ◽  
Primary Author

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The research study was conducted to identify how disruptions in sleep affect daily occupational performance after brain injury and to acknowledge of the role of OT in addressing sleep deficits through semistructured interviews and a multicomponent sleep program. The study was one of few studies to document the effectiveness of OT-directed sleep interventions, offering support for future OT practitioners and researchers to address sleep. Primary Author and Speaker: Brandi Fulwider

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