Research in palliative care

2019 ◽  
pp. 53-62
Keyword(s):  
Palliative Care ◽  
Quantitative Research ◽  
Terminal Illness ◽  
Evidence Base ◽  
Attrition Rates ◽  
Quality Research ◽  
Qualitative And Quantitative ◽  
Good Quality Research

Research in palliative care is gaining momentum and good quality research is helping form an evidence base which clinicians will be able to work within. There are ongoing challenges with carrying out research in palliative care, including high attrition rates, culture and ethical views around research in patients with terminal illness, funding, and gatekeeping. However, it is essential that to provide the best care that robust research is carried out. This can take the form of qualitative and quantitative research, and both are useful and valid in developing a research base of evidence if they are used in the correct contexts.

Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field

2005 ◽  
Vol 10 (1_suppl) ◽  
pp. 6-20 ◽  
Author(s):  
Nicholas Mays ◽  
Catherine Pope ◽  
Jennie Popay
Keyword(s):  
Quantitative Research ◽  
Meta Analysis ◽  
Evidence Base ◽  
Primary Data ◽  
Quantitative Evidence ◽  
Qualitative And Quantitative ◽  
Quantitative Form ◽  
Wide Range ◽  
Quantitative Synthesis ◽  
Basic Approaches

Policy-makers and managers have always used a wide range of sources of evidence in making decisions about policy and the organization of services. However, they are under increasing pressure to adopt a more systematic approach to the utilization of the complex evidence base. Decision-makers must address complicated questions about the nature and significance of the problem to be addressed; the nature of proposed interventions; their differential impact; cost-effectiveness; acceptability and so on. This means that Cochrane-style reviews alone are not sufficient. Rather, they require access to syntheses of high-quality evidence that include research and non-research sources, and both qualitative and quantitative research findings. There is no single, agreed framework for synthesizing such diverse forms of evidence and many of the approaches potentially applicable to such an endeavour were devised for either qualitative or quantitative synthesis and/or for analysing primary data. This paper describes the key stages in reviewing and synthesizing qualitative and quantitative evidence for decision-making and looks at various strategies that could offer a way forward. We identify four basic approaches: narrative (including traditional ‘literature reviews’ and more methodologically explicit approaches such as ‘thematic analysis’, ‘narrative synthesis’, ‘realist synthesis’ and ‘meta-narrative mapping’), qualitative (which convert all available evidence into qualitative form using techniques such as ‘meta-ethnography’ and ‘qualitative cross-case analysis’), quantitative (which convert all evidence into quantitative form using techniques such as‘quantitative case survey’ or ‘content analysis’) and Bayesian meta-analysis and decision analysis (which can convert qualitative evidence such as preferences about different outcomes into quantitative form or ‘weights’ to use in quantitative synthesis). The choice of approach will be contingent on the aim of the review and nature of the available evidence, and often more than one approach will be required.

Empowering the Culture of Quality Research within Ethical Standards in Distance Education

2010 ◽  
pp. 164-182
Author(s):  
J.O. Osiki
Keyword(s):  
Higher Education ◽  
Distance Education ◽  
Quantitative Research ◽  
Raw Material ◽  
Ethical Standards ◽  
Quality Research ◽  
Qualitative And Quantitative ◽  
Research Orientation ◽  
A Value ◽  
Culture Of Quality

Fundamental in today’s Distance Higher education (DHE) in the African sub-regions, is how to continue to harness the dividends inherent in the multi-dimensionality of empowerment, for inducing a virile tradition of research, through the shared-benefits of academic/intellectual symbiotism. In such atmosphere, the mentor is less egoistic and willing to provide leadership as a motivator for a value-driven research orientation of the committed protégés. Using the cyclical model, while the novelty of early academic irritants are to be acknowledged, learners’ emotionality is identified as raw material for boosting both qualitative and quantitative research skills, within clearly defined workplaces’ standards. The acquisition of relevant skills and its benefits is therefore sinequanon for nurturing and sustaining research culture especially in DHE.

A Tale of Two Cultures

2012 ◽  
Author(s):  
Gary Goertz ◽  
James Mahoney
Keyword(s):  
Social Sciences ◽  
Quantitative Research ◽  
Social Science Research ◽  
Measurement Data ◽  
Science Research ◽  
Quantitative Research Methods ◽  
Qualitative And Quantitative ◽  
The Social ◽  
Scientific Worldview ◽  
Different Cultures

Some in the social sciences argue that the same logic applies to both qualitative and quantitative research methods. This book demonstrates that these two paradigms constitute different cultures, each internally coherent yet marked by contrasting norms, practices, and toolkits. The book identifies and discusses major differences between these two traditions that touch nearly every aspect of social science research, including design, goals, causal effects and models, concepts and measurement, data analysis, and case selection. Although focused on the differences between qualitative and quantitative research, the book also seeks to promote toleration, exchange, and learning by enabling scholars to think beyond their own culture and see an alternative scientific worldview. The book is written in an easily accessible style and features a host of real-world examples to illustrate methodological points.

Happiness at the end of life: A qualitative study

2021 ◽  
pp. 1-7
Author(s):  
Tan Seng Beng ◽  
Wong Ka Ghee ◽  
Ng Yun Hui ◽  
Ooi Chieh Yin ◽  
Khoo Wei Shen Kelvin ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
End Of Life ◽  
Terminal Illness ◽  
Terminally Ill ◽  
Social Connections ◽  
Targeted Interventions ◽  
Pain And Suffering ◽  
The University ◽  
Eudaimonic Happiness

Abstract Objective Dying is mostly seen as a dreadful event, never a happy experience. Yet, as palliative care physicians, we have seen so many patients who remained happy despite facing death. Hence, we conducted this qualitative study to explore happiness in palliative care patients at the University of Malaya Medical Centre. Method Twenty terminally ill patients were interviewed with semi-structured questions. The results were thematically analyzed. Results Eight themes were generated: the meaning of happiness, connections, mindset, pleasure, health, faith, wealth, and work. Our results showed that happiness is possible at the end of life. Happiness can coexist with pain and suffering. Social connections were the most important element of happiness at the end of life. Wealth and work were given the least emphasis. From the descriptions of our patients, we recognized a tendency for the degree of importance to shift from the hedonic happiness to eudaimonic happiness as patients experienced a terminal illness. Significance of results To increase the happiness of palliative care patients, it is crucial to assess the meaning of happiness for each patient and the degree of importance for each happiness domain to allow targeted interventions.

scholarly journals Leveraging human factors in cybersecurity: an integrated methodological approach

2021 ◽  
Author(s):  
Alessandro Pollini ◽  
Tiziana C. Callari ◽  
Alessandra Tedeschi ◽  
Daniele Ruscio ◽  
Luca Save ◽  
...  
Keyword(s):  
Human Factors ◽  
Cyber Security ◽  
Quantitative Research ◽  
Methodological Approach ◽  
Quantitative Research Methods ◽  
Security Culture ◽  
Technological Factors ◽  
Qualitative And Quantitative ◽  
The Individual ◽  
Technical Solutions

AbstractComputer and Information Security (CIS) is usually approached adopting a technology-centric viewpoint, where the human components of sociotechnical systems are generally considered as their weakest part, with little consideration for the end users’ cognitive characteristics, needs and motivations. This paper presents a holistic/Human Factors (HF) approach, where the individual, organisational and technological factors are investigated in pilot healthcare organisations to show how HF vulnerabilities may impact on cybersecurity risks. An overview of current challenges in relation to cybersecurity is first provided, followed by the presentation of an integrated top–down and bottom–up methodology using qualitative and quantitative research methods to assess the level of maturity of the pilot organisations with respect to their capability to face and tackle cyber threats and attacks. This approach adopts a user-centred perspective, involving both the organisations’ management and employees, The results show that a better cyber-security culture does not always correspond with more rule compliant behaviour. In addition, conflicts among cybersecurity rules and procedures may trigger human vulnerabilities. In conclusion, the integration of traditional technical solutions with guidelines to enhance CIS systems by leveraging HF in cybersecurity may lead to the adoption of non-technical countermeasures (such as user awareness) for a comprehensive and holistic way to manage cyber security in organisations.

scholarly journals Prognostic predictors relevant to end-of-life palliative care in Parkinson’s disease and related disorders: a systematic review

2021 ◽  
pp. jnnp-2020-323939
Author(s):  
Umer Akbar ◽  
Robert Brett McQueen ◽  
Julienne Bemski ◽  
Julie Carter ◽  
Elizabeth R Goy ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Palliative Care ◽  
Parkinson's Disease ◽  
End Of Life ◽  
Cause Of Death ◽  
Quantitative Research ◽  
Motor Dysfunction ◽  
Clinical Markers ◽  
Hospice Referral ◽  
Survey Responses

Parkinson’s disease and related disorders (PDRD) are the second most common neurodegenerative disease and a leading cause of death. However, patients with PDRD receive less end-of-life palliative care (hospice) than other illnesses, including other neurologic illnesses. Identification of predictors of PDRD mortality may aid in increasing appropriate and timely referrals. To systematically review the literature for causes of death and predictors of mortality in PDRD to provide guidance regarding hospice/end-of-life palliative care referrals. We searched MEDLINE, PubMed, EMBASE and CINAHL databases (1970–2020) of original quantitative research using patient-level, provider-level or caregiver-level data from medical records, administrative data or survey responses associated with mortality, prognosis or cause of death in PDRD. Findings were reviewed by an International Working Group on PD and Palliative Care supported by the Parkinson’s Foundation. Of 1183 research articles, 42 studies met our inclusion criteria. We found four main domains of factors associated with mortality in PDRD: (1) demographic and clinical markers (age, sex, body mass index and comorbid illnesses), (2) motor dysfunction and global disability, (3) falls and infections and (4) non-motor symptoms. We provide suggestions for consideration of timing of hospice/end-of-life palliative care referrals. Several clinical features of advancing disease may be useful in triggering end-of-life palliative/hospice referral. Prognostic studies focused on identifying when people with PDRD are nearing their final months of life are limited. There is further need for research in this area as well as policies that support need-based palliative care for the duration of PDRD.

Joint displays for qualitative-quantitative synthesis in mixed methods reviews

2021 ◽  
pp. 263208432098437
Author(s):  
Ahtisham Younas ◽  
Shahzad Inayat ◽  
Amara Sundus
Keyword(s):  
Mixed Methods ◽  
Nursing Students ◽  
Quantitative Research ◽  
Practice Research ◽  
Quantitative Evidence ◽  
Qualitative And Quantitative ◽  
Quantitative Synthesis ◽  
Research Findings ◽  
Excellent Method ◽  
Levels Of Integration

Mixed methods reviews offer an excellent approach to synthesizing qualitative and quantitative evidence to generate more robust implications for practice, research, and policymaking. There are limited guidance and practical examples concerning the methods for adequately synthesizing qualitative and quantitative research findings in mixed reviews. This paper aims to illustrate the application and use of joint displays for qualitative and quantitative synthesis in mixed methods reviews. We used joint displays to synthesize and integrate qualitative and quantitative research findings in a segregated mixed methods review about male nursing students' challenges and experiences. In total, 36 qualitative, six quantitative, and one mixed-methods study was appraised and synthesized in the review. First, the qualitative and quantitative findings were analyzed and synthesized separately. The synthesized findings were integrated through tabular and visual joint displays at two levels of integration. At the first level, a statistics theme display was developed to compare the synthesized qualitative and quantitative findings and the number of studies from which the findings were generated. At the second level, the synthesized qualitative and quantitative findings supported by each other were integrated to identify confirmed, discordant, and expanded inferences using generalizing theme display. The use of two displays allowed in a robust and comprehensive synthesis of studies. Joint displays could serve as an excellent method for rigorous and transparent synthesis of qualitative and quantitative findings and the generation of adequate and relevant inferences in mixed methods reviews.

Palliative care referral practices and perceptions: The divide between metropolitan and non-metropolitan general practitioners

2011 ◽  
Vol 9 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Claire E. Johnson ◽  
Afaf Girgis ◽  
Christine L. Paul ◽  
David C. Currow
Keyword(s):  
Palliative Care ◽  
General Practitioners ◽  
Advanced Cancer ◽  
Terminal Illness ◽  
Symptom Control ◽  
Physical Symptoms ◽  
Care Physician ◽  
Self Report ◽  
Psychosocial Needs ◽  
Consultative Service

AbstractObjective:Late or non-referral of patients to specialist palliative care (SPC) services may affect patients' and their carers' quality of care. General practitioners (GPs) are key professionals in linking people with SPC. The aim of this article is to assess GPs' perceptions and SPC referrals for their patients with advanced cancer and differences between metropolitan (M GPs) and non-metropolitan GPs (NM GPs).Method:Self-report survey mailed to a stratified random sample of 1,680 Australian GPs was used.Results:Thirty-one percent (469) of eligible GPs returned surveys. More M GPs than NM GPs reported referring >60% of their patients for SPC (p = 0.014); and that a more comprehensive range of SPC services was available. The most frequently reported referral prompts were: presence of terminal illness (M GPs, 71%, NM GPs, 66%, ns (not significant)); future need for symptom control (69% vs. 59%, ns) and uncontrolled physical symptoms (63% vs. 54%, ns). Reasons for not referring were: doctor's ability to manage symptoms (62% vs. 68%, ns) and the absence of symptoms (29% vs. 18%, p = 0.025). Higher referral was associated with: having a palliative care physician or consultative service available; agreeing that all patients with advanced cancer should be referred, and agreeing that with SPC, the needs of the family are better met.Significance of results:Referrals for SPC were primarily disease-related rather than for psychological and emotional concerns. Measures are needed to encourage referrals based upon psychosocial needs as well as for physical concerns, and to support GPs caring for people with advanced cancer in areas with fewer comprehensive SPC services.

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