scholarly journals Stop, Listen, and Learn: Using Mixed Methods to Add Value to Clinical Trials*

2019 ◽  
Vol 24 ◽  
pp. 2515690X1985707 ◽  
Author(s):  
Jennifer Hunter ◽  
Mike Armour
Keyword(s):  
Health Care ◽  
Clinical Trials ◽  
Mixed Methods ◽  
Patient Outcomes ◽  
A Priori ◽  
Mixed Methods Study ◽  
Mixed Methods Approach ◽  
Potential Value ◽  
Study Designs

This commentary discusses the concept of value-based or value-focused health care as a rationale for researchers to incorporate mixed methods study designs a priori into clinical trials evaluating traditional, complementary, alternative, and integrative medicine (TCAIM). Along with assessing patient outcomes, information about patients’ experiences and preferences are needed to determine the value of an intervention. Incorporating a mixed-methods approach can improve the quality of clinical trials and provide important information about the potential value of the intervention.

scholarly journals The effect of a family health-team approach on the quality of health care for Palestinian infants in Jordan: a mixed methods study

The Lancet ◽  
2018 ◽  
Vol 391 ◽  
pp. S28 ◽  
Author(s):  
Noortje Gerritsma ◽  
Maartje-Maria van den Berg ◽  
Ali Khader ◽  
Majed Hababeh ◽  
Loai Farajallah ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Quality Of Health Care ◽  
Family Health ◽  
Mixed Methods Study ◽  
Team Approach ◽  
Health Team ◽  
Family Health Team

scholarly journals Assessing burden, risk factors, and perceived impact of uterine fibroids on women’s lives in rural Haiti: implications for advancing a health equity agenda, a mixed methods study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Christophe Millien ◽  
Anatole Manzi ◽  
Arlene M. Katz ◽  
Hannah Gilbert ◽  
Mary C. Smith Fawzi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mixed Methods ◽  
Black Women ◽  
Uterine Fibroids ◽  
Mixed Methods Study ◽  
University Hospital ◽  
Gynecologic Surgery ◽  
Cross Sectional ◽  
Women's Lives

Abstract Background Uterine fibroids, the most common cause of gynecologic surgery, have a reported cumulative incidence of 59% among Black women in the U.S. Uterine fibroids negatively impact the quality of women’s lives. No study has been found in the literature about fibroids in Haiti. We conducted a mixed methods study to assess the burden and risk factors of uterine fibroids, as well as their effects on women’s quality of life. Methods A convergent mixed methods study was conducted between October 1, 2019 and January 31, 2020 at MUH’s (Mirebalais University Hospital) OB-GYN outpatient department. Quantitatively, in a cross-sectional study 211 women completed consecutively a structured questionnaire. In-depth interviews with 17 women with fibroids and 7 family members were implemented for the qualitative component. Descriptive statistics were calculated for clinical and social demographic variables. Logistic regression was performed to examine associations between fibroids and related risk factors. An inductive thematic process was used to analyze the qualitative data. A joint display technique was used to integrate the results. Results Of 193 women analyzed 116 had fibroids (60.1%). The mean age was 41.3. Anemia was the most frequent complication— 61 (52.6%). Compared to women without uterine fibroids, factors associated with uterine fibroids included income decline (AOR = 4.7, 95% CI: 2.1–10.9, p = < 0.001), excessive expenses for transport (AOR = 4.4, 95% CI: 1.6–12.4, p = 0.005), and family history with uterine fibroids (AOR = 4.6, 95% CI: 1.6–13.6, p = 0.005). In contrast, higher level of education and micro polycystic ovarian syndrome were associated with lower prevalence (AOR = 0.3, 95% CI: 0.1–0.9, p = 0.021) and (AOR = 0.2, 95% CI: 0.1–0.97, p = 0.044), respectively. The qualitative findings delineate how contextual factors such as health system failures, long wait times, gender inequality and poverty negatively affect the quality of women’s lives. The poverty cycle of uterine fibroids emerged. Conclusions A vicious cycle of poverty negatively impacts access to care for uterine fibroids in Haiti. Health insurance, social support, and income generating activities may be keys to promote social justice through access to adequate care for women with uterine fibroids in Haiti.

scholarly journals Exploring anhedonia in adolescents with Chronic Fatigue Syndrome (CFS): A mixed-methods study

2021 ◽  
pp. 135910452110055
Author(s):  
Lucie Smith ◽  
Esther Crawley ◽  
Madeleine Riley ◽  
Megan McManus ◽  
Maria Elizabeth Loades
Keyword(s):  
Mixed Methods ◽  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Diagnostic Interview ◽  
Mixed Methods Study ◽  
Mixed Methods Approach ◽  
Fatigue Syndrome ◽  
Core Symptom ◽  
Clinically Significant ◽  
The Way

Background: Chronic Fatigue Syndrome (CFS/ME) may get in the way of enjoying activities. A substantial minority of adolescents with CFS/ME are depressed. Anhedonia is a core symptom of depression. Anhedonia in adolescents with CFS/ME has not been previously investigated. Method: One hundred and sixty-four adolescents, age 12 to 18, with CFS/ME completed a diagnostic interview (K-SADS) and questionnaires (HADS, RCADS). We used a mixed-methods approach to explore the experience of anhedonia and examine how common it is, comparing those with clinically significant anhedonia to those without. Results: Forty-two percent of adolescents with CFS/ME reported subclinical or clinical levels of anhedonia. Fifteen percent had clinically significant anhedonia. Thematic analysis generated two themes: (1) stopping activities that they previously enjoyed and (2) CFS/ME obstructs enjoyment. Most (72%) of those who reported clinically significant anhedonia met the depression diagnostic criteria. Those who were depressed used more negative language to describe their experience of activities than in those who were not depressed, although the themes were broadly similar. Conclusions: Experiencing pleasure from activities may be affected in CFS/ME, particularly in those who are depressed. Anhedonia may get in the way of behavioural strategies used within CFS/ME treatments.

scholarly journals Payment Reforms for Prehospital Care Services in a Middle Income Country: Assessing Implementation and Patient Outcomes Using a Mixed-Methods Approach

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Paibul Suriyawongpaisal ◽  
Samrit Srithamrongsawad ◽  
Pongsakorn Atiksawedparit ◽  
Khanisthar Phooseemungkun ◽  
Krongkan Bunchaiyai ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Patient Care ◽  
Patient Outcomes ◽  
Prehospital Care ◽  
Clinical Care ◽  
Mixed Methods Approach ◽  
Time Flow ◽  
Care Systems ◽  
Pay System ◽  
Made In

Introduction. Financing health systems constitutes a key element of well-functioning healthcare system. Prior to 2015, two new financial arrangements (direct-pay and E-claim systems) were introduced on a voluntary basis which aimed to pool more financial resources and improve cash flow of prehospital care systems. The aims of this study were to (1) assess the effects of direct-pay system in terms of (a) timeliness of reimbursement to EMS agencies, (b) changes in clinical care processes, and (c) the outcomes of patient care as compared to previous system; (2) identify the reasons for or against EMS agencies to participate in direct-pay system mechanisms; (3) identify the emerging issues with potential to significantly further the advancement of EMS systems. Using a mixed-methods approach, retrospective datasets of 3,769,399 individual records of call responses from 2015 to 2017 were analyzed which compared EMS units with the direct-pay system against those without in terms of time flow of claim data and patient outcomes. For qualitative data, in-depth interviews were conducted. Results. EMS units participating in both systems had the highest percentages of financial claim being made in time as compared to those not participating in any (p=0.012). However, there were not any practically meaningful differences between EMS units participating and not participating in either of the payment systems in terms of patient care such as appropriateness of response time, airway management, and outcome of treatment. Analysis of data from focus-group and individual interviews ended up with a causal loop diagram demonstrating potential explanatory mechanisms for those findings. Conclusion. It is evident that progress has been made in terms of mobilising more financial inputs and improving financial information flow. However, there is no evidence of any changes in patient outcomes and quality of care. Furthermore, whether the progress is meaningful in filling the gaps of financial demands of the prehospital care systems is still questionable. Room for future improvement of prehospital care systems was discussed with implications for other countries.

scholarly journals Feasibility of peer assessment and clinical audit to self-regulate the quality of physiotherapy services: a mixed methods study

BMJ Open ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. e013726 ◽  
Author(s):  
Marjo J M Maas ◽  
Maria W G Nijhuis-van der Sanden ◽  
Femke Driehuis ◽  
Yvonne F Heerkens ◽  
Cees P M van der Vleuten ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Clinical Audit ◽  
Peer Assessment ◽  
Mixed Methods Study

Exploring the association of learning participation with the quality of life of older Chinese adults: A mixed methods approach

2018 ◽  
Vol 44 (5-6) ◽  
pp. 378-390 ◽  
Author(s):  
Renfeng Wang ◽  
Liesbeth De Donder ◽  
Free De Backer ◽  
Karen Triquet ◽  
Li Shihua ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Methods ◽  
Chinese Adults ◽  
Mixed Methods Approach ◽  
Older Chinese ◽  
Older Chinese Adults

scholarly journals Health Care Providers’ Knowledge of HPV Vaccination, Barriers, and Strategies in a State With Low HPV Vaccine Receipt: Mixed-Methods Study

JMIR Cancer ◽  
2017 ◽  
Vol 3 (2) ◽  
pp. e12 ◽  
Author(s):  
Echo L Warner ◽  
Qian Ding ◽  
Lisa Pappas ◽  
Julia Bodson ◽  
Brynn Fowler ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Providers ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Mixed Methods Study ◽  
Care Providers ◽  
Vaccination Barriers

scholarly journals Quality of Inpatient Tuberculosis Health Care in High-Burden Resource-Limited Settings: Protocol for a Comprehensive Mixed Methods Assessment Study

10.2196/13903 ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. e13903
Author(s):  
Nune Truzyan ◽  
Zaruhi Grigoryan ◽  
Lusine Musheghyan ◽  
Byron Crape ◽  
Varduhi Petrosyan
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
International Standards ◽  
World Health ◽  
High Quality ◽  
High Burden ◽  
Resource Limited ◽  
Evaluation Instruments ◽  
Depth Interviews

Background The quality of care for tuberculosis (TB) is deficient in high-burden countries and urgently needs improvement. However, comprehensively identifying the required improvements is challenging. Providing high-quality TB care is an important step toward improving patients’ quality of life and decreasing TB morbidity and mortality. Effective tools for assessing the quality of TB services using international standards and guidelines can identify existing gaps in services and inform improvements to ensure high-quality inpatient TB services. Objective This study aimed to develop evaluation instruments for defining the quality of provision of TB services. Methods To assess quality of services in the largest TB hospital in Armenia, we developed instruments based on the Joint Commission International Accreditation Standards for Hospitals, International Standards for TB Care, TB Laboratories Bio-Safety Standards, and the World Health Organization framework for conducting TB program reviews. A mixed methods approach was utilized, triangulating quantitative (checklists) and qualitative (in-depth interviews) results. A scoring system and strengths, weaknesses, opportunities, and treats analysis was applied to detail results for each of the 122 standards assessed. A scaling approach was used to present overall performances of inpatient services for eight patient-centered functions and five organization management functions. Results Overall, 40 in-depth interviews and 91 checklists (21 observations, 16 policy papers, 20 staff qualification documents, and 34 medical records) were developed, utilized, and analyzed to explore practices of health care professionals, assess inpatient treatment experience of patients and their family members, evaluate facility environmental conditions, and define the degree of compliance to standards. Conclusions The effective comprehensive evaluation instruments and methods developed in this study for quality of inpatient TB services support the implementation of similar effective assessments in other countries. It may also become a platform to develop similar approaches for assessing ambulatory TB services in resource-limited countries. International Registered Report Identifier (IRRID) DERR1-10.2196/13903

scholarly journals Predictors and Consequences of Veterans Affairs Mental Health Provider Burnout: Protocol for a Mixed Methods Study

10.2196/18345 ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. e18345
Author(s):  
Kara Zivin ◽  
Jennifer Kononowech ◽  
Matthew Boden ◽  
Kristen Abraham ◽  
Molly Harrod ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Patient Outcomes ◽  
Primary Care Physicians ◽  
Quantitative Methods ◽  
Expert Panel ◽  
Veterans Affairs ◽  
Mixed Methods Study ◽  
Mental Health Provider ◽  
Health Administration

Background In the Veterans Health Administration (VHA), mental health providers (MHPs) report the second highest level of burnout after primary care physicians. Burnout is defined as increased emotional exhaustion and depersonalization and decreased sense of personal accomplishment at work. Objective This study aims to characterize variation in MHP burnout by VHA facility over time, identifying workplace characteristics and practices of high-performing facilities. Methods Using both qualitative and quantitative methods, we will evaluate factors that influence MHP burnout and their effects on patient outcomes. We will compile annual survey data on workplace conditions and annual staffing as well as productivity data to assess same and subsequent year provider and patient outcomes reflecting provider and patient experiences. We will conduct interviews with mental health leadership at the facility level and with frontline MHPs sampled based on our quantitative findings. We will present our findings to an expert panel of operational partners, Veterans Affairs clinicians, administrators, policy leaders, and experts in burnout. We will reengage with facilities that participated in the earlier qualitative interviews and will hold focus groups that share results based on our quantitative and qualitative work combined with input from our expert panel. We will broadly disseminate these findings to support the development of actionable policies and approaches to addressing MHP burnout. Results This study will assist in developing and testing interventions to improve MHP burnout and employee engagement. Our work will contribute to improvements within VHA and will generate insights for health care delivery, informing efforts to address burnout. Conclusions This is the first comprehensive, longitudinal, national, mixed methods study that incorporates different types of MHPs. It will engage MHP leadership and frontline providers in understanding facilitators and barriers to effectively address burnout. International Registered Report Identifier (IRRID) PRR1-10.2196/18345

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