Remote activity monitoring for family caregivers of persons living with dementia: a mixed methods, randomized controlled evaluation

Abstract Background The goal of the present study was to determine whether a remote activity monitoring (RAM) system benefited caregivers who aided relatives with Alzheimer’s disease or related dementias (ADRD) living at home. We hypothesized that over 18 months, families randomly assigned to receive RAM technology in the home of the person with ADRD would experience statistically significant (p < .05): 1) improvements in caregiver self-efficacy and sense of competence when managing their relative’s dementia; and 2) reductions in caregiver distress (e.g., burden, role captivity, and depression). Methods An embedded mixed methods design was utilized, where 179 dementia caregivers were randomly assigned to receive RAM or not. Caregivers were surveyed bi-annually over an 18-month period to collect quantitative and qualitative data on RAM’s effects. Semi-structured interviews with 30 caregivers were completed following the 18-month data collection period to explore more in-depth how and why RAM was perceived as helpful or not. Results Growth curve models showed no direct or moderation effect of RAM on dementia caregiver outcomes. The qualitative data revealed a complex utilization process of RAM influenced by the care environment/context as well as the temporal progression of ADRD and the caregiving trajectory. Conclusions The findings suggest the need for developing more effective mechanisms to match appropriate technologies with the heterogeneous needs and care contexts of people living with ADRD and their caregivers. A triadic approach that incorporates professional care management alongside passive monitoring systems such as RAM may also enhance potential benefits. Trial registration ClinicalTrials.govNCT03665909, retrospectively registered on 11 Sept 2018.

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Behavioural Red Flags of Fraud: An Ex Post Assessment of Types and Frequencies

Global Business Review ◽

10.1177/0972150919850410 ◽

2019 ◽

Vol 21 (2) ◽

pp. 507-525

Author(s):

Namrata Sandhu

Keyword(s):

Mixed Methods ◽

Data Analysis ◽

Early Detection ◽

Qualitative Data ◽

Working Hours ◽

Living Standard ◽

Red Flags ◽

Structured Interviews ◽

Ex Post ◽

Post Assessment

A number of researchers and professional fraud examiners have emphasized the need for early detection of frauds. Though there are many ways in which frauds can be detected, a particularly effective and inexpensive way is to identify fraudsters by scrutinizing personnel behaviour for peculiarities typical of fraudsters. Towards this end, the present study compiles a checklist of behavioural red flags of fraud based on data collected with the help of 41 semi-structured interviews. The interviewees constitute people who have personally investigated or closely observed a fraud in the last 3 years. A mixed methods triangulation approach is used to quantify the qualitative data collected from the interviews. Data analysis reveals 16 different behavioural red flags exhibited by fraudsters. An examination of frequencies indicates that strong ambition, extended working hours, social aloofness, dissatisfaction with current job and living standard disproportionate to current means are the most frequently displayed behavioural red flags of fraud. The study also shows that fraudsters exhibit three or four behavioural red flags in a majority of cases. Implications for anti-fraud practitioners are discussed.

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Does regular listening to preferred music have a beneficial effect on symptoms of depression and anxiety amongst older people in residential care? The qualitative findings of a mixed methods study.

Music and Medicine ◽

10.47513/mmd.v10i2.567 ◽

2018 ◽

Vol 10 (2) ◽

pp. 54

Author(s):

Fiona Costa ◽

Adam Ockelford ◽

David J Hargreaves

Keyword(s):

Mixed Methods ◽

Older People ◽

Residential Care ◽

Qualitative Data ◽

Care Home ◽

Management Style ◽

Depression And Anxiety ◽

Structured Interviews ◽

Research Procedure ◽

Foot Tapping

This article presents the qualitative findings of a mixed-methods evaluation of the effects of listening to preferred music on depression and anxiety in older people in residential care. One hundred and seventeen participants were recruited from nine care homes, all but one in Greater London. The homes varied in size and management style, and participants came from a range of socio-economic backgrounds. In addition to their usual routine, each participant listened to a daily 30-minute programme of their preferred music for three weeks. Both quantitative and qualitative data relating to anxiety and depression were collected during once-weekly semi-structured interviews. Findings from the qualitative data showed that listening to preferred music resulted in relaxation, positive reminiscence, less depression and less boredom. Physical reactions, such as ‘chills’ or tears, demonstrated emotional arousal; others, such as foot-tapping were beneficial to the most disabled participants. The use of preferred and favourite music was the principal facilitator of its effectiveness, whilst declines in memory, confidence and energy were barriers to the research procedure. It was concluded that listening to preferred music can bring some relief to depression and anxiety amongst older care home residents but that not all will benefit to the same degree.

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Examining school leadership in a transitional context: A mixed-methods study of leadership practices and school cultures as mechanisms of educational change

Educational Management Administration & Leadership ◽

10.1177/1741143220971286 ◽

2020 ◽

pp. 174114322097128

Author(s):

Jasna Kovačević ◽

Alisa Mujkić ◽

Amra Kapo

Keyword(s):

Mixed Methods ◽

Educational Reform ◽

School Leadership ◽

Structural Equation ◽

Large Scale ◽

Qualitative Data ◽

Measurement Model ◽

Equation Modeling ◽

Structured Interviews ◽

School Cultures

This research presents the results of studies designed to observe the effects of school leadership and school culture as mechanisms of change in the context of a large-scale educational reform in Bosnia and Herzegovina. A mixed-methods approach was employed to illuminate how institutional context either activates or deactivates leadership and school cultures as mechanisms that influence teacher efficacy beliefs in times of large-scale educational reform. Quantitative and qualitative data were analyzed through three independent studies. Quantitative procedures included measurement model analysis, structural equation modeling and a non-parametric Mann–Whitney U test. The qualitative analytic approach encompassed procedures of content analysis and quantification of qualitative data from reform documents and semi-structured interviews in the form of hierarchical clustering and multidimensional scaling. The triangulation of findings occurred in the interpretation phase, characterized by the development of meta-inferences that go beyond the findings from each study.

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Facilitators and Barriers to Wearing Hand Orthoses by Adults with Duchenne Muscular Dystrophy: A Mixed Methods Study Design

Journal of Neuromuscular Diseases ◽

10.3233/jnd-200506 ◽

2020 ◽

Vol 7 (4) ◽

pp. 467-475

Author(s):

S.L.S. Houwen-van Opstal ◽

Y.M.E.M. van den Elzen ◽

M. Jansen ◽

M.A.A.P. Willemsen ◽

E.H.C. Cup ◽

...

Keyword(s):

Mixed Methods ◽

Duchenne Muscular Dystrophy ◽

Muscular Dystrophy ◽

Qualitative Data ◽

Comparative Method ◽

Hand Function ◽

Structured Interviews ◽

Validated Questionnaire ◽

Constant Comparative Method ◽

Facilitators And Barriers

Background: To retard shortening of finger flexors in patients with Duchenne muscular dystrophy (DMD), hand orthoses are prescribed. However, many patients do not wear the orthoses regularly. To optimize orthotic interventions, we need insight into the factors influencing compliance. Objective: To evaluate the compliance regarding hand orthoses in an adult DMD population and to explore experiences and perceptions of DMD patients wearing orthoses, and of their caregivers. Methods: Mixed methods observational study, combining quantitative and qualitative data from medical charts combined with qualitative semi-structured interviews using a constant comparative method and a short validated questionnaire (D-QUEST). Results: 65 medical charts were analyzed. 48 patients were assessed as needing hand orthoses, of whom 37.5 % were compliant. Qualitative data analyses revealed (1) motivation: preservation of hand function; (2) barriers: discomfort and impediments; (3) facilitators: good fit and personalized wearing schedule; (4) fitting process: satisfactory, but patients do not readily seek help when barriers appear. Conclusions: Patients are motivated to wear hand orthoses, but often discontinue use because of orthosis-and disease-specific barriers. The identification of these barriers leads to practical and feasible recommendations concerning the orthoses and the fitting process, such as less rigid material, preservation of some function while wearing the orthoses, and fixed evaluation points. The findings were confirmed by the D-QUEST.

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Impact of deep brain stimulation on people with Parkinson’s disease: A mixed methods feasibility study exploring lifespace and community outcomes

Hong Kong Journal of Occupational Therapy ◽

10.1177/1569186119865736 ◽

2019 ◽

Vol 32 (2) ◽

pp. 97-107

Author(s):

Jacki Liddle ◽

Amreetaa Sundraraj ◽

David Ireland ◽

Sally Bennett ◽

Tereza Stillerova ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Mixed Methods ◽

Deep Brain Stimulation ◽

Brain Stimulation ◽

Qualitative Data ◽

Structured Interviews ◽

Before And After ◽

Community Outcomes ◽

Deep Brain

Background Deep brain stimulation is a surgical treatment for Parkinson’s disease. Its impacts on motor symptoms are widely reported; however, little is known about the broader impact of deep brain stimulation on the community lives of people with Parkinson’s disease. Lifespace is a measure of lived community mobility, providing an indication of community access and participation. Aims This pilot study explored the feasibility of remotely monitoring the qualitative and quantitative community outcomes related to deep brain stimulation. Methods A longitudinal mixed methods study with a convergent design was undertaken exploring the lifespace, quality of life, life satisfaction and lived experiences of people with Parkinson’s disease before and after deep brain stimulation. Data were collected through questionnaires, semi-structured interviews and a smartphone-based application which collected geolocation data. Results Quantitative and qualitative data from eight participants living with Parkinson’s disease were analysed and integrated. At baseline, participants had a median age of 68 years and a median Hoehn and Yahr score of 2. Measuring a range of community-based outcomes indicated different change trajectories for individuals across outcomes. Key content areas were developed from the qualitative data: participation in occupations and travel and home. This study indicates the potential value of including geolocation data-based lifespace collection in metropolitan and regional areas. Conclusions Monitoring lifespace in conjunction with subjective measures provides insights into the complex and individually varied experiences. Further research could explore the impacts of deep brain stimulation on occupations and community participation to gain a deeper understanding of the related needs and support clinical approaches.

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Public spaces and physical activity in adults: insights from a mixed-methods study

Cadernos de Saúde Pública ◽

10.1590/0102-311x00028720 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Ietza Bojorquez ◽

Maria de Lourdes Romo-Aguilar ◽

Lina Ojeda-Revah ◽

Fernando Tena ◽

Francisco Lara-Valencia ◽

...

Keyword(s):

Physical Activity ◽

Mixed Methods ◽

Qualitative Data ◽

Health Benefit ◽

Positive Association ◽

Household Survey ◽

Public Spaces ◽

Mixed Methods Study ◽

Structured Interviews ◽

Potential Health

Abstract: Public spaces could promote health equity by providing a place for people to engage in physical activity. Whereas most studies show a positive association between public spaces and physical activity, there are still mixed results, especially in low- and middle-income countries. The objectives of this mixed-methods study were: (i) to assess the quantitative association between access to public spaces and physical activity; (ii) to assess the modification of the association by public spaces quality, area-level walkability, and social stratifiers; (iii) to explain the quantitative results using qualitative data. Quantitative data were obtained with a household survey in two arid-climate Mexican cities in 2017-2018. physical activity was measured with the Global Physical Activity Questionnaire. Access to public spaces was measured in buffers centered on survey blocks, walkability with area-level indicators, and public spaces quality with the Physical Activity Resources Assessment. Qualitative data were obtained with semi-structured interviews and neighborhood observation. No quantitative association between access to public spaces and physical activity was found, as well as no interactions between access to public spaces and other variables. Walkability was positively associated with physical activity. Qualitative analysis showed that local public spaces were rarely used by adults because they were perceived as small, unequipped, unattractive, and unsafe. The results shed light on the relationship between public spaces and physical activity, highlighting the improvements in design and upkeep of public spaces that are necessary to achieve their potential health benefit.

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Acute kidney injury electronic alerts: mixed methods Normalisation Process Theory evaluation of their implementation into secondary care in England

BMJ Open ◽

10.1136/bmjopen-2019-032925 ◽

2019 ◽

Vol 9 (12) ◽

pp. e032925

Author(s):

Jason Scott ◽

Tracy Finch ◽

Mark Bevan ◽

Gregory Maniatopoulos ◽

Chris Gibbins ◽

...

Keyword(s):

Acute Kidney Injury ◽

Mixed Methods ◽

Secondary Care ◽

Qualitative Data ◽

Kidney Injury ◽

Process Theory ◽

Normalisation Process Theory ◽

Successful Implementation ◽

Structured Interviews ◽

Electronic Alerts

ObjectiveAround one in five emergency hospital admissions are affected by acute kidney injury (AKI). To address poor quality of care in relation to AKI, electronic alerts (e-alerts) are mandated across primary and secondary care in England and Wales. Evidence of the benefit of AKI e-alerts remains conflicting, with at least some uncertainty explained by poor or unclear implementation. The objective of this study was to identify factors relating to implementation, using Normalisation Process Theory (NPT), which promote or inhibit use of AKI e-alerts in secondary care.DesignMixed methods combining qualitative (observations, semi-structured interviews) and quantitative (survey) methods.Setting and participantsThree secondary care hospitals in North East England, representing two distinct AKI e-alerting systems. Observations (>44 hours) were conducted in Emergency Assessment Units (EAUs). Semi-structured interviews were conducted with clinicians (n=29) from EAUs, vascular or general surgery or care of the elderly. Qualitative data were supplemented by Normalization MeAsure Development (NoMAD) surveys (n=101).AnalysisQualitative data were analysed using the NPT framework, with quantitative data analysed descriptively and using χ2 and Wilcoxon signed-rank test for differences in current and future normalisation.ResultsParticipants reported familiarity with the AKI e-alerts but that the e-alerts would become more normalised in the future (p<0.001). No single NPT mechanism led to current (un)successful implementation of the e-alerts, but analysis of the underlying subconstructs identified several mechanisms indicative of successful normalisation (internalisation, legitimation) or unsuccessful normalisation (initiation, differentiation, skill set workability, systematisation).ConclusionsClinicians recognised the value and importance of AKI e-alerts in their practice, although this was not sufficient for the e-alerts to be routinely engaged with by clinicians. To further normalise the use of AKI e-alerts, there is a need for tailored training on use of the e-alerts and routine feedback to clinicians on the impact that e-alerts have on patient outcomes.

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A Comparison Between Iranian L3 French and German Learners’ Perception of Factors Influencing Willingness to Speak English in Language Classrooms: A Mixed Methods Study

10.47340/mjellt.v1i1.5.2020 ◽

2020 ◽

pp. 41-61

Author(s):

Mohammad Bavali ◽

Asma Siyahi

Keyword(s):

Second Language ◽

Mixed Methods ◽

Qualitative Data ◽

Population Based ◽

Willingness To Communicate ◽

Survey Method ◽

Sample Population ◽

Structured Interviews ◽

Factors Influencing ◽

Significant Difference

Abstract The present study sought to investigate the effect of learning a third language on learners' willingness to communicate in their second language. The main purpose of the study, however, was to consider the difference between Iranian English/French learners and Iranian English/German learners in their willingness to communicate (WTC) in the second language and to examine the factors influencing their willingness to speak in English. The study benefited from a mixed methodology design comprising both quantitative and qualitative data collection and analysis. The participants of the study were 20 bilingual learners and 40 trilingual learners, including 20 German learners and 20 French learners. They were selected as the sample population based on their performance on the standard test of OPT (Oxford Placement Test). It was an applied research in which a descriptive survey method had been adopted. A (WTC) questionnaire was used for collecting data. The results indicated a significant difference between bilingual and trilingual learners in their willingness to communicate in English. However, no significant difference was detected between trilingual learners. To verify the quantitative findings and to assess the accuracy of their results, interviews were used. Accordingly, a group of German and French learners was invited for interviews. Semi-structured interviews were conducted with twelve L3 learners to examine the factors influencing willingness to communicate in both groups. The qualitative data derived from interviews were analyzed using NVivo software. No significant difference in the factors affecting willingness to communicate was seen between trilingual groups, which was confirmed by the findings of both quantitative and qualitative methods. Keywords: mixed methods, willingness to communicate, bilingualism, trilingualism

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The Effects of Remote Activity Monitoring on Family Caregivers of People Living With Dementia Over an 18-Month Period

Innovation in Aging ◽

10.1093/geroni/igab046.009 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 3-3

Author(s):

Joseph Gaugler ◽

Rachel Zmora ◽

Lauren Mitchell ◽

Jessica Finlay ◽

Christina Rosebush ◽

...

Keyword(s):

Mixed Methods ◽

Family Caregivers ◽

Older Persons ◽

Controlled Trial ◽

Activity Monitoring ◽

Community Dwelling ◽

Individual Growth ◽

Time Data ◽

Dementia Caregivers ◽

Term Care

Abstract Technology interventions for older persons and long-term care are generally utilized as real-time data capture tools to complement clinical or family care for older persons or as interventions themselves designed to improve important dementia care outcomes. Although research on novel technological interventions for people with Alzheimer's disease and related dementias (ADRD) and their family caregivers has grown considerably in the past two decades, much of this work continues to focus on design, feasibility, and acceptability (with a need for conceptual refinement in these areas) and less on controlled outcome studies. The objective of this experimental mixed methods demonstration was to determine the 18-month effectiveness of remote activity monitoring (RAM) technology in improving outcomes among family caregivers of community-dwelling persons with dementia. We used an embedded experimental mixed methods design, collecting qualitative data within the structure of a traditional randomized controlled trial ([QUAN+qual]→QUAN) over an 18-month period for 171 dementia caregivers. Change in caregiver self-efficacy, sense of competence, and caregiver distress served as the main quantitative outcomes of interest. Individual growth curve models indicated that the RAM technology did not have direct effects on caregiving outcomes, and although the qualitative findings indicated several potential moderators of RAM effectiveness on caregiving outcomes, the inclusion of these qualitatively-identified moderators did not result in statistically significant (p < .05) effects. Ensuring effective human care management alongside RAM technology may help to overcome the barriers reported by dementia caregivers in this demonstration study.

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Investigating Humor Integration in Tunisian Tertiary English Classes: A Comparative Study of Teachers’ and Learners’ Perceptions

Advances in Language and Literary Studies ◽

10.7575/aiac.alls.v.12n.3.p.127 ◽

2021 ◽

Vol 12 (3) ◽

pp. 127

Author(s):

Najla Fki

Keyword(s):

Higher Education ◽

Mixed Methods ◽

Qualitative Data ◽

The Other ◽

Structured Interviews ◽

Mixed Methods Approach ◽

English Classes ◽

Starting Point ◽

English Major ◽

The One

This study examines lecturers’ and learners’ perceptions on humor use in Tunisian tertiary classrooms, focusing specifically on the English major. The ultimate aim is to explore the types and frequency of humor use on the one hand and whether teachers regard humor in the same light as their students on the other. To this purpose, a mixed-methods approach consisting of questionnaires and semi-structured interviews is adopted to collect quantitative and qualitative data for analysis. The findings revealed that, in terms of frequency, humor is used by all interviewed teachers irrespective of their gender. Yet, the general percentage of humor use remains moderate and limited to specific oral subjects as confirmed by the students. The results also indicated the participants’ agreement on the efficiency and preference of verbal, spontaneous and relevant humor types. However, it has been shown that the lecturers use a very limited repertoire of humor forms, neglecting jokes which are more appreciated by their students. Inconsistencies between the participants’ responses are further traced at the level of their attitude towards humor use in class. While most of the teachers believe that the merits of humor are undeniable, they expressed skepticism and discomfort in dealing with this tool in class. To overcome these lacunas, this study builds on the students’ recommendations to improve their teachers’ practices and can therefore be a starting point for EFL curriculum designers in Tunisia to revise current materials for a better humor integration in higher education.

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