Risk Perception of Health Professionals in Intrapartum Care Decisions: Protocol for a Mixed Methods Study (Preprint)

BACKGROUND Risk perception plays an important role in decision-making processes. Differences in obstetric intervention rates suggest that, in addition to medical indications, the risk perception of obstetric health professionals might have a major influence on their decision-making process during childbirth. Although studies have investigated whether risk perception affects the role of midwifery or influences decision making during childbirth, little is known about what obstetric health professionals actually perceive as risk or risky situations and whether different risk perceptions lead to more interventions during intrapartum care. OBJECTIVE The objective of this study is to understand the association of risk perception and the decision-making processes of obstetric health professionals (midwives and obstetricians) in Germany during intrapartum care. The study has 3 specific aims: (1) gain insight into what obstetric health professionals perceive as risk in the German clinical setting, (2) assess the extent to which personal and systemic factors have an impact on obstetric health professionals’ risk perception, and (3) investigate whether different perceptions of risk are associated with different decisions being made by obstetric health professionals. METHODS This is an exploratory sequential mixed methods study with 2 phases, a qualitative followed by a quantitative phase. In the first phase, qualitative data are collected and analyzed by conducting focus group discussions and applying qualitative content analysis to address aim 1. In the second phase, for aims 2 and 3 and to help explain the qualitative results, quantitative data are collected and analyzed by conducting an observational study using case vignettes within a survey constructed on the basis of the qualitative results. RESULTS Enrollment in the first (qualitative) phase began in July 2019, and data collection and analysis have been completed. The second (quantitative) phase is currently planned, and data collection is expected to start in December 2020. First results of the qualitative phase are expected to be submitted for publication in 2020, with completion of the second phase scheduled for 2021. CONCLUSIONS This mixed methods study will examine the perception of risk and its association with the decision-making processes of obstetric health professionals during their care of women in childbirth. The rationale for this approach is that the qualitative data and their analysis explore participants' views in more depth, while the quantitative data will help to provide and explore a general understanding of the research problem. The results are expected to be relevant to health care professionals, policymakers, and educational institutions in order to minimize underuse, overuse, and misuse of interventions during intrapartum care. CLINICALTRIAL German Clinical Trials Register DRKS00017172; https://tinyurl.com/y2zoowkx INTERNATIONAL REGISTERED REPORT DERR1-10.2196/21443

Download Full-text

Risk Perception of Health Professionals in Intrapartum Care Decisions: Protocol for a Mixed Methods Study

JMIR Research Protocols ◽

10.2196/21443 ◽

2020 ◽

Vol 9 (11) ◽

pp. e21443

Author(s):

Nina H Peterwerth ◽

Margareta Halek ◽

Sabrina Tulka ◽

Rainhild Schäfers

Keyword(s):

Decision Making ◽

Mixed Methods ◽

Risk Perception ◽

Health Professionals ◽

Qualitative Data ◽

Mixed Methods Study ◽

Second Phase ◽

Intrapartum Care ◽

Decision Making Processes ◽

Qualitative Phase

Background Risk perception plays an important role in decision-making processes. Differences in obstetric intervention rates suggest that, in addition to medical indications, the risk perception of obstetric health professionals might have a major influence on their decision-making process during childbirth. Although studies have investigated whether risk perception affects the role of midwifery or influences decision making during childbirth, little is known about what obstetric health professionals actually perceive as risk or risky situations and whether different risk perceptions lead to more interventions during intrapartum care. Objective The objective of this study is to understand the association of risk perception and the decision-making processes of obstetric health professionals (midwives and obstetricians) in Germany during intrapartum care. The study has 3 specific aims: (1) gain insight into what obstetric health professionals perceive as risk in the German clinical setting, (2) assess the extent to which personal and systemic factors have an impact on obstetric health professionals’ risk perception, and (3) investigate whether different perceptions of risk are associated with different decisions being made by obstetric health professionals. Methods This is an exploratory sequential mixed methods study with 2 phases, a qualitative followed by a quantitative phase. In the first phase, qualitative data are collected and analyzed by conducting focus group discussions and applying qualitative content analysis to address aim 1. In the second phase, for aims 2 and 3 and to help explain the qualitative results, quantitative data are collected and analyzed by conducting an observational study using case vignettes within a survey constructed on the basis of the qualitative results. Results Enrollment in the first (qualitative) phase began in July 2019, and data collection and analysis have been completed. The second (quantitative) phase is currently planned, and data collection is expected to start in December 2020. First results of the qualitative phase are expected to be submitted for publication in 2020, with completion of the second phase scheduled for 2021. Conclusions This mixed methods study will examine the perception of risk and its association with the decision-making processes of obstetric health professionals during their care of women in childbirth. The rationale for this approach is that the qualitative data and their analysis explore participants' views in more depth, while the quantitative data will help to provide and explore a general understanding of the research problem. The results are expected to be relevant to health care professionals, policymakers, and educational institutions in order to minimize underuse, overuse, and misuse of interventions during intrapartum care. Trial Registration German Clinical Trials Register DRKS00017172; https://tinyurl.com/y2zoowkx International Registered Report Identifier (IRRID) DERR1-10.2196/21443

Download Full-text

What Are They Thinking? Students' Affective Reasoning and Attitudes about Course Withdrawal

NACADA Journal ◽

10.12930/0271-9517-32.2.17 ◽

2012 ◽

Vol 32 (2) ◽

pp. 17-25 ◽

Cited By ~ 6

Author(s):

Ethel R. Wheland ◽

Kevin A. Butler ◽

Helen Qammar ◽

Karyn Bobkoff Katz ◽

Rose Harris

Keyword(s):

Decision Making ◽

Mixed Methods ◽

Intellectual Development ◽

Mixed Methods Study ◽

Academic Advisors ◽

Decision Making Processes ◽

Academic Consequences ◽

Self Authorship

In this mixed-methods study we identify situations that impact students' decisions to withdraw from a course and examine their affective reasoning and attitudes toward course withdrawal. Exploring students' decision-making processes through the lens of self-authorship, we show that students frequently seek information from people with whom they have a personal rather than academic relationship, make decisions with little awareness of academic consequences, and often experience a feeling of dissonance when withdrawing from courses, even describing themselves as “quitters.” Our results lead to recommendations that can assist academic advisors in developing meaningful interventions that advance students' decision-making abilities and intellectual development.

Download Full-text

Refining a primary care shared decision-making aid for lifestyle change: mixed methods study

BJGP Open ◽

10.3399/bjgpo.2021.0100 ◽

2021 ◽

pp. BJGPO.2021.0100

Author(s):

Neil Heron ◽

Seán R O’Connor ◽

Frank Kee ◽

David R Thompson ◽

Margaret Cupples ◽

...

Keyword(s):

Primary Care ◽

Decision Making ◽

Mixed Methods ◽

Shared Decision Making ◽

Health Professionals ◽

Decision Aid ◽

Healthy Lifestyle ◽

Lifestyle Change ◽

Mixed Methods Study ◽

Shared Decision

BackgroundThe important role of primary care in promoting healthy lifestyle behaviours needs informed support.AimTo elicit views on a 39-item shared decision-making (SDM) aid (SHARE-D) for lifestyle change and refine it to improve implementation.Design & settingMixed methods study.MethodHealth professionals, patients, and support workers, with experience of managing, or a history of, cardio- or cerebrovascular disease, were purposively recruited based on age, gender, and urban/rural location (n = 34). Participants completed a survey, rating the importance of including each item in a decision-aid, designed for use by patients with health professionals, and suggesting modifications. Semi-structured interviews (n = 30/34) were conducted and analysed thematically.ResultsSubstantial agreement was observed on rating item inclusion. Based on survey and interview data, 9/39 items were removed; 13 were amended. Qualitative themes were: (i) core content of the decision-aid, (ii) barriers to use, (iii) motivation for lifestyle change, and (iv) primary care implementation. ‘Self-reflective’ questions and goal setting were viewed as essential components. The paper-based format, length, clarity, and time required were barriers to its use. Optional support considered within the aid was seen as important to motivate change. A digital version, integrated into patient record systems was regarded as critical to implementation. A revised 30-item aid was considered suitable for facilitating brief conversations and promoting patient autonomy.ConclusionThe SHARE-D decision aid for healthy lifestyle change appears to have good content validity and acceptability. Survey and interview data provided in-depth information to support implementation of a refined version. Further studies should examine its effectiveness.

Download Full-text

Uncertainty about cellulitis and unmet patient information needs: a mixed methods study

British Journal of General Practice ◽

10.3399/bjgp18x697349 ◽

2018 ◽

Vol 68 (suppl 1) ◽

pp. bjgp18X697349

Author(s):

Anna Lalonde ◽

Emma Teasdale ◽

Ingrid Muller ◽

Joanne Chalmers ◽

Peter Smart ◽

...

Keyword(s):

Mixed Methods ◽

Information Needs ◽

Qualitative Data ◽

Information Provision ◽

Mixed Methods Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Face To Face ◽

Patient Information Needs ◽

History Of

BackgroundCellulitis is a common painful infection of the skin and underlying tissues that recurs in approximately a third of cases. Patients’ ability to recover from cellulitis or prevent recurrence is likely to be influenced by their understanding of the condition.AimTo explore patients’ perceptions of cellulitis and their information needs.MethodMixed methods study comprising semi-structured, face-to-face interviews and cross-sectional survey, recruiting through primary care, secondary care and advertising. Adults aged 18 or over with a history of cellulitis (first or recurrent) were invited to complete a survey, take part in an interview or both. Qualitative data was analysed thematically.ResultsThirty interviews were conducted between August 2016 and July 2017. Qualitative data revealed low prior awareness of cellulitis, uncertainty around diagnosis, concern/surprise at the severity of cellulitis, and perceived insufficient information provision. People were surprised they had never heard of the condition and that they had not received advice or leaflets giving self-care information. Some sought information from the internet and found this bewildering. Two hundred and forty surveys were completed (response rate 17%). These showed that, while most people received information on the treatment of cellulitis (60.0%, n = 144), they reported receiving no information about causes (60.8%, n = 146) or prevention of recurrence (73.3%, n = 176).ConclusionThere is a need for provision of basic information for people with cellulitis, particularly being informed of the name of their condition, how to manage acute episodes, and how to reduce risk of recurrence.

Download Full-text

Analyzing trends in the aural decoding errors of Japanese EFL learners

IRAL - International Review of Applied Linguistics in Language Teaching ◽

10.1515/iral-2020-0050 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Kriss Lange ◽

Joshua Matthews

Keyword(s):

Mixed Methods ◽

Qualitative Data ◽

Mixed Methods Study ◽

First Year ◽

Formulaic Language ◽

Decoding Skills ◽

Efl Learners ◽

Japanese University ◽

Syntactic Knowledge ◽

L2 Listening

Abstract Japanese EFL learners’ difficulty with accurately decoding connected English speech motivated this mixed methods study. The aural decoding capacities of 63 first-year Japanese university students, with low to intermediate level English proficiency, were first measured with a battery of paused transcription tests (PTT). The transcriptions were clusters of three-words that each possessed attributes typical of co-articulated speech. In addition, after each test, a subgroup of 10 participants individually listened to the same PTT and recounted introspective self-observations of their perceived difficulties with the aural decoding tasks in their L1. These quantitative and qualitative data were used to identify four trends in decoding errors which were categorized as follows: limited collocation familiarity, syntactic knowledge constraints, difficulties utilizing co-text, and L1 phonological influence. This study investigates some of the difficulties associated with aural decoding, highlights the challenges of identifying the origins of decoding errors and suggests that more focus is needed on developing decoding skills as well as knowledge of formulaic language in L2 listening education.

Download Full-text

Post-mortem general surgeon reflection on decision-making: a mixed-methods study of mortality audit data

ANZ Journal of Surgery ◽

10.1111/ans.14796 ◽

2018 ◽

Vol 88 (10) ◽

pp. 993-997 ◽

Cited By ~ 1

Author(s):

Daniel E. Cattanach ◽

Arkadiusz P. Wysocki ◽

Therese Ray-Conde ◽

Charles Nankivell ◽

Jennifer Allen ◽

...

Keyword(s):

Decision Making ◽

Mixed Methods ◽

Mixed Methods Study ◽

General Surgeon ◽

Post Mortem ◽

Audit Data

Download Full-text

Sexual Enrichment Aids: A Mixed Methods Study Evaluating Use, Hygiene, and Risk Perception among Women

The Journal of Sex Research ◽

10.1080/00224499.2021.2015568 ◽

2021 ◽

pp. 1-10

Author(s):

Amanda L. Collar ◽

Jesus E. Fuentes ◽

Heidi Rishel Brakey ◽

Kathryn M. Frietze

Keyword(s):

Mixed Methods ◽

Risk Perception ◽

Mixed Methods Study

Download Full-text

Multicultural teaching competence among undergraduate faculty: a convergent mixed methods study

Journal for Multicultural Education ◽

10.1108/jme-05-2021-0059 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Chandler Puhy ◽

Nalini Prakash ◽

Clarissa Lacson ◽

Joke Bradt

Keyword(s):

Mixed Methods ◽

Qualitative Data ◽

Teaching Practice ◽

Mixed Methods Study ◽

Student Diversity ◽

Content Type ◽

Knowledge And Skills ◽

Teaching Competence ◽

Quantitative Results ◽

K 12

Purpose Increased student diversity in universities across the USA has increased the need for post-secondary educators to develop multicultural teaching competence (MTC). Most studies of MTC focus on educators teaching grades K-12. The purpose of this study is to determine how faculty members rate themselves in terms of MTC, what multicultural knowledge and skills faculty report and how they integrate these skills into their teaching practice and what barriers exist to developing and implementing MTC. The purpose of this study was to examine the factors that impact undergraduate faculty integration of multicultural awareness and attitudes into their teaching practices to enhance student learning. Design/methodology/approach A convergent mixed methods study used survey and interview data from undergraduate faculty. Select items from the MTC Inventory (MTCI) and social justice scales (SJS) were administered. Interviews (N = 7) were transcribed and analyzed using thematic analysis. Quantitative and qualitative data were compared to examine convergence and divergence. Findings Quantitative results revealed undergraduate faculty’s awareness, knowledge and skills as indicated by percent agreement with items from the MTCI and SJS instruments. Qualitative findings included the following four themes: knowledge building, addressing diversity in the classroom, barriers and challenges, and needs and recommendations. Qualitative data corroborated or explained many of the quantitative results and provided insight into these trends and barriers that impact MTC. Originality/value This is the first study of its kind, to our knowledge, that has used a mixed methods research design to examine factors that impact MTCs and associated barriers among a sample of undergraduate faculty across disciplines in one urban university.

Download Full-text