Case Study as a Method of Qualitative Research

Qualitative case study methodology provides tools for researchers to study complex phenomena within their contexts. When the approach is applied correctly, it becomes a valuable method for health science research to develop theory, evaluate programs, and develop interventions. The purpose of this chapter is to guide the novice researcher in identifying the key elements for designing and implementing qualitative case study research projects. An overview of the types of case study designs is provided along with general recommendations for writing the research questions, developing propositions, determining the “case” under study, binding the case, and a discussion of data sources and triangulation. To facilitate application of these principles, clear examples of research questions, study propositions, and the different types of case study designs are provided. The great contribution of qualitative research is the culturally specific and contextually rich data it produces. This is proving critical in the design of comprehensive solutions to general problems in developing countries.

Measuring health science research and development in Africa: mapping the available data

Background In recent years there have been calls to strengthen health sciences research capacity in African countries. This capacity can contribute to improvements in health, social welfare and poverty reduction through domestic application of research findings; it is increasingly seen as critical to pandemic preparedness and response. Developing research infrastructure and performance may reduce national economies’ reliance on primary commodity and agricultural production, as countries strive to develop knowledge-based economies to help drive macroeconomic growth. Yet efforts to date to understand health sciences research capacity are limited to output metrics of journal citations and publications, failing to reflect the complexity of the health sciences research landscape in many settings. Methods We map and assess current capacity for health sciences research across all 54 countries of Africa by collecting a range of available data. This included structural indicators (research institutions and research funding), process indicators (clinical trial infrastructures, intellectual property rights and regulatory capacities) and output indicators (publications and citations). Results While there are some countries which perform well across the range of indicators used, for most countries the results are varied—suggesting high relative performance in some indicators, but lower in others. Missing data for key measures of capacity or performance is also a key concern. Taken as a whole, existing data suggest a nuanced view of the current health sciences research landscape on the African continent. Conclusion Mapping existing data may enable governments and international organizations to identify where gaps in health sciences research capacity lie, particularly in comparison to other countries in the region. It also highlights gaps where more data are needed. These data can help to inform investment priorities and future system needs.

Meaning-in-Life: A Vital Salutogenic Resource for Health

Based on evidence and theory, we state that facilitating and supporting people’s meaning-making processes are health promoting. Hence, meaning-in-life is a salutogenic concept.Authors from various disciplines such as nursing, medicine, psychology, philosophy, religion, and arts argue that the human search for meaning is a primary force in life and one of the most fundamental challenges an individual faces. Research demonstrates that meaning is of great importance for mental as well as physical well-being and crucial for health and quality of life. Studies have shown significant correlations between meaning-in-life and physical health measured by lower mortality for all causes of death; meaning is correlated with less cardiovascular disease, less hypertension, better immune function, less depression, and better coping and recovery from illness. Studies have shown that cancer patients who experience a high degree of meaning have a greater ability to tolerate bodily ailments than those who do not find meaning-in-life. Those who, despite pain and fatigue, experience meaning report better quality-of-life than those with low meaning. Hence, if the individual finds meaning despite illness, ailments, and imminent death, well-being, health, and quality-of-life will increase in the current situation. However, when affected by illness and reduced functionality, finding meaning-in-life might prove more difficult. A will to search for meaning is required, as well as health professionals who help patients and their families not only to cope with illness and suffering but also to find meaning amid these experiences. Accordingly, meaning-in-life is considered a vital salutogenic resource and concept.The psychiatrist Viktor Emil Frankl’s theory of “Will to Meaning” forms the basis for modern health science research on meaning; Frankl’s premise was that man has enough to live by, but too little to live for. According to Frankl, logotherapy ventures into the spiritual dimension of human life. The Greek word “logos” means not only meaning but also spirit. However, Frankl highlighted that in a logotherapeutic context, spirituality is not primarily about religiosity—although religiosity can be a part of it—but refers to a specific human dimension that makes us human. Frankl based his theory on three concepts: meaning, freedom to choose and suffering, stating that the latter has no point. People should not look for an inherent meaning in the negative events happening to them, or in their suffering, because the meaning is not there. The meaning is in the attitude people choose while suffering from illness, crises, etc.

OP179 Nationwide Electroencephalographic Screening Using Telemedicine Apps

IntroductionDisruptive telemedicine tools can help overcome the lack of specialized care and electroencephalographic (EEG) support for diagnosing and treating nervous system disorders such as epilepsy in remote communities. However, evidence on how such cloud-based platforms could enhance data-driven health care is limited. The utility of telemedicine-based apps to achieve EEG screening of communities in rural areas of Paraguay was investigated.MethodsThis descriptive study was carried out by the Telemedicine Unit of the Ministry of Public Health in collaboration with the Department of Biomedical Engineering and Imaging of the Health Science Research Institute in Paraguay and the Basque Country University in Spain to evaluate the utility of telediagnostic apps for EEG screening. For this purpose, the results obtained by tele-EEG apps implemented in nineteen public community hospitals were analyzed to determine the utility of the apps as epidemiological surveillance tools.ResultsAmong the 10,791 remote EEG studies performed, the most common reasons for the test included epileptic seizure (44%), headache (22%), seizure disorder (8%), follow up (6%), attention deficits in children (5%), cognitive impairment (4%), cranioencephalic trauma (3%), brain death (1%), history of seizure (0.9%), abnormal movements (0.7%), and behavioral disorders (0.5%).ConclusionsThe results showed that telemedicine apps can significantly enhance nationwide EEG screening by freeing up professional time and increasing productivity, improving access and equity, and reducing costs. However, before their systematic implementation a contextualization of the apps using the regional epidemiological profile must be performed.