Qualitative Methods (qualitative + methods)

Distribution by Scientific Domains
Distribution within Medical Sciences

Selected Abstracts

Accident and emergency staff opinion on the effects of family presence during adult resuscitation: critical literature review

Wendy Walker
Abstract Title.,Accident and emergency staff opinion on the effects of family presence during adult resuscitation: critical literature review. Aim., This paper is a report of a critical literature review to identify the positive and negative effects of family presence during adult resuscitation, as perceived by accident and emergency healthcare staff based in primary (out-of-hospital) and secondary (in-hospital) environments of care. Background., The controversial practice of family presence during resuscitation of adults has stimulated debate over the past two decades, giving rise to a growing body of literature and the development of clinical guidelines for practice. Methods., A search was carried out for the period 1987,2007 using the Science Direct, CINAHL, Medline, EMBASE, psychINFO and BNI databases and the search terms resuscitation, witnessed resuscitation, family presence, relatives' presence, attitudes and opinions and accident and emergency. Results., Eighteen studies were included in the critical review, primarily comprising retrospective survey research. The majority of studies were descriptive in design. A standardized approach to the appraisal process was achieved through the utilization of guidelines for critiquing self-reports. The findings revealed that accident and emergency healthcare staff perceive both positive and negative effects as a consequence of family presence during adult resuscitation and their opinions suggest that there are more risks than benefit. Conclusion., Further research is essential if family presence during resuscitation of adults is to be better defined and understood. Qualitative methods of enquiry are recommended as a way of gaining a deeper insight into and understanding of this practice. [source]

Qualitative methods and prescribing research

F. A. Stevenson MA (Hons) PGDip PhD
First page of article [source]

Qualitative assessment of patient experiences following sacrectomy,

K.M. Davidge MD
Abstract Background and Objectives The primary objective was to investigate patient experiences following sacral resection as a component of curative surgery for advanced rectal cancers, soft tissue and bone sarcomas. Methods Qualitative methods were used to examine the experiences, decision-making, quality of life, and supportive care needs of patients undergoing sacrectomy. Patients were identified from two prospective databases between 1999 and 2007. A semi-structured interview guide was generated and piloted. Patient interviews were transcribed verbatim and analyzed using standard qualitative research methodology. Grounded theory guided the generation of the interview guide and analysis. Results Twelve patients were interviewed (6 female, 32,82 years of age). The mean interview time was 34,min. Five themes were identified, including: (1) the life-changing impact of surgery on both patients' and their family's lives, (2) patient satisfaction with immediate care in hospital, (3) significant chronic pain related to sacrectomy, (4) patients' need for additional information regarding long-term recovery, and (5) patients' gratitude to be alive. Conclusions Sacrectomy is a life-changing event for patients and their families. Patients undergoing sacrectomy need further information regarding the long-term consequences of this procedure. This need should be addressed in both preoperative multi-disciplinary consultations and at follow-up visits. J. Surg. Oncol. 2010; 101:447,450. © 2010 Wiley-Liss, Inc. [source]

Does the Early Administration of Beta-blockers Improve the In-hospital Mortality Rate of Patients Admitted with Acute Coronary Syndrome?

Ethan Brandler MD
Abstract Objectives:, Beta-blockade is currently recommended in the early management of patients with acute coronary syndromes (ACS). This was a systematic review of the medical literature to determine if early beta-blockade improves the outcome of patients with ACS. Methods:, The authors searched the PubMed and EMBASE databases for randomized controlled trials from 1965 through May 2009 using a search strategy derived from the following PICO formulation of our clinical question: Patients included adults (18+ years) with an acute or suspected myocardial infarction (MI) within 24 hours of onset of chest pain. Intervention included intravenous or oral beta-blockers administered within 8 hours of presentation. The comparator included standard medical therapy with or without placebo versus early beta-blocker administration. The outcome was the risk of in-hospital death in the intervention groups versus the comparator groups. The methodologic quality of the studies was assessed. Qualitative methods were used to summarize the study results. In-hospital mortality rates were compared using a forest plot of relative risk (RR; 95% confidence interval [CI]) between beta-blockers and controls. Statistical analysis was done with Review Manager V5.0. Results:, Eighteen articles (total N = 72,249) met the inclusion/exclusion criteria. For in-hospital mortality, RR = 0.95 (95% CI, 0.90,1.01). In the largest of these studies (n = 45,852), a significantly higher rate (p < 0.0001) of cardiogenic shock was observed in the beta-blocker (5.0%) versus control group (3.9%). Conclusions:, This systematic review failed to demonstrate a convincing in-hospital mortality benefit for using beta-blockers early in the course of patients with an acute or suspected MI. ACADEMIC EMERGENCY MEDICINE 2010; 17:1,10 © 2010 by the Society for Academic Emergency Medicine [source]

Sensitivity of Bedside Ultrasound and Supine Anteroposterior Chest Radiographs for the Identification of Pneumothorax After Blunt Trauma

R. Gentry Wilkerson MD
Abstract Objectives:, Supine anteroposterior (AP) chest radiographs in patients with blunt trauma have poor sensitivity for the identification of pneumothorax. Ultrasound (US) has been proposed as an alternative screening test for pneumothorax in this population. The authors conducted an evidence-based review of the medical literature to compare sensitivity of bedside US and AP chest radiographs in identifying pneumothorax after blunt trauma. Methods:, MEDLINE and EMBASE databases were searched for trials from 1965 through June 2009 using a search strategy derived from the following PICO formulation of our clinical question: patients included adult (18 + years) emergency department (ED) patients in whom pneumothorax was suspected after blunt trauma. The intervention was thoracic ultrasonography for the detection of pneumothorax. The comparator was the supine AP chest radiograph during the initial evaluation of the patient. The outcome was the diagnostic performance of US in identifying the presence of pneumothorax in the study population. The criterion standard for the presence or absence of pneumothorax was computed tomography (CT) of the chest or a rush of air during thoracostomy tube placement (in unstable patients). Prospective, observational trials of emergency physician (EP)-performed thoracic US were included. Trials in which the exams were performed by radiologists or surgeons, or trials that investigated patients suffering penetrating trauma or with spontaneous or iatrogenic pneumothoraces, were excluded. The methodologic quality of the studies was assessed. Qualitative methods were used to summarize the study results. Data analysis consisted of test performance (sensitivity and specificity, with 95% confidence intervals [CIs]) of thoracic US and supine AP chest radiography. Results:, Four prospective observational studies were identified, with a total of 606 subjects who met the inclusion and exclusion criteria. The sensitivity and specificity of US for the detection of pneumothorax ranged from 86% to 98% and 97% to 100%, respectively. The sensitivity of supine AP chest radiographs for the detection of pneumothorax ranged from 28% to 75%. The specificity of supine AP chest radiographs was 100% in all included studies. Conclusions:, This evidence-based review suggests that bedside thoracic US is a more sensitive screening test than supine AP chest radiography for the detection of pneumothorax in adult patients with blunt chest trauma. ACADEMIC EMERGENCY MEDICINE 2010; 17:11,17 © 2010 by the Society for Academic Emergency Medicine [source]

Enhancing institutional assessment efforts through qualitative methods

Nancy Van Note Chism
Qualitative methods can do much to describe context and illuminate the "why" behind patterns encountered in institutional assessment. Alone, or in combination with quantitative methods, they should be the approach of choice for many of the most important assessment questions. [source]

Practitioners' Perspectives on Effective Practices For Hispanic Teenage Pregnancy Prevention

Stephen T. Russell
CONTEXT: In the United States, the pregnancy rate and birthrate of Hispanic teenagers are higher than those of other races and ethnicities. Although recommendations for culturally appropriate pregnancy prevention programs are commonplace, little is known about how practitioners address such recommendations. METHODS: In individual interviews, 58 teenage pregnancy prevention practitioners who work primarily with Mexican American female teenagers from two regions in California were asked about their understanding of recommendations for best practices and discussed the strategies they have used and challenges they have faced in implementing the recommendations. Qualitative methods were used to categorize responses and identify themes. RESULTS: Practitioners indicated that knowledge and awareness of Hispanic culture are essential, as is commitment to teenagers and their needs. They regard activities that encourage educational and career achievement as critical program components, and view both male partners' and family members' involvement in programs as important but challenging. Furthermore, practitioners feel that the implicit program goals of continued education and female self-sufficiency are often at odds with traditional Hispanic cultural values. CONCLUSIONS: Practitioners have valuable insight into the reality of implementing culturally sensitive programs. Programs need to balance the often competing values and goals of prevention programs with those of Hispanic youth culture and experiences. [source]

Emergency Department Sickle Cell Assessment of Needs and Strengths (ED-SCANS), a Focus Group and Decision Support Tool Development Project

Paula Tanabe PhD
ACADEMIC EMERGENCY MEDICINE 2010; 17:848,858 © 2010 by the Society for Academic Emergency Medicine Abstract Objectives:, A decision support tool may guide emergency clinicians in recognizing assessment, analgesic and overall management, and health service delivery needs for patients with sickle cell disease (SCD) in the emergency department (ED). We aimed to identify data and process elements important in making decisions regarding evaluation and management of adult patients in the ED with painful episodes of SCD. Methods:, Qualitative methods using a series of focus groups and grounded theory were used. Eligible participants included adult clients with SCD and emergency physicians and nurses with a minimum of 1 year of experience providing care to patients with SCD in the ED. Patients were recruited in conjunction with annual SCD meetings, and providers included clinicians who were and were not affiliated with sickle cell centers. Groups were conducted until saturation was reached and included a total of two patient groups, three physician groups, and two nurse groups. Focus groups were held in New York, Durham, Chicago, New Orleans, and Denver. Clinician participants were asked the following three questions to guide the discussion: 1) what information would be important to know about patients with SCD in the ED setting to effectively care for them and help you identify patient analgesic, treatment, and referral needs? 2) What treatment decisions would you make with this information? and 3) What characteristics would a decision support tool need to have to make it meaningful and useful? Client participants were asked the same questions with rewording to reflect what they believed providers should know to provide the best care and what they should do with the information. All focus groups were audiotaped and transcribed. The constant comparative method was used to analyze the data. Two coders independently coded participant responses and identified focal themes based on the key questions. An investigator and assistant independently reviewed the transcripts and met until the final coding structure was determined. Results:, Forty-seven individuals participated (14 persons with SCD, 16 physicians, and 17 nurses) in a total of seven different groups. Two major themes emerged: acute management and health care utilization. Major subthemes included the following: physiologic findings, diagnostics, assessment and treatment of acute painful episodes, and disposition. The most common minor subthemes that emerged included past medical history, presence of a medical home (physician or clinic), individualized analgesic treatment plan for treatment of painful episodes, history of present illness, medical home follow-up available, patient-reported analgesic treatment that works, and availability of analgesic prescription at discharge. Additional important elements in treatment of acute pain episodes included the use of a standard analgesic protocol, need for fluids and nonpharmacologic interventions, and the assessment of typicality of pain presentation. The patients' interpretation of the need for hospital admission also ranked high. Conclusions:, Participants identified several areas that are important in the assessment, management, and disposition decisions that may help guide best practices for SCD patients in the ED setting. [source]

"We Don't Want No Haole Buttholes in Our Stories": Local Girls Reading the Baby-Sitters Club Books in Hawai,i

Donna J. Grace
This study investigates the place of popular cultural texts in the construction of the gendered and cultural subjectivities of seven eight-year-old girls growing up in Hawai,i. Within the context of weekly literature circles held over a period of four months, Grace and Lum sought to understand how these young "local" girls engaged with a book series privileging white, middle-class, mainland values, and how they located themselves within dominant ideologies related to race, culture, and gender. Using qualitative methods, the following questions were addressed: (1) In what ways did the girls identify with particular storylines, subject positions, and views of the world? (2) Were dominant messages accommodated, negotiated, or resisted? (3) What pleasures were produced and experienced in the reading? (4) How were meanings shaped and mediated by "local" culture and the reader's personal histories? The findings suggest that rather than being manipulated by the textual images of femininity, suburban living, and western notions of beauty, the girls had alternative social and cultural discourses with which to negotiate and resist them. These discourses related to notions of the family; gender relations; peer friendships and rivalry; perceptions of beauty; and cultural identity. The findings suggest the importance of local context in understanding textual readings and interpretations. [source]

How do parents perceive their adolescent's diabetes: a qualitative study

Aaron E. Carroll
Abstract Background/aims The developmental tasks of adolescence, combined with physical changes, can interfere with self-management behaviour. Yet little is known about how parents view these challenges as they attempt to help their children cope with diabetes. Our objective was to understand how living with an adolescent with diabetes influences parents' perceptions of their child's well-being, their relationship with their child, and how they perceive the influence of peers and school on their child's diabetes. Methods Twenty-eight parents of adolescents with Type 1 diabetes, aged 13,18 years, participated in focus groups. Transcripts were analysed using qualitative methods to determine dominant themes and incidence density. Results Themes included how diabetes negatively influences their adolescent's lifestyle, how diabetes makes it difficult for parents to understand developmental challenges experienced by their child, concerns regarding the potential to develop long-term complications, perceptions on how diabetes impacts on their relationship with their child and relationships with peers and how their children's school impacts on their diabetes self-management Conclusions This qualitative focus group study provides insight into parental perceptions of adolescents living with Type 1 diabetes, specifically as it relates to lifestyle implications, relationships with parents, peers and physicians, and school experiences. [source]

Individual preparedness and mitigation actions for a predicted earthquake in Istanbul

DISASTERS, Issue 4 2010
ka Tekeli-Ye
This study investigated the process of taking action to mitigate damage and prepare for an earthquake at the individual level. Its specific aim was to identify the factors that promote or inhibit individuals in this process. The study was conducted in Istanbul, Turkey,where an earthquake is expected soon,in May and June 2006 using qualitative methods. Within our conceptual framework, three different patterns emerged among the study subjects. Outcome expectancy, helplessness, a low socioeconomic level, a culture of negligence, a lack of trust, onset time/poor predictability, and normalisation bias inhibit individuals in this process, while location, direct personal experience, a higher education level, and social interaction promote them. Drawing on these findings, the paper details key points for better disaster communication, including whom to mobilise to reach target populations, such as individuals with direct earthquake experience and women. [source]

The Schooling of Women: Maternal Behavior and Child Environments

ETHOS, Issue 3 2001
Professor Robert A. LeVine
Beatrice Whiting was a member of the first generation of graduate students to be trained in psychological anthropology, and she has always presumed a broad range of connections between psychological and social processes. She salvaged the Six Cultures Study through an ecological analysis of its child-observation material, and she stimulated further studies, using quantitative and qualitative methods, of the ways in which broad categories like sex, age, and education influence child development. This article presents in overview a crosscultural research program on the effects of women's schooling that was influenced by her ideas. [source]

Quantitative and qualitative methods in UK health research: then, now and . . . ?

K. Mcpherson phd
Quantitative and qualitative methods in UK health research: then, now and . . . ? This paper examines the current status of qualitative and quantitative research in the context of UK (public) health research in cancer. It is proposed that barren competition between qualitative and quantitative methods is inevitable, but that effective synergy between them continues to be essential to research excellence. The perceived methodological utility, with respect to understanding residual uncertainties, can account for the status accorded various research techniques and these will help to explain shifts witnessed in recent years and contribute towards an understanding of what can be realistically expected in terms of future progress. It is argued that the methodological debate, though familiar to many, is worthy of rearticulation in the context of cancer research where the psychosocial aspects of living with a cancer and the related complexity of providing appropriate cancer care are being addressed across Europe, as evidenced in recent directions in policy and research. [source]

Systematic review of the perceptions and experiences of accessing health services by adult victims of domestic violence

Louise Robinson RGN RHV BSc (Hons) MSc
Abstract This systematic review synthesises evidence on the perceptions and experiences of adult victims of domestic violence when accessing healthcare services. The review was concerned with disclosure of domestic violence by adult victims when accessing health services, the responses of healthcare professionals to these victims, victims' perceived barriers to support, and the appropriateness of support and referrals. These aims required the review to focus on studies using in-depth qualitative methods to explore victims' perceptions and experiences. A comprehensive systematic search of 12 databases was carried out in June/July 2005. Application of the review protocol and inclusion criteria resulted in 10 studies (conducted in the UK, USA and Australia) being considered eligible for the review. Data were extracted from these studies and a quality assessment completed. Thematic analysis was carried out to enable the identification of recurrent themes within the included studies. Findings indicate that victims of domestic violence experience difficulties when accessing healthcare services. Victims perceive that these difficulties can be attributed to inappropriate responses by healthcare professionals, discomfort with the healthcare environment, perceived barriers to disclosing domestic violence, and a lack of confidence in the outcomes of disclosure to a health professional. The methodological quality of included studies was variable, but no papers were rejected based on quality issues. These results can contribute to and inform a comprehensive assessment of the experiences of adult victims of domestic violence when accessing healthcare services. The health service is in a unique position to contribute towards the assessment and identification of domestic violence and to provide access to appropriate support. The messages of this study are important for policy-makers and practitioners. [source]

Observations and recommendations for assessing patient satisfaction in a primary care setting using a previously validated questionnaire

Anné-Lise McDonald BA MSc
Abstract Within the rapidly changing climate of primary care, there is an increasing need to evaluate the reactions of patients to real and proposed changes in practice. There are a number of methodologies, both qualitative and quantitative which have been employed to do this. This article presents the methodological problems which may be encountered in evaluating patients' opinions and attitudes in a primary care setting. We begin by discussing the issues which need evaluation, then describe the research process of a recent case study which aimed to evaluate patient satisfaction using a previously validated survey instrument, including the modifications which had to be made to overcome the problems of research in a real life practice setting. We then discuss the strengths and weaknesses of applying different methodological instruments within a primary care setting, and propose a mixed methodological framework as a template for future research which combines the strengths of both large scale survey and small scale qualitative methods to give more insight into the concerns and beliefs of patients as changes occur within their local practice. [source]

Consumer attitudes towards self-referral with early signs of cancer: implications for symptom awareness campaigns

Douglas Eadie
Traditionally, secondary prevention programmes have employed mass screening approaches to assess for asymptomatic signs of cancer. It has been suggested that early detection strategies, involving public education and self-referral may prove more cost-effective, with low-risk populations for cancers with symptomatic presentation. The success of public education approaches is dependent on careful consideration of the psycho-social factors of self-examination and referral. This paper presents the findings from an exploratory study, using qualitative methods with an at-risk population of older people living in deprived communities in west-central Scotland. The study examines consumer perceptions of the early detection of cancer and the cultural barriers to self-referral, as well as response to aspects of communication strategy. The implications for design of symptom awareness campaigns, including use of message appeals, specification of target symptoms, identification of target audience and selection of communication channels, are discussed. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Peopling Skilled International Migration: Indian Doctors in the UK

Vaughan Robinson
This article uses a case-study approach in relation to the migration of Indian doctors to the UK in order to illustrate the complexity and multi-levelled nature of explanations for international migration. It argues that whereas, at the level of discursive consciousness, the movement of Indian doctors to the UK appears an economically driven and shapedphenomenon akin to other examples of highly skilled international migration, when the practical consciousness of participants is investigated through qualitative methods, the migration can also be seen as a cultural and social phenomenon. Although migrants move to "better themselves", they also make choices based on factors such as the kind of novels they read as children or "taken for granted" familial obligations rooted in the everyday life of their culture. [source]

A Pragmatic Guide to Qualitative Historical Analysis in the Study of International Relations

Cameron G. Thies
Researchers using qualitative methods, including case studies and comparative case studies, are becoming more self,conscious in enhancing the rigor of their research designs so as to maximize their explanatory leverage with a small number of cases. One aspect of qualitative research that has not received as much attention is the use of primary and secondary source material as data or evidence. This essay explores the potential problems encountered by political scientists as they conduct archival research or rely on secondary source material produced by historians. The essay also suggests guidelines for researchers to minimize the main problems associated with qualitative historical research, namely, investigator bias and unwarranted selectivity in the use of historical source materials. These guidelines should enable advanced undergraduates and graduate students to enhance the quality of their historically minded political science scholarship. [source]

Mothers' grief following the death of a child

Hilkka Laakso PhD RN
Mothers' grief following the death of a child Aim of the study.,Research has shown that caring for a dying child is among the hardest and more demanding tasks in nursing, because the staff are forced to manage their heavy work with inadequate skills and experience. This article deals with the findings of a recent study, the purpose of which was to analyse the mother's grief and coping with grief following the death of a child under the age of 7 years. Design.,Data were collected from mothers using a survey (n=91) and an interview (n=50). As the topic was very sensitive ethically and emotionally, survey data were collected first and the mothers were asked to give their consent to taking part in an interview. The study employed both quantitative and qualitative methods. The data were analysed using statistical methods and content analysis. However, only the qualitative part of the study is presented in this article. Findings.,The findings show that nursing staff had skills to support grieving mothers, but that there were many feelings and experiences of grief that remained unidentified by staff. The staff's ability to meet the mothers' individual needs while the child was in hospital and after the child's death was inadequate. The information received from staff was perceived to be insufficient or offensive to mothers. Conclusions.,The development of basic and further education and of various support measures would enable the staff to better cope with their work. Focusing on interactive skills and meeting the patient's individual needs using reflective practice would improve the quality of care. Communication and collaboration between different occupational groups should be promoted, because mothers were dissatisfied with dissemination of information, and ambiguous responsibilities between different occupational groups hampered the acquisition of information. [source]

Good Deaths, Bad Deaths, and Preferences for the End of Life: A Qualitative Study of Geriatric Outpatients

Elizabeth K. Vig MD
OBJECTIVES: Patient involvement in decision-making has been advocated to improve the quality of life at the end of life. Although the size of the oldest segment of the population is growing, with greater numbers of older adults facing the end of life, little is known about their preferences for the end of life. This study aimed to explore the attitudes of older adults with medical illness about the end of life, and to investigate whether current values could be extended to end-of-life preferences. DESIGN: Descriptive study with interviews using open- and closed-ended questions. SETTING: Patients attending two university-affiliated geriatric clinics were interviewed in a private conference room near the clinic they attended or in their homes. PARTICIPANTS: Sixteen older men and women identified by their physicians as having nonterminal heart disease or cancer. MEASUREMENTS: The interview contained open-ended questions such as: "What are the most important things in your life right now?" and "What would you consider a good/bad death?" The interview also contained closed-ended questions about symptoms, quality of life, and health status. Additional questions elicited preferences for the end of life, such as location of death and the presence of others. The open-ended questions were tape-recorded, transcribed, and analyzed using qualitative methods. The closed-ended questions were analyzed using descriptive statistics. RESULTS: Patients with heart disease and cancer provided similar responses. Participants' views about good deaths, bad deaths, and end-of-life scenarios were heterogeneous. Each participant voiced a unique combination of themes in describing good and bad deaths. Because each participant described a multifaceted view of a good death, for instance, no theme was mentioned by even half of the participants. Participants provided differing explanations for why given themes contributed to good deaths. Currently valued aspects of life were not easily translated into end-of-life preferences. For example, although the majority of participants identified their family as being important, many gave reasons why they did not want their family members present when they died. CONCLUSIONS: Because of the heterogeneity of views and the difficulty in inferring end-of-life preferences from current values, older adults should be asked not only questions about general values, but also specific questions about their end-of-life choices and the reasons for these choices. A thorough understanding of an individual's end-of-life preferences may help health professionals working with older adults develop patient-centered care plans for the end of life. [source]

The experience of living with a chronic illness during adolescence: a critical review of the literature

Rachel M Taylor
Aims., To identify and critique literature on the adolescent lived experience of chronic illness; describe the lived experience; and to make recommendations for clinical practice. Background., Young people with chronic illness have the same developmental issues as those who are healthy. However, development can be disrupted by treatment and repeated hospitalisation. While the physical consequences of chronic illness on development have been established, the subjective personal experience is less known. Design., Literature review. Methods., Electronic databases and hand searches were made of the literature published between January 1990,September 2007. Literature was eligible for inclusion if it involved adolescents between 10,19 years, and published in English and used qualitative methods of data collection. Methodological quality was assessed using the criteria described by Cesario et al. [Journal of Obstetrics, Gynaecology and Neonatal Nursing 31 (2002) 31]. Conclusions., Twenty studies were identified involving young people with a wide variety of chronic illnesses. The study quality was variable, however, generally the majority was assessed as being good or fair. Seven common themes were found between the identified studies: developing and maintaining friendships; being normal/getting on with life; the importance of family; attitude to treatment; experiences of school; relationship with the healthcare professionals; and the future. Relevance to practice., As there was commonality in themes between studies strategies to lessen the burden of chronic illness during adolescence do not necessarily need to be disease specific. Nurses need to focus on treating the young person rather than their illness. [source]

Measuring patient assessments of the quality of outpatient care: a systematic review

Tiina Säilä MNSc
Abstract Rationale, aims and objectives, The aim of the study was to answer three questions: first, what methods have been used to measure patient assessments of the quality of care? Second, how do outpatients rate their care? And third, what needs to be taken into account in measuring patient assessments of the quality of care? Methods, Systematic review of the literature. Electronic searches were conducted on Medline, CINAHL and the Cochrane Database of Systematic Reviews. To be included, articles were to deal with patients' assessments of health care in ambulatory units for somatic adult patients. They were to have been published between January 2000 and May 2005, written in English, Swedish or Finnish with an English abstract, and the research was to have been conducted in Europe. The search terms used were: ambulatory care, ambulatory care facilities, outpatient, outpatients, patient satisfaction and quality of health care. The articles were screened by two independent reviewers in three phases. Results, Thirty-five articles were included. The quality of care was measured using both quantitative and qualitative methods. Only a few studies relied on the single criterion of patient satisfaction for quality measurements. It is easy to identify common sources of dissatisfaction in different studies. Sources of satisfaction are more closely dependent on the target population, the context and research design. Conclusion, Patient satisfaction is widely used as one indicator among others in assessing the quality of outpatient care. However, there is no single, universally accepted method for measuring this. [source]

Using Qualitative Research Methods to Ascertain Elementary Students' Understandings of Food Safety

C.J. Trexler
ABSTRACT: Researchers and educators call for educational programs that teach youth about food safety. In this study, researchers used qualitative research methods (interviews and concept mapping) to ascertain elementary students' understandings of food spoilage and preservation benchmarks based on national science education standards. Constructivist learning theory and its attendant qualitative methods framed the study. Few students understood the causes of spoilage and most were unable to discuss the role of bacteria or germs in meat. Students with an understanding of microorganisms clearly explained methods of preventing spoilage, while students who did not understand the microorganism concept could not. Constructivist research methods were fruitful in unearthing students' conceptions related to food spoilage. This research has implications for university food science faculty members interested in strengthening their teaching practice by focusing on helping students develop conceptual understanding. [source]

Operationalizing quality of life for people with profound multiple disabilities: a Delphi study

K. Petry
Abstract Background In a recent study, we constructed an item pool that contains items on the quality of life (QOL) and related aspects of support of people with profound multiple disabilities (PMD). In the present study, a panel of experts assessed the content and the structure of this item pool in order to enhance its validity and usefulness. Method A two-round Delphi study was set up. The panel consisted of 45 experts, of whom 12 were theory-experts, 12 practice-experts and 12 experience-experts from Belgium (n = 12), Germany (n = 12), the Netherlands (n = 11) and the UK/Ireland (n = 10). Both quantitative and qualitative methods of analysis were applied to the data. Results The majority of the items were considered relevant for the QOL of people with PMD. In the first round, 91% of the items reached the 80% criterion of consensus. In the second round, 78.7% of the items reached the 85% criterion of consensus. There were no significant differences in opinion neither between types of experts nor between countries. Several items were reported as missing in the item pool and were added. Conclusions The results provide some evidence that the item pool is a valid operationalization of QOL of people with PMD and can be used in an instrument to measure the QOL of this target group. [source]


Dale R. Hawley
In order to assess trends in family therapy research, empirical articles (N = 195) from three family therapy journals over a 5-year period were coded for several variables: authorship, external funding, methodology, sample, purpose, cost effectiveness, use of therapeutic model, and topic. Results indicated that a large pecentage of research in these journals focused on nonclinical issues and used nonclinical samples. Authors were affiliated with a wide variety of disciplines and reported low levels of external funding for their research. While a majority of the studies used quantitative methods, there appeared to be a growing number of studies using qualitative methods. Implications of these findings are discussed in light of research reviews over the past two decades. [source]


Dale R. Hawley
Ninety-five studies from Family Process and Journal of Marital and Family Therapy were evaluated with regard to their use of theory. While a majority of the articles were judged to use theory in either an explicit or an implicit manner, 42% did not appear to draw on theory in either the introductory or discussion sections. Studies that used qualitative methods appeared to use theory more frequently and explicitly than those using quantitative methods alone. Systems theory was found to be the most common conceptual framework, followed by feminism. We conclude that the link between theory and reasearch in family therapy needs strengthening and suggest that the role of theory in family therapy be reexamined. [source]

The challenge of altering elementary school teachers' beliefs and practices regarding linguistic and cultural diversity in science instruction

Okhee Lee
This study examined the impact of a professional development intervention aimed at helping elementary teachers incorporate elements of students' home language and culture into science instruction. The intervention consisted of instructional units and materials and teacher workshops. The research involved 43 third- and fourth-grade teachers at six elementary schools in a large urban school district. These teachers participated in the intervention for 2 consecutive years. The study was conducted using both quantitative and qualitative methods based on focus group interviews, a questionnaire, and classroom observations. The results indicate that as teachers began their participation in the intervention, they rarely incorporated students' home language or culture into science instruction. During the 2-year period of the intervention, teachers' beliefs and practices remained relatively stable and did not show significant change. Possible explanations for the limited effectiveness of the intervention are addressed, and implications for professional development efforts are discussed. © 2007 Wiley Periodicals, Inc. J Res Sci Teach 44: 1269,1291, 2007 [source]

Physical Activity, Dietary Practices, and Other Health Behaviors of At-Risk Youth Attending Alternative High Schools

Martha Y. Kubik
ABSTRACT: This study assessed the interest of alternative high school staff in intervention research on students' eating and physical activity habits und the feasibility of conducting such research in alternative school settings. A two-phase descriptive design incorporated both quantitative and qualitative methods. In fall/winter 2001,2002, alternative high school administrators in Minnesota were surveyed (response rate = 83%; n = 130/157). During summer 2002, one-on-one, semistruclured interviews were conducted with key-school personnel (n = 15) from urban and suburban schools. Findings indicated few schools had been invited to participate in research on nutrition (11%) and physical activity (7%). However, more than 80% of administrators reported interest in their students participating in such research. Most schools offered health and PE classes and had access to indoor gym facilities and outdoor play areas. While most schools offered a school lunch program, participation was low, cold lunches were common, and food often was unappealing. Beverage and snack vending machines were common. Overall, the physical environment of most alternative schools did not support physical activity and healthy eating as normative behavior. Interest in interventions on physical inactivity, unhealthy dietary practices, und other priority health-risk behavior common in students attending alternative schools was high among teachers and administrators. Results suggest research in alternative high schools is feasible and successful implementation and evaluation of programs possible. [source]

Psychological Research on Homelessness in Western Europe: A Review from 1970 to 2001

Pierre Philippot
The rapidly growing, but still small, research literature on homelessness in Europe has often been provided by non-academics, using qualitative methods, and has been published in sources that are not widely available. This article summarizes definitions employed, observed prevalence, the socio-demographic characteristics, and the physical and mental health status of the homeless in Western Europe. Research pertaining to the causes of homelessness and the societal response to the problem are also reviewed, and the ethical and methodological questions raised by European researchers are debated. A critical analysis of the largely descriptive European research is provided, and some noteworthy exceptions are described. We also discuss a number of promising theoretical models, including those that focus on learned helplessness, social strain, and social stress. [source]

Integrating Formal and Functional Approaches to Language Teaching in French Immersion: An Experimental Study

Elaine M. Day
This experimental study was designed to evaluate the effect on French language proficiency of an integrated formal, analytic and functional, communicative approach (experiential) to second-language teaching in the immersion classroom. The impetus for the study arises from previous research indicating that immersion children show persistent weaknesses in their grammatical skills despite the fluent, functional proficiency they achieve in their second language. The experimental materials, which were custom-designed for our study, highlight form-function relations, promote noticing, encourage metalin-guistic awareness, and provide opportunities for language practice and thus relate to some of the theoretical issues that Rod Ellis (this volume) has indicated are important in SLA in the 90s. This classroom-based study on the conditional is one of a series of studies undertaken in Canadian French immersion to investigate the effectiveness of form-focused instruction in classrooms (see Swain, 2000). The results of our study, which was conducted in grade 7 early immersion, showed that the Experimental group performed significantly higher in writing than the Control group, in both the post- and the follow-up testing. Although this was not found for speaking, an examination of the individual class data revealed greater and more consistent growth in speaking for the Experimental than for the Control classes, suggesting that they benefited somewhat from the experi- mental treatment in this domain as well. Although Ellis (this volume) notes that research on form-focused instruc- tion in the 90s has tended to split pedagogy from theory, the immersion research in this area does not seem t o reflect this shift. In a recent article, Swain (2000) reviews the French Immersion (FI) studies and summarizes their re- sults as follows: "Overall, the set of experiments conducted in FI classes suggest that there is value in focusing on language form through the use of pre-planned curriculum materials in the context of content-based language learn- ing" (Swain, 2000, p. 205). Her reference to curriculum materials and to the specific context of content-based lan- guage learning should signal to the reader the orientation t o pedagogical considerations that characterize this research. As Ellis notes, hybrid research using both experimental and qualitative methods is becoming more common in SLA. Recently, the experimental materials in our study were implemented in a grade 8 immersion classroom, and the children's collaborative language activity was observed by a researcher working from a sociocultural theoretical per- spective (Spielman-Davidson, 2000). The uptake of our research by a researcher working in another paradigm introduces another kind of hybridity that we hope will also shed further light on questions in form-focused instruction and lead to appropriate changes in pedagogy and in the design of immersion curricula. [source]