1
|
von Kutzleben M, Baumgart V, Fink A, Harst L, Wicking N, Tsarouha E, Pohontsch NJ, Schunk M. [Mixed Methods Studies in Health Services Research: Requirements, Challenges and the Question of Integration - a Discussion Paper from the Perspective of Qualitative Researchers]. DAS GESUNDHEITSWESEN 2023; 85:741-749. [PMID: 37253371 PMCID: PMC10444519 DOI: 10.1055/a-2022-8326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
With this discussion paper, the subgroup Mixed Methods of the working group Qualitative Research Methods in the non-profit organization German Network Health Services Research (DNVF) is taking up the topic of three previous discussion papers on the significance and potentials of qualitative research methods in health services research. Mixed methods are being increasingly used and demanded in health services research. However, there are also areas of conflict in the planning and implementation of mixed methods studies, and these are addressed in this paper from the perspective of qualitative research. Special attention is given to the aspect of integration as the fundamental signature of mixed methods research. With this discussion paper, our aim was to stimulate critical as well as constructive exchange of ideas on what constitutes high-quality health services research characterised by a diversity of methods and the framework conditions under which this can succeed.
Collapse
Affiliation(s)
- Milena von Kutzleben
- Department für Versorgungsforschung, Abteilung
Organisationsbezogene Versorgungsforschung, Carl von Ossietzky Universitat
Oldenburg, Oldenburg, Germany
| | - Verena Baumgart
- Department für Angewandte Gesundheitswissenschaften,
Studienbereich Ergotherapie, Hochschule für Gesundheit Bochum, Bochum,
Germany
| | - Astrid Fink
- Fachbereich Gesundheit, Kreis Groß-Gerau, Groß-Gerau,
Germany
| | - Lorenz Harst
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Medizinische
Fakultät Carl Gustav Carus an der Technischen Universität
Dresden, Dresden, Germany
| | - Nele Wicking
- Zahnärztliche Professionsforschung, Institut der Deutschen
Zahnärzte, Koln, Germany
| | - Elena Tsarouha
- Institut für Arbeitsmedizin, Sozialmedizin und
Versorgungsforschung, Universitätsklinikum Tübingen, Tubingen,
Germany
| | | | - Michaela Schunk
- Klinik und Poliklinik für Palliativmedizin, LMU Medizinische
Fakultät, München, Germany
- Fakultät für Angewandte Gesundheits- und
Sozialwissenschaften, Technische Hochschule Rosenheim, Germany
| |
Collapse
|
2
|
Cardona-Arias JA, Salas-Zapata W, Carmona-Fonseca J. A systematic review of mixed studies on malaria in Colombia 1980-2022: what the "bifocal vision" discovers. BMC Public Health 2023; 23:1169. [PMID: 37330477 PMCID: PMC10276438 DOI: 10.1186/s12889-023-16098-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 06/10/2023] [Indexed: 06/19/2023] Open
Abstract
Mixed methods are essential in public health research and malaria control, because they allow grasping part of the complexity and diversity of the factors that determine health-disease. This study analyzes the mixed studies on malaria in Colombia, 1980-2022, through a systematic review in 15 databases and institutional repositories. The methodological quality was assessed with Mixed Methods Appraisal Tool (MMAT), STrengthening the Reporting of OBservational studies in Epidemiology (STROBE), and Standards for Reporting Qualitative Research (SRQR). The qualitative and quantitative findings were grouped into a four-level hierarchical matrix. The epidemiological profile of malaria morbidity, from traditional epidemiology, has been sustained by environmental problems, armed conflict, individual risk behaviors, and low adherence to recommendations from health institutions. However, the qualitative component reveals deeper causes that are less studied, of greater theoretical complexity, and that reflect challenges to design and implement health interventions, such as socioeconomic and political crises, poverty, and the neoliberal orientation in the malaria control policy; the latter reflected in the change in the role of the State, the fragmentation of control actions, the predominance of insurance over social assistance, the privatization of the provision of health services, the individualistic and economistic predominance of health, and low connection with popular tradition and community initiatives. The above confirms the importance of expanding mixed studies as a source of evidence to improve malaria research and control models in Colombia, and to identify the underlying causes of the epidemiological profile.
Collapse
Affiliation(s)
| | | | - Jaime Carmona-Fonseca
- Research group "Salud y Comunidad César Uribe Piedrahíta" School of Medicine, University of Antioquia, Medellín, Colombia
| |
Collapse
|
3
|
Systematic Review of Mixed Studies on Malaria in Pregnancy: Individual, Cultural and Socioeconomic Determinants of Its Treatment and Prevention. Trop Med Infect Dis 2022; 7:tropicalmed7120423. [PMID: 36548677 PMCID: PMC9784813 DOI: 10.3390/tropicalmed7120423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
Malaria in pregnancy (MiP) is a global public health problem; its research is predominantly quantitative. The objective was to analyze the individual, cultural and socioeconomic determinants of the treatment and prevention of MiP with a systematic review of mixed studies (search had no date restriction). Reproducibility and evaluation of the methodological quality were guaranteed. 21 studies were included (20 from Africa). The quantitative component included 7816 pregnant women and 483 health workers. The qualitative component included 800 subjects (pregnant women, health workers, family members and community leaders). The main topics were the use and acceptability of WHO strategies to prevent MiP, individual determinants related with knowledge, perceptions, attitudes and behaviors on MiP, and cultural and socioeconomic barriers for its treatment and prevention. The main determinants of MiP were long distance to the clinic, lack of economic resources, low-coverage antenatal care, few health workers in the communities, drug shortages, cultural rules that prevent women's participation in health issues, and misconceptions about MiP. MiP has determinants related to economic conditions, the structure and functioning of the health system, symbolic and cultural aspects, as well as knowledge, beliefs, perceptions and behavior of pregnant women, which prevent optimal access and use of preventive strategies. This study evidences the importance of intersectional, intersectoral, and interdisciplinary work to prevent MiP.
Collapse
|
4
|
Apolinarski B, Herbst FA, Röwer HAA, Schneider N, Stiel S. Status quo palliativmedizinischer Tageskliniken und Tageshospize in Deutschland: Ergebnisse einer gemischt-methodischen Studie. ZEITSCHRIFT FÜR PALLIATIVMEDIZIN 2021. [DOI: 10.1055/a-1514-8871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Zusammenfassung
Ziel der Studie Der Bestand von Tageshospizen und palliativmedizinischen Tageskliniken in Deutschland soll erstmals systematisch erhoben und analysiert werden.
Methodik In dieser gemischt-methodischen Studie wurden Einrichtungsleitungen in leitfadengestützten Interviews (06.–07.2020) und standardisierter Fragebogenerhebung (08.–10.2020) zu einrichtungsbezogenen Kriterien befragt. Interviewdaten wurden qualitativ inhaltsanalytisch, quantitative Daten deskriptiv ausgewertet.
Ergebnisse Die Interviews (n = 7) liefern einen Überblick über Organisation und Versorgungsangebot hospizlich-palliativer Tageseinrichtungen. Von 28 standardisiert befragten Einrichtungen waren 13 bereits in Betrieb. Die zumeist an andere Versorger angebundenen Einrichtungen bieten in der Regel zwischen 2 und 8 Tagesplätze an.
Schlussfolgerung Aufgrund der gezeigten Entstehungsdynamik scheint eine systematische Integration der neuen Strukturen in die bestehende Hospiz- und Palliativversorgung sinnvoll.
Collapse
Affiliation(s)
- Beate Apolinarski
- Institut für Allgemeinmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Franziska A. Herbst
- Institut für Allgemeinmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Hanna A. A. Röwer
- Institut für Allgemeinmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Nils Schneider
- Institut für Allgemeinmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Stephanie Stiel
- Institut für Allgemeinmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| |
Collapse
|
5
|
Medenwald D, Schmidt-Pokrzywniak A, Kapsner LA, Buttmann-Schweiger N, Hopff S, Schmidt H, Vordermark D. Onkologische Versorgungsforschung in Deutschland. FORUM 2021; 36:492-496. [PMCID: PMC8522174 DOI: 10.1007/s12312-021-00996-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Neben der prospektiven Versorgungsforschung mit ihrem qualitativen und quantitativen Ansatz sind retrospektive Datenquellen essenziell zur Beurteilung von Prozessen im Gesundheitswesen. In Deutschland ermöglichen strukturelle Veränderungen in den Krebsregistern bzw. die Etablierung neuer Datenquellen interessante Möglichkeiten für die Versorgungsforschung. So wurde mit der Medizininformatik-Initiative eine Vernetzung klinischer Einrichtungen aufgebaut, womit sich schnelle, sektorübergreifende und lebensnahe Analysen realisieren lassen. Durch die Neustrukturierung der Krebsregister sollen bevölkerungsbasierte Erhebungen im onkologischen Bereich vereinfacht und die Detailtreue der Daten erhöht werden. Die Folgen der COVID-19-Pandemie (Coronavirus-Krankheit 2019) im onkologischen Bereich lassen sich dabei über das neu geschaffene Nationale Pandemie Kohorten Netz (NAPKON), ein Zusammenschluss universitärer und nichtuniversitärer Gesundheitsdienstleister, abbilden. Durch die Einbeziehung der Akteure im Gesundheitswesen und unter der Mitwirkung prospektiver Studien lässt sich damit ein umfassendes Bild des onkologischen Versorgungsgeschehens in Deutschland zeichnen.
Collapse
Affiliation(s)
- Daniel Medenwald
- Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Halle (Saale), Ernst-Grube-Straße 40, 06120 Halle (Saale), Deutschland
- AG Onkologische Versorgungsforschung, Klinik für Strahlentherapie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | | | - Lorenz A. Kapsner
- Medizinisches Zentrum für Informations- und Kommunikationstechnik, Universitätsklinikum Erlangen, Erlangen, Deutschland
- Radiologisches Institut, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
| | | | - Sina Hopff
- Medizinische Fakultät und Uniklinik Köln, Klinik I für Innere Medizin, Universität zu Köln, Köln, Deutschland
| | - Heike Schmidt
- Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Halle (Saale), Ernst-Grube-Straße 40, 06120 Halle (Saale), Deutschland
- Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
- AG Lebensqualität, Klinik für Strahlentherapie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Dirk Vordermark
- Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Halle (Saale), Ernst-Grube-Straße 40, 06120 Halle (Saale), Deutschland
| |
Collapse
|
6
|
Rind E, Kimpel K, Preiser C, Papenfuss F, Wagner A, Alsyte K, Siegel A, Klink A, Steinhilber B, Kauderer J, Rieger MA. Adjusting working conditions and evaluating the risk of infection during the COVID-19 pandemic in different workplace settings in Germany: a study protocol for an explorative modular mixed methods approach. BMJ Open 2020; 10:e043908. [PMID: 33208339 PMCID: PMC7677339 DOI: 10.1136/bmjopen-2020-043908] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Currently, many countries, affected by the COVID-19 pandemic, discuss how the 'lockdown-restrictions' could be lifted to restart the economy and public life after the first wave of the COVID-19 disease has subsided. This study protocol describes an approach designed to provide an in-depth understanding of how companies and their employees in Germany deal with their working conditions during the COVID-19 pandemic. We are also interested in how and why the risk of infection with SARS-CoV-2 could vary across different professional activities, company sites and regions with different epidemiological activity or infection control measures in Germany. We expect the results of this study to contribute to the development of working conditions protecting the health of employees during and beyond the COVID-19 pandemic. METHODS AND ANALYSIS An explorative multimodal mixed methods approach will be applied. Module 1 comprises a document analysis of prevailing federal and regional laws and regulations at the respective location of the participating company. Module 2 includes qualitative interviews with key actors at different companies. Module 3 is a repeated standardised employee survey designed to capture potential changes in the participants' experiences and attitudes towards working conditions, occupational safety regulations/measures, and infection control measures during the COVID-19 pandemic. Module 4 comprises SARS-CoV-2 seroprevalence testing. This is carried out by the medical service of the participating company sites as a voluntary offer for employees. Qualitative data will be analysed through document and content analysis. The complexity of the quantitative analysis depends on the response rates of modules 3 and 4. ETHICS AND DISSEMINATION The approval of the study design was received in June 2020 from the responsible local ethical committee of the Medical Faculty, University of Tübingen and University Hospital Tübingen (No. 423/2020BO). The results will be presented at national and international conferences and published in peer-reviewed journals.
Collapse
Affiliation(s)
- Esther Rind
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| | - Klaus Kimpel
- Medical Services, Robert Bosch GmbH, Stuttgart, Germany
| | - Christine Preiser
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
- Coordination Centre, Core Facility for Health Services Research, University of Tübingen, Faculty of Medicine, Tübingen, Germany
| | | | - Anke Wagner
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| | - Karina Alsyte
- Medical Services, Robert Bosch GmbH, Stuttgart, Germany
| | - Achim Siegel
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| | - Antje Klink
- Medical Services, Robert Bosch GmbH, Stuttgart, Germany
| | - Benjamin Steinhilber
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| | | | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| |
Collapse
|
7
|
Schneider P, Niederberger M. [Mixed-methods studies in the field of health promotion. Results of a systematic review of German publications]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2020; 153-154:10-22. [PMID: 32601023 DOI: 10.1016/j.zefq.2020.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 10/24/2022]
Abstract
Research in the field of health promotion generates evidence-based knowledge and has the potential to increase the acceptance, impact and long-term effectiveness of interventions. Typically, a distinction is made between qualitative and quantitative approaches. Yet, with complex and multidimensional re-search questions in the field of health promotion a combination of the two approaches has proven useful. Using mixed-methods designs promises, among other things, to compensate for weaknesses of the individual methods, to improve the scope of the results, and to provide a comprehensive insight into the topic. In this systematic review of two German journals we examine the role of the mixed-methods approach in the field of health promotion and how it can be translated into specific research projects. The review's results show that mixed-methods designs are implemented in various contexts. In most studies, the quantitative research strand plays the central role. The use of the mixed-methods designs in health promotion can be further discussed, especially taking into account technical innovations in the field of data collection or with regard to the interpretative potential of qualitative research. The presentation of the review is based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) by the Equator Network.
Collapse
Affiliation(s)
- Pairin Schneider
- Pädagogische Hochschule Schwäbisch Gmünd, Schwäbisch Gmünd, Deutschland
| | - Marlen Niederberger
- Forschungsmethoden in der Gesundheitsförderung und Prävention Pädagogische Hochschule Schwäbisch Gmünd, Schwäbisch Gmünd, Deutschland.
| |
Collapse
|
8
|
Hartenstein-Pinter A, Hübner-Möhler B, Zernikow B, Wager J. [Living with bandages: a mixed-methods-study on the view of families of children with epidermolysis bullosa]. Pflege 2020; 33:75-84. [PMID: 32048916 DOI: 10.1024/1012-5302/a000719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Living with bandages: a mixed-methods-study on the view of families of children with epidermolysis bullosa Abstract. Background: Children with epidermolysis bullosa (EB) often need new bandages regularly due to sore skin and blistering. Aim: The question about the experiences of parents and children affected by EB with dressing materials is intended to identify starting points for effective support of families. Methods: In the first part of the sequential mixed-methods study, guideline-based interviews were conducted and evaluated with qualitative content analysis. Based on the results, a questionnaire was developed and implemented as an online survey. After analysis with descriptive statistics, these results were combined with the qualitative results. Results: In the "Find out what works" process, the cutting of the materials and the importance of flexibility come to the fore. The parents' confidence in their actions is particularly evident in the application of the bandages and in their knowledge of the materials. The removal of glued dressings is often associated with pain. Dirty bandages are the most common problem in everyday life. Both aspects relate to the wearability of the bandages. When bandages are integrated into everyday family life, the most important role is played by cost absorption and expertise in the organisation. Conclusions: Parents develop specific competences on EB, on their child and dressings. With counselling and education, nursing takes a central function within the multi-professional accompanying interventions to support and relieve families.
Collapse
Affiliation(s)
| | | | - Boris Zernikow
- Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik, Datteln.,Lehrstuhl für Kinderschmerztherapie und Pädiatrische Palliativmedizin, Fakultät für Gesundheit, Department für Humanmedizin, Universität Witten / Herdecke
| | - Julia Wager
- Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik, Datteln
| |
Collapse
|