Qualitative methodology

定性方法
  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    尽管患有精神分裂症的女性由于其诊断和性别相关问题而面临重大的终身挑战,在他们的医疗和一般护理中很少考虑这些挑战。为了报告一群精神分裂症妇女的需求和愿望,我们在瓦尔帕莱索的萨尔瓦多医院对9名被诊断为精神分裂症并在门诊就诊的女性进行了一系列半结构化访谈.我们的定性研究遵循现象学设计。使用ATLAS。ti软件,我们对采访记录进行了内容分析,为访谈中涉及的每个主要主题开发了一个编码框架,并对结果进行了三角测量。尽管有精神病症状,一些女性接受了不同的诊断。虽然承认药物的好处,女性还报告了对体重增加和身体形象的担忧。所有女性都报告了与精神分裂症诊断相关的耻辱和自我耻辱的经历,大多数人都经历过童年创伤,包括性虐待,父母的暴力,和/或欺凌。患有精神分裂症的年轻女性还担心,如果她们成为母亲,那么他们的孩子也可能患有精神分裂症和/或他们将无法充分照顾他们。精神分裂症患者有不同的经历,在社会中扮演不同的角色,这种理解应该整合到更个性化的精神分裂症治疗中,考虑到个体特征和需求。
    Although women with schizophrenia face significant lifelong challenges due to their diagnosis and sex-related issues, those challenges are seldom taken into consideration in their medical treatment and general care. In order to report the needs and desires of a group of women with schizophrenia, we conducted a series of semistructured interviews with nine women diagnosed with schizophrenia and attending outpatient clinics at the Hospital Del Salvador in Valparaíso. Our qualitative study followed a phenomenological design. Using ATLAS.ti software, we performed a content analysis of the interview transcripts, developed a coding frame for each major topic addressed in the interviews, and triangulated the results. Despite presenting with psychotic symptoms, some women received different diagnoses. Although acknowledging the benefits of medication, women also reported concerns about weight gain and body image. All women reported experiences with stigma and self-stigma related to the diagnosis of schizophrenia, and most had experienced childhood trauma, including sexual abuse, parental violence, and/or bullying. Young women with schizophrenia also feared that if they become mothers, then their children might also have schizophrenia and/or that they would be unable to adequately care for them. Women with schizophrenia have different experiences and play different roles in society beyond their psychoses, an understanding that should integrated into more personalized treatments for schizophrenia that consider individual characteristics and needs.
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  • 文章类型: Journal Article
    患有精神疾病的人通常会遇到更多的身体健康问题,与一般人口相比。因此,我们对住院的精神病患者进行了医疗咨询。我们研究的目的是从患者的角度调查医疗咨询的经验。
    我们进行了17次定性,对在2023年2月至5月期间接受医疗咨询的住院精神病患者进行半结构化访谈.使用Braun和Clarke的主题分析对访谈进行了分析。
    患者认为医疗咨询对于弥合精神病和躯体治疗之间的差距很重要。协商产生了安全感,患者强调医生认可的重要性。然而,一些患者受到他们的精神状态和精神病治疗的影响,导致记忆障碍,这阻碍了医疗咨询的充分利用。精神科工作人员的支持被证明对患者启动躯体干预至关重要。结果呈现在两个总体主题中:(1)在精神病学环境中进行医疗咨询的经验;(2)沟通和支持是影响医疗咨询收益的影响因素。
    我们的访谈研究表明,住院精神病患者的医疗咨询是一项重要的举措。病人和医生之间的关系,病人的精神状态,精神科工作人员的支持起着重要作用。将这些因素纳入医疗咨询可以带来有益的结果,可以改善精神疾病患者的健康。
    UNASSIGNED: People with mental illness often experience more physical health problems, compared to the general population. Therefore, we conducted medical consultations to hospitalized psychiatric patients. The purpose of our study was to investigate experiences of medical consultations from a patient perspective.
    UNASSIGNED: We conducted 17 qualitative, semi-structured interviews with hospitalized psychiatric patients who received a medical consultation in the period of February to May 2023. The interviews were analyzed using Braun and Clarke\'s thematic analysis.
    UNASSIGNED: Patients perceived the medical consultation as important in bridging the gap between psychiatric and somatic treatment. The consultation created a sense of security, with patients emphasizing the importance of acknowledgment by the medical doctor. However, some patients were affected by their state of mind and their psychiatric treatment, resulting in memory impairment, which prevented fully utilization of the medical consultation. The support from psychiatric staff proved crucial for patients in initiating somatic interventions.The results are presented in the two overarching themes: (1) Experiences of a medical consultation in a psychiatric setting and (2) communication and support as influential factors for benefits of the medical consultation.
    UNASSIGNED: Our interview study reveals that hospitalized psychiatric patients experience a medical consultation as an important initiative. The relationship between the patient and the medical doctor, the patient\'s state of mind, and the support of the psychiatric staff play significant roles. Incorporating these factors in the medical consultation enables a beneficial outcome that can improve the health of people with mental illness.
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  • 文章类型: Journal Article
    研究和临床实践中的行为分析师对不断扩大的主题感兴趣。他们被迫探索他们提出的干预措施及其产生的发现的社会有效性。随着磁场向这些重要方向移动,定性方法变得越来越重要。代表了行为分析师青睐的小n设计的背离,定性方法为分析师提供了一套独特的工具来回答优先考虑语音的问题,经验,和上下文中的理解。尽管认识到定性方法在其他学科中的价值,定性方法在行为分析中的应用仍然有限。一种可能的解释是,行为分析师还不能在他们的临床和研究调查中应用定性方法。为了解决这个问题,需要探索行为分析文献中的定性研究方法,以及对使用定性方法感兴趣的分析师的实用建议。本文简要概述了定性文献,这些文献涉及希望将定性方法纳入其查询的行为分析师。注意力主要集中在设计和实施健壮的定性研究时需要连贯性,该研究与行为分析师的目标和对知识的看法相一致。提供了一系列指导性问题,以将行为分析师定向到定性研究中的考虑因素,并概述分析师如何概念化强大的定性研究。本文旨在支持行为分析师更多地应用定性方法,这些方法最好地解决了行为分析调查的功能。
    Behavior analysts in research and clinical practice are interested in an ever-expanding array of topics. They are compelled to explore the social validity of the interventions they propose and the findings they generate. As the field moves in these important directions, qualitative methods are becoming increasingly relevant. Representing a departure from small-n design favored by behavior analysts, qualitative approaches provide analysts a unique set of tools to answer questions that prioritize voice, experience, and understandings in context. Despite recognition of the value of qualitative approaches in other disciplines, application of qualitative methods in behavior analysis remains limited. One likely explanation is that behavior analysts are not yet fluent in applying qualitative approaches within their clinical and research investigations. To address this issue, exploration of qualitative research approaches in behavior analytic literature is needed, alongside practical advice for analysts who are interested in using qualitative methods. This article briefly outlines qualitative literature which pertains to behavior analysts wanting to incorporate qualitative methods into their inquiries. Attention is primarily drawn to the need for coherence in designing and implementing a robust qualitative study that aligns with the behavior analyst\'s aims and perspective on knowing. A set of guiding questions are provided to orient behavior analysts to considerations in qualitative research and outline how analysts can conceptualize a strong qualitative study. This article aims to support increased application of qualitative methods by behavior analysts, where these methods best address the function of the behavior analytic investigation.
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  • 文章类型: Journal Article
    背景:主动康复三联(ART)模型为长期心理健康环境中的康复护理提供了框架。这项研究的目的是深入了解影响ART模型实施过程的因素。方法:与14个正在实施ART模式的多学科团队一起进行焦点小组。对数据进行主题分析。结果:确定了三个实施阶段。在第一阶段,开始,组织高层和护理人员的支持,向护理人员提供足够的信息,服务用户,和重要的其他人,创造动力被认为是关键因素。在第二阶段,在实施过程中,一个稳定的团队,具有良好的团队精神,领导和大使,优先考虑目标,足够的工具和培训,克服大型组织的结构限制被视为重要因素。在第三阶段,追求可持续性,应对挫折,保持对ART模型的关注,与其他团队和组织的交流被认为是核心因素。结论:这些发现可能会支持团队在长期精神保健中从传统护理方法转向以康复为导向的护理。
    Background: The Active Recovery Triad (ART) model provides a framework for recovery-oriented care in the long-term mental health setting. The aim of this study is to gain insight into factors influencing the implementation process of the ART model. Methods: Focus groups were conducted with fourteen multidisciplinary teams that were in the process of implementing the ART model. Data were thematically analyzed. Results: Three phases of implementation were identified. In the first phase, getting started, support from both the top of the organization and the care workers, sufficient information to care workers, service users, and significant others, and creating momentum were considered crucial factors. In the second phase, during implementation, a stable team with a good team spirit, leadership and ambassadors, prioritizing goals, sufficient tools and training, and overcoming structural limitations in large organizations were seen as important factors. In the third phase, striving for sustainability, dealing with setbacks, maintaining attention to the ART model, and exchange with other teams and organizations were mentioned as core factors. Conclusions: The findings may support teams in making the shift from traditional care approaches towards recovery-oriented care in long-term mental health care.
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  • 文章类型: Letter
    背景:关于研究人员与患者研究伙伴(PRPs)之间有意义的合作的出版物越来越多,但从PRP的角度来看,使用评估框架的此类工作的出版物较少。我们的目标是提出我们自己的观点和思考有意义的合作作为PRP工作的定性研究。
    方法:我们是由PRP组成的研究小组的成员,临床医生和学术研究人员,由PRP领导。该团队设计并进行了一项定性研究,旨在了解患者如何针对炎症性肠病的生物制剂逐渐减少做出决定。这项研究是在网上进行的。PRP负责人通过卡尔加里大学继续教育提供的为期一年的名为“患者和社区参与研究”的证书课程接受了定性方法培训。在此项目之前,我们接受了面向患者的研究培训和定性研究培训。我们的小组领导根据成员的兴趣和意愿为团队成员分配了任务。一些小组成员是面向患者的研究战略的一部分,炎症,微生物组,和饮食:胃-肠和神经精神效应网络,加拿大卫生研究院面向患者的研究战略计划中的五个慢性疾病网络之一。我们根据经验和反思,利用经验-反思-行动周期作为我们的框架,描述了成功合作的五个关键因素。我们确定的五个关键因素是:包容性,目标和角色清晰,多层次培训和能力建设,共同决策,和支持团队的领导。
    结论:总体而言,我们的经验是积极的。成功的合作带来了更高的信任度,承诺和业绩。需要在不同的环境中进行更多具有不同PRP的研究,以验证和/或识别其他因素,以改善面向患者的研究中的合作。
    BACKGROUND: There are increasing publications on meaningful collaboration between researchers and patient research partners (PRPs), but fewer publications of such work from the PRP perspective using an evaluation framework. Our aim is to present our own perspectives and reflections on meaningful collaboration as PRPs working on a qualitative research study.
    METHODS: We were part of a study team that comprised of PRPs, clinicians and academic researchers, and was led by a PRP. The team designed and conducted a qualitative study aimed at understanding how patients make decisions around tapering of biologics for inflammatory bowel disease. The study was conducted online. The PRP lead was trained in qualitative methodology through a one-year certificate program called Patient and Community Engagement Research offered through the University of Calgary Continuing Education. We had received patient-oriented research training and qualitative research training prior to this project. Team members were assigned tasks by our group lead based on member interests and willingness. Some group members were part of the Strategy for Patient-Oriented Research, Inflammation, Microbiome, and Alimentation: Gastro-Intestinal and Neuropsychiatric Effects Network, one of five chronic disease networks in the Strategy for Patient Oriented Research initiative of the Canadian Institutes of Health Research. We describe the five key ingredients to successful collaboration based on our experiences and reflections utilizing the Experience-Reflection-Action Cycle as our framework. The five key ingredients that we identified were: inclusiveness, goal and role clarity, multi-level training and capacity building, shared decision making, and a supportive team lead.
    CONCLUSIONS: Overall, our experience was positive. With successful collaboration came an increased level of trust, commitment and performance. There is a need for more studies with diverse PRPs in different settings to validate and/or identify additional factors to improve collaboration in patient-oriented research.
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  • 文章类型: Journal Article
    在肿瘤护理路径中,接受化疗的乳腺癌患者遭受许多心理-身体变化,和外观相关的副作用是心理社会损害的主要决定因素之一。由于治疗引起的转变与整体生活质量下降有关,因此需要适当的干预措施。人际关系和性困难,以及对治疗依从性的不利影响。在综合肿瘤学的框架内,美容治疗是一种负担得起的直接干预措施,可用于乳腺癌副作用的临床管理。这项研究旨在了解在与持牌美容师进行简短的美容治疗干预后,接受化疗的女性的情感和生活经历。解释性现象学分析被用作方法论指南。16名妇女被有目的地招募到癌症病房的日间医院,实施美容治疗的地方。在干预结束时,数据是使用开放式问题的半结构化访谈收集的。对逐字转录进行了主题分析。研究结果支持对接受化疗的患者进行美容治疗的建议。假设一个关系观点,美容治疗可以改善患者对自己的感觉和对他人的感觉,即使他们没有声明对他们的外表有特定的兴趣。
    During the oncological care path, breast cancer patients treated with chemotherapy suffer from a number of psycho-physical changes, and appearance-related side effects are among the primary determinants of psychosocial impairment. Appropriate interventions are needed due to the fact that treatment-induced transformations have been associated with a decline in overall quality of life, interpersonal and sexual difficulties, and adverse effects on therapeutic adherence. In the framework of integrative oncology, beauty therapy is an affordable and straightforward intervention that could be used in the clinical management of breast cancer side effects. This study aims to comprehend the emotional and lived experiences of women undergoing chemotherapy after a brief beauty therapy intervention with licensed beauticians. The Interpretative Phenomenological Analysis was used as a methodological guideline. Sixteen women were purposefully recruited in a day hospital of a cancer unit, where the beauty therapy was implemented. At the end of the intervention, data were gathered using a semi-structured interview with open-ended questions. A thematic analysis was performed on verbatim transcriptions. Findings support the proposal of beauty therapy for patients undergoing chemotherapy. Assuming a relational viewpoint, beauty therapy could improve patients\' feelings about themselves and the way they feel about others, even if they do not declare a specific interest in their outward appearance.
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  • 文章类型: Journal Article
    撒哈拉以南非洲的艾滋病毒感染者(MLWH)的健康状况较差,由于污名影响检测和治疗的接受和依从性,与艾滋病相关的死亡人数增加。PRISMA2020用于报告SSA中MLWH的污名经历的元合成。在专家图书馆员的帮助下,对六个数据库进行了搜索,以检查现有的定性和混合方法研究以及与研究问题相关的定性结果。研究集中于感染艾滋病毒的成年男子,有五项研究专门研究了男男性行为者的艾滋病毒感染经历。综合研究主题来描述MLWH的感知,内化,预期,颁布,和交叉的污名体验。大多数研究将男性气概作为影响诊断后测试和治疗依从性的关键主题。未来的研究需要更好地了解亚群,比如与携带艾滋病毒的男人发生性关系的男人,以及哪些干预措施可能有利于减轻SSA中MLWH之间的差异。
    Men living with HIV (MLWH) in sub-Saharan Africa experience poor health outcomes and increased AIDS-related deaths due to stigma influencing testing and treatment uptake and adherence. PRISMA 2020 was used to report a meta-synthesis of the stigma experiences of MLWH in SSA. With the help of an expert librarian, a search of six databases was formulated and performed to examine the available qualitative and mixed method studies with qualitative results relevant to the research question. Studies focused on adult men living with HIV, with five studies specifically examining the HIV experience of men who have sex with men. Study themes were synthesized to describe MLWH\'s perceived, internalized, anticipated, enacted, and intersectional stigma experiences. Most studies included masculinity as a key theme that affected both testing and treatment adherence upon diagnosis. Future research is needed to better understand subpopulations, such as men who have sex with men living with HIV, and what interventions may be beneficial to mitigate the disparities among MLWH in SSA.
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  • 文章类型: Journal Article
    背景:有证据表明,大多数人都意识到健康饮食的重要性,并且对增强或损害健康的食物类型有广泛的了解。然而,更高的健康素养并不总是导致更健康的饮食。Andreasen的社会营销模型和基于社区的社会营销都认为,为了改变健康行为,了解当前行为的原因以及改善行为的感知障碍和益处至关重要。进行了有限的研究,然而,与一般人群探讨这些问题。本研究旨在使用定性方法帮助解决证据中的这一差距。
    方法:进行了三个小组讨论,共有23名参与者:(1)18-24岁无子女的年轻女性;(2)35-45岁有小学儿童的女性;(3)35-50岁的男性与伴侣一起生活,并有学龄前或小学年龄的儿童。讨论在维多利亚州的一个区域中心进行,澳大利亚。使用归纳描述性方法并参考最近的食物选择综合框架对转录进行了主题分析,该框架确定了五个关键的相互关联的决定因素:食物内部因素;食物外部因素;个人状态因素;认知因素;和社会文化因素。
    结果:我们发现食物选择很复杂,从讨论中可以看出所有五个决定因素。然而,“食物-外部因素”的“社会环境”子类别,其中包括家庭,工作,和社会结构,以及家庭成员的期望(或感知的期望),同事们,朋友,和其他人,尤其突出。知道一个人应该练习健康饮食,属于“认知因素”类别,虽然被大多数参与者视为一种愿望,通常被认为是不现实的,被对便利的需要和/或渴望所压倒,食物-外部因素的组合:社会环境和个人状态因素:心理因素。
    结论:我们发现关于什么的决定,when,以及吃多少被视为受个人无法控制的因素影响很大。看来,因此,改善人们饮食行为的关键是让人们吃得更健康,或者至少不比吃得不好难。
    BACKGROUND: There is evidence that most people are aware of the importance of healthy eating and have a broad understanding regarding types of food that enhance or detract from health. However, greater health literacy does not always result in healthier eating. Andreasen\'s Social Marketing Model and Community-Based Social Marketing both posit that, in order to change health behaviours, it is crucial to understand reasons for current behaviours and perceived barriers and benefits to improved behaviours. Limited research has been conducted, however, that explores these issues with general populations. This study aimed to help address this gap in the evidence using a qualitative methodology.
    METHODS: Three group discussions were conducted with a total of 23 participants: (1) young women aged 18-24 with no children; (2) women aged 35-45 with primary school aged children; and (3) men aged 35-50 living with a partner and with pre- or primary school aged children. The discussions took place in a regional centre of Victoria, Australia. Transcriptions were thematically analysed using an inductive descriptive approach and with reference to a recent integrated framework of food choice that identified five key interrelated determinants: food- internal factors; food- external factors; personal-state factors; cognitive factors; and sociocultural factors.
    RESULTS: We found that food choice was complex, with all five determinants evident from the discussions. However, the \"Social environment\" sub-category of \"Food-external factors\", which included family, work, and social structures, and expectations (or perceived expectations) of family members, colleagues, friends, and others, was particularly prominent. Knowledge that one should practice healthy eating, which falls under the \"Cognitive factor\" category, while seen as an aspiration by most participants, was often viewed as unrealistic, trumped by the need and/or desire for convenience, a combination of Food-external factor: Social environment and Personal-state factor: Psychological components.
    CONCLUSIONS: We found that decisions regarding what, when, and how much to eat are seen as heavily influenced by factors outside the control of the individual. It appears, therefore, that a key to improving people\'s eating behaviours is to make it easy to eat more healthfully, or at least not much harder than eating poorly.
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  • 文章类型: Journal Article
    目的:重症监护医学正面临职业倦怠和随之而来的减员的流行。需要采取干预措施,将医疗领域重新确立为专业成长的地方,弹性,和个人福祉。人文促进创造,反射,和意义的创造,持有个人和社区转型的承诺。这项研究旨在探索临床医生如何参与人文项目,以及人文学科在他们个人和集体的旅程中扮演什么角色和影响。
    方法:这是一项采用现象学方法的定性研究。参与者是参加该计划的教师和学员。数据包括(a)对人文之夜的60小时观察,(b)参加者带来的200多件人文文物,和(c)15次深入参与者访谈。一组研究人员对数据进行了归纳和反思分析。
    结果:由于过去的艺术经验,参与者被激励参与人文课程,确定重新探索他们的创造力的愿望,从他们的临床经验中产生意义,并希望通过不同的镜头与同事交往并了解他们。晚上促进了自我表达,并启发和授权参与者创作艺术作品,并在日常生活中重新参与艺术。更重要的是,他们找到了一个社区,在那里他们可能容易受到攻击和支持,在那里讨论了分享的经验,情绪得到了验证,同事之间的关系也加深了。
    结论:人文学科可能通过促进具有挑战性的临床工作的反思和意义以及在同事之间建立联系来影响韧性以及个人和社区福祉。
    OBJECTIVE: Critical care medicine is facing an epidemic of burnout and consequent attrition. Interventions are needed to re-establish the medical field as a place of professional growth, resilience, and personal well-being. Humanities facilitate creation, reflection, and meaning-making, holding the promise of personal and community transformation. This study aimed to explore how clinicians engage with a humanities program, and what role and impact do the humanities play in their individual and collective journey.
    METHODS: This is a qualitative study employing a phenomenological approach. Participants were faculty and trainees who participated in the program. Data consisted of (a) 60-h observations of humanities evenings, (b) more than 200 humanities artifacts brought by participants, and (c) 15 in-depth participant interviews. Data were analyzed inductively and reflectively by a team of researchers.
    RESULTS: Participants were motivated to engage with the humanities curriculum because of past experiences with art, identifying a desire to re-explore their creativity to make meaning from their clinical experiences and a wish to socialize with and understand their colleagues through a different lens. The evenings facilitated self-expression, and inspired and empowered participants to create art pieces and re-engage with art in their daily lives. More importantly, they found a community where they could be vulnerable and supported, where shared experiences were discussed, emotions were validated, and relationships were deepened between colleagues.
    CONCLUSIONS: Humanities may impact resilience and personal and community well-being by facilitating reflection and meaning-making of challenging clinical work and building bonds between colleagues.
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