Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research.

Department of Epidemiology and Public Health, University of Leicester.
BMJ Clinical Research (Impact Factor: 14.09). 08/1995; 311(6996):42-5. DOI: 10.1136/bmj.311.6996.42
Source: PubMed

ABSTRACT Qualitative research methods have a long history in the social sciences and deserve to be an essential component in health and health services research. Qualitative and quantitative approaches to research tend to be portrayed as antithetical; the aim of this series of papers is to show the value of a range of qualitative techniques and how they can complement quantitative research.

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    ABSTRACT: This research examined residents’ and relatives’ perspectives on what is important in rehabilitation and long-term care centres for people with neurological conditions. The research participants were residents at three UK neurological centres and relatives with loved ones at these centres. In total 14 residents and 19 relatives participated in the research. Data was collected via focus groups and interviews. The residents who participated in the research all had the mental capacity to consent to the research on their own behalf; the relatives who participated mainly had loved ones with more profound mental and physical impairments.
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    ABSTRACT: Abstract Background. Research has highlighted empathy as an important and effective factor in patient– physician communication. GPs have extensive practical experience with empathy. However, little is known about the personal views of GPs regarding the meaning and application of empathy in daily practice. Objectives. To explore GP’s experiences and the application of empathy in daily practice and to investigate the practical use of empathy. Facts such as preconditions, barriers and facilitating possibilities are described. Methods. Qualitative interview study; 30 in-depth interviews were performed between June 2012 and January 2013 with a heterogeneous sample of Dutch GPs. Interviews were recorded and transcribed verbatim; content analysis was performed with the help of ATLAS-ti. Results. Empathy was seen as an important quality-increasing element during the patient–GP consultation. The application of non-verbal and verbal techniques was described. Attention to cues and references to previous consults were reported separately. Required preconditions were: being physically and mentally fit, feeling no time pressure and having an efficient practice organization. Not feeling connected to the patient and strict medical guidelines and protocols were identified as obstacles. A key consideration was the positive contribution of empathy to job satisfaction. Conclusions. The opinions of GPs in this research can be considered as supplementing and strengthening the findings of previous researches. The GPs in this study discussed, in particular, ideas important to the facilitation of empathy. These included: longer consultations, smaller practices, efficient telephonic triage by practice assistants, using intervision to help reflect on their work and drawing financiers’ attention to the effectiveness of empathy.
    Family Practice 11/2014; 2014. · 1.84 Impact Factor
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    ABSTRACT: Background Nutrition screening in older adults is not routinely performed in Australian primary care settings. Low awareness of the extent of malnutrition in this patient group, lack of training and time constraints are major barriers that practice staff face. This study aimed to demonstrate the feasibility of including a validated nutrition screening tool and accompanying nutrition resource kit for use with older patients attending general practice. Secondary aims were to assess nutrition-related knowledge of staff and to identify the extent of malnutrition in this patient group.Methods Nine general practitioners, two general practice registrars and 11 practice nurses from three participating general practices in a rural, regional and metropolitan area within a local health district of New South Wales, Australia were recruited by convenience sampling.Individual in-depth interviews, open-ended questionnaires and an 11-item knowledge questionnaire were completed three months following in-practice group workshops on the Mini Nutritional Assessment Short Form (MNA-SF). Staff were encouraged to complete the MNA-SF within the Medicare-funded 75+ Health Assessment within this time period. Staff interviews were digitally recorded, transcribed verbatim and analysed thematically using qualitative analysis software QSR NVivo 10.ResultsFour key themes were determined regarding the feasibility of performing MNA ¿SF: ease of use; incorporation into existing practice; benefit to patients¿ health; and patients¿ perception of MNA-SF. Two key themes related to the nutrition resource kit: applicability and improvement. These findings were supported by open ended questionnaire responses. Knowledge scores of staff significantly improved from baseline (52% to 66%; P <¿0.05). Of the 143 patients that had been screened, 4.2% (n =¿6) were classified as malnourished, 26.6% (n =¿38) `at risk¿ of malnutrition and 69.2% (n =¿99) as well-nourished.Conclusion It is feasible to include the MNA-SF and a nutrition resource kit within routine general practice, but further refinement of patients¿ electronic clinical records in general practice software would streamline this process.
    BMC Family Practice 11/2014; 15(1):186. · 1.74 Impact Factor

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