Breaking from binaries – using a sequential mixed methods design

Larkin, Patricia; Begley, Cecily; Devane, Declan

doi:10.7748/nr2014.03.21.4.8.e1219

Cited by 17 publications

(8 citation statements)

References 16 publications

(15 reference statements)

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“… 73 However, quantitative assessment, such as through household surveys, also reported in this review, may be needed to understand the scale and impact of identified barriers. 138 Mixed-method studies with an exploratory sequential design 177 (qualitative exploration to inform the development of quantitative assessment) may be suitable. Other methods such as using verbal autopsy data have been proposed, 6 178 although they miss non-fatal injuries.…”

Section: Discussionmentioning

confidence: 99%

Assessing trauma care systems in low-income and middle-income countries: a systematic review and evidence synthesis mapping the Three Delays framework to injury health system assessments

et al. 2021

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BackgroundThe large burden of injuries falls disproportionately on low/middle-income countries (LMICs). Health system interventions improve outcomes in high-income countries. Assessing LMIC trauma systems supports their improvement. Evaluating systems using a Three Delays framework, considering barriers to seeking (Delay 1), reaching (Delay 2) and receiving care (Delay 3), has aided maternal health gains. Rapid assessments allow timely appraisal within resource and logistically constrained settings. We systematically reviewed existing literature on the assessment of LMIC trauma systems, applying the Three Delays framework and rapid assessment principles.MethodsWe conducted a systematic review and narrative synthesis of articles assessing LMIC trauma systems. We searched seven databases and grey literature for studies and reports published until October 2018. Inclusion criteria were an injury care focus and assessment of at least one defined system aspect. We mapped each study to the Three Delays framework and judged its suitability for rapid assessment.ResultsOf 14 677 articles identified, 111 studies and 8 documents were included. Sub-Saharan Africa was the most commonly included region (44.1%). Delay 3, either alone or in combination, was most commonly assessed (79.3%) followed by Delay 2 (46.8%) and Delay 1 (10.8%). Facility assessment was the most common method of assessment (36.0%). Only 2.7% of studies assessed all Three Delays. We judged 62.6% of study methodologies potentially suitable for rapid assessment.ConclusionsWhole health system injury research is needed as facility capacity assessments dominate. Future studies should consider novel or combined methods to study Delays 1 and 2, alongside care processes and outcomes.

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Section: Discussionmentioning

confidence: 99%

Assessing trauma care systems in low-income and middle-income countries: a systematic review and evidence synthesis mapping the Three Delays framework to injury health system assessments

et al. 2021

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“…For example, it was evident that women wanted a blend of attributes personalised to their own individualised requirements that were contingent on the environment and the support they received. This is understandable, given the stressed maternity hospital environment in Ireland, where staff have little time to support women in labour [11]. Interventions were taken as part and parcel of the childbirth process, not disapproved of, and often welcomed.…”

Section: Discussionmentioning

confidence: 99%

“…An initial qualitative phase consisting of 10 focus group interviews (FGIs) was followed by a Discrete Choice Experiment (DCE) to establish women’s preferences for their childbirth experiences. A more detailed account of the mixed methods design process has been published elsewhere [11]. This paper focuses on the second quantitative phase of the research design, the DCE.…”

Section: Design and Methodsmentioning

confidence: 99%

Women’s preferences for childbirth experiences in the Republic of Ireland; a mixed methods study

Larkin

Begley

Devane

2017

BMC Pregnancy Childbirth

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BackgroundHow women experience childbirth is acknowledged as critical to the postnatal wellbeing of mother and baby. However there is a knowledge deficit in identifying the important elements of these experiences in order to enhance care. This study elicits women’s preferences for the most important elements of their childbirth experiences.MethodsA mixed methods design was used. An initial qualitative phase (reported previously) was followed by a second quantitative one using a discrete choice experiment (DCE), which is reported on here. Participants who had experienced labour, were over 18 and had a healthy baby were recruited from four randomly selected and one pilot hospital in the Republic of Ireland. Data were collected by means of a DCE survey instrument. Questions were piloted, refined, and then arranged in eight pair-wise scenarios. Women identified their preferences by choosing one scenario over another. Nine hundred and five women were sent the DCE three months after childbirth, with a response rate of 59.3% (N =531).ResultsWomen clearly identified priorities for their childbirth experiences as: the availability of pain relief, partnership with the midwife, and individualised care being the most important attributes. In the context of other choices, women rated decision-making, presence of a consultant, and interventions as less important elements. Comments from open questions provided contextual information about their choices.ConclusionsMost women did not want to be typified as wanting the dichotomy of ‘all natural’ or ‘all technology’ births but wanted ‘the best of both worlds’. The results suggest that availability of pain relief was the most important element of women’s childbirth experiences, and superseded all other elements including partnership with the midwife which was the second most important attribute. The preferences identified might reflect the busy medicalised hospital environments, in which the vast majority of women had given birth, and may differ in settings such as midwifery led care or home births.

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“…A sequential explanatory mixed-methods design was used for this study. The study was conducted in two phases (quantitative and qualitative), also referred to as strands (Larkin, Bekley, & Devane, 2014). In the quantitative strand, data were collected with a two-sample (intervention vs. control) randomized pilot design.…”

Section: Methodsmentioning

confidence: 99%

Pilot Testing of the NURSE Stress Management Intervention

Delaney¹,

Barrere

Robertson

et al. 2016

J Holist Nurs

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Student nurses experience significant stress during their education, which may contribute to illness and alterations in health, poor academic performance, and program attrition. The aim of this pilot study was to evaluate the feasibility and potential efficacy of an innovative stress management program in two baccalaureate nursing programs in Connecticut, named NURSE (Nurture nurse, Use resources, foster Resilience, Stress and Environment management), that assists nursing students to develop stress management plans. An explanatory sequential mixed-methods design was used to evaluate the effects of the intervention with 40 junior nursing students. Results from this study provide evidence that the NURSE intervention is highly feasible, and support further testing to examine the effect of the intervention in improving stress management in nursing students.

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Breaking from binaries – using a sequential mixed methods design

Cited by 17 publications

References 16 publications

Assessing trauma care systems in low-income and middle-income countries: a systematic review and evidence synthesis mapping the Three Delays framework to injury health system assessments

Assessing trauma care systems in low-income and middle-income countries: a systematic review and evidence synthesis mapping the Three Delays framework to injury health system assessments

Women’s preferences for childbirth experiences in the Republic of Ireland; a mixed methods study

Pilot Testing of the NURSE Stress Management Intervention

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