Rebuttal—Conceptualizing Integration During Both the Data Collection and Data Interpretation Phases: A Response to David Morgan

Fetters, Michael D.; Molina‐Azorín, José F.

doi:10.1177/1558689818780596a

Cited by 21 publications

(19 citation statements)

References 14 publications

(18 reference statements)

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“…Merging was conducting by CN and co-authors RB, JA and BR. When comparing the quantitative and qualitative results, we examined four possible outcomes [52]: 1) Confirmation , when the quantitative and qualitative findings lead to the same interpretation 2) Complementarity , when the two sets of data show different, non-conflicting conclusions 3) Expansion , when the datasets provide a central overlapping theme and a broader non-overlapping interpretation 4) Discordance , when the two datasets lead to conflicting interpretations. The outcomes are presented in a cross-tabulation format [53] to illustrate how the findings compare.…”

Section: Methodsmentioning

confidence: 99%

How do community-based eye care practitioners approach depression in patients with low vision? A mixed methods study

et al. 2019

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BackgroundClinically significant depressive symptoms are prevalent in people attending low vision clinics and often go undetected. The Low Vision Service Wales (LVSW) plans to introduce depression screening and management pathways. Prior to implementation there is an unmet need to understand how eye care practitioners providing the service currently address depression with patients, and the characteristics and beliefs that influence their practice.MethodsA mixed methods convergent design was employed. Twelve low vision practitioners were purposively selected to engage in individual semi-structured interviews which were analysed using thematic analysis. A further 167 practitioners were invited to complete a questionnaire assessing professional background, current practice, confidence and perceived barriers in working with people with low vision and suspected depression. Multiple regression analyses were performed to determine the characteristics related to the Rasch-transformed questionnaire scores.ResultsOf the 122 practitioners that responded to the questionnaire, 33% aimed to identify depression in patients, and those who were more confident were more likely to do so. Those who scored higher on the perceived barriers scale and lower on confidence were less likely to report acting in response to suspected depression (all p < 0.05). Three qualitative themes were identified; depression is an understandable response to low vision, patients themselves are a barrier to addressing depression and practitioners lacked confidence in their knowledge and skills to address depression. The qualitative data largely expanded the quantitative findings.ConclusionsPractitioners viewed their own lack of knowledge and confidence as a barrier to the identification and management of depression and expressed a need for training prior to the implementation of service changes. The study findings will help to inform the development of a training programme to support low vision practitioners and those working with other chronic illness in Wales, and internationally, in the identification and management of people with depression.

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Section: Methodsmentioning

confidence: 99%

How do community-based eye care practitioners approach depression in patients with low vision? A mixed methods study

et al. 2019

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“…Integration occurred both at the methods level, through basing interview questions on the questionnaire sections, and at the results level, through merging [ 36 , 49 ] questionnaire and interview findings. When merging the two sets of results, four possible outcomes were considered [ 50 ]: 1) Confirmation , when the quantitative and qualitative findings lead to the same interpretation 2) Complementarity , when the two sets of data show different, non-conflicting conclusions 3) Expansion, when the datasets provide a central overlapping theme and a broader non-overlapping interpretation 4) Discordance , when the two datasets lead to conflicting interpretations.…”

Section: Methodsmentioning

confidence: 99%

Barriers to integrating routine depression screening into community low vision rehabilitation services: a mixed methods study

et al. 2020

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Background: Undetected depression is common in people with low vision and depression screening has been recommended. However, depression screening is a complex procedure for which low vision practitioners need training. This study examined the integration of routine depression screening, using two questions, and referral pathways into a national low vision service in Wales at 6 months following practitioner training, and identified key barriers to implementation. Methods: This pre-post single group study employed a convergent mixed methods design to collect quantitative questionnaire and qualitative interview data on low vision practitioners' clinical practice and perceived barriers to implementing depression screening. Forty practitioners completed questionnaires pre-, immediately post-and 6 months post-training and nine engaged in interviews 6 months post-training. Ordinal questionnaire scores were Rasch-transformed into interval-level data before linear regression analyses were performed to determine the change in scores over time and the association between perceived barriers and clinical practice. Thematic Analysis was applied to the interviews and the narrative results merged with the questionnaire findings. Results: Before training, only one third of practitioners (n = 15) identified depression in low vision patients, increasing to over 90% (n = 37) at 6 months post-training, with a corresponding increase in those using validated depression screening questions from 10% (n = 4) to 80% (n = 32). Six months post-training, practitioners reported taking significantly more action in response to suspected depression (difference in means = 2.77, 95% CI 1.93 to 3.61, p < 0.001) and perceived less barriers to addressing depression (difference in means = − 0.95, 95% CI − 1.32 to − 0.59, p < 0.001). However, the screening questions were not used consistently. Some barriers to implementation remained, including perceived patient reluctance to discuss depression, time constraints and lack of confidence in addressing depression. Conclusions: The introduction of depression screening service guidelines and training successfully increased the number of low vision practitioners identifying and addressing depression. However, standardized screening of all low vision attendees has not yet been achieved and several barriers remain. Healthcare services need to address these barriers when considering mental health screening, and further research could focus on the process from the patients' perspective, to determine the desire for and acceptability of screening.

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“…The qualitative and quantitative data were further used to refine and validate the moderating effect of financial literacy—the community-driven solution generated in the FGDs. This continual methodological process of connecting, building, generating, and testing a model (Fetters & Molina-Azorin, 2017, 2019) with community input demonstrates the cyclical nature of a transformative MMR approach (Mertens, 2010). Furthermore, this process integrated community knowledge and researcher expertise in a mutually reinforcing colearning opportunity (Hacker, 2013) that helped cocreate a community solution based on community voices and priorities.…”

Section: Methodsmentioning

confidence: 99%

Expanding the Transformative Explanatory Sequential Mixed Methods Design Archetype in a Cross-Cultural Context: The Polemics of African Refugee Livelihoods in Places of Resettlement

Maleku

Kim

Kagotho

et al. 2020

Journal of Mixed Methods Research

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Transformative sequential mixed methods design in a cross-cultural context is seldom straightforward. Using a community-based participatory research approach as the transformative lens in an African refugee context in the southern United Status, we explored: (a) the intersection of culture, financial stress, and financial self-efficacy and (b) tested the efficacy of financial literacy as the focus of a culturally responsive solution grounded in community-identified priorities. Through a three-phased explanatory sequential mixed methods design, we demonstrate how the addition of a third phase of analysis that focuses on convergence and expansion of quantitative and qualitative data integration and cyclical processes of dissemination and action can strengthen the utility of transformative mixed methods research in a cross-cultural context. Our study offers a unique contribution to the long-standing methodological dialogue between the design elements of mixed methods research, community-based participatory research, and migration studies by expanding the transformative explanatory sequential design archetype in a cross-cultural context.

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Rebuttal—Conceptualizing Integration During Both the Data Collection and Data Interpretation Phases: A Response to David Morgan

Cited by 21 publications

References 14 publications

How do community-based eye care practitioners approach depression in patients with low vision? A mixed methods study

How do community-based eye care practitioners approach depression in patients with low vision? A mixed methods study

Barriers to integrating routine depression screening into community low vision rehabilitation services: a mixed methods study

Expanding the Transformative Explanatory Sequential Mixed Methods Design Archetype in a Cross-Cultural Context: The Polemics of African Refugee Livelihoods in Places of Resettlement

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