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Carnesten H, von Heideken Wågert P, Gustin LW, Toivanen S, Skoglund K, Jaarsma T, Andreae C. Struggling in the dehumanized world of COVID-An exploratory mixed-methods study of frontline healthcare workers' experiences. J Adv Nurs 2024. [PMID: 38305070 DOI: 10.1111/jan.16083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 12/19/2023] [Accepted: 01/15/2024] [Indexed: 02/03/2024]
Abstract
AIM To explore healthcare workers' experiences of the changed caring reality during the COVID-19 pandemic in Sweden. DESIGN An online fully mixed-methods design. METHODS A web-based self-reported questionnaire with fixed and open-ended answers collected data from March to April 2021, analysed in three steps. First, free-text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta-inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting. RESULTS Meta-inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post-traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy. CONCLUSIONS Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID-19 pandemic and to prevent mental health illness in future crisis. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. SUMMARY The pandemic outbreak exposed frontline healthcare workers to unparallelled stress shown as negative for their mental health in several meta-analyses and systematic reviews. In-depth understanding on experiences and how symptoms of post-traumatic stress disorder relate to coping mechanisms have been scarcely explored. This study contributes to understanding on healthcare workers' experiences and the relation between lower sense of coherence and increased risk of developing symptoms of post-traumatic stress disorder. IMPLICATIONS FOR PRACTICE/POLICY This study might guide how to prepare for resilience in future emergencies.
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Affiliation(s)
- Hillewi Carnesten
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
| | | | - Lena Wiklund Gustin
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
- Department of Health and Care Sciences, UiT/The Arctic University of Norway, Narvik, Norway
| | - Susanna Toivanen
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
| | - Karin Skoglund
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Julius Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Christina Andreae
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
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Jantsch LB, Neves ET. “Tabela falante” como estratégia de integração de dados em uma pesquisa de métodos mistos. ESCOLA ANNA NERY 2023. [DOI: 10.1590/2177-9465-ean-2022-0029pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
RESUMO Objetivo relatar a utilização da tabela falante como estratégia de integração e análise de dados em estudo de abordagem mista. Método trata-se de um relato de utilização de uma estratégia metodológica de integração e análise dos dados em pesquisa de método misto. São apresentados dados de um estudo longitudinal analítico, que acompanhou 151 lactentes prematuros no primeiro ano de vida. O estudo abordou aspectos das condições de saúde dessa população e integrou dados quantitativos, coletados por meio de instrumento de avaliação de condições de saúde e dados qualitativos oriundos de entrevista semiestruturada. Resultados a integração dos dados em estudos mistos é uma exigência metodológica que requer dos pesquisadores a utilização de estratégias que possibilitem e facilitem esse processo analítico. A tabela falante, por meio da integração visual dos dados quantitativos expressos em tabelas e suas convergências e divergências analíticas com os enunciados qualitativos, favorece a leitura e interpretação integrada. Conclusão e implicações para a prática considera-se a tabela falante uma ferramenta analítica de integração de dados quantitativos e qualitativos que contribui na formulação de metainferências em pesquisas com métodos mistos.
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Jantsch LB, Neves ET. “Talking table” as a data integration strategy in mixed methods research. ESCOLA ANNA NERY 2023. [DOI: 10.1590/2177-9465-ean-2022-0029en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
ABSTRACT Objective to report the use of a talking table as a data analysis and integration strategy in a mixed approach study. Method this is a report on the use of a methodological strategy for data integration and analysis in mixed methods research. Data from an analytical longitudinal study that followed 151 preterm infants in the first year of life are presented. The study addressed aspects of the health conditions of this population and integrated quantitative data, collected through an instrument to assess health conditions and qualitative data from a semi-structured interview. Results data integration in mixed studies is a methodological requirement that requires researchers to use strategies that enable and facilitate this analytical process. A talking table, through the visual integration of quantitative data expressed in tables and their analytical convergences and divergences with qualitative statements, favors integrated reading and interpretation. Conclusion and implications for practice: a talking table is considered an analytical tool for quantitative and qualitative data integration, which contribute to developing meta-inferences in mixed methods research.
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Younas A, Durante A. Decision tree for identifying pertinent integration procedures and joint displays in mixed methods research. J Adv Nurs 2022. [DOI: 10.1111/jan.15536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/28/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Ahtisham Younas
- Memorial University of Newfoundland St. Johns Newfoundland Canada
| | - Angela Durante
- Department of Nursing University of La Rioja La Rioja Spain
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The Second Side of the Coin-Resilience, Meaningfulness and Joyful Moments in Home Health Care Workers during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073836. [PMID: 35409520 PMCID: PMC8997992 DOI: 10.3390/ijerph19073836] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 12/22/2022]
Abstract
Nursing literature predominantly focuses on job demands but is scarce for resources related to nurses' work. In the face of the COVID-19 pandemic, resources that can buffer the health-impairing effects of increased demands gain importance. The aim of this study is to explore resilience, meaning of work and joyful moments in home health care workers in South Germany during the pandemic. Resilience and meaning of work were measured quantitatively; moments of joy were investigated qualitatively by audio diaries and analyzed with qualitative content analysis. In all, 115 home health care workers (mean age = 47.83 ± 11.72; 81.75% female) filled in the questionnaires and 237 diary entries were made by 23 persons (mean age = 46.70 ± 10.40; 91.30% female). The mean scores of resilience (5.52 ± 1.04; 1-7) and meaning of work (4.10 ± 0.92; 1-5) showed high levels, with significantly higher values in females. Home care workers experienced joyful moments 334 times in 60 different types in the categories of social relationships, work content, work organization, work environment and self-care. A deeper understanding of resilience, meaning of work and joyful moments provides a basis for the development of worksite health promotion programs that address both demands and resources in home health care workers.
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Tripartite Analysis: A Data Analysis Technique for Convergent Mixed Methods Designs. Nurs Res 2022; 71:313-321. [PMID: 35149628 DOI: 10.1097/nnr.0000000000000584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Effective data integration is a daunting task in mixed methods research. Several frameworks for data integration exist, but the choice of and the technique for integration depends upon the research question and design. Innovative integration techniques continuously need to be developed to tackle the integration challenge and provide alternative ways for researchers to generate plausible mixed inferences. OBJECTIVES To describe a new data analysis technique, tripartite analysis (TriPA), and illustrate its use in a convergent mixed methods study. METHODS This technique was developed based on a convergent mixed methods study underpinned by dialectical pluralism aimed to understand Pakistani nursing students' perspectives about compassion and compassionate care and how these perspectives are consistent with the conceptualizations of compassion in nursing literature. RESULTS TriPA entails analysis and integration using joint displays at three levels: case-by-case integrated analysis, separate and then merged quantitative and qualitative analysis, and comparative and integrated analysis of Levels I and II findings. DISCUSSION TriPA can enable researchers to develop a more nuanced understanding of a given phenomenon through integration at various levels by identifying linkages within cases and across the whole data set and recognizing relational connections and emerging patterns.
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Cyr MP, Dostie R, Camden C, Dumoulin C, Bessette P, Pina A, Gotlieb WH, Lapointe-Milot K, Mayrand MH, Morin M. Improvements following multimodal pelvic floor physical therapy in gynecological cancer survivors suffering from pain during sexual intercourse: Results from a one-year follow-up mixed-method study. PLoS One 2022; 17:e0262844. [PMID: 35077479 PMCID: PMC8789131 DOI: 10.1371/journal.pone.0262844] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/06/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND A large proportion of gynecological cancer survivors suffer from pain during sexual intercourse, also known as dyspareunia. Following a multimodal pelvic floor physical therapy (PFPT) treatment, a reduction in pain and improvement in psychosexual outcomes were found in the short term, but no study thus far has examined whether these changes are sustained over time. PURPOSE To examine the improvements in pain, sexual functioning, sexual distress, body image concerns, pain anxiety, pain catastrophizing, painful intercourse self-efficacy, depressive symptoms and pelvic floor disorder symptoms in gynecological cancer survivors with dyspareunia after PFPT, and to explore women's perceptions of treatment effects at one-year follow-up. METHODS This mixed-method study included 31 gynecological cancer survivors affected by dyspareunia. The women completed a 12-week PFPT treatment comprising education, manual therapy and pelvic floor muscle exercises. Quantitative data were collected using validated questionnaires at baseline, post-treatment and one-year follow-up. As for qualitative data, semi-structured interviews were conducted at one-year follow-up to better understand women's perception and experience of treatment effects. RESULTS Significant improvements were found from baseline to one-year follow-up on all quantitative outcomes (P ≤ 0.028). Moreover, no changes were found from post-treatment to one-year follow-up, supporting that the improvements were sustained at follow-up. Qualitative data highlighted that reduction in pain, improvement in sexual functioning and reduction in urinary symptoms were the most meaningful effects perceived by participants. Women expressed that these effects resulted from positive biological, psychological and social changes attributable to multimodal PFPT. Adherence was also perceived to influence treatment outcomes. CONCLUSIONS Findings suggest that the short-term improvements following multimodal PFPT are sustained and meaningful for gynecological cancer survivors with dyspareunia one year after treatment.
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Affiliation(s)
- Marie-Pierre Cyr
- Faculty of Medicine and Health Sciences, School of Rehabilitation, University of Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Rosalie Dostie
- Faculty of Medicine and Health Sciences, School of Rehabilitation, University of Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Chantal Camden
- Faculty of Medicine and Health Sciences, School of Rehabilitation, University of Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Chantale Dumoulin
- Faculty of Medicine, School of Rehabilitation, University of Montreal, Montreal, Quebec, Canada
- Research Center of the Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
| | - Paul Bessette
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Faculty of Medicine and Health Sciences, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Annick Pina
- Faculty of Medicine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada
- Research Center of the Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - Walter Henry Gotlieb
- Faculty of Medicine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | - Korine Lapointe-Milot
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Faculty of Medicine and Health Sciences, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Marie-Hélène Mayrand
- Research Center of the Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, Departments of Obstetrics and Gynecology and Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Mélanie Morin
- Faculty of Medicine and Health Sciences, School of Rehabilitation, University of Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
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Palese A, Mansutti I, Visintini E, Caruzzo D, Moreale R, Longhini J, Danielis M. Framing the time while designing and conducting reviews: A Focused Mapping Review and Synthesis. J Clin Nurs 2021; 31:3523-3534. [PMID: 34936157 DOI: 10.1111/jocn.16180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/09/2021] [Accepted: 12/08/2021] [Indexed: 01/08/2023]
Abstract
AIMS AND OBJECTIVES To identify the profile of time restrictions and their justifications as reported on a set of published reviews. BACKGROUND There is a body of methodological knowledge addressing how to design and perform reviews in their different designs. However, how the time restrictions should be set and the justifications that should be provided have received limited attention to date. DESIGN A Focused Mapping Review and Synthesis following three steps (Focus, Mapping and Synthesis) was performed on 2021. The ENTREQ checklist was followed to report methods and findings. METHODS All Journal of Clinical Nursing reviews published in online or printed version on 2020 (n = 85). Time limits imposed in the literature search, and justifications provided were mapped and synthetised with quantitative and a qualitative analysis. RESULTS Time restrictions in reviews are not always reported and, when available, reflect three different profiles: (a) including all studies, to provide a comprehensive review; (b) selecting a period, to provide reviews for a contemporary practice; and (b) including only recent studies for reviews reflecting current practice. Reasons justifying time restrictions are not always reported; when documented, justifications regard changes in the practice, in the research or in the theory occurred over time, recent or ongoing. CONCLUSIONS In exploring the date restrictions applied in reviews published over the course of a year, it emerged that the time of access to the sources and the justifications are not always indicated. The attributes of the emerging concepts of "comprehensive reviews," "contemporary practice reviews" and "current practice reviews" might be further developed to support researchers in selecting an appropriate time frame. RELEVANCE TO CLINICAL PRACTICE Reviews require improvements regarding the time restrictions and their justifications. Methodological efforts to standardise the approach ensuring transparency in review protocols and in the following review publication are recommended.
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Affiliation(s)
- Alvisa Palese
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Irene Mansutti
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Erica Visintini
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Davide Caruzzo
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Renzo Moreale
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Jessica Longhini
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Matteo Danielis
- Department of Medicine (DAME), University of Udine, Udine, Italy
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Abstract
In this article, I explore the turn to mixed methods in nursing. I examine the alignment of key characteristics (philosophical underpinnings and the concept of integration) of mixed methods with nursing's disciplinary perspective and its links with theory. I also provide a brief overview of the history and current status of mixed methods and conclude by looking to the future to suggest an additional twist in the turn to mixed methods for nursing science.
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Affiliation(s)
- Pamela G Reed
- College of Nursing, The University of Arizona, Tucson, AZ, USA
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Oliveira JLCD, Magalhães AMMD, Matsuda LM, Santos JLGD, Souto RQ, Riboldi CDO, Ross R. MIXED METHODS APPRAISAL TOOL: STRENGTHENING THE METHODOLOGICAL RIGOR OF MIXED METHODS RESEARCH STUDIES IN NURSING. TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2020-0603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to describe the use of the Mixed Methods Appraisal Tool to appraise and to strengthen the methodological rigor of mixed methods studies in nursing. Method: a theoretical essay was used to describe the application of Mixed Methods Appraisal Tool to support the development and assessment of mixed methods research in nursing. Four mixed methods articles in nursing were purposely chosen and evaluated based on the Mixed Methods Appraisal Tool criteria. Results: Mixed Methods Appraisal Tool is a tool for evaluating primary mixed methods studies based on five evaluation criteria: 1) justification for adopting mixed methods methodology; 2) integration between the quantitative and qualitative components; 3) interpretation of integrated findings of quantitative and qualitative data; 4) presentation of divergences between quantitative and qualitative results; and 5) compliance with the methodological rigor of each individual approach in mixed methods research. Conclusion: Mixed Methods Appraisal Tool is an instrumental resource that can be used to appraise mixed methods research and strengthen the methodological rigor in planning and conducting future mixed studies in nursing research.
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