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Viergever RF. The Critical Incident Technique: Method or Methodology? QUALITATIVE HEALTH RESEARCH 2019; 29:1065-1079. [PMID: 30600767 DOI: 10.1177/1049732318813112] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The critical incident technique (CIT) is a qualitative research tool that is frequently used in health services research to explore what helps or hinders in providing good quality care or achieving satisfaction with care provision. However, confusion currently exists on the nature of the CIT: Is it a method for data collection and analysis or a methodology? In this article, I explain why this distinction is important and I argue that the CIT is a methodology (and not a method) for the following reasons: Key methodological dimensions are described for the CIT; it has a clear focus; studies that apply this technique make use of various methods for data collection and analysis; it describes, explains, evaluates, and justifies the use of a specific format for those methods; it implies philosophical and practical assumptions; and studies that use the CIT cannot easily make use of additional methodologies simultaneously.
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Segal AG, Frasso R, Sisti DA. County Jail or Psychiatric Hospital? Ethical Challenges in Correctional Mental Health Care. QUALITATIVE HEALTH RESEARCH 2018; 28:963-976. [PMID: 29562833 DOI: 10.1177/1049732318762370] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Approximately 20% of the roughly 2.5 million individuals incarcerated in the United States have a serious mental illness (SMI). As a result of their illnesses, these individuals are often more likely to commit a crime, end up incarcerated, and languish in correctional settings without appropriate treatment. The objective of the present study was to investigate how correctional facility personnel reconcile the ethical challenges that arise when housing and treating individuals with SMI. Four focus groups and one group interview were conducted with employees ( n = 24) including nurses, clinicians, correctional officers, administrators, and sergeants at a county jail in Pennsylvania. Results show that jail employees felt there are too many inmates with SMI in jail who would benefit from more comprehensive treatment elsewhere; however, given limited resources, employees felt they were doing the best they can. These findings can inform mental health management and policy in a correctional setting.
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Affiliation(s)
- Andrea G Segal
- 1 University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rosemary Frasso
- 2 Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Dominic A Sisti
- 1 University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Dawson G, Crane M, Lyons C, Burnham A, Bowman T, Perez D, Travaglia J. General practitioners' perceptions of population based bowel screening and their influence on practice: a qualitative study. BMC FAMILY PRACTICE 2017; 18:36. [PMID: 28298185 PMCID: PMC5353863 DOI: 10.1186/s12875-017-0610-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 03/02/2017] [Indexed: 01/01/2023]
Abstract
Background Although largely preventable, Australia has one of the highest rates of bowel cancer in the world. General Practitioners (GPs) have an important role to play in prevention and early detection of bowel cancer, however in Australia this is yet to be optimised and participation remains low. This study sought to understand how GPs’ perceptions of bowel screening influence their attitudes to, and promotion of the faecal occult blood test (FOBT), to identify opportunities to enhance their role. Methods Interviews were conducted with 31 GPs from metropolitan and regional New South Wales (NSW), Australia. Discussions canvassed GPs’ perceptions of their role in bowel screening and the national screening program; perceptions of screening tests; practices regarding discussing screening with patients; and views on opportunities to enhance their role. Transcripts were coded using Nvivo and thematically analysed. Results The study revealed GPs’ perceptions of screening did not always align with broader public health definitions of ‘population screening’. While many GPs reportedly understood the purpose of population screening, notions of the role of asymptomatic screening for bowel cancer prevention were more limited. Descriptions of screening centred on two major uses: the use of a screening ‘process’ to identify individual patients at higher risk; and the use of screening ‘tools’, including the FOBT, to aid diagnosis. While the FOBT was perceived as useful for identifying patients requiring follow up, GPs expressed concerns about its reliability. Colonoscopy by comparison, was considered by many as the gold standard for both screening and diagnosis. This perception reflects a conceptualisation of the screening process and associated tools as an individualised method for risk assessment and diagnosis, rather than a public health strategy for prevention of bowel cancer. Conclusion The results show that GPs’ perceptions of screening do not always align with broader public health definitions of ‘population screening’. Furthermore, the way GPs understood screening was shown to impact their clinical practice, influencing their preferences for, and use of ‘screening’ tools such as FOBT. The findings suggest emphasising the preventative opportunity of FOBT screening would be beneficial, as would formally engaging GPs in the promotion of bowel screening.
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Affiliation(s)
- Greer Dawson
- Sax Institute, Level 13, Building 10, 235 Jones Street, Ultimo, NSW, Australia, 2007. .,School of Public Health and Community Medicine, Samuels Building, University of New South Wales, Sydney, NSW, Australia, 2052.
| | - Melanie Crane
- Prevention Research Collaboration, The Charles Perkins Centre, Level 6, The Hub, School of Public Health, University of Sydney, Sydney, NSW, Australia, 2006
| | - Claudine Lyons
- NSW Department of Premier and Cabinet, 52 Martin Place, Sydney, NSW, Australia, 2000
| | - Anna Burnham
- Cancer Institute NSW, Australian Technology Park, Level 9, 8 Central Avenue, Sydney, NSW, Australia, 2015
| | - Tara Bowman
- Cancer Institute NSW, Australian Technology Park, Level 9, 8 Central Avenue, Sydney, NSW, Australia, 2015
| | - Donna Perez
- Cancer Institute NSW, Australian Technology Park, Level 9, 8 Central Avenue, Sydney, NSW, Australia, 2015
| | - Joanne Travaglia
- Faculty of Health, University of Technology Sydney, Level 7, 235 Jones Street, Sydney, NSW, Australia, 2007
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