Tag Archives: qualitative

Posted on by

Improvement Science and Research Methods seminar: Prof Alicia O’Cathain on process evaluation in clinical trials

alicia2 Professor of Health Services Research at the University of Sheffield, Alicia O’Cathain, who heads the Medical Care Research Unit at ScHARR, gave an outstanding CaHRU/LIH seminar on ‘Using process evaluations alongside randomised controlled trials and other outcome evaluations’ on 23 May 2018 at the University of Lincoln.

CaHRU_logotypeThe seminar was based on the Medical Research Council guidance on process evaluations (Moore G, Audrey S, Barker M, Bond L, Bonell C, Cooper C, Hardeman W, Moore L, O’Cathain A, Tannaze T, Wight D, Baird J. Process evaluation of complex interventions. Medical Research Council guidance. BMJ 2015 350:h1258) which Prof O’Cathain co-authored. She described the importance of process evaluations using mixed methods in helping researchers realise how understanding trial processes can help us appreciate how or why a complex interventions works or does not work as intended, which is critical to its effectiveness and subsequent implementation.

LIFH-logo-web2She went on to describe the contextual factors that determine how an intervention works, limit what is delivered, affect how it works and govern what effects it has. Qualitative interviews with those delivering or receiving the intervention can help elucidate the components that are deemed useful and their perceived benefits while quantitative analysis can help to enumerate the mediators of any effects. The analysis can be integrated to develop a logic model and programme theory of the intervention.

Prof O’Cathain concluded by covering key aspects of planning, analysis and reporting of process evaluations and introducing her new book on the subject.

[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2018/07/OCathain-Using-process-evaluations-alongside-RCTs.pdf” width=”660″]Multi-morbidity, goal-oriented care, the community and equity[/su_document]

 

By Prof A N Siriwardena

Posted on by

CaHRU study presented at Abu Dhabi medical education conference

ottawa3_750 Dr Julie Pattinson presented at the Ottawa-International Conference on Medical Education (ICME), Abu Dhabi, United Arab Emirates; March 10th – 14th 2018. The conference is held biennially and provides a forum for medical and other health care profession educationalists to network and share ideas on all aspects of the assessment of competence in both clinical and non-clinical domains, throughout the continuum of education. There were near 1500 attendees, and hosted plenary sessions, symposia, oral presentations, workshops and poster sessions. Overall it was an educative programme covering all aspects of Health Professions with special emphasis on assessment.

ottawa2_750Julie Pattinson of CaHRU gave a presentation in parallel session 13, titled Postgraduate Assessment on Understanding Reasons for Variations by Ethnicity in Attainment in the Performance of General Practitioners in Speciality Training completing the Membership of the Royal College of General Practitioners (MRCGP) Applied Knowledge Test; cognitive interview study. The study was conducted in collaboration with Professor Niro Siriwardena, University of Lincoln, Dr Bijoy Sinha, GP Speciality Training Director, Lincolnshire, and Dr Carol Blow, MRCGP clinical lead. Dr Pattinson talked about the differences that exists in ottawa4_750candidate performance in high stakes medical licensing examinations, specifically the MRCGP AKT, between black and minority ethnic doctors (BME) compared to white British doctors. Grounded theory analysis generated discussions into why differences exist in candidates of different ethnicity highlighted that overseas trained doctors do face additional difficulties answering AKT questions.

The study has provided a basis for developing interventions to reduce differential attainment in UK speciality training for general practice. Overall the conference was interactive and five minute questions were addressed after each presentation.

By Julie Pattinson

Posted on by

New study from CaHRU on caregivers for people with dementia

brainA qualitative study exploring the experiences and perceptions of informal carers of people with dementia when interacting with health care services was published this month in the journal Dementia. The study entitled ‘Caregivers’ interactions with health care services – Mediator of stress or added strain? Experiences and perceptions of informal caregivers of people with dementia – A qualitative study’ was undertaken by Despina Laparidou (lead author), Dr Jo Middlemass, Professor Terence Karran and Prof Niro Siriwardena.

IMG_0923The study explored carers’ unmet needs for both information/knowledge about dementia and support from healthcare services. The researchers found that carers would greatly benefit from detailed information on disease progression, guidelines and tips on dealing with challenging behaviours, as well as information on financial and legal advice. Carers also felt that health and social care services are often fragmented, making it harder for them to receive the support they need and want.

CaHRU_logotypeAt the same time, healthcare professionals stated that while they have a theoretical knowledge of the disease, they felt they often lack knowledge of how it is to live with dementia, which can make it difficult to know how best to support carers. Another interesting finding of the study was that having carers keep a daily diary of symptoms and behaviour could help to empower carers and facilitate communications with healthcare professionals.

The research team hopes to expand this study and develop an educational intervention for informal carers of people with dementia.

By Despina Laparidou

Posted on by

CaHRU study on CFRs presented to National Ambulance Forum

vhp2Viet-Hai Phung presented the findings of a University of Lincoln study on Community First Responders at a meeting of the National Ambulance Service First Responder Managers Forum at East Midlands Ambulance Service NHS Trust at Beechdale, Nottingham on 25th April 2017. The presentation set out the aims and objectives of the research, which were to explore the role of CFRs in a rural location, using a systematic scoping review followed up by qualitative interviews.

This study team of Viet-Hai Phung, Fiona Togher, Ian Trueman, Prof Roderick Ørner and Prof Niro Siriwardena, began the research in April 2016 with a systematic scoping review of CFR schemes in the UK which was published recently. CFRWordItOut-word-cloud-2426149Then followed a qualitative study involving 16 interviews of CFRs, conducted from June-July 2016. After describing the progress of the study, Viet-Hai Phung outlined the key findings of the scoping review. These included that: volunteers became CFRs mainly for altruistic reasons; they wanted more training and feedback on incidents they had attended; there were concerns about the possible emotional impact on CFRs responding to incidents; there was low public recognition of CFR schemes and sometimes confusion with ambulance staff; relationships with the ambulance staff were sometimes affected by confusion over roles; CFRs wanted local autonomy for CFR schemes but with greater sharing of best practice. Some of the findings from the scoping review were reinforced by the interview study. These findings, alongside others, were reinforced by the interview study.

The broad consensus among the regional ambulance managers was that further research was needed on CFRs and CFR schemes building on the work so far, and CaHRU is committed to working with ambulance trusts to further develop the work on CFRs. Professor Niro Siriwardena, who was also present at the event, said there were plans to discuss this further with ambulance service research leads at the next meeting of the National Ambulance Research Steering Group.

By Viet-Hai Phung

Posted on by

CaHRU/LIH seminar: Scoping reviews – Viet-Hai Phung

The latest CaHRU/LIH Improvement Science and Research Methods seminar was on scoping reviews, delivered on 28th February 2017 by Viet-Hai Phung, Research Assistant at CaHRU. Viet-Hai began the seminar by stating the aims of scoping reviews: to “map rapidly the key concepts underpinning a research area and the main sources and types of evidence available, and can be undertaken as stand-alone projects in their own right, especially where an area is complex or has not been reviewed comprehensively before” (Mays et al., 2001: 194).Viet Hai Scoping Reviews

Viet-Hai who is currently conducting a scoping review as the first phase of his PhD, explained that he is doing this because the extent of knowledge on the evidence relating to his research area in ‘healthcare experiences of migrants in Europe’ is limited. Secondly, the scoping review will help to establish themes or research questions for further exploration using appropriate research methods.

He went on to outline the features and steps to conducting a scoping review and took time to explain each in detail, placing emphasis on the need to have a well-defined search strategy for capturing all potentially relevant studies. He also recommended the use of EndNote and Excel for managing the studies or data generated from the search, which can facilitate the identification and inclusion or exclusion of studies from the review. Constructing a flow diagram can also help in presenting a summary of the study identification process.

vhp2For the synthesis of the data generated, Viet-Hai suggested that reviewers may summarise each of the included studies according to relevant headings: population, methods, results etc, and thematically summarise the evidence from the review using a narrative, reflective approach.

He concluded the session by highlighting a number of caveats which should be noted when planning to conduct a scoping review. He said, for example, that some search terms may need to be adapted or modified for different databases, and that only a limited number of publications can be imported to Endnote at a time. In addition, many publications have copyright statements that need to be removed in Excel, and that data extraction can be time consuming.

By Joseph Akanuwe

[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2017/03/Scoping-review-28-February-2017.pdf” responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]