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Journal articles on the topic 'Mixed methods case study'

Author: Grafiati

Published: 4 June 2021

Last updated: 11 February 2022

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1

Hong, Quan Nha, Rebecca Rees, Katy Sutcliffe, and James Thomas. "Variations of mixed methods reviews approaches: A case study." Research Synthesis Methods 11, no. 6 (July 27, 2020): 795–811. http://dx.doi.org/10.1002/jrsm.1437.

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Champagne, Trevor, Peter G. Rossos, Veronica Kirk, and Emily Seto. "Impact of an Intrainstitutional Teledermatology Service: Mixed-Methods Case Study." JMIR Dermatology 1, no. 2 (December 17, 2018): e11923. http://dx.doi.org/10.2196/11923.

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Vincent, Stacy K., and Andrea T. Kirby. "Words Speak Louder than Action?: A Mixed-Methods Case Study." Journal of Agricultural Education 56, no. 1 (March 31, 2015): 32–42. http://dx.doi.org/10.5032/jae.2015.01032.

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Onwuegbuzie, Anthony J., and Nancy L. Leech. "Generalization practices in qualitative research: a mixed methods case study." Quality & Quantity 44, no. 5 (May 9, 2009): 881–92. http://dx.doi.org/10.1007/s11135-009-9241-z.

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Sharp, Julia L., Catherine Mobley, Cathy Hammond, Cairen Withington, Sam Drew, Sam Stringfield, and Natalie Stipanovic. "A Mixed Methods Sampling Methodology for a Multisite Case Study." Journal of Mixed Methods Research 6, no. 1 (September 2, 2011): 34–54. http://dx.doi.org/10.1177/1558689811417133.

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Horrocks, Sue, Katherine Pollard, Lorna Duncan, Christina Petsoulas, Emma Gibbard, Jane Cook, Ruth McDonald, et al. "Measuring quality in community nursing: a mixed-methods study." Health Services and Delivery Research 6, no. 18 (April 2018): 1–132. http://dx.doi.org/10.3310/hsdr06180.

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Background High-quality nursing care is crucial for patients with complex conditions and comorbidities living at home, but such care is largely invisible to health planners and managers. Nursing care quality in acute settings is typically measured using a range of different quality measures; however, little is known about how service quality is measured in community nursing. Objective To establish which quality indicators (QIs) are selected for community nursing; how these are selected and applied; and their usefulness to service users (patients and/or carers), commissioners and provider staff. Design A mixed-methods study comprising three phases. (1) A national survey was undertaken of ‘Commissioning for Quality and Innovation’ indicators applied to community nursing care in 2014/15. The data were analysed descriptively using IBM SPSS Statistics 20.0 (IBM Corporation, Armonk, NY, USA). (2) An in-depth case study was conducted in five sites. Qualitative data were collected through observations, interviews, focus groups and documents. A thematic analysis was conducted using QSR NVivo 10 (QSR International, Warrington, UK). The findings from the first two phases were synthesised using a theoretical framework to examine how local and distal contexts affecting care provision impacted on the selection and application of QIs for community nursing. (3) Validity testing the findings and associated draft good practice guidance through a series of stakeholder engagement events held in venues across England. Setting The national survey was conducted by telephone and e-mail. Each case study site comprised a Clinical Commissioning Group (CCG) and its associated provider of community nursing services. Participants Survey – 145 (68.7%) CCGs across England. Case study NHS England national and regional quality leads (n = 5), commissioners (n = 19), provider managers (n = 32), registered community nurses (n = 45); and adult patients (n = 14) receiving care in their own homes and/or carers (n = 7). Findings A wide range of indicators was used nationally, with a major focus on organisational processes. Lack of nurse and service user involvement in indicator selection processes had a negative impact on their application and perceived usefulness. Indicator data collection was hampered by problematic information technology (IT) software and connectivity and interorganisational system incompatibility. Front-line staff considered indicators designed for acute settings inappropriate for use in community settings. Indicators did not reflect aspects of care, such as time spent, kindness and respect, that were highly valued by front-line staff and service user participants. Workshop delegates (commissioners, provider managers, front-line staff and service users, n = 242) endorsed the findings and drafted good practice guidance. Limitations Ongoing service reorganisation during the study period affected access to participants in some sites. The limited available data precluded an in-depth documentary analysis. Conclusions The current QIs for community nursing are of limited use. Indicators will be enhanced by involving service users and front-line staff in identification of suitable measures. Resolution of connectivity and compatibility challenges should assist implementation of new IT packages into practice. Modifications are likely to be required to ensure that indicators developed for acute settings are suitable for community. A mix of qualitative and quantitative methods will better represent community nursing service quality. Future work Future research should investigate the appropriate modifications and associated costs of administering QI schemes in integrated care settings. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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Waysman, Mark, and Riki Savaya. "Mixed Method Evaluation: A Case Study." Evaluation Practice 18, no. 3 (September 1997): 227–37. http://dx.doi.org/10.1177/109821409701800304.

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While there is growing interest in employing mixed methods in evaluation research, there are few documented examples describing how to implement this in practice. This article describes the use of a mixed method approach to evaluate a nonprofit agency that provides organizational consultation and other support services to nonprofit organizations in Israel. It uses conceptualizations proposed by Greene, Caracelli, and Graham (1989) and by Rossman and Wilson (1994) to discuss the unique benefits of such methodology and also addresses the limitations and disadvantages of mixed method evaluation.

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Walton, Janet B., Vicki L. Plano Clark, Lori A. Foote, and Carla C. Johnson. "Navigating Intersecting Roads in a Mixed Methods Case Study: A Dissertation Journey." Journal of Mixed Methods Research 14, no. 4 (September 15, 2019): 436–55. http://dx.doi.org/10.1177/1558689819872422.

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Practical guidance for navigating issues associated with combining mixed methods and case study research approaches is in short supply, particularly for novice researchers who may grapple with numerous decision points in planning and conducting such studies. This methodological discussion examines the decision-making process used in a qualitatively driven mixed methods dissertation study with a focus on how mixed methods and case study research approaches can be applied together to enhance case descriptions and interpretations. This discussion contributes to the field of mixed methods research methodology by expanding conversations about the inherent messiness of mixed methods research and by providing practical guidance to researchers interested in applying a mixed methods case study approach.

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Zivtins, Roberts, Tim Jay, Robert Winston, and Annalisa Alexander. "Mixed methods single case study research (MMSCR): Challenges in WP evaluation." Widening Participation and Lifelong Learning 22, no. 2 (July 1, 2020): 225–37. http://dx.doi.org/10.5456/wpll.22.2.225.

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Evaluating widening participation (WP) interventions is complex. Early efforts at WP evaluation were criticised for lacking rigour. These criticisms were accompanied with suggested approaches to research, typically favouring randomised control trials. Yet these recommendations have, in turn, become the focus of much discussion and debate within the WP evaluation sector.<br/> This paper presents the use of a 'mixed methods single case study research' (MMSCR) study design to WP evaluation. It describes the work of a PhD researcher evaluating the school – university partnership science outreach programme between the Wohl Reach Out Lab at Imperial College London and a local secondary school.<br/> The article highlights potential challenges when using MMSCR, namely in ensuring internal validity and trustworthiness of the study. Solutions to these challenges are presented and the case is made for broadening what is seen as meaningful research in the sector.

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Leiser, Stephanie. "The Diffusion of State Film Incentives: A Mixed-Methods Case Study." Economic Development Quarterly 31, no. 3 (June 1, 2017): 255–67. http://dx.doi.org/10.1177/0891242417710715.

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In 2000, only six states had tax incentives for film and video production, and by 2010, all but six states had film incentives. What accounts for this growth in popularity? This study combines quantitative event history analysis and qualitative interview methods to try to understand why states adopted film incentive programs and how they were influenced by the adoption of incentives in other states. The analysis suggests that the diffusion processes in state adoptions of film incentives can be largely explained by two factors: (a) the size and sophistication of the existing film industry in the state and (b) a competitive “bandwagon” effect based on the total number of states that had already adopted film incentives. The results emphasize the need to broaden the ways that competitive influences can be conceptualized and modeled in policy diffusion research, especially in economic development.

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Plano Clark, Vicki L., Lori A. Foote, and Janet B. Walton. "Intersecting Mixed Methods and Case Study Research: Design Possibilities and Challenges." INTERNATIONAL JOURNAL OF MULTIPLE RESEARCH APPROACHES 10, no. 1 (July 16, 2018): 14–29. http://dx.doi.org/10.29034/ijmra.v10n1a1.

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Zhang, Wanqing. "Mixed methods application in health intervention research: A multiple case study." International Journal of Multiple Research Approaches 8, no. 1 (April 2014): 24–35. http://dx.doi.org/10.5172/mra.2014.8.1.24.

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Poth, Cheryl N., Michelle Searle, Alexandra M. Aquilina, Jenny Ge, and Alexa Elder. "Assessing competency-based evaluation course impacts: A mixed methods case study." Evaluation and Program Planning 79 (April 2020): 101789. http://dx.doi.org/10.1016/j.evalprogplan.2020.101789.

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Molina-Azorin, José F., and Michael D. Fetters. "In This Issue: Mixed Methods and Interventional Evaluations, Multilevel Mixed Methods Designs, Full Integration in Case Study Research, Mixed Methods-Grounded Theory, Mixed Methods Evaluation Through Cost-Effectiveness Analysis, and Action Research in Mixed Methods Research." Journal of Mixed Methods Research 14, no. 2 (March 17, 2020): 127–30. http://dx.doi.org/10.1177/1558689820912852.

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Silander, Katariina, Paulus Torkki, Antti Peltokorpi, Aino Lepäntalo, Maija Tarkkanen, Petri Bono, Katariina Klintrup, and Minna Kaila. "Modularising outpatient care delivery: A mixed methods case study at a Finnish University Hospital." Health Services Management Research 31, no. 4 (January 16, 2018): 195–204. http://dx.doi.org/10.1177/0951484817752629.

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Background Modularisation is a potential means to develop health care delivery by combining standardisation and customisation. However, little is known about the effects of modularisation on hospital care. The objective was to analyse how modularisation may change and support health care delivery in specialised hospital care. Methods A mixed methods case study methodology was applied using both qualitative and quantitative data, including interviews, field notes, documents, service usage data, bed count and personnel resource data. Data from a reference hospital’s unit were used to understand the context and development of care delivery in general. Results The following outcome themes were identified from the interviews: balance between demand and supply; support in shift from inpatient to outpatient care; shorter treatment times and improved management of service production. Modularisation supported the shift from inpatient towards outpatient care. Changes in resource efficiency measures were both positive and negative; the number of patients per personnel decreased, while the number of visits per personnel and the bed utilisation rate increased. Conclusions Modularisation may support health care providers in classifying patients and delivering services according to patients’ needs. However, as the findings are based on a single university hospital case study, more research is needed.

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Guetterman, Timothy C., and Michael D. Fetters. "Two Methodological Approaches to the Integration of Mixed Methods and Case Study Designs: A Systematic Review." American Behavioral Scientist 62, no. 7 (May 1, 2018): 900–918. http://dx.doi.org/10.1177/0002764218772641.

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Case study has a tradition of collecting multiple forms of data—qualitative and quantitative—to gain a more complete understanding of the case. Case study integrates well with mixed methods, which seeks a more complete understanding through the integration of qualitative and quantitative research. We identify and characterize “mixed methods–case study designs” as mixed methods studies with a nested case study and “case study–mixed methods designs” as case studies with nested mixed methods. Based on a review of published research integrating mixed methods and case study designs, we describe key methodological features and discuss four exemplar interdisciplinary studies.

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Iliffe, Steve, Louise Robinson, Claire Bamford, Amy Waugh, Chris Fox, Gill Livingston, Jill Manthorpe, et al. "Introducing case management for people with dementia in primary care: a mixed-methods study." British Journal of General Practice 64, no. 628 (October 27, 2014): e735-e741. http://dx.doi.org/10.3399/bjgp14x682333.

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Brazier, Alison, Karen Cooke, and Veronika Moravan. "Using Mixed Methods for Evaluating an Integrative Approach to Cancer Care: A Case Study." Integrative Cancer Therapies 7, no. 1 (March 2008): 5–17. http://dx.doi.org/10.1177/1534735407313395.

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Mourtada, Rima, Christian Bottomley, Fiona Houben, Hyam Bashour, and Oona M. R. Campbell. "A mixed methods analysis of factors affecting antenatal care content: A Syrian case study." PLOS ONE 14, no. 3 (March 25, 2019): e0214375. http://dx.doi.org/10.1371/journal.pone.0214375.

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Daniel, Michelle, SunYoung Park, Colleen M. Seifert, P. Paul Chandanabhumma, Michael D. Fetters, Eric Wilson, Hardeep Singh, Kalyan Pasupathy, and Prashant Mahajan. "Understanding diagnostic processes in emergency departments: a mixed methods case study protocol." BMJ Open 11, no. 9 (September 2021): e044194. http://dx.doi.org/10.1136/bmjopen-2020-044194.

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IntroductionDiagnostic processes in the emergency department (ED) involve multiple interactions among individuals who interface with information systems to access and record information. A better understanding of diagnostic processes is needed to mitigate errors. This paper describes a study protocol to map diagnostic processes in the ED as a foundation for developing future error mitigation strategies.Methods and analysisThis study of an adult and a paediatric academic ED uses a prospective mixed methods case study design informed by an ED-specific diagnostic decision-making model (the modified ED-National Academies of Sciences, Engineering and Medicine (NASEM) model) and two cognitive theories (dual process theory and distributed cognition). Data sources include audio recordings of patient and care team interactions, electronic health record data, observer field notes and stakeholder interviews. Multiple qualitative analysis methods will be used to explore diagnostic processes in situ, including systems information flow, human–human and human–system interactions and contextual factors influencing cognition. The study has three parts. Part 1 involves prospective field observations of patients with undifferentiated symptoms at high risk for diagnostic error, where each patient is followed throughout the entire care delivery process. Part 2 involves observing individual care team providers over a 4-hour window to capture their diagnostic workflow, team coordination and communication across multiple patients. Part 3 uses interviews with key stakeholders to understand different perspectives on the diagnostic process, as well as perceived strengths and vulnerabilities, in order to enrich the ED-NASEM diagnostic model.Ethics and disseminationThe University of Michigan Institutional Review Board approved this study, HUM00156261. This foundational work will help identify strengths and vulnerabilities in diagnostic processes. Further, it will inform the future development and testing of patient, provider and systems-level interventions for mitigating error and improving patient safety in these and other EDs. The work will be disseminated through journal publications and presentations at national and international meetings.

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Perez, David. "Latina Baccalaureate Attainment: A Mixed Methods Case Study of a TRIO Intervention." Journal of Hispanic Higher Education 19, no. 3 (May 28, 2018): 250–65. http://dx.doi.org/10.1177/1538192718777862.

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Research demonstrates that Latinas are one of the most at-risk female demographics in higher education and have the lowest baccalaureate attainment rate of all female groups, especially at Hispanic Serving Institutions (HSIs). This case study of a TRIO intervention found that TRIO counselors’ consideration of life circumstances in planning academic schedules, brokering relationships with faculty and staff, promotion of academic accountability, and close personal relationships with Latina advisees boost Latina baccalaureate attainment. Findings demonstrate implications for enhancing retention rates and further research in Hispanic education attainment.

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Streeter, Kaitlyn, and Sarah Deaver. "Art Therapy With Women With Infertility: A Mixed-Methods Multiple Case Study." Art Therapy 35, no. 2 (April 3, 2018): 60–67. http://dx.doi.org/10.1080/07421656.2018.1483163.

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Smith, Danielle Maria, Sharanya Ramesh, Matthew Kent Smith, Ashley Jensen, and Rachel H. Ellaway. "The Calgary student run clinic in context: a mixed-methods case study." Canadian Medical Education Journal 10, no. 3 (July 21, 2019): e27-38. http://dx.doi.org/10.36834/cmej.56911.

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Background: Student Run Clinics (SRCs) provide students with clinical education while caring for underserved populations. While much of the research on SRCs comes from the USA, SRCs in other contexts need to be appraised in the context of the systems they interact with. This study explored how stakeholders in the University of Calgary’s SRC perceived its purpose and beneficiaries with respect to patients, students, undergraduate medical education, and its intersections within the healthcare system in Calgary. Methods: Data came from the SRC’s EMR and stakeholder interviews at the Inn from the Cold (IFTC) shelter. Qualitative data were analyzed using standard grounded theory techniques. Results: There were 13 interviews - seven with student clinicians and six with preceptors and other stakeholders. Interviews highlighted the uncertainty of the SRCs role. Majority of participants saw the SRC as facilitating further access to other healthcare services, while some commented on its primarily education-focused role. Major limitations in the SRC’s scope of care and its integration with other services were identified. Conclusion: SRCs need to consider theiraccountabilities, both educational and healthcare-focused at individual and organization levels, in order to function as responsible healthcare providers in Calgary.

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Aylin, Paul, Alex Bottle, Susan Burnett, Elizabeth Cecil, Kathryn L. Charles, Paul Dawson, Danielle D’Lima, et al. "Evaluation of a national surveillance system for mortality alerts: a mixed-methods study." Health Services and Delivery Research 6, no. 7 (February 2018): 1–314. http://dx.doi.org/10.3310/hsdr06070.

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BackgroundSince 2007, Imperial College London has generated monthly mortality alerts, based on statistical process control charts and using routinely collected hospital administrative data, for all English acute NHS hospital trusts. The impact of this system has not yet been studied.ObjectivesTo improve understanding of mortality alerts and evaluate their impact as an intervention to reduce mortality.DesignMixed methods.SettingEnglish NHS acute hospital trusts.ParticipantsEleven trusts were included in the case study. The survey involved 78 alerting trusts.Main outcome measuresRelative risk of mortality and perceived efficacy of the alerting system.Data sourcesHospital Episodes Statistics, published indicators on quality and safety, Care Quality Commission (CQC) reports, interviews and documentary evidence from case studies, and a national evaluative survey.MethodsDescriptive analysis of alerts; association with other measures of quality; associated change in mortality using an interrupted time series approach; in-depth qualitative case studies of institutional response to alerts; and a national cross-sectional evaluative survey administered to describe the organisational structure for mortality governance and perceptions of efficacy of alerts.ResultsA total of 690 mortality alerts generated between April 2007 and December 2014. CQC pursued 75% (154/206) of alerts sent between 2011 and 2013. Patient care was cited as a factor in 70% of all investigations and in 89% of sepsis alerts. Alerts were associated with indicators on bed occupancy, hospital mortality, staffing, financial status, and patient and trainee satisfaction. On average, the risk of death fell by 58% during the 9-month lag following an alert, levelling afterwards and reaching an expected risk within 18 months of the alert. Acute myocardial infarction (AMI) and sepsis alerts instigated institutional responses across all the case study sites, although most sites were undertaking some parallel activities at a more general level to address known problems in care in these and other areas. Responses included case note review and coding improvements, changes in patient pathways, changes in diagnosis of sepsis and AMI, staff training in case note write-up and coding, greater transparency in patient deterioration, and infrastructure changes. Survey data revealed that 86% of responding trusts had a dedicated trust-level lead for mortality reduction and 92% had a dedicated trust-level mortality group or committee in place. Trusts reported that mortality reduction was a high priority and that there was strong senior leadership support for mortality monitoring. The weakest areas reported concerned the accuracy of coding, the quality of specialty-level mortality data and understanding trends in specialty-level mortality data.LimitationsOwing to the correlational nature of our analysis, we could not ascribe a causal link between mortality alerts and reductions in mortality. The complexity of the institutional context and behaviour hindered our capacity to attribute locally reported changes specifically to the effects of the alerts rather than to ongoing institutional strategy.ConclusionsThe mortality alert surveillance system reflects aspects of quality care and is valued by trusts. Alerts were considered a useful focus for identifying problems and implementing interventions around mortality.Future workA further analysis of site visits and survey material, the application of evaluative framework to other interventions, a blinded case note review and the dissemination of findings.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Creswell, J. W. "Designing A Mixed Methods Study In Primary Care." Annals of Family Medicine 2, no. 1 (January 1, 2004): 7–12. http://dx.doi.org/10.1370/afm.104.

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Hudon, Catherine, Maud-Christine Chouinard, Marie-France Dubois, Pasquale Roberge, Christine Loignon, Éric Tchouaket, Mireille Lambert, Émilie Hudon, Fatoumata Diadiou, and Danielle Bouliane. "Case Management in Primary Care for Frequent Users of Health Care Services: A Mixed Methods Study." Annals of Family Medicine 16, no. 3 (May 2018): 232–39. http://dx.doi.org/10.1370/afm.2233.

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Vaughan, Louella, Martin Bardsley, Derek Bell, Miranda Davies, Andrew Goddard, Candace Imison, Mariya Melnychuk, Stephen Morris, and Anne Marie Rafferty. "Models of generalist and specialist care in smaller hospitals in England: a mixed-methods study." Health Services and Delivery Research 9, no. 4 (February 2021): 1–158. http://dx.doi.org/10.3310/hsdr09040.

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Background The increasing number of older, complex patients who require emergency admission to hospital has prompted calls for better models of medical generalist care, especially for smaller hospitals, whose size constrains resources and staffing. Objective To investigate the strengths and weaknesses of the current models of medical generalism used in smaller hospitals from patient, professional and service perspectives. Methods The design was a mixed-methods study. Phase 1 was a scoping and mapping exercise to create a typology of models of care, which was then explored further through 11 case studies. Phase 2 created a classification using the Hospital Episode Statistics of acute medical ‘generalist’ and ‘specialist’ work and described differences in workload and explored the links between case mix, typology and length of stay and between case mix and skill mix. Phase 3 analysed the relationships between models of care and patient-level costs. Phase 4 examined the strengths and weaknesses of the models of care through focus groups, a discrete choice experiment and an exploration of the impact of typology on other outcomes. Results In total, 50 models of care were explored through 48 interviews. A typology was constructed around generalist versus specialist patterns of consultant working. Twenty-five models were deployed by 48 hospitals, and no more than four hospitals used any one model of care. From the patient perspective, analysis of Hospital Episode Statistics data of 1.9 million care episodes found that the differences in case mix between hospitals were relatively small, with 65–70% of episodes accounted for by 20 case types. The skill mix of hospital staff varied widely; there were no relationships with case mix. Patients exhibited a preference for specialist care in the discrete choice experiment but indicated in focus groups that overall hospital quality was more important. From a service perspective, qualitative work found that models of care were contingent on complex constellations of factors, including staffing, the local hospital environment and policy imperatives. Neither the model of care nor the case mix accounted for variability in the length of stay (no associations were significant at p < 0.05). No significant differences were found in the costs of the models. Professionally, the preferences of doctors for specialist versus generalist work depended on their experiences of providing care and were associated with a healthy organisational culture and a co-operative approach to managing emergency work. Concepts of medical generalism were found to be complex and difficult to define, with theoretical models differing markedly from models in action. Limitations Smaller hospitals in multisite trusts were excluded, potentially leading to sample bias. The rapidly changing nature of the models limited the analysis of typology against outcomes. Conclusions The case mix of smaller hospitals was dominated by patients with presentations amenable to generalist approaches to care; however, there was no evidence to support any particular pattern of consultant working. Matching hospital staff to better meet local need and the creation of more collaborative working environments appear more likely to improve care in smaller hospitals than changing models. Future work The exploration of the relationships between workforce, measures of hospital culture, models of care, costs and outcomes in both smaller and larger hospitals is urgently required to underpin service reforms. Study registration This study is registered as Integrated Research Application System project ID 191393. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 4. See the NIHR Journals Library website for further project information.

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Pinkevičienė, Dalia. "Mixed speech at work: a case study." Taikomoji kalbotyra, no. 9 (May 19, 2017): 73–108. http://dx.doi.org/10.15388/tk.2017.17448.

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The paper delves into the situated usage of mixed speech produced by adult Lithuanians at work, the environment hardly ever sociolinguistically researched in Lithuania. By mixed speech, Lithuanian speech interspersed with occasional insertional elements from other languages is meant. The study aims to see how more diverse linguistic resources that are now available in Lithuania are used to construct and negotiate social relations and social identities in the talk at work. The case study, which is a part of an ongoing larger scale project on Lithuanian workplace discourse, draws on digital audio recordings of naturally occurring spontaneous conversations between employees collected by a volunteer in a media-related company in Vilnius. The recordings containing elements of languages other than Lithuanian (English and Russian) have been transcribed and analysed using Interactional Sociolinguistics (IS), an in-depth qualitative approach that combines the application of the interpretive methods of discourse analysis with insights into social and cultural issues. The paper argues that mixed speech in Lithuanian workplace discourse is creatively used as group or individual stylistic choice to construct certain social images and to perform various functions: for instance, mixed speech containing Russian insertions, slang and swear words serves as an index of belonging to the group (or a community of practice), whereas English is a necessary tool for doing well in a contemporary work environment and presenting oneself as an expert in one’s professional field; English insertions tend to be employed when things need to be quickly and efficiently done while Russian is still used more extensively for off-task talk, such as small talk, gossiping, humour and jokes, which constitute an integral part of the talk at work. It can be hypothesised, however, that the range of functions performed by English insertions is gradually expanding as the command of Russian among co-workers is decreasing. The study depicts mixed speech as a means of negotiating social identities of a friendly and supportive colleague, a skilled and experienced professional, a creative, playful and adaptive communicator, and an open-minded, educated and sophisticated person.

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Kang, Jiyoung. "Simulated Nursing Practice Education in the Ontact Age: A Mixed Methods Case Study." Korean Association For Learner-Centered Curriculum And Instruction 20, no. 18 (September 30, 2020): 937–57. http://dx.doi.org/10.22251/jlcci.2020.20.18.937.

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Khawaja, Irfan, Lorayne Woodfield, Peter Collins, Adam Benkwitz, and Alan Nevill. "Exploring Children’s Physical Activity Behaviours According to Location: A Mixed-Methods Case Study." Sports 7, no. 11 (November 18, 2019): 240. http://dx.doi.org/10.3390/sports7110240.

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The school environment is ideally placed to facilitate physical activity (PA) with numerous windows of opportunity from break and lunch times, to lesson times and extracurricular clubs. However, little is known about how children interact with the school environment to engage in PA and the other locations they visit daily, including time spent outside of the school environment i.e., evening and weekend locations. Moreover, there has been little research incorporating a mixed-methods approach that captures children’s voices alongside objectively tracking children’s PA patterns. The aim of this study was to explore children’s PA behaviours according to different locations. Sixty children (29 boys, 31 girls)—35 key stage 2 (aged 9–11) and 25 key stage 3 (aged 11–13)—wore an integrated global positioning systems (GPS) and heart rate (HR) monitor over four consecutive days. A subsample of children (n = 32) were invited to take part in one of six focus groups to further explore PA behaviours and identify barriers and facilitators to PA. Children also completed a PA diary. The KS2 children spent significantly more time outdoors than KS3 children (p = 0.009). Boys engaged in more light PA (LPA) when on foot and in school, compared with girls (p = 0.003). KS3 children engaged in significantly more moderate PA (MPA) at school than KS2 children (p = 0.006). Focus groups revealed fun, enjoyment, friends, and family to be associated with PA, and technology, costs, and weather to be barriers to PA. This mixed methodological study highlights differences in the PA patterns and perceptions of children according to age and gender. Future studies should utilize a multi-method approach to gain a greater insight into children’s PA patterns and inform future health policies that differentiate among a range of demographic groups of children.

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Barwick, Melanie, Raluca Barac, Melissa Kimber, Lindsay Akrong, Sabine N. Johnson, Charles E. Cunningham, Kathryn Bennett, Graham Ashbourne, and Tim Godden. "Advancing implementation frameworks with a mixed methods case study in child behavioral health." Translational Behavioral Medicine 10, no. 3 (January 30, 2019): 685–704. http://dx.doi.org/10.1093/tbm/ibz005.

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Abstract Despite a growing policy push for the provision of services based on evidence, evidence-based treatments for children and youth with mental health challenges have poor uptake, yielding limited benefit. With a view to improving implementation in child behavioral health, we investigated a complementary implementation approach informed by three implementation frameworks in the context of implementing motivational interviewing in four child and youth behavioral health agencies: the Active Implementation Frameworks (AIF) (process), the Consolidated Framework for Implementation Research (factors), and the Implementation Outcomes Framework (evaluation). The study design was mixed methods with embedded interrupted time series and motivational interviewing (MI) fidelity was the primary outcome. Focus groups and field notes informed perspectives on the implementation approach, and a questionnaire explored the salience of Consolidated Framework for Implementation Research (CFIR) factors. Findings validate the process guidance provided by the AIF and highlight CIFR factors related to implementation success. Novel CFIR factors, not elsewhere reported in the literature, are identified that could potentially extend the framework if validated in future research. Introducing fidelity measurement in practice proved challenging and was not sustained beyond the study. A complementary implementation approach was successful in implementing MI in child behavioral health agencies. In contrast with the typical train and hope approach to implementation, practice change did not occur immediately post-training but emerged over a 7 month period of consultation and practice following a discrete interactive training period. The saliency of CFIR constructs aligned with findings from studies conducted in other contexts, demonstrating external validity and highlighting common factors that can focus planning and measurement.

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Jerez, Oscar, Leslier Valenzuela, Veronica Pizarro, Beatriz Hasbun, Gabriela Valenzuela, and Cesar Orsini. "Evaluation criteria for competency-based syllabi: a Chilean case study applying mixed methods." Teachers and Teaching 22, no. 4 (December 25, 2015): 519–34. http://dx.doi.org/10.1080/13540602.2015.1082728.

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Liao, Hongjing, and Liwen Li. "A Mixed Methods Evaluation of College English Writing: A Case Study in China." Asia-Pacific Education Researcher 26, no. 6 (October 17, 2017): 383–96. http://dx.doi.org/10.1007/s40299-017-0357-y.

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Wathuge, Charuhasini. "The Impact of Affect on Second Language Learning: A Mixed Methods Case Study." International Journal of Research and Innovation in Social Science 05, no. 06 (2021): 29–38. http://dx.doi.org/10.47772/ijriss.2021.5601.

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Heneghan, Nicola R., Jenna Jagodzinska, Isaak Tyros, Wendy Johnson, Madeleine Nazareth, Euson Yeung, Jackie Sadi, Heather Gillis, and Alison Rushton. "Telehealth e-mentoring in postgraduate musculoskeletal physiotherapy education: A mixed methods case study." Musculoskeletal Science and Practice 56 (December 2021): 102448. http://dx.doi.org/10.1016/j.msksp.2021.102448.

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Boeije, Hennie R., Sarah J. Drabble, and Alicia O’Cathain. "Methodological Challenges of Mixed Methods Intervention Evaluations." Methodology 11, no. 4 (October 2015): 119–25. http://dx.doi.org/10.1027/1614-2241/a000101.

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Abstract. This paper addresses the methodological challenges that accompany the use of a combination of research methods to evaluate complex interventions. In evaluating complex interventions, the question about effectiveness is not the only question that needs to be answered. Of equal interest are questions about acceptability, feasibility, and implementation of the intervention and the evaluation study itself. Using qualitative research in conjunction with trials enables us to address this diversity of questions. The combination of methods results in a mixed methods intervention evaluation (MMIE). In this article we demonstrate the relevance of mixed methods evaluation studies and provide case studies from health care. Methodological challenges that need our attention are, among others, choosing appropriate designs for MMIEs, determining realistic expectations of both components, and assigning adequate resources to both components. Solving these methodological issues will improve our research designs and provide further insights into complex interventions.

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Bail, Kasia, Rachel Davey, Marian Currie, Jo Gibson, Eamon Merrick, and Bernice Redley. "Implementation pilot of a novel electronic bedside nursing chart: a mixed-methods case study." Australian Health Review 44, no. 5 (2020): 672. http://dx.doi.org/10.1071/ah18231.

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The aim of this study was to investigate the implementation of a novel electronic bedside nursing chart in an acute hospital setting. The case study used multiple data sources captured within a real-life clinical ward context. Quantitative findings included significant reductions in nurse-reported missed care (P<0.05) and increased mean time spent at the bedside (from 21 to 28min h−1; P<0.0001); reductions in patient-reported missed care and nurses’ walking distances were not significant. Qualitative themes included: (1) inconsistent expectations (perceptions about potential vs actual functionality and benefits of the technology); (2) decisional conflict between managers and end-user nurses (discordance between governance decisions and clinical operations; 30% of beds were closed and six of the eight trained nurse ‘super-users’ were moved from the pilot ward); and (3) workflow effects (ergonomic set-up of the digital interface). This study highlights the complex challenges of implementing and examining the effects of technology to support nursing care. Shared understanding of the technology goals and project scope in relation to nursing care and flexible and adaptive project and contingency planning are fundamental considerations. Complexity, unpredictability and uncertainty of ‘usual business’ are common confounders in acute hospital settings. What is known about the topic?Although much has been written about the implementation of electronic records into hospital systems, there is little research evaluating the effect of information technology systems that support the complex clinical decision making and documentation required to meet nurse and patient needs at the point of care. What does this paper add?This study highlights the potential to reduce missed care through better nursing workflow. Contributing factors to low nurse adoption of new technology have been identified, including inconsistent expectations and goals for the design of systems to support quality nursing care, incongruous decision making in design, adaptation and implementation processes and constrained physical workability in relation to nursing workflow. What are the implications for practitioners?The design of information systems to support nursing work requires a shared understanding of ‘good practice’ for high-quality nursing care that is consistent with theories of nursing practice, best evidence and professional practice standards. Recognition of effective and ineffective sociotechnical interactions that occur during complex nursing processes can help avoid ‘disruption without benefit’ and ‘amplification of errors already in the system’ during acute care technology implementation. Ongoing dynamic input from individuals and groups with different expertise and perspectives, as well as iterative, generative processes for moving towards a shared goal, are critical for effective and efficient implementation.

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Prusaczyk, Beth, Vanessa Fabbre, Nancy Morrow-Howell, and Enola Proctor. "Understanding transitional care provided to older adults with and without dementia: A mixed methods study." International Journal of Care Coordination 23, no. 1 (March 2020): 14–23. http://dx.doi.org/10.1177/2053434520908122.

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Introduction There are numerous effective transitional care interventions yet they are not routinely implemented. Furthermore, few interventions exist for older adults with dementia. A first step in developing effective interventions for dementia patients and increasing intervention uptake for all patients is to understand the current delivery process of transitional care. Methods A mixed methods study using an explanatory multiphase design was conducted. Guided by provider interviews, medical charts were reviewed to collect information on the day-to-day transitional care being delivered to older adults. Then providers were interviewed again to assess the accuracy of those results and provide context. Results The medical charts of 210 older adults (126 with dementia and 84 without) were reviewed and nine providers representing various professional roles including social work, nursing, and case management were interviewed. Social workers and case managers were primarily involved in discharge planning, communicating with providers outside the hospital, advanced care planning, providing social and community supports, and making follow-up appointments. Registered nurses were the primary providers of patient education and medication safety while physicians were primarily involved in ensuring that necessary information was available in the discharge summary and that it was available in the chart. Discussion This study found distinct patterns in the delivery of transitional care, including the unique roles nursing, social work, and case management have in the process. Furthermore, these patterns were found to differ between patients with and without dementia. These findings are both consistent and inconsistent with the existing literature on transitional care interventions.

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Gott, M., C. Ingleton, C. Gardiner, N. Richards, M. Cobb, T. Ryan, B. Noble, et al. "Transitions to palliative care for older people in acute hospitals: a mixed-methods study." Health Services and Delivery Research 1, no. 11 (November 2013): 1–138. http://dx.doi.org/10.3310/hsdr01110.

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BackgroundImproving the provision of palliative and end-of-life care is a priority for the NHS. Ensuring an appropriately managed ‘transition’ to a palliative approach for care when patients are likely to be entering the last year of life is central to current policy. Acute hospitals represent a significant site of palliative care delivery and specific guidance has been published regarding the management of palliative care transitions within this setting.Aims(1) to explore how transitions to a palliative care approach are managed and experienced in acute hospitals and to identify best practice from the perspective of clinicians and service users; (2) to examine the extent of potentially avoidable hospital admissions amongst hospital inpatients with palliative care needs.DesignA mixed-methods design was adopted in two hospitals in England, serving diverse patient populations. Methods included (1) two systematic reviews; (2) focus groups and interviews with 58 health-care professionals to explore barriers to, and facilitators of, palliative care transitions in hospital; (3) a hospital inpatient survey examining palliative care needs and aspects of management including a self-/proxy-completed questionnaire, a survey of medical and nursing staff and a case note review; (4) in-depth interviews with 15 patients with palliative care needs; (5) a retrospective case note review of all inpatients present in the hospital at the time of the survey who had died within the subsequent 12 months; and (6) focus groups with 83 key decision-makers to explore the implications of the findings for service delivery and policy.ResultsOf the 514 patients in the inpatient survey sample, just over one-third (n = 185, 36.0%) met one or more of the Gold Standards Framework (GSF) prognostic indicator criteria for palliative care needs. The most common GSF prognostic indicator was frailty, with almost one-third of patients (27%) meeting this criteria. Agreement between medical and nursing staff and the GSF with respect to identifying patients with palliative care needs was poor. In focus groups, health professionals reported difficulties in recognising that a patient had entered the last 12 months of life. In-depth interviews with patients found that many of those interviewed were unaware of their prognosis and showed little insight into what they could expect from the trajectory of their disease. The retrospective case note review found that 35 (7.2%) admissions were potentially avoidable. The potential annual cost saving across both hospitals of preventing these admissions was approximately £5.3M. However, a 2- or 3-day reduction in length of stay for these admissions would result in an annual cost saving of £21.6M or £32.4M respectively.ConclusionsPatients with palliative care needs represent a significant proportion of the hospital inpatient population. There is a significant gap between NHS policy regarding palliative and end-of-life care management in acute hospitals in England and current practice.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Kendall, M., B. Mason, N. Momen, S. Barclay, D. Munday, R. Lovick, S. MacPherson, et al. "Proactive cancer care in primary care: a mixed-methods study." Family Practice 30, no. 3 (February 4, 2013): 302–12. http://dx.doi.org/10.1093/fampra/cms085.

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Ludlow, Kristiana, Kate Churruca, Virginia Mumford, Louise A. Ellis, and Jeffrey Braithwaite. "Aged care residents’ prioritization of care: A mixed‐methods study." Health Expectations 24, no. 2 (January 21, 2021): 525–36. http://dx.doi.org/10.1111/hex.13195.

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Kurani, Shaheen, Nilay Shah, and Michelle Lampman. "3211 Place, Poverty, and Prevention: A Mixed Methods Study." Journal of Clinical and Translational Science 3, s1 (March 2019): 152. http://dx.doi.org/10.1017/cts.2019.346.

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OBJECTIVES/SPECIFIC AIMS: Understand the association between ADI and completion of preventative cancer screening and high risk behaviors -Identify how to operationalize ADI in clinical settings to assist care teams and improve overall care delivery. METHODS/STUDY POPULATION: Aim 1: Paneled Mayo Clinic patients living in MN, IA, or WI Aim 2: BRFSS survey respondents from MN, IA, or WI Aim. 3: Community health officials and Mayo Clinic care teams. RESULTS/ANTICIPATED RESULTS: We anticipate that areas with greater composite deprivation will have lower completion rates of cancer screening and higher risk behaviors. DISCUSSION/SIGNIFICANCE OF IMPACT: No single body of work has illustrated how ADI relates to completion of preventative cancer screening and high-risk behaviors. Due to the limited research focused on area deprivation and behavioral health, our work will identify some of the first national hot spots with high deprivation and high-risk behaviors. Additionally, this is one of the first studies describing spatial variation in health outcomes for Mayo Clinic patients. Understanding the association between ADI and patient adherence to preventative screening will allow us to support care teams in providing personalized and sustainable care for patients living in areas of high deprivation. The strength and novelty of this project is in the utility of the mixed methods design, which provides a more complete understanding of geographic disparities and a unique perspective to patient care, a perspective that is not portrayed in existing literature.

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Morton, Katherine, Sarah Voss, Joy Adamson, Helen Baxter, Karen Bloor, Janet Brandling, Sean Cowlishaw, et al. "General practitioners and emergency departments (GPED)—efficient models of care: a mixed-methods study protocol." BMJ Open 8, no. 10 (October 2018): e024012. http://dx.doi.org/10.1136/bmjopen-2018-024012.

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IntroductionPressure continues to grow on emergency departments in the UK and throughout the world, with declining performance and adverse effects on patient outcome, safety and experience. One proposed solution is to locate general practitioners to work in or alongside the emergency department (GPED). Several GPED models have been introduced, however, evidence of effectiveness is weak. This study aims to evaluate the impact of GPED on patient care, the primary care and acute hospital team and the wider urgent care system.Methods and analysisThe study will be divided into three work packages (WPs). WP-A; Mapping and Taxonomy: mapping, description and classification of current models of GPED in all emergency departments in England and interviews with key informants to examine the hypotheses that underpin GPED. WP-B; Quantitative Analysis of National Data: measurement of the effectiveness, costs and consequences of the GPED models identified in WP-A, compared with a no-GPED model, using retrospective analysis of Hospital Episode Statistics Data. WP-C; Case Studies: detailed case studies of different GPED models using a mixture of qualitative and quantitative methods including: non-participant observation of clinical care, semistructured interviews with staff, patients and carers; workforce surveys with emergency department staff and analysis of available local routinely collected hospital data. Prospective case study sites will be identified by completing telephone interviews with sites awarded capital funding by the UK government to implement GPED initiatives. The study has a strong patient and public involvement group that has contributed to study design and materials, and which will be closely involved in data interpretation and dissemination.Ethics and disseminationThe study has been approved by the National Health Service East Midlands—Leicester South Research Ethics Committee: 17/EM/0312. The results of the study will be disseminated through peer-reviewed journals, conferences and a planned programme of knowledge mobilisation.Trial registration numberISRCTN51780222.

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Reza, Basiri, Moradi Mostafa, Kiani Bahman, and Babaarabi Maryam Maasumi. "Evaluation of distance methods for estimating population density in Populus euphratica Olivier natural stands (case study: Maroon riparian forests, Iran)." Journal of Forest Science 64, No. 5 (May 31, 2018): 230–44. http://dx.doi.org/10.17221/146/2017-jfs.

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The aim of this study was to determine the performance of distance methods in terms of accuracy, precision, bias, consumed time and sampling efficiency in the Maroon riparian forests, Iran. 40 estimators were used to evaluate the density of Populus euphratica Olivier trees in pure and mixed stands. Fifty quadrates (30 × 30 m) were established in each stand. To evaluate the accuracy, precision, bias, consumed time and efficiency of sampling techniques, relative root mean square error – RRMSE (%), coefficient of variation – CV (%), relative bias – RBIAS (%), t × RBIAS<sup>2</sup>, t × E<sup>2</sup>, where t is study time and E (%) is sampling error at a confidence level of 95%, and efficiency ratio between method j and k (Ef<sub>jk</sub>) were used. A compound of three basic distance estimators sampling method and n-tree were the best in both stands according to all criteria for density estimation. Moreover, variable area transect by Parker (g = 3) and quadrat method were the best methods for density estimation only in pure stand, while the angle order-point-centred quarter method was superior in mixed stand. Regarding to the results, we recommend the use of compound of three basic distances (BDAV3) and basic distance-nearest neighbour (BDNN2) for density estimation of P. euphratica stands in riparian forests.

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Manja, Veena, Sandra Monterio, Gordon Guyatt, John You, Satyan Lakshminrusimha, and Susan Jack. "Understanding the factors that influence clinical decision-making - a sequential explanatory mixed methods study protocol." European Journal for Person Centered Healthcare 6, no. 2 (June 1, 2018): 329. http://dx.doi.org/10.5750/ejpch.v6i2.1510.

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Background: Despite soaring healthcare costs, patient outcomes are suboptimal in the USA. Efforts to limit healthcare costs and improve quality of care have had limited success. An improved understanding of factors that influence clinical decision-making may provide insight into optimizing the quality and costs of care. The process of healthcare decision-making is contextual, complex and poorly understood. This study aims to explore the factors that influence clinical decision-making in the setting of limited evidence of effectiveness, limited or conflicting guidance, significant resource burden and variation in values and preferences.Rationale for study design: This sequential explanatory mixed methods study includes a case-based survey (quantitative phase). The results of the survey will guide the sampling and questions for the semi-structured interviews (qualitative phase). The interviews will provide an in-depth explanation of the survey results. Combining the two methods provides complementary information and deeper understanding of the phenomenon of clinical decision-making.Methods: The quantitative strand will consist of case-based surveys in the fields of neonatology and cardiology. Participants are asked to pick the best management choice for each question followed by a rating of the influence of different factors on a 7-point Likert scale. Follow-up questions explore knowledge and influence of evidence, guideline recommendations and costs on decision-making. Analysis of the survey results will inform sampling and the focus of qualitative interviews. The interviews will be analyzed using qualitative description.Discussion: To our knowledge, this is the first study using a mixed methods approach including a case-based survey of physicians practicing in diverse settings to explore the factors that influence clinical decision-making. The results of this study may assist with strategies to implement high value care resulting in improved patient outcomes and limiting costs.

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Ding, Huiling. "Confucius's Virtue-Centered Rhetoric: A Case Study of Mixed Research Methods in Comparative Rhetoric." Rhetoric Review 26, no. 2 (May 2007): 142–59. http://dx.doi.org/10.1080/07350190709336706.

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Daftary, Amrita, Srinath Satyanarayana, Nita Jha, Mugdha Singh, Shinjini Mondal, Caroline Vadnais, and Madhukar Pai. "Can community pharmacists improve tuberculosis case finding? A mixed methods intervention study in India." BMJ Global Health 4, no. 3 (May 2019): e001417. http://dx.doi.org/10.1136/bmjgh-2019-001417.

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IntroductionIndia has the world’s highest burden of tuberculosis (TB). Private retail pharmacies are the preferred provider for 40% of patients with TB symptoms and up to 25% of diagnosed patients. Engaging pharmacies in TB screening services could improve case detection.MethodsA novel TB screening and referral intervention was piloted over 18 months, under the pragmatic staggered recruitment of 105 pharmacies in Patna, India. The intervention was integrated into an ongoing public–private mix (PPM) programme, with five added components: pharmacy training in TB screening, referral of patients with TB symptoms for a chest radiograph (CXR) followed by a doctor consultation, incentives for referral completion and TB diagnosis, short message service (SMS) reminders and field support. The intervention was evaluated using mixed methods.Results81% of pharmacies actively participated in the intervention. Over 132.49 pharmacy person-years of observation in the intervention group, 1674 referrals were made and 255 cases of TB were diagnosed. The rate of registration of symptomatic patients was 62 times higher in the intervention group compared with the control group (95% CI: 54 to 72). TB diagnosis was 25 times higher (95% CI: 20 to 32). Microbiological testing and test confirmation were also significantly higher among patients diagnosed in the intervention group (p<0.001). Perceived professional credibility, patient trust, symptom severity and providing access to a free screening test were seen to improve pharmacists’ engagement in the intervention. Workload, patient demand for over-the-counter medicines, doctor consultation fees and programme documentation impeded engagement. An additional 240 cases of TB were attributed to the intervention, and the approximate cost incurred per case detected due to the intervention was US$100.ConclusionsIt is feasible and impactful to engage pharmacies in TB screening and referral activities, especially if working within existing public-private mix (PPM) programmes, appealing to pharmacies’ business mindset and among pharmacies with strong community ties.

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Miller, James. "The Design Cycle and a Mixed Methods Approach for Improving Usability: A Case Study." Journal of Web Librarianship 13, no. 3 (May 15, 2019): 203–29. http://dx.doi.org/10.1080/19322909.2019.1600451.

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Madi, M., M. Griffiths, A. Rushton, and N. Heneghan. "Advancing clinical reasoning through postgraduate manipulative physiotherapy education: A mixed methods longitudinal case study." Musculoskeletal Science and Practice 28 (April 2017): e3-e4. http://dx.doi.org/10.1016/j.math.2016.10.014.

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Tjomsland, Hege Eikland. "Sustaining comprehensive physical activity practice in elementary school: a case study applying mixed methods." Teachers and Teaching 16, no. 1 (February 2010): 73–95. http://dx.doi.org/10.1080/13540600903475678.

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