Special Issue "Qualitative Research and Mixed Methods, Application in Health Care Science"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: 31 December 2020.

Special Issue Editor

Prof. Dr. Domingo Palacios-Ceña
Website
Guest Editor
Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Avenida Atenas s/n, 28922, Alcorcón, Madrid, Spain
Interests: qualitative research; mixed methods; pain; geriatrics; caring science; vulnerable groups; disability and rehabilitation

Special Issue Information

Dear Colleagues,

As a result of health science changes, the number of designs and methodology types of health science studies has increased. At the same time, epidemiological designs (quantitative studies) co-exist with different methodological forms to study and describe a complex event related to health science and contexts such as qualitative research and mixed methods.

The actual use of qualitative research and mixed methods in the context of health care, which are often part of complex health conditions, is increased. For qualitative and mixed studies to be implemented in health care science and services and to be part of the common health designs used, many health professionals, managers, stakeholders, patients, and families have to be considered.

This Special Issue welcomes original studies that consider and use qualitative research and mixed methods to study topics in health care science. The studies can show the perspective of health professionals, managers, patients, and family through qualitative research (e.g., phenomenological study, grounded theory) and mixed studies (e.g., qualitative case-study, convergent, exploratory sequential).

For this Special Issue, it is recommended to use the Consolidated Criteria for Reporting Qualitative Research (COREQ), or Standards for Reporting Qualitative Research (SRQR) guides for the qualitative studies, and the Best Practices for Mixed Methods Research in the Health Sciences recommendations, Second Edition by NIH Office of Behavioral and Social Sciences, for mixed methods research.

This Special Issue will provide readers with the theory state-of-the-art and practical information on health research perspectives that determine the uptake of qualitative research and mixed methods in the health care science and services.

Prof. Dr. Domingo Palacios-Ceña
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • qualitative research
  • mixed methods
  • health care
  • health services
  • caring science
  • health science education

Published Papers (13 papers)

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Research

Open AccessArticle
“My Friends are at the Bottom of My Schedule”: A Qualitative Study on Social Health among Nursing Students during Clinical Placement
Int. J. Environ. Res. Public Health 2020, 17(18), 6921; https://doi.org/10.3390/ijerph17186921 - 22 Sep 2020
Abstract
Clinical placement is an essential component for nursing students, allowing them to transfer professional knowledge into practice. The quality of life among nursing students and nurses was reviewed to examine its impact on the quality of provided care. However, it is unclear how [...] Read more.
Clinical placement is an essential component for nursing students, allowing them to transfer professional knowledge into practice. The quality of life among nursing students and nurses was reviewed to examine its impact on the quality of provided care. However, it is unclear how social health among nursing students is affected during clinical placement. Final-year students who had finished clinical placement were invited to participate in this qualitative study. Twenty-one in-depth interviews were conducted and transcribed verbatim for thematic analysis. Two main themes, i.e., contributors to lack of social health, and manifestations of lack of social health, emerged from seven sub-themes. Students experienced different challenges during the clinical placement, but some of these did contribute to effects on their social health. Lack of social health might further influence career development after graduation. Supportive strategies from colleagues, nursing colleges and hospitals might potentially improve students’ social health during the clinical placement. Full article
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Open AccessArticle
Exploring Health Literacy in Individuals with Alcohol Addiction: A Mixed Methods Clinical Study
Int. J. Environ. Res. Public Health 2020, 17(18), 6728; https://doi.org/10.3390/ijerph17186728 - 15 Sep 2020
Abstract
This mixed methods research paper explores health literacy (HL) in individuals with alcohol addiction by using the 47-item version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) and semi-structured interviews concerning health-related competencies (access, understand, appraise, and apply health information), and determines the [...] Read more.
This mixed methods research paper explores health literacy (HL) in individuals with alcohol addiction by using the 47-item version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) and semi-structured interviews concerning health-related competencies (access, understand, appraise, and apply health information), and determines the limitations of the HLS-EU-Q47 when used under specific conditions of clinical practice. The questionnaire survey and the interviews were conducted with individuals of different health literacy levels who were undergoing inpatient alcohol addiction treatment. The findings indicate that individuals with alcohol addiction might require different types of health information according to their health literacy level in terms of quantity and quality of information to recover from alcohol addiction and improve their overall health. The implications for the clinical practice of addiction treatment as well as recommendations for national and regional policy are also discussed. Full article
Open AccessArticle
Psychosocial Influence of Ehlers–Danlos Syndrome in Daily Life of Patients: A Qualitative Study
Int. J. Environ. Res. Public Health 2020, 17(17), 6425; https://doi.org/10.3390/ijerph17176425 - 03 Sep 2020
Abstract
(1) Background: Ehlers–Danlos syndrome is a heterogeneous group of connective tissue disorders causing pain, fatigue, and disabilities; it has several implications for patients who suffer from this disease. The major clinical manifestations of EDS include joint hypermobility, skin hyperextensibility, and generalized conjunctive tissue [...] Read more.
(1) Background: Ehlers–Danlos syndrome is a heterogeneous group of connective tissue disorders causing pain, fatigue, and disabilities; it has several implications for patients who suffer from this disease. The major clinical manifestations of EDS include joint hypermobility, skin hyperextensibility, and generalized conjunctive tissue fragility. This research aims to explore their perceptions and experiences about the phycological and social spheres. (2) Methods: Semistructured interviews were carried out. Participants were encouraged to talk about issues related to their disease by asking open-ended questions in one to one interview. The interview guide included questions to identify the syndrome’s influence on the social and psychological life of patients All interviews were audio recorded, fully transcribed, and analyzed using the phenomenological theoretical framework. The method of analysis was the thematic interpreting of perspectives and approaches. (3) Results: 31 individuals were proposed to participate in this study. Five patients refused to participate, so a total of 26 interviews were performed. Six themes ((1) Pain and its consequences on a daily basis; (2) The need to name the problem: the diagnosis; (3) Restructuring leisure and social relationships; (4) Limitations due to economic conditions; (5) Psychological impact of the disease situation; (6) Professional limitations) and four subthemes ((1) The value of partner support; (2) The weather influence on social plans; (3) Physical exercise and illness; (4) Support groups) emerged from the data. (4) Conclusions: This study revealed the impact of the syndrome on the social and daily life of patients, and not only in a physical level, but also in a psychological and social approach. These findings allow healthcare providers to know more about this disease in order to support and give advice to patients about the changes they will have to make. Full article
Open AccessArticle
Capturing the Spatial Relatedness of Long-Distance Caregiving: A Mixed-Methods Approach
Int. J. Environ. Res. Public Health 2020, 17(17), 6406; https://doi.org/10.3390/ijerph17176406 - 02 Sep 2020
Abstract
Long-distance caregiving (LDC) is an issue of growing importance in the context of assessing the future of elder care and the maintenance of health and well-being of both the cared-for persons and the long-distance caregivers. Uncertainty in the international discussion relates to the [...] Read more.
Long-distance caregiving (LDC) is an issue of growing importance in the context of assessing the future of elder care and the maintenance of health and well-being of both the cared-for persons and the long-distance caregivers. Uncertainty in the international discussion relates to the relevance of spatially related aspects referring to the burdens of the long-distance caregiver and their (longer-term) willingness and ability to provide care for their elderly relatives. This paper is the result of a first attempt to operationalize and comprehensively analyze the spatial relatedness of long-distance caregiving against the background of the international literature by combining a longitudinal single case study of long-distance caregiving person and semantic hierarchies. In the cooperation of spatial sciences and geoinformatics an analysis grid based on a graph-theoretical model was developed. The elaborated conceptual framework should stimulate a more detailed and precise interdisciplinary discussion on the spatial relatedness of long-distance caregiving and, thus, is open for further refinement in order to become a decision-support tool for policy-makers responsible for social and elder care and health promotion. Moreover, it may serve as a starting point for the development of a method for the numerical determination of the long-distance caregivers on different spatial reference scales. Full article
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Open AccessArticle
The 4 U’s Rule of Fibromyalgia: A Proposed Model for Fatigue in a Sample of Women with Fibromyalgia: A Qualitative Study
Int. J. Environ. Res. Public Health 2020, 17(17), 6224; https://doi.org/10.3390/ijerph17176224 - 27 Aug 2020
Abstract
Although fatigue usually goes unnoticed, it is a symptom that poses great challenges to patients with fibromyalgia and is a strong limitation. The aim of this study is to identify and describe the variables involved in fatigue in nine different situations of the [...] Read more.
Although fatigue usually goes unnoticed, it is a symptom that poses great challenges to patients with fibromyalgia and is a strong limitation. The aim of this study is to identify and describe the variables involved in fatigue in nine different situations of the Goal Pursuit Questionnaire (GPQ) that may occur in the daily lives of women with fibromyalgia, according to an ABC (Antecedents–Behaviors–Consequences) model. This study followed a qualitative descriptive research method and a deductive–inductive hybrid approach based on a phenomenological paradigm. Twenty-six women with fibromyalgia participated in focus group discussions between February and March of 2018. Thematic content analysis was carried out from transcribed verbatim interviews. We identified nine major themes that emerged from the participants’ conversations: self-imposed duties, muscle fatigue, overwhelming feeling of tiredness, difficulty thinking, difficulty concentrating, negative emotions, lifestyle changes, affected everyday activities, and lack of motivation for daily activities and social interactions. We conclude that the ABC model allowed certain elements to emerge regarding the fatigue experience, highlighting its importance as a symptom in fibromyalgia. This additional analysis of the ABC model showed that fatigue can be described through the 4 U’s Rule, which is integrated by these four adjectives: (1) Unpredictable, (2) Uncontrollable, (3) Unseen, and (4) Unintelligible. Identifying these characteristics can contribute to a better understanding of fibromyalgia in addition to better treatment for these patients. Full article
Open AccessArticle
Quality of Life and Health in Patients with Chronic Periodontitis: A Qualitative Study
Int. J. Environ. Res. Public Health 2020, 17(13), 4895; https://doi.org/10.3390/ijerph17134895 - 07 Jul 2020
Abstract
Purpose: Periodontal disease causes tooth loss if not treated early, and advanced periodontitis can cause a decline in various oral functions. These results diminish the health-related quality of life (QOL) for various populations. Thus, early detection and management of the disease, as well [...] Read more.
Purpose: Periodontal disease causes tooth loss if not treated early, and advanced periodontitis can cause a decline in various oral functions. These results diminish the health-related quality of life (QOL) for various populations. Thus, early detection and management of the disease, as well as a systematic strategy for the prevention of periodontal disease, are necessary. Methods: Adults, 19 years of age or older and diagnosed with chronic gingivitis or chronic periodontitis under the ICD-10 codes, were selected to participate in the study. A total of 20 participants were informed of the purpose of the study and gave consent to participate in in-depth interviews. Results: The treatment of periodontal disease improved health-related QOL and enabled the participants to have positive dental care health behaviors. Furthermore, the participants recognized the severity of periodontal disease and the importance of dental examinations. It enabled them to be aware of the societal need for dental care awareness. Conclusions: This study was an in-depth examination of the health-related QOL of periodontal patients through a qualitative research methodology. We expect that this study will expand research on health-related QOL due to periodontal disease and revitalize the dental health system and practices. Full article
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Open AccessArticle
Caregivers of Patients with Hematological Malignancies within Home Care: A Phenomenological Study
Int. J. Environ. Res. Public Health 2020, 17(11), 4036; https://doi.org/10.3390/ijerph17114036 - 05 Jun 2020
Cited by 1
Abstract
The role of caregivers in homecare settings is relevant to the patient’s wellbeing and quality of life. This phenomenon is well described in the literature for the oncological setting but not specifically for that of hematological malignancies. The aim of this study was [...] Read more.
The role of caregivers in homecare settings is relevant to the patient’s wellbeing and quality of life. This phenomenon is well described in the literature for the oncological setting but not specifically for that of hematological malignancies. The aim of this study was to explore the experience of primary caregivers of patients with hematological malignancies within home care. We conducted a phenomenological study based on interviews with 17 primary caregivers of hematological patients. Analysis of the contents led to the identification of five main themes. Perhaps, the innovative aspects of this study can be summarized in three points: This service was demonstrated to fulfil the ethical aspects of providing the patient with a dignified accompaniment to the end of life. Secondly, the efficiency of the service and the benefit are directly dependent on the caregivers’ wellbeing, so knowledge of the dynamics and emotions involved can lead to the development and implementation of programs for hematological malignancies. Lastly, a collaborative caregivers–professionals relationship can improve a sense of accomplishment for all parties involved, lessening the family’s frustration related to not having done their best. Home care brings significant benefits for both the patient and the caregivers and fulfils the ethical obligation of providing the patient dignified end-of-life care. Full article
Open AccessArticle
Influence of Aquatic Therapy in Children and Youth with Cerebral Palsy: A Qualitative Case Study in a Special Education School
Int. J. Environ. Res. Public Health 2020, 17(10), 3690; https://doi.org/10.3390/ijerph17103690 - 23 May 2020
Cited by 1
Abstract
Cerebral palsy results in the progressive loss of motor functions, with a negative impact on daily activities and participation. Despite the well described benefits of aquatic therapy in children, little is known about the effects of the same in school settings. This study [...] Read more.
Cerebral palsy results in the progressive loss of motor functions, with a negative impact on daily activities and participation. Despite the well described benefits of aquatic therapy in children, little is known about the effects of the same in school settings. This study aimed to describe the experience of children and youth with cerebral palsy participating in an aquatic therapy program within a special education school considering their educational and therapeutic perspectives. A qualitative descriptive case study with embedded units was developed, comprising 27 participants. This study employed purposeful sampling to include children and youth with cerebral palsy from the Asociación Ayuda a la Paralisis Cerebral (APACE) special education school, together with their parents, the special education teachers, and health care professionals. Data were collected via non-participant observation, semi-structured and informal interviews, focus groups, and researcher field notes. A thematic analysis was conducted, revealing the following themes: (a) the connection with the environment; (b) postural improvements and mobility; (c) the opportunity to perform tasks; (d) learning and transfer. A motivating environment leads to physical, cognitive and social benefits, both at school and in the home. Aquatic therapy was viewed as a means for learning and participation. These findings may enhance understanding regarding the potential benefits of implementing multidisciplinary aquatic therapy programs in specialist school settings. Full article
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Open AccessArticle
Perceptions of Medical Students Regarding Career Counseling in Korea: A Qualitative Study
Int. J. Environ. Res. Public Health 2020, 17(10), 3486; https://doi.org/10.3390/ijerph17103486 - 16 May 2020
Abstract
Current medical school education focuses on acquiring appropriate knowledge with relatively little interest in developing the career selection skills of medical students. We investigated medical students’ perceptions of career problems and the required types of career counseling programs. Five focus group discussions were [...] Read more.
Current medical school education focuses on acquiring appropriate knowledge with relatively little interest in developing the career selection skills of medical students. We investigated medical students’ perceptions of career problems and the required types of career counseling programs. Five focus group discussions were held with 23 medical students. The consensual qualitative study method was used to analyze the recorded discussion process. The medical students were more influenced by parents and grades than by subjective choices when deciding on admission to medical school. In future career choices, medical students considered the stability and feasibility of the career and expected quality of life. However, there were several opinions that it is essential to understand oneself. Objective and specific career information was lacking, and meeting with the professor was not very helpful for career counseling. Most medical students expected the effectiveness of the career counseling program but hoped the program would proceed with voluntary participation. Medical students wanted a variety of concrete and objective information, such as specialty information for choosing residency training, trainee hospital information, and post-residency training information in the career counseling program. Most medical students are not ready for career-related problems, therefore making it necessary to develop a career counseling program suitable for them. Full article
Open AccessArticle
Impact of Perinatal Death on the Social and Family Context of the Parents
Int. J. Environ. Res. Public Health 2020, 17(10), 3421; https://doi.org/10.3390/ijerph17103421 - 14 May 2020
Abstract
Background: Perinatal death (PD) is a painful experience, with physical, psychological and social consequences in families. Each year, there are 2.7 million perinatal deaths in the world and about 2000 in Spain. The aim of this study was to explore, describe and understand [...] Read more.
Background: Perinatal death (PD) is a painful experience, with physical, psychological and social consequences in families. Each year, there are 2.7 million perinatal deaths in the world and about 2000 in Spain. The aim of this study was to explore, describe and understand the impact of perinatal death on parents’ social and family life. Methods: A qualitative study based on Gadamer’s hermeneutic phenomenology was used. In-depth interviews were conducted with 13 mothers and eight fathers who had suffered a perinatal death. Inductive analysis was used to find themes based on the data. Results: Seven sub-themes emerged, and they were grouped into two main themes: 1) perinatal death affects family dynamics, and 2) the social environment of the parents is severely affected after perinatal death. Conclusions: PD impacts the family dynamics of the parents and their family, social and work environments. Parents perceive that society trivializes their loss and disallows or delegitimizes their grief. Implications: Social care, health and education providers should pay attention to all family members who have suffered a PD. The recognition of the loss within the social and family environment would help the families to cope with their grief. Full article
Open AccessArticle
What Bothers Me Most Is the Disparity between the Choices that People Have or Don’t Have”: A Qualitative Study on the Health Systems Responsiveness to Implementing the Assisted Decision-Making (Capacity) Act in Ireland
Int. J. Environ. Res. Public Health 2020, 17(9), 3294; https://doi.org/10.3390/ijerph17093294 - 09 May 2020
Cited by 1
Abstract
Objective: The Assisted Decision-Making (ADM) (Capacity) Act was enacted in 2015 in Ireland and will be commenced in 2021. This paper is focused on this pre-implementation stage within the acute setting and uses a health systems responsiveness framework. Methods: We conducted face-to-face interviews [...] Read more.
Objective: The Assisted Decision-Making (ADM) (Capacity) Act was enacted in 2015 in Ireland and will be commenced in 2021. This paper is focused on this pre-implementation stage within the acute setting and uses a health systems responsiveness framework. Methods: We conducted face-to-face interviews using a critical incident technique. We interviewed older people including those with a diagnosis of dementia (n = 8), family carers (n = 5) and health and social care professionals (HSCPs) working in the acute setting (n = 26). Results: The interviewees reflected upon a healthcare system that is currently under significant pressures. HSCPs are doing their best, but they are often halted from delivering on the will and preference of their patients. Many older people and family carers feel that they must be very assertive to have their preferences considered. All expressed concern about the strain on the healthcare system. There are significant environmental barriers that are hindering ADM practice. Conclusions: The commencement of ADM provides an opportunity to redefine the provision, practices, and priorities of healthcare in Ireland to enable improved patient-centred care. To facilitate implementation of ADM, it is therefore critical to identify and provide adequate resources and work towards solutions to ensure a seamless commencement of the legislation. Full article
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Open AccessArticle
Experience and Awareness of Health Managers, Administrators, and Workers on a Hearing Conservation Program in Korea: A Qualitative Study
Int. J. Environ. Res. Public Health 2020, 17(7), 2302; https://doi.org/10.3390/ijerph17072302 - 29 Mar 2020
Abstract
This study aims to evaluate the experience and awareness of a hearing conservation program to explore its activation plan. Three focus group discussions were conducted with five health managers, five labor supervisors, and five workers. A single in-depth interview was conducted with a [...] Read more.
This study aims to evaluate the experience and awareness of a hearing conservation program to explore its activation plan. Three focus group discussions were conducted with five health managers, five labor supervisors, and five workers. A single in-depth interview was conducted with a health manager. Since hearing loss has a significant influence on the quality of life of workers, all participants recognized the importance of management. Although the need for hearing conservation programs was acknowledged, the participants had negative views about their effectiveness. Most health managers have not been able to demonstrate tangible results from their efforts to solve hearing problems, and they have been unable to demand that their employers actively invest resources and personnel in solving or preventing hearing problems. The participants in this study did not entirely understand the hearing conservation program, negative comments suggested that it is impossible to eliminate noise sources from the workplace, and measures for noise reduction would reduce work efficiency. This study can be supplied not only as a basis for reidentifying the real problems of the hearing conservation program but also for the tailored implementation method of future hearing conservation programs at each worksite. Full article
Open AccessArticle
Bus Workers’ Experiences with and Perceptions of a Health Promotion Program: A Qualitative Study Using a Focus Group Discussion
Int. J. Environ. Res. Public Health 2020, 17(6), 1992; https://doi.org/10.3390/ijerph17061992 - 18 Mar 2020
Abstract
We conducted a focus group discussion with bus workers to evaluate their experiences and perceptions, as well as their reasons for participating in a program for vulnerable workers. The study also sought to identify the strengths and weaknesses of the program. A total [...] Read more.
We conducted a focus group discussion with bus workers to evaluate their experiences and perceptions, as well as their reasons for participating in a program for vulnerable workers. The study also sought to identify the strengths and weaknesses of the program. A total of nine bus workers participated in the focus group discussion. The focus group discussion was conducted based on a semi-structured guide, which was developed from discussions among the researchers and a review of major preliminary studies. The verbatim transcriptions were analyzed using content analysis. The sole existence of a health promotion program for vulnerable workers in Ulsan was sufficient to attract participants who had not been involved in other health management programs. Participants reported that participation in the program mitigated some of their musculoskeletal symptoms, which are often faced by bus workers. The findings of this study may contribute to the expansion of the health promotion program targeting workers in vulnerable working environments in Ulsan and other places. In order to increase users’ satisfaction and the sustainability of the program, it is necessary to develop a strategy to increase the accessibility of the program and enhance the self-efficacy of participants. Full article
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