0

An exploration of mixed-methods research

What is Mixed-methods research?…. a mixture of methods? …or a multitude of methods in either one study or a succession of research?….Yes….it is a pickle.

What is mixed methods research?

I am on a learning curve (as always)…and I have been refining my understanding of mixed methods research…so what is mixed-methods research as I understand it now?

Firstly…what is a method?

I like to think of it as a recipe. Everyone knows a recipe for making a Victoria sponge…Eggs, sugar, butter, jam…and cream….But perhaps my method is different from your method..I add vanilla essence….you prefer yours with blackcurrant jam….We are both using a recipe or ‘method’ for making a Victoria sponge…

It’s just that the recipe or ‘method’ has both agreed standards… and modified versions.

Image result for victoria sponge

So…in research terms, I used to think of mixed-methods as literally a mixture of methods used in a single study….perhaps questionnaires and interviews…or a focus group and a literature review…But there are others who have defined it differently. Basically…we are actually looking at a mixture of both qualitative and quantitative research in one study/paper…Here are some other definitions below from leaders in the field..

Pat Bazeley: I tend to distinguish between mixed methods and multimethod, although if I need a generic term, I used mixed methods. Multimethod research is when different approaches or methods are used in parallel or sequence but are not integrated until inferences are being made. Mixed methods research involves the use of more than one approach to or method of design, data collection or data analysis within a single program of study, with integration of the different approaches or methods occurring during the program of study, and not just at its concluding point. Note that I am not limiting this to a combination of qualitative and quantitative research only, but more broadly, combinations of any different approaches/methods/data/analyses.

 

Valerie Caracelli: A mixed method study is one that planfully juxtaposes or combines methods of different types (qualitative and quantitative) to provide a more elaborated understanding of the phenomenon of interest (including its context) and, as well, to gain greater confidence in the conclusions generated by the evaluation study.

 

Huey Chen: Mixed methods research is a systematic integration of quantitative and qualitative methods in a single study for purposes of obtaining a fuller picture and deeper understanding of a phenomenon. Mixed methods can be integrated in such a way that qualitative and quantitative methods retain their original structures and procedures (pure form mixed methods). Alternatively, these two methods can be adapted, altered, or synthesized to fit the research and cost situations of the study (modified form mixed methods).

 

John Creswell: Mixed methods research is a research design (or methodology) in which the researcher collects, analyzes, and mixes (integrates or connects) both quantitative and qualitative data in a single study or a multiphase program of inquiry.

 

Steve Currall: Mixed methods research involves the sequential or simultaneous use of both qualitative and quantitative data collection and/or data analysis techniques.

 

Marvin Formosa: Mixed methods research is the utilitization of two or more different methods to meet the aims of a research project as best as one can. The research project may be conducted from either one or two paradigmatic standpoints (mixed methodology study).

 

Jennifer Greene: Mixed method inquiry is an approach to investigating the social world that ideally involves more than one methodological tradition and thus more than one way of knowing, along with more than one kind of technique for gathering, analyzing, and representing human phenomena, all for the purpose of better understanding.

 

Al Hunter: Mixed methods is a term that is usually used to designate combining qualitative and quantitative research methods in the same research project. I prefer the term multimethod research to indicate that different styles of research may be combined in the same research project. These need not be restricted to quantitative and qualitative; but may include, for example, qualitative participant observation with qualitative in-depth interviewing. Alternatively it could include quantitative survey research with quantitative experimental research. And of course it would include quantitative with qualitative styles.

 

Burke Johnson and Anthony Onwuegbuzie: Mixed methods research is the class of research where the researcher mixes or combines quantitative and qualitative research techniques, methods, approaches, concepts or language into a single study or set of related studies.

 

Udo Kelle: Mixed methods means the combination of different qualitative and quantitative methods of data collection and data analysis in one empirical research project. This combination can serve for two different purposes: it can help to discover and to handle threats for validity arising from the use of qualitative or quantitative research by applying methods from the alternative methodological tradition and can thus ensure good scientific practice by enhancing the validity of methods and research findings. Or it can be used to gain a fuller picture and deeper understanding of the investigated phenomenon by relating complementary findings to each other which result from the use of methods from the different methodological traditions of qualitative and quantitative research.

 

Donna Mertens: Mixed methods research, when undertaken from a transformative stance, is the use of qualitative and quantitative methods that allow for the collection of data about historical and contextual factors, with special emphasis on issues of power that can influence the achievement of social justice and avoidance of oppression.

 

Steven Miller: Mixed methods is a form of evolving methodological inquiry, primarily directed to the human sciences, which attempts to combine in some logical order the differing techniques and procedures of quantitative, qualitative and historical approaches. At present mixed methods must devote itself to resolving a set of issues, both epistemological and ontological. The first must devote itself to what Miller and Gatta (2006) call the “epistemological link,” that is the rules and rationales which “permit” one to proceed mixed methodologically. The second must adhere to some form of “minimal realist” ontology, where either social reality is “One” but can be accessed by different methods separately or working in conjunction, or social reality is multiple in nature and can ONLY be accessed through mixed methods. Present day attempts to couch mixed methods within some broad notion of pragmatism are not satisfactory.

 

Janice Morse: A mixed method design is a plan for a scientifically rigorous research process comprised of a qualitative or quantitative core component that directs the theoretical drive, with qualitative or quantitative supplementary component(s). These components of the research fit together to enhance description, understanding and can either be conducted simultaneously or sequentially.

 

Isadore Newman: Mixed methods research is a set of procedures that should be used when integrating qualitative and quantitative procedures reflects the research question(s) better than each can independently. The combining of quantitative and qualitative methods should better inform the researcher and the effectiveness of mixed methods should be evaluated based upon how the approach enables the investigator to answer the research question(s) embedded in the purpose(s) (why the study is being conducted or is needed; the justification) of the study. (See Newman, Ridenour, Newman & DeMarco, 2003.)

 

Michael Q. Patton: I consider mixed methods to be inquiring into a question using different data sources and design elements in such a way as to bring different perspectives to bear in the inquiry and therefore support triangulation of the findings. In this regard, using different methods to examine different questions in the same overall study is not mixed methods.

 

Hallie Preskill: Mixed methods research refers to the use of data collection methods that collect both quantitative and qualitative data. Mixed methods research acknowledges that all methods have inherent biases and weaknesses; that using a mixed method approach increases the likelihood that the sum of the data collected will be richer, more meaningful, and ultimately more useful in answering the research questions.

 

Margarete Sandelowski: First, I think of this in terms of either a single primary research study or as a program of research. Then, I see mixed methods as something of a misnomer as mixing implies blending together. Mixed methods research, though, is more the use of different methodological approaches TOGETHER in a single study or single program of research. One cannot blend methods in the sense of assimilating one into the other. I use methods here to refer to larger inquiry approaches (e.g., experiments and grounded theory) which are themselves based in distinctive theoretical perspectives. Yet this sets up a problem too, as grounded theory, for example, can be “positivist” (a la Strauss & Corbin), “constructivist” (a la Charmaz), or “postmodern” (a la Clarke) in sensibility or influence. So, if a researcher is doing grounded theory (positivist style) and an experiment (positivist influence), are any methods actually being mixed? In other words, mixed methods research can be defined at the technique level as the combination of, e.g., purposeful & probability sampling, open-ended and closed-ended data collection techniques, and narrative and mutivariable analyses—i.e., in which anything can be used together (linked or assimilated into each other)—or it can be defined at a larger theoretical/paradigmatic level as using divergent approaches to inquiry together. I would not define mixed methods research as constituting ANY combination of 2 or more things, as any research involves the use of 2 or more of something and the use of experiment and survey is 2 things, but they are informed by one mind (typically positivist/objectivist/realist). We get tangled in words, do we not?

 

Lyn Shulha: By collaborative mixed method research, we will mean the purposeful application of a multiple person, multiple perspective approach to questions of research and evaluation. Decisions about how methods are combined and how analyses are conducted are grounded in the needs and emerging complexity of each project rather than in preordinate methodological conventions. . . . Within this context, methods can be “mixed” in a variety of ways. Sometimes, one method serves another in validating and explicating findings that emerge from a dominant approach. On other occasions, different methods are used for different parts of the issues being investigated, and in an independent way. In more complex cases, the methods and perspectives are deliberately mixed from the beginning of the process. The resulting interaction of problem, method, and results produce a more comprehensive, internally consistent, and ultimately, more valid general approach. What sets the most complex forms of collaborative mixed method research apart from other forms of inquiry is that findings depend as much on the researchers’ capacities to learn through joint effort and to construct joint meaning as on their expertise in conventional data collection and analysis techniques.

 

Abbas Tashakkori and Charles Teddlie: Mixed methods research is a type of research design in which QUAL and QUAN approaches are used in type of questions, research methods, data collection and analysis procedures, or in inferences.

 

Note: QUAL = qualitative research; QUAN = quantitative research

Source for quotes = Toward a Definition of Mixed Methods Research R. Burke Johnson University of South Alabama, Mobile Anthony J. Onwuegbuzie University of South Florida, Tampa Lisa A. Turner University of South Alabama, Mobile

Image result for mixed methods studies

There are also now reporting guidelines emerging for Mixed Methods studies (O’Cathain, Alicia, Elizabeth Murphy, and Jon Nicholl. “The quality of mixed methods studies in health services research.” Journal of Health Services Research & Policy 13.2 (2008): 92-98.)

Good Reporting of A Mixed Methods Study (GRAMMS)…Guidelines as follows…

(1) Describe the justification for using a mixed methods approach to the research question

(2) Describe the design in terms of the purpose, priority and sequence of methods

(3) Describe each method in terms of sampling, data collection and analysis

(4) Describe where integration has occurred, how it has occurred and who has participated in it

(5) Describe any limitation of one method associated with the present of the other method

(6) Describe any insights gained from mixing or integrating methods

Mixed methods research is more specific in that it includes the mixing of qualitative and quantitative data, methods, methodologies, and/or paradigms in a research study or set of related studies. One could argue that mixed methods research is a special case of multimethod research.

 

Image result for mixing bowl research

So until next time… look after yourselves & each other…then …in the words of Bob Marley…go ahead and stir it up….🎓💜🌟

Advertisements
0

Maximising your academic potential via social media

This is just a short blog post to say that I will be hosting a seminar on …

Maximising your academic potential via social media this week at @covcampus

Many people have said they would like to come… but cannot attend on this occasion…..

As such, I will be publishing this seminar in a series of blog posts designed for academics looking to maximise their potential via social media – Hope this helps 🙂

Follow my blog with Bloglovin

 

0

Annual Virtual Conference to celebrate International Day of the Midwife 2nd May

Virtual International Day of the Midwife Conference POSTER 2015

Virtual International Day of the Midwife Conference POSTER 2015

The Virtual International Day of the Midwife (VIDM) celebrates the International Day of the Midwife by bringing midwives, students, consumers and all parties interested in childbirth from across the globe together using online electronic media. A 24 hour conference is held each year covering a wide range of topics with speakers from all over the world.

The programme is now confirmed and looks really awesome! There are so many innovative projects and events going on around the world in midwifery, this will be a great way to catch up with some of them from the comfort of home!!! – The speakers are truly global this year.

I will be one of the speakers presenting my PhD research project from the UK at 10:00 (British time) BST Saturday, 2 May 2015. I am hoping that many of you will tune in to the conference when you can. I would love to share my projects with you all!!

@VIDofM

Click here for instructions on how to join the webinar – I will be presenting at 10am UK Time (GMT).

My Abstract: This presentation will discuss a PhD project aiming to explore the value of online interventions in supporting midwives in work-related psychological distress.

Much emphasis is placed upon providing support for patients who are part of traumatic incidents, yet limited attention has been paid to the ‘second victim’, i.e. the midwives involved, who may also experience mental and emotional distress (Wu, 2000). The prevalence of these second victims has been seen to rise up to 43.3% as practitioner’s soldier on, often in silence (Wolf et al, 2000). Those affected can develop symptoms as severe as those in post-traumatic stress disorder (Rassin et al, 2005).

This presentation will educate its audience upon the psychiatric and physical morbidities associated with traumatic midwifery work, the epidemiology and etiology of ‘the second victim’ and the consequences of this under reported issue for midwifery practice. It will also offer solutions for supporting midwives in distress.

Rassin M, Kanti T, Silner D. Chronology of medication errors by nurses: accumulation of stresses and PTSD symptoms. Issues Ment Health Nurs. 2005;26:873-886.

Wu AW (2000) Medical error: the second victim. The doctor who makes the mistake needs help too. BMJ. Vol. 320 Pp.726–7.

Wolf, Z. R., Serembus, J. F., Smetzer, J., Cohen, H., & Cohen, M. (2000) Responses and concerns of healthcare providers to medication errors. Clinical Nurse Specialist. 14, 278–287.

2

Partnering with the Colombo Institute of Research and Psychology – Sri Lanka…

colombo institute of research and psychology

colombo institute of research and psychology

I apologize for the lack of posts over the last 2 weeks. I have been to visit the wonderful people in the Colombo Institute of Research and Psychology and the National Institute of Mental Health, Angoda.Then of course I had to deal with copious amounts of work/emails upon my return, which I am sure will fill exciting posts to come.

When I embarked upon this research journey, I also signed up for the Global Leaders Programme at Coventry University. I did this to become a part of the global healthcare community and reach key opinion leaders with the same directive goals as myself…Starting the conversation has always been the most productive way to make change happen. Indeed, it has already put me in touch with some inspiring people, and this trip proved to be no different.

I have always had a keen interest in getting to know how the various healthcare systems across our globe work. We are all human… so what works best? I have already visited the Royal Victoria Teaching Hospital in Banjul, The Gambia and the Gimbie Adventist Hospital, Ethiopia. With the help of Maternity Worldwide and clinical work placements, I was privileged to have the opportunity to see how our health care systems contrast and compare to other healthcare systems around the globe. I was excited to take part in this visit, which promised to enlighten us all to the mental healthcare provisions and psychology research in Sri Lanka.

National Institute of Mental Health, Angoda Colombo, Sri Lanka

National Institute of Mental Health, Angoda Colombo, Sri Lanka

Speaking with the researchers in the Colombo Institute of Research and Psychology, it was clear that their research shared the same concerns as western research. Healthy debates generated interesting insights into the work they were forming in breaking stigma and securing new funding for the people of Sri Lanka. However, their population base faces some new and very real challenges:

-Less than 1% of Sri Lankas healthcare budget is spent on the mental health care of the nation.

-Sri Lankan communities often use astrology and homeopathic remedies to treat mental ill health rather than access medical facilities.

– There are only 2 psychiatric consultants for the whole of Colombo and surrounding areas.

-Limited facilities for mother and baby units, which need more space for mentally unwell mothers and their families. (In Sri Lanka, reported maternal death due to suicide is notably high) – See Puerperal Psychosis.

– The stigma around mental health issues remains great in Sri Lanka, therefore many of those who may be ready to re-enter their communities following treatment have no where to return to. They become rejected by their families.

– This stigma creates a culture where those in need are reluctant to seek help.

– Families are keen not to disclose the mental ill health of loved ones and may isolate problems.

-Mental health facilities are used as holding places for those on remand following the identification of the antisocial behavioral symptoms of ill mental health.

Speaking to one of the consultant psychiatrists about these issues was so valuable to my research. Comparing the etiologies of psychological distress with the cultures and social norms of both populations highlighted how our UK populations may face triggers for distress which are entirely unique to the UK. Although some of these factors will also translate to other populations, it may be that specific factors correlate only with our own health care professionals, within western society.

From the point of view of research, this leaves much to be explored. How do we breakdown the populations into completely homogeneous samples? Is it ever possible to?

After speaking with Dr Shavindra Dias from the University of Peradeniya, (which by the way is the most beautiful university campus I have ever seen!) it is clear that the connections I have made throughout this research trip will last throughout my career as I continue to network with and learn from some of the most outstanding and inspirational leaders who take pride in making changes to ensure a brighter future for all. The struggle to improve the overall well being of society by authenticating and placing value upon the needs of those in psychological distress is hard. Yet I still believe that is the most noble and kind thing we can do for humanity. The connections I have made throughout this trip will forever remain a part of my professional journey going forward, and I would like to thank @PsychColombo again for hosting such an amazing trip of discovery in partnership with @covcampus.

In addition to this wonderful experience we also visited:

-Galle Face Green

-Galle Fort

-The National Museum of Colombo

-International Maritime Museum in Colombo

– The National Elephant Orphanage

-The Temple of the Tooth

-Anuradhapura

-Botanical Gardens

-Tea Factories

View from the World Trade Centre in Colombo

View from the World Trade Centre in Colombo

Sri Lankan Elephant Orphanage

Sri Lankan Elephant Orphanage

I hope to reunite with the amazing people I met here soon…. Perhaps for my up and coming Delphi Study?

0

Hospital Staff Absences for Mental Health Reasons Double – but do the Figures Add Up?

Today I was up early to watch Danny Mortimer NHSE_Danny (Chief Executive Employers) Speak on BBC Breakfast in light of new figures obtained via a Freedom of Information Act Request, that Hospital staff absences for mental health reasons has doubled across England in the last 4 years!

This information is obviously very relevant to my PhD study, and I will be reviewing it in time. However, the initial response that Danny Mortimer gave was that  staff feel comfortable talking about their . Hmm…

Has all of my research to date been wrong? Are #NHS staff comfortable talking freely about their mental ill health? (would love to hear your thoughts, but ironically you may feel unable to speak out – I tell myself this is the reason for a lack of comments on, and interactions with my blog all of the time :P)

Anyway, as you can imagine, I became worried that I was ‘missing something’ and asked Danny if he had any evidence for this? – See our conversation here

As you can see, he did not provide me with evidence for this statement, but agreed that we all need to do more to support our colleagues, and I know that we all share the same constructive goals. Unfortunately people don’t always have an answer, they just know that something needs to be done. I still believe that my PhD research could be the key to effective support, but this project is in its infancy and I will keep the readers of this blog as updated upon its progress as I am able.

So… the evidence provided by NHS Employers upon the mental health & well being of NHS staff is this:

MentalHealth Infographic WEB FINAL

A great infographic! However, one thing concerns me…. Apparently 76% of NHS trusts report that they monitor the well being of their staff (RCP, London). Yet 3 out of 4 people suffering from mental illness get NO TREATMENT AT ALL. (www.mentalhealth.org). So, are NHS trusts doing anything about the staff they find to be unwell? or are NHS staff fine? I think not. I worry that there is a lot of good rhetoric out there around NHS staff health and wellbeing, but not many interventions to support staff. The figures don’t add up, and seemingly only smarties have the answer.

I hope I have the answer coming… I hope its not too late.

http://www.mentalhealth.org.uk/content/assets/PDF/publications/fundamental_facts_2007.pdf?view=Standard

http://www.rcplondon.ac.uk/resources/nice-public-health-guidance-workplace-organisational-audit’

0

Health Professionals who Die by Suicide – 5 Tips for Change


If the content of this post has affected you in any way, please visit the support page of this blog….

Yesterday was #NHSChangeDay, and I pledged to #StartTheConversation and raise awareness about health professionals who are in psychological distress. As it happens, @WeDocs conveniently hosted a  #WeDocs Tweetchat on preventing suicide in health care professional populations. It was great to see an issue I feel so passionate about being discussed, shared and given some much needed attention. This kind of innovative Twitter usage is one of the things I love about our NHS radicals!

Throughout the conversation, there were seemingly many people concerned and wanting to prevent clinician suicide, but not many solutions to prevention were put forward. -> See the chat summary here

A recent situational analysis into Suicide by clinicians involved in serious incidents in the NHS has identified the current support services available clinical staff, yet there is no consensus on how to effectively support clinical staff, and nobody has yet taken responsibility for the well being of NHS staff (Strobl et al, 2014). This has been further complicated by the fact that Clinicians often have difficulty in recognising symptoms and risk factors associated with their own suicidal behaviour (Goldney et al, 2002). Clinicians are at a higher risk of suicide than the general population, can be misunderstood and left unsupported whilst under immense pressure (Chan et al, 2014). The GMC have recently published a report in regards to a high rate of professionals dying by suicide whilst under investigation. A tragedy for all.

Psychological safety for NHS staff is critical for patient safety and every shiny new white paper will tell you this. But it is also critical for the NHS’s ‘ethical well being’ to care for it’s staff. If the NHS as an organization lets its staff suffer, how will it ever live with itself? The trauma will inevitably become endemic.

So what changes can we make to prevent suicide?

1. We could treat NHS staff as ‘innocent until proven guilty’ & eradicate ‘Name Blame and Shame’ Cultures.

2. Consider that poor behaviour may actually be ‘ill’ behaviour in need of medical treatment before disciplinary action takes place (Brooks et al, 2014).

3. Consider alternatives to discipline & create psychologically safe work cultures.

4.Expose investigation staff to front line clinical practice to understand organizational cultures and pressures.

5. Develop a tailor made national support programme for NHS staff which is confidential, anonymous and provides professional amnesty (The aim of my entire PhD research project)

Also… please keep the conversation going 🙂

Brooks, S, Del Busso, L, Chalder, T, Harvey, S ,Hatch, S, Hotopf, M, MadanHenderson, M (2014) ‘You feel you’ve been bad, not ill’: Sick doctors’ experiences of interactions with the General Medical Council BMJ Open 2014;Vol.4 (7) :e005537 doi:10.1136/bmjopen-2014-005537.

Chan, W., Batterham, P., Christensen, H., Galletly, C (2014) Suicide literacy, suicide stigma and help-seeking intentions in Australian medical students. Australas Psychiatry April 2014 vol. 22 no. 2 132-139

Goldney RD, Fisher LJ, Wilson DH (2002). Mental health literacy of those with major depression and suicidal ideation: an impediment to help seeking. Suicide Life Threat Behav 2002; 32: 394–403.

2

Am I too late to the ‘NHS staff wellbeing research’ party?

I began this research journey because I saw an opportunity to make a positive contribution to the healthcare community (and gain a PhD)! I believed that NHS Staff wellbeing was an under researched and undervalued subject (and it is to a large extent). When I began my time at Coventry University, I presented my research proposal to a group of peers at the West Midlands Health Informantics Conference just before Christmas 2014. My ideas were met with enthusiastic conversations and praise for my work, people were excited that it was happening, it was ‘new’.

Then of course I begin to delve into the literature and start to see a plethora of papers and super duper academics who have introduced me to this wondrous world. I see TV snippets, twitter conversations, national and local conferences, action groups and new research on the topic. Am I too late to the party?

What I plan to do has never been done before, but I know that many people have had the same idea. Will it be a race to publish? I hope not. I hope I can find similar minded people to drive forward this positive movement forward, collectively. We should all be in this together, making change happen through collective leadership and a shared passion for the wellbeing of NHS staff. I do worry that I am not really contributing towards new knowledge, but I must keep focussed on the end goal (and beyond the PhD)!

The most refreshing thing is the open discussions being generated through twitter – The next one I will be involved with is on the 11th March, 2015 hosted by WeDocs using #WeDocs – Preventing suicide in NHS staff

This new research is inspiring and I would like to share it:

Wilkinson, M (2015) UK NHS staff: stressed, exhausted, burnt out. The Lancet Volume 385, No. 9971, p841–842, 7 

Sheen, K, Slade, P, Spiby, H (2014) An integrative review of the impact of indirect trauma exposure in health professionals and potential issues of salience for midwives. Journal of Advanced Nursing. Volume 70, Issue 4, pages 729–743, April 2014

Implementing culture change within the NHS: Contributions from Occupational Psychology