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Chronic kidney disease (CKD), a progressive chronic disease common in older persons, is estimated to affect approximately 44% of individuals aged 65 and older [4] and more than 10% of the population worldwide [5, 6]. End-stage renal disease (ESRD) refers to patients with an estimated glomerular filtration rate lower than 15 ml per minute per 1.73 m2 body surface area [7, 8]. ESRD treatment involves renal replacement therapy (RRT), which includes peritoneal dialysis (PD), hemodialysis (HD), and kidney transplantation (KT) [9].
Mixed methods research: what it is and what it could be
An example of mixed methods research is a study that combines quantitative and qualitative data. This type of research uses surveys, interviews, and observations to collect data from multiple sources. Mixed methods research designs combine the strengths of qualitative and quantitative data, deepening and enriching qualitative results with quantitative data and validating quantitative findings with qualitative data. This method offers more flexibility in designing research, combining theory generation and hypothesis testing, and being less tied to disciplines and established research paradigms. The exploratory sequential design collects qualitative data first, followed by quantitative data. This type of mixed methods research is used when the goal is to explore a topic before collecting any quantitative data.
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Despite this constraint, she required a dental consultation to receive advice for initial self-care, as her symptoms significantly impacted her daily life. Furthermore, she was designated to encounter difficulties with the technological use of the teledentistry platform. All rights are reserved, including those for text and data mining, AI training, and similar technologies. (b) Context – refers to cases in which the combination is justified in terms of qualitative research providing contextual understanding coupled with either generalizable, externally valid findings or broad relationships among variables uncovered through a survey. Expansion seeks to extend the breadth and range of inquiry by using different methods for different inquiry components.
What does this paper contribute to the wider global clinical community?
It is at this point that the components are “mixed”, hence the label “mixed methods designs”. The term “mixing”, however, is misleading, as the components are not simply mixed, but have to be integrated very carefully. The integration of quantitative and qualitative data involves combining the results from both types of data analysis to gain a more comprehensive understanding of the research question. Concurrent integration involves analyzing quantitative and qualitative data at the same time, while sequential integration involves analyzing one type of data first and then using the results to inform the analysis of the other type of data.
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In a sequential design, the quantitative component precedes the qualitative component, or vice versa. In the notation of Morse (1991), concurrence is indicated by a “+” between components (e. g., QUAL + quan), while sequentiality is indicated with a “→” (QUAL → quan). Note that the use of capital letters for one component and lower case letters for another component in the same design suggest that one component is primary and the other is secondary or supplemental.
Questionnaire – Definition, Types, and Examples
This was combined with the website, which included a home page, a user panel, and an administration panel, and the mobile app, which included a user area and an expert area. The panel of experts made comments and suggestions, and the model was revised twice and returned to the panel of experts for evaluation until they were satisfied. There were 18 residents from Year 1 to 3 of the Residency Training Program in Advanced General Dentistry who participated in this research (six from each year). There was no participant dropout, as all of them completed all required tasks, including the pre- and post-perceived assessments, gamified online role-play, and satisfaction questionnaire. According to the purposive sampling, the participants from the quantitative phase were selected for semi-structured interviews by considering sex, year of study, and self-perceived assessment scores. Twelve students (ten females and two males) participated in semi-structured interviews, where their characteristics are presented in Table 1.
This pedagogical approach could mimic real-life practice, where dental learners could gain experience in the use of teledentistry in simulated situations before interacting with actual patients. Role-play could provide learners opportunities to develop their required competencies, especially communication and real-time decision-making skills, in a predictable and safe learning environment20,23,46. Potential obstacles could also be arranged for learners to deal with, leading to the enhancement of problem-solving skill50. In addition, the recognition of teledentistry benefits can enhance awareness and encourage its adoption and implementation, which could be explained by the technology acceptance model51. Therefore, a gamified online role-play with a robust design and implementation appeared to have potential in enhancing self-perceived confidence and awareness in the use of teledentistry. Not all applied researchers have insight into the underlying philosophy and/or the skills to apply each set of methods appropriately.
The power of mixed methods research is its ability to deal with diversity and divergence. A first set of strategies takes the detected divergence as the starting point for further analysis, with the aim to resolve the divergence. One can also look for a more comprehensive theory, which is able to account for both the results of the first component and the deviating results of the second component. At some point in writing down the results of the first component, the results of the second component are added and integrated. A joint display (listing the qualitative and quantitative findings and an integrative statement) might be used to facilitate this process. Mixed methods research (“Mixed Methods” or “MM”) is the sibling of multimethod research (“Methodenkombination”) in which either solely multiple qualitative approaches or solely multiple quantitative approaches are combined.
What are the strengths and challenges in using mixed methods?
The value of a home telehealth self-monitoring model with nurse oversight has been demonstrated with positive results in terms of reducing clinical complications. Despite less contact with homecare facilities due to shortages of clinical nurse specialists visiting patients at home, OPLWH experienced sustained quality of life and improved clinical outcomes after receiving the integrated home telehealth model. The conceptual framework of this study applies the continuum of home telehealth technologies, developed by Hebert, Korabek, and Scott, to examine the feasibility of using a home telehealth program for older persons living with hemodialysis (OPLWH) in Thailand [15]. These technologies can be categorized following the 3 steps of the home telehealth technologies’ continuum [17], from 1) patients initiating contact, through 2) automatic monitoring via technology, to 3) healthcare professionals initiating contact (see Fig. 1). Categorizing telehealth services may also be based on desirable patient outcomes and the need for services [15].
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These mixed methods researchers are likely to believe that qualitative and quantitative data and approaches will add insights as one considers most, if not all, research questions. The number of possible purposes for mixing is very large and is increasing; hence, it is not possible to provide an exhaustive list. Greene et al.’s (1989) purposes, Bryman’s (2006) rationales, and our examples of a diversity of views were formulated as classifications on the basis of examination of many existing research studies. They indicate how the qualitative and quantitative research components of a study relate to each other. These purposes can be used post hoc to classify research or a priori in the design of a new study. When designing a mixed methods study, it is sometimes helpful to list the purpose in the title of the study design.
Note that each research tradition receives an equal number of letters (four) in its abbreviation for equity. Interviews are a qualitative data collection method that involves asking open-ended questions to gather in-depth information about a participant’s experiences, perspectives, and opinions. This article will outline common types of mixed methods designs and provide examples of how nursing researchers can apply different mixed methods designs in order to answer important nursing practice questions. Mixed methods designs allow for method flexibility and can provide differing and even conflicting results.
Focusing on the core MMR group, the top ten authors of the group together collect 458 citations from the 797 articles in the sample, locating them at the center of the citation network. Creswell is the most cited author (210 citations) and his work too receives most citations from journals in nursing and education studies. According to Bourdieu, their position can, to a certain degree, explain the strategy they pursue and the options they perceive to be viable in the trade-off regarding the risks and potential rewards for their work.
The medical units had a register of OPLWH which included patients’ telephone numbers; using this register, the researcher was able to invite potential participants to take part in the study by telephone. An advanced practitioner nurse in hemodialysis and two hemodialysis nurses who were trained as “supporters” helped to recruit participants, participated in monthly meetings and discussions with researcher and participants at the hemodialysis unit, and provided monitoring and consultation online. They also helped the researcher collect laboratory parameters from medical records at the hemodialysis unit.
Dependence indicates whether the implementation of one component depends upon the results of data analysis of the other component. As we will see in the example case studies, a concurrent design could include dependent data analysis, and a sequential design could include independent data analysis. It is conceivable that one simultaneously conducts interviews and collects questionnaire data (concurrent), while allowing the analysis focus of the interviews to depend on what emerges from the survey data (dependence). In the mixed methods literature, the distinction between sequential and concurrent usually refers to the combination of concurrent/independent and sequential/dependent, and to the combination of data collection and data analysis. This design involves collecting both qualitative and quantitative data concurrently and then comparing the results to find areas of agreement and disagreement.
One can go a long way in depicting a complex design with Morse’s (1991) notation when used to its full potential. We also recommend that researchers understand the process approach to design from Maxwell and Loomis (2003), and realize that research design is a process and it needs, oftentimes, to be flexible and interactive. This study evaluated whether a hemodialysis nursing team integrated with a home telehealth model was a feasible method of holistic care delivery to maintain quality of life and improve health outcomes among OPLWH.
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