Explore the vast range of titles available.

In diesem Beitrag führen wir in den ersten Teil der Schwerpunktausgabe zur qualitativen Inhaltsanalyse (QIA) ein. In einem ersten Schritt beschreiben wir die Überlegungen, die dem Schwerpunkt zugrunde liegen, und erläutern die Unterteilung in zwei Teilausgaben. Anschließend geben wir einen Überblick über zentrale Fragestellungen in der gegenwärtigen Methodenliteratur zur QIA und identifizieren vier Kernbereiche: 1. die Konzeptualisierung der QIA als hybride Kombination quantitativer und qualitativer Elemente oder als genuin qualitative Methode; 2. die Relation zwischen dem deutschsprachigen und dem internationalen Methodendiskurs; 3. die Frage, ob sich theoretische und/oder epistemologische Grundlagen der QIA identifizieren lassen; 4. fehlende Transparenz bei der Dokumentation von Anwendungen der Methode. In einem nächsten Schritt gehen wir auf den Prozess der Erstellung der Schwerpunktausgabe ein und erläutern die Struktur und die Zusammenhänge zwischen den Beiträgen. In dem vorliegenden ersten Teil legen wir den Fokus auf Artikel zur Konzeptualisierung der QIA sowie auf Beiträge, in denen Herausforderungen bei der Methodenanwendung und Lösungsansätze beschrieben werden. Auf dieser Grundlage kommen wir zu dem Schluss, dass sich in der gegenwärtigen Methodenliteratur durchaus unterschiedliche Konzeptionen der QIA identifizieren lassen. Dies spiegelt sich auch in der Vielfalt der Herausforderungen bei der Anwendung der Methode wider und in den unterschiedlichen kreativen Umgangsweisen mit diesen Herausforderungen, wie sie von den Autor_innen dieser ersten Teilausgabe beschrieben werden.

Background Person-centred care (PCC) is promoted as an innovation that will improve patients’ rights and increase their participation in healthcare. Experience shows that the implementation of PCC is challenging and often results in varying levels of adoption. How health care professionals (HCPs) perceive an innovation such as PCC is an important factor to consider in implementation. Yet, such studies are scarce. Thus, in a sample of healthcare units in a region in Sweden, involved in a transition to PCC, we aimed to investigate HCPs’ perceptions of PCC. Methods An interview study was conducted in 2018 during the implementation of PCC with HCPs ( n  = 97) representing diverse vocational roles in six healthcare contexts. Data were collected via focus groups ( n  = 15), dyadic interviews ( n  = 5), and individual interviews ( n  = 22) and analysed using a deductive–inductive content analysis. The deductive approach was guided by the Consolidated Framework for Implementation Research (CFIR), followed by an inductive analysis to describe HCPs’ in-depth perceptions of PCC in relation to each of the CFIR constructs. Results Eight constructs from two of the CFIR domains, Intervention characteristics and Inner setting, were used to code HCPs’ perceptions of PCC. One construct, Observability, was added to the coding sheet to fully describe all the data. The constructs Relative advantage, Complexity, Compatibility, Observability, and Available resources were discussed in depth by HCPs and resulted in rich and detailed data in the inductive data analysis. This analysis showed large variations in perceptions of PCC among HCPs, based on factors such as the PCCs ethical underpinnings, its operationalisation into concrete working routines, and each HCPs’ unique recognition of PCC and the value they placed on it. Conclusions We identified nine CFIR constructs that seem pertinent to HCPs’ perceptions of PCC. HCPs report an array of mixed perceptions of PCC, underlining its complex nature. The perceptions are shaped by a range of factors, such as their individual understandings of the concept and the operationalisation of PCC in their local context. Stakeholders in charge of implementing PCC might use the results as a guide, delineating factors that may be important to consider in a wide range of healthcare contexts.

Background Implementation of person-centred care (PCC) is a challenging undertaking. Thus, a call has been issued for a robust and generic instrument to measure and enable evaluation of PCC across settings and patient groups. This study aimed to develop a generic questionnaire measuring patients’ perceptions of PCC. Further aims were to evaluate its content and measurement properties using a mixed-methods approach entailing Rasch and qualitative content analyses. Methods The study was conducted in three iterative phases. Phase one included six key informants to gain a broad view of the concept. Phase two entailed a Delphi study involving two rounds with eight experts who generated ratings on relevance, readability, comprehensiveness and suggestions for revision. Data were analysed using the Item Content Validity Index in conjunction with qualitative comments to improve the questionnaire. Phase three was performed using a mixed-methods design. Quantitative data were collected from patients ( n  = 553) responding to the questionnaire who were recruited from six in- and outpatient care units in a health care region in Sweden. Data was analysed using the Rasch measurement model. Qualitative data were based on the respondents’ free-text comments, cognitive interviews ( n  = 10) and field notes, and then analysed with deductive content analysis. Results A questionnaire was developed and operationalised based on the information given by key informants in phase one and then validated for its content by experts in phase two. In phase three Rasch analyses revealed problems with targeting, thresholds and two misfitting items. These problems were corroborated by data from the qualitative analyses, which also revealed some issues of wording and interpretation of items. When thresholds were resolved and two items removed, the questionnaire met the assumptions of the Rasch model. Conclusions Experts gave the questionnaire content high ratings and it met measurement requirements assumed by the Rasch model after revisions. Those problems on targeting that remain need to be addressed in future studies. Meanwhile, we regard the questionnaire as of sufficient quality to be useful in benchmarking PCC.

PurposeThis study aimed to describe facilitators and barriers in terms of regulation and financing of healthcare due to the implementation and use of person-centred care (PCC).Design/methodology/approachA qualitative design was adopted, using interviews at three different levels: micro = hospital ward, meso = hospital management, and macro = national board/research. Inclusion criteria were staff working in healthcare as first line managers, hospital managers, and officials/researchers on national healthcare systems, such as Bismarck, Beveridge, and mixed/out-of-pocket models, to obtain a European perspective.FindingsCountries, such as Great Britain and Scandinavia (Beveridge tax-based health systems), were inclined to implement and use person-centred care. The relative freedom of a market (Bismarck/mixed models) did not seem to nurture demand for PCC. In countries with an autocratic culture, that is, a high-power distance, such as Mediterranean countries, PCC was regarded as foreign and not applicable. Another reason for difficulties with PCC was the tendency for corruption to hinder equity and promote inertia in the healthcare system.Research limitations/implicationsThe sample of two to three participants divided into the micro, meso, and macro level for each included country was problematic to find due to contacts at national level, a bureaucratic way of working. Some information got caught in the system, and why data collection was inefficient and ran out of time. Therefore, a variation in participants at different levels (micro, meso, and macro) in different countries occurred. In addition, only 27 out of the 49 European countries were included, therefore, conclusions regarding healthcare system are limited.Practical implicationsSupport at the managerial level, together with patient rights supported by European countries' laws, facilitated the diffusion of PCC.Originality/valueFragmented health systems divided by separate policy documents or managerial roadmaps hindered local or regional policies and made it difficult to implement innovation as PCC. Therefore, support at the managerial level, together with patient rights supported by European countries' laws, facilitated the diffusion of PCC.

Background Delirium is common in older hospitalized patients. It has serious consequences e.g., poor health outcomes, mortality and increased costs. Despite that, many cases are undetected. Early detection of delirium is important in improving outcomes and use of assessment tools improves detection rates. The 4AT is a brief screening tool for delirium detection, which has not previously been translated into Swedish. The study aim was to evaluate diagnostic accuracy and clinical applicability of a Swedish version of the screening tool 4AT for delirium detection. Method This diagnostic test accuracy study used a quantitative and a qualitative approach and evaluated the patients’ and the health care professionals’ experiences of the tool. Study included 200 patients ≥65 years from a university hospital and a county hospital in two Swedish regions. Medical specialties were geriatric stroke/neurology, geriatric multimorbidity, severe cognitive impairment, orthopaedic, and urology. The translated 4AT was tested against the reference standard DSM-IV-TR criteria, based on the Organic Brain Syndrome scale and patient records. The 4AT was assessed simultaneously and independently by two assessors. Additionally, data was collected through patient record reviews, and questions about applicability to the patients ( n  = 200) and the assessors ( n  = 37). Statistical analyses, and qualitative content analyses were conducted. Results By reference standard 18% had delirium, and by 4AT 19%. The overall percent agreement was 88%, AUROC 0.808, sensitivity 0.70 (95% CI 0.51–0.84) and specificity 0.92 (95% CI 0.87–0.96). In the ward for severe cognitive impairment ( n  = 63) the 4AT was less sensitive and less specific. In the other wards ( n  = 132) sensitivity was 0.77 (95% CI 0.50–0.93), specificity 0.93 (95% CI 0.87–0.97), and AUROC 0.848. Interrater reliability (Kappa) was 0.918, p  = < 0.001 ( n  = 144). The 4AT was well tolerated by patients, easy to use for health care professionals, and took a few minutes to conduct. Conclusion The Swedish version of 4AT is an accurate and applicable tool to use in clinical practice for detecting delirium in hospitalized patients across different medical specialities, and to use by different professionals and levels of seniority. To improve patient outcomes, we recommend the 4AT to be incorporated in clinical practice in health care settings in Sweden.

Qualitatives Design besteht aus verschiedenen Ansätzen zur Datenerhebung und -analyse, die insbesondere für die Erstellung kultureller und kontextueller Beschreibungen und die Interpretation sozialer Phänomene anwendbar sind. Qualitative Inhaltsanalyse (QCA) und thematische Analyse (TA) stellen beides qualitative Ansätze dar, die üblicherweise von Forscher_innen aus unterschiedlichen Disziplinen gleichermaßen eingesetzt werden. Allerdings besteht in der internationalen Literatur eine Leerstelle in Bezug auf den Begriff von \"Thema\" in beiden Ansätzen und des Prozesses der Entwicklung von Themen. Daher gehen wir in unserem Beitrag auf diese Leerstelle ein und stellen Unterschiede und Ähnlichkeiten zwischen beiden Methoden in Bezug auf das \"Thema\" als Endprodukt der Datenanalyse dar. Zur Unterstützung unserer Sichtweisen und zur Erstellung international fundierter analytischer Begriffe von \"Thema\" greifen wir auf die aktuelle Literatur aus unterschiedlichen Disziplinen zurück. Wir gehen davon aus, dass Forscher_innen von einem vertieften Verständnis des Prozesses der Themenentwicklung in mehreren Hinsichten profitieren, nämlich bei der Auswahl einer geeigneten Methode für die Beantwortung ihrer Forschungsfrage, bei der Erzielung qualitativ hochwertiger und valider Ergebnisse sowie dabei, den analytischen Anforderungen an QCA und TA gerecht zu werden.

Background The Framework Method is becoming an increasingly popular approach to the management and analysis of qualitative data in health research. However, there is confusion about its potential application and limitations. Discussion The article discusses when it is appropriate to adopt the Framework Method and explains the procedure for using it in multi-disciplinary health research teams, or those that involve clinicians, patients and lay people. The stages of the method are illustrated using examples from a published study. Summary Used effectively, with the leadership of an experienced qualitative researcher, the Framework Method is a systematic and flexible approach to analysing qualitative data and is appropriate for use in research teams even where not all members have previous experience of conducting qualitative research.

Data analysis approaches such as qualitative content analysis are notoriously time and labor intensive because of the time to detect, assess, and code a large amount of data. Tools such as ChatGPT may have tremendous potential in automating at least some of the analysis. The aim of this study was to explore the utility of ChatGPT in conducting qualitative content analysis through the analysis of forum posts from people sharing their experiences on reducing their sugar consumption. Inductive and deductive content analysis were performed on 537 forum posts to detect mechanisms of behavior change. Thorough prompt engineering provided appropriate instructions for ChatGPT to execute data analysis tasks. Data identification involved extracting change mechanisms from a subset of forum posts. The precision of the extracted data was assessed through comparison with human coding. On the basis of the identified change mechanisms, coding schemes were developed with ChatGPT using data-driven (inductive) and theory-driven (deductive) content analysis approaches. The deductive approach was informed by the Theoretical Domains Framework using both an unconstrained coding scheme and a structured coding matrix. In total, 10 coding schemes were created from a subset of data and then applied to the full data set in 10 new conversations, resulting in 100 conversations each for inductive and unconstrained deductive analysis. A total of 10 further conversations coded the full data set into the structured coding matrix. Intercoder agreement was evaluated across and within coding schemes. ChatGPT output was also evaluated by the researchers to assess whether it reflected prompt instructions. The precision of detecting change mechanisms in the data subset ranged from 66% to 88%. Overall κ scores for intercoder agreement ranged from 0.72 to 0.82 across inductive coding schemes and from 0.58 to 0.73 across unconstrained coding schemes and structured coding matrix. Coding into the best-performing coding scheme resulted in category-specific κ scores ranging from 0.67 to 0.95 for the inductive approach and from 0.13 to 0.87 for the deductive approaches. ChatGPT largely followed prompt instructions in producing a description of each coding scheme, although the wording for the inductively developed coding schemes was lengthier than specified. ChatGPT appears fairly reliable in assisting with qualitative analysis. ChatGPT performed better in developing an inductive coding scheme that emerged from the data than adapting an existing framework into an unconstrained coding scheme or coding directly into a structured matrix. The potential for ChatGPT to act as a second coder also appears promising, with almost perfect agreement in at least 1 coding scheme. The findings suggest that ChatGPT could prove useful as a tool to assist in each phase of qualitative content analysis, but multiple iterations are required to determine the reliability of each stage of analysis.

Bayesian model averaging (BMA) provides a coherent and systematic mechanism for accounting for model uncertainty. It can be regarded as an direct application of Bayesian inference to the problem of model selection, combined estimation and prediction. BMA produces a straightforward model choice criterion and less risky predictions. However, the application of BMA is not always straightforward, leading to diverse assumptions and situational choices on its different aspects. Despite the widespread application of BMA in the literature, there were not many accounts of these differences and trends besides a few landmark revisions in the late 1990s and early 2000s, therefore not accounting for advancements made in the last decades. In this work, we present an account of these developments through a careful content analysis of 820 articles in BMA published between 1996 and 2016. We also develop a conceptual classification scheme to better describe this vast literature, understand its trends and future directions and provide guidance for the researcher interested in both the application and development of the methodology. The results of the classification scheme and content review are then used to discuss the present and future of the BMA literature.

Although grounded theory and qualitative content analysis are similar in some respects, they differ as well; yet the differences between the two have rarely been made clear in the literature. The purpose of this article was to clarify ambiguities and reduce confusion about grounded theory and qualitative content analysis by identifying similarities and differences in the two based on a literature review and critical reflection on the authors’ own research. Six areas of difference emerged: (a) background and philosophical base, (b) unique characteristics of each method, (c) goals and rationale of each method, (d) data analysis process, (e) outcomes of the research, and (f) evaluation of trustworthiness. This article provides knowledge that can assist researchers and students in the selection of appropriate research methods for their inquiries.