자연주의적 탐구조사(Naturalistic Inquiry)

Self-Directed Learning, A Guide for Learners and Teachers

Rob Eisinga, Manfred te Grotenhuis, Ben Pelzer Department of Social Science Research Methods and Department of Sociology, Radboud University Nijmegen, PO Box 9104, 6500 HE Nijmegen, The Netherlands October 8 2012 To obtain reliable measures researchers prefer multiple-item questionnaires rather than single-item tests. Multiple-item questionnaires may be costly however and time-consuming for participants to complete. They therefore frequently administer two-item measures, the reliability of which is commonly assessed by computing a reliability coefficient. There is some disagreement, however, what the most appropriate indicator of scale reliability is when a measure is composed of two items. The most frequently reported reliability statistic for multiple-item scales is Cronbach’s coefficient alpha and many researchers report this coefficient for their two-item measure

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The reliability of a two-item scale: Pearson, Cronbach, or Spearman-Brown?

The Theory of Communicative Action, Vol. 1, Reason and the Rationalization of Society

https://thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)01044-2.pdf

Why invest, and what it will take to improve breastfeeding practices?

[Executive Summary]:

Synopsis: A study of 10,000 nurses in Australia (44% response rate) on their use of information technology has clearly identified that nurses recognise benefits to adopting more information technology in the workplace. They are however frustrated by limitations of access to the technology; software that is not always fit for purpose; and lack of opportunities for training. The level of use of information technology and information management systems is generally low and confidence in
use is low even among those nurses who are users. There is evidence that familiarity, use and confidence in use are slightly higher in nurses who have recent tertiary education. Nurses feel poorly informed about information technology health initiatives and poorly consulted about
implementation of these initiatives. Workload, number of computers, inadequate technical support and lack of training are principal barriers to the use of information technology. Technical support is especially poor in more remote locations. Neither the full potential of information technology in the provision of health and aged care nor the recognition by all nurses that information technology is an integral part of nursing will be realised until these limitations are addressed.

Nurses and information technology

Extended, expanded, multi-skilled or advanced practice? -Rural nurses in Australia, 1991-1994

Introduction: This article provides an in-depth investigation of the accommodation circumstances of a population of aging adults with intellectual disability living at home with parents or in supported accommodation in an Australian regional centre. Given the ageing of both the carer and adult population with intellectual disability our research explored the accommodation needs and perceptions of future lifestyle issues from the perspective of both the carers and the adults with intellectual disability. This study aimed to describe these accommodation circumstances related to a regional/rural location and did not make direct comparisons with urban/metropolitan situations. Methods: A mixed methods approach, specifically an explanatory design, participant selection model was utilised for the overall study. This article reports on the qualitative study consisting of data from both free response open-ended survey questions and semi-structured interviews with selected adults with intellectual disability and their carers. This study explored and described participants’ experiences and perceptions regarding their accommodation needs and future lifestyle issues. A purposive sampling technique was used to identify a representative sample of participants for interviews. The interview questions were guided by the results of the quantitative first study phase. Data were analysed by content analysis for major themes emerging from the interview and free response survey data. Results: A total of 146 carers (mean age 61.5 years; range 40–91 years) and 156 adults with intellectual disability (mean age 37.2 years; range 18–79 years) participated in the study. Data saturation was reached after 10 interviews were undertaken with carers (mean age 60 years) and 10 with adults with intellectual disability (no age criteria applied). Six major themes were identified: ageing, family issues, living at home, living away from home, government support and funding, and future needs. The perceptions and views of both adults with intellectual disability and their carers around these major themes are reported and discussed. Conclusions: This study indicates that there is a lack of suitable, available, supported accommodation for people aged 18 years and older with intellectual disability in this Australian regional centre. Consequently, aging parents caring at home have little choice but to continue in their caring role. For those caring away from home, existing services are decreasingly seen as fitting the ideal life they want for the person with intellectual disability for whom they care. The told experiences, perceptions and views of older carers of and adults with intellectual disability have highlighted their increasing vulnerability to the ‘disability system’. The findings suggest that government and disability services must acknowledge the changing needs of people with intellectual disability in connection with their advancing age and the urgency of increasing care needs due to the advancing age of their carer/s. The overwhelming feeling is that the carer’s voice will only be heard when the situation reaches crisis point. For many carers and their families this has already occurred.

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Accommodation needs for carers of and adults with intellectual disability in regional Australia: their hopes for and perceptions of the future

Objective: In-depth exploration of the perceptions, experiences and expectations of current long-term rural GPs and medical students intent on a rural career, regarding the current and future state of rural medicine. 

Design: Qualitative study using semistructured interviews. 

Setting: Rural and remote towns in Central and Southern Queensland and the School of Medicine, University of Queensland. 

Participants: Thirteen rural GPs with 10–40 years experience. Medical students (five second- and seven third-year), all of whom are members of a rural students' club and have an intention to pursue rural practice. Interviews were conducted between August and December 2004. 

Main outcome measures: Emergent themes relating to participant perceptions of the current and future state of rural medicine. 

Results: Despite large differences in generation and experience, medical students and rural GPs hold similar perceptions and expectations regarding the current and future state of rural practice. In particular, they cite a lack of professional support at the systems level. This includes specific support for: continuing medical education to obtain and retain the skills necessary for rural practice; dealing with the higher risks associated with procedural work; and consequences of medico-legal issues and workforce shortage issues such as long hours and availability of locums. 

Conclusions: Issues relating to recruitment and retention of the rural health workforce are identified by both cohorts as relating to professional support. Medical schools and institutional support systems need to join forces and work together to make rural practice a viable career in medicine.

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Medical students and rural general practitioners: Congruent views on the reality of recruitment into rural medicine

Background: Postnatal breastfeeding support in the form of home visits is difficult to accommodate in regional Australia, where hospitals often deal with harsh economic constraints in a context where they are required to provide services to geographically, dispersed consumers. This study evaluated a predominately telephone-based support service called the Infant Feeding Support Service. Methods: A prospective cohort design was used to compare data for 696 women giving birth in two regional hospitals (one public, one private) and participating in the support service between January and July 2003 with data from a cohort of 625 women who gave birth in those hospitals before the introduction of the support service. Each mother participating in the support service was assigned a lactation consultant. First contact occurred 48 hours after discharge, and approximately it weekly thereafter for 4 it weeks. Breastfeeding duration was measured at 3 months postpartum. Results: For women from the private hospital, the support service improved exclusive breastfeeding duration to 4.5 weeks postpartum, but these improvements were not evident at 3 months postpartum. No effects were observed for mothers from the public hospital. Quantitative and qualitative data demonstrated high levels of client satisfaction with the support service. Conclusions: This small-scale, predominately telephone-based intervention provided significant, although apparently context-sensitive, improvements to exclusive breastfeeding duration.

Desley Hegney

Papers

Nurses and information technology

Extended, expanded, multi-skilled or advanced practice? -Rural nurses in Australia, 1991-1994

Accommodation needs for carers of and adults with intellectual disability in regional Australia: their hopes for and perceptions of the future

Medical students and rural general practitioners: Congruent views on the reality of recruitment into rural medicine

An evaluation of a telephone-based postnatal support intervention for infant feeding in a regional Australian city