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Basics of qualitative research: Grounded theory procedures and techniques

Evaluating complex interventions is complicated. The Medical Research Council9s evaluation framework (2000) brought welcome clarity to the task. Now the council has updated its guidance

https://www.bmj.com/content/bmj/337/bmj.a1655.full.pdf

Developing and evaluating complex interventions: The new Medical Research Council guidance

The Theory of Planned Behaviour (TPB) has received considerable attention in the literature. The present study is a quantitative integration and review of that research. From a database of 185 independent studies published up to the end of 1997, the TPB accounted for 27% and 39% of the variance in behaviour and intention, respectively. The perceived behavioural control (PBC) construct accounted for significant amounts of variance in intention and behaviour, independent of theory of reasoned action variables. When behaviour measures were self-reports, the TPB accounted for 11% more of the variance in behaviour than when behaviour measures were objective or observed (R2s = .31 and .21, respectively). Attitude, subjective norm and PBC account for significantly more of the variance in individuals' desires than intentions or self-predictions, but intentions and self-predictions were better predictors of behaviour. The subjective norm construct is generally found to be a weak predictor of intentions. This is partly attributable to a combination of poor measurement and the need for expansion of the normative component. The discussion focuses on ways in which current TPB research can be taken forward in the light of the present review.

/pdf/efficacy-of-the-theory-of-planned-behaviour-a-meta-analytic-32gm69pazu.pdf

Efficacy of the Theory of Planned Behaviour: a meta-analytic review.

In this chapter a theory of motivation and emotion developed from an attributional perspective is presented Before undertaking this central task, it might be beneficial to review the progression of the book In Chapter 1 it was suggested that causal attributions have been prevalent throughout history and in disparate cultures Studies reviewed in Chapter 2 revealed a large number of causal ascriptions within motivational domains, and different ascriptions in disparate domains Yet some attributions, particularly ability and effort in the achievement area, dominate causal thinking To compare and contrast causes such as ability and effort, their common denominators or shared properties were identified Three causal dimensions, examined in Chapter 3, are locus, stability, and controllability, with intentionality and globality as other possible causal properties As documented in Chapter 4, the perceived stability of a cause influences the subjective probability of success following a previous success or failure; causes perceived as enduring increase the certainty that the prior outcome will be repeated in the future And all the causal dimensions, as well as the outcome of an activity and specific causes, influence the emotions experienced after attainment or nonattainment of a goal The affects linked to causal dimensions include pride (with locus), hopelessness and resignation (with stability), and anger, gratitude, guilt, pity, and shame (with controllability)

/pdf/an-attributional-theory-of-achievement-motivation-and-2eu5g13rxj.pdf

An attributional theory of achievement motivation and emotion.

Is taking up smoking a reasoned action

AIMS AND OBJECTIVES: To explore the perspectives of practice nurses in their role of communicating cardiovascular risk to patients. BACKGROUND: Nurses in primary care have for some time been engaged in cardiovascular risk discussions with patients. With the recent introduction of the NHS Health Checks, the focus on this work is set to increase. DESIGN: Qualitative using a framework approach. METHODS: Two focus groups and 16 semi-structured interviews were conducted with nurses purposively sampled from those working in primary care. RESULTS: The nurses' accounts revealed the need to develop a relationship of trust and establish a level of relevance with each individual patient whilst discussing cardiovascular risk. Potential aspects of these discussions were as follows: working within a highly structured data-collecting task; time constraints and consideration of the individual's context. We used the idea of tailoring to describe how nurses navigate and constantly modify and pitch their approach for each patient they see in response to these constraints. CONCLUSION: We suggest that in order for risk to be made meaningful to patients, practice nurses recognise the need for such information to be embedded in the more reciprocal dynamics of nurse-patient consultations. From their perspective, success is often as much about not saying something, or saying it in a particular way, as saying anything accurately or consistently. RELEVANCE TO CLINICAL PRACTICE: For practice nurses to be instrumental in the successful delivery of health prevention policy initiatives such as the NHS Health Checks, it is important to acknowledge their views and perspectives in undertaking this work. This study suggests that the nurses recognised the need for further skills and a refinement of approach for those health professionals involved.

Tinkering and tailoring individual consultations: how practice nurses try to make cardiovascular risk communication meaningful.

The effects of measurement method on levels of unrealistic optimism for developing diabetes were examined in 323 UK adults. A mixed factorial design comprised direct and indirect measures of unrealistic optimism as the within-subjects variable, and between-subjects manipulations of the order of direct versus indirect assessment, the order of self-other comparison, the number of response options used and the polarity of the ratings. More unrealistic optimism was obtained using the direct method and using unipolar scales, and/or with the self-other order in the indirect method. The results indicate that levels of unrealistic optimism depend on its assessment method.

Assessing Unrealistic Optimism Impact of Different Approaches to Measuring Susceptibility to Diabetes

Practical meta-analysis of correlation matrices generally ignores covariances (and hence correlations) between correlation estimates. The authors consider various methods for allowing for covariances, including generalized least squares, maximum marginal likelihood, and Bayesian approaches, illustrated using a 6-dimensional response in a series of psychological studies concerning prediction of exercise behavior change. Quantities of interest include the overall population mean correlation matrix, the contrast between the mean correlations, the predicted correlation matrix in a new study, and the conflict between the existing studies and a new correlation matrix. The authors conclude that accounting for correlations between correlations is unnecessary when interested in individual correlations but potentially important if concerned with a composite measure involving 2 or more correlations. A simulation study indicates the asymptotic normal assumption appears reasonable. Because of potential instability in the generalized least squares methods, they recommend a model-based approach, either the maximum marginal likelihood approach or a full Bayesian analysis.

Allowing for correlations between correlations in random-effects meta-analysis of correlation matrices.

Some combinations of hazards yield disease rates greater than would be expected from the risk attributable to each hazard in isolation. However, perceptions are often more consistent with the combined risk being seen as less than the sum of the individual factors, raising concerns over the validity of some measures of risk perception. Here, 249 adults estimated the risk of cardiac events for four hypothetical men, described as having high or low levels of smoking and family history of heart disease. Three distinct measures were used. A 9-point scale produced a strong sub-additive interaction, a 101-point scale produced a weaker sub-additive interaction, and an unbounded scale produced no interaction. In this study, as in all previous research, scales with relatively few points (here a 9-point scale) yield sub-additive interactions. Given the consistency of results yielded by such scales, irrespective of context, it is concluded that these scales are not valid for perceptions of multiple risk factors. Copyright # 2004 John Wiley & Sons, Ltd.

http://www.phpc.cam.ac.uk/pcu/wp-content/files/2012/01/Paper93.pdf

Stephen Sutton

Papers

Is taking up smoking a reasoned action

Tinkering and tailoring individual consultations: how practice nurses try to make cardiovascular risk communication meaningful.

Assessing Unrealistic Optimism Impact of Different Approaches to Measuring Susceptibility to Diabetes

Allowing for correlations between correlations in random-effects meta-analysis of correlation matrices.

Different measures of risk perceptions yield different patterns of interaction for combinations of hazards: smoking, family history and cardiac events