자연주의적 탐구조사(Naturalistic Inquiry)

世界経済・社会統計 = World development indicators

2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC)

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2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC).

Attachment--and loss.

Since 1980, the American College of Cardiology (ACC) and American Heart Association (AHA) have translated scientific evidence into clinical practice guidelines (guidelines) with recommendations to improve cardiovascular health. In 2013, the National Heart, Lung, and Blood Institute (NHLBI) Advisory

http://kidneys.zaslavsky.com.ua/article/download/122220/118980

2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Qualitative case study methodology provides tools for researchers to study complex phenomena within their contexts. When the approach is applied correctly, it becomes a valuable method for health science research to develop theory, evaluate programs, and develop interventions. The purpose of this paper is to guide the novice researcher in identifying the key elements for designing and implementing qualitative case study research projects. An overview of the types of case study designs is provided along with general recommendations for writing the research questions, developing propositions, determining the “case” under study, binding the case and a discussion of data sources and triangulation. To facilitate application of these principles, clear examples of research questions, study propositions and the different types of case study designs

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Qualitative Case Study Methodology: Study Design and Implementation for Novice Researchers

Background
People who are prescribed self-administered medications typically take less than half the prescribed doses. Efforts to assist patients with adherence to medications might improve the benefits of prescribed medications, but also might increase their adverse effects.

Objectives
To update a review summarizing the results of randomized controlled trials (RCTs) of interventions to help patients follow prescriptions for medications for medical problems, including mental disorders but not addictions.

Search methods
We updated searches of The Cochrane Library, MEDLINE, CINAHL, EMBASE, International Pharmaceutical Abstracts (IPA), PsycINFO (all via OVID) and Sociological Abstracts (via CSA) in January 2007 with no language restriction. We also reviewed bibliographies in articles on patient adherence and articles in our personal collections, and contacted authors of relevant original and review articles.

Selection criteria
Articles were selected if they reported an unconfounded RCT of an intervention to improve adherence with prescribed medications, measuring both medication adherence and treatment outcome, with at least 80% follow-up of each group studied and, for long-term treatments, at least six months follow-up for studies with positive initial findings.

Data collection and analysis
Study design features, interventions and controls, and results were extracted by one review author and confirmed by at least one other review author. We extracted adherence rates and their measures of variance for all methods of measuring adherence in each study, and all outcome rates and their measures of variance for each study group, as well as levels of statistical significance for differences between study groups, consulting authors and verifying or correcting analyses as needed. The studies differed widely according to medical condition, patient population, intervention, measures of adherence, and clinical outcomes. Therefore, we did not feel that quantitative analysis was scientifically justified; rather, we conducted a qualitative analysis.

Main results
For short-term treatments, four of ten interventions reported in nine RCTs showed an effect on both adherence and at least one clinical outcome, while one intervention reported in one RCT significantly improved patient adherence, but did not enhance the clinical outcome. For long-term treatments, 36 of 83 interventions reported in 70 RCTs were associated with improvements in adherence, but only 25 interventions led to improvement in at least one treatment outcome. Almost all of the interventions that were effective for long-term care were complex, including combinations of more convenient care, information, reminders, self-monitoring, reinforcement, counseling, family therapy, psychological therapy, crisis intervention, manual telephone follow-up, and supportive care. Even the most effective interventions did not lead to large improvements in adherence and treatment outcomes.

Authors' conclusions
For short-term treatments several quite simple interventions increased adherence and improved patient outcomes, but the effects were inconsistent from study to study with less than half of studies showing benefits. Current methods of improving adherence for chronic health problems are mostly complex and not very effective, so that the full benefits of treatment cannot be realized. High priority should be given to fundamental and applied research concerning innovations to assist patients to follow medication prescriptions for long-term medical disorders.

Interventions for enhancing medication adherence.

Title. Qualitative case study methodology in nursing research: an integrative review.

Aim.  This paper is a report of an integrative review conducted to critically analyse the contemporary use of qualitative case study methodology in nursing research.

Background.  Increasing complexity in health care and increasing use of case study in nursing research support the need for current examination of this methodology.

Data sources.  In 2007, a search for case study research (published 2005–2007) indexed in the CINAHL, MEDLINE, EMBASE, PsychINFO, Sociological Abstracts and SCOPUS databases was conducted. A sample of 42 case study research papers met the inclusion criteria.

Methods.  Whittemore and Knafl’s integrative review method guided the analysis.

Results.  Confusion exists about the name, nature and use of case study. This methodology, including terminology and concepts, is often invisible in qualitative study titles and abstracts. Case study is an exclusive methodology and an adjunct to exploring particular aspects of phenomena under investigation in larger or mixed-methods studies. A high quality of case study exists in nursing research.

Conclusion.  Judicious selection and diligent application of literature review methods promote the development of nursing science. Case study is becoming entrenched in the nursing research lexicon as a well-accepted methodology for studying phenomena in health and social care, and its growing use warrants continued appraisal to promote nursing knowledge development. Attention to all case study elements, process and publication is important in promoting authenticity, methodological quality and visibility.

Qualitative case study methodology in nursing research: an integrative review.

Background. Home visiting by public health nurses and family visitors is promoted as an important intervention for enhancing parent and child development. Mothers of children at-risk for developmental delays tend to be the most difficult to access and engage, and commonly drop out of home visiting programmes prematurely.

Purpose.  This paper reports a study developing a theory that describes the process by which mothers of children at-risk engage with public health nurses and family visitors in a blended home visiting programme.

Methods.  Grounded theory was used to guide the collection, recording, organization and analysis of the data. A purposeful sample of 20 mothers receiving public health nurse and family visitor home visits were recruited from a public health unit in Canada. Data were collected through client record reviews and 29 in-depth interviews that explored participants’ experiences, beliefs and expectations about engagement. Data collection and analysis continued until all categories were saturated.

Findings.  Mothers felt vulnerable and frequently powerless when they allowed the service providers into their home. Mothers with children at-risk engage with public health nurses and family visitors through a basic social process of limiting family vulnerability, which has three phases: (1) overcoming fear; (2) building trust; and (3) seeking mutuality. The personal characteristics, values, experiences and actions of the public health nurse, family visitor and mother influence the speed at which each phase is successfully negotiated and the ability to develop a connected relationship.

Conclusion.  Public health nurses working with families at risk need to identify client fears and perceptions related to home visiting, and to explain the role of public health nurses and family visitors to all family members. Given the importance that mothers place on the development of an interpersonal relationship, it is important for home visitors continually to assess the quality of their relationships with clients.

A theory of maternal engagement with public health nurses and family visitors

Objectives: The purpose of this study was to identify decision-makers' preferences for the transfer and exchange of research knowledge. This article is focused on how the participants define evidence-based decision-making and their preferences for receiving research evidence to integrate into the decision-making process.



Methods: Semistructured interviews were conducted with a purposive sample of 16 Ontario public health decision-makers from six Ontario public health units in this fundamental qualitative descriptive study. The sample included nine program managers, six directors, and one Medical Officer of Health. Participants were asked to define the term evidence-based decision-making and identify preferred research dissemination strategies. The interviews were audio-taped, transcribed verbatim, and coded for emerging concepts.



Results: Participants defined evidence-based decision-making as a process whereby multiple sources of information were consulted before making a decision concerning the provision of services. To facilitate integration of research evidence into the decision-making process, public health administrators appreciate receiving, in both electronic and hard copy, systematic reviews, executive summaries of research, and clear statements of implications for practice from health service researchers.



Conclusions: Although consensus exists among participants concerning the definition of evidence based public health decision-making, ongoing efforts are required to continue to promote the use of research evidence in program planning and public health policy. It is also important to continue to improve the ease with which public health decision-makers access systematic reviews, as well as to ensure the relevance and applicability of the results to the practice setting.

https://works.bepress.com/anita_kothari/34/download/

Susan M. Jack

Papers

Qualitative Case Study Methodology: Study Design and Implementation for Novice Researchers

Interventions for enhancing medication adherence.

Qualitative case study methodology in nursing research: an integrative review.

A theory of maternal engagement with public health nurses and family visitors

Public health decision-makers' informational needs and preferences for receiving research evidence.