Qualitative research & evaluation methods

The understanding of spirituality and the potential role of spiritual care in end-of-life and palliative care: a meta-study of qualitative research.

Abstract: Spirituality and spiritual care are gaining increasing attention but their potential contribution to palliative care remains unclear. The aim of this study was to synthesize qualitative literature on spirituality and spiritual care at the end of life using a systematic (‘meta-study’) review. Eleven patient articles and eight with healthcare providers were included, incorporating data from 178 patients and 116 healthcare providers, mainly from elderly White and Judaeo-Christian origin patients with cancer. Spirituality principally focused on relationships, rather than just meaning making, and was given as a relationship. Spirituality was a broader term that may or may not encompass religion. A ‘spirit to spirit’ framework for spiritual care-giving respects individual personhood. This was achieved in the way physical care was given, by focusing on presence, journeying together, listening, connecting, creating openings, and engaging in reciprocal sharing. Affirmative relationships supported patients, enabling them to respond to their spiritual needs. The engagement of family caregivers in spiritual care appears underutilized. Relationships formed an integral part of spirituality as they were a spiritual need, caused spiritual distress when broken and were the way spiritual care was given. Barriers to spiritual care include lack of time, personal, cultural or institutional factors, and professional educational needs. By addressing these, we may make an important contribution to the improvement of patient care towards the end of life.

The Role of Formative Evaluation in Implementation Research and the QUERI Experience

Abstract: This article describes the importance and role of 4 stages of formative evaluation in our growing understanding of how to implement research findings into practice in order to improve the quality of clinical care. It reviews limitations of traditional approaches to implementation research and presents a rationale for new thinking and use of new methods. Developmental, implementation-focused, progress-focused, and interpretive evaluations are then defined and illustrated with examples from Veterans Health Administration Quality Enhancement Research Initiative projects. This article also provides methodologic details and highlights challenges encountered in actualizing formative evaluation within implementation research.

Interventions in Organizational and Community Context: A Framework for Building Evidence on Dissemination and Implementation in Health Services Research

Abstract: The effective dissemination and implementation of evidence-based health interventions within community settings is an important cornerstone to expanding the availability of quality health and mental health services. Yet it has proven a challenging task for both research and community stakeholders. This paper presents the current framework developed by the UCLA/RAND NIMH Center to address this research-to-practice gap by: (1) providing a theoretically-grounded understanding of the multi-layered nature of community and healthcare contexts and the mechanisms by which new practices and programs diffuse within these settings; (2) distinguishing among key components of the diffusion process—including contextual factors, adoption, implementation, and sustainment of interventions—showing how evaluation of each is necessary to explain the course of dissemination and outcomes for individual and organizational stakeholders; (3) facilitating the identification of new strategies for adapting, disseminating, and implementing relatively complex, evidence-based healthcare and improvement interventions, particularly using a community-based, participatory approach; and (4) enhancing the ability to meaningfully generalize findings across varied interventions and settings to build an evidence base on successful dissemination and implementation strategies.

From Combat to Campus: Voices of Student-Veterans

Abstract: What needs do veterans bring to campus? Little is known about this emerging student population. The researchers interviewed 25 students who served in the current Iraq and Afghan conflicts. This was a multicampus study, with the sample derived from three geographically diverse universities representing northern, southern, and western regions of the United States. Using a model of adult transition by Schlossberg as a guiding theory, a grounded theory epistemology was used to generate a conceptual framework for understanding students who are making the transition from wartime service to college. Findings and implications will help institutions organize a holistic approach for assisting veterans and improving their chances for success.

Constraints and opportunities facing women entrepreneurs in developing countries: A relational perspective

Abstract: Purpose – This purpose of the paper to examine the interplay of constraints and opportunities affecting female entrepreneurship in developing countries. The paper integrates salient micro‐ and macro‐level perspectives and provides a rounded account of opportunities and constraints as part of a holistic interdependent system.Design/methodology/approach – The paper adopts an integrative multi‐level research design and an interpretive research methodology, capitalizing on in‐depth interviews with ten women entrepreneurs to explore their perceptions and interpretations of constraints and opportunities facing female entrepreneurship in the Lebanese context.Findings – The findings presented in this paper clearly illustrate the relevance of micro‐, meso‐, and macro‐level factors in entrepreneurship research and the usefulness of integrating multiple lens and units of analysis to capture the complexity of the women entrepreneurship experience in any particular context.Originality/value – The value added of this r...