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PubMed2003

A new methodological approach in nursing research: an actor, partner, and interaction effect model for family outcomes.

Methodological and statistical challenges have been identified in family research when the parental dyad is under study. The purposes of this article are to review the literature on methodological and statistical procedures in research on families, and to introduce an analysis technique that is new to the nursing literature, the actor-partner interdependence model (APIM). The use and interpretation of the APIM method is illustrated through an example of families of young children with asthma. In the APIM an actor effect is the impact a person has on his or her own outcome, whereas a partner effect is the impact a member of a dyad has on his or her partner's outcome. The main findings from the data example indicate that family adaptation is influenced by the actor effect of resiliency factors (sense of coherence and family hardiness), the partner effect of caregiving demands, as well as by both the actor and partner effects of family demands. The APIM method gives new insight into how parental data can be analyzed by taking both the individual and the partner contribution into account when studying family phenomena. Knowing how outcomes may be influenced not only by individuals (via an actor effect) but also by their partners (through a partner effect) enriches our understanding of how families function.

Adaptation, Psychological↗

PubMed2026

Detection of antibiotic heteroresistance in clinical microbiology: current and emerging methodologies.

BACKGROUND: Antibiotic heteroresistance (HR) is characterised by the coexistence of susceptible and resistant subpopulations within an apparently isogenic bacterial isolate. Because routine antimicrobial susceptibility testing (AST) primarily assesses the dominant population, HR may escape detection, potentially leading to discrepancies between laboratory susceptibility categorisation and the underlying bacterial population structure. OBJECTIVES: To provide a critical and practice-oriented evaluation of current and emerging methodologies for HR detection and to discuss their strengths, limitations, and potential for clinical implementation. SOURCES: Narrative review based on PubMed searches, complemented by screening of key reference lists and relevant EUCAST and CLSI documents. Peer-reviewed literature was prioritised. CONTENT: Phenotypic approaches, particularly population analysis profiling, remain the reference method for HR definition, but their labour-intensive workflows, long turnaround times, and limited standardisation restrict routine implementation. Alternative strategies, including modified AST assays, metabolic assays, and single-cell platforms, offer gains in speed or throughput but require broader validation. Molecular approaches such as quantitative PCR, droplet digital PCR, targeted deep sequencing, and whole-genome sequencing improve detection of minority resistance determinants. Emerging computational frameworks, including machine learning models integrating phenotypic and genomic data, represent a promising frontier for scalable HR prediction. IMPLICATIONS: Available evidence supports the clinical relevance of HR, although its association with adverse outcomes varies across bacterial species and antibiotic classes. Harmonised methodologies and clinically validated interpretive criteria are needed to support integration of HR assessment into routine diagnostics. Prospective multicentre studies and further standardisation, including engagement with EUCAST and CLSI, will be important to advance clinical implementation.

Antimicrobial resistance↗

PubMed2006

Distributed computing methodology for training neural networks in an image-guided diagnostic application.

Distributed computing is a process through which a set of computers connected by a network is used collectively to solve a single problem. In this paper, we propose a distributed computing methodology for training neural networks for the detection of lesions in colonoscopy. Our approach is based on partitioning the training set across multiple processors using a parallel virtual machine. In this way, interconnected computers of varied architectures can be used for the distributed evaluation of the error function and gradient values, and, thus, training neural networks utilizing various learning methods. The proposed methodology has large granularity and low synchronization, and has been implemented and tested. Our results indicate that the parallel virtual machine implementation of the training algorithms developed leads to considerable speedup, especially when large network architectures and training sets are used.

Algorithms↗

PubMed2005

Parental decision making in pediatric cancer end-of-life care: using focus group methodology as a prephase to seek participant design input.

The ultimate aim of our research program is to provide strategies that facilitate parental decision-making for parents of children with cancer receiving end-of-life care. As a first step to develop this program, we needed insight into parents' reactions and opinions about the research methods planned for a larger study. In particular, we needed their opinions about the general experience of making the decision between palliative cytotoxic chemotherapy and supportive care alone and the factors that parents regard as important when making this decision. In addition, we wished to know whether the methodology proposed for the future study was easy to understand and whether it might cause unnecessary emotional trauma. Finally, we asked their opinions regarding the appropriate target sample of parents to include in the future study. Qualitative data about these issues were collected using focus group methodology involving seven participants. The comments made during the focus group discussions were content-analyzed for common themes. The results from the focus group discussion led to particular modifications in the proposed design and interview strategies planned for the future larger study. We found it was extremely beneficial to include a focus group pre-phase in a study that will interview parents in a high sensitivity area.

Adaptation, Psychological↗

PubMed2005

Methodological triangulation showed the poorest quality of life in the youngest people following treatment of coronary artery disease: a longitudinal study.

The purpose of the longitudinal study was to describe, explain and understand the subjective health related quality of life (HRQoL) and life course of people (N=280) with coronary artery disease (CAD) during the period following the onset of the disease, the process of therapy and the period of rehabilitation. Methodological triangulation was used in this research. The significance of the results obtained with quantitative and qualitative methods was evaluated by means of meta-analysis. A longitudinal quantitative study was undertaken through the year after the treatments (medication, balloon angioplasty or bypass surgery), and 19 persons attended thematic interviews 1 year after the treatments carried out in their homes. The results of quantitative analysis showed that the male and female CAD patients in the youngest age group had the poorest HRQoL. Although, the patients average HRQoL improved on the dimensions of pain, energy and mobility, it deteriorated on the dimensions of social isolation, sleep and emotional reactions. From the viewpoint of methodological triangulation, the most significant finding was that the qualitative approach provided an explanation for the poor psychosocial HRQoL obtained by the quantitative approach, showing the crucial factor to be age and age-related aspects of the life situation. Interviews and the method of phenomenological psychology helped to gain insight into the informants' situational experience of HROoL and life course, which was not detectable with a questionnaire.

Activities of Daily Living↗

PubMed2001

Grounded theory as a qualitative research methodology.

Grounded theory as a qualitative research approach provides nurses with strategies to build theories in areas previously unexplored or under explored. Although similar to other inductive processes, this methodology differs in that it emerges from the discipline of sociology. In addition, strategies for data analysis differ according to each methodologist. As with other qualitative methods, the researcher must link philosophy, methodology, and research method for rigorous and credible scholarship.

Humans↗

PubMed2003

An exploration of tutors' experiences of facilitating problem-based learning. Part 1--an educational research methodology combining innovation and philosophical tradition.

The use of problem-based learning (PBL) in Health Professional curricula is becoming more wide spread. Although the way in which the tutor facilitates PBL can have a major impact on students' learning (Andrews and Jones 1996), the literature provides little consistency as to how the tutor can effectively facilitate PBL (Haith-Cooper 2000). It is therefore important to examine the facilitation role to promote effective learning through the use of PBL. This article is the first of two parts exploring a study that was undertaken to investigate tutors' experiences of facilitating PBL. This part focuses on the methodology and the combining of innovative processes with traditional philosophical traditions to develop a systematic educational research methodology. The study was undertaken respecting the philosophy of hermeneutic phenomenology but utilised alternative data collection and analysis technique. Video conferencing and e-mail were used in conjunction with more traditional processes to access a worldwide sample. This paper explores some of the issues that arose when undertaking such a study. The second article then focuses on exploring the findings of the study and their implications for the facilitation of PBL.

Attitude of Health Personnel↗

PubMed2000

Methodological issues in grounded theory.

Examination of the qualitative methodological literature shows that there appear to be conflicting opinions and unresolved issues regarding the nature and process of grounded theory. Researchers proposing to utilize this method would therefore be wise to consider these conflicting opinions. This paper therefore identifies and attempts to address four key issues, namely, sampling, creativity and reflexivity, the use of literature, and precision within grounded theory. The following recommendations are made. When utilizing a grounded method researchers need to consider their research question, clarify what level of theory is likely to be induced from their study, and then decide when they intend to access and introduce the second body of literature. They should acknowledge that in the early stages of data collection, some purposeful sampling appears to occur. In their search for conceptually dense theory, grounded theory researchers may wish to free themselves from the constraints that limit their use of creativity and tacit knowledge. Furthermore, the interests of researchers might be served by attention to issues of precision including, avoiding method slurring, ensuring theoretical coding occurs, and using predominantly one method of grounded theory while explaining and describing any deviation away from this chosen method. Such mindfulness and the resulting methodological rigour is likely to increase the overall quality of the inquiry and enhance the credibility of the findings.

Humans↗

PubMed1998

Conceptual bases and methodology for the evaluation of women's and providers' perception of the quality of antenatal care in the WHO Antenatal Care Randomised Controlled Trial.

In this paper, we describe the conceptual bases and methodology used to assess women's and providers' perception of the quality of antenatal care, as part of a large randomised trial in four developing countries. Information has been obtained by applying both qualitative and quantitative methodologies. The focus group discussions and in-depth interviews have contributed useful insights into the cultural milieu in which care is provided, users' and providers' expectations, and their concept of quality. Based on these findings, we developed two standardised questionnaires, one being administered to a representative sample of pregnant women (n = 1600) and the other for all care providers. In this paper we present some of the findings of the focus group discussions and in-depth interviews with women in one country as an example of the kind of information we have obtained. Women expressed their point of view concerning a reduced number of visits, type of provider, information that they get during clinical encounters and interpersonal relations with health professionals. The qualitative information, together with the data we obtain from the surveys, will highlight the aspects that will have be to considered if the new model of care is to be introduced on a routine basis.

Argentina↗

PubMedDate not supplied

The tyranny of feminist methodology in women's health research.

Awareness of the insufficient degree to which mainstream research has created useful knowledge about women's health has drawn many researchers to feminist methodologies. Such approaches tend to privilege qualitative designs, emancipatory objectives, and cooperative strategies. They challenge the notions of expert power, the appropriation of voice, and ownership of the research products. By uncovering the extent to which power inequities are embedded in our research traditions, including such issues as who conducts research, which questions are studied, and how they are studied, feminist critique can be a powerful tool toward stronger research with more socially relevant findings. However, taken to extremes, feminist methodological requirements can immobilize and discourage active inquiry. In this paper, we articulate major directives of a feminist stance, explain the extremes at which they become problematic, and propose responsive options for women's health researchers. We intend such analysis to overcome divisiveness and promote inclusiveness without sacrificing excellence in research and action.

Female↗

PubMed1992

A content methodology for advancing gerontological nursing practice.

The content methodology process is a method of observation, research, and application that refines the caregiving practice. An application of the content methodology process with cognitively-impaired individuals with dementia is explored, and correlations drawn to language abilities of older patients.

Aged↗

PubMedDate not supplied

Methodological considerations for grounded theory research in critical care settings.

BACKGROUND: The context of critical care and human phenomena involved in critical illness offer rich opportunity for nursing research. Naturalistic investigation with grounded theory methods can uncover previously unexamined elements and interactions in the critical care setting. This article presents methodological considerations for conducting grounded theory research in fast-paced physiologically and technologically complex critical care settings. APPROACH: Critique and recommendations are based in review and analysis of grounded theory research in adult critical care settings and on the literature describing grounded theory methods. The authors' experiences in medical and surgical intensive care units provide added practical context for this article. RESULTS: Barriers to achieving grounded theory in critical care settings, such as communication impairments, participant attrition, and observational difficulties, are explored. Methodological strategies and data sources particular to critical care settings are also discussed. Critical care settings offer a variety of data sources that should be rigorously pursued in grounded theory research. DISCUSSION: Given current trends in healthcare treatments and demographics, future research must examine physiological and technological data as integral components of basic social psychological or social structural processes in critical care interactions and should include technology as a component of nurse-patient interaction.

Critical Care↗

PubMedDate not supplied

Narrative research: a viable methodology for clinical nursing.

TOPIC: Narrative research provides a reasonable methodology for gathering rich, multidimensional data in the clinical setting. PURPOSE: To familiarize nurses with the concept of narrative research, review pertinent narrative research literature, and identify some ways this methodology can be integrated into clinical nursing. SOURCES: A review of published literature from psychology, sociology, anthropology, and nursing, with citations from women with breast cancer. CONCLUSIONS: Narrative research can make a valid contribution to nursing science in language familiar to nurses and other healthcare professionals.

Adaptation, Psychological↗

PubMed1994

Whose quality of care is it anyway? Methodological issues in evaluating residential care for the mentally ill.

The paper reports on issues of methodology regarding the evaluation of residential care for mentally ill people. A literature review examines the development of research approaches to studying residential care practices, from qualitative descriptive studies to quantitative comparative studies. The difficulty of definition and measurement in high-quality residential care is discussed. Findings are presented from an ethnographic study of care structure and process, and the experience of staff and clients, conducted in two residential care settings. Anomalies are reported in the use of quantitative and qualitative research methods. There is a discussion of methodological issues that arise from anomalous findings.

Adult↗

PubMed2004

Researching emotion: the need for coherence between focus, theory and methodology.

There is a longstanding awareness of the significance of emotion in nursing and yet it remains one of the more elusive areas of practice. Surprisingly, there has been little discussion in the nursing literature of how the phenomenon of emotion might be understood or studied. This paper gives an overview of theoretical and methodological approaches to emotion, and how the researcher's emotions may inform the research process. In addition, it draws on ethnographic research exploring the role of emotion in the practice and clinical supervision of a group of psychosexual nurses undergoing Balint seminar training to help highlight some of the inherent problems of researching emotion. The paper argues that these sorts of problems may be avoided or reduced by ensuring coherence between the research focus, the way emotion is theorised, and the methodological approach of the study.

Adult↗

PubMed2006

The potential contribution of emancipatory research methodologies to the field of child health.

The knowledge production of researchers interested in improving the health-care of young clients through the employment of emancipatory research methodologies may be limited by the complexity that working with young children presents to the research process. The purpose of this paper is to explore whether emancipatory research methodologies have application within the context of research with children. Critical examination of the challenges inherent in emancipatory research with children reveals that the application of aspects of these approaches presents possibilities for contributing significantly to our knowledge development for the nursing of children.

Age Factors↗

PubMed1996

[Longitudinal study of the mother and child population in an urban region of southern Brazil, 1993: methodological aspects and preliminary results].

All babies born in the hospitals of the city of Pelotas, Brazil, in 1982 were studied soon after delivery and followed up prospectively during the first years of their lives. In 1993, this study was repeated with a similar methodology, with the aim of assessing eventual changes in the level of maternal and child health. All five maternity hospitals in the city were visited daily and the 5,304 babies born included in the study. They were weighed and measured, and their gestational age was assessed using the Dubowitz method. Their mothers were examined and interviewed regarding a large number of risk factors. The mortality of these children was studied through the surveillance of all hospitals, cemeteries and death registries, and all hospital admissions were also recorded. Two nested case-control studies were carried out to assess risk factors for mortality and hospital morbidity. A systematic sample of 655 children were examined at home at one and three months of age, and these infants, as well as another sample of 805 children including all low-birthweight babies were also examined at the ages of six and twelve months. Their psychomotor development was also assessed. Losses to follow-up were only 6.6% at twelve months. Relative to the 1982 indicators, perinatal mortality fell by about 30% and infant mortality by almost 50%. The median duration of breastfeeding increased from 3.1 to 4.0 months. On the other hand, there was little change in the prevalences of low birthweight or of length for age at twelve months. The article that refers this abstract describes the methodology of the study and forthcoming publications will present detailed results.

Birth Weight↗

PubMed2004

A Q-methodological study on nursing students' attitudes toward nursing ethics.

PURPOSE: Professional nursing ethics is a living, dynamic set of standards for nurses'professional moral behavior. Furthermore, in daily clinical nursing training, nursing students are constantly confronted with decision-making that is moral in nature. The aim of this study was to identify the perceived ethical attitudes in the clinical training process of senior nursing students using Q-methodology to offer basic strategies for nursing ethics education and thereby improve patients'care. METHODS: Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty-seven participants in a university rated 38 selected Q-statements on a scale of 1-9. The collected data were analyzed using pc-QUNAL software. RESULTS: Principal component analysis identified 3 types of ethical attitudes in nursing students in Korea. The categories were labeled Sacred-life, Science-realistic and Humane-life. Sacred-life individuals think that a life belongs to an absolute power (God), not a man, and a human life is a high and noble thing. Science-realistic individuals disagreed that allowing an induced abortion or embryo (human) duplication is unethical behavior that provokes a trend, which takes the value of a life lightly; most of them took a utilitarian position with respect to ethical decisions. Humane-life individuals exhibit a tendency toward human-centered thought with respect to ethical attitudes. CONCLUSION: This study will be of interest to educators of students of nursing and hospital nursing administrators. Also, the findings may provide the basis for the development of more appropriate strategies to improve nursing ethics education programs.

Adaptation, Psychological↗