Quan Nha Hong

Combining the Power of Stories and the Power of Numbers: Mixed Methods Research and Mixed Studies Reviews

This article provides an overview of mixed methods research and mixed studies reviews. These two approaches are used to combine the strengths of quantitative and qualitative methods and to compensate for their respective limitations. This article is structured in three main parts. First, the epistemological background for mixed methods will be presented. Afterward, we present the main types of mixed methods research designs and techniques as well as guidance for planning, conducting, and appraising mixed methods research. In the last part, we describe the main types of mixed studies reviews and provide a tool kit and examples. Future research needs to offer guidance for assessing mixed methods research and reporting mixed studies reviews, among other challenges.

A Literature Review Describing the Role of Return-to-Work Coordinators in Trial Programs and Interventions Designed to Prevent Workplace Disability

Objective Return-to-work (RTW) coordination has been suggested as an effective strategy for preventing workplace disability, but the scope of these services is not well described. The objective of this study was to describe the activities of RTW coordinators in published trials to provide a basis for establishing necessary competencies. Methods A keyword search of MEDLINE and CINAHL databases was conducted to identify intervention studies with a RTW coordinator providing direct, on-site workplace liaison to reduce work absences associated with physical health ailments. This search yielded 2,383 titles that were inspected by two examiners. Using a stepwise process that allowed for assessment of inter-observer agreement, 90 full articles were selected and reviewed, and 40 articles (22 studies) met criteria for inclusion. Results All but two studies (of traumatic brain injury) focused on musculoskeletal conditions or work injuries. Twenty-nine RTW coordinator activities were identified, but there was variation in the training background, workplace activities, and contextual setting of RTW coordinators. Based on reported RTW coordinator activities, six preliminary competency domains were identified: (1) ergonomic and workplace assessment; (2) clinical interviewing; (3) social problem solving; (4) workplace mediation; (5) knowledge of business and legal aspects; and (6) knowledge of medical conditions. Discussion Principal activities of RTW coordination involve workplace assessment, planning for transitional duty, and facilitating communication and agreement among stakeholders. Successful RTW coordination may depend more on competencies in ergonomic job accommodation, communication, and conflict resolution than on medical training.

Systematic mixed studies reviews: updating results on the reliability and efficiency of the Mixed Methods Appraisal Tool.

This commentary is an update of results regarding an novative critical appraisal tool, called the ‘Mixed ethods Appraisal Tool’ (MMAT), which were published two papers in the International Journal of Nursing udies. In August 2014, the first paper was mentioned as e of the ‘most cited articles’ on the journal’s website luye et al., 2009). The second paper reported a pilot test the MMAT reliability and efficiency (Pace et al., 2012). e MMAT checklist includes two screening questions and items corresponding to five methodological domains: alitative research, randomized controlled trials (RCTs), n-randomized studies (NRS), quantitative descriptive dies, and mixed methods studies (MMS). The MMAT is sed on a constructionist theory and has been content lidated: for each domain, items were developed from the erature as well as consultations and workshops with perts (Pace et al., 2012; Pluye et al., 2009, 2011). The MMAT is a unique tool (http://mixedmethodsappraisaltoolpublic.pbworks.com) that allows reviewers to concomitantly assess the methodological quality of studies with diverse designs (qualitative, quantitative and MMS) included in systematic mixed studies reviews (Crowe and Sheppard, 2011). Critical appraisal constitutes a key stage of systematic reviews, but appraising the methodological quality of studies with diverse designs remains challenging. The MMAT was designed to help overcome this challenge. The MMAT is recommended by the National Institute of Excellence in Health Services in Québec (INESS). To date, authors of more than 50 published systematic mixed studies reviews have used the MMAT, and MMAT developers have provided counsel on using the MMAT to 29 researchers, from multiple disciplines, in Australia, Belgium, Canada, China, Denmark, Germany, Netherlands, New Zealand, Switzerland, UK, and USA. Mixed studies review is a new, and increasingly popular, form of literature review that includes studies with diverse designs (qualitative, quantitative and mixed methods) and addresses complex review questions (Pluye and Hong, 2014). Mixed studies reviews consist of mixed methods research applied to the field of literature reviews, and combine the strengths of quantitative and qualitative research (http://toolkit4mixedstudiesreviews.pbworks. com). This commentary is aimed to update results on the reliability and efficiency of the MMAT, specifically the new 2011 version (MMAT-v2011) (Pluye et al., 2011). There is a growing need for a tool like the MMAT, and as per our two previous papers, a need for additional supporting evidence for the MMAT. In previous work, we tested the pilot version of the MMAT (Pace et al., 2012) and results indicated that R T I C L E I N F O

Development and validation of competencies for return to work coordinators.

Introduction Return to work (RTW) coordinators are a key element in programs that facilitate RTW of injured or ill workers, yet little research documents the competencies required for success in this role. Methods Competencies were defined as knowledge, skills, attitudes, and behaviors. Eight focus groups were conducted with 75 experienced RTW coordinators to identify 904 individual competencies. These were subsequently reduced to 234 unique items through affinity mapping, and sorted into eight groups: administration, individual personal attributes, information gathering, communication, professional credibility, evaluation, problem-solving, and conflict management. A subset of 100 items, including 88 items most often cited, were incorporated in an Internet-based survey that sampled a broad range of RTW coordinators from three countries. Results Eighty-three of the questionnaire items were rated 4 or 5 (very important or essential) by over half of the 148 respondents. There were no differences in affinity group mean ratings by country, employer, profession, or type of clients. The highest-rated items reflect general personal characteristics, or specific skills related to coordinating among all involved with the RTW process. RTW coordinators with nursing backgrounds provided slightly higher ratings for items related to medical knowledge, but otherwise their ratings were similar to non-nurses. Conclusions These findings indicate a consensus across a wide range of RTW coordinators, and results can be applied to improve coordinator selection, training, and development. Certain key competencies may be well-established individual attributes, and others may be best developed through mentorship. Most of these competencies are probably best evaluated by direct observation.

Supervisors' perception of the factors influencing the return to work of workers with common mental disorders.

Introduction Over the last decade, common mental disorders have become an area of major concern in the field of work disability prevention due to the rising number of claims, costs, and impacts on quality of life. It has been shown that supervisory behavior influences return-to-work outcomes. This study aimed to investigate the perception held by supervisors involved in work disability management, of the factors facilitating or hindering the return to work of workers with common mental disorders. Methods This project consisted of an exploratory qualitative study. Semi-structured interviews were conducted of supervisors. All subjects had experience with the return to work of at least one worker who had been off work due to a common mental disorder (i.e., anxiety, mood or adjustment disorder). Content analysis of the transcripts was performed. Results A total of 11 supervisors from large and medium-sized companies participated in the project. Twenty-four factors that could hinder or facilitate the return-to-work process were found and classified into three main categories: factors related to the worker, work context, and return-to-work process. Conclusions This study brought to light several factors influencing the return to work of workers with common mental disorders. Most of the supervisors interviewed were very open to finding ways to facilitate the return to work of these workers, but felt that the interventions used should take both their perspective and the constraints they face in the workplace into account. Subsequent studies on return to work should therefore focus equally on the individual and the workplace to ensure that the actions taken can be appropriately implemented and well received by all stakeholders, including supervisors, who are continually involved in front-line interventions.

Convergent and sequential synthesis designs: implications for conducting and reporting systematic reviews of qualitative and quantitative evidence

BackgroundSystematic reviews of qualitative and quantitative evidence can provide a rich understanding of complex phenomena. This type of review is increasingly popular, has been used to provide a landscape of existing knowledge, and addresses the types of questions not usually covered in reviews relying solely on either quantitative or qualitative evidence. Although several typologies of synthesis designs have been developed, none have been tested on a large sample of reviews. The aim of this review of reviews was to identify and develop a typology of synthesis designs and methods that have been used and to propose strategies for synthesizing qualitative and quantitative evidence.MethodsA review of systematic reviews combining qualitative and quantitative evidence was performed. Six databases were searched from inception to December 2014. Reviews were included if they were systematic reviews combining qualitative and quantitative evidence. The included reviews were analyzed according to three concepts of synthesis processes: (a) synthesis methods, (b) sequence of data synthesis, and (c) integration of data and synthesis results.ResultsA total of 459 reviews were included. The analysis of this literature highlighted a lack of transparency in reporting how evidence was synthesized and a lack of consistency in the terminology used. Two main types of synthesis designs were identified: convergent and sequential synthesis designs. Within the convergent synthesis design, three subtypes were found: (a) data-based convergent synthesis design, where qualitative and quantitative evidence is analyzed together using the same synthesis method, (b) results-based convergent synthesis design, where qualitative and quantitative evidence is analyzed separately using different synthesis methods and results of both syntheses are integrated during a final synthesis, and (c) parallel-results convergent synthesis design consisting of independent syntheses of qualitative and quantitative evidence and an interpretation of the results in the discussion.ConclusionsPerforming systematic reviews of qualitative and quantitative evidence is challenging because of the multiple synthesis options. The findings provide guidance on how to combine qualitative and quantitative evidence. Also, recommendations are made to improve the conducting and reporting of this type of review.

Tools for Assessing Work Disability

In current practice, the task of evaluating workers’ capacity to return to their pre-injury employment or other jobs and of evaluating the environmental and personal factors influencing the return-to-work process poses a daily challenge for health care professionals, insurers’ counselors, and employers. An examination of the scientific literature reveals that a wide range of work disability assessment tools are available, from self-administered questionnaires to observational tools. Choosing the right tools from all those available is no easy task. This book chapter presents an overview of work disability assessment tools, as well as criteria intended to guide users in their choice of the most appropriate instruments. It also provides details on ten instruments available for the purpose of screening for long-term work disability, assessing work ability, and assessing return-to-work obstacles.

Improving the usefulness of a tool for appraising the quality of qualitative, quantitative and mixed methods studies, the Mixed Methods Appraisal Tool (MMAT)

RATIONALE, AIMS, AND OBJECTIVES Systematic reviews combining qualitative, quantitative, and/or mixed methods studies are increasingly popular because of their potential for addressing complex interventions and phenomena, specifically for assessing and improving clinical practice. A major challenge encountered with this type of review is the appraisal of the quality of individual studies given the heterogeneity of the study designs. The Mixed Methods Appraisal Tool (MMAT) was developed to help overcome this challenge. The aim of this study was to explore the usefulness of the MMAT by seeking the views and experiences of researchers who have used it. METHODS We conducted a qualitative descriptive study using semistructured interviews with MMAT users. A purposeful sample was drawn from the researchers who had previously contacted the developer of the MMAT, and those who have published a systematic review for which they had used the MMAT. All interviews were transcribed verbatim and analyzed by 2 coders using thematic analysis. RESULTS Twenty participants from 8 countries were interviewed. Thirteen themes were identified and grouped into the 2 dimensions of usefulness, ie, utility and usability. The themes related to utility concerned the coverage, completeness, flexibility, and other utilities of the tool. Those regarding usability were related to the learnability, efficiency, satisfaction, and errors that could be made due to difficulties understanding or selecting the items to appraise. CONCLUSIONS On the basis of the results of this study, we make several recommendations for improving the MMAT. This will contribute to greater usefulness of the MMAT.

Discriminating between empirical studies and nonempirical works using automated text classification

OBJECTIVE Identify the most performant automated text classification method (eg, algorithm) for differentiating empirical studies from nonempirical works in order to facilitate systematic mixed studies reviews. METHODS The algorithms were trained and validated with 8050 database records, which had previously been manually categorized as empirical or nonempirical. A Boolean mixed filter developed for filtering MEDLINE records (title, abstract, keywords, and full texts) was used as a baseline. The set of features (eg, characteristics from the data) included observable terms and concepts extracted from a metathesaurus. The efficiency of the approaches was measured using sensitivity, precision, specificity, and accuracy. RESULTS The decision trees algorithm demonstrated the highest performance, surpassing the accuracy of the Boolean mixed filter by 30%. The use of full texts did not result in significant gains compared with title, abstract, keywords, and records. Results also showed that mixing concepts with observable terms can improve the classification. SIGNIFICANCE Screening of records, identified in bibliographic databases, for relevant studies to include in systematic reviews can be accelerated with automated text classification.

A Conceptual Framework for Critical Appraisal in Systematic Mixed Studies Reviews

The past decade has been rich with methodological advancements in systematic reviews, several of which were inspired by the literature on mixed methods research. Systematic mixed studies reviews—that is, reviews combining qualitative and quantitative evidence—are increasingly popular as they can provide a better understanding of complex phenomena and interventions. However, they raise new challenges, especially regarding how to perform critical appraisal of the included studies that vary regarding the methodologies used. To address this challenge, conceptually clarifying critical appraisal is necessary. To this end, this article provides a framework for critical appraisal in systematic mixed studies reviews. This framework is an essential first step toward providing clear guidance on how to perform critical appraisal.