Department of Global Health and Welfare, SINTEF Society and Technology, Oslo, Norway.
Implement Sci. 2011 May 27;6:53. doi: 10.1186/1748-5908-6-53.
Qualitative research is used increasingly alongside trials of complex interventions to explore processes, contextual factors, or intervention characteristics that may have influenced trial outcomes. Qualitative research conducted alongside trials can also be used to shed light on the results of systematic reviews of effectiveness by looking for factors that can help explain heterogeneous results across trials. In a Cochrane review on the effects of using lay health workers on maternal and child health and infectious disease control, we identified 82 trials. These trials showed promising benefits but results were heterogeneous.
To use qualitative studies conducted alongside these trials to explore factors and processes that might have influenced intervention outcomes.
We attempted to identify qualitative research carried out alongside the trials by contacting trial authors, checking papers for references to qualitative research, searching Pubmed for related studies, and carrying out citation searches. For those qualitative studies that we included, we extracted information regarding study objective, data collection and analysis methods, and key themes and categories.
For 52 (63%) of the trials, we found no qualitative research that had been conducted alongside the trials. For 16 (20%) trials, some form of qualitative data collection had been done but was unavailable or had been done before the trial. For 14 (17%) trials, qualitative research had been done during or shortly after the trial, although descriptions of qualitative methods and results were often sparse. Most of these 14 studies aimed to elicit trial participants' perspectives and experiences of the intervention. A common theme was participants' appreciation of the lay health workers' shared circumstances, for instance with regard to social background or experience of the health condition. In six studies, researchers explored the experiences of the lay health workers themselves. Issues included the importance of regular supervision and health professionals' support or lack of support.
Qualitative studies carried out alongside trials of complex interventions could offer opportunities to authors of systematic reviews of effectiveness wishing to understand the heterogeneity of trial results. For interventions of lay health worker programmes at least, too few such studies exist at present for these opportunities to be realised.
定性研究越来越多地与复杂干预措施的试验一起使用，以探索可能影响试验结果的过程、背景因素或干预特征。与试验一起进行的定性研究也可以用于阐明对有效性的系统评价结果，寻找有助于解释试验结果异质性的因素。在 Cochrane 关于利用非专业卫生工作者对母婴健康和传染病控制影响的综述中，我们确定了 82 项试验。这些试验显示出有希望的益处，但结果存在异质性。
利用与这些试验一起进行的定性研究，探讨可能影响干预结果的因素和过程。
我们通过联系试验作者、检查论文中是否有定性研究的参考文献、在 Pubmed 上搜索相关研究以及进行引文搜索，试图确定与试验一起进行的定性研究。对于我们纳入的定性研究，我们提取了关于研究目标、数据收集和分析方法以及关键主题和类别等信息。
对于 52 项（63%）试验，我们没有找到与试验同时进行的定性研究。对于 16 项（20%）试验，已经进行了某种形式的定性数据收集，但不可用或在试验之前已经完成。对于 14 项（17%）试验，在试验期间或之后不久进行了定性研究，尽管定性方法和结果的描述通常很简略。这些研究大多旨在了解试验参与者对干预措施的看法和经验。一个共同的主题是参与者对非专业卫生工作者共同情况的赞赏，例如社会背景或健康状况的经验。在六项研究中，研究人员探讨了非专业卫生工作者自身的经验。问题包括定期监督的重要性以及卫生专业人员的支持或缺乏支持。
与复杂干预措施的试验一起进行的定性研究可以为希望理解试验结果异质性的有效性系统评价作者提供机会。至少对于非专业卫生工作者计划的干预措施，目前存在的此类研究太少，无法实现这些机会。
