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物理治疗领域中开展定性研究的临床医生面临的风险与陷阱。

Perils and pitfalls for clinicians embarking on qualitative research in physiotherapy.

作者信息

Marshall Laura Rachel, Edgley Alison

机构信息

Nottingham University Hospitals NHS Trust, Nottinghamshire, UK.

出版信息

Nurse Res. 2015 May;22(5):30-4. doi: 10.7748/nr.22.5.30.e1330.

Abstract

AIM

To consider the pros and cons of focus groups versus interviews for studies interested in examining patient experiences of clinical interventions. The paper looks at the hazards of being a clinician when collecting qualitative data and shares these experiences to provide useful learning for other clinicians embarking on qualitative approaches.

BACKGROUND

Sub-acromial decompression surgery (SAD) is the accepted, surgical intervention for shoulder impingement syndrome. Evidence suggests that outcomes from SAD are no more superior to conservative management. This raises questions as to whether alternative explanations such as patient experience are at play when considering patient outcomes.

DATA SOURCES

A study looking at patients' experiences of subacromial decompression surgery six months after the operation.

REVIEW METHODS

One small focus group and one individual interview took place to explore patient experience following sub-acromial decompression shoulder surgery.

DISCUSSION

Focus groups risk producing competitive and comparative discussions, and clinical researchers require sufficient training and mentoring to recognise and assist group dynamics. The study exposed ways in which clinicians involved in collecting data may be injured to aspects of patients' experiences, and accordingly may not explore in depth aspects important to patients.

CONCLUSION

This paper highlights the importance of novice researchers thinking carefully about the capacity for 'practitioner eyes' to influence analytical decisions about study design and the direction of data collection. Focus group interactions are complex and risk being underestimated by inexperienced clinical researchers.

IMPLICATIONS FOR RESEARCH/PRACTICE: Novice researchers are advised to be open to the possibility that unpredictable situations are likely to occur and expose assumptions about the study design. Preparation and guidance is required to avoid some of the challenges and manage group dynamics effectively in the first instance.

摘要

目的

探讨焦点小组访谈与个体访谈在研究患者临床干预体验方面的利弊。本文着眼于临床医生在收集定性数据时面临的风险,并分享这些经验,为其他采用定性研究方法的临床医生提供有益借鉴。

背景

肩峰下减压手术(SAD)是治疗肩峰撞击综合征公认的手术干预方式。有证据表明,SAD的治疗效果并不比保守治疗更优。这就引发了一个问题,即在考虑患者治疗效果时,诸如患者体验等其他因素是否在起作用。

数据来源

一项关于患者术后六个月肩峰下减压手术体验的研究。

综述方法

进行了一次小型焦点小组访谈和一次个体访谈,以探究肩峰下减压肩部手术后患者的体验。

讨论

焦点小组访谈存在引发竞争性和比较性讨论的风险,临床研究人员需要接受充分的培训和指导,以识别并引导小组互动。该研究揭示了参与数据收集的临床医生可能会受到患者体验某些方面影响的方式,因此可能无法深入探究对患者重要的方面。

结论

本文强调了新手研究人员仔细思考“从业者视角”对研究设计分析决策和数据收集方向影响的重要性。焦点小组互动很复杂,可能会被缺乏经验的临床研究人员低估。

对研究/实践的启示:建议新手研究人员要意识到可能会出现不可预测的情况,并揭示对研究设计的假设。需要做好准备并获得指导,以避免一些挑战,并首先有效管理小组互动。

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