Personal Social Services Research Unit, University of Manchester, Manchester, UK.
School of Biological Sciences, University of Manchester, Manchester, UK.
BMC Geriatr. 2019 Aug 22;19(1):227. doi: 10.1186/s12877-019-1240-x.
Qualitative methods are increasingly included in larger studies to provide a richer understanding of people's experience. This paper explores the potential of using a novel approach to embedded qualitative design as part of an observational study examining the effectiveness of home support for people in later stage dementia in England. The method involved collecting and analysing unsolicited conversational comments made by participants as they completed standardised measures. An evaluation of the method is presented using the voices of participants to illustrate its potential.
The conversations of 17 carers recruited to an observational study were audio recorded to gather commentary made while completing a structured interview. Data were interrogated using thematic analysis to investigate the feasibility of conducting an embedded qualitative study, the potential richness of the material and participants' reactions to formal questioning and participating in research.
The findings revealed that qualitative data were available from this approach. Analysis generated three themes from carers: conflicting carer emotions; the importance of maintaining normality and agency within day-to-day life; and tensions between these desires and making use of formal services. Important issues for carers were revealed establishing the benefit of using the method. The advantages of exploiting unsolicited conversation included enhancing understanding of people's lived experience, reducing participant burden in research and easing the process of data collection. In addition, it provided an opportunity to evaluate individuals' experience of the research process.
The findings demonstrate how unsolicited comments during structured interviews may appear incidental but can reveal important aspects of living with dementia. The method also emphasised methodological challenges for research in dementia, including the influence and impact of the research context. Further research is required to evaluate the method with other groups including people with dementia themselves.
定性方法越来越多地被纳入更大的研究中，以更深入地了解人们的体验。本文探讨了在观察性研究中使用一种新的嵌入式定性设计方法的潜力，该研究旨在评估英格兰为晚期痴呆症患者提供家庭支持的效果。该方法涉及收集和分析参与者在完成标准化测量时的非请求性对话评论。本文通过参与者的声音来评估该方法的有效性，以说明其潜力。
本研究招募了 17 名护理人员参与观察性研究，对他们完成结构化访谈时的对话进行录音，以收集评论。使用主题分析来检查嵌入式定性研究的可行性、材料的潜在丰富性以及参与者对正式提问和参与研究的反应。
研究结果表明，这种方法可以提供定性数据。分析从护理人员中得出了三个主题：护理人员的矛盾情绪；在日常生活中保持正常和自主性的重要性；以及这些愿望与利用正式服务之间的紧张关系。这些问题揭示了护理人员的重要关注点，为使用该方法带来了好处。利用非请求性对话的优势包括增强对人们生活体验的理解、减轻研究中参与者的负担以及简化数据收集过程。此外，它还提供了一个评估个体对研究过程体验的机会。
研究结果表明，在结构化访谈中出现的非请求性评论可能看起来是偶然的，但可以揭示出与痴呆症相关的重要方面。该方法还强调了痴呆症研究中的方法论挑战，包括研究背景的影响和作用。需要进一步研究来评估该方法在其他群体中的效果，包括痴呆症患者本身。
