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在疫情限制下开展定性研究——考量、挑战与益处:一份方法学领域报告

Conducting Qualitative Research under Pandemic Restrictions - Considerations, Challenges, and Benefits: A Methodological Field Report.

作者信息

Suslow Anastasia, Giehl Chantal, Hergesell Jannis, Vollmar Horst Christian, Otte Ina Carola

机构信息

Abteilung für Allgemeinmedizin (AM RUB), Ruhr-Universität Bochum, Bochum, Germany.

Forschungsnetzwerk Alterssicherung, Deutsche Rentenversicherung Bund, Berlin, Germany.

出版信息

Gesundheitswesen. 2023 Sep;85(S 03):S189-S196. doi: 10.1055/a-2129-6311. Epub 2023 Sep 26.

Abstract

BACKGROUND

The Covid-19 pandemic has a significant impact on professionals working in the medical area, with very high workload and tightened safety restrictions for physicians, nurses, caregivers, and patients. One of the main target participants in health services research are medical professionals. Their experiences contribute immensely to any research project aiming to improve delivery and quality of care. Furthermore, their input gives significantly greater insights into the handling of the pandemic and into what future improvements should be considered. In our research project ADAPTIVE (Impact of Digital Technologies in Palliative Care) we evaluate with qualitative research methods the impact of a web-based software on communication, teamwork, and lasting transformations in accountability in multidisciplinary teams (e. g., medication and independent decisions). In this paper, we discuss the challenges and benefits of conducting a qualitative research project under pandemic conditions by illustrating the progress of ADAPTIVE.

METHODS

ADAPTIVE started in March 2020 and ended in August 2021. For data collection, we interviewed 26 participants about using a web-based program to facilitate the exchange of patient information in multidisciplinary teams in outpatient palliative care in Germany (mainly physicians and nurses). However, due to emerging hygiene regulations, corona-related restrictions, and the ongoing workload of medical professionals, the recruiting and interviewing process were challenging. Hence, we had to modify the original study design of two face-to-face interviews per participant and a focus group discussion into one telephone interview. The focus groups were cancelled.

RESULTS

We discussed several adjustments to the data collection. However, the privacy policies of different clinics, participants' lack of experience with video calls, and a potential poor internet connectivity eliminated the option of digital video interviewing. Therefore, we interviewed 21 participants by telephone and only five face-to-face. Further, the focus group discussions initially planned had to be dropped since a simultaneous gathering of the participants was not possible due to several reasons. Nonetheless, we obtained many insights into the usage of digital support systems in palliative care by conducting 26 interviews, allowing us to complete the research project.

DISCUSSION

Telephone interviews come with limitations. Firstly, it may be difficult for participants to establish a trusting relationship with the interviewer. Secondly, non-verbal communication is lost during a telephone interview. However, expanding the survey methodology to include telephone interviews gave us the option of allowing us to expand the recruitment nationwide and overcome issues successfully.

CONCLUSIONS

Recruitment and data collection showed to be more time-consuming under pandemic circumstances, and further survey methods such as focus groups were nearly impossible. However, a qualitative research design offers greater flexibility when adapting study designs.

摘要

背景

新冠疫情对医疗领域的专业人员产生了重大影响,医生、护士、护理人员和患者的工作量极高,安全限制也更加严格。医疗专业人员是卫生服务研究的主要目标参与者之一。他们的经验对任何旨在改善医疗服务提供和质量的研究项目都有巨大贡献。此外,他们的意见能让我们更深入地了解疫情应对情况以及未来应考虑哪些改进措施。在我们的研究项目ADAPTIVE(数字技术在姑息治疗中的影响)中,我们采用定性研究方法评估了一款基于网络的软件对多学科团队(如药物治疗和独立决策)中的沟通、团队合作以及责任方面的持久转变所产生的影响。在本文中,我们通过阐述ADAPTIVE项目的进展情况,讨论在疫情条件下开展定性研究项目所面临的挑战和带来的益处。

方法

ADAPTIVE项目于2020年3月启动,2021年8月结束。为收集数据,我们就德国门诊姑息治疗中使用一款基于网络的程序促进多学科团队中患者信息交流的情况,对26名参与者(主要是医生和护士)进行了访谈。然而,由于新出现的卫生法规、与新冠相关的限制措施以及医疗专业人员持续的工作量,招募和访谈过程颇具挑战性。因此,我们不得不将原计划的每位参与者进行两次面对面访谈和一次焦点小组讨论的研究设计改为一次电话访谈。焦点小组讨论取消。

结果

我们讨论了对数据收集的多项调整。然而,不同诊所的隐私政策、参与者缺乏视频通话经验以及潜在的网络连接不佳等因素,排除了数字视频访谈的选项。因此,我们通过电话访谈了21名参与者,仅5名进行了面对面访谈。此外,由于多种原因无法同时召集参与者,最初计划的焦点小组讨论不得不取消。尽管如此,通过进行26次访谈,我们对姑息治疗中数字支持系统的使用有了很多深入了解,从而得以完成研究项目。

讨论

电话访谈存在局限性。首先,参与者可能难以与访谈者建立信任关系。其次,电话访谈中会失去非语言沟通。然而,将调查方法扩展到包括电话访谈,使我们能够在全国范围内扩大招募范围并成功克服相关问题。

结论

在疫情情况下,招募和数据收集显示耗时更长,诸如焦点小组等进一步的调查方法几乎无法实施。然而,定性研究设计在调整研究设计时具有更大的灵活性。

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