Showing 2 results for Mixed Method
Fatemeh Moaddab, Atefeh Ghanbari, Zahra Taheri-Ezbarami, Amir Savar Rakhsh, Marjan Mahdavi Roshan, Marziye Jafari,
Volume 32, Issue 211 (8-2022)
Abstract
Background and purpose: A major reason for readmission in patients with heart failure is inadequate transfer of care from hospital to home. The aim of this study was to design a comprehensive model of home care for these patients.
Materials and methods: This mixed-method study was performed in Rasht Heshmat Hospital in 2020-21. In qualitative phase, interviews were conducted with 28 people, selected by purposeful sampling. In quantitative phase (descriptive cross-sectional design), 115 patients were selected via convenience sampling. They were studied using a demographic questionnaire, European Heart Failure Self-care Behavior Scale, Heart Failure Knowledge Scale, Medication Adherence Report Scale, and Minnesota Living with Heart Failure Questionnaire. Qualitative data analysis was performed by conventional content analysis method and quantitative data were analyzed using descriptive statistics. Then, data of two phases were combined to design a care model using matrix analysis.
Results: The mean scores for patients' self-care, knowledge, medication adherence, and quality-of-life were 24.49±11.82, 27.25±8.36, 82.09±14.69, and 52.46±9.57, respectively, out of 100 scores. The care model designed included eight components: 1-Providing a comprehensive and organized care program to meet the care needs, 2-Establishing appropriate relationship, 3-Enhancing support systems, 4-Improving self-care, 5-Enhancing adaptation to chronic disease, 6-Family-centered care, 7-Management of health-seeking behavior, and 8-Improving quality-of-life.
Conclusion: This model is a comprehensive model for caring patients with heart failure and unlike other models does not have many shortcomings, therefore, it can help in more successful control of the problems associated with heart failure in patient, family, care team, and health care systems.
Maryam Khazaee-Pool, Tahereh Pashaei, Farhad Gholami, Alireza Rafiei, Koen Ponnet, Hossein Rastegar,
Volume 34, Issue 233 (5-2024)
Abstract
Background and purpose: Health tourism is one of the dimensions of sustainable development to help Mazandarn’s economic dynamic. A strong agreement is doubted in identifying factors influencing the attraction of health tourists. This study was implemented to design a questionnaire to measure the factors influencing the attraction of healthy tourists and investigate its psychometric properties.
Materials and methods: This study was done with a combinatorial approach in three steps, including relevant literature and the opinions of experts as long as health tourists' opinions of Mazandaran province were applied to the development of the item pool. Then, content validity, face validity, construct validity, and reliability of the questionnaire were assessed for the psychometric properties of the questionnaire. The final questionnaire was approved after performing 17 interviews and applying professional expertise in the qualitative part. In the first stage of the quantitative part content validity was studied by 10 people from an expert panel, and its face validity, the questionnaire was completed by 10 participants. Finally, the construct validity of the designed instrument was calculated using exploratory factor analysis using SPSS 24 software and confirmatory factor analysis using AMOS 24 software by asking 300 people familiar with health tourism in Mazandaran province. The internal and external validity were determined using Cronbach's alpha and test-retest in 25 people.
Results: The results of the literature review and interviews with experts in the first and second stages of the study led to the design of 76 items. In the next step, the changes in the qualitative stage 15 questions did not receive favorite points in Content validity ratio (CVR) and content validity index (CVI) calculation in the quantitative part of content validity. Then face validity was applied and the item effect index for 8 items was lower than 1.5 in the quantitative stage of face validity. Then the questionnaire with 53 items was entered into construct validity. In the exploratory factor analysis, the value of KMO was equal to 0.778. Furthermore, the value of Bartlett's test of significance was less than 5%. Based on the rotated matrix of components, eight factors with positive values were obtained. The results of exploratory factor analysis showed that 7 items had a factor loading of less than 0.4, which were removed from the questionnaire, and finally, 46 items remained. In the confirmatory factor analysis stage, the factor load of all dimensions was in good condition and the P-value was in the acceptable range. Cronbach alpha rate was calculated as 0.831. The external reliability was lower than 0.05 (ICC= 0.90, P<0.001).
Conclusion: The designed questionnaire, due to the low number of questions, the simplicity of the sentences, as well as the acceptable validity and reliability, can be used to identify and investigate the factors affecting the attraction of health tourists. Normalization of the questionnaire in other cultures is suggested. It is hoped that the findings of this study will be utilized by researchers, healthcare and tourism system managers, and other stakeholders to inform the planning of interventions aimed at increasing medical tourism. Additionally, it is hoped that the results of this study will serve as a springboard for future research in this area.
