Development of indicators and moral intelligence scales for junior high school students: mixed-method research.

The purposes of this research were (1) to study the indicators of moral intelligence for junior high school students, (2) to develop moral intelligence scales for junior high school students, and (3) to assess the needs of moral intelligence for junior high school students. By the mixed-method research, the sample group used in the research was 11 key informants for in-depth interviews, 100 students in mixed classes of 20 schools, 1,997 students in total. The results show the following:1. The moral intelligence indicators for junior high school students consisted of 6 indicators: Equality, Empathy, Morality, Tolerance, Self-control, and Kindness.2. To create moral intelligence scales for junior high school students, the Cronbach's alpha coefficients for each section were.939,0.920 and.841, respectively. With corroborative component analysis classified by the overall composition, it was found that the mean was at a high level (M = 3.955), with a low distribution with a standard deviation (SD) of 0.576 and a distribution coefficient (C.V.) of 14.566.3. For needs assessment of moral intelligence for junior high school students, it was found that the third component of morality had the most needs (PNImodified=0.095), followed by the 5th component of self-control (PNImodified=0.081), the second component of empathy (PNImodified=0.075), the 4th component of tolerance (PNImodified=0.073), the 6th component of kindness (PNImodified=0.055) and the first component of equality (PNImodified=0.053).

An exploration of person-centredness among emergency department physiotherapists: a mixed methods study.

PURPOSE: There is a growing number of primary contact physiotherapists based in United Kingdom emergency departments (ED) who are expected to deliver person-centred practices. Perceptions of physiotherapists working in these high-pressure environments on person-centredness are currently unknown. A mixed methods exploration of person-centredness among ED physiotherapists targeted this knowledge gap to inform future clinical practice. METHODS: Online survey and semi-structured interviews followed a convergent mixed methods design with sequential explanatory features. Data sets were analysed separately using descriptive statistics and thematic analysis, respectively, before merged analysis using joint display. RESULTS: Twenty-six surveys and 11 in-depth interviews were completed. The three overarching themes of ED patients, ED physiotherapists, and ED environment were generated. Themes were integrated and analysed alongside quantitative survey findings. This produced three novel contributions that further our understanding of person-centred practices among ED physiotherapists. CONCLUSION: ED physiotherapists were mindful of an apparent, yet unspoken struggle between the competing philosophies of biomedicine and person-centredness. The results here support entering a patient's world as a person-centred approach to help navigate the line between what an ED attender wants and the clinical need of their visit.

Most primary contact physiotherapists believe in the possibility of achieving person-centred practices within emergency departments (ED) and endorse attempts to deliver on this.Any idealised visions of delivering person-centred practice in ED must be adapted to local operational limitations and the acuity of the presenting case in question.ED physiotherapist could consider the notion of 'entering a patient's world' as a route to the meaning of a patient's problems to them by using a more narrative approach to assessment.A framework to support an ED-specific version of person-centred practice is currently lacking.

Ageism in Birthday Cards: A Mixed Method Content Analysis.

BACKGROUND AND OBJECTIVES: Ageism is oftentimes sugarcoated within humor. Paper birthday cards are one delivery approach in which ageist messages are perpetuated and reinforced through humor. RESEARCH DESIGN AND METHODS: A convenience sample of birthday cards (k = 227), all indicating a decade of age, were acquired from seven national retail stores in Colorado Springs, Colorado. The decades sampled ranged from 21 to 100. With a pre-developed codebook, three raters coded the decade birthday cards on various variables, including age group, ageist tone, and humor. RESULTS: Birthday cards intended for age 30 to 60 contained significantly more ageist messages compared to cards intended for age 21 and age 70 to 100, which did not show a significant difference from each other. Additionally, birthday cards with humor showed more ageist messages than cards without humor. Characteristics of decade birthday cards were also explored. DISCUSSION AND IMPLICATIONS: Consumers need to learn to evaluate these ageist messages in birthday cards to reduce the perpetuation of damaging stereotypes.

Post-Migration Changes in Dietary Patterns and Physical Activity among Adult Foreign Residents in Niigata Prefecture, Japan: A Mixed-Methods Study.

The migrant population of Japan is gradually increasing, but it is not well known how and why diet and physical activity (PA) change post-migration. Therefore, this study used a mixed-method approach to investigate the changes in dietary patterns and PA through a web- and paper-based survey (n = 128) and understand the contextual factors for those changes through semi-structured interviews (n = 21). Descriptive and thematic analyses of quantitative and qualitative data were conducted, respectively. The majority of survey (57.8%) and interview (66.7%) participants were female, and the mean duration of stay in Japan was 5 and 3.6 years, respectively. The survey revealed an increased consumption of foods attached to Japanese culture, frozen and microwavable food, and a reduced consumption of fruits. We identified environmental (availability, accessibility, and affordability of foods; food safety and diet-related information; and climate), individual (living status; post-migration lifestyle; and food preferences and limitations), or socio-cultural (relationships with Japanese people; cultural differences; and religious influences) factors that impact diet changes. Language proficiency and the duration of stay shape dietary behaviors. Determinants of PA changes were climate, lifestyle, and the influence of Japanese culture. In conclusion, immigrants in Japan experience post-migration diet and PA changes, and this study adds knowledge about how and why such changes occur.

Evaluating the Effectiveness of a Psychological and Adventure-based Multicomponent Therapeutic Program for Victims of Intimate Partner Violence: A Pilot Study.

Intimate partner violence (IPV) is a global health problem with different negative consequences for women's mental health. This pilot study aims to evaluate the efficacy of a multicomponent intervention for battered women using a comparison group design to analyze improvement in self-esteem, self-concept, self-efficacy, body dissatisfaction, and depression. The intervention consisted of an eight-session multicomponent intervention program based on the combination of group psychological therapy and adventure activities. The study sample originally consisted of 34 women IPV victims. Self-report psychological assessment was conducted during the pre-test and post-test while interviews were conducted during the post-test among the experimental group. The results of this pilot study suggest the efficacy of the cognitive-behavioral multicomponent intervention on self-esteem, self-efficacy, and depression in the IPV victims from the experimental group. We conclude that these findings support the efficacy of this psychological intervention program. Practical implications and suggestions are also discussed.

Art Therapy in Australian Prisons: A Research Agenda.

Art therapy in prisons remains widely under-researched in Australia and beyond and represents a major gap in the literature. Despite evidence that art therapy can be a tool for social change, to date, there are no recorded studies in Australia which have investigated the therapeutic benefits of art in prison populations with measured outcomes. Literary analysis suggests that research tends to be hampered by limitations in methodological approaches that are suited to prison environments. By engaging "inside" with inmates over the course of an 8-week art therapy program, this research design addresses this knowledge gap. Building on 5 years of piloting, the research methodological design presented in this paper embodies a prototype that promises to overcome the limitations of previous research approaches. This research agenda promises to facilitate creative interventions through sensitively attuned art therapy delivery. Benefits are expected to accrue to diverse stakeholder groups, including inmates, chaplaincy and parole services, voluntary facilitators, policymakers, criminologists, and taxpayers, among others.

Comprehensive coordinated community based palliative care (C3PaC) model for cancer patients in North India: a mixed-method implementation research study protocol.

BACKGROUND: Cancer remains an escalating and challenging public health issue. The management, especially palliative care (PC), is disintegrated and out of reach of in need patients. The overall aim of the project is to develop a feasible and scalable Comprehensive Coordinated Community based PC model for Cancer Patients (C3PaC); congruent with socio-cultural, context and unmet needs in north India. METHODS: A mixed method approach will be used for three-phased pre- and post-intervention study in one of the districts of North India, having a high incidence of cancer. During phase I, validated tools will be used for quantitative assessment of palliative needs among cancer patients and their caregivers. Barriers and challenges for provision of palliative care will be explored using in-depth interviews and focus group discussions among participants and health care workers. The findings of phase I along with inputs from national experts and literature review will provide inputs for the development of the C3PAC model in phase II. During phase III C3PAC model will be deployed over a period of 12 months and its impact assessed. Categorical and continuous variables will be depicted as frequency (percentages) and mean ± SD/median (IQR) respectively. Chi-square test/Fischer test, independent samples Student t-tests and Mann-Whitney U tests will be used for categorical, normally and non-normally distributed continuous variables, respectively. Qualitative data will be analyzed using thematic analysis using Atlas.ti 8 software. DISCUSSION: The proposed model is designed to address the unmet palliative care needs, to empower community-based healthcare providers in comprehensive home-based PC and to improve the quality of life of cancer patients and caregivers. This model will provide pragmatic scalable solutions in comparable health systems particularly in low- and lower-middle Income countries. TRIAL REGISTRATION: The study has been registered with the Clinical Trial Registry-India (CTRI/2023/04/051357).

Feasibility of Developing Audiovisual Material for Training Needs in a Vietnam Orphanage: A Mixed-Method Design.

Disabled children living in orphanages in low-income countries may not have access to the therapy they need. The COVID-19 pandemic has complicated the situation dramatically, making online training activities a possible innovative option to meet the real needs of local staff. This study aimed to detect the training needs of the local staff of an orphanage in Vietnam, as well as develop an audiovisual training material and measure its feasibility. Training needs were identified through a focus group carried out by the volunteers of Fisios Mundi, a nongovernmental organization. The audiovisual training material was developed to meet these specific needs. Lastly, its feasibility was evaluated, in terms of both content and format, through an ad hoc questionnaire. Nine volunteers participated in the project. Twenty-four videos were created and structured around five themes. This study expands the body of knowledge on how an international cooperation project can be developed in a pandemic situation. The audiovisual training material content and format created in this project was considered by the volunteers as very feasible and useful for training the staff of a Vietnamese orphanage.

Emergency remote teaching of foreign languages at Saudi universities: Teachers' reported challenges, coping strategies and training needs.

Though considerable research has been reported on COVID-19-related distance education, some dimensions of remote foreign language teaching experiences during the pandemic crisis remain to be explored. The study reported in this paper investigated Saudi university foreign language teachers' accumulated experiences and reflective beliefs of emergency remote instruction. The study focused specifically on: a) the general educational challenges the teachers encountered and their attempts to overcome them; b) the teachers' perceived difficulties in remotely teaching and assessing foreign language areas and their strategies for coping with them; and c) their reflective evaluation of remote foreign language teaching after doing it for three academic terms. Questionnaire data was collected from 112 teachers of Arabic and English as foreign languages, and semi-structured interviews were conducted with 14 teachers. The analysis of both data types showed that the participants had a number of general educational and language-teaching-specific challenges in their COVID-19-related remote teaching. The teachers generally viewed the remote assessment of language areas is a more challenging task than teaching them. Reading was rated as the least difficult language area to teach and assess remotely, whereas writing was the most difficult one. The teachers reported using various coping strategies to overcome the educational and language teaching-specific challenges. They perceived their remote teaching experiences positively, but reported their needs for further training in developing better online assessment methods, using different teaching platforms and technological tools, and managing classroom interactions. The paper ends by discussing the results of the study and their implications.

Perceptions and factors affecting the adoption of digital games for engineering education: a mixed-method research.

Digital games are considered relevant in higher education due to their ability to foster authentic, active and experiential learning opportunities that are of importance in engineering education. However, as a relatively new pedagogical tool, there is the need to understand the perceptions of engineering students as well as to identify factors that influence their adoption of games for learning. So far, only a few studies have investigated the perceptions of higher education students towards learning games and even fewer for engineering students. To bridge this research gap, the current study utilises a mixed-method research design to identify factors that influence the adoption of digital learning games by engineering students as well as their overall perceptions of the use of games for engineering education. Results from the analysed quantitative and qualitative data suggest that engineering students value fun and engagement as well as relevance to the curriculum as factors that would influence their intentions to use digital games for engineering education. Students also showed openness to the use of digital games for learning, but resistance to their use for assessment. These findings have implications for the design of games and classroom deployment of games, as these provide insights to game designers and educators on the factors to consider in the design and classroom deployment of games, respectively.

Potential advantages of combining randomized controlled trials with qualitative research in mood and anxiety disorders - A systematic review.

INTRODUCTION: Most randomized controlled trials (RCTs) of mood and anxiety disorders employ solely quantitative methods. Supplementing quantitative data with qualitative methods, a so-called mixed-method approach, would seem useful, however this area has not been rigorously reviewed. We undertook a systematic review of RCTs of mood and anxiety disorders that employed concurrent quantitative data collection and qualitative methods exploring the participants' perspective, with the aim of 1. determining the number of such studies, 2. describing study characteristics, and 3. identifying potential advantages of a mixed-method approach. METHODS: Following PRISMA guidelines, a systematic literature search for RCTs of mood and anxiety disorders, concurrently applying quantitative and qualitative methods, was conducted using EMBASE, PsycINFO and Pubmed, from their inception to February 2021. Categories of potential advantages of this mixed method approach were developed. RESULTS: A total of 45 RCTs were included. The qualitative components typically included 10-40 participants, mostly consisting of interviews after the intervention. The majority of papers did not state a specific rationale for using a mixed method approach. Four categories of advantages emerged: 1. determine acceptability/feasibility, 2. investigate efficacy, 3. inform implementation in clinical practice and 4. generate new hypotheses based on the combination of quantitative and qualitative data. LIMITATIONS: Lack of cross-referencing and consistent terminology challenged identification of relevant publications. CONCLUSION: There are a number of potential advantages of applying mixed method approaches in RCTs within psychiatric research. Intentional consideration of such advantages early in trial design may increase the likelihood of gaining added value.

Evaluating Trust in the Patient-Dentist Relationship: A Mixed-Method Study.

BACKGROUND: The objective of this article was to understand the trust of study participants in dental providers and trust-building practices used by dentists to establish and maintain trust with their patients. METHODS: This study used a concurrent cross-sectional mixed-methods design to measure the participants' trust in their dental providers. An 11-item Dental Trust Scale (DTS) questionnaire was administered to 150 White, Black, and Hispanic study participants. In addition, the research team conducted semistructured interviews with 7 dentists in order to understand their perspectives related to patient trust. The internal consistency of the DTS was tested using Cronbach's α. Univariate and multivariable logistic regression models were run to test the association between the DTS mean score and individual participant factors. Qualitative information from interviews was analyzed using a thematic analysis approach. RESULTS: The overall mean score of dental trust for the entire sample was 3.4. The DTS had good internal consistency (α = 0.93). Overall, dental trust was significantly higher in participants who had a regular dentist (F = 8.74, P = 0.003). The qualitative data were grouped under these key thematic categories: the importance of trust, building trust, and trust in treatment planning. Qualitative analysis also showed that the 2 main trust-building tools used by dentists were communication and understanding the patient's lifestyle or social determinants of health. KNOWLEDGE TRANSFER STATEMENT: This study provides insight into the dentist-patient relationship. It increases our understanding of levels of dental trust among patients and examines methods used by the dentist to build trust. The outcomes of this study can be considered by dentists in their everyday practice as they seek to build trust with their patients.

The specific outcome Assessment Modal of acupuncture and Tuina treatment for pain / 国际中医中药杂志

Acupuncture and Tuina are the main non-drug therapies for low back pain, which are recommended by the guidelines. Acupuncture and Tuina can alleviate pain, which is regarded as conditional specific outcome, and improve mental, emotional problems, as non-conditional specific outcomes. There are some problems of the outcome assessment of acupuncture and Tuina treatment for pain such as insufficient evaluation of specific effect and unclear evaluation of characteristic outcome. Therefore, the key to above problems is to construct a Specific ouTcomE Assessment Modal of acupuncture and Tuina treatment for pain (STEAM-A&T) based on the qualitive and quantitative methods. By describing the experience, narrative expression, feelings and needs of patients who receiving acupuncture and Tuina treatment, the item banks of acupuncture and Tuina treatment effect are constructed, and the characteristic outcome of acupuncture and Tuina for pain will be screened, and then the relationship model among outcomes is constructed and optimized, which reflected the characteristics of acupuncture and Tuina for pain from multiple dimensions, multiple levels and multiple views. We reveal the relationship between the outcome of acupuncture and Tuina for pain. It will provide a new theory and methods for the construction of specific outcome assessment modal of Traditional Chinese Medicine.

Analysis of pre-service teachers' argumentation-based academic writing process.

The purpose of this research is to examine the participating students' argumentation-based academic writing processes and the contributions of these processes to the students' academic writing skills. The participants of the study, which was conducted through mixed method research design, were a group of 53 pre-service Turkish Teachers who are in their first year of Turkish education program at a state university in Turkey during the 2020-2021 academic year. In this research, the data were obtained through student products, rubrics, reflective participant diaries, and a semi-structured interview form. SPSS 23 was used in the analysis of the quantitative data, and NVivo 12 programs were used in the analysis of qualitative data. When the results of the analyses are considered in general, it can be deduced that academic writing practices based on argumentation contributed to the development of students in the dimensions of "subject and content," "organization," "language use," "citation," and "writing process." In the data obtained from the reflective diaries and interviews, although some difficulties were pointed out, the statements of the students regarding their development came to the fore. In addition, it was pointed out that argumentation contributes not only to students' academic writing skills, but also their development of thinking, objectivity, research motivation, and critical thinking.

Research, education, ethics consultation: evaluating a Bioethics Unit in an Oncological Research Hospital.

BACKGROUND: This study aims to quantitatively and qualitatively evaluate the activities of a Bioethics Unit (BU) 5 years since its implementation (2016-2020). The BU is a research unit providing empirical research on ethical issues related to clinical practice, clinical ethics consultation, and ethical education for health care professionals (HPS). METHODS: We performed an explanatory, sequential, mixed-method, observational study, using the subsequent qualitative data to explain the initial quantitative findings. Quantitative data were collected from an internal database and analyzed by descriptive analysis. Qualitative evaluation was performed by semi-structured interviews with 18 HPs who were differently involved in the BU's activities and analyzed by framework analysis. RESULTS: Quantitative results showed an extensive increment of the number of BU research projects over the years and the number of work collaborations with other units and wards. Qualitative findings revealed four main themes, concerning: 1. the reasons for contacting the BU and the type of collaboration; 2. the role of the bioethicist; 3. the impact of BU activities on HPs, in terms of developing deeper and more mature thinking; 4. the need to extend ethics support to other settings. Overall, our results showed that performing both empirical bioethics research and more traditional clinical ethics activities at the same unit would produce an impetus to increase collaboration and spread an 'ethical culture' among local HPs. CONCLUSIONS: Our findings contribute to a growing body of literature on the models of clinical ethics support services and the role of empirical research in bioethics internationally. They also prepare the ground for the implementation of a multidisciplinary Clinical Ethics Committee (CEC) that aims to support the BU's ethics consultation service within the local context.

Attitude and perceptions regarding online teaching in dental undergraduate program during COVID-19 pandemic: A mixed method study.

BACKGROUND: Transformation of education to virtual mode during COVID-19 pandemic was a major challenge for a clinical specialty like dentistry. MATERIALS AND METHODS: A sequential explanatory mixed method was adopted with quantitative dominant design. A self-reported questionnaire on attitude and perceptions toward online learning were distributed among dental undergraduate students. The qualitative arm explored perceptions of online teaching among various stakeholders and thematic content analysis was performed. RESULTS: A total of 141 responses were obtained, about 21% of them felt online classes to be highly useful and 78% felt it was moderately useful. About 80% of the students were satisfied with the online education. About 40% of participants felt internet connectivity was a frequent issue. The qualitative data analysis revealed five emergent themes of lecture content and delivery, instructional control, resource management, interaction, and evaluation exploring the perceptions of various stakeholders toward online learning and provided several insights. CONCLUSION: Though online education cannot be compared to traditional education in a clinical specialty like dentistry, it does have its advantages and a portion of student learning can be conducted through this mode.

The impact of the COVID-19 pandemic on perinatal loss among Italian couples: A mixed-method study.

Background: Perinatal bereavement is an event that greatly impacts the emotional, psychological, and psychosocial aspects of those who want to have a child. Objectives: Since there are few studies on the psychological impact of the COVID-19 pandemic on couples grieving for perinatal loss, this research aimed to survey this experience. Participants: Between 2020 and 2021, in Italian provinces highly affected by the COVID-19 pandemic, 21 parents participated: 16 mothers (76%; mean age 36.2; SD: 3.1) and 5 fathers (24%; mean age 40.2; SD: 3.4), among which there were 4 couples. Methods: A mixed-method design was used through self-report questionnaires and in-depth interviews. Accompanied by a sociodemographic form, the following questionnaires were administered: Prolonged Grief-13, the Parental Assessment of Paternal Affectivity (PAPA) (to fathers), the Parental Assessment of Maternal Affectivity (PAMA) (to mothers), the Dyadic Adjustment Scale short version, the Daily Spiritual Experiences Scale, and the Impact of Event Scale-Revised. The texts obtained through the in-depth interviews underwent thematic analysis. Results: Fifty per cent of participants suffered from Post-Traumatic Stress Disorders (PTSD) symptoms and 20% suffered from relational dyadic stress. Four areas of thematic prevalence emerged: psychological complexity of bereavement, the impact of the COVID-19, disenfranchisement vs. support, and spirituality and contact with the lost child. Participants interpreted their distress as related to inadequate access to healthcare services, and perceiving the pandemic restrictions to be responsible for less support and lower quality of care. Furthermore, they needed psychological help, and most of them were unable to access this service. Spirituality/religiosity did not help, while contact with the fetus and burial did. Conclusion: It is important to implement psychological services in obstetrics departments to offer adequate support, even in pandemic situations.

Documentation of adherence to infection prevention best practice in patient records: a mixed-methods investigation.

BACKGROUND: Healthcare-associated infections remain a preventable cause of patient harm in healthcare. Full documentation of adherence to evidence-based best practices for each patient can support monitoring and promotion of infection prevention measures. Thus, we reviewed the extent, nature, and determinants of the documentation of infection prevention (IP) standards in patients with HAI. METHODS: We reviewed electronic patient records (EMRs) of patients included in four annual point-prevalence studies 2013-2016 who developed a device- or procedure-related HAI (surgical site infection (SSI), catheter-associated urinary tract infection (CAUTI), ventilator-associated infection (VAP), catheter-related bloodstream infection (CRBSI)). We examined the documentation quality of mandatory preventive measures published as institutional IP standards. Additionally, we undertook semi-structured interviews with healthcare providers and a two-step inductive (grounded theory) and deductive (Theory of Planned Behaviour) content analysis. RESULTS: Of overall 2972 surveyed patients, 249 (8.4%) patients developed 272 healthcare-associated infections. Of these, 116 patients met the inclusion criteria, classified as patients with SSI, CAUTI, VAP, CRBSI in 78 (67%), 21 (18%), 10 (9%), 7 (6%), cases, respectively. We found documentation of IP measures in EMRs in 432/1308 (33%) cases. Documentation of execution existed in the study patients' EMRs for SSI, CAUTI, VAP, CRBSI, and overall, in 261/931 (28%), 27/104 (26%), 46/122 (38%), 26/151 (17%), and 360/1308 (28%) cases, respectively, and documentation of non-execution in 67/931 (7%), 2/104 (2%), 0/122 (0%), 3/151 (2%), and 72/1308 (6%) cases, respectively. Healthcare provider attitudes, subjective norms, and perceived behavioural control indicated reluctance to document IP standards. CONCLUSIONS: EMRs rarely included conclusive data about adherence to IP standards. Documentation had to be established indirectly through data captured for other reasons. Mandatory institutional documentation protocols or technically automated documentation may be necessary to address such shortcomings in patient safety documentation.

Transformational Leadership and Psychological Well-Being of Service-Oriented Staff: Hybrid Data Synthesis Technique.

Leaders play a significant role in organizations and their leadership behaviors can either enhance or undermine the well-being of their employees. This study aimed to meta-analyze the relationship between transformational leadership and well-being in the service industry, and how employees' gender and service sector moderated the strength of this relationship. This study used a convergent mixed-method approach. PubMed, MEDLINE, Google Scholar, AMED, and Scopus electronic databases were utilized to search for relevant studies. Textual data were analyzed using a text data-mining technique (Leximancer) to determine the relevant themes and concepts. Statistical data were examined through a comprehensive meta-analysis to determine their effect sizes. The qualitative results outline the major themes that emerged: leadership, well-being, and health. The quantitative findings revealed that the perceived well-being of male employees and those working outside of the health-care service sector was positively higher when employees' leaders showed transformational leadership. In general, the findings from the qualitative and quantitative data converge. The findings confirm the positive relationship between transformational leadership and employee well-being. This study also highlights the applicability of a convergent mixed-method approach as a useful methodological strategy when analyzing both lexical and statistical data.