Mixed Methods-Studien in der Versorgungsforschung: Anforderungen, Herausforderungen und die Frage der Integration – ein Diskussionspapier aus der Perspektive qualitativ Forschender

 

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Zusammenfassung

Mit diesem Diskussionspapier greift die Kleingruppe Mixed Methods der AG Qualitative Methoden im Deutschen Netzwerk Versorgungsforschung e. V. (DNVF) das Thema dreier voran-gegangener Diskussionspapiere zum Stellenwert und den Potenzialen qualitativer Forschungsmethoden für die Versorgungsforschung auf. Mixed Methods sind in der Versorgungsforschung zunehmend verbreitet und gefordert. Allerdings ergeben sich auch Konfliktfelder in der Planung und Durchführung von Mixed Methods-Studien, die in diesem Papier aus Perspektive der qualitativen Forschung thematisiert werden. Besondere Aufmerksamkeit erhält der Aspekt der Integration als grundlegende Signatur der Mixed Methods-Forschung. Mit diesem Diskussionspapier möchten wir einen gleichermaßen kritischen wie konstruktiven Austausch darüber anregen, was eine qualitativ hochwertige, von Methodenvielfalt geprägte Versorgungsforschung ausmacht und unter welchen Rahmenbedingungen diese gelingen kann.

Abstract

With this discussion paper, the subgroup Mixed Methods of the working group Qualitative Research Methods in the non-profit organization German Network Health Services Research (DNVF) is taking up the topic of three previous discussion papers on the significance and potentials of qualitative research methods in health services research. Mixed methods are being increasingly used and demanded in health services research. However, there are also areas of conflict in the planning and implementation of mixed methods studies, and these are addressed in this paper from the perspective of qualitative research. Special attention is given to the aspect of integration as the fundamental signature of mixed methods research. With this discussion paper, our aim was to stimulate critical as well as constructive exchange of ideas on what constitutes high-quality health services research characterised by a diversity of methods and the framework conditions under which this can succeed.

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Publication History

Article published online:
30 May 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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• Literatur

• 1 Greene JC. Mixed methods in social inquiry. San Francisco, CA: Jossey-Bass; 2007
  Google Scholar
• 2 Pfaff H, Demirer I, Nellessen Martens G. Berücksichtigung des Kontextes bei der Evaluation und Interpretation der Wirkung von neuen Versorgungsformen. Plädoyer für eine kontextbezogene Versorgungsforschung. Gesundheits- und Sozialpolitik 2001; 26-33
  PubMedGoogle Scholar
• 3 Curry LA, Krumholz HM, O’Cathain A. et al. Mixed methods in biomedical and health services research. Circ Cardiovasc Qual Outcomes 2013; 6: 119-123 DOI: 10.1161/CIRCOUTCOMES.112.967885.
  CrossrefPubMedGoogle Scholar
• 4 Skivington K, Matthews L, Simpson SA. et al. A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance. BMJ 2021; 374: n2061 DOI: 10.1136/bmj.n2061.
  CrossrefPubMedGoogle Scholar
• 5 Rölker-Denker L, Kowalski C, Ansmann L. et al. DNVF-Memorandum III – Methoden für die Versorgungsforschung, Teil 4 – Konzept und Methoden der organisationsbezogenen Versorgungsforschung. Kapitel 2 – Methodische Ansätze der organisationsbezogenen Versorgungsforschung: Zielgrößen, Datenquellen, Datenerhebung und Datenanalyse. Gesundheitswesen 2019; 81: e72-e81 DOI: 10.1055/a-0862-0565.
  Article in Thieme ConnectPubMedGoogle Scholar
• 6 Blettner M, Dierks M-L, Donner-Banzhoff N. et al. Überlegungen des Expertenbeirats zu Anträgen im Rahmen des Innovationsfonds. Z Evid Fortbild Qual Gesundhwes 2018; 130: 42-48 DOI: 10.1016/j.zefq.2018.01.004.
  CrossrefPubMedGoogle Scholar
• 7 Schreier M. Kontexte qualitativer Sozialforschung: Arts-Based Research, Mixed Methods und Emergent Methods [Forum Qualitative Sozialforschung/Forum: Qualitative Social Research, Vol 18, No 2 (2017)]. Forum Qualitative Sozialforschung/Forum: Qualitative Social Research 2017; 18: 1-27 DOI: 10.17169/fqs-18.2.2815.
  CrossrefPubMedGoogle Scholar
• 8 Giddings LS. Mixed-methods research. Positivism dressed in drag?. Journal of research in nursing 2006; 11: 195-203 DOI: 10.1177/1744987106064635.
  CrossrefPubMedGoogle Scholar
• 9 Niederberger M, Peter L. Mixed-Methods-Studien in den Gesundheitswissenschaften. Ein kritischer Überblick. Z Evid Fortbild Qual Gesundhwes 2018; 133: 9-23 DOI: 10.1016/j.zefq.2018.02.008.
  CrossrefPubMedGoogle Scholar
• 10 Fetters MD, Curry LA, Creswell JW. Achieving integration in mixed methods designs-principles and practices. Health Serv Res 2013; 48: 2134-2156 DOI: 10.1111/1475-6773.12117.
  CrossrefPubMedGoogle Scholar
• 11 O’Cathain A, Murphy E, Nicholl J. Integration and publications as indicators of” yield” from mixed methods studies. J Mix Methods Res 2007; 1: 147-163
  CrossrefPubMedGoogle Scholar
• 12 Meyer T, Karbach U, Holmberg C. et al. Qualitative Studien in der Versorgungsforschung – Diskussionspapier, Teil 1: Gegenstandsbestimmung. Gesundheitswesen 2012; 74: 510-515 DOI: 10.1055/s-0032-1323693.
  Article in Thieme ConnectPubMedGoogle Scholar
• 13 Karbach U, Stamer M, Holmberg C. et al. Qualitative Studien in der Versorgungsforschung – Diskussionspapier, Teil 2: Stand qualitativer Versorgungsforschung in Deutschland – ein exemplarischer Überblick. Gesundheitswesen 2012; 74: 516-525 DOI: 10.1055/s-0032-1323694.
  Article in Thieme ConnectPubMedGoogle Scholar
• 14 Stamer M, Güthlin C, Holmberg C. et al. Qualitative Studien in der Versorgungsforschung – Diskussionspapier, Teil 3: Qualität qualitativer Studien. Gesundheitswesen 2015; 77: 966-975 DOI: 10.1055/s-0035-1565235.
  Article in Thieme ConnectPubMedGoogle Scholar
• 15 Kuckartz U. Mixed Methods: Methodologie, Forschungsdesigns und Analyseverfahren. Wiesbaden: Springer VS; 2014
  CrossrefGoogle Scholar
• 16 Kleining G. Methodologie und Geschichte qualitativer Sozialforschung. In: Flick U, Hrsg. Handbuch qualitative Sozialforschung. Grundlagen, Konzepte, Methoden und Anwendungen. München: Psychologie-Verl.-Union; 1991: 11-22
  Google Scholar
• 17 Lamnek S, Krell C. Qualitative Sozialforschung. 6. Aufl.. Beltz; 2016
  Google Scholar
• 18 Reichertz J. Qualitative und interpretative Sozialforschung. Eine Einladung. Studientexte zur Soziologie. Wiesbaden: Springer VS; 2016. DOI: 10.1007/978-3-658-13462-4
  CrossrefGoogle Scholar
• 19 Wirtz MA, Strohmer J. Anwendung und Integration qualitativer und quantitativer Forschungsmethoden in der rehabilitationswissenschaftlichen Interventionsforschung. Rehabilitation (Stuttg) 2016; 55: 191-199 DOI: 10.1055/s-0042-105940.
  Article in Thieme ConnectPubMedGoogle Scholar
• 20 Lunde Å, Heggen K, Strand R. Knowledge and Power. J Mix Methods Res 2013; 7: 197-210 DOI: 10.1177/1558689812471087.
  CrossrefPubMedGoogle Scholar
• 21 Haan M, van Eijk-Hustings Y, Vrijhoef HJ. Using mixed methods in health services research: A review of the literature and case study. J Health Serv Res Policy 2021; 26: 141-147 DOI: 10.1177/1355819620955223.
  CrossrefPubMedGoogle Scholar
• 22 Greene JC. Is Mixed Methods Social Inquiry a Distinctive Methodology?. J Mix Methods Res 2008; 2: 7-22 DOI: 10.1177/1558689807309969.
  CrossrefPubMedGoogle Scholar
• 23 Burzan N. Methodenplurale Forschung: Chancen und Probleme von Mixed Methods. Weinheim: Beltz Juventa; 2016
  Google Scholar
• 24 Hesse-Biber S. Mixed Methods Research: The “Thing-ness” Problem. Qual Health Res 2015; 25: 775-788 DOI: 10.1177/1049732315580558.
  CrossrefPubMedGoogle Scholar
• 25 Wisdom JP, Cavaleri MA, Onwuegbuzie AJ. et al. Methodological reporting in qualitative, quantitative, and mixed methods health services research articles. Health Serv Res 2012; 47: 721-745
  CrossrefPubMedGoogle Scholar
• 26 Palinkas LA, Aarons GA, Horwitz S. et al. Mixed method designs in implementation research. Administration and Policy in Mental Health and Mental Health Services Research 2011; 38: 44-53
  CrossrefPubMedGoogle Scholar
• 27 Plano Clark VL, Ivankova NV. Mixed methods research: A guide to the field. Bd. 3. SAGE Publications; 2015
  Google Scholar
• 28 Kuckartz U. Datenanalyse in der Mixed-Methods-Forschung. Kölner KZfSS 2017; 69: 157-183 DOI: 10.1007/s11577-017-0456-z.
  CrossrefPubMedGoogle Scholar
• 29 Creamer EG. An introduction to fully integrated mixed methods research. Los Angeles, London, New Delhi: SAGE; 2018
  CrossrefGoogle Scholar
• 30 Bazeley P. “Mixed methods in my bones”: Transcending the qualitative-quantitative divide. International Journal of multiple research approaches 2018; 10: 334-341
  CrossrefPubMedGoogle Scholar
• 31 Kelle U. Die Integration qualitativer und quantitativer Forschung–theoretische Grundlagen von „Mixed Methods“. KZfSS 2017; 69: 39-61
  CrossrefPubMedGoogle Scholar
• 32 Mekki TE, Hallberg IR, Øye C. Lessons learned from mixed method research when designing and evaluating an education intervention in nursing homes – a retrospective reflection IPDJ 8(2) 2018; 2046-9292
  PubMed
• 33 O’Cathain A, Murphy E, Nicholl J. Three techniques for integrating data in mixed methods studies. BMJ 2010; 341: c4587 DOI: 10.1136/bmj.c4587.
  CrossrefPubMedGoogle Scholar
• 34 Guetterman TC, Fetters MD, Creswell JW. Integrating Quantitative and Qualitative Results in Health Science Mixed Methods Research Through Joint Displays. Ann Fam Med 2015; 13: 554-561 DOI: 10.1370/afm.1865.
  CrossrefPubMedGoogle Scholar
• 35 Farmer T, Robinson K, Elliott SJ. et al. Developing and implementing a triangulation protocol for qualitative health research. Qual Health Res 2006; 16: 377-394 DOI: 10.1177/1049732305285708.
  CrossrefPubMedGoogle Scholar
• 36 Saal S, Meyer G, Beutner K. et al. Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study. BMC Geriatr 2018; 18: 61 DOI: 10.1186/s12877-018-0745-z.
  CrossrefPubMedGoogle Scholar
• 37 Bieber A, Bartoszek G, Stephan A. et al. Formal and informal support of patients with dementia at home: A mixed methods study within the Actifcare project. Z Evid Fortbild Qual Gesundhwes 2018; 139: 17-27 DOI: 10.1016/j.zefq.2018.11.004.
  CrossrefPubMedGoogle Scholar
• 38 Dür M, Coenen M, Stoffer MA. et al. Do patient-reported outcome measures cover personal factors important to people with rheumatoid arthritis? A mixed methods design using the International Classification of Functioning, Disability and Health as frame of reference. Health Qual Life Outcomes 2015; 13: 27 DOI: 10.1186/s12955-015-0214-8.
  CrossrefPubMedGoogle Scholar
• 39 Kremeike K, Frerich G, Romotzky V. et al. The desire to die in palliative care: a sequential mixed methods study to develop a semi-structured clinical approach. BMC Palliat Care 2020; 19: 49 DOI: 10.1186/s12904-020-00548-7.
  CrossrefPubMedGoogle Scholar
• 40 Sandelowski M, Voils CI, Knafl G. On Quantitizing. J Mix Methods Res 2009; 3: 208-222 DOI: 10.1177/1558689809334210.
  CrossrefPubMedGoogle Scholar
• 41 Rihoux B, Ragin CC. Configurational comparative methods: Qualitative comparative analysis (QCA) and related techniques. SAGE Publications; 2008
  Google Scholar
• 42 Kahwati LC, Kane HL. Qualitative comparative analysis in mixed methods research and evaluation. Bd. 6. SAGE Publications; 2018
  Google Scholar
• 43 Hong QN, Pluye P, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, Gagnon MP, Griffiths F, Nicolau B. Mixed Methods Appraisal Tool (MMAT), version 2018. Registration of Copyright (#1148552). Canadian Intellectual Property Office. 2018
  PubMedGoogle Scholar
• 44 O’Cathain A, Murphy E, Nicholl J. The quality of mixed methods studies in health services research. J Health Serv Res Policy 2008; 13: 92-98 DOI: 10.1258/jhsrp.2007.007074.
  CrossrefPubMedGoogle Scholar
• 45 Doyle L, Brady A-M, Byrne G. An overview of mixed methods research – revisited. Journal of research in nursing 2016; 21: 623-635 DOI: 10.1177/1744987116674257.
  CrossrefPubMedGoogle Scholar
• 46 Fetters MD. Six Equations to Help Conceptualize the Field of Mixed Methods. J Mix Methods Res 2018; 12: 262-267 DOI: 10.1177/1558689818779433.
  CrossrefPubMedGoogle Scholar