scholarly journals Cardiac patients’ biopsychosocial profiles in remote rehabilitation process: Mixed-methods grounded theory approach (Preprint)

10.2196/16864 ◽  
2019 ◽  
Author(s):  
Marjo-Riitta Anttila ◽  
Anne Söderlund ◽  
Teemu Paajanen ◽  
Heikki Kivistö ◽  
Katja Kokko ◽  
...  
Keyword(s):  
Grounded Theory ◽  
Mixed Methods ◽  
Cardiac Patients ◽  
Theory Approach ◽  
Rehabilitation Process ◽  
Grounded Theory Approach

Cardiac patients’ biopsychosocial profiles in remote rehabilitation process: Mixed-methods grounded theory approach (Preprint)

2019 ◽  
Author(s):  
Marjo-Riitta Anttila ◽  
Anne Söderlund ◽  
Teemu Paajanen ◽  
Heikki Kivistö ◽  
Katja Kokko ◽  
...  
Keyword(s):  
Grounded Theory ◽  
Physical Fitness ◽  
Cardiac Rehabilitation ◽  
Theory Approach ◽  
Web Based ◽  
Rehabilitation Process ◽  
Lifestyle Behavior ◽  
Classic Grounded Theory ◽  
Lifestyle Risk ◽  
Grounded Theory Approach

BACKGROUND Digital development has caused rehabilitation services and rehabilitees to become increasingly interested in using technology as part of rehabilitation. However, there is insufficient information available on the biopsychosocial differences between technology user groups. This study was based on our previous research that categorized four cardiac patient groups based on different experiences and attitudes towards technology (e-usage groups): “feeling outsider”, “being uninterested”, “reflecting benefit”, and “enthusiastic using”. OBJECTIVE This study aimed to identify differences in cardiac patients’ biopsychosocial profiles in e-usage groups and to deepen the understanding of these profiles in cardiac rehabilitation. METHODS Focus group interviews and measurements were conducted with 39 coronary artery disease patients aged 34−77 years (average 54.8 years; male 74%). Quantitative data were gathered during a 12-month rehabilitation period. First, we used analysis of variance and Tukey’s HSD test, a t-test or non-parametric tests, i.e., Mann-Whitney and Kruskal-Wallis tests, to compare the four e-usage groups in biopsychosocial measurements. Second, we compared the four e-groups’ results in terms of recommended and reference values. This analysis contained thirteen variables related to biomedical, psychological and social functioning. Finally, we formed biopsychosocial profiles based on meaning interpretation through the constant comparative analysis phase of classic grounded theory. RESULTS The biomedical variables were larger for waistline (p=0.031) and lower for physical fitness (p=0.029) in the “being uninterested” group than in the “enthusiastic using” group. The “feeling outsider” group had lower physical fitness (p=0.047) than the “enthusiastic using” group. For psychosocial variables, such as the degree of self-determination in exercise (p=0.023), the “being uninterested” group had lower values than the “enthusiastic using” group. Social variables such as performing guided tasks in the program (p=0.025) and communicating via messages (p=0.034) were lower in the “feeling outsider” group than in the “enthusiastic using” group. The recommended and reference values were lower than the cut-off values for waistline and physical fitness for the “feeling outsider” and “being uninterested” groups than for the “reflecting benefit” and “enthusiastic using” groups. Exercise self-efficacy was lower in the “enthusiastic using” group than in the “feeling outsider” group. The most essential result of the study was the formation of the “reflecting lifestyle management” category associated with different biopsychosocial profiles in remote rehabilitation. The “feeling outsider” and “being uninterested” groups had high-risk lifestyle behavior, and adherence to the Web-based program was low. In contrast, members of the “being uninterested” group were interested in tracking their physical activity. The “reflecting benefit” and “enthusiastic using” groups had low-risk lifestyle behavior and good adherence to Web-based interventions, but the “enthusiastic using” group had low self-efficacy in exercise. These profiles showed how individuals reflected their lifestyle risk factors differently in the rehabilitation process. We re-named the four groups “building self-awareness”, “increasing engagement”, “maintaining a healthy lifestyle balance” and “strengthening self-confidence”. CONCLUSIONS The results can facilitate more effective and meaningful personalization guidance and inform the remote rehabilitation counseling process. Cardiac rehabilitation professionals can tailor individual Web-based lifestyle risk management interventions by using these biopsychosocial profiles. According to the classic grounded theory approach, the study results will be used to generate substantive theory. CLINICALTRIAL ISRCTN Registry: ISRCTN61225589

scholarly journals Mixing a Grounded Theory Approach with a Randomized Controlled Trial Related to Intimate Partner Violence: What Challenges Arise for Mixed Methods Research?

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Cristina Catallo ◽  
Susan M. Jack ◽  
Donna Ciliska ◽  
Harriet L. MacMillan
Keyword(s):  
Intimate Partner Violence ◽  
Grounded Theory ◽  
Mixed Methods ◽  
Partner Violence ◽  
Intimate Partner ◽  
Mixed Methods Study ◽  
Theory Approach ◽  
Randomized Controlled ◽  
Data Collection And Analysis ◽  
Grounded Theory Approach

Little is known about how to systematically integrate complex qualitative studies within the context of randomized controlled trials. A two-phase sequential explanatory mixed methods study was conducted in Canada to understand how women decide to disclose intimate partner violence in emergency department settings. Mixing a RCT (with a subanalysis of data) with a grounded theory approach required methodological modifications to maintain the overall rigour of this mixed methods study. Modifications were made to the following areas of the grounded theory approach to support the overall integrity of the mixed methods study design: recruitment of participants, maximum variation and negative case sampling, data collection, and analysis methods. Recommendations for future studies include: (1) planning at the outset to incorporate a qualitative approach with a RCT and to determine logical points during the RCT to integrate the qualitative component and (2) consideration for the time needed to carry out a RCT and a grounded theory approach, especially to support recruitment, data collection, and analysis. Data mixing strategies should be considered during early stages of the study, so that appropriate measures can be developed and used in the RCT to support initial coding structures and data analysis needs of the grounded theory phase.

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