Tagged / Dr. Rachel Arnold

The importance of understanding mixed methods

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Earlier this week ResearchGate alerted us that the paper ‘The Growing Importance of Mixed-Methods Research in Health‘ has been read 900 times on that platform [1].  This methods paper focuses on  the growing importance of mixed-methods research to a wide range of health disciplines ranging from nursing to epidemiology.

Mixed-methods approaches requires not only the skills of the individual quantitative and qualitative methods but also a skill set to bring two methods/datasets/findings together in the most appropriate way. Health researchers need to pay careful attention to the ‘best’ approach to designing, implementing, analysing, integrating both quantitative (number) and qualitative (word) information and writing this up in a way that enhances its applicability and broadens the evidence-based practice. This paper highlights the strengths and weaknesses of mixed-methods approaches as well as some of the common mistakes made by researchers applying mixed-methods for the first time.

Our team in the Centre for Midwifery & Women’s Health (CMWH) has written several other methods papers on the importance of mixed-methods research in community-based health studies [2-5].  We have, of course, conducted and published many mixed-methods studies over the past two decades [see for example 6-10].

 

Prof. Edwin van Teijlingen

 

 

References:

  1. Wasti, S. P., Simkhada, P., van Teijlingen, E., Sathian, B., & Banerjee, I. (2022). The Growing Importance of Mixed-Methods Research in Health . Nepal Journal of Epidemiology, 12(1), 1175–1178.
  2. Simkhada, P., van Teijlingen, E., Wasti, S.P., Sathian, B. (2014) Mixed-methods approaches in health research in Nepal, Nepal Journal of Epidemiology 4(5): 415-416.
  3. Mahato, P., Angell, C., van Teijlingen, E., Simkhada, P. (2018) Using Mixed-methods Research in Health & Education in Nepal, Journal of Health Promotion 6: 45-8.
  4. Harvey, O., van Teijlingen, E., Parrish, M. (2022) Mixed-methods research on androgen abuse – a review, Current Opinion in Endocrinology & Diabetes 29(6):586-593.
  5. MacKenzie Bryers, H., van Teijlingen, E. Pitchforth, E. (2014) Advocating mixed-methods approaches in health research, Nepal Journal of Epidemiology 4(5): 417-422. http://www.nepjol.info/index.php/NJE/article/view/12018/9768
  6. Pitchforth, E, Watson, V, Tucker, J, Ryan, M, van Teijlingen E, Farmer, J, Ireland, J, Thomson, E, Kiger, A , Bryers, H. (2008) Models of intrapartum care and women’s trade-offs in remote and rural Scotland: A mixed-methods study BJOG: An International Journal of Obstetrics & Gynaecology, 115(5): 560-569.
  7. Wasti, SP, Simkhada, P., Randall, J, van Teijlingen, E, Freeman, J. (2012) Factors influencing adherence to antiretroviral treatment in Nepal: a mixed-methods study. PLoS ONE 7(5): e35547. doi:10.1371/journal.pone.0035547.
  8. Simkhada, P., van Teijlingen, E., Devkota, B., Pathak, RS, Sathian, B. (2014) Accessing research literature: A mixed-method study of academics in Higher Education Institutions in Nepal, Nepal Journal of Epidemiology 4(4): 405-14.
  9. Dost, S., Arnold, R., van Teijlingen, E. (2023) Management capacity in the Afghan Ministry of Public Health pre-Taliban: A mixed-methods study of political and socio-cultural issues, Razi International Medical Journal, 3(1): 9–18
  10. Sharma, S., van Teijlingen, E, Hundley, V., Stephens J., Simkhada, P., Angell, C., Sicuri, E., Belizan, J.M. (2013) Mixed-methods evaluation of maternity care intervention in rural Nepal: measuring what works, Poster P.2.3.004(A), Tropical Medicine & International Health 18(Suppl. 1): 183-184.

Dr Rachel Arnold on Appreciative Inquiry

In March of this year I had the pleasure of announcing in a BU Research Blog the publication of Dr. Rachel Arnold’s contribution to the book Appreciating Health and Care: A Practical Appreciative Inquiry Resource for the Health & Social Care Sector  [1].  There is also a supplementary eBook, called Appreciating Health and Care: AI in practice [2], which introduces more professional experiences of using AI (not Artificial Intelligence, but Appreciative Inquiry) in the health and care sector.  Rachel is the lead author of the contribution ‘Let’s get messy! Where to start with using Appreciative Inquiry’ and her co-authors are Dr. Jo Hartley, Prof. Edwin van Teijlingen and Dr. Preeti Mahato.  ‘Let’s get messy! Where to start with using Appreciative Inquiry’ is a case study which reflects on our experiences of using Appreciative Inquiry to explore staff well-being in an NHS maternity service during the COVID-19 pandemic. We explain how we adapted and overcame some of the challenges, strategies that worked, and practical ideas for anyone interested in using Appreciative Inquiry in health or social care.

 

References:

  1. Hodgkiss, D., Quinney, S., Slack, T., Barnett, K., Howells, B. (2024a)  Appreciating Health and Care: A practical Appreciative Inquiry resource for the Health and Social Care sector, Forres: Appreciating People; ISBN: 978-1-9160267-6-6
  2. Hodgkiss, D., Quinney, S., Slack, T., Barnett, K., Howells, B. (2024b) Appreciating Health and Care: AI in practice, Forres: Appreciating People.

 

 

An Appreciate Inquiry into NHS Maternity Services

NHS, writing

 

 

Congratulation to Dr. Rachel Arnold and her Centre for Midwifery & Women’s Health research team on the publication yesterday of their paper ‘I might have cried in the changing room, but I still went to work’. Maternity staff balancing roles, responsibilities, and emotions of work and home during COVID-19: An appreciative inquiry [1].   This paper focuses on how to support staff and enhance their well-being in a small UK maternity service.  The underpinning methodological approach is appreciative inquiry using interviews with 39 maternity staff and four group discussions exploring meaningful experiences, values and factors that helped their well-being.

The key findings are that maternity staff members were highly motivated, managing a complex melee of emotions and responsibilities including challenges to professional confidence, mental health, family situation, and conflict between work-life roles. Despite staff shortages, a demanding workload, professional and personal turmoil, and the pandemic participants still found meaning in their work and relationships.  The authors go on to argue for a ‘whole person’ approach, since this approach provided insight into the multiple stressors and emotional demands staff faced. It also revealed staff resourcefulness in managing their professional and personal roles. They invested in relationships with women but were also aware of their limits – the need to be self-caring, employ strategies to switch-off, set boundaries or keep a protective distance.  Overall, the paper concludes hat staff’s well-being initiatives, and research into well-being, would benefit from adopting a holistic approach that incorporates home and family with work. Research on emotion regulation strategies could provide insights into managing roles, responsibilities, and the emotional demands of working in maternity services. Emotion regulation strategies could be included in midwifery and obstetric training.

This paper was proceeded by a more methodological paper on the application of Appreciative Inquiry in this study [2].

 

References:

  1. Arnold, R., Way, S., Mahato, P., van Teijlingen, E. (2023) “I might have cried in the changing room, but I still went to work”. Maternity staff managing roles, responsibilities, and emotions of work and home during COVID-19: an Appreciative Inquiry, Women & Birth (online first) 
  2. Arnold, R., Gordon, C., Way, S., Mahato, P., van Teijlingen, E. (2022) Why use Appreciative Inquiry? Lessons learned during COVID-19 in a UK maternity service, European Journal of Midwifery 6 (May): 1-7.

This Sunday is a midwifery day

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Today Sunday 21st November was a midwifery dominated day today.  This lunchtime a interdisciplinary team from CMMPH (Centre for Midwifery, Maternal & Perinatal Health) at BU and the University of Exeter submitted a research proposal to the ICM (International Confederation of Midwives) on Midwife-Led Birthing Centres in Low- and Middle-Income  Countries.   As a personal observation: whoever thought that setting the submission deadline for a Sunday was a good idea has no respect for researchers’ work-life balance!

This afternoon many of us attended the  March with Midwives vigils which were held nationwide in the UK to highlight issues with midwifery staffing and working conditions.  The March with Midwives vigil took place in 50 towns and cities, as a vigil to make the general public and politicians aware about the maternity crisis.  In Poole Park it attracted over fifty people.

Prof. Edwin van Teijlingen
CMMPH

BMC blog on latest HSS paper

international, open access, PG research, Publishing, writing

Dr. Rachel Arnold’s recent paper in BMC Pregnancy & Childbirth was highlighted in a blog promoted by the publisher.  The paper ‘Villains or victims? An ethnography of Afghan maternity staff and the challenge of high quality respectful care‘ reports on the everyday lives of maternal healthcare providers working in a tertiary maternity hospital in Kabul, Afghanistan (1). BMC Pregnancy & Childbirth is an Open Access journal so the paper is available free of charge to anybody in Afghanistan (and elsewhere) with an internet connection.  The aim was to understand the staff’s notions of care, their varying levels of commitment to providing care for women in childbirth, and the obstacles and dilemmas that affected standards, and thereby gain insight into their contributions to respectful maternity care, whether as ‘villains’ or as ‘victims.’

Dr. Arnold is Postdoctoral Midwifery Researcher in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH).  This is the third paper from Rachel’s excellent PhD project, the previous two papers appeared in BJOG and Social Science & Medicine (2-3).

Click here for BMC Blog post:

Villains or victims? The role of maternity staff in decreasing or enhancing respectful care

Reference:

  1. Arnold, R., van Teijlingen, E., Ryan, K., Holloway, I. (2019) Villains or victims? An ethnography of Afghan maternity staff and the challenge of high quality respectful care, BMC Pregnancy & Childbirth 19 :307 https://rdcu.be/bPqlj
  2. Arnold R., van Teijlingen E, Ryan K., Holloway I. (2015) Understanding Afghan health care providers: Qualitative study of culture of care in Kabul maternity hospital, BJOG 122: 260-267.
  3. Arnold, R., van Teijlingen, E., Ryan, K., Holloway, I. (2018) Parallel worlds: an ethnography of care in an Afghan maternity hospital, Social Science & Medicine 126:33-40.