Article
Evaluation using a mixed-methods design: experiences from the EvaSIS-study to evaluate a new nursing documentation
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Published: | April 30, 2018 |
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Background and Purpose: Mixed-methods designs help to approach a complex research topic from different methodological perspectives. Such a design was used to evaluate the efficiency of a newly established nursing documentation system (structural model). We explored the importance of using different methods in evaluation research.
Methods: In a formative process evaluation standardized surveys, focus groups, interviews and a document analysis were conducted. Target groups were nurses in inpatient and outpatient care facilities throughout Germany. Patients and their relatives as well as external auditors were also involved.
Results: In total 1.485 nurses from 1.146 care facilities as well as 292 auditors participated in online and paper-based surveys. 54 participants took part in the focus groups and 13 interviews were conducted with patients and their relatives. Additionally, 104 nursing records were analysed. Different methods sometimes yielded contradictory results: Despite individual care objectives not being part of the structural model and focus group participants welcoming this fact, they were still included in almost half of records. Also, while about 80% of participants in the online survey described the different elements of the structural model as transparent and comprehensible, the same elements were sometimes described as confusing when discussed in the focus groups.
Conclusions: To gain balanced results in the evaluation of complex subjects, a mixed methods approach and data triangulation can counter the weaknesses of individual methods. For example, supplementary document analysis can help to identify socially desirable responses in surveys or interviews.
Funding: The project was funded by the National Association of Statutory Health Insurance Funds (GKV-S).