Mixed methods research in the development and evaluation of complex interventions in palliative and end-of-life care:report on the MORECare consensus exercise

Farquhar, Morag and Preston, Nancy and Evans, Catherine J. and Grande, Gunn and Short, Vicky and Benalia, Hamid and Higginson, Irene J. and Todd, Chris (2013) Mixed methods research in the development and evaluation of complex interventions in palliative and end-of-life care:report on the MORECare consensus exercise. Journal of Palliative Medicine, 16 (12). pp. 1550-1560. ISSN 1557-7740

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Abstract

Abstract Background: Complex interventions are common in palliative and end-of-life care. Mixed methods approaches sit well within the multiphase model of complex intervention development and evaluation. Generic mixed methods guidance is useful but additional challenges in the research design and operationalization within palliative and end-of-life care may have an impact on the use of mixed methods. Objective: The objective of the study was to develop guidance on the best methods for combining quantitative and qualitative methods for health and social care intervention development and evaluation in palliative and end-of-life care. Methods: A one-day workshop was held where experts participated in facilitated groups using Transparent Expert Consultation to generate items for potential recommendations. Agreement and consensus were then sought on nine draft recommendations (DRs) in a follow-up exercise. Results: There was at least moderate agreement with most of the DRs, although consensus was low. Strongest agreement was with DR1 (usefulness of mixed methods to palliative and end-of-life care) and DR5 (importance of attention to respondent burden), and least agreement was with DR2 (use of theoretical perspectives) and DR6 (therapeutic effects of research interviews). Narrative comments enabled recommendation refinement. Two fully endorsed, five partially endorsed, and two refined DRs emerged. The relationship of these nine to six key challenges of palliative and end-of-life care research was analyzed. Conclusions: There is a need for further discussion of these recommendations and their contribution to methodology. The recommendations should be considered when designing and operationalizing mixed methods studies of complex interventions in palliative care, and because they may have wider relevance, should be considered for other applications.

Item Type:
Journal Article
Journal or Publication Title:
Journal of Palliative Medicine
Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/2700
Subjects:
ID Code:
67557
Deposited By:
Deposited On:
14 Nov 2013 17:02
Refereed?:
Yes
Published?:
Published
Last Modified:
05 Aug 2020 02:36