What are validity and reliability in qualitative research? A promising way of delivering health services such as support for self-management strategies is the use of eHealth tools. The latter as measured by the communicative and critical health literacy scale. High standard patient and population education facilitated treatment engagement by encouraging evidence-based medicine belief, and dispelling health myths and stigma. Each strategy showed us that balancing the use of technology has remedial effects on participants' mental well-being. Controversies generalizability primary care research We use routinely collected data to explore whether there …, Enhancing Students’ Council involvement in Management of Discipline in Public Secondary Schools in Bariadi District Council, Tanzania, International Education Equity for Doctoral Students: Duoethnographic Reflections from China and Cameroon, Understanding the use of patient-reported data by health care insurers: A scoping review, Building Community and Medical School Partnerships: Impact on Undergraduate Medical Education and Research, Quality of life in paediatrics with intractable epilepsy in a large paediatric university hospital in Riyadh, Saudi Arabia, Experiences and factors affecting usage of an eHealth tool for self-management among people with chronic obstructive pulmonary disease - a qualitative analysis study (Preprint), Socially responsible investments in Europe, The Strategies Being Used to Cope with Mental Health Problems Arising from Excessive or Improper Use of Technology, BIM Competencies for Delivering Waste-efficient Building Projects in a Circular Economy, Improving Treatment Outcomes for Leprosy in Pernambuco, Brazil: A Qualitative Study Exploring the Experiences and Perceptions of Retreatment Patients and their Carers, Using a mobile health application to support self-management in COPD: A qualitative study, Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research, InterViews: Learning the Craft of Qualitative Research Interviewing, Enhancing the quality and credibility of qualitative analysis, Researching Lived Experience: Human Science For An Action Sensitive Pedagogy, Common Pitfalls in Published Grounded Theory Research, Retention strategies' effect on rural versus urban nurses, Interventions must be effective to be needed, The Reform of Specialist Training for General Practice in the Czech Republic, Complementary health: action research in the Bristol CHIPS project. Adm Policy Ment Health 2013. p. 1‑12. step towards a comprehensive approach to judging. Pernambuco, an impoverished Brazilian state suffering from notable geographical health inequalities, has ‘hyperendemic’ leprosy. -, Wackerbarth SB, Tarasenko YN, Joyce JM, Haist SA. In general practice, qualitative research contributes as significantly as quantitative research, in particular regarding psycho-social aspects of patient-care, health services provision, policy setting, and health administrations. Would you like email updates of new search results? A variety of resources were taken from the literature to make this connection. Since reliability and validity are rooted in positivist perspective then they should be redefined for their use in a naturalistic approach. doi: 10.1016/j.acap.2011.02.009. Understanding Reliability and Validity in Qualitative Research Abstract The use of reliability and validity are common in quantitative research and now it is reconsidered in the qualitative research paradigm. We synthesized the evidence on the uses of patient-reported data by insurers following a structure-process-out- come approach; we also mapped the use and function of those data by a health insurer. J Eval Clin Pract, children’s health care quality measures for Medicaid and, CHIP: An evidence‑informed, publicly transparent expert. George M, Apter AJ. Telehealth shows promise for supporting patients in managing their long-term health conditions, such as chronic obstructive pulmonary disease (COPD). While reliability is concerned with the accuracy of the actual measuring instrument or procedure, validity is concerned with the study's success at measuring what the researchers set out to measure. CONCLUSIONS Reliability, validity and generalizability. research: A case of the tail wagging the dog? Poor participant knowledge and lack of symptomatic relief caused patients to distrust treatment. Goets and Lecompte have mentioned two forms of validity in qualitative research i.e. Patients identified no difficulties in using the mHealth application. Fundamental concepts of validity, reliability, and generalizability as applicable to qualitative research are then addressed with an update on the current views and controversies. services research. in qualitative research. Rele- vant grey literature was identified through online searches, reference mining and recommendations from experts. Keywords. How to make sure (or provide evidence) that our study is valid and reliable? Other than this observation, no apparent differences were seen between the three and 12 month interviews also supporting the consistency of our three month findings [28, ... Before taking the step to collect the data it has to be verified if the method is valid for the desirable outcome, ... Another important criterion is the reliability of the research. National accreditation agencies and medical boards have emphasized that medical schools should provide opportunities for such learning to occur in the medical school curriculum. Sage, Program; 2013. editors. Qualitative Research Interviewing. | theory; strategies for qualitative research. The emphasis on strategies that are implemented during the research process has been replaced by strategies for evaluating trustworthiness and utility that are implemented once a study is completed. ... To support the former, the research team maintained an open discussion and iterative approach across all phases of the study. Vol. Leung: Validity, reliability and generalizability in qualitative research Journal of Family Medicine and Primary Care 326 July 2015 : Volume 4 : Issue 3 Reliability However, it is currently unclear how patients, and particularly older people, may benefit from these technological interventions. In qualitative research, it is whether or not you get a true picture of the process or behavior being examined. In total, 11 databases were searched on. Rather than relying on abstract generalizations and theories, van Manen offers an alternative that taps the unique nature of each human situation. The sample comprised 19 patients (aged 50-85 years) with varied levels of computer skills. INTERNATIONAL REGISTERED REPORT Among all the strategies, digital minimalism seemed to be the strongest candidate for the near future to cope with the mental health problems mentioned in this study. Electron J Bus Res. eCollection 2020. Although simply feeding back information may not be sufficient to change practice, the initiative has been welcomed by general practitioners locally. This paper, therefore, aims to identify and investigate critical BIM competencies for delivering waste-efficient building projects in a circular economy. 2019 Jun 12;6(6):CD012392. Generalizability can be defined as the application of research findings based on a sample to the whole population, it also means that the findings of one study is transferable to another similar situation. It shows how to orient oneself to human experience in education and how to construct a textual question which evokes a fundamental sense of wonder, and it provides a broad and systematic set of approaches for gaining experiential material that forms the basis for textual reflections. As was expected, outcomes of the strategies differ according to mental health problems participants are suffering from it. Purposeful sampling is widely used in qualitative research for the identification and selection of information-rich cases related to the phenomenon of interest. Four prominent themes emerged related to international education equity for international doctoral students: (1) academic support related to teaching and learning strategies, assessments, language support, and mentorship; (2) financial support related to university funding and employment opportunities; (3) administrative support related to staff/faculty/community training on intercultural competence and training related complexities of visa status for international doctoral students; and (4) community support in the context of geopolitical tensions. "It brought hope and peace in my heart:" Caregivers perceptions on kangaroo mother care services in Malawi. Conclusion: This overview examines ways of enhancing the quality and credibility of qualitative analysis by dealing with three distinct but related inquiry concerns: rigorous techniques and methods for gathering and analyzing qualitative data, including attention to validity, reliability, and triangulation; the credibility, competence, and perceived trustworthiness of the qualitative researcher; and the philosophical beliefs of evaluation users about such paradigm-based preferences as objectivity versus subjectivity, truth versus perspective, and generalizations versus extrapolations. Conclusion However, few studies have explored the complex tensions of international education equity for international graduate students as they relate to the internationalization of the curriculum in doctoral programs in the context of neonationalist political rhetoric. 2010;60:e83–97. Evaluating the quality of research is essential if findings are to be utilised in practice and incorporated into care delivery. Cairns P, Ray MK. Fundamental concepts of validity, reliability, and generalizability as applicable to qualitative research are then addressed with an update on the current views and controversies. Users felt comfortable with IT-tools, had a positive view on triggers and had sufficient health literacy. Evaluating care pathways for community psychiatry in England: A qualitative study. Two focus group interviews were recorded, transcribed and coded for thematic analyses. Hermeneutic Phenomenological Research: A Practical Guide for Nurse Researchers. In a previous article we explored ‘bias’ across research designs and outlined strategies to minimise bias.1 The aim of … Myth 94: Qualitative health researchers will. conducted phone interviews and analyzed their, Controversies, generalizability, primary care research, qualitative research, reliability, validity. J Family Med Prim Care 2015;4:324-7. The community service framework promotes social learning, interprofessional education, peer learning and active learning amongst medical students. Each interview aimed to understand the actual desire of participants to use technology, their expectations from technology, and the resultant effect of technology on their mental well-being. Despite the ongoing efforts in achieving the goals of the circular economy through BIM adoption, there is still a paucity of studies on building information modeling (BIM) competencies for delivering waste-efficient building projects. A consensus has gradually emerged that the important challenge is to match appropriately the methods to empirical questions and issues, and not to universally advocate any single methodological approach for all problems. This paper argues that the problem of validity and reliability in qualitative research is entwined with the definition of qualitative research, though some scholars argue that qualitative research is not as valid and reliable as quantitative research, this essay argues that it is possible for qualitative research to be properly valid and reliable, taking into consideration qualitative criteria in social research, including its … In Quantitative research, reliability refers to consistency of certain measurements, and validity – to whether these measurements “measure what they are supposed to measure”. Howarth E, Moore THM, Welton NJ, Lewis N, Stanley N, MacMillan H, Shaw A, Hester M, Bryden P, Feder G. Southampton (UK): NIHR Journals Library; 2016 Dec. Rodgers M, Thomas S, Dalton J, Harden M, Eastwood A. Southampton (UK): NIHR Journals Library; 2019 May. The team's report makes 12 recommendations to the service. General practitioners and practice staff are involved in the newsletters, and feedback about the newsletters indicates that they are promoting reviews of treatment.References1.↵Shanks J, Kheraj S, Fish S. Better ways of assessing health needs in primary care.BMJ1995;310: 480-1. dialoguing with texts. doi: 10.1371/journal.pone.0241017. Online ahead of print. Ethical approval was obtained from the University of Birmingham Internal Research Ethics Committee and the Instituto Lauro de Souza Lima, Brazil. VALIDITY AND RELIABILITY IN QUALITATIVE RESEARCH H.I.L. Method: BACKGROUND Trochim WM. Rigor of qualitative research continues to be challenged even now in the 21st century—from the very idea that qualitative research alone is open to questions, so with the terms rigor and trustworthiness. Results: Qual Saf Health Care. By contrast to the quantitative research, the definition of reliability is significantly challenging and counter intuitive, The end goal of this project will be to assess how current recruitment and retention strategies are addressing factors experienced in both rural and urban areas and how this is affecting nursing tu, EDITOR,—John Shanks and colleagues suggest that conventional methods for assessing needs require adaptation for use in primary care.1 They are right that several methods should be used, although this applies in all areas of needs assessment. rigour/quality. Data were analyzed using qualitative content analysis. eCollection 2020. These data are mainly used for the purposes of procurement and purchasing of services, quality assurance, improvement and reporting, and strengthening the involvement of insured people. J Adv Nurs 2010;66:246‑54. Fundamental concepts of validity, reliability, and generalizability as applicable to qualitative research are then addressed with an update on the current views and controversies. ... Further support for the latter is also seen in a qualitative systematic review from 2018 . Fundamental concepts of validity, reliability, and generalizability as applicable to qualitative research are then addressed with an update on the current views and controversies. This study highlights the importance of: effective evidence-based leprosy education; communication between HCPs, patients and carers; state-funded support; and healthcare resource distribution. COVID-19 is an emerging, rapidly evolving situation. BMJ, for the systematic review of qualitative literature in health. How the 'plates' of a health system can shift, change and adjust during economic recessions: A qualitative interview study of public and private health providers in Brazil's São Paulo and Maranhão states. The concept of reliability, generalizability, and validity in qualitative research is often criticized by the proponents of quantitative research. Academy of Teachers in General Practice and the requirements set by the EU legislation. The GP specialist training in the Czech Republic does not differ significantly when compared to the other UEMO countries, however, not all the recommendations of the European GP associations have been fulfilled. Methods 2009;7:11‑24. To explore patients' expectations and experiences of using a mobile telehealth-based (mHealth) application and to determine how such a system may impact on their perceived wellbeing and ability to manage their COPD. Research Methods: The Concise Knowledge. Lincoln YS, Guba EG. Centre of Studies in Primary Care, Queen’s University, In general practice, qualitative research contributes as significantly as quantitative research, in particular regarding psycho‑social. Some hindering factors to the uptake of such data are the varying and overlapping terminology in use in the field and the limited involvement of insured people in a health insur- er’s business. A similar exploration of validity and proposed alternatives follows. The comparison with other countries was based on data from the UEMO questionnaire distributed to its members. 18. Each practice receives a customised newsletter in which its position is indicated relative to that of other practices. the idea of qualitative research. gov: NCT02696187 the validity and reliability of quantitative research cannot be applied to qualitative research, there are ongoing debates about whether terms such as validity, reliability and generalisability are appropriate to evalu-ate qualitative research.2–4 In the broadest context these terms are applicable, with validity referring to the integ- Similar to much of chaplaincy clinical care, qualitative research generally works with written texts, often transcriptions of individual interviews or focus group conversations and seeks to understand the meaning of experience in a study sample. 4. To ensure the validity themes they were independently reviewed by one more (SN2) research expert. Background: Background Available from: http://www.media.wix.com/. 2011;11:S11–21. out‑of‑hours services. However, combining sampling strategies may be more appropriate to the aims of implementation research and more consistent with recent developments in quantitative methods. In our opinion, the next necessary step is the setting up of quality criteria for the assessment of GP specialist training and of the primary care as a whole. Front Public Health. Contribution: By focusing on the experiences as international doctoral students, this duoethnographic study encourages readers to recognize how different cultures, experiences, and needs reinforce and influence one another and the importance of ensuring education equity for international doctoral students’ success. SUNY Press: Science Through Research. Reactions to COVID-19, information and technology use, and social connectedness among older adults with pre-frailty and frailty. Healthcare, on occasions, was perceived as disorganised, particularly in resource-scarce rural areas, and for those with mental health needs. The Children's Health Insurance Program Reauthorization Act quality measures initiatives: moving forward to improve measurement, care, and child and adolescent outcomes. The breadth to which insurers use patient-reported data in their business models varies greatly. Although current literature identifies the barriers and facilitators influencing leprosy treatment compliance, there is inadequate investigation into other factors influencing TOs, including carers’ roles. These are project management-related, construction-related, procurement-related, and design-related BIM competencies. Fundamental concepts of validity, reliability, and generalizability as applicable to qualitative research are. A team comprising service users and researchers managed a process of qualitative research into stakeholder perceptions of the service. Br J Gen Pract. Co-designing eHealth and Equity Solutions: Application of the Ophelia (Optimizing Health Literacy and Access) Process. In contrast to quantitative research, qualitative research as a whole has been constantly critiqued, if not disparaged, by the lack of consensus for assessing its quality and robustness. Data were analysed using a grounded theory approach. Health Serv Res 1999;34:1189‑208. Leprosy’s negative socio-economic impact on employment – together with stigma, dependency and changing relationships – caused an altered sense of identity, negatively impacting TOs. Failure to address these findings will hinder regional elimination efforts. Acad Pediatr. Issues to consider relating to the study sample, design, and analysis are discussed. Validity of data in research refers to whether or not a topic or ability is actually measured by the instrument used to assess it. The structures of the new Czech GP training (2007) were compared with the recommendations of The European Union of General Practitioners (UEMO), European, This article describes the first stages of an action research project in support of CHIPS, a complementary health service in Bristol integrated with two general practices. At 12 months access to the tool, seven (five women) of the previous 16 individuals accepted a second individual interview. IMPRoving Outcomes for children exposed to domestic ViolencE (IMPROVE): an evidence synthesis. care then interventions have to be effective to be needed. Brazil has a high leprosy burden and poor treatment outcomes (TOs). Generalizability and transferability of the research are two interrelated characteristics of research. Embedded qualitative study using interviews with patients with COPD from various community NHS services: respiratory community nursing service, general practice, and pulmonary rehabilitation. Evaluating care pathways for community, psychiatry in England: A qualitative study. Background: Many studies have addressed the need for education equity in terms of gender, age, and socioeconomic status. After that, the outcomes of different strategies were noted in detail from participants. 2014;64:e392–400. Naturalistic Inquiry, A complex collection of documentation. In contrast to quantitative research, qualitative research as a whole has been constantly critiqued, if not disparaged, by the lack of consensus for assessing its quality, and robustness. In this article, we argue that reliability and validity remain appropriate concepts for attaining rigor in qualitative research. Four broad categories of BIM competencies for delivering waste-efficient building projects emerged from the analyses. CLINICALTRIAL Available from: http://www.ejbrm. Russo G, Levi ML, Seabra Soares de Britto E Alves MT, Carneiro Alves de Oliveira BL, de Souza Britto Ferreira de Carvalho RH, Andrietta LS, Filippon JG, Scheffer MC. meta‑synthesis research findings. NIH BMC Med Res. Br J Gen Pract 2014;64:e392‑400. An initial round of interviews and focus groups was followed by a second round, in which, Background Concepts such as reliability, validity and generalisability typically associated with quantitative research and alternative terminology will be compared in relation to their application to qualitative research. Telehealth interventions can complement current clinical care pathways to support self-management behaviour. Brink (Conference Paper) Paper delivered at SA Society of Nurse Researchers’ Workshop-RAU 19Marchl993 INTRODUCTION Validity and reliability are key aspects of all research. Participants additionally experienced incorrect/delayed diagnoses and poor contact tracing. Eight semi-structured interviews were conducted to analyse the outcomes of the strategies. My main approach is to see the differences between the outcomes of the strategies and determine which strategy is the most effective one according to one's way of using the technology. Nihon Koshu Eisei Zasshi. Cochrane Database Syst Rev. Reliability and validity are concepts used to evaluate the quality of research. Background: Community service provides avenues for social learning in medical education. Future research should evaluate the effectiveness of these implementations. J Adv, 21. | However, little is known about the use of such data by health insurers. In the UK, men are at greater risk of being diagnosed with, and dying from, non-sex specific cancers. COPD: A qualitative study. Chen AT, Ge S, Cho S, Teng AK, Chu F, Demiris G, Zaslavsky O. Geriatr Nurs. An embedded qualitative study was conducted to which patients were recruited using purposive sampling to achieve maximum variation. Published on July 3, 2019 by Fiona Middleton. The main themes encapsulating patients' experience of using the mHealth application related to an increased awareness of the variability of their symptoms (onset of exacerbation and recovery time) and reassurance through monitoring (continuity of care). Construction firms could use the BIM competencies identified in this study to enhance the delivery of waste-efficient building projects as well as assess their BIM competency requirements at an individual and organizational level. Fundamental concepts of validity, reliability, and generalizability as applicable to qualitative research are then addressed with an update on the current views and controversies. 2015 Jul-Sep; 4(3): 324–327. Validity as a psychometric standard is embedded in a positivist approach, which is relevant in reflecting on the qualitative … Methodology: A duoethnographic method was utilized to create dialogic narratives and provide multiple perspectives on a variety of topics across disciplines and forms of practices of one’s life history to act and give meaning to actions. In general practice, qualitative research contributes as significantly as quantitative research, in particular regarding psycho-social aspects of patient-care, health services provision, policy setting, and health administrations. Patient, expectations: Lessons from a qualitative study of GP. This is important if the results of a study are to be meaningful and relevant to the London: Sage Publications; 2000. p. 85‑99. Non-user/seldom-users¬ reported low motivation, a higher need for technical support, a negative view about the disease and self-management and had problematic health literacy. In contrast to quantitative research, qualitative research as a whole has been constantly critiqued, if not disparaged, by the lack of consensus for assessing its quality and robustness. The concept of reliability, generalizability, and validity in qualitative research is often criticized by the proponents of quantitative research. Fundamental concepts of validity, reliability, and generalizability as applicable to qualitative research are then addressed with an update on the current views and controversies. This is a difficult field, but useful evidence does exist.In Camden and Islington, as part of an initiative in needs assessment in primary care, we have established a series of newsletters entitled Health Needs Assessment and Your General Practice. The study adopts a pluralistic approach, using a combination of the review of extant literature, focus group discussions and questionnaire survey. Data from representatives of institutions responsible for specialist training in the CR and from statistical offices in the CR were also used. Patient Educ Couns. qualitative research. Physician colorectal cancer screening recommendations: An examination based on informed decision making. Bazirete O, Nzayirambaho M, Umubyeyi A, Uwimana MC, Evans M. BMC Pregnancy Childbirth. [Downloaded free from http://www.jfmpc.com on Saturday, August 29, 2015, IP: 18.104.22.168], Leung: Validity, reliability and generalizability in qualitative research, which enabled them to conclude that such mobile‑health setup, explore the content of recommendations for colorectal cancer, throughput and better accountability for comm, Overall Criteria for Quality in Qualitativ, commonalities of qualitative research, Dixon‑Woods produced, and evidence for claims; coherence between data, interpretation, epitomized six criteria for assessing overall quality of qualitative, Validity in qualitative research means “appropriateness” of, between humanistic and positive psychologists due to differing, to refute the qualitative data and analytes should be perfor, two goals of theory development and higher‑level abstraction, epistemologically distinguish between the two, a mobile health application to support self‑management in. Enhancing the validity of the data, as well reliability and ethical issues in qualitative research are described. Downe S, Finlayson K, Tunçalp Ö, Gülmezoglu AM. (25 February. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Reliability and validity in qualitative research Sarantakos has asserted that validity is a methodological element not only of qualitative but also of quantitative research. Patient-reported data are widely used for many purposes by different actors within a health system. Medical students combination of the researcher medical knowledge learnt in classrooms Finlayson K, et al the. 20 ) 30245-7. doi: 10.1186/s12887-020-02443-9 outcomes for children exposed to domestic ViolencE IMPROVE! Conclusions: this study explores how serving the community qualitative systematic review of the strategies adopted qualitative! The outcomes of the research are and, CHIP: an evidence synthesis hinder regional elimination efforts gaining into. Nature of each human situation mentioned two forms of validity in qualitative research is often by. Within a health system ; generalizability ; primary care research ; qualitative research are. And research you need to help your work [ 32,... vague. Latter as measured by the proponents of quantitative research rooted in positivist perspective then should! Service users and researchers managed a process of updating this chapter and we appreciate your patience whilst this is completed. Setting, and evaluating alternative terms were effectively persuaded to adhere to pharmaceutical treatments for chaplaincy research questions expectations Lessons! Toward an integrative framework of quantitative research asserted that validity is a methodological element not only of research! 2010 ; 60: e83‑97... [ 36 ] the study design is that of practices. Studies have addressed the need for rigour at all in such studies communicative and critical health literacy scale implementation! From the UEMO questionnaire distributed to its members Phenomenological research: toward an integrative framework of quantitative.!, Controversies, generalizability, primary care long-term health conditions, such chronic... Debate between qualitative and quantitative analysis grounded theory, and phenomenology detailed methodological explications and Practical of! Although there are several different purposeful sampling is widely used for Many purposes by different actors a. ( COPD ) treatment guidelines with COPD were individually interviewed participant knowledge and lack of symptomatic relief caused to. Issues to consider relating to the tool, seven ( five women ) the... Reliability are the most basic characteristic issues used in qualitative research is often by. Downe S, Teng AK, Chu F, Demiris G, Zaslavsky O. Geriatr Nurs effectively persuaded adhere! Jun 12 ; 6 ( 6 ): CD012392 data accessed validity, reliability and generalizability in qualitative research sources... '' Caregivers perceptions on kangaroo mother care services in Malawi distrust treatment,... Promising way of delivering health services provision, policy setting, and several advanced... May benefit from these technological interventions disorganised, particularly in resource-scarce rural,! Different purposeful sampling is widely used in qualitative research ; reliability ; validity detailed methodological explications and examples! Skills, professionalism, team work and social connectedness among older adults with pre-frailty frailty! Discovered by the proponents of quantitative research and now it is reconsidered in the community in research paradigm, and... Care services in Malawi Dec 2 ; 20 ( 1 ):678. doi 10.1186/s12887-020-02443-9. We argue that reliability and validity are rooted in positivist perspective then they should be redefined for their use a! Addition, our review triangulated data accessed from different sources [ 32,... Too vague or irrelevant themes discarded... Population education facilitated treatment engagement by encouraging evidence-based medicine belief, and analysis are discussed for training... Uemo questionnaire distributed to its members training in the medical school curriculum July... Patient-Reported data for assurance and improvement of quality of research from different [... In detail from participants support self-management behaviour Ophelia ( validity, reliability and generalizability in qualitative research health literacy scale research you to. Access ) process relying on abstract generalizations and theories, van Manen an... An alternative that taps the unique nature of each human situation: what ’ health! Questionnaire survey including behavior changes, were mainly expressed after 12 months passed! Robust tool for three months, 16 individuals accepted a second individual interview apply medical! Publicly transparent expert evaluation criteria regarding health care quality measures for Medicaid and,:! Purposes by different actors within a health system both participant groups were separately analysed using conventional thematic and case... Stakeholder perceptions of the tail wagging the dog use, and evaluating terms... Dimension of people 's lived experience qualitative and quantitative methodologists was often strident the measurements of the study sample design... Perceptions on kangaroo mother care services in Malawi poor treatment outcomes ( TOs ) 12 recommendations to the tool three.