How to analyse longitudinal data from multiple sources in qualitative health research : the pen portrait analytic technique

BACKGROUND: Longitudinal qualitative research is starting to be used in applied health research, having been popular in social research for several decades. There is potential for a large volume of complex data to be captured, over a span of months or years across several different methods. How to analyse this volume of data - with its inherent complexity - represents a problem for health researchers. There is a previous dearth of methodological literature which describes an appropriate analytic process which can be readily employed. METHODS: We document a worked example of the Pen Portrait analytic process, using the qualitative dataset for which the process was originally developed. RESULTS: Pen Portraits are recommended as a way in which longitudinal health research data can be concentrated into a focused account. The four stages of undertaking a pen portrait are: 1) understand and define what to focus on 2) design a basic structure 3) populate the content 4) interpretation. Instructive commentary and guidance is given throughout with consistent reference to the original study for which Pen Portraits were devised. The Pen Portrait analytic process was developed by the authors, borne out of a need to effectively integrate multiple qualitative methods collected over time. Pen Portraits are intended to be adaptable and flexible, in order to meet the differing analytic needs of qualitative longitudinal health studies. CONCLUSIONS: The Pen Portrait analytic process provides a useful framework to enable researchers to conduct a robust analysis of multiple sources of qualitative data collected over time

Improving the lives of people living with and beyond cancer: Generating the evidence needed to inform policy and practice

Improvements in screening, early detection and treatment have led to more people surviving and living longer following cancer diagnosis. There is growing recognition that people living with and beyond cancer may experience symptoms and problems related to the disease and its treatment in the months and years following diagnosis. The impact this can have is variable, but with a growing number of cancer survivors it is important to know who needs support and how this should be delivered in a resource constrained health service. Researchers and policy-makers must find ways to work together to generate and use evidence to improve the quality of survival.We must: (1) Continue to investigate this growing population and recognise the importance of patient reported outcomes and experiences in the design, planning and evaluation of services; (2) Focus on the most pressing research questions to improve the lives of people living with and beyond cancer. Understanding the experiences of people living with and beyond cancer will support future patients to make choices, manage the consequences of cancer and its treatment, identify who needs most support and how this should be delivered; (3) Acknowledge and seek solutions to the challenges of building the evidence and using it to develop, implement and sustain practice innovation. Challenges include identifying most effective ways for researchers to work with stakeholders (policy, practice, public) to maximise the impact of research, establishing mechanisms for effective implementation and sustainability of clinical services, securing large scale research funding and developing next generation of research leaders

The holistic needs assessment in cancer care: identifying barriers and facilitators in the UK and Canada

Background: Personalised information and support can be provided to cancer survivors using a structured approach. Assessment tools such as the Holistic Needs Assessment (HNA) in the UK and the Comprehensive Problem and Symptom Screening (COMPASS) in Canada have been recommended for use in practice. However, completion of the HNA/COMPASS is not widely embedded into practice and Clinical Nurse Specialists (CNSs) express concern about their ability to respond to issues raised by patients. Aims: To investigate CNS's views on HNAs/COMPASS and identify barriers and facilitators to implementation. Methods: This international on‐line survey using a snowball technique recruited CNSs across the UK and one Canadian province (Manitoba) in 2017. Results: A total of 306 CNSs in the UK and 162 in Canada completed the on‐line survey. In the UK, HNAs were completed primarily prior to and immediately after treatment. In Canada, COMPASS was usually completed at every appointment. Participants expressed concerns that HNAs/COMPASS were becoming “tick‐box exercises” which did not meet patients' needs. Barriers to completion were time, staff shortages, lack of confidence, privacy and signposting of resources. Facilitators were privacy for confidential discussions, training, confidence in knowledge and skills, and signposting of resources. Conclusions: That so many busy CNSs completed this survey demonstrates the importance they attach to HNAs and COMPASS. The challenges faced with implementing these assessments into everyday practice require training, time, support services and an appropriate environment. It is vital that the HNA and COMPASS are conducted at optimum times for patients to make the best use of time and resources