Exploration des traitements offerts aux personnes atteintes d'épicondylite enquête sur la pratique des ergothérapeutes et des physiothérapeutes du Québec

Ce mémoire intitulé"Exploration des traitements offerts aux personnes atteintes d'épicondylite : enquête sur la pratique des ergothérapeutes et des physiothérapeutes du Québec" est présenté par Quan Nha Hong à la Faculté de médecine de l'Université de Sherbrooke en vue de l'obtention du grade de Maître ès sciences. La prévalence des lésions professionnelles aux membres supérieurs a connu une recrudescence importante au cours de la dernière décennie, de même que les coûts qui y sont associés. Une des lésions souvent rencontrée est l'épicondylite. Malgré qu'elle soit souvent associée aux sports de raquette, ce sont les travailleurs qui constituent la population la plus à risque. De plus, les statistiques démontrent que cette problématique est liée à un taux d'absentéisme au travail important ainsi qu'à des incapacités résiduelles permanentes. Malgré l'ampleur de ce problème de santé, la façon dont elle est prise en charge reste mal connue. Cette étude avait donc comme objectif de dresser un portrait des traitements conservateurs non médicaux de l'épicondylite suggérés dans la littérature scientifique et ceux utilisés dans la pratique clinique courante."--Résumé abrégé par UMI

Taking a critical stance towards mixed methods research: A cross-disciplinary qualitative secondary analysis of researchers’ views

Recent growth and institutionalization in the field of mixed methods research has provided fertile ground for a wide range of thoughtful criticism of how this research approach has been developed and conceptualized by some members of the mixed methods community. This criticism reflects the increasing maturity of the field as well as the different theoretical perspectives and methodological practices of researchers in different disciplines. While debates addressing these criticisms are likely to lead to valuable insights, no empirical studies have been carried out to date that have investigated researchers’ critical views on the development and conceptualization of mixed methods research. This study examines the criticisms of the mixed methods field raised by a cross-national sample of researchers in education, nursing, psychology, and sociology. We carried out a secondary analysis of semi-structured interviews with 42 researchers and identified 11 different criticisms, which we classified in four domains: essence of mixed methods, philosophy, procedures, and politics. The criticisms related to the procedures domain were equally distributed among the four disciplines, while those related to the essence, philosophy and politics domains were more common among sociologists. Based on our findings, we argue that the divergence of views on foundational issues in this field reflects researchers’ affiliation to different communities of practice, each having its own principles, values, and interests. We suggest that a greater awareness of this divergence of perspectives could help researchers establish effective collaboration and anticipate potential challenges when working with researchers having different methodological approaches

Using systems perspectives in evidence synthesis: A methodological mapping review

BACKGROUND: Reviewing complex interventions is challenging because they include many elements that can interact dynamically in a non-linear manner. A systems perspective offers a way of thinking to help understand complex issues, but its application in evidence synthesis is not established. The aim of this project was to understand how and why systems perspectives have been applied in evidence synthesis. METHODS: A methodological mapping review was conducted to identify papers using a systems perspective in evidence synthesis. A search was conducted in seven bibliographic databases and three search engines. RESULTS: A total of 101 papers (representing 98 reviews) met the eligibility criteria. Two categories of reviews were identified: 1) reviews using a 'systems lens' to frame the topic, generate hypotheses, select studies, and guide the analysis and interpretation of findings (n=76) and 2) reviews using systems methods to develop a systems model (n=22). Several methods (e.g., systems dynamic modeling, soft systems approach) were identified and they were used to identify, rank, and select elements, analyze interactions, develop models, and forecast needs. The main reasons for using a systems perspective were to address complexity, view the problem as a whole, and understand the interrelationships between the elements. Several challenges for capturing the true nature and complexity of a problem were raised when performing these methods. CONCLUSION: This review is a useful starting point when designing evidence synthesis of complex interventions. It identifies different opportunities for applying a systems perspective in evidence synthesis, and highlights both commonplace and less familiar methods

The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers

INTRODUCTION: Appraising the quality of studies included in systematic reviews combining qualitative and quantitative evidence is challenging. To address this challenge, a critical appraisal tool was developed: the Mixed Methods Appraisal Tool (MMAT). The aim of this paper is to present the enhancements made to the MMAT. DEVELOPMENT: The MMAT was initially developed in 2006 based on a literature review on systematic reviews combining qualitative and quantitative evidence. It was subject to pilot and interrater reliability testing. A revised version of the MMAT was developed in 2018 based on the results from usefulness testing, a literature review on critical appraisal tools and a modified e-Delphi study with methodological experts to identify core criteria. TOOL DESCRIPTION: The MMAT assesses the quality of qualitative, quantitative, and mixed methods studies. It focuses on methodological criteria and includes five core quality criteria for each of the following five categories of study designs: (a) qualitative, (b) randomized controlled, (c) nonrandomized, (d) quantitative descriptive, and (e) mixed methods. CONCLUSION: The MMAT is a unique tool that can be used to appraise the quality of different study designs. Also, by limiting to core criteria, the MMAT can provide a more efficient appraisal

Translation and cross-cultural adaptation of the mixed methods appraisal tool to the brazilian context / Tradução e adaptação transcultural do instrumento mixed methods appraisal tool ao contexto brasileiro

Objective: Transculturally translate and adapt the Mixed Methods Appraisal Tool to the Brazilian reality. Methods: The methodology followed the 10 steps determined by the transcultural translation and adaptation process conducted by one of the Working Groups of the Special Interest Group on Quality of Life and the Cultural Translation and Adaptation Group. Results: o The test with the instrument was carried out from the development of two systematic systematic reviews. The translated version obtained a strong / substantial Kappa coefficient (k = 0.67), and was titled "Method of evaluating the quality of researches with mixed methods - Version 2011". The produced version presents structural and semantic components compatible with those of the original version, allowing good understanding and brings clarity in its content. Conclusion: the translated and adapted instrument can be an important tool for scientific production in Brazil, optimizing the production of systematic reviews in the different areas of knowledge

The Work Disability Prevention CIHR Strategic Training Program: Program Performance After 5 Years of Implementation

Introduction The Work Disability Prevention (WDP) Canadian Institutes of Health Research (CIHR) Strategic Training Program was developed in 2001 and is a unique program in the world. The main objective of this program is to help future researchers develop transdisciplinary knowledge, skills and attitudes regarding WDP. The purpose of this paper is to present a descriptive portrait of the program's performance over the past 5 years, as well as the trainees' and alumni's perspectives on the WDP CIHR Training Program. Methods Data on the program's performance were collected from documents in the program records. The trainees' opinions on the WDP training program were obtained through focus groups and telephone interviews. The data collected were compiled and divided into themes to summarize the qualitative findings pertaining to each question. Results From 2003 to 2007, five successive summer sessions have been offered, involving 44 high-caliber applicants from nine countries, 34 mentors and collaborators, 29 guest speakers and 15 stakeholders. Overall, trainees appreciated the networking, the opportunity to interact with people from different disciplines and countries, the openness, and the international perspective and uniqueness of the program. The least appreciated aspects concerned mainly the e-learning course, evaluations and information on optional courses. The coordination and logistics were judged appropriate and several topics were suggested to improve the program quality. Conclusion In general, the program implementation went well, with good participation from mentors, speakers and stakeholders; the program was appreciated by the trainees and alumni. This paper underscores the importance of the international perspective, the transdisciplinarity and the scientific networking established through the progra

Revision of the mixed methods appraisal tool (MMAT): A mixed methods study

Background: Systematic mixed studies reviews (SMSRs), i.e., systematic reviews combining qualitative, quantitative and mixed methods studies, are growing in popularity owing to their potential to provide a rich and practical understanding of complex health interventions and problems. Due to the heterogeneity of the included studies, one challenging issue concerns the critical appraisal of studies. A critical appraisal tool was developed to address this challenge: the Mixed Methods Appraisal Tool (MMAT). The MMAT includes criteria for appraising the methodological quality of five categories of studies: (a) qualitative studies, (b) randomized controlled trials, (c) non-randomized studies, (d) quantitative descriptive studies, and (e) mixed methods studies. Pilot studies provided proof-of-concept for the feasibility of the MMAT and a need for further development. Objectives: The overall objective of this project was to revise the MMAT. The specific objectives were to identify the changes that need to be made in the MMAT and the most relevant criteria that should be included in the MMAT.Methods: A sequential exploratory mixed methods design was used. A first phase consisted in a qualitative descriptive study. Semi-structured interviews with researchers having used the MMAT were conducted to identify the strengths, limits, and areas for improvement of the tool. Then, the team composed of 12 researchers with complementary expertise in qualitative, quantitative and mixed methods research met to discuss the results and plan the next step. In a second phase, a modified e-Delphi study was performed with experts in qualitative, survey and mixed methods studies to identify the most relevant critical appraisal criteria. Consensus was reached when at least 80% of experts judged a criterion 'very' or 'extremely' relevant. In addition, a mapping of criteria from 33 existing critical appraisal tools was performed to identify the core criteria for randomized controlled trials and non-randomized studies. The results of these two phases informed the development of a revised version of the MMAT (version 2018). Results: For the first phase, a total of 20 participants from eight different countries were interviewed. Thirteen main themes were identified and grouped into the dimensions of usefulness, i.e., utility and usability. The themes related to utility concerned the coverage, completeness, flexibility, and other utilities of the tool (educational tool). Those on usability were related to the tool's learnability, efficiency, satisfaction and errors that could be made due to difficulties in understanding or selecting the criteria to rate. For the second phase, respectively 73 and 56 experts participated in Round-one and Round-two of the modified e-Delphi study. The experts were from 11 different countries. Consensus was reached for six qualitative criteria, eight survey criteria, and seven mixed methods criteria. The mapping of the criteria of randomized controlled trials and non-randomized studies led to add new criteria in the MMAT to covers the different categories of bias addressed in critical appraisal tools. On the basis of these results, of the 19 criteria in the MMAT (version 2011), four were removed, seven were reformulated, five were replaced, and ten new were added. Explanations were added in the user manual as well as an algorithm to help reviewers judge and select the criteria to use.Discussion and conclusion: This project addressed the usefulness and content validity of the MMAT. A revised version of the MMAT was developed and includes 25 criteria on five categories of studies. Changes from the previous version concerned mainly the number of criteria, the user manual, and the overall scoring. This revised version will need to be pilot tested and the website will be modified. Continuous development of the MMAT is required and future research should focus on its validity, reliability, and usefulness.Introduction : Les revues systématiques mixtes sont populaires, car elles permettent une compréhension approfondie de phénomènes et interventions complexes. Toutefois, la combinaison d'études quantitatives, qualitatives et méthodes mixtes pose comme défi l'évaluation de la qualité des études. Pour répondre à ce défi, un outil d'évaluation de la qualité méthodologique a été développé: le Mixed Methods Appraisal Tool (MMAT). Le MMAT permet d'évaluer cinq types d'études : (a) qualitatives, (b) quantitatives avec répartition aléatoire, (c) quantitatives sans répartition aléatoire, (d) quantitatives descriptives et (e) méthodes mixtes. Des études pilotes sur le MMAT ont démontré sa faisabilité et le besoin de poursuivre son développement.Objectifs : L'objectif général de ce projet était de mettre à jour le MMAT. Les objectifs spécifiques étaient d'identifier les changements requis à apporter et les critères pertinents à inclure dans le MMAT.Méthode : Un devis mixte séquentiel exploratoire a été utilisé. Dans une première phase, une étude qualitative descriptive a été menée. Des entrevues semi-structurées ont été réalisées avec des chercheurs qui ont utilisé le MMAT pour identifier ses forces, limites et améliorations requises. Une réunion des membres de l'équipe composée de 12 chercheurs avec des expertises complémentaires en recherche qualitative, quantitative et méthodes mixtes a été organisée pour discuter des résultats et planifier la phase suivante. Dans une deuxième phase, une étude e-Delphi modifiée a été menée avec des experts méthodologiques en recherche qualitative, sondage et méthodes mixtes afin d'identifier les critères d'évaluation jugés les plus pertinents. Un consensus était considéré atteint lorsqu'au moins 80% des experts ont jugé un critère « très » ou « extrêmement » pertinent. En outre, une analyse des critères provenant des outils d'évaluation de la qualité pour des études quantitatives avec et sans répartition aléatoire a été effectuée. Les résultats de ces phases ont servi à développer une nouvelle version du MMAT (version 2018).Résultats : Dans la première phase, un total de 20 participants de huit pays différents ont été interviewés. Treize thèmes ont été identifiés et regroupés dans les dimensions de l'utilité et l'utilisabilité. Les thèmes liés à l'utilité concernaient la couverture, l'exhaustivité, la flexibilité et une autre utilité de l'outil (outil éducatif). Ceux sur l'utilisabilité étaient liés à la facilité d'apprentissage, l'efficience, la satisfaction et les erreurs qui peuvent survenir en raison de difficultés dans le choix et la compréhension des critères à évaluer. Dans la deuxième phase, respectivement 73 et 56 experts provenant de 11 pays différents ont participé aux deux rondes de l'étude e-Delphi. Un consensus a été atteint pour six critères sur les études qualitatives, huit sur les sondages et sept sur les méthodes mixtes. L'analyse des critères provenant des outils d'évaluation de la qualité pour des études quantitatives avec et sans répartition aléatoire a permis d'ajouter de nouveaux critères pour couvrir les différentes catégories de biais abordées dans ces outils. Parmi les 19 critères du MMAT (version 2011), quatre ont été retirés, sept reformulés, cinq remplacés et dix ajoutés. Le manuel d'instruction a été modifié pour inclure des explications sur les critères ainsi qu'un algorithme pour aider les réviseurs à choisir les critères à utiliser.Discussion et conclusion : Ce projet a permis d'étudier l'utilité, l'utilisabilité et la validité du contenu du MMAT. Une nouvelle version du MMAT a été développée et comporte 25 critères sur cinq catégories d'études. Les modifications apportées concernent principalement le nombre de critères, le manuel d'instruction et le score global. Cette nouvelle version sera testée et le site web sera modifié. Un développement continu du MMAT est nécessaire et les recherches futures devront étudier sa validité, fidélité, utilité et utilisabilité

Exploration des traitements offerts aux personnes atteintes d'épicondylite enquête sur la pratique des ergothérapeutes et des physiothérapeutes du Québec

Ce mémoire intitulé"Exploration des traitements offerts aux personnes atteintes d'épicondylite : enquête sur la pratique des ergothérapeutes et des physiothérapeutes du Québec" est présenté par Quan Nha Hong à la Faculté de médecine de l'Université de Sherbrooke en vue de l'obtention du grade de Maître ès sciences. La prévalence des lésions professionnelles aux membres supérieurs a connu une recrudescence importante au cours de la dernière décennie, de même que les coûts qui y sont associés. Une des lésions souvent rencontrée est l'épicondylite. Malgré qu'elle soit souvent associée aux sports de raquette, ce sont les travailleurs qui constituent la population la plus à risque. De plus, les statistiques démontrent que cette problématique est liée à un taux d'absentéisme au travail important ainsi qu'à des incapacités résiduelles permanentes. Malgré l'ampleur de ce problème de santé, la façon dont elle est prise en charge reste mal connue. Cette étude avait donc comme objectif de dresser un portrait des traitements conservateurs non médicaux de l'épicondylite suggérés dans la littérature scientifique et ceux utilisés dans la pratique clinique courante."--Résumé abrégé par UMI