Directed qualitative content analysis: the description and elaboration of its underpinning methods and data analysis process

Author's accepted version (post-print).Qualitative content analysis consists of conventional, directed and summative approaches for data analysis. They are used for provision of descriptive knowledge and understandings of the phenomenon under study. However, the method underpinning directed qualitative content analysis is insufficiently delineated in international literature. This paper aims to describe and integrate the process of data analysis in directed qualitative content analysis. Various international databases were used to retrieve articles related to directed qualitative content analysis. A review of literature led to the integration and elaboration of a stepwise method of data analysis for directed qualitative content analysis. The proposed 16-step method of data analysis in this paper is a detailed description of analytical steps to be taken in directed qualitative content analysis that covers the current gap of knowledge in international literature regarding the practical process of qualitative data analysis. An example of “the resuscitation team members' motivation for cardiopulmonary resuscitation” based on Victor Vroom's expectancy theory is also presented. The directed qualitative content analysis method proposed in this paper is a reliable, transparent, and comprehensive method for qualitative researchers. It can increase the rigour of qualitative data analysis, make the comparison of the findings of different studies possible and yield practical results.acceptedVersio

Mission impossible? The paradoxes of stretch goal setting

© 2016, © The Author(s) 2016. Stretch goal setting is a process involving multiple and nested paradoxes. The paradoxical side of stretch is attractive because it holds great promise yet dangerous because it triggers processes that are hard to control. Paradoxes are not readily managed by assuming a linear relation between the here and now and the intended future perfect. Before adopting stretch goal setting, managers should thus be prepared for the tensions and contradictions created by nested or interwoven paradoxes. Achieving stretch goals can be as difficult for the managers seeking to direct the process as for designated delegates. While the increasing popularity of stretch goal setting is understandable, its unexpected consequences must be taken into account. The inadequate use of stretch goals can jeopardize the social sustainability of organizations as well as their societal support systems

Labour intensity of guidelines may have a greater effect on adherence than GPs' workload

Background: Physicians' heavy workload is often thought to jeopardise the quality of care and to be a barrier to improving quality. The relationship between these has, however, rarely been investigated. In this study quality of care is defined as care 'in accordance with professional guidelines'. In this study we investigated whether GPs with a higher workload adhere less to guidelines than those with a lower workload and whether guideline recommendations that require a greater time investment are less adhered to than those that can save time. Methods: Data were used from the Second Dutch National survey of General Practice (DNSGP- 2). This nationwide study was carried out between April 2000 and January 2002. A multilevel logistic-regression analysis was conducted of 170,677 decisions made by GPs, referring to 41 Guideline Adherence Indicators (GAIs), which were derived from 32 different guidelines. Data were used from 130 GPs, working in 83 practices with 98,577 patients. GP-characteristics as well as guideline characteristics were used as independent variables. Measures include workload (number of contacts), hours spent on continuing medical education, satisfaction with available time, practice characteristics and patient characteristics. Outcome measure is an indicator score, which is 1 when a decision is in accordance with professional guidelines or 0 when the decision deviates from guidelines. Results: On average, 66% of the decisions GPs made were in accordance with guidelines. No relationship was found between the objective workload of GPs and their adherence to guidelines. Subjective workload (measured on a five point scale) was negatively related to guideline adherence (OR = 0.95). After controlling for all other variables, the variation between GPs in adherence to guideline recommendations showed a range of less than 10%. 84% of the variation in guideline adherence was located at the GAI-level. Which means that the differences in adherence levels between guidelines are much larger than differences between GPs. Guideline recommendations that require an extra time investment during the same consultation are significantly less adhered to: (OR = 0.46), while those that can save time have much higher adherence levels: OR = 1.55). Recommendations that reduce the likelihood of a follow-up consultation for the same problem are also more often adhered to compared to those that have no influence on this (OR = 3.13). Conclusion: No significant relationship was found between the objective workload of GPs and adherence to guidelines. However, guideline recommendations that require an extra time investment are significantly less well adhered to while those that can save time are significantly more often adhered to.

Satisfaction with Creativity: A Study of Organizational Characteristics and Individual Motivation

In answering the question of what influences satisfaction with creativity in the workplace, this work takes into account the extent to which the organization supports human aspiration to act creatively. The work throughout reflects a pragmatist approach to creativity and fulfillment, bridging it with needs theory in psychology. The empirical model uses survey data encompassing over 4,000 workers in Italian social enterprises. Results show that satisfaction with creativity is supported, at organizational level, by teamwork, autonomy, domain-relevant competences, as well as by inclusive, fair processes and relationships. At the individual level, satisfaction with creativity is enhanced by the strength of intrinsic initial motivations. The analysis of interaction terms shows that teamwork and workers' initial motivations are complementary in enhancing satisfaction with creativity, while a high degree of domain-relevant competences appears to substitute advice and supervision by superiors in accomplishing the desired level of creative action

When Flexibility Is Stable: Implicit Long-Term Shaping of Olfactory Preferences

Preferences are traditionally assumed to be stable. However, empirical evidence such as preference modulation following choices calls this assumption into question. The evolution of such postchoice preference over long time spans, even when choices have been explicitly forgotten, has so far not been studied. In two experiments, we investigated this question by using a variant of the free choice paradigm: In a first session, participants evaluated the pleasantness of a number of odors. We then formed pairs of similarly rated odors, and asked participants to choose their favorite, for each pair. Participants were then presented with all odors again, and asked for another pleasantness rating. In a second session 1 week later, a third pleasantness rating was obtained, and participants were again asked to choose between the same options. Results suggested postchoice preference modulation immediately and 1 week after choice for both chosen and rejected options, even when choices were not explicitly remembered. A third experiment, using another paradigm, confirmed that choice can have a modulatory impact on preferences, and that this modulation can be long-lasting. Taken together, these findings suggest that although preferences appear to be flexible because they are modulated by choices, this modulation also appears to be stable over time and even without explicit recollection of the choice. These results bring a new argument to the idea that postchoice preference modulation could rely on implicit mechanisms, and are consistent with the recent proposal that cognitive dissonance reduction could to some extent be implicit

Towards an Effective Multi-Stakeholder Consultation Process: Applying the Imagine Method in Context of Abu Dhabi’s Education Policy

This paper is concerned with the many interleaving issues that emerge when engaging multiple stakeholders in decision-making. Whilst recognising the intrinsic value of group work and keeping in mind the numerous issues that obstruct group work (including multiple roles for participants, bias due to domination and distortion emerging from uneven group inputs), we applied the Imagine method to propose a new framework - the ‘Multiple Formation Consultation Framework’ (MFCF) - for organising effective multi-stakeholder consultations along the Policy Sciences Framework. Our proposed framework was applied in the context of education policy in the Emirate of Abu Dhabi, where 24 small group formations were tasked and assessed in a systemic manner. Evidence from the exercise suggests that: (1) when moving participants from heterogeneous to homogenous groups, the working of the groups became more focused and the outcomes gained greater clarity in terms of the thinking of group members. (2) Yet, when groups moved from homogenous formations to heterogeneous, they became more inquisitive and explored broader aspects of the tasks at hand. (3) A repeat of the process over two-day period where different members of the groups experience both homogenous and heterogeneous formations back and forth (in order to capture the unique value emerging from each composition) have led to more efficient and effective working and outcomes of the groups

A multidimensional evaluation framework for personal learning environments

Evaluating highly dynamic and heterogeneous Personal Learning Environments (PLEs) is extremely challenging. Components of PLEs are selected and configured by individual users based on their personal preferences, needs, and goals. Moreover, the systems usually evolve over time based on contextual opportunities and constraints. As such dynamic systems have no predefined configurations and user interfaces, traditional evaluation methods often fall short or are even inappropriate. Obviously, a host of factors influence the extent to which a PLE successfully supports a learner to achieve specific learning outcomes. We categorize such factors along four major dimensions: technological, organizational, psycho-pedagogical, and social. Each dimension is informed by relevant theoretical models (e.g., Information System Success Model, Community of Practice, self-regulated learning) and subsumes a set of metrics that can be assessed with a range of approaches. Among others, usability and user experience play an indispensable role in acceptance and diffusion of the innovative technologies exemplified by PLEs. Traditional quantitative and qualitative methods such as questionnaire and interview should be deployed alongside emergent ones such as learning analytics (e.g., context-aware metadata) and narrative-based methods. Crucial for maximal validity of the evaluation is the triangulation of empirical findings with multi-perspective (end-users, developers, and researchers), mixed-method (qualitative, quantitative) data sources. The framework utilizes a cyclic process to integrate findings across cases with a cross-case analysis in order to gain deeper insights into the intriguing questions of how and why PLEs work

A theory of organizational readiness for change

<p>Abstract</p> <p>Background</p> <p>Change management experts have emphasized the importance of establishing organizational readiness for change and recommended various strategies for creating it. Although the advice seems reasonable, the scientific basis for it is limited. Unlike individual readiness for change, organizational readiness for change has not been subject to extensive theoretical development or empirical study. In this article, I conceptually define organizational readiness for change and develop a theory of its determinants and outcomes. I focus on the organizational level of analysis because many promising approaches to improving healthcare delivery entail collective behavior change in the form of systems redesign--that is, multiple, simultaneous changes in staffing, work flow, decision making, communication, and reward systems.</p> <p>Discussion</p> <p>Organizational readiness for change is a multi-level, multi-faceted construct. As an organization-level construct, readiness for change refers to organizational members' shared resolve to implement a change (change commitment) and shared belief in their collective capability to do so (change efficacy). Organizational readiness for change varies as a function of how much organizational members value the change and how favorably they appraise three key determinants of implementation capability: task demands, resource availability, and situational factors. When organizational readiness for change is high, organizational members are more likely to initiate change, exert greater effort, exhibit greater persistence, and display more cooperative behavior. The result is more effective implementation.</p> <p>Summary</p> <p>The theory described in this article treats organizational readiness as a shared psychological state in which organizational members feel committed to implementing an organizational change and confident in their collective abilities to do so. This way of thinking about organizational readiness is best suited for examining organizational changes where collective behavior change is necessary in order to effectively implement the change and, in some instances, for the change to produce anticipated benefits. Testing the theory would require further measurement development and careful sampling decisions. The theory offers a means of reconciling the structural and psychological views of organizational readiness found in the literature. Further, the theory suggests the possibility that the strategies that change management experts recommend are equifinal. That is, there is no 'one best way' to increase organizational readiness for change.</p