Aspectos generales del uso de métodos mixtos para investigación en salud / General aspects of the use of mixed methods for health research

Tradicionalmente la investigación se ha dividido según su metodología en cuantitativa y cualitativa. La metodología mixta de investigación, que combina ambos métodos, se ha consolidado como una tercera vía, permitiendo abordar de forma integral problemas de investigación de alta complejidad. Aunque existen diversas definiciones sobre la investigación con métodos mixtos, todas ellas comparten aspectos como la recolección y análisis de datos tanto cuantitativos como cualitativos, y la interpretación integrada de los resultados dentro de una misma investigación. Este tipo de investigación es una herramienta importante para abordar la complejidad propia del campo de la salud, permitiendo comprender e integrar los datos cuantitativos con aspectos vivenciales y experienciales. Con ello se logra una perspectiva amplia y profunda de los problemas de salud, dando respuesta a las políticas y servicios sanitarios. Durante el desarrollo de una investigación con métodos mixtos, existen etapas clave donde ambos enfoques pueden integrarse dependiendo de los objetivos planteados por los equipos de investigación. Aunque los estudios con métodos mixtos pueden ser muy diferentes, se han identificado modelos generales que guían el desarrollo de un diseño específico a utilizar. Estos modelos se clasifican según la prioridad de cada enfoque, la secuencia en la que se ejecutará cada enfoque, el nivel y momento de integración de los datos y el propósito de esta integración para el estudio en particular.

Traditionally, research has been divided according to its methodology into quantitative and qualitative. Mixed research methodology combines both methods and has established itself as a third approach, allowing to comprehensively address high-complexity research problems. Although there are various definitions of mixed methods research, they all share aspects such as the collection and analysis of both quantitative and qualitative data and the integrated interpretation of the results within the same research. This type of research is an important tool to address the complexity of health sciences, allowing the understanding and integration of quantitative data with experience-based aspects. In this way, a broad and deep perspective of health problems is achieved, providing a solution to sanitary policies and services. During the development of mixed methods research, there are key stages where both approaches can be integrated depending on the objectives set by the investigators. Although mixed methods studies may differ widely, general models have been identified to guide the development of a single specific design. These models are classified according to the priority of each approach, the sequence in which each approach will be executed, the level and timing of data integration, and the purpose of integrating the data for the study.

Personalidad en adolescentes de la ciudad del Alto en periodo de pandemia por covid -19

Este artículo describe los perfiles de personalidad de 95 adolescentes de la ciudad del Alto de La Paz. Los datos surgen del proceso empírico realizado en periodo de emergencia sanitaria por la pandemia por COVID -19. Los adolescentes en este contexto buscan nuevas e innovadoras maneras de afrontar esta realidad. Para eso se proyectan a partir de sus cualidades, habilidades, competencias y características que permiten la búsqueda de un proyecto de vida o la elección de una carrera universitaria. Se utilizó técnicas de investigación cuantitativa (Cuestionario Big Fives o Cinco Grandes) para reconocer los índices en cada dimensión, sub dimensión y escala de distorsión de la personalidad y se realizó un abordaje cualitativo en el reconocimiento de los perfiles de personalidad. Se observó que existe una tendencia mayor de adolescentes con predisposición a ser creativos e investigadores y no así realistas, sociales y dirigentes. La conclusión es que los datos permitirán a los adolescentes una perspectiva distinta en la elección de carreras universitarias convencionales.

This article describes the personality profiles of 165 adolescents from the City of Alto de La Paz. In times of health emergency it is a problem to set medium-term objectives. Teenagers must seek new and innovative ways to deal with this reality. For this, it is necessary to recognize the qualities, skills, competencies and characteristics of adolescents who are looking for a life project or the choice of a university career. Quantitative research techniques (Big Fives or Big Five Questionnaire) were used to recognize the levels in each dimension, sub-dimension and personality distortion scale and a qualitative approach was carried out in the recognition of personality profiles. It was observed that there is a greater tendency of adolescents with a predisposition to be creative and investigative and not so realistic, social and leaders. The conclusion is that the data will allow adolescents a different perspective in the choice of conventional university careers.

Este artigo descreve os perfis de personalidade de 165 adolescentes da cidade de Alto de La Paz. Em tempos de emergência sanitária é um problema estabelecer objetivos de médio prazo. Os adolescentes devem buscar formas novas e inovadoras de lidar com essa realidade. Para isso, é necessário reconhecer as qualidades, habilidades, competências e características dos adolescentes que buscam um projeto de vida ou a escolha de uma carreira universitária. Técnicas de pesquisa quantitativa (Big Fives ou Big Five Questionnaire) foram utilizadas para reconhecer os níveis em cada dimensão, subdimensão e escala de distorção de personalidade e uma abordagem qualitativa foi realizada no reconhecimento de perfis de personalidade. Observou-se que há uma maior tendência de adolescentes com predisposição a serem criativos e investigativos e não tão realistas, sociais e líderes. A conclusão é que os dados permitirão aos adolescentes uma perspectiva diferente na escolha das carreiras universitárias convencionais.

Screening of Clinical Efficacy Evaluation Indicators for Traditional Chinese Medicine Injections based on Mixed Method Research / 中医杂志

Currently， evidence on the efficacy and risk of traditional Chinese medicine （TCM） injections is seriously insufficient， and it is difficult to evaluate TCM injections comprehensively， truly and objectively using available efficacy evaluation indicators. Therefore， establishing a clinical efficacy evaluation system that can effectively reflect TCM injections is imperative. Core outcome set （COS） has played an important role in screening TCM efficacy evaluation indicators， however， there are still certain problems， such as large differences in efficacy indicators， non-standardization， and lack of featured and specific TCM indicators. Mixed method research （MMR） has the advantages of looking at problems from both quantitative and qualitative perspectives. It is thereby proposed to use COS and MMR integrated model to establish a clinical efficacy evaluation indicator system that not only fully considers the cha-racteristics of TCM injections， but also highlights the efficacy and advantages of TCM injections from the perspective of TCM intervention. Simultaneously， an indicator screening method using MMR to optimize COS research model is formulated， which can provide ideas for the research on efficacy evaluation indicators of TCM injections.

Mixed methods research of pediatric professional training for general practitioners: taking Longhua District of Shenzhen as an example / 中华医学教育探索杂志

Objective:To investigate the past continuing medical education (CME) in pediatrics for general practitioners in community health centers in Longhua District, Shenzhen, so as to explore the willingness, needs and suggestions of general practitioners for CME in pediatrics.Methods:A mixed methods research were used in this study. Firstly, the purpose sampling method was used to select general practitioners in community health centers in Longhua District, Shenzhen for personal in-depth interviews. The interview contents were recorded and transcribed. The interview contents were coded by NVivo software. Theme frame analysis method was used for data sorting and theme extraction. Based on the results of qualitative interviews, the questionnaire was developed and distributed through the electronic questionnaire platform, and relevant questionnaire data were analyzed by Excel.Results:The results of qualitative research showed that after personal in-depth interviews with 10 general practitioners, the information reached saturation. Through repeated reading, induction and analysis of the interview data, four themes were extracted: ① previous pediatric training opportunities and satisfaction; ② willingness to participate in pediatric training; ③ the demand of training content, form and duration; ④ measures to encourage participation in training. In terms of quantitative research results, a total of 223 electronic questionnaires were collected, among which there were 219 valid questionnaires. Besides, 150 (68.5%) general practitioners said that they had no or only a few training opportunities in pediatrics CME in the past. There were some problems in the past CME training, such as unsystematic training (39 practitioners, 66.1%), narrow course coverage (30 practitioners, 50.8%), the content divorced from clinical practice (29 practitioners, 49.2%), monotonous teaching method (27 practitioners, 45.8%), etc. And 210 (95.9%) general practitioners were willing to participate in pediatric training, and 161 (73.5%) hoped that the form of training would be a combination of online and offline. In terms of pediatrics specialty content training needs, the general practitioners had higher demand for respiratory (188 practitioners, 85.8%), digestive (160 practitioners, 73.1%), infectious (145 practitioners, 66.2%) and dermatology (136 practitioners, 62.1%) specialty.Conclusion:There are still some problems in pediatrics CME, such as few training opportunities, unsystematic training, etc. In the future, we need to formulate systematic training plans and incentive measures according to the needs of general practitioners, to strengthen the pediatric professional training for general practitioners and improve their ability to receive children, in order to promote the implementation of hierarchical medical system for children.

Assessing the effectiveness of the Well-Being Through Occupational Participation (WBOP) intervention in promoting Filipino Occupational Therapy Faculty Members' Well-Being: A pilot study

Background@#Filipino occupational therapy educator emigration and limited preparedness for an academic role has resulted in high university turnovers. Remaining faculty experience decreased well-being due to increased academic role responsibilities.@*Objective@#Assess the effectiveness of an occupation-based intervention in promoting Filipino occupational therapy faculty members' well-being.@*Methodology@#This pilot study used a convergent mixed-methods design. Participants were recruited to participate through the Philippine Academy of Occupational Therapists and the University of Philippines Manila - Department of Occupational Therapy. Faculty members participated in the Well-Being through Occupational Participation (WBOP) intervention. Quantitative data was analyzed using a Wilcoxon Signed-Rank Test, comparing pre and post-test scores from four standardized measures: Self Compassion Scale Short Form (SCS-SF), Scales of General Well Being (SGWB), Engagement in Meaningful Activities Survey (EMAS), and Occupational Balance Questionnaire 11 (OBQ). Qualitative data was analyzed using a multi-level coding process resulting in three themes.@*Results@#Five faculty members participated. The SCS-SF scores (T=15, p=0.042, r=0.64) and SGWB (T=15, p=0.041, r=0.65) scores showed a significant increase post-intervention, with large effect sizes. The OBQ (T=14, p=0.078) and EMAS (T=13.5 p=0.102) post-intervention scores did not reflect a significant increase. From the qualitative data, three themes emerged: time to reflect on well-being and occupational engagement, opportunity to view well-being differently, and increased mindset and intentionality.@*Conclusion@#Results suggest the WBOP intervention was effective in promoting well-being in these Filipino occupational therapy faculty members. Future intervention implementation may be helpful in positively impacting faculty member well-being. A research study with a larger number of participants is warranted.

Entre lo personal y lo político: experiencias de vida durante la pandemia de covid-19 en Tucumán, Argentina, en el periodo 2020-2022 / Between the personal and the political: life experiences during the covid-19 pandemic in Tucumán, Argentina, 2020-2022

Resumen Este artículo analiza sentimientos, experiencias, prácticas y acciones que subyacen a los significados atribuidos a la pandemia por covid-19. A partir de un estudio de caso situado en la provincia de Tucumán (Argentina), se desarrolló una investigación mixta, interesada en captar experiencias de vida. Los discursos evidencian la resignificación de la propia vida, la valorización de los vínculos, el capital social comunitario, el Estado y la política. Desde lo personal o desde lo político, el marco interpretativo con el que las personas significan las experiencias de vida durante la pandemia por covid-19 configura sentimientos, experiencias, prácticas y acciones diferenciadas.

Abstract This article analyzes feelings, experiences, practices, and actions that underlie the meanings attributed to the covid-19 pandemic. Based on a case study located in the province of Tucumán (Argentina), a mixed-methods investigation was developed, interested in capturing life experiences. Discourse analysis show the resignification of life itself, the valorization of close ties, community social capital, the State and politics. From the personal to the political, the interpretive frames people use to signify life experiences during the covid-19 pandemic exhibit differentiated feelings, experiences, practices, and actions.

Why Villagers Use Toilets Only During Specific Time and Season? A Mixed-Methods Study in Rural Tamil Nadu

Background: Due to the efforts of sanitation promotion interventions in India, majority of the villagers started using toilets. But there is an inconsistency in toilet usage with regard to time and season. Objectives: The objectives were to determine the time and seasonal variations in toilet usage among vil-lagers who use toilets and to identify the reasons for time and seasonal variations in toilet usage. Methodology: A community-based mixed-methods study was executed in the four field practice villages of UHTC, Villupuram. After IEC clearance, 405 individuals who were using an owned toilet were selected by Simple Random Sampling. Qualitative component (free listing) was used for questionnaire develop-ment and quantitative component (survey + observation) was used for data collection. Results: Majority, 52% villagers used toilets only in the night and 64% villagers used toilets during rainy season. Fear of darkness and snakes, emergency and large family size were the common reasons for night time toilet usage. While, non-availability of open space, illness on exposure to rain and quick filling of toilet pit contributed to toilet usage in the rainy season.Conclusion: The study findings would help in the development of culturally-sensitive and socially-acceptable key messages for future sanitation promotion interventions

Mediación parental en el uso de tecnologías móviles en niños y niñas costarricenses: Una aproximación metodológica mixta / Parental mediation in children's use of mobile technology in Costa Rica: A mixed-methods approach

Resumen Las tecnologías digitales móviles son parte de la vida cotidiana de los niños. Sin embargo, poco se conoce sobre su contexto de uso en Latinoamérica. Esta investigación utilizó un diseño mixto para describir las características del uso de teléfonos móviles y tabletas en niños costarricenses entre 1 y 5 años de edad y sus cuidadores. El Estudio 1 analizó las interacciones familiares en áreas de comida de centros comerciales a través de observaciones no participantes. Los resultados indicaron que fueron los cuidadores quienes utilizaron los teléfonos durante la observación, ante lo cual los niños usualmente realizaron actividades que no implicaron interactuar con sus cuidadores. Frente a intentos de los niños por interactuar, los cuidadores raramente respondieron. A través de una metodología de encuesta dirigida a padres, el Estudio 2 exploró el uso de los dispositivos por parte de los niños y sus cuidadores en el hogar. Los resultados indicaron que los niños acceden principalmente a contenidos educativos al usar los dispositivos, y los cuidadores mencionaron usualmente acompañar a los niños durante su uso. También reportaron casi siempre utilizar las estrategias mediadoras de tipo restrictivo y de supervisión, y en menor medida la mediación instructiva y de uso conjunto. Además, los cuidadores consideraron que la actividad física y el sueño son los aspectos más negativamente afectados por el uso infantil de dispositivos, mientras que las habilidades matemáticas y lingüísticas tienden a verse más afectadas positivamente. Estos resultados caracterizan el uso temprano de dispositivos móviles en contextos de cuidado parental en Costa Rica.

Abstract Mobile technologies are part of children's everyday lives. However, little is known about their context of use in Latin America. The goal of this paper is to describe how Costa Rican caregivers and their children between the ages of 1 and 5 years old use smartphones and tablets. A mixed-methods approach was used, including two studies. Study 1 used non-participant observations to analyze family interactions related to smartphone use in food court areas in shopping malls. A total of 22 children were observed while interacting with their caregivers and their use of smartphones was registered (N = 269 events) and classified according to (a) the person who used the smartphone and (b) the actions that took place during its use. Results indicated smartphones were mostly used by caregivers (n = 226, 84.01 %), followed by a co-use to take pictures or make videos (n = 27, 10.03 %). Children's use was infrequent (n = 16, 5.94 %). During caregivers' use, children usually engaged in activities that did not involve their caretaker, such as silently eating, interacting with another adult not using a smartphone at the moment or looking around. When children attempted to interact with their caregivers while they were using their smartphones, caregivers rarely responded. No disruptive behaviors on children were observed after caregivers' lack of response. Using a survey methodology, Study 2 explored children's and caregivers' use of mobile devices at home. A total of 42.9 % of caregivers reported they sometimes facilitate a device to their children to be able to accomplish other domestic and work-related tasks, as well as to satisfy personal needs. Daily duration of caregivers' use of devices was longer on weekdays (M = 207 minutes, SD = 116.02) than weekends (M = 164.25 minutes, SD = 118.54). Caregivers' daily duration of use was related to children's daily duration of use during weekdays (r = .414) and weekends (r = .451), and during caregiving time on weekdays (r = .328) and weekends (r = .541). Using a Likert scale (1 = never, 5 = always), the children's consumed content was explored. Findings indicate that children mostly consumed content from YouTube (M = 3.60, SD = 1.14) and children's educational apps (M = 3.13, SD = 1.5). Use of educational videogames (M = 3.27, SD = 1.34), puzzle-like videogames (M = 2.36, SD = 1.26) and word games (M = 2.23, SD = 1.14) was more frequent than action (M= 1.48, SD = 1.02) and sports videogames (M= 1.55, SD = 0.93). Educational televised programs (M = 3.58, SD = 1.10) and musical cartoons (M = 3.27, SD = 1.11) were frequently consumed by children. A total of 47.2 % of caregivers also indicated that they always accompany their children while they use devices at home. Caregivers reported a higher use of technological restrictive mediation (M = 4.14, SD = 1.14) and supervision (M = 4.1, SD = 1.11), followed by instructive (M = 3.93, SD = 1.19) and co-use mediation (M= 3.62, SD = 1.14). On a scale of 1 (very negative) to 5 (very positive), caregivers indicated that physical activity (M = 1.72, SD = 1.07) and sleep (M = 2.09, SD = .96) were most negatively affected by children's device use, whereas mathematical (M = 3.36, SD = 1.04) and linguistic skills (M = 3.44, SD = 1.13) were the most positively affected. This study's results provide a preliminary understanding of the context of use of mobile technology during caregiving of young children.

Enablers & challenges of tribal women & health system for implementation of screening of non-communicable diseases & common cancers: A mixed-methods study in Palghar district of Maharashtra, India

Background & objectives: Non-communicable diseases (NCDs) and cancers of breast, oral cavity and cervix contribute to around 5.87 million (60%) deaths in India. Despite this, there is limited evidence on preparedness of the tribal health system in mitigating these conditions. This mixed-methods study aimed at identifying enablers and challenges using a multistakeholder approach for the screening of NCDs and common cancers in a tribal block of Maharashtra, India. Methods: This study was conducted in a tribal community of Dahanu taluka in Palghar district of Maharashtra. A total of nine focus group discussions (FGDs) among tribal women and accredited social health activists (ASHAs), 13 key informant interviews (KIIs) among auxiliary nurse midwives (ANMs) and community health officers (CHO) and facility surveys of five public health facilities were conducted. The FGDs and KIIs were conducted using guides, recorded digitally, transcribed, analyzed and triangulated to identify emerging themes. Results: The tribal women had limited knowledge about NCDs and common cancers. Paucity of health facilities, out-of-pocket expenditure, misconceptions, belief on traditional healers and inability to prioritize health were identified as major challenges. The ASHAs were recognized as a key connecting link between health system and community while provision of culturally appropriate IEC materials and adequate training were recognized as critical enablers by healthcare providers in implementing screening for NCDs and common cancers. Interpretation & conclusions: The study recommends incorporating socioculturally relevant strategies in the tribal population and strengthening health facilities in terms of infrastructure and training with involvement of ASHAs for successful implementation of the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) through health and wellness centres.

Application and significance of mixed methods research in traditional Chinese medicine and narrative medicine / 中国中药杂志

Since narrative medicine was introduced in China, it has been widely used in medical education and clinical practice. The research on narrative medicine in China is especially characterized by its combination with traditional Chinese medicine(TCM). At present, the research on narrative medicine in China is still in the stage of small-scale practicing and theory advocating. Besides, there is also a lack of guidance on experimental design methodology for clinical application, which leads to few high-quality studies in this field. The present study reviewed the current high-quality research on narrative medicine to discuss the value and prospects of mixed methods research in narrative medicine. In addition, the common design, application procedures, and notes of mixed methods research were explained to provide references for the extensive applications of narrative medicine in the medical field, especially TCM clinical practice, education, and scientific research.

Students' Perceptions of the Integration of Sexual and Gender Minority Constructs within the Dental Curriculum

Background and Objective@#The sexual and gender minorities (SGMs) are at risk for various health disparities. To address this, the World Health Organization (WHO) calls for the training of healthcare providers who demonstrate cultural competence. To facilitate this, studies have suggested the inclusion of SGM-specific constructs in the curriculum that is complemented with campus climate-related efforts. This study aimed to determine the degree of coverage of cultural competence towards the SGM constructs in the required curriculum and describe the campus climate towards the SGM of a dental school in the Philippines from the students' perspective. @*Methodology@#A convergent parallel mixed-methods design was employed. A survey questionnaire was developed and administered to determine the coverage of SGM-specific constructs. This was followed by semi-structured interviews to discuss the campus climate towards the SGM. Data collection utilized a twostage stratified random sampling method for the survey while a purposive sampling method was used for interviewing dental students enrolled in a private, non-sectarian school. @*Results and Conclusion@#Survey results show that the most reported covered concepts are the oral manifestations of sexually transmitted diseases and the use of inclusive terminologies. Interview responses reveal instances of inadvertent perpetuation of heteronormative ideologies, however, the campus climate is perceived as neutral towards the SGM. The integration of the two datasets reveals incongruences between the curricular coverage and the perceived campus climate. Nevertheless, findings imply that the dental curriculum remains largely objective and asexual. Additionally, the integration underscores the importance of complementing curricular content with an inclusive campus climate in developing cultural competence among dental students.

Study on the current situation and influencing factors of unmet needs of patients after radical gastrectomy for gastric cancer based on mixed-methods approach / 中国实用护理杂志

Objective:To investigate the status quo and influencing factors of unsatisfied needs of patients after radical gastrectomy for gastric cancer through quantitative and qualitative mixed research methods, and to provide reference for the development of effective health management programs in the future.Methods:A total of 297 patients who were hospitalized in Tianjin Medical University Cancer Hospital from January to December 2021 after radical gastretomy were selected as subjects by convenient sampling method. The general data questionnaire and Short-Form Survivor Unmet Needs Survey (SF-SUNS) were used to investigate. Selected 12 patients with gastric cancer by objective sampling method for semi-structured in-depth interview and collate data by Colaizzi 7-step analysis method.Results:The total average score of 297 subjects who did not meet the requirements was (60.91 ± 16.00), which was in the middle level. The average score of each dimension from high to low was: continuous care unmet needs (2.37 ± 0.75) points, work economy unmet needs (2.22 ± 0.65) points, information unmet needs (2.20 ± 0.92) points, emotion unmet needs (1.72 ± 0.60) points. Educational background, main economic source of family and working state were the influencing factors of unmet demand ( t=5.32, -3.59, -3.28, all P<0.05). Qualitative research had extracted four themes: unmet needs for symptom network recognition and accurate symptom management, unmet needs for shared decision participation and disease perception trajectory, unmet needs for dignity maintenance and reconstruction of psychological stress mechanism, and unmet needs for "Internet plus" mobile medical continuous care. Conclusions:The problem of unmet needs of patients after radical gastritis is still prevalent and affected by a variety of factors. It is suggested that medical workers build an effective supportive care system based on the status quo of unmet needs of patients, promote the whole process of multidimensional health management services for patients with gastric cancer, and improve the quality of life.

Study Protocol of a Mixed-Methods Study to Develop and Validate the Malaysian Anti-Hypertensive Agents Non-Adherence Scale in Hypertensive Patients

@#Introduction: Domains of adherence and non-adherence to hypertensive medications have not been extensively documented in Malaysia due to the absence of theoretically driven and culturally appropriate measurement tools, leading to a poor understanding of the adherence and underlying factors. We aim to identify these domains in Malaysian hypertensive patients and subsequently apply the findings to develop and validate the Malaysian Anti-Hypertensive Agents Non-Adherence Scale (MAANS). Methods: This study has an exploratory mixed-methods design. In Phase 1, we will recruit hypertensive patients from two health clinics to participate in a semi-structured interview. Recruitment of participants will terminate once thematic saturation is achieved. Coding and thematic analyses will be performed to identify the domains of adherence and non-adherence to anti-hypertensive medications. In Phase 2, based on the domains generated from Phase 1, we will develop the Malaysian Anti-Hypertensive Agents Non-Adherence Scale (MAANS). Four hundred hypertensive patients will be randomly selected. Data from 200 participants (serving as the calibration sample) will be subjected to exploratory factor analysis while data from additional 200 participants (serving as the validation sample) will be subjected to confirmatory factor analysis. Factor structure, predictive validity, and reliability of the MAANS will be statistically tested. Discussion: With the presence of the MAANS, health care providers can gather crucial information regarding barriers and facilitators to hypertensive treatment adherence and design effective health promotion programmes to reduce complications of uncontrolled hypertension. Trial registration: Ethical approval is granted by the Medical Research Ethics Committee, Ministry of Health, Malaysia (NMRR-18-3251-44694).

Educação permanente em saúde na transferência da política do tratamento diretamente observado da tuberculose: uma abordagem de métodos mistos / Permanent health education in the transfer of the policy of directly observed treatment of tuberculosis: a mixed methods approach

Este estudo objetivou analisar as contribuições da Educação Permanente em Saúde na transferência da Política de Controle da Tuberculose. Trata-se de uma pesquisa de métodos mistos, do tipo paralelo convergente, realizada em dois municípios do interior de Minas Gerais. Foram utilizados dados quantitativos provenientes da aplicação do instrumento: "Avaliação da Transferência de Políticas - Inovação, Informação e Conhecimento em Tuberculose". Os dados qualitativos foram obtidos por meio da aplicação de entrevistas semidirigidas aos coordenadores municipais e profissionais de referência das equipes do Programa de Controle da Tuberculose, e os resultados foram organizados no software ATLAS.ti 6. Na etapa quantitativa participaram os profissionais de saúde de nível médio e superior das equipes de Atenção Primária à Saúde, 2. A coleta de dados ocorreu no período entre fevereiro de 2020 a fevereiro de 2021. Empregou-se, a fusão da análise dos dados para comparar os resultados, sendo adotada a mostra conjunta, com a adoção de categorias para a análise dos dados. Para o tratamento dos elementos quantitativos foi realizada a análise de estatísticas descritiva e multivariada, sendo utilizados o software Statistical Package for Social Sciences versão 24, e o software Statistica 7, da Statsoft.Inc. A análise dos elementos quantitativos foi realizada à luz do referencial teórico-metodológico da Análise de Discurso. A pesquisa atendeu a Resolução número 466/2012 do Conselho Nacional de Saúde. Participaram da etapa quantitativa 202 pessoas, destas 26,2% eram técnicos em Enfermagem, 51,5% enfermeiros, e 22,3% médicos; sendo 58,9% do "município 1" e 41,1% do "município 2". Na etapa qualitativa participaram cinco enunciadores. Os dados quantitativos foram organizados de acordo o domínio geral da Educação Permanente em Saúde e os subdomínios "ações da gestão para a equipe/unidade de saúde", "ações da equipe/unidade de saúde", "ações individuais do profissional e estratégias/ferramentas educativas". Identificou-se um melhor desempenho nas variáveis sobre a liberação da equipe para as ações de capacitação e treinamentos, reconhecimento da equipe sobre a importância do Tratamento Diretamente Observado e sobre a adoção das diretrizes do Tratamento Diretamente Observado. Já, as variáveis com desempenho inferior foram as relacionadas à frequência dos treinamentos oferecidos pelo Programa de Controle da Tuberculose, e o oferecimento de treinamentos aos profissionais recém-contratados. Os resultados qualitativos foram organizados em famílias temáticas. Os resultados da mostra conjunta possibilitaram a apresentação em três categorias: "o campo de interação entre o Programa Municipal de Controle de Tuberculose e as equipes de Atenção Primária à Saúde", "Atenção Primária e a gestão do cuidado: Tratamento Diretamente Observado e o controle da Tuberculose" e "Manifestação da Educação Permanente em Saúde: o que evidenciam as equipes e o que dizem os profissionais dos Programa Municipal de Controle de Tuberculose". Este estudo corrobora e oferece subsídio para o reconhecimento do protagonismo da Atenção Primária à Saúde na gestão do cuidado e controle da Tuberculose, e confirma a Educação Permanente em Saúde como instrumento para a efetivação da transferência dessa política. Assim a Educação Permanente em Saúde pode se valer da Educação Continuada, assim como ocorre no cotidiano, sustentada pela micropolítica do trabalho e interação na roda

This study aimed to analyze the contributions of Permanent Health Education in the transfer of Tuberculosis Control Policy. This is a mixed-methods research, of the convergent parallel type, carried out in two municipalities in the interior of Minas Gerais. Quantitative data from the application of the instrument "Evaluation of Policy Transfer - Innovation, Information and Knowledge in Tuberculosis" were used. Qualitative data was obtained through the application of semi-directed interviews to municipal coordinators and reference professionals of the Tuberculosis Control Program teams, and the results were organized in the software ATLAS.ti 6.. In the quantitative stage, the participation of middle and upper level health professionals from Primary Health Care teams, 2. Data collection occurred in the period between February 2020 and February 2021. The fusion of data analysis was used to compare the results, with the adoption of categories for data analysis. For the treatment of the quantitative elements, the analysis of descriptive and multivariate statistics was performed, using the Statistical Package for Social Sciences software version 24, and the Statistica 7 software, from Statsoft.Inc. The analysis of the quantitative elements was conducted in light of the theoretical and methodological framework of Discourse Analysis. The research met the Resolution number 466/2012 of the National Health Council. In the quantitative stage 202 people participated, 26.2% were nursing technicians, 51.5% nurses, and 22.3% physicians; 58.9% from "municipality 1" and 41.1% from "municipality 2". In the qualitative stage, five enunciators participated. The quantitative data were organized according to the general domain of Continuing Health Education and the subdomains "management actions for the team/health unit", "team/health unit actions", individual professional actions", and "educational strategies/tools". A better performance in the variables about the release of staff for capacity building and training actions, staff recognition about the importance of Directly Observed Treatment and about the adoption of Directly Observed Treatment guidelines was identified. The variables with lower performance were those related to the frequency of training offered by the Tuberculosis Control Policy., and the offering of training to newly hired professionals. The qualitative results were organized into thematic families. The results of the joint exhibition allowed the presentation in three categories: "the field of interaction between the Municipal Tuberculosis Control Program and the Primary Health Care teams", "Primary Health Care and the management of care: Directly Observed Treatment and Tuberculosis control", and "Manifestation of Continuing Education in Health: what the teams evidence and what the professionals from the Municipal Tuberculosis Control Program "say". This study corroborates and offers subsidies for the recognition of the protagonism of Primary Health Care in the management of care and control of Tuberculosis, and confirms the Permanent Health Education as an instrument for the effective transfer of this policy. Thus, Permanent Health Education can draw on Continuing Education, as it occurs in everyday life, supported by the micropolitics of work and interaction in the wheel

A determinação social das internações de adolescentes por condições sensíveis à atenção primária / The social determination of adolescent hospitalizations due to conditions sensitive to primary care

Resumo: Indicador de Internações por Condições Sensíveis à Atenção Primária possibilita analisar situação de saúde, avaliar os serviços, investigar inequidades, e promover fortalecimento da Atenção Primária à Saúde. Este é um estudo de métodos mistos, do tipo sequencial explanatório na perspectiva da Teoria de Intervenção Práxica da Enfermagem em Saúde Coletiva. O objetivo foi compreender processos relacionados à determinação social das Internações por Condições Sensíveis à Atenção Primária de adolescentes de 10 a 19 anos na 2ª Regional de Saúde do Paraná no período de 2013 a 2017. Foram desenvolvidas três etapas da Teoria de Intervenção Práxica da Enfermagem em Saúde Coletiva: captação, interpretação, e proposta de intervenção na realidade objetiva. Na fase quantitativa foram utilizados dados secundários de site público das internações de adolescentes na 2ª Regional de Saúde do Paraná entre 2013 e 2017. As causas sensíveis à atenção primária foram baseadas nos diagnósticos da Lista Brasileira de Condições Sensíveis à Atenção Primária. Os dados foram agrupados no software Tabwin e analisados de forma descritiva considerando a idade, sexo, local de moradia e grupo de causas de internação. Na fase qualitativa se investigou o planejamento e as ações de saúde para os adolescentes em dois planos Estaduais de Saúde do Paraná (2012-2015 e 2016- 2019), e conteúdo de 35 entrevistas com gestores e profissionais, que atuam em Unidades de Atenção Primária à Saúde. A análise destes dados foi apoiada no software webQDA®. Posteriormente, foi elaborado o Pilar Integration Process à luz da categoria de análise, Determinação Social da Saúde, que permitiu a integração dos dados quantitativos e qualitativos, e a construção de meta-inferências. Na dimensão estrutural, evidenciou-se que as políticas públicas estão fragilizadas para garantir os direitos do cidadão em uma sociedade justa; a concepção de saúde é baseada na teoria do risco, fator(es) para adoecimento(s), problema(s) de saúde, processo(s) individual/ biológico e familiar; a explicação do adoecimento é limitada à concepção multicausal, segundo características do(s) indivíduo(s) e comportamento(s) na adolescência. Na dimensão particular, o processo saúde é compreendido por fatores e estatísticas relacionados ao(s) agravo(s), não há historicidade e dinamicidade nos processos de vida e, o território é espaço geográfico delimitado, determinado pelo modo de vida das pessoas que ali vivem, onde há instituições e ações públicas. Na dimensão singular, os problemas de saúde do(s) adolescente(s) não têm relação com a qualidade e resolutividade dos cuidados primários, o adoecimento explicado é limitado à(s) característica(s) do(s) indivíduo(s) e ao(s) comportamento(s) na adolescência. Conclui-se que a determinação social das Internações por Condições Sensíveis à Atenção Primária de adolescentes é um processo social, dinâmico e histórico, construído na realidade que tem a objetividade do modo de vida dos grupos sociais, e a subjetividade daqueles que se entrelaçam nesses grupos. Compreender o processo saúde implica evidenciar os processos protetores e destrutivos que se encontram nas dimensões singular, particular e estrutural da realidade, assim como, explorar as relações que esses estabelecem entre si. A partir do estudo foi construída a proposta de intervenção, Oficina de Trabalho Crítico Emancipatória, para o enfrentamento do fenômeno.

Abstract: The Indicator of Hospitalizations for Primary Health Care Sensitive Conditions allows analyzing the health status, evaluating services, investigating inequities, and promoting the strengthening of the Primary Health Care. This is a sequential explanatory mixed-methods study from the perspective of the Theory of Praxis Intervention in Collective Health Nursing. This study aimed to understand processes related the social determination of Hospitalizations for Primary Health Care Sensitive Conditions of adolescents aged 10 to 19 years in the 2nd Health Care Region of Paraná State, Brazil, between 2013 and 2017. Three phases of the Theory of Praxis Intervention in Collective Health Nursing were developed: capture, interpretation, and intervention proposal in the objective reality. In the quantitative phase, secondary data from the public website of adolescents' hospitalizations in the 2nd Health Care Region of Paraná State between 2013 and 2017 were used. The sensitive causes to primary care were based on the diagnoses of the Brazilian List of Primary Health Care Sensitive Conditions. Grouped data were descriptively analyzed by means of the Tabwin software considering age, gender, residence, and group of hospitalization causes. The qualitative phase investigated the program and health care actions for adolescents in two Paraná State Health Care Plans (2012-2015 and 2016-2019), and in the content of 35 interviews with managers and professionals working at Primary Health Care Units. Data analysis was performed by means of the WebQDA® software. Subsequently, the Pillar Integration Process was elaborated in light of the Social Health Determination analysis category, which allowed the integration of quantitative and qualitative data, as well as the construction of meta-inferences. In the structural dimension, it was evidenced that public policies to guarantee citizens' rights in a fair society are weakened; the concept of health is based on the theory of risk, factor(s) for illness outcomes, health problem(s), individual/biological and family process(es); disease explanation is limited to the multicausal conception, according to individuals' traits and adolescent behavior(s). In the particular dimension, health process is understood by disease-related factors and statistics, there is no historicity and dynamism in the life processes, and the territory is a geographically delimited space, determined by its dwellers' way of life, where there are institutions and public actions. In the singular dimension, the adolescent's health problems are not related to the quality and resolution of primary care; illness is explained by individuals' features and adolescent behavior(s). Concluding, the social determination of Hospitalizations for Primary Health Care Sensitive Conditions of adolescents is a social, dynamic, and historical process, constructed in a reality that has the objectivity of the social groups' way of life, and the subjectivity of those intertwined within these groups. Understanding the health process implies highlighting the protective and destructive processes found in the singular, particular and structural dimensions of reality, as well as exploring the relationships that they establish with each other. From the study, the intervention proposal, Critical Emancipatory Workshop, was constructed to cope with the phenomenon.

Resumen: Indicador de Hospitalizaciones para Condiciones Sensibles a la Atención Primaria permite analizar la situación de salud, evaluar los servicios, investigar las desigualdades y promover el fortalecimiento de la Atención Primaria de Salud. Se trata de un estudio de métodos mixtos, del tipo explicativo secuencial desde la perspectiva de la Teoría de la Intervención Práxica de Enfermería en Salud Colectiva. El objetivo fue comprender procesos relacionados a la determinación social de Hospitalizaciones para Condiciones Sensibles a la Atención Primaria de adolescentes de 10 a 19 años en la 2a Regional de salud de Paraná en el periodo 2013-2017. Se desarrollaron tres etapas de la Teoría de la Intervención Práxica de Enfermería en Salud Colectiva: captación, interpretación, y propuesta de intervención en la realidad objetiva. En la fase cuantitativa se utilizaron datos secundarios del sitio web público de hospitalizaciones de adolescentes en la 2a Regional de Salud de Paraná entre 2013 y 2017. Las causas sensibles a la atención primaria se basaron en el diagnóstico de la Lista Brasileña de Condiciones Sensibles a la Atención Primaria. Los datos fueran agrupados en el software Tabwin y analizados de forma descriptiva considerando edad, sexo, lugar de residencia y grupo de causas de hospitalización. En la fase cualitativa se investigó la planificación y las acciones de salud para los adolescentes en dos Planes Estatales de Salud de Paraná (2012-2015 y 2016-2019), y contenido de 35 entrevistas a gestores y profesionales, que laboran en Unidades de Atención Primaria, cuyo análisis fue apoyado por el software webQDA®. Posteriormente, se elaboró el Pilar Integration Process a la luz de la categoría de análisis, Determinación Social de la Salud, que permitió la integración de datos cuantitativos y cualitativos, y la construcción de meta-inferencias. En la dimensión estructural, se hizo evidente que las políticas públicas están frágiles para garantizar los derechos ciudadanos en una sociedad justa; la concepción de la salud se basa en la teoría del riesgo, factor(es) de enfermedad(es), problema(s) de salud, proceso(s) individual/biológico y familiar; la explicación de la enfermedad se limita a la concepción multicausal, de acuerdo con las características del(los) individuo(s) y comportamiento(s) en la adolescencia. En la dimensión particular, el proceso de salud se entiende por factores y estadísticas relacionados con la(s) enfermedad(es), no hay historicidad y dinamismo en los procesos de vida y, el territorio es un espacio geográfico delimitado, determinado por el modo de vivir de las personas que viven allí, donde hay instituciones y acciones públicas. En la dimensión singular, los problemas de salud del(los) adolescente(s) no están relacionados con la calidad y resolución de la atención primaria, la enfermedad explicada se limita a las características del(los) individuo(s) y comportamiento(s) en la adolescencia. Se concluye que la determinación social de Hospitalizaciones por Condiciones Sensibles a la Atención Primaria de adolescentes es un proceso social, dinámico e histórico, construido en la realidad que tiene la objetividad del modo de vivir de los grupos sociales, y la subjetividad de aquellos que se entrelazan. en estos grupos. Comprender el proceso de salud implica resaltar los procesos protectores y destructivos que se encuentran en las dimensiones singulares, particulares y estructurales de la realidad, así como explorar las relaciones que estas establecen entre sí. A partir del estudio, se construyó la propuesta de intervención, Taller de Trabajo Crítico Emancipatorio, para enfrentar el fenómeno.

Guia prático para o diagnóstico da cultura de segurança do paciente: um modelo de métodos mistos / Practical guide for diagnosing patient safety culture: a mixed-methods model

Resumo: Introdução: Avaliar a cultura de segurança do paciente é imprescindível. Esta prática tem sido realizada nas diversas Organizações de Saúde ao redor do mundo e revela os pontos fortes e as fragilidades, possibilitando a discussão de estratégias e processos decisórios em prol do fortalecimento da assistência segura. Objetivo: Elaborar um Guia Prático para o Diagnóstico da Cultura de Segurança do Paciente que integre dados quantitativos e qualitativos. Método: Trata-se de pesquisa metodológica, com execução do procedimento teórico de Pasquali (2010). Os procedimentos incluíram revisão de escopo, elaboração de um modelo gráfico de diagnóstico de cultura de segurança do paciente com abordagem de métodos mistos e validação de conteúdo por um painel de especialistas. A avaliação do constructo se deu mediante a técnica Delphi Online. Foi considerado como índice de validade de conteúdo (IVC) o valor ?0,85, baseado no quantitativo de especialistas e nas características do construto. Fizeram parte do painel de especialistas profissionais com no mínimo cinco pontos do critério para a seleção de especialistas de Joventino (2010). Participaram da primeira rodada 28 profissionais da equipe multiprofissional e da segunda, 20 profissionais. As avaliações transcorreram via plataforma Survey Monkey®, totalizando duas rodadas de consenso. Resultados: A revisão de escopo indicou três pontos críticos relacionados aos aspectos metodológicos dos estudos de cultura de segurança do paciente: 1) indistinção conceitual entre os termos "Cultura" e "Clima", 2) uso exclusivo de questionários para acessar a cultura de segurança, e 3) participação de apenas um estrato profissional nas pesquisas de cultura de segurança do paciente. Foi elaborado inicialmente um modelo gráfico e a ser validado por um comitê de especialistas. Foram avaliados quatro itens - Título Geral, Etapas, Detalhamento da Etapa e Método - em relação à quatro componentes - Layout, Cores, Fonte e Conteúdo -. A média dos IVCs de cada componente na primeira rodada foram, respectivamente, 0,86; 0,60; 0,68 e 0,84. A segunda rodada de consenso culminou na validação do conteúdo do modelo gráfico e na elaboração e validação de um Checklist para o diagnóstico de cultura de segurança do paciente. O Item "Detalhamento da Etapa" foi substituído pelo Checklist. As médias obtidas na segunda rodada para cada componente foram, na mesma ordem, 0,96; 0,91; 0,95 e 0,86. Os produtos validados serão incorporados como produto final, em formato e-book, no Guia Prático para o Diagnóstico da Cultura de Segurança do Paciente, o qual será submetido à processo de editoração e conterá os seguintes elementos: a) Background de Segurança do Paciente; b) Fundamentação teóricometodológica do diagnóstico de Cultura Organizacional; c) Modelo gráfico validado; d) Checklist validado. Conclusão: O diagnóstico da cultura de segurança do paciente por meio da abordagem de métodos mistos tem sustentação na literatura. Uma abordagem integrativa imputa sinergia entre os componentes metodológicos e promove um diagnóstico da cultura de segurança do paciente mais assertivo. O Guia Prático sobrepuja a prática de aplicação única de questionários para avaliar a cultura de segurança, ao apropriar-se da abordagem de métodos mistos como método propício ao modelo proposto de diagnóstico de cultura de segurança do paciente.

Abstract: Introduction: Assessing the patient safety culture is essential. This practice has been carried out in different Health Organizations around the world and reveals both strengths and weaknesses, thus enabling the discussion of strategies and decision-making processes in favor of strengthening safe care. Objective: To Develop a Practical Guide for the Diagnosis of the Patient Safety Culture using the mixed methods approach. Method: This is methodological research, with the execution of the theoretical procedure by Pasquali (2010). The procedures included scope review, development of a graphic model of diagnosis of patient safety culture with the mixed-methods approach, and content validation by a panel of experts. The construct was evaluated using the Delphi Online technique. The content validity index was considered to be ?0.85, based on the number of specialists and the characteristics of the construct. The expert panel included professionals with at least five points of the criterion for the selection of experts by Joventino (2010). 28 professionals from the multi-professional team participated in the first round and 20 professionals in the second round. The evaluations took place via the Survey Monkey® platform, totaling two rounds of consensus until the final version of the construct. Results: The review indicated three critical aspects related to the methodological aspects of patient safety culture studies: 1) conceptual indistinction between the terms "Culture" and "Climate", 2) exclusive use of questionnaires to access the safety culture, and 3) participation of only one professional stratum in the safety culture research of the patient. A graphic model was initially developed and to be validated by a committee of experts. Four items were evaluated - General Title, Stages, Detail of the Stage, and Method - concerning the four components - Layout, Colors, Font, and Content -. The average CVI of each component in the first round was, respectively, 0.86, 0.60; 0.68, and 0.84. The second round of consensus culminated in the validation of the content of the graphic model and the elaboration and validation of a Checklist for the diagnosis of patient safety culture. The item "Detailing of the Stage" was replaced by the Checklist. The averages obtained in the second round for each component were, in the same order, 0.96; 0.91; 0.95, and 0.86. The validated products will be incorporated as a final product, in e-book format, in the Practical Guide for the Diagnosis of the Patient Safety Culture, which will be submitted to the editing process and will contain the following elements: a) Patient Safety Background; b) Theoretical-methodological basis for the diagnosis of Organizational Culture; c) Validated graphic model; d) Validated checklist. Conclusion: The diagnosis of patient safety culture by the mixed methods approach is supported by the literature. An integrative approach attracts synergy between the methodological components and promotes a more assertive diagnosis of patient safety culture. The Practical Guide surpasses the practice of single application of questionnaires to assess the safety culture, by appropriating the approach of mixed methods as a method conducive to the proposed model of diagnosis of patient safety culture.

Faculty perceptions and applications of the in-service training programs of the Association of Philippine Medical Colleges

@#<p style="text-align: justify;"><strong>Objectives.</strong> The Association of Philippine Medical Colleges (APMC) responded to the global call for transformative learning by conducting a series of Faculty In-service Training. This study was commissioned to determine faculty trainees' perceptions of the program in terms of relevance, comprehensiveness, and quality. It also described their applications of the program in their delivery of instruction, assessment, organization, and management skills.</p><p style="text-align: justify;"><strong>Methods.</strong> This is a sequential explanatory mixed-method research. The quantitative phase refers to the analysis of the rating scale accomplished by participants as feedback. The qualitative phase includes analysis of focus group discussion results and actual course syllabi used by selected participants, including medical schools' documents. Both data were integrated using a combination of descriptive statistics, measures of central tendency and dispersion, as well as joint displays.</p><p style="text-align: justify;"><strong>Results.</strong> APMC conducted six in-service trainings from 2015 to 2018. Themes focused on medical teachers' roles as instructional designers, facilitators, assessors of learning, and as leaders and managers. Respondents perceived the programs as most relevant, comprehensive, and interesting. The syllabi, instructional resources, and assessment instruments and practices were consistent with the standards of the Commission on Higher Education. Medical teachers showed that they use innovative teaching and assessment strategies, and are dealing with medical education's continuous challenges.</p><p style="text-align: justify;"><strong>Conclusion.</strong> Faculty participants perceived the APMC in-service training programs most favorably for capacitating them to enhance their teaching skills and inculcate the culture of quality in medical schools. APMC's training also reflects the organization's commitment to social accountability.</p>

Afrontamiento y viudez en la vejez: Estudio mixto en población colombiana / Coping and widowhood in the older adulthood: Mixed methods study in Colombian population

Resumen La viudez está catalogada como uno de los eventos de vida adversos más estresantes. El cambio de estado civil genera un cambio de rol e implica una resignificación de la vida. El presente estudio tuvo como objetivo comprender la forma en que las personas mayores viven y afrontan la viudez y determinar cuál es la relación entre las respuestas psicológicas, el sexo y los estilos de afrontamiento. Se utilizó metodología mixta con un diseño CUALI-cuanti a partir de la teoría fundamentada y análisis log lineal. La muestra estuvo compuesta por 29 personas mayores viudas residentes en Bogotá. Este estudio reporta las respuestas psicológicas de un grupo de personas mayores viudas que facilitan el afrontamiento exitoso a la pérdida de la pareja y aquellas que lo dificultan. Los resultados en la fase cualitativa mostraron que el afrontamiento a la viudez se enmarca en siete factores: sentido de vida, apoyo social, relación previa, satisfacción con el matrimonio, participación en actividades, consecuencias generadas por la pérdida y fortalezas personales. En la fase cuantitativa se encontró una interacción significativa entre respuesta psicológica y afrontamiento, lo que reveló que algunas respuestas psicológicas en particular llevan a un afrontamiento activo o por el contrario, lo dificultan. Las respuestas que se encontraron significativas fueron aislamiento, soledad, seguir adelante y participación en actividades. Los resultados demuestran que el afrontamiento es producto de las interacciones entre los sistemas macro y micro y muestra a la viudez como una transición multifacética. Se discuten las similitudes con estudios anteriores y limitaciones.

Abstract Widowhood is cataloged as one of the most stressful adverse life events; the change of civil status generates a change of role and implies a resignification of life. The aim of this study was to understand how older people experience and cope with widowhood. The research used mixed methods approach with a QUALI- quanti design, through grounded theory and log lineal analysis, with a sample of 29 elderly widows and widowers living in Bogotá. This study reports the psychological responses of a group of elderly widows that facilitate successful coping with the loss of the couple, and the responses that make it difficult. The results in the qualitative stage showed that coping with widowhood is framed in seven factors: sense of life, social support, previous relationship, satisfaction with marriage, participation in activities, consequences generated by the loss and personal strengths. In the quantitative stage a significant interaction between psychological response and coping was found, which revealed that some psychological responses in particular lead to an active coping or, on the contrary, made coping difficult. The answers that were significant were isolation, loneliness, moving forward and participation in activities. The results revealed that coping is a product of the interactions between macro and micro systems and showed widowhood as a multifaceted transition. Similarities with previous studies and limitations are discussed.

Prediction and Explanation on Adolescent Aggression: A Study Protocol

@#Adolescent aggression is an important public health concern with escalating prevalence of juvenile cases and violence among these age groups including robbery, homicide, and gang fights. The objectives of this study protocol are to determine the biopsychosocial predictors and explore the contextual factors of adolescent aggression among secondary school students in Hulu Langat. Methods: Explanatory mixed method study design will be used, consist of quantitative cross-sectional study followed by basic qualitative study. Proportionate population sampling among Form 4 secondary school students from selected public secondary schools in Hulu Langat will be executed. Questionnaires will be distributed to 481 students on aggression as the dependent variable, and several independent variables: demographic (ethnicity, family income), biological (sex, head injury, nutritional deficiency, breakfast skipping), psychological (attitude and normative beliefs, personality trait, emotional intelligence), and social factors (family environment, single parent status, domestic violence, peer deviant affiliation, alcohol, smoking, substance abuse). Subsequently, participants with moderate to high aggression scores will be further explored on the contextual factors of adolescent aggression by in-depth interview. Multiple linear regression will be executed using SPSS to determine significant predictors whereas thematic analysis will be applied for qualitative data analysis on the context of adolescent aggression. Both findings will be further integrated and discussed to give comprehensive description on the phenomena. Conclusion: Better knowledge and understanding on adolescent aggression may generate new framework to drive more effective preventive strategies and unravel adolescent aggressive related Public Health problems.

Reflexiones en torno a la investigación con métodos mixtos / Reflexão sobre pesquisa com métodos mistos / Reflections on research with mixed methods

Objetivo Se presenta una reflexión teórica basada en la experiencia de los autores como investigadores y docentes de unidades curriculares de Metodologías de Investigación. Método reflexión teórica-filosófica. Resultados la dicotomía entre los enfoques cualitativos y cuantitativos dio lugar a la discusión sobre la necesidad de pensar en la posibilidad de combinar estos métodos con el objetivo de responder a los nuevos y complejos problemas de investigación con los que actualmente nos enfrentamos. Esta discusión se transformó en una disputa que algunos autores apodaron "Science War", debido a los desafíos metodológicos y epistemológicos de esta combinación que, por su vez, dio origen a los Métodos Mixtos (Mixed Methods). La reflexión que se propone se centra en algunas de las principales cuestiones que surgen en el ámbito de las actuales discusiones entre investigadores y reflejan/traducen algunas de las inquietudes de los mismos.

Objetivo se presenta una reflexión teórica basada en la experiencia de los autores como investigadores y docentes de unidades curriculares de Metodologías de Investigación. Método reflexión teórica-filosófica. Resultados la dicotomía entre los enfoques cualitativos y cuantitativos dio lugar a la discusión sobre la necesidad de pensar en la posibilidad de combinar estos métodos con el objetivo de responder a los nuevos y complejos problemas de investigación con los que actualmente nos enfrentamos. Esta discusión se transformó en una disputa que algunos autores apodaron "Science War", debido a los desafíos metodológicos y epistemológicos de esta combinación que, por su vez, dio origen a los Métodos Mixtos (Mixed Methods). La reflexión que se propone se centra en algunas de las principales cuestiones que surgen en el ámbito de las actuales discusiones entre investigadores y reflejan/traducen algunas de las inquietudes de los mismos.

Objective this study presents a theoretical reflection based on the experience of the authors as researchers and professors of curricular units of research methodologies. Method theoretical-philosophical reflection. Results the dichotomy between qualitative and quantitative approaches originated the discussion on the need to think about the possibility of combining these methods aiming to answer the new and complex research problems currently facing us. This discussion was transformed into a dispute that some authors nicknamed "Science War", due to the methodological and epistemological challenges of this combination, which, in its turn, originated the Mixed Methods. The proposed reflection focuses on some of the main issues that arise in the scope of the current discussions between researchers and reflecting/translating some of their concerns.