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 Table of Contents 
Year : 2015  |  Volume : 4  |  Issue : 3  |  Page : 324-327  

Validity, reliability, and generalizability in qualitative research

Department of Family Medicine and Centre of Studies in Primary Care, Queen's University, Kingston, Ontario, Canada

Date of Web Publication23-Jul-2015

Correspondence Address:
Lawrence Leung
Centre of Studies in Primary Care, Queen's University, 220 Bagot Street, Kingston, ON K7L 5E9
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2249-4863.161306

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In general practice, qualitative research contributes as significantly as quantitative research, in particular regarding psycho-social aspects of patient-care, health services provision, policy setting, and health administrations. In contrast to quantitative research, qualitative research as a whole has been constantly critiqued, if not disparaged, by the lack of consensus for assessing its quality and robustness. This article illustrates with five published studies how qualitative research can impact and reshape the discipline of primary care, spiraling out from clinic-based health screening to community-based disease monitoring, evaluation of out-of-hours triage services to provincial psychiatric care pathways model and finally, national legislation of core measures for children's healthcare insurance. Fundamental concepts of validity, reliability, and generalizability as applicable to qualitative research are then addressed with an update on the current views and controversies.

Keywords: Controversies, generalizability, primary care research, qualitative research, reliability, validity

How to cite this article:
Leung L. Validity, reliability, and generalizability in qualitative research. J Family Med Prim Care 2015;4:324-7

How to cite this URL:
Leung L. Validity, reliability, and generalizability in qualitative research. J Family Med Prim Care [serial online] 2015 [cited 2021 Sep 16];4:324-7. Available from: https://www.jfmpc.com/text.asp?2015/4/3/324/161306

  Nature of Qualitative Research versus Quantitative Research Top

The essence of qualitative research is to make sense of and recognize patterns among words in order to build up a meaningful picture without compromising its richness and dimensionality. Like quantitative research, the qualitative research aims to seek answers for questions of "how, where, when who and why" with a perspective to build a theory or refute an existing theory. Unlike quantitative research which deals primarily with numerical data and their statistical interpretations under a reductionist, logical and strictly objective paradigm, qualitative research handles nonnumerical information and their phenomenological interpretation, which inextricably tie in with human senses and subjectivity. While human emotions and perspectives from both subjects and researchers are considered undesirable biases confounding results in quantitative research, the same elements are considered essential and inevitable, if not treasurable, in qualitative research as they invariable add extra dimensions and colors to enrich the corpus of findings. However, the issue of subjectivity and contextual ramifications has fueled incessant controversies regarding yardsticks for quality and trustworthiness of qualitative research results for healthcare.

  Impact of Qualitative Research upon Primary Care Top

In many ways, qualitative research contributes significantly, if not more so than quantitative research, to the field of primary care at various levels. Five qualitative studies are chosen to illustrate how various methodologies of qualitative research helped in advancing primary healthcare, from novel monitoring of chronic obstructive pulmonary disease (COPD) via mobile-health technology, [1] informed decision for colorectal cancer screening, [2] triaging out-of-hours GP services, [3] evaluating care pathways for community psychiatry [4] and finally prioritization of healthcare initiatives for legislation purposes at national levels. [5] With the recent advances of information technology and mobile connecting device, self-monitoring and management of chronic diseases via tele-health technology may seem beneficial to both the patient and healthcare provider. Recruiting COPD patients who were given tele-health devices that monitored lung functions, Williams et al. [1] conducted phone interviews and analyzed their transcripts via a grounded theory approach, identified themes which enabled them to conclude that such mobile-health setup and application helped to engage patients with better adherence to treatment and overall improvement in mood. Such positive findings were in contrast to previous studies, which opined that elderly patients were often challenged by operating computer tablets, [6] or, conversing with the tele-health software. [7] To explore the content of recommendations for colorectal cancer screening given out by family physicians, Wackerbarth, et al. [2] conducted semi-structure interviews with subsequent content analysis and found that most physicians delivered information to enrich patient knowledge with little regard to patients' true understanding, ideas, and preferences in the matter. These findings suggested room for improvement for family physicians to better engage their patients in recommending preventative care. Faced with various models of out-of-hours triage services for GP consultations, Egbunike et al. [3] conducted thematic analysis on semi-structured telephone interviews with patients and doctors in various urban, rural and mixed settings. They found that the efficiency of triage services remained a prime concern from both users and providers, among issues of access to doctors and unfulfilled/mismatched expectations from users, which could arouse dissatisfaction and legal implications. In UK, a care pathways model for community psychiatry had been introduced but its benefits were unclear. Khandaker et al. [4] hence conducted a qualitative study using semi-structure interviews with medical staff and other stakeholders; adopting a grounded-theory approach, major themes emerged which included improved equality of access, more focused logistics, increased work throughput and better accountability for community psychiatry provided under the care pathway model. Finally, at the US national level, Mangione-Smith et al. [5] employed a modified Delphi method to gather consensus from a panel of nominators which were recognized experts and stakeholders in their disciplines, and identified a core set of quality measures for children's healthcare under the Medicaid and Children's Health Insurance Program. These core measures were made transparent for public opinion and later passed on for full legislation, hence illustrating the impact of qualitative research upon social welfare and policy improvement.

  Overall Criteria for Quality in Qualitative Research Top

Given the diverse genera and forms of qualitative research, there is no consensus for assessing any piece of qualitative research work. Various approaches have been suggested, the two leading schools of thoughts being the school of Dixon-Woods et al. [8] which emphasizes on methodology, and that of Lincoln et al. [9] which stresses the rigor of interpretation of results. By identifying commonalities of qualitative research, Dixon-Woods produced a checklist of questions for assessing clarity and appropriateness of the research question; the description and appropriateness for sampling, data collection and data analysis; levels of support and evidence for claims; coherence between data, interpretation and conclusions, and finally level of contribution of the paper. These criteria foster the 10 questions for the Critical Appraisal Skills Program checklist for qualitative studies. [10] However, these methodology-weighted criteria may not do justice to qualitative studies that differ in epistemological and philosophical paradigms, [11],[12] one classic example will be positivistic versus interpretivistic. [13] Equally, without a robust methodological layout, rigorous interpretation of results advocated by Lincoln et al. [9] will not be good either. Meyrick [14] argued from a different angle and proposed fulfillment of the dual core criteria of "transparency" and "systematicity" for good quality qualitative research. In brief, every step of the research logistics (from theory formation, design of study, sampling, data acquisition and analysis to results and conclusions) has to be validated if it is transparent or systematic enough. In this manner, both the research process and results can be assured of high rigor and robustness. [14] Finally, Kitto et al. [15] epitomized six criteria for assessing overall quality of qualitative research: (i) Clarification and justification, (ii) procedural rigor, (iii) sample representativeness, (iv) interpretative rigor, (v) reflexive and evaluative rigor and (vi) transferability/generalizability, which also double as evaluative landmarks for manuscript review to the Medical Journal of Australia. Same for quantitative research, quality for qualitative research can be assessed in terms of validity, reliability, and generalizability.

  Validity Top

Validity in qualitative research means "appropriateness" of the tools, processes, and data. Whether the research question is valid for the desired outcome, the choice of methodology is appropriate for answering the research question, the design is valid for the methodology, the sampling and data analysis is appropriate, and finally the results and conclusions are valid for the sample and context. In assessing validity of qualitative research, the challenge can start from the ontology and epistemology of the issue being studied, e.g. the concept of "individual" is seen differently between humanistic and positive psychologists due to differing philosophical perspectives: [16] Where humanistic psychologists believe "individual" is a product of existential awareness and social interaction, positive psychologists think the "individual" exists side-by-side with formation of any human being. Set off in different pathways, qualitative research regarding the individual's wellbeing will be concluded with varying validity. Choice of methodology must enable detection of findings/phenomena in the appropriate context for it to be valid, with due regard to culturally and contextually variable. For sampling, procedures and methods must be appropriate for the research paradigm and be distinctive between systematic, [17] purposeful [18] or theoretical (adaptive) sampling [19],[20] where the systematic sampling has no a priori theory, purposeful sampling often has a certain aim or framework and theoretical sampling is molded by the ongoing process of data collection and theory in evolution. For data extraction and analysis, several methods were adopted to enhance validity, including 1 st tier triangulation (of researchers) and 2 nd tier triangulation (of resources and theories), [17],[21] well-documented audit trail of materials and processes, [22],[23],[24] multidimensional analysis as concept- or case-orientated [25],[26] and respondent verification. [21],[27]

  Reliability Top

In quantitative research, reliability refers to exact replicability of the processes and the results. In qualitative research with diverse paradigms, such definition of reliability is challenging and epistemologically counter-intuitive. Hence, the essence of reliability for qualitative research lies with consistency. [24],[28] A margin of variability for results is tolerated in qualitative research provided the methodology and epistemological logistics consistently yield data that are ontologically similar but may differ in richness and ambience within similar dimensions. Silverman [29] proposed five approaches in enhancing the reliability of process and results: Refutational analysis, constant data comparison, comprehensive data use, inclusive of the deviant case and use of tables. As data were extracted from the original sources, researchers must verify their accuracy in terms of form and context with constant comparison, [27] either alone or with peers (a form of triangulation). [30] The scope and analysis of data included should be as comprehensive and inclusive with reference to quantitative aspects if possible. [30] Adopting the Popperian dictum of falsifiability as essence of truth and science, attempted to refute the qualitative data and analytes should be performed to assess reliability. [31]

  Generalizability Top

Most qualitative research studies, if not all, are meant to study a specific issue or phenomenon in a certain population or ethnic group, of a focused locality in a particular context, hence generalizability of qualitative research findings is usually not an expected attribute. However, with rising trend of knowledge synthesis from qualitative research via meta-synthesis, meta-narrative or meta-ethnography, evaluation of generalizability becomes pertinent. A pragmatic approach to assessing generalizability for qualitative studies is to adopt same criteria for validity: That is, use of systematic sampling, triangulation and constant comparison, proper audit and documentation, and multi-dimensional theory. [17] However, some researchers espouse the approach of analytical generalization [32] where one judges the extent to which the findings in one study can be generalized to another under similar theoretical, and the proximal similarity model, where generalizability of one study to another is judged by similarities between the time, place, people and other social contexts. [33] Thus said, Zimmer [34] questioned the suitability of meta-synthesis in view of the basic tenets of grounded theory, [35] phenomenology [36] and ethnography. [37] He concluded that any valid meta-synthesis must retain the other two goals of theory development and higher-level abstraction while in search of generalizability, and must be executed as a third level interpretation using Gadamer's concepts of the hermeneutic circle, [38],[39] dialogic process [38] and fusion of horizons. [39] Finally, Toye et al. [40] reported the practicality of using "conceptual clarity" and "interpretative rigor" as intuitive criteria for assessing quality in meta-ethnography, which somehow echoed Rolfe's controversial aesthetic theory of research reports. [41]

  Food for Thought Top

Despite various measures to enhance or ensure quality of qualitative studies, some researchers opined from a purist ontological and epistemological angle that qualitative research is not a unified, but ipso facto diverse field, [8] hence any attempt to synthesize or appraise different studies under one system is impossible and conceptually wrong. Barbour argued from a philosophical angle that these special measures or "technical fixes" (like purposive sampling, multiple-coding, triangulation, and respondent validation) can never confer the rigor as conceived. [11] In extremis, Rolfe et al. opined from the field of nursing research, that any set of formal criteria used to judge the quality of qualitative research are futile and without validity, and suggested that any qualitative report should be judged by the form it is written (aesthetic) and not by the contents (epistemic). [41] Rolfe's novel view is rebutted by Porter, [42] who argued via logical premises that two of Rolfe's fundamental statements were flawed: (i) "The content of research report is determined by their forms" may not be a fact, and (ii) that research appraisal being "subject to individual judgment based on insight and experience" will mean those without sufficient experience of performing research will be unable to judge adequately - hence an elitist's principle. From a realism standpoint, Porter then proposes multiple and open approaches for validity in qualitative research that incorporate parallel perspectives [43],[44] and diversification of meanings. [44] Any work of qualitative research, when read by the readers, is always a two-way interactive process, such that validity and quality has to be judged by the receiving end too and not by the researcher end alone.

In summary, the three gold criteria of validity, reliability and generalizability apply in principle to assess quality for both quantitative and qualitative research, what differs will be the nature and type of processes that ontologically and epistemologically distinguish between the two.

  References Top

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36 Claiming space: photovoice, identity, inclusion and the work of disability
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37 Role of and challenges to environmental impact assessment proponents in Pakistan
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38 Comparing Face-to-Face, Emergency Remote Teaching and Smart Classroom: A Qualitative Exploratory Research Based on Students’ Experience during the COVID-19 Pandemic
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39 Clinical guidance for podiatrists in the management of foot problems in rheumatic disorders: evaluation of an educational programme for podiatrists using a mixed methods design
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40 “Dispense antiretrovirals daily!” restructuring the delivery of HIV services to optimize antiretroviral initiation among men in Malawi
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41 Flammable cladding and the effects on homeowner well-being
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42 The Effects of Enmeshment and Familism in Armenian Mothers
Christina Kirikian,Tara Zolnikov,Humera Afaq
The American Journal of Family Therapy. 2021; : 1
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43 Identities: experiences and impacts of the COVID-19 pandemic from the perspectives of older Chinese immigrants in Canada
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44 ‘Implementing a broad quality of life tool for determining care wishes and needs of older adults living at home
M. S. Van Loon,G. Widdershoven,K. Van Leeuwen,J. Bosmans,S. Metselaar,R. Ostelo
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45 Experiences of adults with intellectual disabilities who identify as lesbian, gay, bisexual, or transgender within mainstream community: a systematic review of qualitative studies
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46 Exploration of workplace bullying in the foodservice industry
Ruth A. Smith,Miranda Kitterlin-Lynch,Yselande Pierre,Andrew Moreo
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47 Access to Healthcare Following Serious Injury: Perspectives of Allied Health Professionals in Urban and Regional Settings
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International Journal of Environmental Research and Public Health. 2021; 18(3): 1230
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48 Incarcerated older persons’ motivation to engage in criminal court-mandated treatment: Findings from a qualitative study
Helene Seaward,Tenzin Wangmo,Monika Egli-Alge,Lutz-Peter Hiersemenzel,Marc Graf,Bernice S. Elger,Elmar Habermeyer
Forensic Science International: Mind and Law. 2021; 2: 100057
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49 Overcoming Cultural Barriers to Being Agile in Distributed Teams
Darja Šmite,Nils Brede Moe,Javier Gonzalez-Huerta
Information and Software Technology. 2021; : 106612
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50 Content Management Systems Performance and Compliance Assessment Based on a Data-Driven Search Engine Optimization Methodology
Ioannis Drivas,Dimitrios Kouis,Daphne Kyriaki-Manessi,Georgios Giannakopoulos
Information. 2021; 12(7): 259
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51 Childbirth experiences of immigrant women in Chile: Trading human rights and autonomy for dignity and good care
Jovita Ortiz,Constanza Adrián,Cindy Fernández,Maribel Mella,Marisa Villagrán,Marcela Diaz,Jael Quiroz
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52 Promoting Rigorous Research: Generalizability and Qualitative Research
Danica G. Hays,W. Bradley McKibben
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53 Social Dynamics of a Population-Level Dashboard for Antimicrobial Stewardship: A Qualitative Analysis
Peter Taber,Charlene Weir,Jorie M. Butler,Christopher J. Graber,Makoto M. Jones,Karl Madaras-Kelly,Yue Zhang,Ann F. Chou,Matthew H. Samore,Matthew Bidwell Goetz,Peter A. Glassman
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54 Improving treatment outcomes for leprosy in Pernambuco, Brazil: a qualitative study exploring the experiences and perceptions of retreatment patients and their carers
Divya Khanna,Gilles de Wildt,Luiz Antonio Miranda de Souza Duarte Filho,Mitali Bajaj,Jo Freda Lai,Esme Gardiner,Andrea Maia Fernandes de Araújo Fonseca,Antje Lindenmeyer,Patrícia Sammarco Rosa
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55 Study protocol for the COvid-19 Toolbox for All IslaNd (CONTAIN) project: A cross-border analysis in Ireland to disentangle psychological, behavioural, media and governmental responses to COVID-19
Catherine D. Darker,Nicola OćConnell,Martin Dempster,Christopher D. Graham,Cliodhna OćConnor,Lina Zgaga,Ann Nolan,Katy Tobin,Niamh Brennan,Gail Nicolson,Emma Burke,Luke Mather,Philip Crowley,Gabriel Scally,Joseph Barry
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56 Assessing Preservice Teachers’ Cultural Competence With the Cultural Proficiency Continuum Q-Sort
Dwayne Ray Cormier
Educational Researcher. 2021; 50(1): 17
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57 Mothers’ quality of life delivering kangaroo mother care at Malawian hospitals: a qualitative study
Alinane Linda Nyondo-Mipando,Mai-Lei Woo Kinshella,Tamanda Hiwa,Sangwani Salimu,Mwai Banda,Marianne Vidler,Elizabeth Molyneux,Queen Dube,David M. Goldfarb,Kondwani Kawaza
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58 Scavenging for Survival and its Health Implications. The nexus between Unemployment and Ill-health
Chux Gervase Iwu,Franklin Ikenna Eze,Abdullah Promise Opute,Gianni Utomhe Dongo,Oluwatosin Wuraola Dongo
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59 What matters to people aged 80 and over regarding ambulatory care? A systematic review and meta-synthesis of qualitative studies
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60 How is the medical assistance in dying (MAID) process carried out in Nova Scotia, Canada? A qualitative process model flowchart study
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61 Stigma Mechanisms and Outcomes among Sub-Saharan African Descendants in Belgium—Contextualizing the HIV Stigma Framework
Lazare Manirankunda,Aletha Wallace,Charles Ddungu,Christiana Nöstlinger
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62 How Do Areas of Work Life Drive Burnout in Orthopaedic Attending Surgeons, Fellows, and Residents?
Claire Isabelle Verret,Joseph Nguyen,Carolyne Verret,Todd J. Albert,Duretti T. Fufa
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63 A systematic review of existing observational tools to measure the food and physical activity environment in schools
Hannah G. Lane,Hannah G. Calvert,Rachel Deitch,Ryan Harris,Oyinlola T. Babatunde,Lindsey Turner,Erin R. Hager,Stephanie Jilcott Pitts
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64 The protocol of a qualitative descriptive study application for the theory of planned behavior: why do some early adolescents drink?
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65 Applying the ICF-CY to Specialist Speech-Language Pathologists’ Practice With Toddlers With Cleft Palate Speech
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66 Reactions to COVID-19, Information and Technology Use, and Social Connectedness among Older Adults with Pre-Frailty and Frailty
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67 Study protocol for the COvid-19 Toolbox for All IslaNd (CONTAIN) project: A cross-border analysis in Ireland to disentangle psychological, behavioural, media and governmental responses to COVID-19
Catherine D. Darker,Nicola OćConnell,Martin Dempster,Christopher D. Graham,Cliodhna OćConnor,Lina Zgaga,Ann Nolan,Katy Tobin,Niamh Brennan,Gail Nicolson,Emma Burke,Luke Mather,Philip Crowley,Gabriel Scally,Joseph Barry
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68 Barriers to Prostate Cancer Screening Among Indo-Guyanese
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69 Education during Surgical Outreach Trips in Vietnam: A Qualitative Study of Surgeon Learners
Jessica I. Billig,Jacob S. Nasser,William H. J. Chung,Kristine A. Huynh,Kevin C. Chung
Plastic and Reconstructive Surgery - Global Open. 2020; 8(7): e2969
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70 A Review of the Quality Indicators of Rigor in Qualitative Research
Jessica L. Johnson,Donna Adkins,Sheila Chauvin
American Journal of Pharmaceutical Education. 2020; 84(1): 7120
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71 General practitioners’ perceptions of compassionate communities: a qualitative study
E. Abbey,C. Craig,C. R. Mayland
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72 Sosyal Bilgiler Ögretiminde Çokkültürlülük Çalismalari: Bir Meta-Sentez Çalismasi
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73 The male familial caregiver experience of caring for persons with Alzheimer’s disease from low socio-economic status: A South African perspective
Abeedah Hendricks-Lalla,Chrisma Pretorius
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74 Evaluating networked drug checking services in Toronto, Ontario: study protocol and rationale
N. Maghsoudi,K. McDonald,C. Stefan,D. R. Beriault,K. Mason,L. Barnaby,J. Altenberg,R. D. MacDonald,J. Caldwell,R. Nisenbaum,P. Leece,T. M. Watson,K. W. Tupper,L. Kufner,A. I. Scheim,D. Werb
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75 In my remembered country: what poetry tells us about the changing perceptions of volcanoes between the nineteenth and twenty-first centuries
Arianna Soldati,Sam Illingworth
Geoscience Communication. 2020; 3(1): 73
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76 Barriers and facilitators for partnerships between parents with immigrant backgrounds and professionals in ECEC: a review based on empirical research
Helga Norheim,Thomas Moser
European Early Childhood Education Research Journal. 2020; : 1
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77 Practices for evaluating qualitative research in information science
Melanie Rügenhagen
Proceedings of the Association for Information Science and Technology. 2020; 57(1)
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78 Establishing psychological relationship between female customers and retailers
Dilini Edirisinghe,Alireza Nazarian,Pantea Foroudi,Andrew Lindridge
Qualitative Market Research: An International Journal. 2020; 23(3): 471
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79 Defining compassionate nursing care
Jing Jing Su,Golden Mwakibo Masika,Jenniffer Torralba Paguio,Sharon R Redding
Nursing Ethics. 2020; 27(2): 480
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80 Adapting rapid assessment procedures for implementation research using a team-based approach to analysis: a case example of patient quality and safety interventions in the ICU
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81 Emotional Intelligence from Perspectives of Malaysian Helping Professionals: A Qualitative Study
Ida Hartina Ahmed Tharbe,Melati Sumari,Kok-Mun Ng
Pertanika Journal of Social Sciences and Humanities. 2020; 28(4)
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82 Understanding the use of patient-reported data by health care insurers: A scoping review
Anne Neubert,Óscar Brito Fernandes,Armin Lucevic,Milena Pavlova,László Gulácsi,Petra Baji,Niek Klazinga,Dionne Kringos,Mathieu F. Janssen
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83 Problem- and solution-focused characteristics of parenting support, 3 years after implementation of the solution-focused approach: A qualitative content analysis
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Child & Family Social Work. 2020;
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84 A qualitative study of the operating room experience of patients who underwent surgery under spinal anesthesia: “It was like an adventure”
Emel Yilmaz,Hülya K. Togaç,Aynur Çetinkaya,Soner Togaç
Nursing & Health Sciences. 2020; 22(3): 648
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85 Let Their Voices Be Seen
Amanda J. Young,Frances Richardson,Dawn Fitzgerald,Benjamin S. Heavrin,Brooke Tweddell,Lydia Gettings,Ashley Cooper,Cori Cohen Grant
Annals of Emergency Medicine. 2020; 76(3): S73
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86 Managing Corporate Sustainability and Responsibility Efficiently: A Review of Existing Literature on Business Groups and Networks
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87 Co-designing eHealth and Equity Solutions: Application of the Ophelia (Optimizing Health Literacy and Access) Process
Christina Cheng,Gerald R. Elsworth,Richard H. Osborne
Frontiers in Public Health. 2020; 8
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88 Exploring Deal of the Day: an e-commerce strategy
Achint Nigam,Prem Prakash Dewani,Abhishek Behl
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89 Big Five Personality Traits and Workplace Spirituality: A Mixed Method Study
Hasan Tutar,Emre Oruç,Ahmet Tuncay Erdem,Harun Serpil
South East European Journal of Economics and Business. 2020; 15(2): 96
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90 Experiences of Family Caregivers After an Acute Neurological Event
Michelle K. Roberts,Kearsley A. Stewart,Nadia M. Tessore,Eduardo San Roman,Gabrielle Harris,Fernando D. Goldenberg,Janet Prvu Bettger
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91 Building capacity for community-based participatory research to address cancer disparities: Case report from a Community Networks Program Center
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92 The meaning of corporate social performance in seaports: the managers’ perspective
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93 What feedback do reviewers give when reviewing qualitative manuscripts? A focused mapping review and synthesis
Oliver Rudolf HERBER,Caroline BRADBURY-JONES,Susanna BÖLING,Sarah COMBES,Julian HIRT,Yvonne KOOP,Ragnhild NYHAGEN,Jessica D. VELDHUIZEN,Julie TAYLOR
BMC Medical Research Methodology. 2020; 20(1)
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94 Dimensions of Housing Insecurity for Older Women Living with a Low Income
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95 “Tell Me About Your Child”: A Grounded Theory Study of Mothersć Understanding of Language Disorder
Andrea C. Ash,Tyler T. Christopulos,Sean M. Redmond
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96 Role and implementation of sustainability management control tools: critical aspects in the Italian context
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97 Improving the quality of community primary palliative care in COPD: A qualitative study of health-care providers
Yoshihisa Hirakawa,Satoshi Hirahara,Yasuhiro Yamaguchi,Takashi Yamanaka,Hidenori Arai,Hisayuki Miura
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98 BIM Competencies for Delivering Waste-efficient Building Projects in a Circular Economy
Sikiru Abiodun Ganiyu,Lukumon Oyedele,Olugbenga Akinade,Hakeem Owolabi,Lukman Akanbi,Abdulqayum Gbadamosi
Developments in the Built Environment. 2020; : 100036
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Tadas Vadvilavicius,Aurelija Stelmokiene
Business: Theory and Practice. 2020; 21(2): 820
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100 Perceptions of music therapists regarding their work with children living under continuous war threat: Experiential reframing of trauma through songs
Moshe Bensimon
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101 Investigating police officersć perceptions of their role in pathways to mental healthcare
Molly Marsden,Jessica Nigam,Henna Lemetyinen,Dawn Edge
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102 Important components of a programme for children with medical complexity: An Australian perspective
Anita DćAprano,Susie Gibb,Suzi Riess,Monica Cooper,Nicki Mountford,Elaine Meehan
Child: Care, Health and Development. 2020; 46(1): 90
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103 Influencing factors for prevention of postpartum hemorrhage and early detection of childbearing women at risk in Northern Province of Rwanda: beneficiary and health worker perspectives
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104 ‘Keep Them on the Straight and Narrow’: Understanding, Selecting and Governing Subjects Through Intensive Supervision Units
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The British Journal of Criminology. 2020;
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105 Reading-Metacognitive Strategy Awareness and Use in Reciprocal Teaching Settings: Implementing a Computerized RMSA System
Elnaz Reshadi-Gajan,Nader Assadi,Hanieh Davatgari Asl
Journal of Educational Computing Research. 2020; 58(7): 1342
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106 ‘It is like learning how to live all over again’ A systematic review of people’s experiences of living with a chronic illness from a self-determination theory perspective
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Health Psychology and Behavioral Medicine. 2020; 8(1): 270
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107 A Qualitative Study of Precursors to Rape in Sexual Behaviour of Juvenile Offenders with Underage Partners in Malaysia
Taufik Mohammad,Intan Nooraini
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108 Rigor in PhD dissertation research
Petra Goodman,Rebecca C. Robert,Joyce E. Johnson
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109 Energy efficiency in Indonesia’s manufacturing industry: a perspective from Log Mean Divisia Index decomposition analysis
Dhani Setyawan
Sustainable Environment Research. 2020; 30(1)
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110 Patients’ Experiences of Diabetes Self-Management Education According to Health-Literacy Levels
Suhyun Kim,Yeoungsuk Song,Jihyun Park,Sonja Utz
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111 An Exploratory Study of Factors Influencing Chinese Outbound Medical Tourism
Kei Wei Chia,Yi Ming Liao
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112 Decolonizing Tactics as Collective Resilience: Identity Work of AAPI Communities on Reddit
Bryan Dosono,Bryan Semaan
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113 Multimodal expressive arts in school counselling: a strength-based intervention program for academic underachievers in secondary schools
Angela F.Y. Siu,Amy H.C. Chan
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114 Human Papillomavirus Immunization in Rural Primary Care
Rose Gunn,Laura K. Ferrara,Caitlin Dickinson,Isabel Stock,Jennifer Griffith-Weprin,Amy Wiser,Brigit Hatch,L.J. Fagnan,Patricia A. Carney,Melinda M. Davis
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115 “It brought hope and peace in my heart:” Caregivers perceptions on kangaroo mother care services in Malawi
Alinane Linda Nyondo-Mipando,Mai-Lei Woo Kinshella,Sangwani Salimu,Brandina Chiwaya,Felix Chikoti,Lusungu Chirambo,Ephrida Mwaungulu,Mwai Banda,Laura Newberry,Jenala Njirammadzi,Tamanda Hiwa,Marianne Vidler,Queen Dube,Elizabeth Molyneux,Joseph Mfutso-Bengo,David M. Goldfarb,Kondwani Kawaza
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116 Quality of life in paediatrics with intractable epilepsy in a large paediatric university hospital in Riyadh, Saudi Arabia
WaleedA Altwaijri,ButhainaJ Yahya,LamaB Alasmari,RofanN Alsultan,ShoqM Alsuhaibani,RawanM Alsemih,AfafK Moukaddem
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117 An examination of the level of local authority sustainable planning for event management: a case study of Ireland
Kelly Maguire
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118 How the ‘plates’ of a health system can shift, change and adjust during economic recessions: A qualitative interview study of public and private health providers in Brazil’s Săo Paulo and Maranhăo states
Giuliano Russo,Maria Luiza Levi,Maria Teresa Seabra Soares de Britto e Alves,Bruno Luciano Carneiro Alves de Oliveira,Ruth Helena de Souza Britto Ferreira de Carvalho,Lucas Salvador Andrietta,Jonathan Gonçalves Filippon,Mário César Scheffer,Jonathan Garcia
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119 Inequalities in older LGBT peoplećs health and care needs in the United Kingdom: a systematic scoping review
Dylan Kneale,Josie Henley,James Thomas,Robert French
Ageing and Society. 2019; : 1
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120 Overcoming Performance Slumps: Psychological Resilience in Expert Cricket Batsmen
Christopher J. Brown,Joanne Butt,Mustafa Sarkar
Journal of Applied Sport Psychology. 2019; : 1
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121 Comparison of rapid vs in-depth qualitative analytic methods from a process evaluation of academic detailing in the Veterans Health Administration
Randall C. Gale,Justina Wu,Taryn Erhardt,Mark Bounthavong,Caitlin M. Reardon,Laura J. Damschroder,Amanda M. Midboe
Implementation Science. 2019; 14(1)
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122 Autism and the right to education in the EU: policy mapping and scoping review of Nordic countries Denmark, Finland, and Sweden
Robin van Kessel,Sebastian Walsh,Amber N. V. Ruigrok,Rosemary Holt,Anneli Yliherva,Eija Kärnä,Irma Moilanen,Eva Hjörne,Shruti Taneja Johansson,Diana Schendel,Lennart Pedersen,Meta Jřrgensen,Carol Brayne,Simon Baron-Cohen,Andres Roman-Urrestarazu
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123 Why is reporting quality improvement so hard? A qualitative study in perioperative care
Emma Leanne Jones,Mary Dixon-Woods,Graham P Martin
BMJ Open. 2019; 9(7): e030269
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124 Defining modifiable barriers to uptake of dietary recommendations in Chinese immigrants with type 2 diabetes: a qualitative study
Feiyue Deng,Catherine B. Chan,Charles Couillard
FACETS. 2019; 4(1): 551
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125 A Qualitative Study to Understand the Potential Efficacy of an Information-Based Sugar Reduction Intervention among Low Socioeconomic Individuals in the UK
Hannah Forde,Emma Solomon-Moore
International Journal of Environmental Research and Public Health. 2019; 16(3): 413
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126 Representations of maladaptive daydreaming and the self: A qualitative analysis of drawings
Eli Somer,Liora Somer,Naomi Halpern
The Arts in Psychotherapy. 2019;
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127 A Qualitative Evaluation of the Implementation of an Intimate Partner Violence Education Program in Fracture Clinics
Sheila Sprague
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128 Advancing Student-Centric Education in Korea: Issues and Challenges
JeongA Yang,Charlene Tan
The Asia-Pacific Education Researcher. 2019;
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129 Delaying factors for maternal health service utilization in eastern Ethiopia: A qualitative exploratory study
Gezahegn Tesfaye,Catherine Chojenta,Roger Smith,Deborah Loxton
Women and Birth. 2019;
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130 Experience of care through patients, family members and health professionals in an intensive care unit: a qualitative descriptive study
Julian Rodriguez-Almagro,María Azucena Quero Palomino,Elena Aznar Sepulveda,María Del Mar Fernandez-Espartero Rodriguez-Barbe,Francisca Ortiz Fernandez,Virginia Soto Barrera,Antonio Hernandez-Martinez
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131 Comparing life satisfaction and functioning 15 years after September 11, 2001 among survivors with and without injuries: a mixed-method study
Lisa M. Gargano,Ho Ki Mok,Melanie H. Jacobson,Patricia Frazier,Sascha K. Garrey,Lysa J. Petrsoric,Robert M. Brackbill
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132 Nursing assistantsć perceptions of their role in the resident experience
Kathleen Abrahamson,Rebekah Fox,Aimee Roundtree,Kristen Farris
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133 Ineffectiveness of information and access to health services: vulnerability to human papillomavirus
M.C.M.P. Carvalho,A.B.A. Queiroz,M.A. Ferreira,M.A.V. Moura,C.B. Pinto,B.D.G. Vieira
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134 A fragile normality – illness experiences of working-age individuals with osteoarthritis in knees or hips
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