From the article : "In this paper the implications of different research approaches and methods are illustrated by using two projects of the authors. Both projects take place in the same context: exploring participatory innovation within Small-to-Medium sized Enterprizes (SMEs). The main aspects coming forward when comparing the research characteristics of both projects are the importance of time and momentum, the structural set up of the project, people or participants and the abilities of the people involved. The research goal and the background of the researcher are main determinants for the chosen research methods. We hope with this paper to make researchers aware of the implications of the research methods and approach on the results of the project."
Aim: To evaluate healthcare professionals' performance and treatment fidelity in the Cardiac Care Bridge (CCB) nurse-coordinated transitional care intervention in older cardiac patients to understand and interpret the study results. Design: A mixed-methods process evaluation based on the Medical Research Council Process Evaluation framework. Methods: Quantitative data on intervention key elements were collected from 153 logbooks of all intervention patients. Qualitative data were collected using semi-structured interviews with 19 CCB professionals (cardiac nurses, community nurses and primary care physical therapists), from June 2017 until October 2018. Qualitative data-analysis is based on thematic analysis and integrated with quantitative key element outcomes. The analysis was blinded to trial outcomes. Fidelity was defined as the level of intervention adherence. Results: The overall intervention fidelity was 67%, ranging from severely low fidelity in the consultation of in-hospital geriatric teams (17%) to maximum fidelity in the comprehensive geriatric assessment (100%). Main themes of influence in the intervention performance that emerged from the interviews are interdisciplinary collaboration, organizational preconditions, confidence in the programme, time management and patient characteristics. In addition to practical issues, the patient's frailty status and limited motivation were barriers to the intervention. Conclusion: Although involved healthcare professionals expressed their confidence in the intervention, the fidelity rate was suboptimal. This could have influenced the non-significant effect of the CCB intervention on the primary composite outcome of readmission and mortality 6 months after randomization. Feasibility of intervention key elements should be reconsidered in relation to experienced barriers and the population. Impact: In addition to insight in effectiveness, insight in intervention fidelity and performance is necessary to understand the mechanism of impact. This study demonstrates that the suboptimal fidelity was subject to a complex interplay of organizational, professionals' and patients' issues. The results support intervention redesign and inform future development of transitional care interventions in older cardiac patients.
Little is known about the effects of different instructional approaches on learner affect in oral interaction in the foreign language classroom. In a randomized experiment with Dutch pre-vocational learners (N = 147), we evaluated the effects of 3 newly developed instructional programs for English as a foreign language (EFL). These programs differed in instructional focus (form-focused vs. interaction strategies- oriented) and type of task (pre-scripted language tasks vs. information gap tasks). Multilevel analyses revealed that learners’ enjoyment of EFL oral interaction was not affected by instruction, that willingness to communicate (WTC) decreased over time, and that self-confidence was positively affected by combining information gap tasks with interactional strategies instruction. In addition, regression analyses revealed that development in learners’ WTC and enjoyment did not have predictive value for achievement in EFL oral interaction, but that development in self-confidence did explain achievement in EFL oral interaction in trained interactional contexts.
