Sequential Mixed Methods Study Research Articles

Fathers’ perceived role, self-efficacy and support needs in promoting positive nutrition and physical activity in the first 2000 days of life: a mixed methods study

BackgroundThe first 2000 days of life are a crucial and opportunistic time to promote positive dietary and physical activity behaviours that can continue throughout life. The bulk of research on the impact of parents promoting positive dietary and physical activity behaviours has been on mothers, with the impact of fathers rarely investigated. The aim of this study is to investigate fathers’ perceived role, self-efficacy and support needs in promoting positive dietary and physical activity behaviours in early childhood.MethodsA sequential explanatory mixed methods study design consisted of a cross sectional survey of Australian fathers (n = 200) from a convenience sample, followed by semi-structured qualitative interviews (n = 21) with a purposeful sample of Australian fathers.ResultsQuantitative survey data revealed that more than 90.0% of fathers agreed that it is important to role model healthy eating and participating in physical activity with their babies, toddlers and children. A majority of fathers were confident in getting their child to eat fruit/ vegetables (90%) and playing with their child (80%). When searching for information about nutrition and physical activity, the highest proportion of fathers nominated online sources (52%) as their preferred source in survey data. Qualitative interview data revealed that while fathers exhibited high self-efficacy in their abilities, this was susceptible to deterioration due to feelings of isolation, pressures of fatherhood, a lack of information and resources that are father specific, and difficulties navigating the different types of information/resources to find what is right for them.ConclusionsAlthough possessing self-efficacy, being committed and seeking knowledge, many fathers found that useful information was hard to find and understand. Appropriate resources are therefore required to support the specific needs of fathers to promote positive dietary and physical activity behaviours in their infants and young children.

"I am not the same as before": a mixed-methods study on depression in people with spinal injury in Qatar.

The objectives of the study were to determine depression prevalence; identify relationships between depression and cause and site of spinal injury, sociodemographic factors, and social support; and explore the lived experiences of depression in people with spinal injury in Qatar. A sequential cross-sectional mixed methods study was conducted. In the quantitative component, the universal sample consisted of 106 consenting individuals presenting with spinal injury at Hamad General Hospital, Doha, Qatar between January and December 2020. The Patient Health Questionnaire-9 was used to assess levels of depression and the Medical Outcomes Study Social Support Survey was used to assess perceived social support. The cause and site of injury were obtained from patient records. In the qualitative component, semi-structured in-depth interviews were conducted with 12 purposively selected participants from the quantitative component. Spinal injury had a negative impact on participants physical, mental, social, and spiritual wellbeing. In total, 69% of participants had some level of depression: 28% mild, 25.5% minimal, and 15% moderate to severe. Depression was not associated with socio-demographic factors, or the cause or site of spinal injury. Higher levels of emotional/informational support and positive social interaction were associated with milder depression. Social support and religious faith were critical in assisting participants to cope with their new situation. Depression is prevalent among people with spinal injury attending health services. Early detection, referral, and treatment of depression are recommended. Strategies to enhance emotional/informational support and positive social interaction should be developed and tested with people with spinal injury.

The role of spirituality in pain experiences among adults with cancer: an explanatory sequential mixed methods study.

Foundational research demonstrates that spirituality may affect the way people with cancer experience pain. One potential route is through alterations in thoughts and beliefs, such as pain-related catastrophizing. The purpose of this study is to understand whether spirituality impacts pain experiences through pain-related catastrophizing. This explanatory sequential mixed methods study was informed by an adapted Theory of Unpleasant Symptoms. Data were collected via online surveys (N = 79) and follow-up qualitative interviews (N = 25). Phase 1 employed Empirical Bayesian analysis. Phase 2 used deductive content analysis. Phase 3 involved creating a mixed methods joint display to integrate findings and draw meta inferences. Results indicate that total spiritual well-being was directly negatively associated with pain-related catastrophizing, and indirectly negatively associated with the outcomes of pain interference, pain severity, and pain-related distress. Qualitative categories highlight the supportive role of spirituality when facing pain, while also shedding light on the limitations of spirituality in the context of some pain (i.e., severe, neuropathic, and/or chronic). Mixed methods findings reveal the importance of spirituality for some people as they face cancer and cancer-related pain, as well as the need for integrating spirituality as part of a larger pain management plan. This research advances supportive cancer care by exploring the complex role of spirituality in pain experiences. Findings will inform further exploration into the role of spirituality in supporting holistic symptom management in the context of cancer, as well as developing and testing interventions to enhance spirituality and address symptom-related suffering.

Technology-Enabled Collaborative Care for Type-2 Diabetes and Mental Health (TECC-D): Findings From a Mixed Methods Feasibility Trial of a Responsive Co-Designed Virtual Health Coaching Intervention.

Type-2 diabetes (T2D) is a complex chronic condition associated with a lower quality of life due to disease specific distress. While there is growing support for personalized diabetes programs, care for mental health challenges is often fragmented and limited by access to psychiatry, and integration of care. The use of communication technology to improve team based collaborative care to bridge these gaps is promising but untested. We conducted an explanatory sequential mixed methods study to assess the feasibility and acceptability of the co-designed Technology-Enabled Collaborative Care for Diabetes and Mental Health (TECC-D) program. Participants included adults aged ≥18 years who had a clinical diagnosis of T2D, and self-reported mental health concerns. 31 participants completed the 8-week virtual TECC-D program. Findings indicate that the program is feasible and acceptable and indicate that there is a role for virtual diabetes and mental health care. The TECC-D program, designed through an iterative co-design process and supported by innovative, responsive adaptations led to good uptake and satisfaction. The TECC-D model is a feasible and scalable care solution that empowers individuals living with T2D and mental health concerns to take an active role in their care.

Does language teachers’ intercultural competence influence oral participation in EFL classrooms?: unveiling learner perspectives through a mixed methods inquiry

ABSTRACT The present two-phased sequential explanatory mixed methods study investigates the potential association between foreign language teachers’ (FLTs) intercultural competence and Japanese students’ oral participation through the perspectives of students. In Study 1, a survey questionnaire was administered to second-year advanced-level students at two Japanese universities (N = 115). The participants were asked about their learning styles and FLTs’ teaching practices that promoted and hindered their oral participation based on their prior language learning experiences. The results confirmed the associations between FLTs’ host language proficiency, host cultural understanding, and students’ oral participation. In Study 2, qualitative data were obtained from 21 students to explain and build upon the quantitative results. The findings showed that demonstrating intercultural competence by emphasizing group work, showing tolerance for silence, and using Japanese gestures, personal anecdotes, and stories from Japanese culture could create avenues to students’ own worlds and give them psychological safety to express themselves. The study concludes that FLTs’ intercultural competence needs to be further emphasized in teacher training manuals and school curricula in Japanese EFL settings.

Preservice teachers’ cultural competence factors in teacher preparation programs: an explanatory sequential mixed methods study

ABSTRACT Cultural competence is a framework that develops preservice teachers’ self-awareness to confront their attitudes, beliefs, biases, and values, to learn and understand culturally diverse groups’ needs, and to translate such knowledge into culturally responsive professional practices and skills. Previous studies investigating teacher preparation programmes through the lens of cultural competence examined its application in early childhood and elementary undergraduate programmes, in an ESOL course, in a study abroad programme, and in a literacy method course. However, questions were left unanswered concerning the factors affecting preservice teachers’ perceptions of being culturally competent to teach culturally and linguistically diverse (CLD) students. The purpose of this study is to examine the factors that affect preservice teachers’ cultural competence development to teach CLD students using an explanatory sequential mixed-method design. The goal is to provide a holistic understanding of preservice teachers’ experiences with cultural competence in their teacher preparation programmes by integrating quantitative and qualitative data. The findings from this study highlight the need to implement intentional efforts to prepare preservice teachers to attend to the increasing demand for offering high-quality education to CLD students.

The indignities of shielding during the COVID-19 pandemic for people with sickle cell disorders: an interpretative phenomenological analysis.

This article seeks to understand the first-hand experiences of people with sickle cell, a recessively inherited blood disorder, who were identified as clinically extremely vulnerable during the COVID-19 pandemic. Part of a larger sequential mixed-methods study, this article uses a selective sample of eight qualitative semi-structured interviews, which were analysed using interpretative phenomenological analysis (IPA). The first stage of IPA focused on practical concerns participants had correlated to understanding shielding and their feelings about being identified as clinically extremely vulnerable. In a secondary stage of analysis, we examined the emotions that it brought forth and the foundations of those based on discriminations. This article adds to our theoretical understanding of embodiment and temporality with respect to chronicity and early ageing. It explains how people with sickle cell disorders have an embodied ethics of crisis and expertise. It also elucidates how people's experiences during the pandemic cannot be seen in void but illustrates ableism, racism, and ageism in society writ large.

Exploring workplace mental health: educator perspectives and factors in the medical education system – a mixed method study

IntroductionThe present study aimed to assess the status of workplace mental health from the viewpoints of educators, and explore their experiences concerning influential factors on occupational mental health at Shahid Sadoughi University of Medical Sciences.MethodsThe study was a sequential mixed-method study that was conducted in quantitative and qualitative phases. In the quantitative phase, the perception of educators (n = 205) was assessed by a Workplace Mental Health Questionnaire, including 37 items in 9 categories (including an opportunity to control, an opportunity to use skills, external goals created, environmental diversity, environmental clarity, access to money, physical security, opportunity to contact others, and valuable social status and position). In the qualitative phase, data were collected using semi-structured interviews (n = 21) and were analyzed based on the conventional content analysis approach.ResultsThe results showed that the status of workplace mental health of educators was at a moderate level (mean (± SD) = 115.87 (±3.21). The highest and lowest scores of the median were reported in the domains of “opportunity for control” (median = 4) and “opportunity to contact others” (median = 2.75), respectively. The theme of “contrast between preferences and disappointments in the development path” with two categories including “induced demotivation of system elements” and “tendencies of promotion” was explored from the educators’ perspective.ConclusionThe results indicated the moderate level of mental health of educators was influenced by the contrast between preferences and disappointments in the development path. The tendency of educators for promotion was explored as a positive factor in the mental health of educators in the academic environment. A growing desire for creative advancement among educators as a personal factor and a demand to stay updated with all developments as a system factor explained the positive experiences of educators in the university. The results showed the gap between the current situation and the desired state of occupational mental health may result from cultural challenges, lack of adherence to professionalism at the personal level (non-compliance with the principles of well-being and excellence), and interpersonal level (non-compliance with respect, justice, etc.). Moreover, factors disrupting occupational mental health at the system level explored in job stress, a resilient culture, lack of managerial support, ingratitude, lack of reward-effort matching mechanism, and lack of resources.

Biology lecturers’ perceptions of genetics literacy in Indonesia: an explanatory sequential mixed methods study

ABSTRACT Given its impact on medicine, agriculture, and society, genetics literacy has attracted international interest. Biology lecturers play a crucial role in supporting students’ genetics literacy empowerment. However, research into biology lecturers’ perceptions of genetics literacy still needs to be undertaken. This study aimed to explore the understanding, perception, and awareness of genetics literacy among Indonesian biology lecturers. We performed an explanatory sequential mixed method study in two phases: online survey and semi-structured interviews. Results showed that (a) most biology lecturers agreed that genetics literacy was correlated with scientific literacy, information and communication technology literacy, reading literacy, and numerical literacy, and then genetics literacy is understood as consisting of genetics concepts and skills; (b) most biology lecturers agreed that argumentation, informal reasoning, and decision-making skills were appropriate for enhancing genetics literacy development; (c) despite less than half of the biology lecturers teaching skills related to genetics literacy and only a fourth assessing skills related to genetics literacy, most biology lecturers were willing to teach and assess skills related to genetics literacy comprehensively. The findings revealed that biology lecturers’ perceptions of genetics literacy must be explored, given their critical role in ensuring effective and successful genetics educational practice.

Assessing Acceptability: The Role of Understanding Participant, Neighborhood, and Community Contextual Factors in Designing a Community-Tailored Cooking Intervention.

Cooking is an identified dietary strategy that is positively associated with optimal diet quality. Prior to initiating cooking interventions, evaluating the prospective acceptability of the intervention among community members living within low food access areas and understanding geospatial food shopping locations may aid in designing community-tailored interventions. A sequential mixed methods study was conducted to determine the prospective acceptability of a planned community-located cooking intervention among African American adults living in a low food access area and with at least one cardiovascular disease risk factor. A semi-structured guide was used to conduct five virtual focus groups. Qualitative data were analyzed using thematic analysis and validated through participant check-in interviews. Survey responses were analyzed based on descriptive data. Geospatial analysis of participant locations that were reported for food shopping was conducted to show food environment utilization. Focus groups with study participants (n = 20, all female, mean age 60.3, SD 9.3, mean cooking frequency per week 4.0, food insecure n = 7) were conducted between March and April, 2021. Thematic analysis of the focus group transcripts identified five main themes as follows: (A) Barriers to Cooking (family and caregiving, transportation, COVID-19 pandemic, time availability, household composition); (B) Motivators for Cooking (family, caregiving, health, enjoyment, COVID-19 pandemic); (C) Strategies (food shopping, social support, social media, meal planning); (D) Neighborhood (gentrification, perceived safety, stigmatization, disparities in grocery stores); (E) and Acceptability of the Intervention (reasons to participate, barriers, recruitment, intervention delivery). Participant validation interviews confirmed the themes and subthemes as well as the illustrative quotes. Geospatial analysis showed a majority of locations were outside of the participants' residential areas. Prospective acceptability of a community-tailored cooking intervention found that the planned intervention could be modified to address individual level factors, such as caregiving and health, community contextual factors, such as perceived safety, and the general health needs of the community.

Understanding “patient deterioration” in psychotherapy from depressed patients’ perspectives: A mixed methods multiple case study

Objective: This study scrutinizes the meaning of deterioration in psychotherapy beyond the widely used statistical definition of reliable symptom increase pre-to-post treatment. Method: An explanatory sequential mixed-methods multiple case study was conducted, combining quantitative pre–post outcome evaluation of self-reported depression symptoms and qualitative analysis of patients’ interviews. In a Randomized Controlled Study on the treatment of Major Depression, three patients showing reliable increase in symptom severity on the BDI-II pre-to-post therapy were selected. An interpretative phenomenological analysis (IPA) was performed on individual interviews conducted pre-, peri- and post-treatment. Results: Cross-case outcome experiences were: (1) uncontrollable complaints; (2) remaining questions and uninternalized insights and (3) persisting interpersonal difficulties. Within-case idiosyncratic differences revealed that the statistical classification of “deterioration” not necessarily corresponds to a “deteriorated experience,” nor univocally indicates unwanted therapy effects. Our findings point at the influences of the patient’s (lack of) agency in the process, a discrepancy between patients’ expectations and the therapy offer, the therapeutic relationship, interpersonal difficulties, and contextual influences. Conclusion: The meaning of symptomatic deterioration should be interpreted within a patient’s idiosyncratic context. The multi-faceted nature of deterioration requires further research to rely on multiple perspectives and mixed methods.

Use of herbal medicine during pregnancy and associated factors among pregnant women with access to public healthcare in west Shewa zone, Central Ethiopia: sequential mixed-method study

ObjectiveThis study was aimed at assessing the prevalence of herbal drug use among pregnant women with access to modern medicine and associated factors in public health facilities in the west...

Acceptability to donate human milk among postnatal mothers at St. Francis hospital Nsambya, Uganda: a mixed method study

BackgroundThe World Health Organization recommends the use of donated human milk (HM) as the second-best option for mothers who are temporarily unable to provide sufficient breast milk to meet the needs of their infants. However, HM donation is yet to become an accepted practice in Uganda. We assessed the level of, and factors associated with acceptability to donate HM among postnatal mothers at St. Francis Hospital Nsambya (SFHN).MethodsA cross-sectional sequential explanatory mixed method study was conducted between October 2018 and March 2019. A questionnaire on sociodemography, awareness and likely acceptability to donate HM was administered to 410 postnatal mothers at SFHN. Multivariate logistic regression analysis was undertaken to determine factors associated with acceptance of HM donation. Focus Group Discussions (4) and Key Informants Interviews (4) were used to explore factors influencing behaviours to donate human milk. Qualitative data were analysed using a content thematic approach.ResultsOverall acceptance of donating the HM was 77.6%, and the significant factors were: willingness to express the HM (AOR 7.5; 95% CI 3.01, 18.68); wet-nursing knowledge (AOR 2.3; 95% CI 1.1, 5.0) and visit to under-5 years’ clinic (AOR 21.3; 95% CI 2.3, 196.9). The major themes in relation to accepting to donate HM were wet nursing experience, and confidence in donating the HM, and its perceived effectiveness. There were concerns about the safety and adequacy of HM and fear of transmitting criminal behaviours and mental illness through human milk.ConclusionsAcceptance to donate HM among postnatal mothers at St. Francis Hospital Nsambya was very high. Willingness to express and store human milk, prior knowledge about wet nursing and a visit to an under-five outpatient clinic were associated with acceptance. Thus, establishing a human milk bank is feasible in the study setting.

Development and psychometric properties evaluation of nurses’ innovative behaviours inventory in Iran: protocol for a sequential exploratory mixed-method study

IntroductionNurses’ innovative behaviours play a crucial role in addressing the challenges including adapting to emerging technologies, resource limitations and social realities such as population ageing that are intricately tied to...

Exploring the effect of EFL students’ self-made digital stories on their vocabulary learning

In spite of the growing interest in digital storytelling (DST) in the English as a foreign language (EFL) context, there is a lacuna in research on the role it plays in learning vocabulary. This sequential explanatory mixed-methods study explored the potential of collaborative learner-generated digital stories (DSs) for vocabulary knowledge development and students’ attitudes towards DST-based vocabulary learning experiences. The primary data sources included pre/post-treatment vocabulary tests, collective reflection journals, weblog comments, and interviews. Two experimental groups of undergraduate EFL students were engaged in collaborative DST projects and their vocabulary test scores were compared with those of students in two control groups. The quantitative data were analyzed using independent and paired samples t-tests. Constant comparative method was employed to analyze the qualitative data. As the results showed, the students that were involved in learning the new words through collaborative DSs in the experimental groups outperformed the students in the control groups. The findings further demonstrated that DST empowers the students to integrate vocabulary learning into immediate daily contexts, experience peer-promoted vocabulary learning, contextualize vocabulary in multimodal stories, personalize the vocabulary knowledge development process, and enhance cognitive-affective engagement with stories to learn new words. The students also stated that DST is not a stand-alone pedagogical approach and recommended using animated, game-based, immersive, synchronous, social media-based, and micro DSs to facilitate vocabulary learning. The study promises implications for technology-assisted vocabulary instruction.

The Patients' Presupposed Distrust to Doctors in China: An Explanatory Sequential Mixed Methods Study.

The aim of this study was to investigate the current status of patients' presupposed distrust, and to clarify the causes of high presupposed distrust. An explanatory sequential mixed methods study was conducted using a two-stage design. The first phase was a quantitative cross-sectional survey, a total of 384 patients by convenience sampling completed the survey. Study instruments including demographic and clinical characteristics sheet, patients' presupposed distrust scale. In the qualitative phase, 16 patients on the basis of their mean score for all PPDS items were higher than 4 were identified as extreme cases participated in one-to-one semi-structured interviews. The total item mean score for all patients on PPDS was 3.59(3.18, 4.09), which above the median range of the PPDS (item mean score of 3). Personal income level and educational level were significant predictive influencing factors of patients' presupposed distrust, which could explain 17.347% of the variance. The reasons of high patients' presupposed distrust were as follows: moral character, health knowledge, patient perceptions, and the social circumstance. The level of patients' presupposed distrust was high, which needs to be further decreased. Demographic and clinical variables (personal income level, educational level) are identified to be the major contributing factors. The main causes for the formation of the high patients' presupposed distrust are patients internal factors and social circumstance.

User Requirements in Developing a Novel Dietary Assessment Tool for Children: Mixed Methods Study.

The prevalence of childhood obesity and comorbidities is rising alarmingly, and diet is an important modifiable determinant. Numerous dietary interventions in children have been developed to reduce childhood obesity and overweight rates, but their long-term effects are unsatisfactory. Stakeholders call for more personalized approaches, which require detailed dietary intake data. In the case of primary school children, caregivers are key to providing such dietary information. However, as school-aged children are not under the full supervision of one specific caregiver anymore, data are likely to be biased. Recent technological advancements provide opportunities for the role of children themselves, which would serve the overall quality of the obtained dietary data. This study aims to conduct a child-centered exploratory sequential mixed methods study to identify user requirements for a dietary assessment tool for children aged 5 to 6 years. Formative, nonsystematic narrative literature research was undertaken to delineate initial user requirements and inform prototype ideation in an expert panel workshop (n=11). This yielded 3 prototype dietary assessment tools: FoodBear (tangible piggy bank), myBear (smartphone or tablet app), and FoodCam (physical camera). All 3 prototypes were tested for usability by means of a usability task (video analyses) and user experience (This or That method) among 14 Dutch children aged 5 to 6 years (n=8, 57% boys and n=6, 43% girls). Most children were able to complete FoodBear's (11/14, 79%), myBear's (10/14, 71%), and FoodCam's (9/14, 64%) usability tasks, but all children required assistance (14/14, 100%) and most of the children encountered usability problems (13/14, 93%). Usability issues were related to food group categorization and recognition, frustrations owing to unsatisfactory functioning of (parts) of the prototypes, recall of food products, and the distinction between eating moments. No short-term differences in product preference between the 3 prototypes were observed, but autonomy, challenge, gaming elements, being tablet based, appearance, social elements, and time frame were identified as determinants of liking the product. Our results suggest that children can play a complementary role in dietary data collection to enhance the data collected by their parents. Incorporation of a training program, auditory or visual prompts, reminders and feedback, a user-friendly and intuitive interaction design, child-friendly food groups or icons, and room for children's autonomy were identified as requirements for the future development of a novel and usable dietary assessment tool for children aged 5 to 6 years. Our findings can serve as valuable guidance for ongoing innovations in the field of children's dietary assessment and the provision of personalized dietary support.

Improving Athletic Trainers' Knowledge of Clinical Documentation through Novel Educational Interventions: A Randomized Controlled Trial.

Athletic trainers (ATs) have reported the need for more educational resources about clinical documentation. To investigate the effectiveness of passive and active educational interventions to improve practicing ATs' clinical documentation knowledge. Randomized control trial, sequential explanatory mixed methods study. Online module(s), knowledge assessment and interviews. We emailed 18,981 practicing ATs across employment settings, of which 524 ATs were enrolled into a group [personalized learning pathway (PLP=178), passive reading list (PAS=176), control (CON=170)] then took the knowledge assessment. There were 364 ATs who did not complete the intervention and/or post-knowledge assessment; therefore, complete responses from 160 ATs (PLP=39, PAS=44, CON=77; age=36.6±11.2y, years certified=13.9±10.7y) were analyzed. Knowledge assessment (34 items) and interview guides (12-13 items) were developed, validated, and piloted with ATs prior to study commencement. We summed correct responses (1 point each, 34 points maximum) and calculated percentages and pre- and post-knowledge mean change scores. Differences among groups (PLP, PAS, CON) and time (pre- intervention, post-intervention) were calculated using a 3X2 repeated-measures ANOVA (P≤.05) with post hoc Tukey HSD. Semi-structured interviews were conducted (PLP=15, PAS=14), recorded, transcribed, and analyzed following the consensual qualitative research tradition. No differences in the pre-knowledge assessment were observed between-groups. We observed a group x time interaction (F2,157 = 15.30, P<.001; partial eta-squared=0.16). The PLP exhibited greater mean change (M=3.0±2.7) than PAS (M=1.7±3.0, P=.049) and CON (M=0.4±2.2, P<.001). Descriptively, ATs scored lowest on legal (61.3%±2.1%), value of the AT (63.7%±4.3%), and health information technology (65.3%±3.7%) items. Whereas ATs described being confident in their documentation knowledge, they also identified key content (eg, legal considerations, strategies) they deemed valuable. The educational interventions improved ATs' knowledge of clinical documentation and provided valuable resources for their clinical practice; however, targeted continuing education is needed to address knowledge gaps.

Effective English teachers in online EFL learning: A post-pandemic reflection on students’ perspectives

In the framework of conventional academic settings, there have been a large number of studies on the qualities of effective teachers; however, studies in the context of online environments seem to be scarcely documented in the literature. This explanatory sequential mixed-method study of 224 secondary school students, 21 of whom were interviewed in detail, examined their perspectives on effective teacher characteristics in online EFL instruction. This study differed from earlier investigations of the qualities of effective teachers in terms of its research site and inquiry emphasis. The results of the surveys and interviews provided students’ judgments of effective teacher traits in terms of roles, professional abilities, personal qualities, and pedagogical expertise. According to the results of the polls, the most significant criteria for effective online learning management were instructors’ classroom management roles and their professional skills. The interviews stressed the importance of teachers’ qualities in managing classrooms and their pedagogical knowledge. In an online EFL instruction, students needed their teachers to scaffold them and explain what they should do with the lesson and the procedures they should follow for activities and assignments. In addition, the interviews validated teachers’ capacity to establish a favorable rapport with the students to facilitate their meaningful learning. As this study identified teachers’ professional abilities in managing online learning as a requirement, an online-learning-based professional development program for teachers is highly recommended as the most plausible alternative for the post-pandemic reflection of this current study.

Development and psychometric evaluation of nurse’s intention to care for patients with infectious disease scale: an exploratory sequential mixed method study

AimsNurses who care for patients with infectious disease may experince significant stress and negative psychological reactions. The intention of nurses to care is a complex and multifaceted concept that is influenced by a range of factors. Therefore, this study was conducted to explain the concept of nurses’ intention to care for patients with infectious disease and then develop a reliable and valid scale to measure this concept accurately in Iranian nurses.DesignThis study is a cross-sectional study with a sequential-exploratory mixed-method approach from May 2022 to July 2023. The concept of nurses’ intent to care for patients with infectious disease was explain using deductive content analysis, and item pools were generated. In the sconed step the samples were 455 nurses. Data was collected by an online form questionnaire using a convenience sampling technique. In this step to determine the psychometric properties of nurse’s intention to care for patients with infectious disease scale (NICPS), face and content validity performed. Then construct validity was determined and confirmed using exploratory and confirmatory factor analysis followed by convergent and divergent validity respectively. Finally, scale reliability including stability and internal consistency were evaluated.ResultsThe finding showed that NICPS with seventeen items were classified into three factors namely “Social support” with seven items, “Spiritual motivation” with six items and “Job satisfaction” with four items. These three factors explained 56.14% of the total variance. The fit indices showed that the model has a fit and acceptable (TLI, CFI, IFI > 0.9; PNFI, PCFI > 0.5, REMSEA > 0.049, CMIN/DF = 2.477). Reliability revealed acceptable internal consistency and stability (> 0.7).ConclusionThe finding showed that NICPS has three factors in Iranian nurses. Nursing managers can use these results to provide training and support intervention for nurses in order to increase their intention to care for this patient. Also, the NICPS is a reliable and valid for evaluating this concept in future studies.