从单独的流向到交汇:一个框架,有意义的混合方法集成在非洲初级保健研究中的框架

Robin E Dyers1, Kéfilath Bello, Timothy C Guetterman

  • 1Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; WHO-FIC Collaborating Centre, Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; and Department of Health and Wellness, Western Cape Government, Cape Town. rdyers@sun.ac.za.

混合方法研究在非洲初级卫生保健研究中日益普遍,然而系统综述显示,大多数混合方法研究在整合定性与定量成分方面存在方法学严谨性不足的问题。这种整合失败削弱了应对非洲初级卫生保健系统所面临复杂健康挑战的能力,而这些挑战——包括医学多元性、资源限制以及多样的疾病负担——正需要复杂的方法学综合。本文提出一个在非洲初级卫生保健研究背景下实现有意义混合方法整合的框架,旨在应对关键挑战,并提供实现转化性综合的实用策略。该框架基于近期方法学进展,包括混合方法整合质量框架、对非洲混合方法研究的系统综述以及初级卫生保健研究中的典型案例,将理论基础与资源受限环境中的实际应用相结合。该框架涵盖:整合决策的时间安排考量;整合接口点的识别;包括联合展示和数据转换在内的实用策略;团队协作的综合方法;以及对常见整合陷阱的解决方案。该框架回应了非洲研究背景下的认识论张力、制度性障碍和资源限制问题。通过推动研究者从分离的方法学路径走向真正的汇流,该框架有助于生成超越单一方法学贡献的转化性洞见。在保持方法学严谨性的同时应对特定情境的挑战,支持产生加强非洲卫生系统所必需的细致理解。该框架针对非洲初级卫生保健研究中的整合难题,为博士研究生和资深研究者在资源受限环境中探索复杂健康现象提供了实用工具。 关键词:混合方法研究,初级卫生保健,非洲,方法学整合,数据综合,联合展示,资源受限环境,转化性综合

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