2021年中国基层卫生和全科医学研究方法学质量评价报告:定性研究和混合方法研究部分

Report on Methodological Quality Assessment of Primary Care and General Practice Research in China in 2021:Qualitative and Mixed Methods Research Section

背景全科医学具有显著的跨学科领域特征,定性研究和混合方法研究均适用于该领域的科研工作,近年来我国基层卫生和全科医学相关学术论文发表数量稳步增长,但整体文献质量尚未经过系统评估。目的探明我国基层卫生与全科医学领域发表的定性研究和混合方法研究的方法学质量。方法于2022年8月—2023年4月,由4名研究人员采用质量评估项目(CASP)中的定性研究评价工具和混合方法研究评价工具(MMAT)分别对我国2021年全科医学与基层卫生领域发表的定性研究和混合方法研究进行分析和方法学质量评价。研究人员两两分组,独立进行信息提取和方法学质量评价。结果共纳入35篇定性研究文献及9篇混合方法研究文献。定性研究的主要问题包括:65.71%(23/35)的研究未充分考虑伦理学问题;94.29%(33/35)的研究未讨论招募参与者的问题;82.86%(29/35)的研究未充分考虑研究者和参与者之间的关系;42.86%(15/35)的研究样本量<20人,且25.71%(9/35)的研究未讨论资料饱和问题。混合方法研究的主要问题包括:8/9的研究未明确报告混合方法研究设计类型,且8/9的研究未能有效整合研究的不同组成部分以共同回答研究问题。结论我国2021年发表的基层卫生及全科医学领域的定性研究和混合方法研究的方法学质量仍存在部分限制,尤其是在定性研究的伦理性、可靠性及信息饱和程度等方面和混合方法研究的整合方面受限严重,应进一步加强科研方法学的培训,并严格遵循科研设计和报告规范,以改善科研工作和所得证据的质量。

Background General practice has significant interdisciplinary characteristics,both qualitative research and mixed methods research are applicable to scientific research in this field.In recent years,there has been a steady increase in the number of relevant academic papers published in China,but the overall quality of the literature has not been systematically assessed.Objective To explore the methodological quality of qualitative and mixed methods research literature published in the field of primary care and general practice.Methods From August 2022 to April 2023,four investigators analyzed and assessed the methodological quality of qualitative and mixed methods research published in the field of primary care and general practice in China in 2021 using the qualitative assessment tools of Critical Appraisal Skills Programme(CASP)and Mixed Methods Appraisal Tool(MMAT),respectively.The researchers were grouped in pairs and independently for information extraction and quality evaluation.Results A total of 35 qualitative research and 9 mixed methods research were included.Among the qualitative research,23 literature(65.71%)did not sufficiently considered ethical issues;recruitment of participants was not discussed in 94.29%(33/35)of the research;the relationship between the researcher and the participants was not adequately considered in 82.86%(29/35)of the research;42.86%(15/35)of the research had a sample size of<20 participants and data saturation was not discussed in 25.71%(9/35)of the research.Major problems with mixed methods research included the fact that:8/9 of the research did not explicitly report the type of mixed methods research design and 8/9 of the research failed to effectively integrate the different components of the study to answer the research question.Conclusion The methodological quality of such qualitative and mixed methods research in primary care and general practice published in 2021 in China is still partially limited,especially in the ethics,reliability and information saturation among qualitative research,and the integration among mixed methods research,which should be further strengthened by training in research methodology and strict adherence to research design and reporting statements in order to improve the quality of research and even evidence for decision making.