基于深度访谈法初步研究中医临床实施方案优化.pdf

  本文关键词：基于深度访谈法初步研究中医临床实施方案优化，，由笔耕文化传播整理发布。

淘豆网网友你是我的全部近日为您收集整理了关于基于深度访谈法初步研究中医临床实施方案优化的文档，希望对您的工作和学习有所帮助。以下是文档介绍：密级:分类号:.I三0 5 b‘d单位代码:84502学号:845022005021256中国中医科学院2005级硕士研究生学位论文基于深度访谈法初步研究中医临床实施方案优化申请人:廖星专业:中医内科研究方向:中医临床评价方法学导师:谢雁鸣研究员中国中医科学院西苑医院2008年5月北京关于学位论文使用授权的声明本人完全知道中国中医科学院有关保留使用学位论文的规定,同意学校保留或向国家有关部门机构送交论文的复印件和电子版,容许被查阅和借阅。本人授权中国中医科学院可以将本学位论文的全部或部分内容编入有关数据库进行检索,可以采用影印、缩印或其他复印手段保存和汇编本学位论文。(保密论文在解密后应遵守此规定)论文作者签名廛塾. 日期趔:』:塑l——1.6定性研究的基本方法………………………………………………………………………13 1.7定性研究的证据等级评判…………………………………………………………………14 2深度访谈法………………………。 15 2.1访谈法的来源和定义………………………………………………………………………15 2.2访谈法的类型………………………………………………………………………………15 2.3深度访谈的研究步骤………………………………………………………………………16 2.4深度访谈者的具体要求……………………………………………………………………18 2.5深度访谈资料的整理和分析………………………………………………………………19 2.6深度访谈的信度、效度和推广度问题……………………………………………………。19 2.7深度访谈研究中伦理的探讨………………………………………………………………21 2.8深度访谈中质最控制………………………………………………………………………22 2.9深度访谈的评价……………………………………………………………………………23 2.10深度访谈法在中医临床研究领域中应用的探讨…………………………………………25 3扎根理论(GROUNDED THEORY,GTM)……………………………………………………………27 3.1扎根理论的来源和定义……………………………………………………………………..27 3.2扎根理论的思路……………………………………………………………………………27 3.3扎根理论操作程序…………………………………………………………………………29 3.4扎根理论中的核心技术……………………………………………………………………32 3.5备忘录(memos)的撰写和概念图的编制(ptmapping)……………………………….33 3.6扎根理论方法的流程图……………………………………………………………………34第二部分范例研究………………………………………………………………………………….39I前言…………………。…………………………:19 2研究设计……………………………………………………………………………………………….39基于深度访谈法初步研究中医临床实施方案优化2.1研究目的………………………………………………………………………………………39 2.2研究内容…………………………………………………………………………………….40 2.3研究路线图…………………………………………………………………………………41 2.4抽样……………………………………………………………………………………………………………………….42 2.5访谈设计………………………………………………………………………………………………………………。43 3数据收集………………………………………………………………………………………………45 3.1进入现场……………………………………………………………………………………45 3.2资料存档(见附件7和附件8)…………………………………………………………..45 4数据整理和分析………。.………..49 4.1八个预备访谈的个案分析………………………………………………………………….5l4.2关丁8个预备访谈的跨个案分析………………………………………………………….57 4.3十二个正式访谈的个案分析………………………………………………………………6l4.4关于12个正式访谈的跨个案分析…………………………………………………………72 5结论…………………………………………………………………………………..……………………74 5.1结论一……………………………………………………………………………………….74 5.2结论二……………………………………………………………………………………….75 5.3结论三……………………………………………………………………………………….75 6讨论……………………….……….…..。.……………………………………………………………..75 6.1关于深度访谈法……………………………………………………………………………75 6.2关于扎根理论………………………………………………………………………………76 6.3本访谈的信度和效度闯题…………………………………………………………………76 6.4本访谈的的评价…………………………………………………………………………….77 6.5有关本访谈的“内省”问题……………………………………………………………….78 7附件……………………………..……….…….……………………………………………………..80 7.1附件1;受访者信息表……………………………………………………………………..80 7.2附件2:访谈研究小组成员名单……………………………………………………………83 7.3附件3:预访谈计划………………………………………………………………………。84 7.4附件4:预访谈提纲……………………………………………………………………….87 7.5附件5:正式访谈计划…………………………………………………………………….92 7.6附件6:正式访谈提纲……………………………………………………………………。98 7.7附件7:8个预备访谈的分析过程………………………………………………………..102 7.8附件8:12个正式访谈的分析过程………………………………………………………102致谢……………………….….……...……….…….....…………………..……………………1 03个人简历………………….Ⅱ基于深度访谈法初步研究中医临床实施方案优化摘要目的:主要目的:探讨定性研究深度访谈法在中医临床研究中的基本步骤和规范以及数据分析程序。次要目的:以深度访谈法对中医临床实施方案优化的研究作为应用范例。方法:运用定性研究中的深度访谈法,对8个对象进行预备访谈并在其基础上,对12个对象进行正式访谈,访谈时进行现场录音和现场备忘录记录。然后转录成逐字稿并进行分类存档。对于个案的整理和分析,采用定性研究经典理论“扎根理论",严格按照规范的程序进行三级译码。将受访档案数据先进行开放性译码整理出“码号(code)分析表”;再进行主轴译码,整理并构建出受访者的概念类属分析表,然后根据“译码典范”分析矩阵表,得出相关类属(categories)和概念(concepts)之间的关联:最后通过选择性译码萃取核心类属(centralcategories)并构建理论。在个案分析的基础之上,进行跨个案综合分析,先后有预备访谈综合分析和J下式访谈综合分析两部分。结果:主要研究结果:通过范例研究,对深度访谈法在中医临床研究领域应用的规范、步骤以及数据分析程序进行了具体的探讨。次要研究结果:范例研究中,通过预备访谈使“优选”和“优化”两个概念得以明确,即“优选”是指由临床研究者自身对治疗方案的择优比较;“优化”则是立项后启动前这段时间罩对研究设计的改良。对于以从事临床实践活动为主的研究者来说,他们多偏向对治疗方案“优选”的探讨。正式访谈在前面8个预备访谈的基础上进行了完善和规范。通过严格遵守一系列深度访谈步骤和规范程序,将受访者档案数据先进行开放性译码,整理出12个码号分析表,再于主轴译码阶段,先后整理并构建出12个受访者的概念类属分析表,然后根据“典范译码"分析矩阵表,得出相关类属和概念之间的关联关系,最后通过选择性译码萃取出9个核心类属(centralcategories)并构建相关理论。从正式访谈的12个受访者的访谈中得出三对关系即治疗方案和设计方案、临床实践和科研工作、主研单位和参加单位;三种被优化课题研究者对优化课题的态度即抵触型、依赖型、独立型。从正式访谈的12个受访档案分析得出如下结果:三对关系:治疗方案和设计方案、临床实践和科研工作、主研单位和参加单位;三种被优化课题研究者对优化课题的态度:抵触型、依赖型、独立型;五个关注方面即疗效、研究者素质、时间、经费、认可度。此基于深度访谈法初步研究中医临床实旄方案优化外,依据概念类属之间相互关联影响的分析,最终建构出9个围绕“方案优化”的研究者反应模式概念分析图。此外,依据概念类属之间相互关联影响的分析,最终建构出9个围绕“方案优化”的研究者反应模式概念分析图和9个相关理论。同时通过访谈可知:此次有关重大疑难疾病课题的研究,都是在以往课题研究基础之上进一步深化的研究,相关的课题研究者都有丰富的临床研经验,而且都期望通过“优化"能够更加科学地验证他们研究方案中的中医临床疗效,提升认可度并进行推广。结论:本研究整个过程的执行参照国际标准按照规范的定性研究程序进行,通过范例研究得以实际运用。通过研究可知定性研究是一种与以往定量研究不同的研究方法,中医临床研究领域引入定性研究不仅能弥补定量研究所的不足,而且对于某些特殊问题的解决有独到之处。本研究对“十一五’’国家科技支撑计划重大项目“重大疑难疾病中医防治研究"中的部分研究者进行了深度访谈,是定性研究在中医临床研究领域的初次规范系统的应用,为将来定性研究在中医研究领域进一步深化和实际操作奠定了基础。范例研究所得结果为“十一五”国家科技支撑计划重大项目“重大疑难疾病中医防治研究”“中医临床研究的方案优我们结合中医临床根理论;方法学研究Method:We did a pilot study with eight interviewees by in—depth interview and aformal one with twelve inteviewees.We recorded in the field and made notes about allkinds of emotional expressions and movements of interviewees.And then wetranscribed all the recordings into verbal manuscript which has been catergarized intodifferent archives and labled by letter from A to T.In fact,there were two parts of thisstudy including the pilot suty and the formal one in different stages,which also inseparate analyzing process.The classical theory Grounded Theory for analyzingqualitative data has been used in this study for analyzing every interviewee’S data,which includes three kinds of coding procedures such as opening coding,axial codingand selective coding.After the opening coding procedure codes table has been made.Different categories and concepts table has showed up in the axial coding procedurewhich is followed by a matrix table showing plicated relationship betweencategories and concepts according to coding paradigm.And at last central categorieshave been selected abiding by the selective coding procedure,panying which atheory was also constructed.In order to make parative analysis we did acomprehensive analysis for the pilot study and the formal study separately.Results:There are two parts ofthe result about this study.The first and importantpart is that in-depth interview has been in仃oduced to the clinical research field ofChinese Medicine and it is the first time that the process and data analyzing procedureof in-depth interview been applied in detail in the example.The secondary restult arethe es from the example.Two concepts have been identified clearly in the pilotstudy.One is paring different clinical programme for selecting the bestone.111e other one is about optimizing research designing for refming to improve the researchquality.However,for most of the researchers whose daily work is maily concernedwith clinical practice,t11ey were apt to discuss the former one.The formal interviewhas been done on the base of the pilot study.There were nine theories with central3基于深度访谈法初步研究中医临床实施方案优化categories have been constructed by following Grounded theory’S three codingprocedures.We got some important results for the research of optimizing clinicalresearch programme of Chinese Medicine嬲follows:Thl'∞kinds of relationshipsincluding relationship between treating programme and designing programme,between clinical practice and research work and between main research hospitals andsupportive hospitals.Three kinds of researchers’attitudes to the research of optimizingclinical research programme of Chinese Medicine such雒being contradicted.beingdependent and being independent.Besides,we constructed nine analyzing conceptualgraphs and nine theories related with the research of optimizing clinical researchprogramme,from which much useful information Was elicited.As we knew from theformal interview,most of the researchers wish they could test their clinical curativeeffect easily for their clinical research porgrm and generizing their program in thefuture by attending the research of optimizing clinical research programme of ChineseMedicine.Conclusion:Qualitative research is SO different from quantitative research by OBrstudy that we know it Can arrive where quantitative research can’t.Applyingqualitative reseach Can explore important and useful information that quantitativeresearch Can’t get,especially for much subjective information in people’S mind.It isthe first time that researchers use in-depth interview systematically to study theresearch of optimizing clinical research programme of Chinese Medicine,particularlyin the part of the Eleventh Five Key Technologies R&D Programm.The first time ofusing in-depth interview will be a base for the application and set a good example forthe novice who wants to use qualitative methods in the research filed of ChineseMedicine.The results of the in-depthe interview example have indicated someimportant and benefical information for the Research of Optimizing Clinical ResearchProgramme of Chinese Medicine in the part of the Eleventh Five Key Technologies R&D Programm.And we formed a series of process and data analysis procedures ofin—depth interview,which are suitable for Chinese Medicine clinical research.Key words:clinical research of Chinese Medicine;in—depth interview;qualitative research;Grounded theory;methodology4

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  本文关键词：基于深度访谈法初步研究中医临床实施方案优化，由笔耕文化传播整理发布。