Developing DESCARTE: using the prism of mixed-methods to advance case study design in healthcare research

Citation

Carolan C, Forbat L & Smith A (2015) Developing DESCARTE: using the prism of mixed-methods to advance case study design in healthcare research. MMIRA San Antonio Mixed Methods Regional Conference, San Antonio, TX, 03.08.2015-04.08.2015. http://www.nursing.uthscsa.edu/ce/MMIRA_AGENDA.pdf

Abstract
This presentation introduces the DESCARTE model: the DESign of CAse study Research in healThcarE. Case study is a long-established research approach typified by the use of multiple data sources. Although methodological flexibility is a considered strength of case study, there is limited attention to methodological design in case studies in healthcare and limited critical debate on approaches to data analysis and integration. Emergent issues pertaining to data analysis and integration in a case study of emotional distress in palliative care led to the development of the DESCARTE model. This three stage schematic design model is informed by the case study and mixed-methods literature. The first stage examines informing philosophical approach, positioning of self and ethical dimensions of the research. The second stage presents an innovative interactive model of case study design shifting away from restrictive typological classifications of design. The third stage proposes that three concurrent stances of philosophical, strategic and integrative stances must be adopted during data analysis. Accepting the iterative nature and complexity of case study research, the model explicitly states the need for researchers to describe the purpose of data integration, the timing of data integration and data transformation. The model is accompanied by twelve questions to guide research. Application of the DESCARTE model will be illustrated by the example of a case study of emotional distress in families in palliative care. The DESCARTE model is proposed as an innovative yet flexible research design to enhance the conduct and methodological robustness of case studies in healthcare. Advancing the application of case study as a valuable research approach will further improve our understanding of patients' health and illness experience within real life complex healthcare systems. Developing DESCARTE: using the prism of mixed-methods to advance case study design in healthcare research.