Domain-specific vignette development in polyarthitis: Arends, et al. (2015)

This paper by Arends et al. (2015) sheds further light on the use of vignettes and the difficulties (for me) in categorising care phenomena. There is a great deal of overlap in the three domains that the authors apply to patients with arthritis. Their domain-specific focus is also of interest.

Independent functioning extends across the interpersonal and sciences domains of Hodges' model as mental functioning and physical. Sports, holidays, hobbies and other activities while usually social in nature can be solitary pursuits. In this example even if the context is social as per the domain, it is the impact upon the individual that the researcher's note:

"Changes in life domains caused by a chronic disease can have psychological and social consequences for patients and can affect their identity"... (p.1896)

In the quote below, copied across the domains of Hodges' model, volunteering is political in nature, but the reward in this instance - voluntary work in a nursing home - could be intrapersonal, derived from the interaction with and making a difference to the residents, staff and visitors.

So, it is vital to capture - or freeze the context in some way, vignettes it appears are one way to achieve this.

"The 11 vignettes all have a main character that is diagnosed with RA. In each situation, the impact of the disease on daily life is described as the main character always encounters a limitation or difficulty. The stories are set in three different domains:

the social domain,

the leisure activities domain,

and the independent functioning domain...

individual
|
INTERPERSONAL : SCIENCES
humanistic ---------------------------------------  mechanistic
SOCIOLOGY : POLITICAL
|
group

In the independent ... psyche        identity	functioning domain, the topics are gardening, household tasks, and running errands.
Topics of the vignettes in the social domain are activities with partner, children, family, and friends. In the leisure activities domain, the topics are sports, holidays, hobby,	and volunteering." (p.1900)

Reference:
Arends, R., Bode, Y., Taal, C., & Laar, E. (2015). Exploring preferences for domain-specific goal management in patients with polyarthritis: What to do when an important goal becomes threatened? Rheumatology International, 35(11), 1895-1907. DOI: 10.1007/s00296-015-3336-8 

Hodges' model - Integrating the five vignettes?

Some reading while working on my research proposal:


Vignette methodologies for studying clinicians’ decision-making: Validity, utility, and application in ICD-11 field studies

Abstract

Vignette-based methodologies are frequently used to examine judgments and decision-making processes, including clinical judgments made by health professionals. Concerns are sometimes raised that vignettes do not accurately reflect “real world” phenomena, and that this affects the validity of results and conclusions of these studies. This article provides an overview of the defining features, design variations, strengths, and weaknesses of vignette studies as a way of examining how health professionals form clinical judgments (e.g., assigning diagnoses, selecting treatments). As a “hybrid” of traditional survey and experimental methods, vignette studies can offer aspects of both the high internal validity of experiments and the high external validity of survey research in order to disentangle multiple predictors of clinician behavior. When vignette studies are well designed to test specific questions about judgments and decision-making, they can be highly generalizable to “real life” behavior, while overcoming the ethical, practical, and scientific limitations associated with alternative methods (e.g., observation, self-report, standardized patients, archival analysis). We conclude with methodological recommendations and a description of how vignette methodologies are being used to investigate clinicians’ diagnostic decisions in case-controlled field studies for the ICD-11 classification of mental and behavioural disorders, and how these studies illustrate the preceding concepts and recommendations.

Evans, Roberts, Keeley, Blossom, Amaro, Garcia, . . . Reed. (2015). Vignette methodologies for studying clinicians’ decision-making: Validity, utility, and application in ICD-11 field studies. International Journal of Clinical and Health Psychology, 15(2), 160-170. DOI: 10.1016/j.ijchp.2014.12.001 

Abstract

Vignette studies use short descriptions of situations or persons (vignettes) that are usually shown to respondents within surveys in order to elicit their judgments about these scenarios. By systematically varying the levels of theoretically important vignette characteristics a large population of different vignettes is typically available – too large to be presented to each respondent. Therefore, each respondent gets only a subset of vignettes. These subsets may either be randomly selected in following the tradition of the factorial survey or systematically selected according to an experimental design. We show that these strategies in selecting vignette sets have strong implications for the analysis and interpretation of vignette data. Random selection strategies result in a random confounding of effects and heavily rely on the assumption of no interaction effects. In contrast, experimental strategies systematically confound interaction effects with main or set effects, thereby preserving a meaningful interpretation of main and important interaction effects. Using a pilot study on attitudes toward immigrants we demonstrate the implementation and analysis of a confounded factorial design.

Atzmüller, C., & Steiner, P. (2010). Experimental Vignette Studies in Survey Research. Methodology: European Journal of Research Methods for the Behavioral and Social Sciences, 6(3), 128-138. DOI: 10.1027/1614-2241/a000014