Table 4.

Example of integration of quantitative and qualitative results for individual questionnaire statements

Statement from the 2011 survey with version 1 of the questionnaire	Missing data (for n = 2153)	Quantitative results [n (%)]	Qualitative results	Integration	Statement from the 2015 survey with version 2 of the questionnaire
Item 7 “Ignore situations of suspected patient abuse by caregivers”	Frequency 63 (2.9%) Level of Disturbance 65 (3.0%)	Frequency Never (0): 1501 (69.7) 1: 394 (18.3) 2: 119 (5.5) 3: 47 (2.2) very often (4): 29 (1.3) Level of Disturbance None (0): 653 (30.3) 1: 221 (10.3) 2: 288 (13.4) 3: 396 (18.4) Very high (4): 530 (24.6)	The item is important and generally formulated in a comprehensible way. The tense used in the formulation makes it unclear whether it refers to present behaviour or to past actions. Several participants had never experienced the situation described. Some feel that the description is not precise enough, making different interpretations possible. For example, one response was: “But isn't what it meant by that, whether someone is or is not taken seriously? … That's the most difficult question for me” or another example: “The question is, when does neglect begin?” The assessment of frequency and level of disturbance varies from person to person. The same individual may even assess identical situations differently depending on their own personal circumstances or workplace environment.	The small amount of missing data and the information gained from the focus groups confirm that the item was generally formulated comprehensibly and is important. The tense has to be changed so that it is clear that it refers to an assessment of the respondent's own actions in the past. The qualitative results confirm the quantitative results, which show that this is a situation that rarely occurs. The description of neglect and abuse must be made more precise. It is noticeable that, for this statement, there are significantly more assessments for level of disturbance (value >0) than there are for frequency (value >0). This can be explained by the instruction to give a hypothetical assessment of disturbance for situations that have not occurred. The fluid nature of the assessments on frequency and level of disturbance, makes an accurate interpretation of the quantitative results difficult. The response scale must be formulated more precisely, the instructions revised and the assessment period shortened.	New formulation of the statement: “Have taken no action in instances where there were signs of possible verbal or physical abuse of patients or patient neglect”. (and supplemental reference to abuse and neglect) The response scales were with supplemented with revised qualifiers. The instructions were revised to remove the need for a hypothetical assessment and the assessment period was reduced to 3 months.