I recommend a single Results chapter with three sections for the presentation of the survey, then the interviews, then the integration. And I especially appreciate your attention to integration, which I believe is a crucial component in mixed methods research.

Dear Dr. David Morgan,

Thank you so much for your clear and insightful response. I am genuinely happy to have received your reply. During my PhD journey, I have read many of your papers and books on mixed methods, especially Integrating Qualitative and Quantitative Methods: A Pragmatic Approach, which has been foundational to my research design and methodology. I have consistently followed the approach of "follow-up qualitative extensions to core quantitative research projects" throughout the design and data collection phases of my study.

I have now completed both the survey phase and the qualitative descriptive research phase, including data collection and analysis. Currently, I am working on integrating the two phases and have encountered a few issues that are puzzling to me.

My research questions are as follows:

Quantitative Research Questions:

What is the incidence rate of patient/visitor violence experienced by emergency department nurses?

What is the nature of the patient/visitor violence that nurses experience?

What are the most relevant contributing factors associated with these violent incidents?

What are the consequences for the victims following the occurrence of such violence?

Qualitative Research Question:

How do nurses perceive and experience violence from patients/visitors in terms of its nature, contributing factors, and consequences?

Upon reviewing my research design, I am uncertain if the timing sequence truly qualifies as sequential. My sampling strategy is nested sampling, but I realize that’s not enough to indicate full integration at the research design level, which requires a connecting process. After analyzing my survey results, I found that nurses experienced more violence from visitors than from patients. Therefore, I intentionally recruited interview participants who had experienced at least some form of visitor-related violence. Ultimately, I recruited 13 nurses, and since each nurse may have experienced more than one source of violence, there were 44 incidents of violence in total—27 from visitors and 17 from patients. This is the only possible point that could serve as a connecting link between the two phases. However, I am unsure if this truly serves as a point of connection between the two phases. In the interview content, I paid close attention to building connections by focusing on the triggers and related outcomes of violence from both sources.

My confusion lies in the fact that both the quantitative and qualitative phases focus on the nature of violence, its contributing factors, and consequences . The quantitative phase mainly addresses the incidence of violence and the most frequent contributing factors, and consequences (it’s descriptive and not correlational, and all the nurses in the quantitative phase had experienced violence). The qualitative interviews aim to provide a deeper explanation of these points. I am unsure if my design still qualifies as a sequential priorities model, or if it is more aligned with a convergent design.

I would really appreciate your thoughts on this.

Thank you again for your guidance.

Best regards,

Yongchao Hou