Management of Arthritis in Older People - Research Paper Example

Management of Arthritis in Older People RUNNING HEAD: QUALITATIVE RESEARCH METHODOLOGIES Name: Grade Course: Tutor’s Name: 28thAugust, 2010 Introduction The discussion provided below is about qualitative research methodologies and how they can be applied in a research study. Descriptions of three methodologies and a discussion on how they are applied have been shown through a guidance of the following: Determination of the research aim for which qualitative research methodologies would be appropriate Identification of three methodological approaches that can be used to explore the research aim The significance of the research study The reasons and rationale for selecting a specific methodological approach The nature of knowledge that would be obtained if a specific methodological approach is used and The critiques for the chosen methodological approach Research Aim: To find out how the pain management activities help older people manage to live with Arthritis related pain? Qualitative Methodological Approaches that Could Be Used To Explore the Research Aim A qualitative approach is a way of conducting a qualitative research that has been thought of (Byrne, 2001). If for example a researcher wants to know what nurses think about having knowledge about patients’ cultures, the researcher would have to think of an approach that will give him/her appropriate results and that will help him/her achieve the results. Such are the approaches. There are so many approaches and the type of research or information needed from a research determines what approach is taken to accomplish the missions of the research (Ploeg, 1999). The approach describes the purpose of the research, the research stages, the methods of data analysis and the role of the researcher (Byrne, 2001). In this case for example, the aim of the research is to find out how the older people live with Arthritis related pain. As stated before, the type of approach taken is dependent on the information needed and how that information can be achieved among so many other factors that will be mentioned later. There are ethnographic research approaches, phenomenological, feminist research approaches, constructions, symbolic interactions and approaches based on ground theory. A specific research approach has to match the aim of the qualitative research (Pope & Mays, 2006). Phenomenology Phenomenologists believe that the truth and understanding can be obtained from human experiences. A research based on phenomenology therefore considers human experience as part of the data necessary for finding out the truth (Groenewald, 2004). According to Byrne, phenomenology methodology of research connects a particular philosophy to research methods and ensures certain research strategies are linked to philosophical notions to obtain the research aims (the truth) (2001). A philosophical notion can be about women for example, that equality can only be achieved through influencing policy makers and law makers of the government as female liberalists believe it. Husserl for example, contended that setting aside predetermined ideas (bracketing) would help a researcher to impartially describe the phenomenon under study based on a philosophical notion that essences are the ultimate structure of consciousness (Byrne, 2001, Groenewald, 2004 & Moustakas, 1994). The phenomenon under study in this case is how the older people cope with their chronic condition. The question that a researcher should ask himself or herself is: how can the answers be obtained? One of the ways is through getting the experiences that the older people suffering from Arthritis have gone through. Through this, the truth will be known. Another way is through collection of information from already conducted researches and the other is through long term observation (Van Manen, 1990). This approach can therefore be used to explore the research aim. Grounded Theory This is a type of approach in which theory is developed from collected data. The method of study is based on categories, propositions and concepts but the theory is developed from conceptualization of data rather than the actual data (Strauss & Corbin, 1990). The research aim can also be accomplished by first collecting data and developing a theory about how the older people cope with Arthritis. Ethnography This is a kind of study that focuses on the culture of a specific group of people. The researcher’s aim is to get to know about the culture which includes the people’s behavior, the social structures, the role of certain cultural practices and a lot more about a specific group’s culture. The researcher aims at understanding how the specific group under study views the world (Spradley, 1979). In the above research aim, there is a specific group that is targeted (The older people with Arthritis), and the research aims at finding out how pain management helps them cope with Arthritis related pain. The research question could be: what culture do the older people adopt in their ways of coping with Arthritis related pain? There is a culture that results from behavior and health management targeted in this case. The three qualitative research methodologies that can be used to explore the aim of the research are: phenomenology, ground theory and ethnography. Research Questions: Grounded Theory: How are the old trying to cope with pain in their chronic condition? Phenomenology: What are the experiences of older people suffering from Arthritis? Ethnography: what culture do the older people adopt in their ways of coping with Arthritis related pain? Selected Research Question for the Study: How are the old trying to cope with pain in their chronic condition? Methodological Approach for the Research Study: Grounded Theory Significance of the Research Pain management in an Arthritis management program is meant to help reduce pain in patients with Arthritis (Backman, 2006). A study that aims at finding out how older people cope with pain in a chronic condition helps develop knowledge that is important in pain management. The knowledge can be translated into improving pain relief (). The results will give the most preferred activities by the old aged people suffering from Arthritis and the most suitable. It all works towards providing a better health for the people with Arthritis (the old aged) (Cerns et al, 2009). One method can be effective in relieving pain but may also have dangerous effects of so many negative impacts. With such kind of information, new ideas are developed on how to relieve pain with very little negative effects on the patients (Cerns et al, 2009). Making improvements in a program also improves the standards of pain management as required by national medical associations, encourages patient satisfaction and professional skills and knowledge. The results of this research will also improve the pain management standards in Arthritis management, encourage patient satisfaction and improve professional knowledge and skills in areas of pain management (Bookbinder et al, 1996). Why Grounded Theory is Preferred to Phenomenology and Ethnography Methodologies Phenomenology This approach aims at understanding the truth behind people’s life experiences and this can provide the necessary information needed for the research (Byrne, 2001, Groenewald, 2004, Moustakas, 1994 & Ploeg, 1999). The approach can produce answers to what is required in the research study with the aim of finding out the effects but this will only focus on the lived experiences of those suffering from Arthritis. It therefore covers only part of what is required in the research. By trying to find out how the old age patients suffering from Arthritis try to cope with their condition, the target of the research study is vast. It focuses on the processes of pain management that help the old people cope with pain in their condition. In phenomenology, data collection is focused on people’s lived experiences and involves observation, videotapes, interactive interviews and descriptions by subjects (Van Manen, 1990). Lived experiences can only be obtained from the sufferers, the affected by the sufferers’ condition (family members) and the medical professionals involved in management of their arthritis. Data is collected by in depth conversation (Van Manen, 1990). How the old try to cope with pain in their chronic condition seeks to understand ways through which the old aged people cope with pain. Cases where phenomenology approach is appropriate are such as ‘exploring the lived experiences of people with HIV and AIDS, exploring the lived experiences of families of people in a coma, exploring the lived experiences of people with Arthritis and so on (Schutz, 1970). The research question above targets a lot more than lived experiences. Ethnography This is an approach that focuses on the people’s culture (Spradley, 1979). There may be a culture developed by the people (old age) suffering from Arthritis but this is not the focus of the research. Finding out the how the old aged patients suffering from Arthritis cope with pain depends not on the culture developed by the people, but seeks to find out processes through which they cope with the pain. Focusing on the people’s culture cannot give the processes needed by the research question. A culture developed by people suffering from Arthritis can however be studied. Ethnography would be an appropriate approach if may be nursing practices in Arthritis management was the aim of the study. Rationale for Selecting Grounded Theory In this type of approach, the theory is developed from the data collected (Strauss & Corbin, 1990). The data is collected through interviews, records, observation or a combination of all. The researcher is involved in observation, collection and organization of data that will be analyzed and a theory developed out of the results. Data collection and analysis are done simultaneously so that further collection of data is guided by already analyzed data. Analyzed data are categorized based on their properties and concepts and aims at finding out the processes that are used to help the old aged people cope with pain (Charmaz, 2006). Based on the information needed by the research study, it would be appropriate to use this approach since it will give a lot of information about how the patients cope with pain. Information collected through interviews (from the older people as well as from the staff members of the program), observation and even from records are all important for the study. The study aim is not specific about how they cope therefore a general approach that will cover all the practices and activities from people’s views to records of the pain management program and those observed will provide answers. Data analysis is carried out by categorizing and coding of data (Shannak & Aldhmour, 2009 & Borgatti, n.d). As noted earlier, conceptualization forms the basic element of analysis, so categorization is mostly based on the concept obtained from the data even though the properties also serve as an element of categorization (Charmaz, 2006). From this analysis, a theory is developed (Strauss & Corbin, 1990). This is another reason why this approach is best for the research study selected. All the activities whether effective or not, whether financial or operational are all included in the data and a later analysis is carried out to categorize them into financial, operational and so on, or positive or negative depending on the results (Byrne, 2001). It provides answers that can help improve or find solutions to all areas affected hence improve the performance of the pain management program. If for example one activity is found to be very expensive yet has poor performance in its role in reducing pain in the patients, the managers of the program can decide to eliminate it. This is the importance of the study, to be able to find out areas of poor performance and make improvements or areas of good performance and maintain such performance. Nature of Knowledge That Would Be Produced In This Research Study Using Grounded Theory Approach The outcome of the research is a theory explaining the phenomenon under study. An example of an outcome can be that most patients prefer to exercise to manage their pain while some prefer medications. After analysis of the data, some theory has to be developed that is proved by the data collected (Strauss & Corbin, 1990). Critique of Grounded Theory Methodology Grounded theory is widely used in the medical field of research but the methodology has issues. Since its development in 1967 (Glasser & Strauss, 1967), improvements or additional opinions have been added to the original methodology. The initial grounded theory was developed by Glaser and Strauss, but since then, Strauss developed another version with Corbin in 1990 (Strauss & Corbin, 1990) and Glaser developed his versions in 1978 and 1992 (Glaser, 1978 & Glaser, 1992). Researchers are forced to specify the version of methodology used or intend to use in their research. Strauss and Corbin published the ‘Basics of Qualitative Research: Grounded Theory, procedures and Techniques in 1990 and what followed were accusations of misinterpretations and disloyalty to the main objectives and the theory of the methodology’s emergence (Glaser, 1992). Because of these accusations by one of the original authors, a variation has been created in the grounded theory approach with Strauss more emphasizing the use of systematic and complex coding techniques while Glaser stressing contextual, interpretative and emergent nature of the theory that should be developed from the data (Glaser, 1992 & Strauss & Corbin, 1990). When the original work of the two authors on grounded theory is compared to their other versions, that is, Strauss and Corbin’s ‘Basics of Qualitative Research’ published in 1990 and Glaser’s ‘Theoretical Sensitivity’ published in 1978, a slight difference in perception about the methodology is revealed in the terminology as well as the style (Glaser, 1992). Additionally, Strauss’s version has developed systematic coding system which is very complex and different from the original version (Strauss & Corbin, 1990). The kind of information provided by the two original authors of the methodology may be misleading but selection of an appropriate approach depends on the researcher and what the researcher aims to accomplish. Glaser in a 1992 publication criticizes Strauss and Corbin’s work. In any research involving this approach therefore, researchers may be required to specify a specific version selected. This theory has had misconceptions that researchers do not give suitable attention the quality of gathered materials and the data collection techniques (Charmaz, 1983 & Allan, 2003). With this kind of knowledge, researchers will be able to avoid such misconceptions and apply appropriate techniques and will also be able to know the right version to use in a research methodology approach. Conclusion Three qualitative research methodologies have been discussed which are; ethnography, phenomenology and grounded theory. Only one of the methodologies has been selected for a specific research question developed for the research study which is grounded theory. More has been discussed about this methodology including the reason why it is appropriate for the selected research aim and its critique. Other methodologies have also been discussed showing where they can be applied and why they are not necessary in this research study. List of References Allan, G. (2003). A Critique Of Using Grounded Theory As A Research Method. Electronic Journal of Business Research Methods, 2(1), 1-10. Backman, C.L. (2006). Arthritis and Pain. Psychosocial Aspects In The Management Of Arthritis Pain. Vancouver, Canada. Arthritis Research & Therapy Journal, (8):221. Borgatti, S. (n. d). Introduction to Grounded Theory. Viewed on 3th August, 2010 Byrne, M. M. (2001). Understanding Life Experiences through A Phenomenological Approach To Research. The AORN Journal. Byrne, M. (2001). Grounded Theory As A Qualitative Research Methodology -Brief Article, AORN Journal. Viewed on 30th August, 2010: Cerns, S., Mueller, E., Glatzel, C., Duffy, M and Ebright, P. (2009). Improving Pain Management Through Continuing Education.The Journal for Advanced Nursing Practice Volume 23 (2), Pp102 – 102. Charmaz, K. (2006). Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis Introducing Qualitative Methods. London: SAGE. Charmaz, K. (1983) The Grounded Theory Method: An Explication and Interpretation, In: Emerson, R. (Ed) Contemporary Field Research: A Collection of Readings Boston: Little Brown Company Glaser, B. (1992). Basics of Grounded Theory Analysis: Emergence v Forcing. Mill Valley: The Sociology. Glaser, B. & Strauss, A. (1967). The Discovery of Grounded Theory: Strategies for Qualitative Research Chicago: Aldine. Glaser, B. (1978) Theoretical Sensitivity. Mill Valley: The Sociology Press. Groenewald, T. (2004). A Phenomenological Research Design Illustrated. International Journal of Qualitative Methods, 3 (1). Moustakas, C. (1994). Phenomenological Research Methods. London: SAGE Publishers. Ploeg, J. (1999). Identifying the Best Research Design To Fit The Question. Part 2: Qualitative Designs. Evidence Based Nursing Journal (2):36-37. Pope, C. and Mays, N. (2006). Qualitative Research In Health Care. 3rd Ed. New York: Wiley Blackwell. Schutz, A. (1970). Introduction On Phenomenology And Social Relations: selected Writings, Chicago: University of Chicago Press. Shannak, R. O. and Aldhmour, F. M.(2009). Grounded Theory as a Methodology for Theory Generation in Information Systems Research. European Journal of Economics, Finance and Administrative Sciences, (15) Viewed on 30th August, 2010: Spradley, P. J. (1979). The Ethnographic Interview New York: Holt Rhinehart & Watson Strauss, A. & Corbin, J. (1994) Grounded Theory Methodology: An Overview, In: N. Denzin & Y. Lincoln (Eds) Handbook of Qualitative Research California: SAGE Publishers. Van Manen, M. (1990). Researching Lived Experience: Human Science For An Action Sensitive Pedagogy. London: Althouse Press. Read More