Meeting of the Minds on WRMSD - Research Paper Example

Meeting of the Minds on WRMSD i. Abstract This research study intends to provide a framework about the importance of creating awareness of the implications of not reporting WRMSI amongst sonographers. As a result, this purpose of this research is based on the importance of sonographers preventing occurrence of WRMSI and reporting when it occurs (Craig, 2001). More significantly, this study wants to emphasize on the importance of individual sonographers reporting the increasing proven cases of WRMSI to their employee as a way of getting their access to workers compensation (Baker, 2003). 1.0 Introduction Workplace-related injuries are a constant headache to employers. On most occasions, employees sustain avoidable injuries because they failed to report their medical conditions to their employers. While most employers have limited information regarding the medical history of their employees, they therefore allocate any kind of duties to them while oblivious of the consequences that may be associated with this. It is therefore imperative for all employees to provide detailed information of their previous or current medical conditions to their employers in order to avoid cases of avoidable accidents. That notwithstanding, it is imperative that employees seek medical examination for musculoskeletal pains that they may be undergoing at the workplace. Then objective of this study were triggered by the dangers that employees face for failure of reporting their medical conditions to their employee before disaster strikes. Most sonographers experience musculoskeletal pains which they fail to report to their employers because of varied reasons. It is important for sonographers to report Work-Related Musculoskeletal Injury (WRMSI) to their employees. This research proposal therefore seeks to investigate the consequences associated with failure of sonographers to report WRMSI to their employers. Consequently, the study will create awareness for sonographers to report their conditions to their employers. 2.0 Research Problem Over the years, the cases of increased unreported cases of WRMSI amongst sonographers in health facilities have increased even with more reported surveys being undertaken to raise awareness. Considerably, there is an increasing number of sonographers who are highly affected by WRMSI caused by long term pain and disability associated with procedures they carry out in their work practices. In most cases, the sonographers experience extensive cases of discomfort and pain when performing scans and thus, have to take sick leave away from work (Wihlidal&Shrawan, 1997). Recent researches indicates that sonographers with WRMSI need to be assessed further using objective and subjective measures of productivity especially on reduced work hours, number of scans performed and length of time spent scanning (Krupinski&Kallergi, 2007). In most cases, intensity and duration of work among sonographers especially while they work on tight schedules with long appointments and increased motion of their muscles leads to pain and impaired work performance. In most case, lack of timely reporting of WRMSI by employees leads to increased levels of mechanical and physiological processes resulting in high levels of stress at work. 3.0 Research Question To what extent should sonographers report WRMSI and create barriers to prevent them? To what extent are sonographers willing to report WRMSI cases to their employer? How will sonographers remain aware of the help and treatment available to treat work-related musculoskeletal injury? What can be learnt from the consequences of sonographers with WRMSI not seeking treatment? 4.0 Research Objectives To make recommendations on importance of sonographers reporting WRMSI and creating barriers that prevent them. To carry out research based on whether sonographers are aware of the importance of reporting WRMSI cases to their employer. To analyze on whether sonographers are aware of the help, treatment available to treat work-related musculoskeletal injury. To evaluate the extent to which sonographers are aware of the consequence of not seeking treatment. 5.0 Literature Review Evidence based practice Evidence based practice (EBP) is an approach that entails the making to important decisions on the manner in which health can be promoted or offering care with the help of the best available evidence. This approach is based on the principle that all the practical decisions related to health should be guided by research studies on that discipline. In addition, the researches ought to be interpreted and selected in accordance with the various EBP characteristics. The EBP has five critical steps that must be followed during it execution. They include: a) Seek the answers to important questions about the care of your respondents, populations or their communities. b) Retrieve the most appropriate evidence based on the questions being asked. c) Critically analyze the evidence provided in order to ascertain its applicability and validity to the questions being asked. d) Apply the obtained evidence through making collaborated decisions with the participants. e) Examine the outcomes of your application of the evidence and provide the results. Diagrammatic representation of EBP Carrying out journal critique of these articles ensures understanding of current research while undertaking analysis of research methods used in different articles research question. Research CASP framework was used in critiquing remains essential as it seeks to focus on future research based on this proposal (Whittaker, & Williamson, 2011). The framework was aimed at validating the literatures including asking whether the literature was valid, what its results are and whether the results will help locally. This is because, increased search show minimal research study carried out on reported cases of WMSTI amongst sonographers to their employers. Remarkably, the three studies based on journal critique below focuses on increased occurrence of musculoskeletal symptoms among sonographers is most likely to extensive exposure to workplace risk factors leading to work-related musculoskeletal injury (Whittaker, & Williamson, 2011). Appropriate criteria will be employed to evaluate the trustworthiness of qualitative research. The criterion involves the following; (Whittaker, & Williamson, 2011) Trustworthiness Dependability Credibility Transferability Confirmability The trustworthiness of a research is its ability to divulge information that can be believed and that is true. On the other hand, the dependability of a research is its capability of being relied on by the researcher. Credibility is the truthfulness and integrity of a research while the transferability of a research is its ability to be passed on from one person to the next. The confirmability of a research is its ability to be validated and verified by a researcher. Necas (1996) explains how an increasingly high number (sixty-five percent of sonographers) with musculoskeletal related symptoms received positive medical diagnosis of Work-Related Musculoskeletal Injury (WRMSI) when they consulted a medical professional. Considerably, this research findings indicate that an approximately two-thirds of sonographers with musculoskeletal related symptoms who received a medical diagnosis indicating that some sonographers are aware of help they can get from accessing earlier treatment of the regular WRMSI they are continuously exposed to while carrying on their daily duties (Magnivata et al, 1999). More so, the present research shows need for increased awareness to the sonographer of the possible consequential outcome of not seeking early treatment of the WRMSI (Darragh, Huddleston and King, 2003). Notably, the persistent occurrence of frequent and severe musculoskeletal injury symptoms have increased advanced negative impacts on the sonographer’s work and home life. Vanderpool et al. (1993) reported existence of significant association between posture and musculoskeletal symptoms from results of research findings conducted among sonographers. Notably, the increasing case of musculoskeletal injury among sonographer population shows that small a proportion of respondents with such diagnosed cases have reported instances of absenteeism and reduced working hours when they experienced pain or reported such cases (Pilette, 2005). More significantly, research findings indicate low levels of individual sonographers reporting the proven cases of WRMSI to their employee as a way of getting their access to workers compensation (Goetzel et al., 2004). More so, increased psychosocial factors among sonographers remain highly linked to cases of WRMSI as there exists an increased level of monotonous work schedule, low job satisfaction and low decision-making power on how work schedules are designed (Stewart et al, 2003). More benefits are gained by sonographers who report the WRMSI cases to their employers it is essential to highlight the gains of such actions. Research indicate the existence of positive impact from social support gained from other co-worker, supervisor and senior management after reported cases of WRMSI especially on work task and schedule to reduce work pressure (Society of Radiographers. 2007). Most physiotherapists sessions for sonographers with WRMSI improve body awareness during scanning as they adapt less harmful new techniques as an approach to the problem (Christiansson, 2001). In addition, research indicate that sonographer who report their cases gain unexpected benefit as they engage with others with similar conditions and know other individuals suffering from WRMSI (Jakes, 2001). Wihlidal and Kumar, (1996) focus their research on the problem sonographers face in short-term and long term as a result of WMSTI cases. Notably, this research was focused on using mail survey based on a sample size of 180 sonographers working in different health institutions. The research showed existence of work-related risk factors, based on activities associated with awkward and static postures besides repetitive twisting of the neck and trunk leading to prevalence of a high degree of musculoskeletal symptoms. Exploratory interviews using structured questionnaires reported existence of significant association between posture and musculoskeletal symptoms from results of their findings among sonographers. Use of interviews in data collection shows increased reliability and validity of content collected from participants. The questionnaire used in the exploratory interview was tested for its relevance of length, clarity and acceptability through a pilot study. As a result, the research focused on seeking varied opinions on the research questions, while focusing on the consequent conclusions based on the research objectives. In this research, theoretical sampling analysis of participants’ feedback was used in data analysis. Notably, the choice of research method showed focus on qualitative research methods through structured research methods that were used in the collection of quantifiable data used for qualitative comparative analysis of the research (Whittaker & Williamson, 2011).With an increased sample size of one hundred and fifty-six (156) practicing sonographers, adequate qualitative research on work-related injuries among sonographers was widely covered. As an ethically approved article, the study gave an in-depth analysis thus promoting trust, confidentiality and accountability. The research avoided ethical issues based on the respect of persons, as it requires researchers to carry out the research with autonomy and self-determination. Research study on sonographer’s career showed prevalence to WRMSI with an increased level of ninety one percent of reported symptoms at the time of the survey while some had an average of five years experiencing the symptoms. The research study concurred with similar research that reported increased prevalence rate of WRMSI symptoms among practicing sonographers in Washington and Oregon states that stood at sixty six percent. Village and Trask (2007) focused on the various musculoskeletal disorders that remain prevalent among diagnostic sonographers. This is because research indicated that the ultrasound procedure performed by sonographers exposed them to WRMSI because it required unsupported abduction of the arm, accompanied by static contractions. This was aimed at keeping the arms in a fixed position to get correct image using transducer against the patient. Unlike previous study this research used a different approach of video assessment of the stop-motion postural analysis of sonographers full scan sections to quantify the postural and muscular loads. Findings indicated that carotid scans compared with abdominal, obstetrical or leg scans cases indicated high-pressure handgrip based on type of equipment used, and sonogram required to perform which affected the posture of sonographers. Unlike previous research study, based on questionnaire and case study analysis this research used observation research through video assessment to gather information based on sonographers’ natural working settings as a way of analyzing their experiences. As a result, the research used in this study accomplished a high level of objective as it sought to remain rational by seeking an independent opinion on the musculoskeletal injury cases through research methodology and procedure on time and accurate analysis of muscle strain that gave unbiased, independent research results. More significantly, the research based on exploratory studies on assessment of abductions and postures of shoulder, neck and showed an increased understanding of specific musculoskeletal injury cases studies. As an ethically approved article, the study promoted trust, confidentiality and accountability. Remarkably, the researcher conducted research within a health facility and focused on human beings’ dignity and safety. As a result, the researcher avoided ethical issues based on the respect of persons, as researchers are required to carry out the research with autonomy and self-determination. Other research findings indicated that sonographers should be advised to rest on one shoulder as a way of gaining balance on neck and back muscles while performing scan besides sitting and standing at intervals during the procedure . In addition, the use of voice activated ultrasound controls to assist sonographers in gaining better posture would reduce the growing problem of WRMSI amongst sonographers. Considerably, other findings indicated that sonographers with WRMSI need to be assessed further by using objective and subjective measures of productivity especially on reduced work hours, number of scans performed and length of time spent scanning. In their study, David (2005)used descriptive data to suitably illustrate the incidence of sonographers reporting work-related musculoskeletal pain and factors that deter them from reporting to employers. Unlike previous research this study used survey analysis as a way of collecting data with slightly seventy surveys against a population size of one hundred thirty five sonographers who received survey. As a descriptive study, the study had no specific rationale for selection of the participants but was based on the experience, age and practice based on voluntary basis. Remarkably, primary data collection through the use of survey analysis in the study of WRMSI cases remained relevant due its subjectivity and capacity to accommodate more information as detailed study is carried out. Based on response time, participants surveyed from affiliates of the sonography program gave accurate information. The use of at least seventy sonographers based on the study gave feedback showing limitations of available participants. Recent researches have shown increased problems as a result of lack of support in the workplaces especially concerning how employers should conduct themselves when employees report cases of WRMSI. Notably, emphasis on the reporting of cases of WRMSI remains essential because researches indicate that many sonographers experience severe problems. Changes in their postures show improvements after introducing minor changes to their prevalent conditions. Remarkably, employers should conduct workshops for sonographers, as a way of raising awareness on potential problems of WRMSI and how to manage it. The lack of support from employees will see many sonographers suffer in silence because of problems associated with WRMSI. Research shows relevance of effective education to sonographers on ways of reducing cases of WRMSI by carry out survey on factors that led to injury cases. More so, interest groups should focus on supporting sonographers by giving them support and encourage them to accept treatment and preventive measures as a way of reducing cases of work-related musculoskeletal injury. However, it is necessary to follow proper guidelines in coming up with regulations to protect the interest of sonographers both in the long term and short terms from the effects of work-related musculoskeletal injury. CURRENT RESEARCH Based on the findings from the literature there is a clear gap in the research literature indicating there is a lack of support from employees in promoting the importance of seeking help when suffering with WRMSI. Therefore the aim of this research will be to provide a framework about the importance of creating awareness of the implications of not reporting WRMSI amongst sonographers. In addition, this research will recognize a need to promote guidelines of recognizing and preventing WRMSI. 5.1Research Methodology 5.1.1Design 5.1.1.1 Introduction The research approach that was most appropriate for the purposes of this study was primary research which is a qualitative research. Qualitative research was chosen as opposed to quantitative research approaches because of the first hand information always associated with qualitative research (Taylor, & Francis, 2013). This is because qualitative approaches involve the actual collected of raw data from the field whereas quantitative approaches involve the examination of measurements and statistics from previous researches. Raw data was most appropriate for the purposes of this research because of the validity and freshness of the data. Raw data explains phenomenon like they are at present while quantitative research approaches depend on data that might have been invalidated already (Whittaker, & Williamson, 2011). Interpretivism will be used for in qualitative research. It involves the interpretation of the elements of the study by the researcher. For this reason, this approach integrates the interest of humans in a study and it is for this reason that it will be used for this research (Marshal, &Rossman, 2010). It is opposed to positivism which is a philosophical approach based on the principle that all rationally justifiable assertions can be proven or verified scientifically or are capable of mathematical or logical proof. This principle is the reason why it will not be used for the purposes of this study (Whittaker, & Williamson, 2011). In addition to interpretivism, inductive reasoning will be used in this study. Inductive reasoning is the process through which premises that are true or realized to be true at most times are brought together in order to make a certain conclusion (Whittaker, & Williamson, 2011). This study will be aimed at examining the experiences of sonographers which have been found to be true most of the time and it is for this reason that inductive reasoning will be used. It is important to note that inductive reasoning is opposed to deductive reasoning which is the process through which conclusions are made based on premises that are assumed to be true (Marshal, &Rossman, 2010). It is due to the fact that deductive reasoning is based on premises that are assumed to be true that is why it will not be used in the study. An overview of the methodology for this study indicates the relevance of using qualitative methodologies because study is based on an area of medical research that requires in-depth analysis on WRMSI cases (Taylor, & Francis, 2013). Notably, the choice of data research collection method will be qualitative as it is a health research focused on giving an independent overview (Bassett, 2004). In healthcare, research study use of qualitative research methods as compared to quantitative methods enable researchers to carry an in-depth analysis of practices and processes as a way of establishing barriers to change while seeking reasons based on success or failure of interventions. Since a research study focused on obtaining desired results, choice of method ensures that the study remains focused and that the quality of results is enhanced (Marshal, &Rossman, 2010). 5.1.1.2 Theory of the study Grounded theory was preferred in this study as the phenomenology approach. Grounded theory is a methodology that involves the constructions of theories used to explain phenomenon through the analysis of data collected from first persons (raw data). Other study theories like positivist research were not preferred for this research because of their tendency of objectifying or criticizing existing or previous studies (Whittaker, & Williamson, 2011). It is important to note that this study was focused on interviewing subjects on a personal basis and coming up with conclusions from the data obtained. Positivist researches relate with grounded theory when it comes to carrying out researched in the sense that they all lead to original and not implied conclusions. However, the most important thing to consider is the fact that grounded theory constructs other theories from a study while positivist research does not (Taylor, & Francis, 2013). As a research study, which seeks to remain rational in obtaining an independent opinion on the positive impacts of sonographers reporting WRMSI cases to their employers, the use of qualitative research methodology and procedure is focused on giving independent research results that are unbiased (Taylor & Francis, 2013). This research study proposes the use of grounded theory as opposed to phenomenology in data collection due to its analytical perspective in analysis of social process that focuses on factors that affect individuals in health sciences. As a methodology focused on human experience, grounded theory seeks to develop a symbolic interactionism based on experience and social interaction. Grounded theory focuses on the processes of assignment of events while undertaking research study based on emotions and relationships (Whittaker, & Williamson, 2011). As compared to phenomenology, grounded theory ensures that research is carried out based on increased awareness and understanding of the data as research study is focused in ascertaining appropriate information from other evidence based studies. Unlike phenomenology, grounded theory methodology focuses on theoretical sampling through assessment of few individuals within the sonographers based on the whole population of people who have experienced WRMSI cases, to give an all-encompassing account of their experience (Marshal, &Rossman, 2010). 3.2 Participants or respondents of the study As a qualitative medical research the sample size choice for the study is influenced by nature and scope of study, study design and quality of the data collected. Since this proposal is concerned with the impact of reported cases of WRMSI amongst sonographers as reported to their employers, the sample size will be based on 20 (twenty) sonographers to get accurate information based on the study limitations of available participants will be relevant (Marshal, &Rossman, 2010). Notably, research will be carried out based on sufficient number of participant as per timetable, analysis of content and interview arrangements based on the total sample size of sonographers in this research. According to the requirements of any study based on rounded theory, the respondents of such a study should be between 20 and 60 (Taylor, & Francis, 2013). This study settled on 20 as the number of respondents for the study because of the difficulty of getting sonographers who are willing to divulge truthful information even if their anonymity is guaranteed (Whittaker, & Williamson, 2011). Probability sampling, which is the use of random selection to identify respondents, will be used for this study. This is opposed to non-probability sampling which is the use of predetermined procedures to choose respondents of a research. Probability sampling is the most appropriate for this study because the respondents of the study should not be predetermined because this means their information will be compromised (Marshal, &Rossman, 2010). From the total number of sonographers, the inclusion criterion for the participants is based on the length of experience and practice because participants will give information voluntarily (Taylor, & Francis, 2013). First, the sonographers will be selected based on the independent view of changes derived from reported WRMSI cases to their employers. Notably, participants wishing to take part in the interview will receive the information sheet and declare their intent to the researcher of their participation (Bassett, 2004). The study also seeks to diversely analyze the benefits derived from reduction of injury cases based on creating awareness of the help, prevention and treatment available to treat WRMSI. Therefore, the set of sonographers eligible to participate in the study will be based on sample representative of sonographers with WRMSI medically proven cases. The specific selection of participants will be from North East hospitals and based on random sampling (Streubert& Carpenter, 2011). Purposive sampling was chosen for this study because of this type of sampling seeks respondents with certain information needed. Convenience sampling will not be used because it only seeks participants who are conveniently available. As a result, the timetable for participants’ interview time, date and location will be based on ensuring privacy and anonymity of the participant is maintained (Norwood, 2009). More essentially, each participant should be willing to divulge truthful information after reading through and understanding the consent form and information sheet. The interview process will take an hour for each of the participants and the interviewer is allowed to ask more questions to get an in-depth view of the study. Data collection during the interview will be through recording and notes taken throughout the interview process (Whittaker, & Williamson, 2011). To ensure high confidentiality of the research participant their identity even from their employer is concealed and the participant has an independent choice to withdraw from participating in the research at any time (Bassett, 2004). 5.2 Data Collection Techniques 5.2.1. Mode of interview chosen for the study It is worth noting that semi-structured interviews were chosen for the purposes of the study. This mode of interviews was preferred for this study to structured interviews because of the flexibility that comes with them. It is worth noting that structured interviews are rigid and have sets of questions that do not allow respondents to divert and provide other information that may have been significant for a study but were not asked (Taylor, & Francis, 2013). This implies that structured interviews do not give the respondents an opportunity to provide further information that may be relevant to the study under investigation. On the contrary, semi-structured interview questions are open-ended and allow respondents to provide any other information that may be important for the study under investigation. Since this study was based on grounded theory, it was important that the respondents of the study provide as much information as they could. In addition, it is possible that the use of structured interviews would limit the respondents and it is for this reason that semi-structured interviews were chosen. Focus groups will not be ideal for the study because of the fact that confidentiality is important for this study. Focus groups is when all the respondents are asked to provide information all at a go, and the same time and place (Whittaker, & Williamson, 2011). Based on primary data collection methods such as semi-structured interviews, accurate and timely information will be analyzed from content given by participants. Taylor and Francis, (2013), describe primary data collection as an efficient way of constructing semi-structured interviews, pre-testing them in terms of functional capabilities through conducting rigorous interviews before arriving at the data analysis stage (Bassett, 2004). Notably, use of primary data over secondary data in this research gives increased objectivity and real time feedback as compared to the use of secondary data based on analysis of other previous studies based on assumptions. Notably, this study requires high objectiveness as it addresses an area that requires accurate feedback through use of subjective primary data (Norwood, 2009). This study will use primary data based on semi-structured interviews set to analyze cases of WRMSI deemed suitable. Moreover, the research will focus on seeking varied opinions on the research questions, while focusing on the consequent conclusions based on the research objectives and carrying out an analysis of the responses collected from the semi-structured interviews (Bassett, 2004). More significantly, qualitative primary research methods are more likely favored as it involves the collection of quantifiable and qualitative data that are later used for qualitative comparative analysis of the research (Whittaker & Williamson, 2011). 5.3 Procedure One participant will be required to get into the interview room at a go. This implies that only one participant at a time will be interviewed. Before the commencement of the interview session, each participant will be assured of his or her anonymity in order to encourage them to provide truthful information without fear of being exposed to the public (Norwood, 2009). The process of interviewing the participants of this study will begin by explaining to them the purpose of the study and their being participants. This will be done both verbally and through an information sheet that will be given to them to read. This will be followed by giving the respondents a consent sheet to sign. The consent sheet will be a sheet seeking the permission of the respondents for using their responses for the purposes of this study (Bassett, 2004). Participants will be given enough time to read through the information sheet in order to understand all that the study entails. They will also be given enough time to read and understand the consent sheet (Norwood, 2009). The interview session will commence once all the relevant documents have been signed by both the participant and the interviewer (Marshal, &Rossman, 2010). It is important to note that the interviewer will introduce each respondent by a pseudo-anonymised identification number. This will be provided on a tape recorder and will be followed asking some fundamental induction questions. The induction questions will only be meant to put the respondents at ease and will not be documented for the purposes of the research (Streubert, & Carpenter, 2011). After that, the interview questions will follow. They will be asked to the respondents in accordance with the interview guide. However, it is important that if any themes that are relevant to the study arise during the interview session, the interviewer will be allowed to diverge from the interview guide thereby allowing him or her to ask further questions. This is why semi-structured interview questions were chosen for the study. Each interview session will be allocated 1 hour but a deviation of 30 minutes will be allowed in case the participants exceeded the time allocated. Audio recorded interviews will then be transcribed and be provided to the participant. This will be after they have read and understood the information sheet and signed the consent sheet. Member checking is the process through which respondents will be verified and their consent sheets checked (Norwood, 2009). 5.4 Data Analysis Although grounded theory and qualitative content analysis have significant similarities, it is important to note that the differences between the two research methods remain relevant in carrying out successful research. Significantly, the use of systematic coding process of data analysis, both in grounded theory and qualitative content analysis shows increased similarity in categorizing and coding (Norwood, 2009). However, it is essential to consider that the procedure is different because in ground theory data collection and analysis are parallel while in qualitative content analysis data analysis is carried out sequentially after data collection. As a result, use of qualitative content analysis over grounded theory remains essential as the amount of data used in analysis is based on availability rather than saturation (Marshal, &Rossman, 2010). Qualitative content analysis will focus on achieving research objective by carrying out analysis of research question, revision and development of inductive categories besides interpretation of research results (Norwood, 2009). Grounded theory and qualitative content analysis ensure that research is carried out based on naturalistic inquiry by critically identifying themes and patterns as they analyze and interpret qualitative data. In research, grounded theory is a research methodology focused on establishing of theoretical framework and content analysis of textual data analysis. Considerably, use of qualitative content analysis ensure adherence to analysis of qualitative descriptive studies based on research methods technique in ethnographic and grounded theory (Saks &Allsop, 2013). As an inductive methodology, grounded theory studies ensures efficient use of open questions by the researchers who focus on the actions of their participants get more information as it is based on a practical social problem using open research questions (Marshal, &Rossman, 2010). Grounded theory methodology emphasizes on inductive analysis. Choice of using grounded theory oversees the use of analytic thinking in medical research as analysis move from general to particular. Essentially grounded theory start with pre-existing hypotheses before testing its relevance based on collected data (Marshal, &Rossman, 2010). In contrast, to use of content analysis, grounded theory undertakes a very open approach as the researchers focus on what remains important to the study participants rather than the main aim of carrying out the study. Unlike, qualitative content analysis use of grounded theory study uses data collected from participants even as analysis of data collection process continues thus leading to increased theoretical sampling (Watson et al., 2008). In research study, use of qualitative content analysis especially in health care research remains flexible as it analyses data based on data purpose by inductive and deductive analysis. Based on high level of interpretation, qualitative content analysis uses flexibility of either inductive or deductive approaches or both approaches combination in data analysis. An analysis of inductive approach is based on the appropriateness of the approach with limited prior knowledge of area of study under investigation (Whittaker & Williamson, 2011). Essentially, use of deductive approach in research study focuses on testing existing theory as an objective of the study. Considerably, descriptive statistics based on cross tabulations and Pearson's correlations analysis give the demographic profile of the research subjects. Clusters of the results will be based on demographic variables such as symptom diagnosis, prevalence of work-related and specific work-related symptoms based on degree and level of involvement and degree in the scanning where open-ended questions give data group categories and frequencies were determined for each question. Content analysis is relevant because it involves high level of transparency, modest nature, and ease data collection by presentation through tabulation tables generated based on research results using the questionnaire (Saks &Allsop, 2013). The methodology selected for this study data analysis is based on qualitative content analysis of finding in semi-structured interviews based on in-depth information of the respondents from the sonographers in different health institution (Watson et al., 2008). This is because, the semi-structured interviews will be based on the sonographers work setting, status and years of experience and the level ergonomic training achieved. In addition, the research interview will focus on WRMSI, coping strategies and, work factors based on how frequent respondents experience discomfort, injuries or fatigue in any part of their body (Marshal, &Rossman, 2010). An overview of the qualitative content analysis approach involves the analysis of responses from respondents who indicated their different experience of WRMSI disorder and continue working without reporting such cases to their employers (Whittaker & Williamson, 2011). 6.0 Ethics Indeed, there are various ethical issues ranging from the concealment of participants identity and presentation of data as the author has to reveal all the information. The information needs to give an in-depth truth and un-biasness thus promoting trust, confidentiality and accountability. Some ethical issues are likely to arise when the researcher is carrying out research especially as it involves human beings interested in their dignity and safety thus, the researcher should avoid ethical issues based on the respect of persons, as it requires researchers to carry out the research with autonomy and self-determination. In addition, the researcher should ensure beneficence and justice is maintained besides the requirement of confidentiality and autonomy according to University Ethics Committee. In this case, the information that is confidential gains exposure even though there is increased protection of the research subjects from harm through their engagement in the research. As a result, anonymous identification numbers replaces identification information of participant to conceal identity. Information is confidential between the research and study supervisor after the interview in its collection, processing and destruction. 7.0 Summary In summary, the study will be aimed at identifying the consequences related to failure by sonograhers to report cases of to their employers. In conducting this research, grounded theory will form the basis of the study. It is for this reason that 20 respondents, who will have to be willing sonographers, will be randomly selected to provide vital information needed to meet the objectives of the study. Semi-structured interviews will be used to collect the necessary data because of their open-endedness. During the interviews, respondents will be assured of their anonymity in order to give them the morale to divulge truthful and dependable information. 8.0 REFERENCES Baker J.: Meeting of the minds on WRMSD. Radiology Today 2003:6–7. Baldry P.( 2001): Myofascial Pain and Fibromyalgia Syndromes: A Clinical Guide to Diagnosis and Management.London, Churchill Livingstone. Bassett. C. (2004) Qualitative Research in Health Care. London: Whurr Publishers Ltd. Bongers, P., Kremer, A., and Laak, J., 2002. Are psychosocial factors riskfactors for symptoms and signs of the shoulder, elbow, or hand/wrist? A review of the epidemiological literature. American Journal of Industrial Medicine 41 (5), 315–342. 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