Research Methods in Health Science - Essay Example

?Research Methods in Health Science Research and development have been part and parcel of every aspect of human life since the dawn of civilization. It is by research that mankind has progressed to the modern era. As in other fields, any research in health sciences involves identification of a specific problem during the course of delivery of health services, or when an inquisitive researcher attempts to identify reasons behind a phenomenon that can be modified or manipulated towards a positive outcome by adopting novel means or practices emerging from deliberate and intensive research conducted on an aspect. Both qualitative and quantitative research methodologies are appropriate depending upon the question that is being raised on a particular aspect. If a distinctly measurable commodity within the confines of the presently available measurement parameters’ and statistical instruments’ is being looked into, then a quantitative approach is the most rational option. However, when the area of research is more abstract i.e. involves looking at trends or measuring human perceptions and beliefs on a particular aspect that might be vital for health issues, a qualitative approach is the only method available which can lead to any conclusive inference. Statistical tools have been developed which allow classification, tabulation and grouping of even qualitative data into comprehensible forms which can lead to entirely valid inferences. Qualitative research involves comprehension of complex factors contributing to a particular phenomenon and numerous factors have to be identified, standardized and transformed into some measurable form before they can be evaluated to gain insight into the particular aspect being researched. Although considered unscientific by skeptics, as it lacks the experimental and observational approach followed in quantitative research which believes in the evidence generated by repeatable experiments yielding consistent data in biomedical sciences, it has gained belief in scientific circles during the last few decades due to the complex human, social, cultural and other factors influencing health in its entirety (Pope & Mays, 2006). Normal health or success of a particular medical procedure cannot be ruthlessly related to the success of a particular mode or procedure of therapy by its proven 100% success rate suggested by quantitative experimental data. Myriad factors, such as the psychological state of the patient, the manner in which the healthcare providers interact with the patient, family, economic and social standing of the patient and multiple other factors might be contributing in a significant manner. Such factors can only and only be evaluated by qualitative research. In order to evaluate the influence of such abstract factors, the right question has to be framed before any research strategy can be developed. It has to be assured that the research is conducted employing a design which can generate results which can be generalized within and without the applicable population. A prime example of a phenomenological qualitative study is the one recently conducted in Sweden, wherein the authors’ have tried to role of prenatal education from the perspective of the male parent regarding their role as primary caregivers immediately following birth (Erlandsson & Haggstrom-Nordin, 2010). Either parent’s opinion, irrespective of the sex is a complex collection of cultural background, personal education, experience and aptitude, which are difficult to evaluate using quantitative methodology as such things are not measurable. As the study has been conducted in an exclusive country i.e. Sweden, it can be assumed that the cultural background is free of any particular bias. The authors’ have sought to identify the concepts within the fathers’ minds about the topics covered in prenatal education especially after firsthand experience after childbirth and the difficulties encountered thereafter. The framing of the research question by the authors’ is therefore in coherence with the specifications necessary for initiating qualitative research (Module 3). This is a typical example of an interpretive paradigm in which the researchers presume to arrive at a consensus on the father’s concepts about the advantages and lacunae they might have encountered in the prenatal training modules. The settings for the study are truly naturalistic and aim is to explore the subjective experience of the male parents’ after the actual experience. The significance of the research question arose when the researchers observed that ante natal training had been established in the country since long without exploration of the effects it was exerting on the affected parties, especially fathers who are considered secondary in terms of care to be imparted to the child immediately after birth. The need for political equality between the sexes and identification of the problem that fathers who were not involved in antenatal training programs failed to assist their spouses in postnatal care even after elapse of a fair amount of time after childbirth made the Swedish government to initiate programs in which the participation of fathers’ was made mandatory. It was speculated that involving fathers’ during the early stages of pregnancy and establishment of an early care providing relationship with the infant after birth could assist in providing better emotional support to the mother as well as the baby. How far such regulations have been successful in ensuring better care by both parents is therefore a matter of conjecture subject to research. The authors’ have therefore identified a valid topic for research. As all births are not eventless occasions, the complexities encountered in individual cases might be posing novel situations to the parents, which they may be capable or incapable of handling independently. These are some of the outcomes which the authors’ presumed to infer after analyzing the data obtained through interviews. The authors carefully selected the parents according to pre-specified criteria after obtaining informed consent and due permission from the appropriate ethics committee. Although the sample size was small (n=15), it was irrelevant as it was a first time investigation and the interview structure was appropriately built to evaluate the subjective experience of fathers’ with similar background, and experiencing similar situations after childbirth. The authors’ employed an established phenomenographic model for their study. The criteria adopted for short-listing of participants included experience as a primary care giver immediately following birth while the mother underwent necessary medical procedures, history of attendance of parental education classes and the mother/child being healthy (Erlandsson & Haggstrom-Nordin, 2010). In addition, all fathers’ needed to have cared for their newborn infant within the first 7 hours of childbirth. However the age range varied from 28 to 54 years old fathers’ which may lead to some scope for bias as older fathers’ and those caring for newborn children as their second or subsequent might have radically different viewpoints, based on experience. However, the content of their prenatal education was standardized according to prevalent Swedish regulations. Training had been imparted by midwives and covered topics such as pregnancy, childbirth, early parenthood, personal development, partner relationship, and relaxation techniques. As a precaution, two pilot interviews were conducted in advance to pave the way for uniformity in the actual interviews. The study was conducted in the form of interviews conducted between 8 days and 6 weeks following the birth of a child (Erlandsson & Haggstrom-Nordin, 2010). This is a fairly wide span of time in which the scope for occurrence and identification of the problems encountered by the fathers’ stands covered and can lead to a fairly logical conclusion which can be substantiated with further studies involving more participants with appropriately framed questions to elicit accurate responses. Interviews were conducted employing an exploratory approach either at the university or at the participant’s home based upon their preference. Interviews were audiotaped and then transcribed for further analysis. The transcribed interviews were analyzed for uniformity based upon the expected and the actual difficulties encountered by the interviewed fathers’ and similar responses classified into specific categories based upon the aim of this particular study. The uniformity encountered by the researchers was in the fathers’ perception that antenatal training programs were oriented more towards the expectant mothers’ rather than themselves. Based upon this concept, the fathers’ found themselves to be ill equipped while handling emergent situations as and when they actually happened in individual cases. The authors’ analysis yielded 127 different ‘conceptions’ garnered from the transcribed interviews which they generalized and categorized further through the process of ‘condensation’, after which ‘grouping’ was done to put them into two categories viz. ‘similarities’ and ‘variations’. The outcomes of the grouped results yielded categories and sub-categories which were formed from the actual experience after child birth and the correlation with antenatal training programs. The three categories which the analysis yielded included 'Parental education emphasized the importance of normal birth', 'Parental education defused the issue of complicated birth 'and 'Parental education preserved traditional gender roles in parenthood' (Erlandsson & Haggstrom-Nordin, 2010). The interviewed fathers’ were consistent in their viewpoint that the training modules stressed more upon the normal birth procedures while relegating any complications to the secondary position. In addition, the fathers’ consistently reported the trainings to be more ‘mother-oriented’. Thus the authors’ were able to identify three categories, five subcategories and 12 qualitatively different conceptions, based upon which they were able to advise the incorporation of ‘father-oriented’ approaches to be adopted in the future prenatal trainings. The conclusion of the study into a valid and reasonable sounding recommendation suggests that although the study design involved a very small sample size according to the number of participants, a phenomenographical qualitative approach, if employed can yield pertinent information which hitherto was considered irrational and non valid by the firm believers of experimental quantitative research in health sciences. Such first time qualitative studies are therefore unique in their nature as well as design, as the motive for conducting them emanates from the emerging trends in society as well as the concern felt by the healthcare professionals directly involved with a peculiar situation or circumstance. In this particular study, the authors’ have been able to identify the problems faced by fathers’ when encountered with situations’ different from normal. They were left looking for knowledge when a caesarian section was necessary or the baby had to remain in isolation from the mother for an extended period of time. They also found the trainings deficient in terms of what they could do to ensure ‘skin to skin’ contact, handling the baby while the mother was being subjected to medical procedures and in other peculiar situations. The study therefore paves the way for recommendations which can enhance the content and efficiency of prenatal training modules. Healthcare sciences are not confined to basic medical sciences alone, which are based on hard theoretical and practical principle and facts, but also involve a social context under which a holistic cure from a condition or disease evolves. Patients’ perception of the condition he or she is suffering from and the belief in the efficacy of the administered modalities are of prime importance in proper healthcare delivery. Such nuances therefore are increasingly being recognized all over the world triggering research employing the qualitative approach. Quantitative research fails where qualitative succeeds. For example, it allows a researcher to identify "what is X, and how does X vary in different circumstances and why? rather than "how big is X or how many X’s are there?" (Pope & Mays, 2006). A study has identified seven criteria for qualitative research to be considered valid and appropriate (Cohen & Crabtree, 2008). These criteria include adherence to an ethical approach while conducting research, importance of the research topic, clarity and coherence of the research report, employment of rigorous and appropriate methodology, awareness/identification of factors leading to bias, establishing validity and credibility and verifiability of reliability. If all these criteria are satisfied, there is no doubt that qualitative research can impact healthcare in a big way. In the present era of evidence based practice, patient outcomes and aftercare have assumed great importance as the best treatment modalities fail if they are not administered employing a personal caring attitude by the healthcare professionals. Treatment of any condition has to be holistic rather than being a mere impersonal procedure for treating the condition a patient is suffering from. Identification of patient’ attitudes, preferences and weaknesses need to be considered before compliance with the recommendations can be expected. Conclusion The above critique is a prime example of qualitative research contributing to the discovery of the lacunae which exist in the administration of a training procedure for antenatal training to prospective parents. Despite the small number of participants and the absence of experimental data/statistical methods, the authors’ have been successful in using a phenomenological approach to identify numerous categories of opinions from experienced participants’ which have added to the knowledge of prenatal training content which needs to be improved for better outcomes in the future. The research has made an inroad into the psyche of prospective fathers’ and their comprehension of personal roles before, during and after pregnancy which is a primary event in one’s life. The implications of the analyzed results are clear. The antenatal training programs should not be mother-centric; the father should not be relegated to a secondary position and should be familiarized with the responsibilities and procedures he has to undertake following any aberration from the normal recourse of childbirth, such as what to do if caesarian section is imperative and the mother needs to be isolated from the newborn child for an extended period of time. References Cohen, D. J. & Crabtree, B. F. (2008). Evaluative Criteria for Qualitative Research in Health Care: Controversies and Recommendations, Annals of Family Medicine, Vol. 6 (4), pp. 331-339 Erlandsson, K., & Haggstrom-Nordin, E., (2010). Prenatal Parental Education from the Perspective of Fathers with Experience as Primary Caregiver Immediately Following Birth: A Phenomenographic Study. The Journal of Perinatal Education. 19(1), 19-28. Mays, N. & Pope, C. (2000). Assessing quality in qualitative research, BMJ. Vol. 320 (7226), Retrieved May 30, 2011 from: http://www.bmj.com/content/320/7226/50.1.extract Module 3, HLT505 Research Methods, A Study Guide (2008). Charles Stuart University: Wagga Wagga, NSW, Australia. Read More