Lived Experience of Older Hispanic Women with Chronic Arthritis - Research Proposal Example

? Research Proposal on Lived experience of older Hispanic women with chronic arthritis and their perception of pain Introduction In the dynamics of fast transforming social changes, the effective healthcare delivery has become a major concern. With the increase of life expectancy, whole new issues of healthcare, fitness and quality of life of old people has emerged. The demography of diseases, especially related to chronic diseases in aging population reflect growing insecurity and health concern for the segment. While the inevitability of age and its socio physical and cognitive changes are natural process, the accompanying deterioration of quality of life due to chronic pain requires focused and specialized healthcare. The various factors that influence the effectiveness of the treatment or prevention need to be identified and evaluated for providing better care and mechanisms of pain management and preventive measures. The study would look at the lived experience of older Hispanic women with chronic arthritis and help identify the various aspects of health disparity, disability and pain due to chronic arthritis in older Hispanic women who are 65 years and above. 2a. Statement of the problem In the target demographic segment of 65 years and above age group, chronic diseases are quite common. Christ and Diwan (2009) assert that from 2010, when the baby boomers start turning 65 years and above, there would be significant rise in the aged population. CDC (2007) reports that ethnic minority and Hispanic older population would be nearly 39% of 65 and over population by 2050! Hispanic American would increase by 18%. The racial diversity of older population becomes important ingredient of healthcare deliverables because of the increasing health disparity. It further informs that 54% of women are afflicted with arthritis. With relatively large percentage of population constituting of Hispanic Americans, women, in particular, are more prone to arthritis and other chronic diseases. 2b. Purpose of the study The basic purpose of the study would be to study the lived experience of older Hispanic women with chronic arthritis and find out various aspects of the illness that impact quality of life in the target segment. It would help to address the issue from the wider perspective of socio-economic and cultural paradigm that would help evolve new mechanisms for improving their life. 2c. Significance of the study The study would help the authorities and healthcare industries to address the various external factors that impact the effectiveness of the arthritis treatment in older Hispanic women. It would go a long way in easing the pain of the chronic illness in aged Hispanic women who have been living with the constant pain and disability caused due to chronic arthritis. 3a. Research question Q1 To what extent ethnicity or culture influence the treatment experience? Q2 Why women are more vulnerable to chronic arthritis than men? Q3 What are the external environmental factors that impact the lived experience of older Hispanic women? Q4 How pain is perceived in chronic diseases across cultures? Q5 Should geriatric care be redefined vis-a-vis pain perception across culture? 3b. Hypothesis Arthritis, especially rheumatoid arthritis is associated with chronically painful syndrome of aching and burning pain of the joints (Merskey and Bogduck, 1994). Constant pain and difficulty in carrying out daily work are the major consequences of arthritis (Melanson and Downe-Wambolt, 2003). The disability becomes a crucial factor that not only impacts the physical condition of the women but also influences her mental and cognitive abilities to live normal life. The socio-economic conditions of the people can aggravate or delay the chances of age related diseases, especially arthritis. Indeed, environmental factors like poverty, cultural paradigms, racial health disparity etc. are significant factors that have adverse effect on the health. It is therefore assumed that by identifying the factors that influence its treatment, women would be better equipped to cope with the disease and respond to the treatment. 4. Review of the literature Arthritis is a disabling disease that progressively gets worse. It broadly refers to the inflammation of the joints and damage of the cartilage which results in pain and discomfort (Escalante, 2007). While there are different types of arthritis, osteoarthritis, rheumatoid arthritis, infectious arthritis, fibromalgia, gout etc. are few that are more widespread Furner et al., 2003). According to CDC (2006) arthritis affects more than 3.1 million Hispanics in America with higher prevalence rate of 28.3% amongst women. The most distressing fact is that it would affect more and more people in the future. Helmick (2008) says that due to the degenerative disease, more than 59 million people have acute to moderate low back pain. Indeed the key issue with the chronic arthritis is the constant pain and its perception by the individuals which differs vastly across the culture. The lived experience of older Hispanic women with chronic arthritis is ambivalent in terms of degree of tolerance (Jorge, 2011; Jordan, 2008). They have high degree of tolerance to pain as against their white counterpart which results in the ignorance of the disease. The early treatment is not possible because pain is not perceived as related to disease. Moreover, many studies have shown that arthritis is either misdiagnosed or not diagnosed at all amongst Hispanics and Afro Americans (Meghani et al., 2012; Miller & Newton, 2006; Caldwell, 2001; Edwards et al., 2001). Indeed, there are considerable differences in perception and meaning of pain across the cultures. Studies show that meaning and coping strategies of pain have emerged as major factors that contribute to human sufferings (Moore & Brodsgaard, 1999; Jordan, Lumley, & Leisen, 1998). The various factors like demography, macro environmental factors and micro economic compulsions significantly influence choice and decisions regarding chronic arthritis and pain management. The racial discrimination and inequity in the healthcare has emerged as major problem that adversely impacts the well-being of minority (Meghani, 2008). It is therefore a crucial issue that must be addressed urgently for the wider welfare of society. 5. Research plan 5a. Framework of the study The study would use mixed research methodology with focus on qualitative research along with elements of quantitative research. Qualitative study helps to identify trend and behavioral pattern (Creswell, 2007) and therefore is pertinent in assessing and evaluating the living experience of chronic arthritis amongst older Hispanic women. Thus, it would be evaluating the behavioral pattern of pain perception and factors that have impact on their treatment. It would also analyse the impact of changing socio-economic conditions and help identify drivers of cultural paradigm. The semi structured questionnaire would be used as sampling tool to collect data from the target respondents mainly comprising of older Hispanic women (65 years and above) within a defined region. The questionnaire would also take into account the family structure and the macro environment factors like poverty, education, employability etc. 5b. Data collection and sample Measurement techniques would comprise of questionnaires and interview schedules. Special interview schedules would be used to evaluate the responses of the family towards the disease and patient. Sample size would consist of 50 respondents of Hispanic origin. 5c. Data analysis Data analysis would broadly use Typology method. Lofland and Lofland (1995) as it is based on patterns and themes. The method describes the arrangement of data in some pre-defined criteria of theme, pattern and/or issues so as to develop and predict model that best reveals the trend. The methodology is useful in interpreting the data in the wider context of external factors that impact perception of the disease and pain management. Most importantly, qualitative analysis through Typology greatly facilitates in identifying critical drivers of cultural imperatives that influence the treatment. 6. Ethical consideration Ethical considerations are intrinsic part of research that promote trust and confidence building which is crucial part of qualitative research. It is important that researcher is equipped with cross cultural understanding and conform to the cultural ideologies so as to gain their trust. It is also important their confidentiality of information is maintained. 8. Contribution of the research The study would hugely contribute to the efficacy of the treatment of chronic arthritis amongst older Hispanic women. The research focuses on the cultural paradigms that influence treatment and also helps identify the varying perception of the disease and pain amongst the Hispanic women. This would encourage the government and healthcare industry to evolve more creative approach and introduce new mechanisms of promoting awareness of early detection and treatment of the disease before it turns chronic. (words: 1379) Reference Caldwell, N. L. 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Cross-cultural investigations of pain. Force on Epidemiology of the International Association for theStudy of Pain, (1999): 53-80. Merskey H., & Bogduk, N. Classification of chronic pain: Definitions of Chronic Pain Syndromes and Definition of Pain Terms, 2nd ed. Seattle: International Association for the Study of Pain, 1994. Read More