NR 505 Discussion Data Collection

My refined PICOT question is, how can we better pain management of rural adults with chronic/acute pain care needs, and the alternative medications compared to narcotic medications to improve pain management? I decided to use the qualitative research approach for this specific research topic. I chose this research approach because “qualitative research is primarily exploratory research. It is used to gain an understanding of underlying reasons, opinions, and motivations” (Simply Psychology, 2017). Since pain management is in abstract and immeasurable nursing assessment, it makes it hard for health professionals to gauge pain levels and treatment options based solely off the patient’s opinion of the pain level. I believe qualitative its better tailored to this type of research because quantitative research is based more off of mathematical data and numerical measurements to analyze the data collected. Data will then be collected in a few different ways. One way will be through face to face interaction through interviews and focus groups. Another way to collect data will be through ” impressions, environmental contexts, behaviors, and nonverbal cues” (US National Library of Medicine National Institutes of Health, 2015) on pain levels and pain management techniques. Lastly, data can be collected through readings of transcripts or other written articles. The quality data they may be produced by my EBP project is better pain management techniques for rural areas to implement for their chronic and acute pain patients. Ideally this will cut back on the narcotic epidemic and over prescribing of narcotics to those whose pain can be controlled in a more therapeutic way. We will evaluate patients pain and listen to what has worked and not worked, and create a personalized pain management plan based off the needs of the patient. This will better control their pain and allow them to have an improved quality of life on a daily basis.

Simply Psychology. (2017). Qualitative vs. Quantitative. Retrieved from https://www.simplypsychology.org/qualitative-quantitative.htmlLinks to an external site. US National Library of Medicine National Institutes of Health. (2015). Qualitative Research: Data Collection, Analysis, and Management. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485510/Links to an external site.

I really enjoyed your post this week. Pain management and the use of narcotics is a large problem these days. I like that you are looking into using alternative therapies for pain management. Have you heard of pain contracts? My understanding is that when a patient goes to a pain management clinic or even to their regular general practitioner, he or she must sign a contract saying they will not sell their narcotics to others. The practitioner will also take a urine or blood sample every month to make sure the drug is in the patients system. Also, the patient promises not to doctor shop while they are receiving prescriptions from their current practitioner. Is this the correct interpretation of pain contract? I currently date someone who has a lot of chronic pain. He has costochondritis. He was using various medications, OTC’s, to help him with his pain. He did a lot of research online and found a device which has helped him a lot with his pain. It is called a ‘back pod’ . The theory behind this device is that with costochondritis, there is a build up of scar tissue, which causes the pain. So, when he lays on this device every evening, he is breaking up the scar tissue. He told me that his pain has gone from 80% of the time down to 15%. And he has only been using this device for one month. My point to sharing this selection, is that there is a lot of alternatives out there for pain management, not just medications. And, you are correct, peoples ideas of pain and the management of it varies. A lot of people would just like to take a pill and get rid of the pain; however, that may not be the best alternative for them.

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I am very interested in how your project turns out as compared to mine. We are both doing pain management and are both interested in finding alternative/ non-narcotic pain regimens. Instead of going the qualitative route, I am choosing the quantitative route. True, pain is difficult to measure and that everyone has their own definition of pain. Working in the ER, it is difficult for me to believe that someone has 10/10 pain while they are laughing and conversing with friends, sleeping or asking for a turkey sandwich. Unfortunately, there are people out there that are in search of anything narcotic for their own fix or to sell. Because of the unfortunate loss of faith in people’s honesty, I need solid proof. There are, in fact, ways to measure pain. I have seen many times a person come in with complaints of severe pain and a high blood pressure and after the pain is taken care of, per patient reporting on the pain scale, the blood pressure often returns to normal range. Though it is not an absolute, physical signs such as these are good indicators of level of pain. I am very interested in how both of our projects compare with two different designs aiming to reach the same goal.

The PICo question for my evidenced based practice research project is: Are post war veterans (P) at a greater risk for suicide (I) as they reintegrate into society (Co)? I have chosen the qualitative research design approach because I want to better understand how the post war veteran is feeling and understand their lived experiences as they return from combat. A qualitative study allows the researcher to understand the participants characteristics and lived experiences when the participant is allowed to speak freely (Polit & Beck, 2017). I feel the qualitative study has the potential to create further avenues of researcher as themes develop throughout the interview process.
In-depth interviews are my data collection method of choice with permission received to audio tape the session and take notes in the anticipation that themes and commonalities emerge from the data. Clark and Veale (2018), discussed how images or words will consistently emerge during in-depth interviews showing a connection with individual participants and the research being accomplished. The collection of data retrieved from the in-depth interview process will provide adequate information to answer my PICo question and is considered a strength in my research process. A weakness to this type of data collection would be allowing my own personal feelings, bias, or opinions interfere with the appropriate interpretation of data. Often, we see things through the lens of our own personal experiences and that could inhibit the subjective nature of the data.
The actions I plan to incorporate into my qualitative study is to ensure my sample size is appropriate to gather appropriate information but not too large so that the information becomes diluted or deters from the main objective outlined in the PICo statement. Secondly, I plan to write out a personal belief statement and establish a baseline of personal opinion and bias and ensure my interpretation of data is not being occluded or misrepresented through my own experience. My objective is to ensure the data is in its most raw and authentic form in the hopes that further studies will emerge as a result of the information provided.

Clark, K. R., & Vealé, B. L. (2018). Strategies to Enhance Data Collection and Analysis in Qualitative Research. Radiologic Technology, 89(5), 482CT-485CT.
Polit, D. & Beck, C. (2017). Essentials of nursing research: Appraising evidence for nursing practice (9th ed.). Philadelphia, PA: Wolters Kluwer.

Thank you for your insight on formulating questions for my qualitative research.

For this week’s professor response, I have chosen to discuss the interview questions and whether they are semi-structured or open-ended. I must admit, I had to do some research to better understand what constituted a semi-structured question and interview format. Based on different articles and questionnaires, my understanding of the semi-structured question is best implemented when the researcher has only one opportunity to interview the participant and the pre-formulated questions allow more information to be covered. My understanding of the open-ended interview is more of allowing the participant to respond freely to the initial question and then utilizing their response to lead and guide other questions.

In a research article by Marsilio (2017), participants were involved in a qualitative study where phenomenological methods were utilized, and veterans were asked a series of semi-structured questions regarding social media use. The semi-structured interview process seemed to allow structure and direction to the data collection process and keep the focus of the conversation on a specific topic. My plan is to develop a few semi-structured questions such as, “What has been your biggest challenge since returning home”? Incorporating questions such as, “Tell me about your experience returning home from deployment?” would perhaps open the door for other questions that discuss suicide or thought of self-harm. My goal is to facilitate a discussion but leave room for the participant to openly discuss what they are feeling and how their lived experience in combat has impacted their present reality. Marsilio, K. (2017). Student Veterans’ Shared Experience Using Social Media in Higher Education: A Pilot Study with a Hybrid Phenomenological Data Analysis Method. Information Systems Education Journal, 15(5), 45-59.

I have always struggled with the PICOT questions on if I am doing them correctly to get the best information for the research that I want to do. For my PICOT question I have chose to do: In women who are diagnosed with PPD is exercise a more effective way of treatment than medication or no intervention for decreasing their depression?

I plan on using a quantitative research for my research on PPD and the use of exercise as a treatment instead of medication. One may choose quantitative research if there is a lack of research that exists on a particular topic or if there are unanswered research questions (Rutberg & Bouikidis, 2018). When choosing to use quantitative research there are three different designs to choose from such as experimental, non-experimental, and quasi-experimental designs. I would like to do the experimental design for quantitative research for my project as this a control group that has at least one experimental group in the design and is one of the most reliable studies used for randomization process for group assignment wherein the control group receives a placebo (Rutberg & Bouikidis, 2018). For example I would have some women exercise, some women would receive a placebo drug, and some would receive depression medication. I would then see if taking medication and exercising together has a possible greater effect on decreasing the women’s PPD. It would be interesting to see what has a greater and faster effect. I could then also study women who exercise and receive placebo medication and see what the results show from that. The strengths to doing this type of research would be that I think it would give me some different areas of research to show what works and has better effects for women with PPD. A potential weakness for this study would be I would not have a way of knowing if the women are actually exercising 3-4 times a week. Not sure how I would be able to make this area more reliable in the study? I could possibly have the women go to a certain gym or log their walking or running on an app that shows there exercise for that day? This could possibly be one way of making sure I have quality dat for my research.

Rutberg, S., & Bouikidis, C. D. (2018). Exploring the Evidence. Focusing on the Fundamentals: A Simplistic Differentiation Between Qualitative and Quantitative Research. Nephrology Nursing Journal, 45(2), 209-213. Retrieved from eds-a-ebscohost-com.chamberlainuniversity.idm.oclc.org

Your research regarding post-partum depression (PPD) is quite interesting and much needed. It will be interesting to learn what develops from your research. Until recently, post-partum depression was not given the attention it deserved. I recently read an article about a mom who was experiencing post-partum depression for over a year. Sadly, during a panic attack, she jumped out of a car and ran onto a busy interstate where she was killed. Her husband discussed the difficulties they experienced in trying to find the right help they needed. He has since started a foundation and online help center, The Emily Effect, for women experiencing perinatal mood disorders (Free, 2016). Some of the testimonials shared on the website are truly heartbreaking. Postpartumdepression.org (2018) reports that approximately 70%-80% of women will experience the baby blues. The reported rate of clinical depression is between 10%-20% of all live births which is roughly 600,000 births per year in the United States. However, many of the numbers associated with PPD involve live births. The women who experience miscarriage or stillbirth are not included in these numbers but may very well experience postpartum depression symptoms as well which raises the potential number of women experiencing PPD to around 900,000 per year (Postpartumdepression.org, 2018). Some of the symptoms of PPD include anxiety, depression and adjustment disorders (Coates, Ayers, & de Visser, 2014) but many times they are written off as just a normal part of recent childbirth. However, it is becoming painfully clear, we need to begin being more mindful of moms who are experiencing these symptoms to ensure there is not cause for more attention and concern.

Coates, R., Ayers, S., & de Visser R. (2014). Women’s experiences of postnatal distress: a qualitative study. BMC Pregnancy and Childbirth 14(359). DOI:https://doi.org/10.1186/1471-2393-14-359

Free, C. (2016). Utah father of five starts foundation for moms with postpartum depression in honor of his late wife. PeopleOnline. Retrieved from: https://people.com/human-interest/eric-dyches-utah-dad-helps-moms-with-postpartum-depression/Links to an external site.

Postpartumdepression.org. (2018). Postpartum depression statistics. Retrieved from: https://www.postpartumdepression.org/resources/statistics/

I am glad that you have chosen this research topic because not much is known about PPD and it’s prevelance. PPD is one that has been under researched and needs EBP to conclude with positive results. I too chose the quantiative approah for my research project. I think that you will achieve positive results with the use of quantitative research approach. I think quantiative research will yield positive results for the study of PPD and the advantages are great. The quantiative approach allows control over the study conditions, less time consuming, and allows the use of surveys (Rutberg& Bouikidis, 2018). Because quantiative research allows the use of a large group, a broader study can be performed enabling more respondents to be reviewed, thus allowing more generalization of results (Rutberg & Bouikidis, 2018). The disadvantages with the use of quantitative research is a less in-depth observation of pertinent information. The information can be overlooked with the use of this research method, resulting in vague information. All in all, both qualitative and quantiative research approaches are beneficial to EBP, the importance lies with the results that can cause a positive change that will improve quality healthcare.

Reference:

Rutberg, S. & Bouikidis, C.D. ( 2018). Exploring the Evidence. Focusing on the Fundamentals: A Simplistic Differentiation Between Qualitative and Quantiative Research. Nephrology Nursing Journal, 45(2), 209-213

NR 505 Discussion Data Collection