Introduction
Qualitative research has come into play with the onset of patient-centered and evidence-based practices due to arising ethical issues. There is a common consensus that qualitative research is a mainstay method in evidence-based practices such as physical therapy and as such ethical issues are paramount in such type of research.
These methods are geared d towards studying the behavior of humans in different social environments especially in physical therapy practice and education. The study focuses on the application and importance of qualitative research and ethical issues that arise during such studies (Mayan, 2009).
The mainstay ethical principles of autonomy, justice, and beneficence are outlined in this study. Furthermore, the study focuses on the current approaches in carrying out medical research, the purpose, and strategies of qualitative research, and the ethical issues that may arise in such studies. In this article, the main focus is on the strategy of reflexivity as a means of promoting ethical and concise methodology in conducting qualitative research for fostering the adequate provision of health services.
The phenomenon of reflexivity in this study is focused on the researcher since the actions of the researchers determine to a lot of an extent the outcome of the study. Reflexivity goes a long way in identifying areas that a researcher can focus on bringing out the best from participants without infringing on their rights as being reflexive ensure relationships and interactions are based on mutual respect.
Medical Research and Governance
Moral issues are part and parcel of any medically related research or study. These moral issues are an interplay of a myriad of factors that encompass trust and power and at the same time the benefit versus risk ratio. All these factors tie up to ethics, in terms of how far are researchers willing to go regarding keeping to ethical standards of society.
Principles on ethical research, dictate that researchers should act with the highest standards of ethics. This has been achieved through the establishment of structures that govern all types of medical research. This came up given reports of abuse of power by healthcare providers when carrying out research that resulted in harm to the participants. These structures dictate that any participant should before the study be educated about the nature, purpose, risks, and benefits of the study.
In addition, they need to be reassured that the study is safe and it will not have any detrimental effect on their health. Various declarations have been instituted. These include the Nuremberg code (1949), the World Medical Association Declaration of Helsinki (1964; last revised in 2008), and the Belmont Report (1979).
The biomedical model usually brings about quantitative data as it is in the positivist archetype. This approach is usually in association with a hypothetico-deductive model of science that entails a well-structured process of collection of what are termed observable “facts”. These observable “facts” are then subjected to a rigorous process of testing and scrutinization to obtain relevant information needed by the researcher. On the other hand, the quantitative study focuses on the interpretive archetype.
This entails studying naturally occurring events and comprehension of a variety of actualities and if these occurrences can be reproduced in other different places. Qualitative research aims at identifying the reasons behind certain responses to different situations by different individuals. This is achieved through a series of interviews that aim to put the researcher in the “shoes” of the participants. Despite numerous gains, the issue of ethics in research has been a major issue that needs to be addressed (Draper, Wilson, Flanagan & Ives, 2009).
Value of Qualitative Health Research
Qualitative research is critical for many medically related studies. These studies have provided a great insight into the modes of actions of medicines and the perils and benefits surrounding self-medication strategies. In fields such as physical therapy, qualitative studies have provided an insight based on certain decisions made by health care practitioner experts in providing evidence-based care.
The Early Rheumatoid Arthritis Help-Seeking Experience (ERAHSE) Project
The study aimed at understanding the perception and reception people have on early symptoms of rheumatoid arthritis (RA) and the corresponding response they had in terms of initiating changes in their daily lives. Pilot and main studies were conducted on the participants who met the inclusion criteria.
Comparison of the quantitative and qualitative data obtained was carried out with the main focus being on qualitative data. Inclusion criteria entailed any individual residing in the area around British Columbia in Canada, and who had been diagnosed with rheumatoid arthritis in the last twelve months. In addition, the individual needed to be an English speaker. Recruitment for the pilot study was carried out by enlisting the help of the participants’ family physicians or rheumatologists.
Recruitment for the main study entailed the use Web sites, newsletters, leaflets at local arthritis centers, and rheumatologists. Interviews entailed a set of questions to the participants over the phone. The phone calls were recorded and later transcribed verbatim. The obtained information was shared among a select group of medical practitioners for further analysis and interpretation (Townsend, Cox & Li, 2010).
Ethical issues in the Qualitative Research Process
Three principles are applied in identifying and analyzing the ethical issues encountered in our study.
Autonomy
Autonomy is the ability o carry out any action or thought with free will and without coercion or force from any party. Autonomy is a function of two principles; liberty and agency. To foster autonomy, the study was designed in such a way that there was no personal contact between the healthcare providers and the participants. Since recruitment occurred in the offices of the physicians the study was subject to bias as the patient felt not to have free consent in the presence of their physicians.
In addition, patients in the pilot study saw their physicians as allies and this amounted to coercion. For the validity of a study, the participants should be allowed to have autonomy over their decisions. This enables them to make an informed decision that is devoid of bias and as such ethical issues do not arise in such studies (Salmon, Peters & Rogers, 2007).
Justice
Justice entails offering equal treatment to all without favor or bias. All participants in the study were given information sheets on rheumatoid arthritis. Denying participants some of the information or actions that pertain to the research can be viewed as unjust. In addition, the results of the study were disclosed to the participants and this was well received by the participants.
Beneficence
Beneficence entails the provision of benefits to the participant and a calculated balance of benefit-risk ratio to the participants to achieve valid results and stay within the ethical boundaries of qualitative research. As such no harm whatsoever should be done t the participant in the name of research. Any information obtained from the participants should be held in confidence (Wilson, Draper & Ives, 2008).
Conclusion
Qualitative research faces obstacles such as ethical issues. However, these ethical issues may be approached by the use of the three traditional approaches to ensure that the rights of the participants are protected and that no harm whatsoever occurs. Accountability to the participants is paramount for successful qualitative research.
References
Draper, H., Wilson, S., Flanagan, S., & Ives, J. (2009). Offering payments, reimbursements and incentives to patients and family doctors to encourage participation in research. Family Practice, 26, 231–238.
Mayan, M. (2009). Essentials of qualitative inquiry. Walnut Creek, CA: Left Coast Press Inc.
Salmon, P., Peters, S., Rogers, A. (2007). Peering through the barriers in GPs’ explanations for declining to participate in research: The role of professional autonomy and the economy of time. Family Practice, 24, 269–275.
Townsend, A., Cox, S., & Li, L. (2010). Qualitative research ethics: Enhancing evidence-based practice in physical therapy. Physical Therapy, 90(4), 615-628.
Wilson, S., Draper, H., & Ives, J. (2008). Ethical issues regarding recruitment to research studies within the primary care consultation. Family Practice, 25, 456–461.