Problem
The study was conducted to investigate the experiences of the old groups who are mentally challenged (Schroeder, 2013). The pains and discomforts in the relationship with the healthcare providers are thus the problems that are being explored by this research.
Research conducted by other scholars in the past has failed to explore the relationship of the old mentally challenged patients and has generalized their findings irrespective of the age groups (Bartels, Miles, Dums, & Levine, 2003). They have ignored the fact that the old sufferings from the condition are the most affected since everyone neglects them including their family members, a situation that worsens the problem (Linkins, Lucca, Housman, & Smith, 2006). Establishing a good relationship between nurses and patients would thus be of great significance in containing the problems brought about by such neglect.
Study Purpose
The study aims at investigating the experiences of old persons living with mental disorders (Schroeder, 2013).
Research Questions
The main question in this research is whether old people with chronic mental disorders receive proper attention from their health givers.
The research question given is broadly enough for a qualitative study because it targets a broad group of participants (old people with chronic mental disorders).
Study Design
A qualitative hermeneutic phenomenological methodology has been applied in this research.
This is a qualitative research methodology that is often used in research in medical fields. It involves collecting data from first-hand informers (Kafle, 2011). The data is then recorded and stored in the form of video clips awaiting analysis. The collected data is analyzed in processes and the evident main theme is identified.
In what way is the method used an appropriate one for this study? Clearly justify your answer. In the description given above, this method produces useful results in studies involving human experiences, especially in the medical field. The study could only be conducted using this method since it involved conducting direct interviews with patients with the aim of obtaining their experiences with their respective healthcare providers.
Philosophical/Theoretical Basis of the Study
There is an unprecedented rise in the number of people living with serious mental illness (SMI).
Numerous references were cited to support the theoretical approach used. The references were used to emphasize the cases of rising numbers of old people living with SMI and the need to be taken care of in healthcare centers.
The theoretical basis of the study was clearly linked to the study’s assumptions, data collection procedures and analytical approach as it indicates cases of elderly SMIs in society, which is the interest of this study.
The framework is based on the findings of earlier research on the same aspect. The study as a whole only expounds what other researchers have earlier reported
Review of the Related Literature
Previous researchers have identified an enhanced relationship between patients and nurses as a solution to the problem in question. This study agrees with this fact and affirms other researchers’ findings on neglect and stigmatization of mentally challenged individuals.
The author has used both current and past references in his support of his work. 30 of the references fall in the bracket of the past 10 years while 8 of them fall in the bracket of the past 5 years.
The knowledge that is currently available in the available literature has supported the need for a good relationship between the health providers and the patients (Corrigan, 2004). However, the literature is not age-sensitive and it does not describe the severity of the condition depending on age.
Previous research has failed to focus on the old people in society suffering from a mental disorder. Instead, they have generalized their findings without considering that the condition is more severe in the old than it is amongst the youth. The gap in research on this issue has necessitated further research that focuses exclusively on the old people suffering from the condition.
Subjects and Setting
The setting of the study was a mental healthcare hospital in the United States. This setting probably was the most appropriate to carry out the study since expert nurses in the hospital would help in identifying the required sample. The hospital would provide the patients’ diagnosis history for researchers to pick the correct group, thus reducing the chances of engaging a wrong sample.
To be included in the study, a participant had to have had an earlier experience with a healthcare provider. Only those who had personal contact with medical providers were allowed to participate in the study. The participants were required to have chronic mental challenges. All participants had to have attained a minimum age of 55 years with a chronic mental disorder. The patients included in the study had to have been diagnosed with the ailment for a period of more than a year.
The sample size used was not adequate. 8 participants were not enough for a qualitative study. However, Gender equality was considered when selecting the sample, and thus the sample was composed of 4 participants from both genders.
This setting probably was the most appropriate to carry out the study since expert nurses in the hospital would help in identifying the required sample. In addition, the hospital would provide the patients’ diagnosis history for researchers to pick the correct group, thus reducing the chances of engaging a wrong sample.
The participants in the study had to provide written consent of their acceptance to be part of the study. Before a participant could be asked to append his/her signature as a sign of acceptance to participate in the study, the team offered some kind of education on the risks and benefits of the study. The study was conducted in one of the nursing homes in the United States. For researchers to be allowed to conduct such research on the group there had to be approval from the institution heads.
Firstly, the participants were educated on their rights and obligations during the study before they were required to submit their consent. Secondly, the participants’ names were not disclosed.
Data Collection Procedure and Appropriateness of Data Analysis Methods
Questionnaires were used for data collection. The participants were first required to fill in their personal information in a questionnaire prepared in advance. The other process that followed the questionnaire was the interview where each participant was interviewed by a panel of nurses. The interviews were recorded in the form of video clips and transcend for analysis later on.
The aim of the research was to determine the individual feeling and attitude of the patient towards the health providers. Recording each patient’s statements was important as it provided a good way in which the panel would later revisit the statements, conduct peer reviews, and subsequent analysis of the data to provide useful information.
Data saturation underscores the point at which the participants do not give new information concerning the given questions (Guest, Bunce & Johnson, 2006).
Data saturation was evidenced in analysis where repetitive information was noted.
Specific Data Analysis Procedures Used
The qualitative data analysis procedure used in the study was the thematic analysis and hermeneutic phenomenological procedure.
Thematic analysis is a method used in the analyses of collected data in the view of extracting the major themes in research. It involves identifying the major themes and analyzing the patterns thereon. A qualitative hermeneutic phenomenological procedure is used in data collection where the participants were engaged in an interview to provide their experiences with the nurses.
Thematic and qualitative hermeneutic phenomenological data analysis procedures are appropriate for interviews where major themes are extracted to establish patterns from the participants’ responses.
As aforementioned, these data analysis procedures fit the qualitative method used, which depended on responses from interviews.
Evidence of Auditability/Decision Trail/Member checks
The decision trail is a phenomenon used to allow other researchers to use the logic developed in certain research in future studies (Koch, 1994).
A decision trail was developed and reported sufficiently as the researchers developed their logic and explained it in detail such that another researcher can follow the same,
Specific Results Obtained
The results of the study identified 7 themes that were then reduced into two classes, viz. the good provider and the uncertain provider. The patients insisted on the establishment of mutual relations between them and nurses.
Strengths and Limitations
The study can be said to be strong in two areas. Firstly, the method used to collect data was the most appropriate since it involved interviewing each participant, which is the best way of collecting data in a medical study designed to extract information from patients. Secondly, the study was peer-reviewed and analyzed statistically to reduce inaccuracy and errors.
The study involved interviewing mentally ill patients. Given that the reliability of the data collected solely depends on the memory, the data may thus be inaccurate and biased due to poor memory by the patients. The second limitation evident in this study is the sample size. The researchers used a sample of 8 people, which is too small to represent the actual experiences of mentally ill persons.
The findings of the study were valid as they answered the research question sufficiently.
Implications/Recommendations
The research found 8 themes that were integrated to come up with 2 themes, viz. the good provider and the uncertain provider. The results obtained from the sample were then generalized for all the old patients with mental disorders.
Data collected from the good provider was regarded as relevant, while data from the uncertain providers was regarded as being biased and irrelevant.
The research did not answer the question of how healthcare providers can actually meet the relationship demands of the old mentally challenged individuals. Future research should thus seek to answer this important question.
The findings of the study are well explained and understandable. The discussion is clear and it connects to the purpose of the study. It is thus right to conclude that the description is clear and can be replicated.
Reflection
Qualitative research denotes the process of collecting data from a targeted group and then converting the data into a numerical form for statistical analysis (Hoe & Hoare, 2012a). The researchers must have in place the theory or a problem that they want to research (Bronson, 2013). Study instruments underscore the other common feature in qualitative research and a plan for the research is usually prepared in advance.
Research based on the qualitative method is one in which the researcher invokes post-positivist assertions to develop facts about a certain problem (Sokal et al., 2004). It involves identifying a problem and the use of suitable data collection instruments to investigate the set variables (Hoe & Hoare, 2012b). Qualitative research is best applied in the nursing and medical fields to acquire information regarding patients’ feelings and attitudes through interviews.
My understanding of qualitative skills will help me improve my skills in nursing. Nursing today is based on evidence-based treatment. Therefore, the skills acquired here will change my view of nursing from a theoretical practice perspective to an evidence-based approach. Understanding the method will enhance my skills in analyzing problems in nursing to better the profession. Most researches in the nursing field involve interrogations with patients, thus qualitative skills are important to enhance better interviews with the patients especially when gathering information on the history of patients.
References
Bartels, J., Miles, M., Dums, R., & Levine, J. (2003). Are nursing homes appropriate for older adults with severe mental illness? Conflicting consumer and clinician views and implications for the Olmstead decision. Journal of the American Geriatrics Society, 51(11), 1571-1579.
Bronson, C. (2013). Understanding Quantitative Design: A Resource for Qualitative Researchers. The Qualitative Design, 18(28), 1-3.
Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614.
Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18(1), 59-82.
Kafle, P. (2011). Hermeneutic phenomenological research method simplified. Bodhi: An Interdisciplinary Journal, 5, 181-200.
Koch, T. (1994). Establishing rigor in qualitative research: the decision trail. Journal of Advanced Nursing, 19(5), 976-86.
Linkins, K., Lucca, A., Housman, M., & Smith, A. (2006). Use of PASRR Programs to Assess Serious Mental Illness and Service Access in Nursing Homes. Psychiatric Services, 57(3), 325-332.
Schroeder, R. (2013). The Seriously Mentally Ill Older Adult: Perceptions of the Patient-Provider Relationship. Perspectives in Psychiatric Care, 49, 30–40.
Sokal, J., Messias, E., Dickerson, B., Kreyenbuhl, J., Brown, H., Goldberg, W., & Dixon, L (2004). Comorbidity of medical illnesses among adults with serious mental illness who are receiving community psychiatric services. The Journal of nervous and mental disease, 192(6), 421-427.