Research for Evidence Based Practice 

Research for Evidence Based Practice 

Discussion Response

Deliverables:

“Read a selection of your colleagues’ responses and  respond to  two of your colleagues on  two in one of the following ways:

· Provide additional strategies for addressing challenges to obtaining a sample from the identified population.

· Suggest a different population that may be appropriate for addressing the research problem.

· Summarize the strengths of the data collection method identified in the post.

· Share any problems or concerns over the identified data collection method.

· Suggest an alternative data collection method and provide your rationale.”

Be sure to return to the discussion forum often to read responses and engage in the community learning activities.

PEER #1

Kendra Kendrick

Main Post – Sampling researchable populations

Article: Recruiting vulnerable populations for research

How could you address these challenges?

It is the responsibility of researchers and healthcare providers to safeguard vulnerable populations, including individuals with acute, chronic, and terminal illnesses, prisoners, ethnic and racial minorities, the elderly, low-income individuals, children, and women. To ensure the inclusion and protection of these populations in research, scholars have recommended several strategies. One of the most effective strategies is fostering collaboration and open communication among researchers, healthcare providers, and the targeted populations. This approach can increase transparency and encourage voluntary participation, preventing ethical conflicts and violations. Effective communication and collaboration are also crucial in recruiting enough subjects to ensure the scientific validity of the study.

Recommend collecting data from this sample.

Successfully recruiting research participants often requires the assistance of healthcare providers who act as gatekeepers to potential subjects. Healthcare providers must remain impartial to ensure a transparent and fair recruitment process. Any biases they hold could impact the recruitment of participants and compromise the validity of the research. Gathering observations or measurements from a sample is a systematic process that heavily relies on successful participant recruitment. To increase subject participation rates, investigators must rely on help from healthcare providers who often serve as gatekeepers to potential research study subjects. Creating a consent procedure that meets their needs is crucial when working with a population likely to face language barriers. This can be achieved by translating the document, writing it in a more straightforward language, or discussing it to clarify doubts.

Summary

My primary focus is examining the barriers specific populations face when seeking healthcare services. The vulnerability issue can manifest in various ways, particularly within the hospital environment. The healthcare industry constantly evolves, presenting healthcare systems and hospitals with many challenges and opportunities. In some regions, hospitals serve as the sole healthcare resource, making access to healthcare a crucial decision for vulnerable communities. As a result, many must weigh their options based on their unique support structures, preferences, and needs.

Boerner, H. (2016). A “Durable Opportunity”: Ed Overcrowding in the Aca Era. Physician Leadership Journal, 3(3), 32–34.

Elliott, C. (2016). Whatever Happened to Human Experimentation? The Hastings Center Report, 46(1), 8–11. https://doi.org/10.1002/hast.531

Research to improve the health of vulnerable populations. (2017). Bulletin of the World Health Organization, 95(2), 92–93. https://doi.org/10.2471/BLT.17.030217

Sutton, L.B., Erlen, J.A., Glad, J.M., & Siminoff, L.A. (2003). Recruiting vulnerable populations for research: Revisiting the ethical issues. Journal of Professional Nursing, 10(3), 106-112

Survey shows hope for solving ED overcrowding. (2007). Hospitals & Health Networks / AHA, 81(2), 62–64.

PEER # 2

Roslyn Stewart

Researchable Populations

The components of researchable populations are the target population, the accessible population, and elements. The target population is the whole group that is being studied. (Gray & Grove, 2020). For example, with my research study on the effect of spiritual health promotion on elderly with depression, the target population is all elderly people with depression. Studying every elderly person with depression in one study is impossible for a lone researcher.  Thus, an accessible population is needed.

The accessible population is a part of the whole or total population that is reachable. This sample of the population becomes a representation of the whole.  Through the results of this research, inferences can be made. (Gray & Grove, 2020). For my study, this would be the elderly in my local area. The location of the participants will need to be determined. I could study elderly individuals in a skilled care facility, in a hospital, or in home settings. These individuals are considered elements (Gray & Grove, 2020).

When thinking about elements, there are specific variables related to the individuals in the sample group. The individuals will need to be evaluated to include only those with diagnosed depression. This will mean that not every elderly person can be included in the study. Other demographic factors to take into consideration are gender, race/ethnicity, and educational background (Bruce et. al., 2018). I will include these demographics. Age is already part of the independent variable and thus does not need to be evaluated separately.

Most Appropriate in Research Study

The most appropriate population for my research study is an accessible population of elderly clients with depression in a skilled care facility (SNF). The rationale for using a SNF is the ability to obtain medical records that may not be possible if the study was conducted in home settings. The medical records will determine those who are diagnosed with depression. This would also determine if there are any additional medical conditions that could affect the study such as diagnosis of dementia. Those with dementia will need to be removed from the research study as the study will require cognitive specific interventions and evaluation.

Another benefit of a SNF is the mixed demographics of male and female clients with varying economic status and education backgrounds all in one location.  The age range at SNFs is typically elderly clients, 65 years and older, though there may be a few younger aged individuals present. These younger aged individuals would be excluded from the study. A further benefit of a SNF is the length of stay for the clients in this location in comparison to the hospital length of stay. In a hospital, participants may be discharged from the hospital before the study can be completed.

Addressing Challenges of Obtaining Sample

Choosing the Sample Size: Choosing an appropriate sample size can be challenging. This will require obtaining the census of the number of elderly individuals living in SNFs throughout the United States. Once this number is obtained, I can utilize a statistical formula such as one mentioned in Gray & Grove (2020) by which 30% was utilized as an acceptable sample size. More than likely, this would mean I would need to extend my research study to include more than one SNF to have enough participants. This poses another challenge. One solution is conducting a pilot study (Bruce et. al., 2018; Gray & Grove, 2020). The benefit of conducting a pilot study is it requires a smaller sample size. I would be able to focus on participants in one SNF while testing the interventions and survey tools. This will also allow for potential buy-in for additional researchers based on the results. Additional researchers will be needed to accomplish a 30%, multi-location accessible population.

Accessing Medical Records: Determining elderly individuals who are depressed would require access to medical records. The records would be used to determine those who have a diagnosis of depression. It will also help determine their current treatment plan, medication regimen, etc that could impact the study. Obtaining the records would require permissions from the individuals and from the facility. A solution to this is active communication with the facility and participants regarding the purpose for the study. I would also need to guarantee to these stakeholders that the sensitive medical information shared with me will remain confidential and secure.

Collaboration with Medical Management: While conducting the study, I need to be sure to identify participants in the study and communicate with the medical team. There is risk of the provider adjusting a participant’s medication regimen or other treatment plan during the study, which could interfere with the validity of the results. This would create a question of whether the new medication was the cause of improvement or the study interventions. Thus, it is imperative for me to collaborate with the medical team and communicate the purpose of the study and the intent of causative study.

Refusal Rate: Gray & Grove (2020) describes a factor called refusal rate. As participants decline the study, this decreases the chance of the sample adequately representing the total population. (Gray & Grove, 2020). In my study, there is risk that elderlies who are not religious may refuse to participate in study due to confusion between spirituality and religiosity. To reduce refusal, adequate education about the purpose of the study and defining the terms is essential.

Systematic Bias: Systematic bias occurs if the population is all the same demographically (Bruce et. al., 2018). For example, an all-women’s SNF will not be an appropriate choice for this study. I will need to be sure to choose a SNF with demographic diversity.

Recommended Collection Data Approach

The study that I have chosen is a causative study. I will be exploring the effect of spiritual health interventions on quality of life for elderly patients with depression. Thus, this will be a qualitative or quasi-experimental study with a control group and an experimental group. The collection data approach that will best fit is a quote sampling approach.

The quote sampling approach is a nonrandom method (Gray & Grove, 2020). I want to be sure the participants are demographically dispersed evenly. If possible, I would prefer the same number of women and men in the control group as the experimental group. I also want to be sure education levels and ethnic groups are represented as close to evenly on both sides.

In conducting the study, tools such as pre and post surveys will be utilized to collect the data. Similar to a study conducted by Heidari et. al. (2019), my pre and post surveys will be written for the participants to complete on paper. There will also be an option to read to those individuals who cannot read, with the researcher entering the data for the individual based on their responses. The data will be collected and tallied to determine report rating and specific comments. (Heidari et. al., 2019).

References:

Bruce, N., Pope, D., & Stanistreet, D. (2018). Quantitative methods for health research. A practical interactive guide to epidemiology and statistics (2nd ed.). Wiley.

Gray, J. R., & Grove, S. K. (2020). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (9th ed.). Elsevier.

Heidari, M., Borujeni, M.G., Abyaneh, S.K., & Rezaei, P. (2019). The effect of spiritual care on perceived stress and mental health among the elderlies living in nursing home. Journal of Religion and Health 58, 1328-1339. https://doi.org/10.1007/s10943-019-00782-1