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The U.S. Department of Health and Human Services’ division titled Futures Without Violence (2018) reports

The U.S. Department of Health and Human Services’ division titled Futures Without Violence (2018) reports

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Qualitative and Mixed Methods Research Designs Qualitative and Mixed Methods Research Designs Program Transcript NARRATOR: Not all nursing research involves collecting quantitative data and numerical values. Qualitative and mixed methods research studies also provide valuable insights into health care-related issues and questions. In this video, Dr. Kristen Mauk justifies the value of qualitative and mixed methods research within the nursing field, and provides an overview of a qualitative study she conducted for her doctoral dissertation. Please note that this research study is separate from the material presented in other videos in this course about Dr. Mauk’s DNP project. KRISTEN MAUK: When you’re looking at your levels of evidence, I think that qualitative gets a bad rap because it falls way low on the evidence scale. But I think you get very rich data from qualitative. You get that rich information and data that you don’t get just from looking at numbers. Now, numbers don’t lie. And so it’s great to have statistics and to know that whatever you’re choosing to do for your project has all of this great backing to it. But you’re not going to get the substance, and the richness, and the underlying feelings of participants unless you look at the qualitative piece, too. I think it’s great to have some quantitative data and also qualitative, too. A lot of students will use a post-project survey to get that qualitative piece. Ask their participants about satisfaction with the project, what would they suggest, that’s all nice qualitative rich data that can improve your research later. And also, shed light on things that you might not have known if you just hand them a survey and look at numbers. So I think there’s a place for both and we should use both in our projects. Deciding whether you’re going to do quantitative or qualitative depends on your question. And that’s why whether you’re doing EBP or original research, your question drives your method. That’s the main takeaway point. © 2013 Laureate Education, Inc. 1 Qualitative and Mixed Methods Research Designs For my PhD, I developed a grounded theory for post-stroke recovery. There was tons on what caregivers thought and the physical problems the doctors see in stroke patients. There is tons of literature on that. But there wasn’t something from the stroke survivor’s perspective themself about, how did they go through this journey? And how did they feel? And so that was something about there was little known about it. So my method was qualitative. And because I wanted to look at the process– process is grounded theory. So I could come up with a framework and a model that nurses can look at to say, here’s the process that survivors, themselves, said they go through. So here’s a couple good examples of the pitfalls of qualitative research. I asked for volunteers and I went to an assisted living, and there were several people who signed up to be a volunteer. And one of the women had had a– well, they all had strokes. And one of the women who let me interview her, I went to their homes. And so we were in her little assisted living apartment and her husband was there with her. And so I started my open-ended questions. And I said, so tell me about what happened to you from the time you had your stroke till now. And she said, I don’t remember. And then her husband had to pipe in and said her major problem after her stroke was memory loss. So every question I asked was, I don’t remember. I don’t remember. So that was one example. Another example is things like equipment failure. So I always take backup batteries, backup video, backup audio. But sometimes you’ll get to someone’s house and none of the outlets work. Or you realize that your batteries that you grabbed aren’t working, and you run out of batteries because it was an extra long interview. So just little things like that are pitfalls of actually working with people, in their home, trying to do your own equipment and things like that. I interviewed people until data saturation was reached, which is– that’s kind of a qualitative term for since we can’t do power analysis of how many people do we need to interview before we keep hearing the same thing. We call it data saturation. So once you start hearing the participants say the same thing over and over and over, then you know that you’ve reached that point of you’re not © 2013 Laureate Education, Inc. 2 Qualitative and Mixed Methods Research Designs hearing anything new. And that’s the point that determines your n, or number of subjects. So that’s different from quantitative where you could do a power analysis and say, how many variables do I have? And the more variables I have, probably the more participants I need to show that my study is valid and reliable. Because you want to make sure that you’re not looking at 100 variables and only two subjects. We can’t generalize from that. Well, for qualitative research, it’s all about trustworthiness. Trustworthiness is like the big umbrella for qualitative research. So when we talk about that, we’re talking about things like looking at how the qualitative researcher assured you that you can trust her or his results. And for me and any qualitative researcher, it’s things like audit trails, and using journaling, and keeping track of everything. Keeping really good records, writing everything down. How did you do your interviews? And describing them and giving examples of questions. And then, did you go back and talk to your participants to see if what you concluded in fact was right? Did you use focus groups? Just talking about how you came up with your question, how you investigated your question, and why should the reader believe you? So basically, I founded in my PhD research that there were six phases that stroke survivors go through, from agonizing to owning. And they are buffered by different factors such as, did they expect to have a stroke? How old were they? How severe was the stroke? And that determined how fast they went through this process. But that everybody who has a stroke kind of goes through these different phases of adjusting to it, adapting to life, blending their new and old life, finding out why they have the stroke. And eventually, if they do positively adapt and get to owning their stroke, that they have developed a new life. And they’ve just learned to live with whatever deficits that they had. But to me that was a real eye-opener because as nurses we don’t get to keep them in the hospital very long. When I first started in nursing, we would have stroke patients as long as we needed to have them. I mean, it could be months. Now you might get them 10 days in rehab. That’s not enough to teach them everything they’re going to need to adjust to life– not being able to use this arm, or move this leg, or speak. So we don’t do our teaching, probably when we should be doing it, which is later after © 2013 Laureate Education, Inc. 3 Qualitative and Mixed Methods Research Designs they’ve had a chance to see, oh, wow, this isn’t going away. I guess I need some help and need to figure out how to live like this now. So that was a big eyeopener to me, but very interesting. © 2013 Laureate Education, Inc.

COLLEAGUE #1 DISCUSSION POST BELOW

DISCUSSION POST BY ROBYN

The U.S. Department of Health and Human Services’ division titled Futures Without Violence (2018) reports that one in four women experience intimate partner violence (IPV), which can be higher in LGBTQ communities. In the article, “Living in Fear and Prioritizing Safety: Exploring Women’s lives after Traumatic Brain Injury from Intimate Partner Violence,” Ivany et al. (2018) developed a qualitative study to examine the effects of IPV on women who were diagnosed with a traumatic brain injury (TBI). Researchers utilized the constructivist grounded theory approach, which involved the philosophical concept of intersectionality (Ivany et al., 2018). Intersectionality is defined as “the critical insight that race, class, gender, sexuality, ethnicity, nation, ability and age operate not as unitary, mutually exclusive entities, but as reciprocally constructing phenomena that in turn shape complex social inequities” (Ivany et al., 2018, p. 1709). This concept assisted the researchers in understanding how multiple concepts can overlap and produce a health inequality, which resulted in a feminist intersectional perspective to examine the women to identify potential barriers in obtaining resources (Ivany et al., 2018). Ultimate goals of the study were to describe the experience and context of IPV of women who reported passing out from being hit in the head and to describe the everyday impact of the TBI from IPV such as with the abuser, family, and in general (Ivany et al., 2018).

Data collection consisted of primary and secondary data. Secondary data was obtained by interviewing 239 women aged 18 to 44 years old in the mid-Atlantic region of the United States with purposive sampling of the Domestic Violence Enhanced Home Visitation Program (DOVE) to identify those involved in IVP with related TBI over the course of two years (Ivany et al., 2018, p. 1709). Of the 239 women interviewed by Ivany et al. (2018), 21 out of women answered yes to “Have you ever passed out from being hit in the heard by your partner,” with 16 answering yes initially and an additional 5 answering yes throughout the two-year interview process. Of those 21 women, nine participated in the two-year study, which resulted in 29 interviews that formed the premise for the secondary analysis (Ivany et al., 2018, p. 1709).

The researchers also utilized primary data by placing flyers, asking for volunteers who had passed out from being hit in the head, within women’s shelters, general social areas such as grocery stores, ads on craigslist, and snowball sampling (Ivany et al., 2018, p. 1709). Volunteers totaled 31 one, with 21 women being ineligible due to a head injury from a source not related to IPV, which resulted in 10 participants. All interviews were transcribed and stripped of identifying information prior to open code analysis and provided a situational map of concepts (Ivany et al., 2018). The most common finding of the study was the prioritization of safety, hyper-protection of children instead of seeking treatment, and falling into isolation, all of which can cause a shift in social norms such as the inability of finding a job due to potential attacker stalking or memory complications interfering with pressing charges (Ivany et al., 2018).

This study appears to have utilized an appropriate design that allowed for flexibility with the participants and the ability to obtain answers openly without pressure. Dr. Mauk(Laureate, 2018) discusses that in order for researchers to promote trustworthiness, one must be aware of biases and take steps to prevent personal conflict from interfering with the data through thorough audit trails and/or journaling. Ivany et al . do not mention utilizing any of these features to promote unbiased research. Polit and Beck (2017) explained that “Constructivist (is) to acknowledge subjectivity and the researcher’s involvement in the construction and interpretation of data” (p. 476). Perhaps the researchers felt that the constructivist grounded theory design had provided a buffer for potential bias. In addition, all researchers listed are in fact, women. This can potentially reduce credibility due to situational bias or sexual bias. Also, the study only examines women who speak English with TBI due to IPV, while IPV occurs in both males and females and in different languages. While I feel that this study provides a great start for future research, I do feel that the design and framework for the study could be greatly improved by identifying and correcting potential biases.

Resources:

Laureate Education (Producer). (2012l). Qualitative and mixed methods research designs. Baltimore, MD: Author.

Intimate Partner Violence is A Leading Health Issue. (2018). Retrieved on October 9, 2018, from http://ipvhealth.org/health/ipv-health/?gclid=CjwKCAjwo_HdBRBjEiwAiPPXpPx35TG1tCqcTxPaOsF7q6fCsDTrV44YzS3ZNRSv-y0KlP5RID9eXBoCyK4QAvD_BwE

Ivany, A.S., Bullock, L., Schminkey, D., Wells, K., Sharps, P., and Kools, S. (2018). Living in fear and prioritizing safety: Explorring women’s lives after traumatic brain injury from intimate partner violence. Qualitative Health Research. 28 (11). pp. 1708–1718. Retrieved on October 9, 2018, from http://journals.sagepub.com.ezp.waldenulibrary.org/doi/pdf/10.1177/1049732318786705

Polit, D.F., & Beck, C.T. (2017) Nursing research: Generating and assessing evidence for nursing practice (10 ed.) Philadelphia, PA: Wolters Kluwer.

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The U.S. Department of Health and Human Services' division titled Futures Without Violence (2018) reports

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