Last Experience with Radiotherapy - Essay Example

Part One: Item Construction What did you think about the quality of care during your last radiotherapy session (circle one) 1 2 3 4 5 Poor Somewhat Neutral Acceptable Excellent Limited 2. What is your opinion of the after-care information you were provided with (circle one) 1 2 3 4 5 Poor Somewhat Neutral Acceptable Excellent Limited 3. Place in order what you consider to be factors that impact on your sessions (1=the most, 7=the least) Amount of sleep Social support network Optimal dietary habits High quality of care Financial stressors Relationship with GP Other _________________ 4. Take a few moments to write about your last experience of radiotherapy. Is there any thing that stands out that pleased or frustrated you. Why ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ A recent investigation focus has been research into the involvement of the patient/user in cancer services. The patient/user's expectations, needs and attitudes are recognised as factors that directly influence the health and well being of those receiving cancer treatments. Previously, research has explored patient emotional or symptom control, as well as healing experiences (Koller et al., 2000; Mackillop, Stewart, Ginsburg, & Stewart, 1988). However, the literature lacks reference to investigations of the patient-therapist relationship and the perceived level of quality of care of radiotherapy sessions. This study would require a random probabilistic sample of patients. Those eligible for participation would be receiving treatment for only one form of cancer, such as breast cancer. The less homogeneity of the IV (i.e. cancer) would help control for a normal population, as well as allow for wider generalisation of the results. The first two items are on Likert scales to provide an indication of the strength of the response. The third item is categorical, and although the level of measurement is low, the data will provide control variables when items 1 and 2 are correlated. Finally, the open question will show patients that their opinions and experiences are valued, and allow them to write in an un-restricted manner. The investigator will have two RAs analyse the texts to determine key themes, and their conclusions will be analysed using inter-rater reliability. The investigator will then draw conclusion from the final themes selected. Part Two: Research Design Sampling A random probabilistic sample would be used to recruit the 80 students from a given university. All undergraduates in medicine degrees would be eligible to take part, across genders, ethnicities and ages. The sample will also be stratified by activity habits, with those who regularly take part in 30 minutes or more of structured exercise a day in one group, and those who don't in another. However, to be recruited each student must meet the selection criteria: they do not experience a heart condition; they are not asthmatic; and they are physically able to navigate eight flights of stairs without assistance. Materials A heart rate arm-cuff, which will be calibrated after each participant had had his or her pulse rate recorded. An isolated stairwell within the university has been allowed to be used only for this study, so as to control for others being on the course and distracting or slowing down the participants. Internal Validity In regards to sample selection the study does not adequately control for randomness, as the participants are self-selecting (either they exercise or they do not). As such, the quasi nature of the experiment does not control for the interaction of selection with other variables that are perhaps unknown to the study (Mitchell and Jolley, 2004). It is recommended that if there are a large number of students available to take part, that the sample be matched on age or gender to increase the control of extraneous variables. Otherwise, pulse rate means may regress. Alternatively, a control group could be introduced. In regards to the DV internal validity is high in that the measure of pulse rate is in milliseconds (ms) using a high-quality heart rate monitor. The monitor is tested at the factory to ensure consistent readings of pulse rate. Also, the level of measurement of the DV is interval data and so provides a very accurate measure of the DV. As the heart rate monitor can be calibrated this will provide a consistent benchmark for all participants. Limitations for Generalisation As the sample has not been stratified for gender or age the results will be limited given that females and males generally differ in physical strength, endurance and gait. Additionally, it could be argued that not enough data is available to confidently draw conclusions about those who exercise and those who don't (Mitchell & Jolley, 2004). Instead, the design could have been to take multiple baselines of pulse rate before the intervention, as well as having multiple trials of running the stairwell. A larger sample would contribute to more accurate results. Also, a sample of university students does not accurately reflect the general population. Students are perhaps more likely to exercise in day-to-day activities such as traveling between classes, library, labs and caf than the average 9-5 commuter, and most likely less than blue-collar and stay-at-home parents. It is recommended that future studies in this area include surveys to determine demographic factors that may influence group differences. For example, variations in exercise type, duration, and frequency, as well as motivation to exercise. Design This study will be a 2 x 2 mixed ANOVA quasi-experiment. The independent variables are the activity habits ('Do Exercise' or 'Do Not Exercise'), and the time of data collection (pre and post intervention). The dependant variable is a measure of pulse rate using an arm-cuff heart rate monitor. The design is a quasi-experiment because there is no random allocation (self-selection) of participants, and the investigator does not manipulate one of the IVs (i.e., activity habits). Hence, it cannot be assured that there is a baseline equivalence across the groups. Results Table 1 displays the descriptive statistics across the groups of students. Kurtosis and skewness values are indicators of a normal distribution. Understanding of the distribution of the data scores and if they are spread out to resemble the bell-curve. Kurtosis to determine the spread around the mean, perhaps a ceiling or floor effect - too easy or too difficult. Mode indicates the frequency of each data score and can be used to provide percentages and percentiles. The median is the halfway point amongst the data, 50% of scores above or below this mark. The mean provides the statistical average of the most typical score. The mean is the most accurate measure of central tendency. When the mode, median and man are very similar in value can be confident that data is normally distributed. The standard deviation provides the average distance from the mean of each score, a measure of distribution and diversity within the data. The mean should always be reported with the value of standard deviation as a large deviation implies that the data is too diverse and more likely to be not normally distributed and so data lacks the ability to be compared because the groups are not comparable. The measure of standard error indicated the likelihood the mean is representative of a hypothetical population mean. As there is a lot of numerical data to present, a Table would be the best form to communicate the information and to allow the reader to make comparisons between and within groups. Table 1 Descriptive statistics of pre-post pulse rate scores across groups Statistic Do Exercise Do Not Exercise Pre-Condition Post-Condition Pre-Condition Post-Condition Kurtosis Skew Mode Median Mean Standard deviation Standard error Alternatively, Figure 1 will illustrate clearly and concisely to the reader the average scores within and across groups for each condition. If an interaction occurs between activity habit and time of data collection then the cross over of lines will be easily seen on the graph. The standard error bars will allow the reader to see how close the sample means are to reflecting hypothetical population means. Figure 1. Mean and error bars of pre-post pulse rate across student groups. The Interview Method: Collection of Subjective Data An in-depth interview provides a human element to the research process (Bryman, 2004). It is a flexible method in that it uses a guide of questions as a framework, whilst allowing the participant to have a free flow of conversation. As such, it provides an opportunity for the participant to talk in-depth about a topic. Although the order of items in the question guide will not change across participants, the different responses of each participant will necessitate different promptings for additional details. This type of interview provides the researcher with insight into the experiences of participants, from the participant's point of view (Guion, 2001). The interview is a one-to-one process, usually, and allows the researcher to gauge the participant's interpretation of the relationships they see between events, people and social values (Bryman, 2004). The researcher asks neutral questions and listens actively, does not approve or disapprove of answers, and does not encourage the participant to provide particular answers, instead facilitating the participant to follow up on previous answers (Padgett, 2004). References Bryman, A. (2004). Social Research Methods (2nd ed.). Oxford University Press, Oxford. Guion, I. (2001). Conducting an in-depth interview. Family Youth and Community Sciences Koller, M., Lorenz, W., Wagner, K., Keil, A., Trott, D., Engenhart-Cabillic, R., & Nies, C. (2000). Expectations and quality of life of cancer patients undergoing radiotherapy. Journal of Research, Sociology and Medicine, 93(12), 621-628. Mackillop, W.J., Stewart, W.E., Ginsburg, A.D., & Stewart, S.S. (1988). Cancer patients' perceptions of their disease and its treatment. British Journal of Cancer, 58(3), 355-358. Mitchell, M. L., & Jolley, J. M. (2004) Research Design Explained (5th ed). Belmont, C. A.: Wadsworth. Padget, D. K. (2004). The Qualitative Research Experience. Southbank: Thompson Learning. Read More