The Role of Qualitative Research in Evidence-Based Practice

Introduction

The article, ‘Keeping safe. Continuous glucose monitoring (CGM) in persons with Type 1 diabetes and impaired awareness of hypoglycaemia: a qualitative study.’ By Vloemans, Van Beers., De Wit, Cleijne, Rondags, Geelhoed-Duijvestijn and Snoek (2017).  Provides an evidence based approaches to the management of diabetes.  Effective diabetes therapy usually calls for a delicate balance between the advantages related to strict glycaemic control and the risk of drug related side effects in relation to hypoglycaemia.  The fear of episodes of hypoglycaemia also contributes to the patients missing or forgetting the time of insulin doses thus compromising the glycaemic control. From the article, it is evident that even with the comprehensive treatment approaches, most often patients will experience years of unregulated glycaemic control due to the delays on the intensification of treatment, especially in the event that the transition to the treatment of insulin is required.  In the event that the insulin therapy is also provided, most patients are still going to work extra hard to ensure that they have achieved maintained the required targets for glycaemic control.  This article thus look at some of the increased risks and complications which include cardiovascular events due to delayed treatment or poor glycaemic control. 

Research Design

To ensure this kind of understanding, on the patients experience in glucose monitoring for adults with Type 1 diabetes and unmonitored hypoglycaemia, the researchers conducted a qualitative study through randomized control trials (Ranney et al., 2015).  The reason this research design was chosen was because it allowed the participants in the study to express their experiences and understanding in regard to interventions in the trial of the decision supporting tools in regard to patients with the trial fibration as the ones considered in the study. 

Sampling

In this study the researcher is going to make use of a sample of 30 participants who have been diagnosed with Type 1 and II diabetes (Vloemans et al., 2017). The age of these participants will be of people from 60 years and above that will be taking part in the decision support tools.  When it comes to the validity, integrity and trustworthiness of the sample,  this study will look at the reasonableness or selecting participants above ages 60, which is based on the fact that diabetes is common among this age group, showing that the data they provide can be trusted.  However when it comes to limitations, the most anticipated will be the unwillingness of selected sample to participate in the study, authorization from the healthcare centres and language barrier. 

Data collection Methods

In this study the researcher is going to utilize interviews, focussed group discussion, document analysis and observational methods.  It will be important for the researcher to utilize tow data collection methods for which interviews and focussed group discussion will be appraise in enhancing the evidence based study credibility (Polit & Beck, 2018). The researcher will also keep a diary during the data collection, there will also be the use of tape or recorder and reflection process and how this influenced the study (Ranney et al., 2015).  The interviews are important as they will be able to collect the views, experiences, opinions and specific issues. These accounts will be compared to other existing practices so that there is an understanding in regard to the research objectives.  In any study, the interview is very important in also enhancing interaction between the interviewee and the researcher, the setting and the skills of the researcher will also be very important in developing a level of trust.  Also tape recorder will be used during the data collection methods as this will ensure that the evidence based data is kept.

According to Ranney et al., (2015), the data that is collected during qualitative research can be streamlined to create various texts to a particular pattern or theme or the systematic issue being approached.  In regard to these steps in a data analysis technique is also worked out in the same line for example the analysis based in age, gender or race.  The most relevant qualitative method in this study however will be the use of Key informant interviews and focus group discussions. The former is usually identified through elitists, sophisticated and snowballing methodologies (Ranney et al., 2015).  When it comes to the focus group discussions it will entail the moderators controlling the group discussion between the particular topic and study individuals in the selected topic, during this time the researcher will have a tape recorder and a video upon the consent of the respondent, and the important of coordinated approach to research in studying the phenomenon in various environments will also be looked in to. 

Analysis of Data

Data analysis will be done by listen to the audio tapes and analysing the questionnaires filled during the interviews and focussed group discussion. According to Ranney et al., (2015), when it comes to analysing data in qualitative research, it is always important that the researcher seeks the meaning from all the related data that is available during the collection.  The data is also classified and organized in various patterns like thematic analysis and patterns which can be used as part of the primary basis for the reporting and organisation of the study findings.  For example it can look at the activities that the responded performs when they are at home with their caregivers like lifestyle and physical exercise and the activities that they perform when they are at hospital with the nurse like physical therapy, lifestyle changes and adherence to medication (Ranney et al., 2015). For most qualitative studies, there will be an association with the education field, but in general form, to get the required information, the following methods of data collection will be relevant: Field Notes, Participant Observation, reflective journals from the Patients, Non-participant observation,  structured interview, Narrative interview, Unstructured interviews, semi-structure interviews, and materials and documentation analysis of the studies. 

Trustworthiness and Integrity

Trustworthiness is usually not accepted in qualitative research, however the framework in regard to this form of work continue to exist in many years. When it comes to the trustworthiness of this study, the researcher will be seeking to address several criterion that include addressing the issue of credibility. In this manner, the researcher is going to ensure a demonstration of the phenomenon for which the study is all about.  Also for the researcher to allow transferability, this is important as it allows for the context in which the study was done to be able to relate reader, so they can make own decisions regard the prevailing environment that is almost the same to the one that they may have gone through in another setting.  Also when looking at the criterion for dependability, it is usually a challenge when it comes to qualitative study, it is however important that the researcher continue to strive to ensure that future studies in the same topic repeats the study (Ranney et al., 2015). Finally trustworthiness is also about achieving conformability, in which the study will achieve by taking steps in demonstrating the said findings from the respondent’s data and not from their personal views or predispositions. 

To ensure trustworthiness and integrity, all participants will be required to sign a consent form which declaration of anonymity will be made for participating in the study. 

References

Polit, D. F., & Beck, C. T. (2018). Essentials of Nursing Research: Appraising Evidence for Nursing Practice. NLM WY: Lippincot Williams & Wilkins. 

Ranney, M. L., Meisel, Z. F., Choo, E. K., Garro, A. C., Sasson, C., & Morrow Guthrie, K. (2015). Interview-based Qualitative Research in Emergency Care Part II: Data Collection, Analysis and Results Reporting. Academic Emergency Medicine, 22(9), 1103-1112. doi:10.1111/acem.12735

Vloemans, A. F., Van Beers, C. A., De Wit, M., Cleijne, W., Rondags, S. M., Geelhoed-Duijvestijn, P. H., … Snoek, F. J. (2017). Keeping safe. Continuous glucose monitoring (CGM) in persons with Type 1 diabetes and impaired awareness of hypoglycaemia: a qualitative study. Diabetic Medicine, 34(10), 1470-1476. doi:10.1111/dme.13429