Author Topic: Qualitative Study on Counseling for Parents of DMI Children  (Read 665 times)

Lorenzo

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The following is a rough draft of a qualitative study research I am working on right now. This is just the rough draft and am in no ways done. I would really appreciate all the editorial remarks / comments, recommendations etc.

This paper is for my Ph.D doctoral class on Advanced Research Design. Please, be generous with the comments or editorial review. Salamat daan!


Sincerely,
Lorenzo L

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Lorenzo

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Re: Qualitative Study on Counseling for Parents of DMI Children
« Reply #1 on: May 15, 2012, 01:17:28 PM »
Abstract


The disease called Diabetes Mellitus Type I is a rather pernicious disease that affects a great deal of American juveniles and children. The disease is caused by the inability of the B-cell of the pancreas to produce insulin, rendering the child to unable produce insulin and thus is dependent on drugs and care from parents. The study focuses on what types of intervention protocols can be used for parents of children with DMI and exposes what can be done to improve intervention strategies for parents. The results were gathered via a qualitative format, focusing on the specifics and descriptive, thereby improving and paving new ground for a subset of pediatric psychological issues

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Lorenzo

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Re: Qualitative Study on Counseling for Parents of DMI Children
« Reply #2 on: May 15, 2012, 01:20:23 PM »
The article that is of interest is entitled Using Qualitative Methods to Guide Clinical Trial Design: Parent Recommendations for Intervention Modification in Type I Diabetes, which is written by Mauren Monaghan, Risa E. Sanders, Katherine Kelly, Fran Cogen and Randi Streisand. Monaghan, Sanders, Kelly, Cogen and Streisand (2011) present the fact that Diabetes Mellitus Type I is a disease that is currently one of the most prevalent childhood chronic illnesses and the incidence is rising for children that are under the age of 5. This disease, Diabetes Mellitus Type I, is a disease that manifests as polydipsia, polyuria, polyphagia, weight loss, diabetic ketoacidosis, coma, as well as unopposed secretion of growth hormone and epinephrine (Monaghan et al, 2011) due to the loss of the Beta-cells of the pancreas, which leads to the deficiency in the production of insulin.

   The researchers of the study efficiently provided the background information of the disease and also provided the rationale of the study, which basically was to address the fact that the management of diabetes in younger children, below the age of 5, was rather different than for children who were of older. Because of this difference, the parents of the younger children with Type I Diabetes Mellitus experienced significantly higher levels of stress and also about 20% of them reported symptoms of anxiety as well as depression (Monaghan et al, 2011). The researchers state that there was a limited support intervention for parents of younger children with Diabetes Mellitus Type I, the researchers implemented qualitative as well as quantitative study to evaluate the best type of intervention strategies to use for parents of children with DMI and what particular strategy works for specific parents. The study deigns to make sure to evaluate the program, with the qualitative methods coming into hand in determining which strategy will be useful and using the results of the qualitative data to change or modify any existing intervention strategies.

In the field of pediatric psychology and pediatric endocrinology, there is very little data available on the issues regarding parental intervention strategies for parents of diabetic patients, this research, with the expanded use of qualitative methods will be particularly useful in pediatric psychology. Considering the fact that the data on the subject matter is quite limited, any and all information gathered through qualitative study will provide important information and evidence on the value of anticipatory guidance when transferring Diabetes Mellitus responsibility to the adolescents and adjustment following the diagnosis of Type I Diabetes Mellitus (Monaghan et al, 2011).  The study is rather revolutionary for the field of pediatric psychology and will provided guidance for parents in what to do when they are experiencing stress as they care for their children with Type I Diabetes Mellitus.  The researchers were rather comprehensive and thorough in their analysis.

In the field of psychological research, bias is a concept that should be taken into consideration. Bias in testing refers to the presence of systematic error in the measurement of certain factors, which include academic potential, intelligence, psychopathology, among certain individuals or groups. It is important to make sure that bias is limited as a plethora of bias can lead to the decrease in validity in a particular research study ( Aiken & Groth-Marnat, 2006). Considering the fact that the study focused on the effects of caring for a child with Diabetes Mellitus Type I, it is important for the participants to understand the concept of Diabetes, how it affects the body in terms of physiology as well as how the physical and mental stress affects the caregiver. There bias  in that the participants selected were parents of children with diabetes mellitus type I, not of parents of children with Diabetes Mellitus Type II or any other type of Diabetes.

Monaghan, Sanders, Kelly, Cogen and Streisand (2011) were quite precise in how they presented the information about Diabetes Mellitus Type I in children through vis-à-vis etiology and mechanisms of action. The researchers also explained that qualitative data collection would be beneficial in pediatric psychological studies by highlighting critical components for study refinement and guide future directions for parents of affected children.


   The purpose statement of the article was clearly expressed. . Monaghan, Sanders, Kelly, Cogen and Streisand (2011) state the purpose statement as, “Program evaluation, an integral component of clinical trial research, incorporates quantitative and qualitative methods, with qualitative methods being particularly useful in modifying existing interventions, evaluating intervention delivery, determining for whom the intervention is most beneficial, and assessing what components may be downsized
or enhanced. Expanded use of qualitative methods can be particularly useful in pediatric psychology.  The study will provide a mixed-methods program evaluation data from participants who will complete  a 5 session intervention designed to promote parent mastery of diabetes-related tasks and increase social and emotional support.” The purpose statement is clearly based on the argument developed in the literature review.


   This study used a qualitative study design which used a case study of participants drawn from an ongoing RCT for parents of young children from ages 1 to 6 who had Diabetes Mellitus Type I. Considering the fact that the participants were randomized to either the supporting parents intervention group or the diabetes education comparison group, there was an effort on the researchers’ part to reduce bias in the methods aspect. There were 12 participants in the supporting parents program evaluation, of which, some 75% of them were women and also married and of Caucasian or African American origin. So in regards to methods, the study was quite representative of the general public; the participants were also randomized.  There didn’t seem to be any instance of bias in sampling as all participants were volunteers and the grouping of the participants were done so in a randomized manner.  (Monaghan et al, 2011). 


   One has to take into consideration that the sample size was rather limited, considering the fact that this study was one of the first of its kind in the field of pediatric psychology, the participant numbers were small and the amount of those who completed their programs were not reported, indicating that there needs to be more follow-up study( Houser, 2009).  The program evaluation consisted of two parts; a general intervention satisfaction survey completed by all parents, 12, and an in-depth telephone interview with a smaller sample of 4 participants. The reason why this was done was because it follows the aspect of qualitative research in which sampling is designed to ensure a range of perspective as compared to probability sampling designed to allow for statistical inferences in a quantitative research. The qualitative research was augmented with the use of a 6 item semi structured interview guide that the research team probed to details related to satisfaction survey results (Monaghan et al, 2011).  The limitation in the data collection was the fact that there were only 12 participants who took part in the general program and only 4 took part in the phone interview; there should have been more participants to provide a wider and greater point of view.


   The qualitative data was analyzed through the review of audio tapes and transcribed parent answers to interview questions into key phrases, which constituted the units for analysis. The phrases were coded by a study author for broad thematic areas and reviewed later by other authors to reach a consensus of 100%. The teams that reviewed the data engaged in the larger ongoing RCT (Monaghan et al, 2011). The researchers were quite efficient in linking the results analysis to the themes discussed; they showed that there were high levels of program satisfaction. An overwhelming amount of participants reported feeing “very” to “extremely” satisfied with their experience in the supporting parents programs at a rate of 91.7%. The participants also endorsed that their individual phone counselors were “very” to “extremely” happy and knowledgeable about the background information and the kinds of stresses that the parents were experiencing. It was also important to note that qualitative feedback by the participants coalesced into two overarching themes, which included “timing of intervention delivery”, which represented parents’ belief that the program would be of greatest benefit closer to the time of initial diagnosis and “increased resources/ support”, which describes the parents’ desire for increased education and information and support for themselves and other caregivers (Managhan et al, 2011). 


   The researchers were able to clearly restate the purpose and research questions. They reiterated the fact that by using qualitative data one can help augment quantitative satisfaction data in evaluating interventions within pediatric psychology for parents of children with Diabetes Mellitus Type I. The researchers are able to discuss the implication of the test result, which shows that qualitative data procurement can be efficient in identifying strong points in interventions for parents of children with DMI, the study also espouses the importance of using a dual quantitative and qualitative study. Some questions that were used in the study included, “What was your experience with the project?”, “What topics that were not covered should have been included?”, “Who do you think would best benefit from the participation in the project?”, “How has diabetes affected your family life?”, “Any suggestions for increasing connections among participants?”, “Any other recommendations or suggestions?”


Qualitative data collection can be a useful addition to pediatric psychology (Heiman, 2001), particularly for intervention research and can highlight critical components for study refinement and guide future directions. The study highlights the importance of using a larger RCT. It is important to note that because of these findings, the researchers are modifying the existing Young Child Project for parents of young children newly diagnosed with TID and are now conducting a pilot trial.  



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Lorenzo

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Re: Qualitative Study on Counseling for Parents of DMI Children
« Reply #3 on: May 15, 2012, 01:23:19 PM »
Right now, I am currently performing qualitative trials methodology on patients , and developing a multibattery unbiased questionnaire to be applied in the pilot trial. I just want to know if I have covered grounds....I would like to know if there is any weakness in my points, please, be generous with the editorial, guys. Again, i appreciate all and any help.


Sincerely,
Lorenzo




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Lorenzo

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Re: Qualitative Study on Counseling for Parents of DMI Children
« Reply #4 on: May 15, 2012, 01:26:21 PM »
I will post any pertinent qualitative results I find in this thread. For those who are interested to know. I am actually collaborating with another student who is going to be doing the quantitative analysis of my qualitative results. he he he ! We decided to collaborate do do a "mixed" qualitative and quantitative analysis on the clinical pilot trial.



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