This paper outlines these issues concerning two different studies carried on cancer patients aimed at determining several fac
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Introduction
In carrying out research, the importance of having a clear understanding as to the setting of the study, the adequacy of the sample and using the appropriate sampling method cannot be gainsaid. This paper outlines these issues concerning two different studies carried on cancer patients aimed at determining several factors pertaining to their lives.
McMillan, S. C., & Small, B. J. (2007). Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients. Oncology Nursing Forum, 34(2), 313-21.Describe the population for this study.
This research is carried out in a large nonprofit hospice involved in the provision of home care. The patients included in the study were supposed to be adults who had been diagnosed with cancer as well as identified family caregivers. The caregivers and patients included in the research were also supposed to have sixth grade education at the minimum and be in a position to read and comprehend English. They should also attain a score of at least seven in the Short Portable Mental Status Questionnaire (SPMSQ) as well as at least 40 in the Palliative Performance Scale (PPS). Since the study concentrated on management of pain, constipation and dyspnea, the patients included in the research had to be experiencing two of them.
How was the sample selected? What are the strengths and weaknesses of this sampling strategy?
A sample of 329 home care patients suffering from cancer and family caregivers were selected and randomly grouped into three categories. One control group comprised of 109 people received standard care, another group with the same number received standard care and friendly visits while the third group comprised of 111 people received standard care and COPE intervention. This method of sampling is known as cluster sampling in which case naturally occurring groups would be selected and be included in a sample. In this method, the population would be divided into groups or samples. In some cases, rather than collecting data from every group, a sub-sample would be used.
Advantages of cluster sampling
Economical- expenditure is one of the major concerns in any sampling method. However, since the research will be carried out on clusters, the expenditure is tremendously reduced due to the fewer listing efforts incorporated (William 2007).
Feasibility- cluster sampling method is also more feasible when carrying out research on large populations (William 2007). Given that the population in the large hospice is in excess of 300, carrying out comprehensive research may not be very feasible and therefore, clustering the samples would make it more feasible.
Increased variability- unlike other sampling methods, cluster sampling comes with increased variability.
Disadvantages of cluster sampling
Sampling errors- cluster sampling comes with more errors compared to other sampling methods. In this case, beginners are discouraged from using this method.
Biased samples- in case the clusters in the populations have biased opinions, it then follows that the whole population would be inferred as having similar results, which may not be the case.
Were the subjects in this study vulnerable? Were there any risks for them as the result of participation in the research study?
In carrying out any form of research, the vulnerability of the variables used in the samples is taken into consideration (William 2007). In essence, the patients and caregivers used in the research are quite vulnerable given the terminal nature of their diseases. However, their participation in the research did not put them in any risk more so having in mind that they were to be under the constant watch of qualified medical analysts who ensured that they got all the necessary standard care.
Are there any HIPAA concerns that are evident in this study?
Health Insurance Portability and Accountability Act (HIPAA) is a legislation that requires physicians and doctors to ensure that the security and privacy of the patients’ medical information and use standard formats to submit electronic transactions. From the research, one deduces that the data was recorded in tapes, 10% of which were reviewed every month to evaluate whether the interveners provided the interventions in line with the protocols and ensure that COPE interventions groups and friendly visits were not mixed in the protocols. This raises questions on the safety of the data more so having in mind that the information could be accessed by the interveners at any time.
What methods were put in place to ensure that the subjects were giving true informed consent?
While carrying out research, obtaining the informed consent of the respondents is imperative to come up with the right data. In this research, apart from meeting other criteria, the patients had to consent to participating in it. There was a minimum requirement as to the education level of the respondents not to mention their capability to read and comprehend English. Combined with the minimum score in the Short Portable Mental Status Questionnaire (SPMSQ) and the Palliative Performance Scale (PPS), the respondents met the requirements as to the mental aptitudes necessary for giving true and informed consent.
What was the setting for the study?
The research was carried out in a large (nonprofit) hospice which provided home care to most patients. The study was on patients who had been diagnosed with cancer and family caregivers. Both were supposed to consent and have a minimum o sixth grade education not to mention their capability to read and comprehend English. The main focus of the study was on management of pain, constipation and dyspnea. Only patients with two of the conditions were included in the study.
Was the sample adequate for the research design that was selected?
Given the importance of sample adequacy in research, it is always important that a representative sample be constituted. While there is quite a large number of patients suffering from these conditions in varied parts of the world, it would be important to acknowledge that the 329 patients included in the study were adequate for the research design. This is especially having in mind that the patients in the facility were 480, in which case, almost all of them were involved in the study.
The following questions pertain to: Rosedale, M., & Fu, M. R. (2010). Confronting the unexpected: Temporal, situational, and attributive dimensions of distressing symptom experience for breast cancer survivors. Oncology Nursing Forum, 37(1), 28-33.
Describe the population for this study.
This research was carried among a group of women aged between 33 and who had successfully gone through active treatment for breast cancer between one to 18 years before this study. In essence, they were assured of confidentiality and data protection. The interviews were held in the participants’ homes, libraries or private offices depending on the participants’ preferences. The participants outlined that they experienced distressing and unexpected symptoms after undergoing breast cancer treatment. These symptoms included loss of energy, pain, impaired movement of limbs altered sexual experience, lymph-edema and cognitive disturbances. Apart from the persistence of cancer symptoms even after undergoing treatments, many of the participants would not talk about the real experience since they thought that their doctors or confidants expected them to go back to their pre-cancer selves or could not handle their fears.
How was the sample selected? What are the strengths and weaknesses of this sampling strategy?
Participants in the research were derived from a cancer survivors’ network. The sample comprised of 13 English-speaking women between the ages of 33 and 74. These women had completed an active treatment regimen for breast cancer about one to eighteen years before the study. This method of sampling is known as purposive sampling method, which is one of the none-probability sampling methods (William 2007). This method targets a defined group of individuals.
The advantage of this method of sampling is that it can be used in situations where one would want to study a population that is very rare or difficult to come by and recruit for research. Given the fears exhibited by the participants in the research, you can be sure that getting the appropriate subjects to participate in the study would be a herculean task (William 2007). Most of them are living in denial and are not sure whether anyone they disclose the information to will understand their plight. Other sampling methods would fail to identify the appropriate subjects but a purposive sampling method would come in handy (William 2007).
However, purposive sampling method may introduce bias in that the people used in the study may not be a true representative of the population who may not be available to participate.
Were the subjects in this study vulnerable? Were there any risks for them as the result of participation in the research study?
Right from the beginning of the study, it was evident that the subjects picked for research purposes were vulnerable. This is demonstrated by the insinuation that many people do not open up to their doctors or confidants as to the real experiences they are undergoing. They live in constant fear that their doctors would abandon them after misconstruing some symptoms as indications of cancer. In addition, they felt that as much as their loved ones understood their plight, they still expected them to go back to their pre-cancer selves. They basically could not understand why the participants were still suffering from certain symptoms if the cancer was gone. Nevertheless, their participation in this study did not pose any risks to the participants.
Are there any HIPAA concerns that are evident in this study?
HIPAA or Health Insurance Portability and Accountability Act aims at regulating the ability of physicians to disclose information of their patients to researchers. This enhances the security and privacy of the patients’ medical information as well as the use of standard format to submit electronic transactions. In this particular research, the issue of HIPAA does not arise since the data is retrieved from the American Cancer Society ACS and not a health care facility. In any case, the respondents in the research participated in it voluntarily and therefore any data derived was as a result of their own disclosure.
What methods were put in place to ensure that the subjects were giving true informed consent?
It is always important that the subjects participating in the study be done with a true informed consent of the participants (William, 2007). While the study may not explicitly state the requirements for the participants, it is worth noting that the participants’ were at a relatively advanced age (33-74). In addition, they were participating in the study by their own accord and by their own volition.
What was the setting for the study?
The participants were derived from a cancer survivors’ network called Reach for Recovery which is sponsored by American Cancer Society ACS. However, the interviews could take place at any setting depending on the preferences of the participants. The study was aimed at determining and outlining the distressing and unexpected symptoms that women who have undergone cancer
treatment experience. The study was set on the premise of the symptoms that women who have undergone breast cancer treatment experience afterwards. It was all in an effort to determine the symptoms that women continue experiencing even after undergoing treatment and how they were dealing with them.
Was the sample adequate for the research design that was selected?
In carrying out a research, the adequacy of the study has a bearing on the results. In this case, choosing a representative sample is prerequisite for the success of the study (William, 2007). However, given the large number of women who have been treated for cancer, a sample of thirteen women would barely be adequate to cover their opinions. This however does not undermine the fact that all of them agree on the symptoms that they experience after undergoing treatment.
References
William G. Cochran, (2007). Sampling Techniques, 3Rd Edition, Wiley India Pvt. Ltd.
