In the article Factors Involved in Recovery From Schizophrenia: A Qualitative Study of Thai Mental Health Nurses by Kaewprom, C., Curtis, J., and Deane, F. P. there is an investigation done, in the form of a qualitative study of Thai mental health nurses in an effort to discern the different factors that are involved in the recovery process from schizophrenia. This was a non-experimental, qualitative study and it is my opinion that the researchers did everything as ethically as possible and took great care to keep participants anonymous. There was a total of 24 Thai nurses involved as participants. The results of the research were quite interesting to me. The article states, “This study revealed that the Thai nurses viewed recovery from schizophrenia as involving symptom stabilization and the restoration of psychosocial functioning. Their views of recovery were characterized by a focus on clinical and functional improvement, such as symptom remission, an ability to carry out daily living activities,and a return to work or study. It is concluded that the Thai nurses’ understanding of recovery from schizophrenia was dominated by a biomedical perspective of health” (Kaewprom, C., Curtis, J., & Deane, F. P, 2011). In this paper, I will design a research study on the topic of recovery from schizophrenia and create a design that will seek to resolve the limitations that I saw in the article.
The mental disorder of schizophrenia is something that most of us have heard about but do not necessarily know the details about. Schizophrenia is defined as, “ A psychotic disorder typically characterized by hallucinations, delusions, and a loss of contact with reality” (Getzfeld & Schwartz, 2011). Living with schizophrenia can be very difficult and individuals may require full-time care from a nurse. In this study, we are hoping to learn about the different factors that are involved in the recovery from schizophrenia in patients that have had the disorder for ten years or more. It is important that we understand schizophrenia and the different factors that are involved in treating it and recovering from it. When we have more information, we will be able to better understand and treat those suffering from schizophrenia.
II. Literature Review
The current state of knowledge about schizophrenia is growing. There is endless amounts of information on the causes of schizophrenia, how to live with schizophrenia and how to treat schizophrenia. In my search for more knowledge about schizophrenia, specifically the factors involved in the recovery from schizophrenia, I realized that precious little is known about the factors involved in the recovery from schizophrenia. Knowing that there is not much information about the recovery from schizophrenia has made me all the more eager to do this study so that we might add to full picture of life with schizophrenia and recovering from it. “As already noted, the DSM–IV–TR diagnostic criteria for schizophrenia are relatively narrow. Yet, despite this narrowing, there is no single symptom or set of symptoms that describes all schizophrenic people. The schizophrenic syndrome is heterogeneous (mixed or varied or different; homogeneous means “the same”) in the presentation of symptoms, course, response to treatment, and outcome. These differences among people may mean that Bleuler was correct: Schizophrenia is not a single disorder but a syndrome or series of disorders with different etiologies (origins) and outcomes” (Getzfeld & Schwartz, 2011). There are seemingly endless amounts of research studies that have been done concerning all aspects of schizophrenia, including the article Factors Involved in Recovery From Schizophrenia: A Qualitative Study of Thai Mental Health Nurses by Kaewprom, C., Curtis, J., and Deane, F. P which is a qualitative study of 24 Thai mental health nurses. The article states of their results “This study revealed that the Thai nurses viewed recovery from schizophrenia as involving symptom stabilization and the restoration of psychosocial functioning. Their views of recovery were characterized by a focus on clinical and functional improvement, such as symptom remission, an ability to carry out daily living activities,and a return to work or study. It is concluded that the Thai nurses’ understanding of recovery from schizophrenia was dominated by a biomedical perspective of health” (Kaewprom, C., Curtis, J., & Deane, F. P, 2011).My proposed study is almost a replication of the study of Thai mental health nurses except for a few important changes. The study that I am proposing will be much larger than the study done in Thailand (which had only 24 nurses as participants), I will have 500 mental health nurses as participants, nurses whose patients have suffered from schizophrenia for more than 10 years. I will use the same data collection techniques, such as the semi-structured interviews that last 60 minutes, and also the same methods for data analysis. The proposed study will also be qualitative.
This proposed study is going to be qualitative. Qualitative research is defined as, “ a descriptive approach that attempts to gain a deep understanding of particular cases and contexts” (Newman, 2011). I will be interviewing the nurses of these patients, a total of 500 participants. The research design that I will be utilizing is non-experimental. This study will be non-experimental because none of the variables will be manipulated. There will be no manipulation done by the researchers on the circumstances of the study, on the experience of the participants and absolutely no manipulations on the participants themselves. By making sure to not manipulate any of the variables in this study I will be able to get clear information that has not been manipulated in any way.
The sampling strategy that I would use to recruit participants for my study would be individual sampling. Individual sampling is defined as, “ involves collecting data by observing one person at a time in order to test hypotheses about individual behaviors” (Newman, 2011). Data will be collected through the use of semi-structured interviews with the nurses of patients that have suffered from schizophrenia for more than 10 years. Each interview will last about 60 minutes. To recruit the participants needed for the study I would go to several different general hospitals and one psychiatric hospital and ask to speak with nurses that have experience caring for individuals suffering from schizophrenia. I would do quite a bit of traveling in order to garner the needed amount of participants, about 500. I think that it could be difficult to get nurses to partake in a sit-down interview and discuss the factors involved in the recovery from schizophrenia, but I think that with perseverance that I would be able to get the desired amount of participants, it just might take six months or more. However, I think that putting in the time and effort to find these nurses would be worth it. I would also call hospitals in every state and get the names and numbers of the different nurses that work with schizophrenic patients and call and ask them to participate. However, it is harder to say no to someone in person than it is over the phone, so I would rather meet with the nurses face to face to ask them to participate in this important study. I would want to have a diverse amount of participants, with regard to their age, their work experience, and also their educational background. This sampling strategy would be appropriate and hopefully yield the desired number of participants.
The scientific method would play a vital role in the research process. The scientific method is defined as, “ a method of approaching problems and drawing conclusions based on empirical observations; consists of four steps: hypothesize, operationalize, measure, and explain, abbreviated HOME” (Newman, 2011). The data will be collected through the use of semi-structured interviews that will be analyzed by a thematic analysis method. There will be a total of 500 American mental health nurses interviewed, and each interview will last about 60 minutes. The participants will be asked to share their opinions about recovery from schizophrenia, and also the factors that they feel are involved in the recovery process. In the article, Factors Involved in Recovery From Schizophrenia: A Qualitative Study of Thai Mental Health Nurses, the nurses are all asked several questions in a semi-structured form. The questions included (i) What does recovery from schizophrenia mean to you?; (ii) What do you consider to be the characteristics of recovery from schizophrenia?; (iii) Which factors facilitate recovery from schizophrenia?; and (iv) What are the barriers to recovery from schizophrenia? I think that all of these questions are very important and I would include these questions in the interviews that would be conducted with American mental health nurses. All of the interviews would be audio-recorded to ensure that our data analysis would have the correct word for word answers the nurses gave.
It is important for all information to be reliable and valid. Validity is defined as, “the extent to which they accurately measure what they are designed to measure” (Newman, 2011). In the case of our proposed research study, there is no scale or measuring tool that is used because we are gathering the necessary data through the use of semi-structured interviews. Learning what the nurses feel are the factors involved in the recovery from schizophrenia, as well as learning what they think the barriers are to successfully recover from schizophrenia is very important. I would be very interested to learn if there are any factors involved in the recovery from schizophrenia that is recognized by most of the mental health nurses.
D. Data Analysis
There were two separate types of data analysis done in the Thai mental health study, because the recorded audio had to be perfectly translated into English texts. However, since our proposed study is taking place in the United States, we would not need to translate the audio into English. We would, however, just need to take the audio recordings and word for word turn it into a text document. This would have to be done with each interview and is very important. The second type of data analysis that I would use would be thematic analysis. Thematic analysis involves gaining familiarity with the data, generating initial codes, data extracts, and themes and then the refining and naming of the themes. Throughout this process of generating codes and themes, researchers would be confirming and refining the themes and the codes, and discovering the relationship between the codes and themes and double checking to make sure that everything is accurate. Having data that is accurate is beyond imperative when doing research studies (Cassell & Symon, 2011). It is important for researchers to not make any predictions about what they think will happen or what they think should happen.
E. Ethical Issues.
I think that in the qualitative study of Thai mental health nurses that there were a few ethical concerns, mainly that there would be a problem with the translating of the audio recordings into English text. Also there was the concern that the word “recovery” means different things to different people. In my proposed study, I would give the participants each the same definition of “recovery” so that they would all be on the same page with their understanding of recovery from schizophrenia. I also think that making sure that the participants remain anonymous is very important and also that they sign a contract of informed consent and understand the goal of the study. I would also make sure that the study would receive approval from the IRB. The IRB is the Institutional Review Board (IRB) and “ reviews and monitors all research involving humans in order to protect the welfare of research participants. The IRB is tasked with determining whether a study is consistent with ethical principles, and it has the authority to approve, reject, or require modification of any research proposal” (Newman, 2011). Receiving this approval is vitally important and I do no think that there will be any trouble with getting approval because this study is not going to cause any harm to any individuals and is placing a great amount of effort on keeping the participants anonymous. The fact that this study involves about 500 participants means that we would have a lot more information than the Thai study that only had 24 participants. This will be a benefit to the study and will offer more concrete factors that we know are involved in the recovery from schizophrenia. I do not think that there will be any other ethical issues to contend with.
This proposed study of finding out the factors involved in the recovery from schizophrenia, an American qualitative study would be a great way to learn more about schizophrenia, especially in patients that have had schizophrenia for more than 10 years. Schizophrenia is often something that scares people because schizophrenics are often viewed as “crazy” and this study would help people to have a better understanding of schizophrenia and to understand that it is possible to recover. This study would ethically recruit 500 mental health nurses in the United States, that work with patients that have had schizophrenia for 10 years or more and would gather data through semi-structured interviews lasting 60 minutes. This study would be able to pin-point specific factors that are involved in the recovery process and it would really broaden people’s perceptions of schizophrenia.
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