How behavioural research can identify factors which influence the patient s experience. Margaret Brown

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1 How behavioural research can identify factors which influence the patient s experience Margaret Brown

2 Qualitative Research in healthcare Qualitative research seeks to gain an understanding of the participant s worldview, or in the case of healthcare, the participant s view of health and illness experiences. Strauss & Corbin 1998

3 Grounded Theory Definition Grounded theory provides a way to transcend experience to move the knowledge gained from description of what is happening to understand the process by which is happens Artinan 1998

4 Developing Theory A developed theory should: Enable prediction and explanation of behaviour Be applicable in practice Provide a perspective on behaviour Provide clear categories and hypotheses for verification in present and future research

5 Why use qualitative research? Grounded Theory Very little previous work undertaken on chosen subject Little known about identified subject No suitable theoretical framework Generates theory from data Flexible (theoretical sampling) Use of constant comparative analysis

6 Data Collection in Grounded Theory Interviews negotiate access (face to face) Presentation of self Gaining Trust Establishing rapport Observational data Memos Documentary evidence/literature

7 Data Collection Telephone interviews: More challenging Non verbal cues absent Silence

8 Challenges of Qualitative Research Quality of interviews Ethical considerations Abstract thinking required? Waiting for the data to emerge Length of time to reach data saturation

9 Anger Trying to adapt Becoming hopeless control The Isolated Patient s Cycle Attention-seeking behaviour Buzzer happy Learned helplessness Difficult patient Avoidance tactics Depressed/ uncommunicative Less attention

10 motivation Loss and anger trust staff/system Lost out on information goals communication freedom attention rehabilitation Losing identity assumptions control hope relationships power society quality care

11 Core categories and sub-core categories Feeling angry L Trying to adapt O S I N Becoming hopeless G Control

12 Relating Therapeutically Informing Control by the patient Knowing the person Communicating /engaging Recognising

13 Theory in to practice

14 Core Content of the Programme What is isolation? a brief look at what isolation is and the two different types of isolation patients can experience What happens in isolation The effect isolation has on patients and families, focusing on the sense of loss they experience What can we do to help An exploration of attitudes, skills and techniques that can help us to support patients and families through this unique experience

15 Learning Outcomes Explain the reasons for isolation Differentiate between the two types of isolation Identify when the use of transmission based precautions is necessary Describe the application of transmission based precautions Identify the psychosocial problems patients may experience while in isolation Highlight the elements that need to be incorporated when devising a plan of care for a patient in isolation

16 Trustworthiness Credibility Prolonged engagement with subject matter Member checks (return to participants) Peer debriefing (experienced colleague) Supporting evidence (literature)

17 Confirmability Trustworthiness Leave an audit trail Recording of activities another could follow

18 Transferability Probability that the findings have meaning to others in similar situations Guba & Lincoln 1985

19 Qualitative research credibility is demonstrated when informants, and also readers who have had the human experience recognise the researcher s described experiences as their own Beck 1993

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