Ethical considerations in chronic low back pain research

¶ … living with chronic low back pain." (Snelgrove & Liossin, 2009 P. 735). Chronic low back pain (CLBP) is a major health problem with enormous economic and social costs. In the United States, between 60% and 80% of the people suffer from back pain in their life of which 30% develop into CLBP. Despite the widespread occurrence of CLBP, the traditional treatments which include back exercises, drug, physical treatment, and education do not always help. (Hadi, Ali, Isa et al. 2009).

Weiss, & Werkmann, (2009) define CLBP as the pain in the lumbosacral region and the sacroiliac joints. Typically, the radicular symptoms and iliolumbar ligaments may also be part of syndrome in the CLBP, and there is prevalent of CLBP in the aged population. CLBP is a type of chronic pain that results to diverse painful and benign condition. Chronic pain may occur despite no evidence of tissue damage in the body. Estimates reveal that CLBP place heavy demand on economic and health service.

Seminowicz, Wideman, Naso. et al. (2011) argue that chronic pain is associated with the impaired cognitive ability. Evaluation of CLBP reveals that CLBP is the most expensive disability among the younger people. In addition, approximately two-third of the adult patients suffers from CLBP. The cause of this pain might be related to para-vertebral, vertebra, muscles, joint, ligaments and spiral nerve root. Typically, chronic LBP might also be associated with the physical, psychological, social and economic difficulties, and treatment of such cases might be challenging. (Hadi, Ali, Isa et al. 2009). The cost of treating the CLBP continues to rise, and the treatment of CLBP continues to become the major public health burden. (Briggs, Jordan, O'Sullivan, et al. (2011).

The paper provides the ethical aspect to provide greater understanding on the extent the study adheres to the ethical considerations.

B. The Ethical Aspects of the Study

Ethical consideration is being implemented in the study, and there is no deception in the study. The ethical approval was obtained from the Local Medical Research Ethics Committee. The major purpose for seeking for ethical approval is to safeguard the participant. The safeguarding steps used for the participants are that the researcher seeks for the consents and the approval of the participants before they are included in the research. In addition, confidentiality and anonymity of the participants are preserved. To preserve the confidentiality of the participants, the use of substituted names is used.

There is approval process from the Local Medical Research Ethics Committee to enhance the ethical consideration of the study. The researcher seeks for the ethical approval from the body before using the patients for research purpose, and informed consents is handled by writing the patients and seek for their consents to be included in the interview process.

There is no undue influence in recruiting the participants because the researcher has already written for the consents of the participants before they are being included in the interview process. The researcher removes the names any participant that does not agree to be included in the interview.

There is a need for debriefing of the participants because the participants need to be aware that they are taking part in the investigation. The researcher should provide the participants the appropriate information to enhance greater understanding of the participants on the nature of the study.

C. Strengths, Limitations, and Suggestions

Snelgrove et al. (2009) uses qualitative technique in their approach. The qualitative technique used is semi-structured interview used for the data collection. There are several strengths that qualitative technique contributes to this study.

First, by using qualitative technique for data collection, the author is able explore deeply into the phenomenon. The use of semi-structured interview allows the author to probe more deeply into the research questions, and this technique allows the researcher to answer the research questions as well as providing findings for the study.

Another strength of the qualitative study is that the author has been able to use analytical process in the data collection and data analysis as well as explaining the social phenomenon.

More strength of the qualitative study is that the researcher is able to collect data from the natural setting. By collecting data from the natural setting, the author has been able to get into the deeper understanding of the research topic. (Pope, Ziebland, & Mays 2000).

Despite the strength of the qualitative study, there are limitations identified in the use of qualitative study.

The first limitation of the qualitative technique in the study is that it is difficulty for research to prevent induced bias. Using qualitative technique for data collection, data analysis, there is no way the researcher could completely eliminate bias in the study.

Moreover, due to the subjectivity in a qualitative research, it may be difficult to establish reliability and validity.

Gathering data through qualitative research is time consuming, and a researcher may incur huge costs in the process of gathering data. The study reveals that the researcher uses approximately 3 years before the researcher could complete the data collection process. This process is time consuming and involves huge costs. (Curry, 2009).

Evaluation of the study shows that the methodological approach for gathering data is relevant to the research topic since the author needs to probe into the phenomenon to generate the research findings. Typically, the quantitative technique will not be appropriate for the study. With the nature of the research topic, the qualitative method is more appropriate. The ethical consideration is also appropriate because of the author seeks for the consent of the interviewees and the appropriate committee before the interview was conducted, and the author took necessary precaution to enhance confidentiality of the interviewees.

Relating the interpretations with the findings, it is revealed that the interpretation is consistence with the results because the study has been able use semi-structured interview to reveal the cause of pain, crucial nature of pain, and the management of pain.

Additionally, there are generalizations that are not warranted on the basis of sample used. For example, the author discusses maintenance of integrity in the research findings which is not warranted.

Relating the research implication, the researcher has offered the implications of the research for practical purpose. The researcher provides the method the psychological therapist could benefit from research findings. From the research findings, the psychological therapist could effective manage the patients pain if the biomedical understanding of the pain is known.

Despite the contribution of the study, there are still limitations identified in the study. First limitation is that the qualitative approach being for the study is not enough; the researcher ought to use the mixed methods for research approach. The advantages of mixed methods will eliminate the shortcoming identified in the qualitative study. The suggestion for the study is that mixed methods should be used for subsequent research because mixed methods places high regard for reality.

E. Participants

The sampling plan is inadequate. The study reveals that all the 10 participants have not yet attended the chronic pain clinic at the time of the interview. This is the shortcoming in the sampling plan. To enhance the effectiveness of the sample plan, the sampling strategy should be the mixture of the participants who have previously attended the chronic pain clinic and those who have not yet attended. There would have been rich contribution of the participants who have previously attended the clinic, and this would have provided great contribution to the research findings. More inadequacy in the research findings is that the researcher only samples the Caucasians for the study. The researcher ought to have mixed other ethic groups in the study to enrich the research findings.

There are no identified biases in the sampling. The setting is not appropriate to investigate the research questions because the participants are very few in numbers. Moreover, there is no control group in the sampling plan to provide greater understanding on the chronic low back pain findings. "The participants were recruited from the waiting list of a medically staffed chronic pain clinic and had experienced significant CLBP for at least 4 years that was unrelieved by previous medical and surgical treatments" (Snelgrove & Liossin, 2009 P. 737).. The sample size is not adequate because only 10 Caucasians adults which include 7 women and 3 men were chosen. The selection of the participants reveals that the sampling technique does not represent all diverse ethic groups.

F. Data Quality & Collection

The DV is dependent variable. Method used to collect data is through qualitative technique. The researcher uses semi-structured interview to collect data. Each interview starts with the participant biography and illness history, and followed by the lead questions. The technique used in estimating reliability is multilevel analysis. The researcher revisited the data throughout the analytical process. The procedure is appropriate for estimating the reliability because the researcher uses the independent validation check for the validity of data. The credibility check is undertaking at each stage of the analysis to provide the established credibility of the research findings. The collection of data places undue burden to the researcher because data were collected from semi-structured interview in the span of three years. Based on the technique of the data collection, there is no suspected bias in the study.

Data were collected through semi-structured interview. To maintain the confidentiality of the research, there was no other person present during the data collection process apart from the researcher and interviewees. The data collection could place undue burden on the participants because the researcher uses longitudinal study in the data collection which spans within 3 years. The quality of data is not affected because the participants are ready to take part in the interview process. Based on the method that the researcher employs in the data collection and data validity, the findings has been able to reveal the overall trustworthiness. The trustworthiness of data refers to the validity and reliability of data. The trustworthiness is the data that that have been able generate valid and reliable research findings and be accepted by the academic community. To enhance and appraise the credibility of the data, the independent auditor should attest to the reliability and credibility of the data in order to reveal data trustworthiness.

G: Data Analysis

The study does not use the quantitative study. The study uses qualitative technique for data analysis. The statistical data is not presented in the study. The results are related to the research questions, and the context of the phenomenon adequately emerged from the results because the cause of pain is revealed in the results. The effect of chronic back pain has shown that pain is a threat to an individual and the consequent could lead to the loss of social roles.

H: Summary

The paper provides the critique of a research paper titled "An interpretative phenomenological analysis of living with chronic low back pain." (Snelgrove & Liossin, 2009 P. 735).Evaluation of the paper reveals that the ethical consideration is adhered to in the study. The researcher seeks for the approval of the Local Medical Research Ethics Committee before the researcher recruits the participants. The researcher also seeks for the consents of the participants before the interview. There are 10 participants and the data collection is the qualitative technique of which the semi-structured interview is used as a method of data collection. The researcher uses longitudinal approach of which data are collected over three years. To enhance the validity and reliability of the data, the data is validated by an independent auditor to enhance the research trustworthiness.