Topic: 1
My research is being designed to investigate the efficacy of a culturally appropriate and targeted diabetes education program on the reduction of A1C levels after six months. The population I am focusing on is Asian Americans with Type II diabetes, within a specific age range. My hypothesis is that after three months of the program, the A1C levels of the experimental group will be lower than they were prior to starting the program.
Because I intend to measure the same population of people before and after the intervention, the ideal methodology to be used would be a pre/post test. I would like to employ quantitative research methods regardless, particularly for measuring the dependent variable (A1C levels). This is a unifactorial study, focusing only on one diabetes factor (A1C levels), making it relatively straightforward. Another way I can approach this study is to design a correlational study in which I compare two different samples of Asian Americans with diabetes. However, the pre/post method controls for intervening variables because it is testing the exact same group. I need to operationalize the education intervention and clearly define how it will be implemented in the research.
The opposite methodology, such as qualitative methods, may be useful if I were to change my research question. Qualitative methods used may include interviews or case studies. For example, in addition to measuring A1C levels, I would also measure patient perceptions of the program, and other subjective markers. It might be helpful to do so in order to determine whether the program needed to be redesigned. Both qualitative and quantitative methods are efficacious in evidence-based practice but not all research questions can be appropriately designed as quantitative studies. I happen to have a research question that does lend itself to quantitative analysis.
Topic: 2
Healthcare institutions and their administrators have long known that “patient perception is reality,” (Koska, 1989, p. 40). To improve healthcare outcomes, administrators and nurses need to change patient perceptions. Changing perceptions can be challenging, but in some cases entails low-cost or no-cost changes to human resources policies and the environmental design of healthcare institutions (Balfour, 2012).
A person’s epistemology or way of knowing also informs perceptions. Thus, a patient’s worldviews, values, attitudes, background, and beliefs will all impact how that individual perceives healthcare delivery and health itself. The subjective way of knowing is all about perceptions, not about measurable, verifiable reality. For example, many patients do not care about numbers in their chart or whatever percentage of persons benefitted from a specific treatment intervention. The patient also cares more about how the nurse communicates, and whether eye contact or touch was used, and less about whether the nurse referred to clinical studies before recommending a course of treatment. What the patient cares about is how they feel, and whether their perceptions align with their expectations. Nurses need to understand the salience of subjective reality.
If patients had an objective paradigm of the world, they would have a detached view towards their health and treatment options. They would make decisions based on calculations and algorithms, not on psychological motives. Even nurses who are guided by evidence-based practice models still do operate within a subjective paradigm of the world. It is important to recognize the difference between subjective and objective ways of knowing when…
