Nurses' Role in Recognizing and Responding to Elder Abuse

Introduction and Research Design

The aim of this study is a qualitative investigation of the nurse's role in recognizing and responding to elder abuse. The primary research question the researcher seeks to clarify is: "What is the nurse's role in recognizing and responding to elder abuse?" Qualitative research methodology is most often used to examine the historical context and subjective dimensions of a given phenomenon and encompasses multiple research designs. Qualitative research allows analysis of the context of reality and enables the researcher to examine what people actually do, as opposed to their subjective feelings about what they do (Adler & Adler, 1987).

For purposes of this study the researcher will use a case study approach, which will entail use of an "unstructured interview combined with ethnographical methodology" (Berg, 1989; Macionis & Plummer, 1998, p. 44). This will allow the researcher to gather information from the subject population by permitting subjects to express their opinions and feelings in their own words and from their own viewpoints. This approach is also sometimes referred to as participant observation, where the researcher's goal is to describe people in a "social setting within their own culture, group and society" in order to record a given phenomenon (Macionis & Plummer, 1998, p. 48).

Recent evidence supports the use and implementation of case studies in a systematic manner to increase the "validity and causal nature of given phenomena" (Jensen & Rodgers, 2001, p. 34). Case studies involve multiple typologies. The format adopted for purposes of this research will be a comparative case study that examines multiple cases of varying entities for cross-unit and longitudinal comparison using qualitative research methods (Jensen & Rodgers, 2001). This will allow qualitative investigation of the research entities selected at multiple points in time and enable a cohort design so that research material can be converted into quantitative figures at a later date if necessary.

From the sample population examined, the researcher will attempt to generalize the data to other populations. One limitation of the case study is that opponents argue it is difficult to "generalize data from one population to another" (Berg, 1989, p. 27). In this case the researcher will attempt to use a nomothetic, or group, design to overcome this obstacle and calculate averages and totals from the group rather than from individuals.

Ethnography, or field research, will allow the people surveyed to reflect their needs more accurately. It is based on extensive observation and note-taking and assumes a condition of naturalism, meaning the researcher is as non-invasive as possible when examining natural phenomena in order to prevent interference (Neuman & Wiegand, 2000). In this context, the researcher is better able to develop rapport with study participants and make observations without undue scrutiny. In this type of examination the researcher will observe the group and then take notes separately, being careful to record the sequence of events that occurred, movements and gestures used by participants, and the researcher's own thoughts and feelings about the situation.

Participants will be encouraged to answer open-ended questions, as this will not restrict responses and will enable collection of unstructured data. This information will be more difficult to measure, organize, and code, but will allow a greater range of response and thus more information gathering from the subjects being examined.

Data Collection Procedures

Each time the researcher visits the residential care home, data will be collected through participant observation. The researcher will plan questions in advance and use a tape recorder to capture initial responses to interview questions. This will enable the researcher to make notes after each interview and to create a report of the events that occur within each session. Comments and conclusions drawn from the research will be based on the researcher's experiences in the setting selected for the study. The researcher will also reference written records of information provided by the residential community to offer a well-rounded observational analysis of the phenomena explored.

The raw data collected will be converted, or coded, and utilized for analysis. The researcher will transform data into coding units to provide a frame of reference for interpretation. The most commonly used coding methods for analyzing unstructured data include use of "nominal and binary scales" (Britton, 1996, p. 2). Using a nominal scale, numbers are assigned values in order to classify them; information is then distributed using frequency distribution scales (Ford & Foley, 1999, s. 5). In this case the researcher will use a frequency distribution to arrange groups of responses and determine how frequently they occur within the case studies examined. Three-letter tags will be created to interpret data for analysis and distribution on the frequency scale.

Data Analysis

The researcher will also select samples from each category of coded information and use frequency counts to summarize research findings (Ford & Foley, 1997; Britton, 1996).