Long-Term Care Facilities Treatment of PTSDResearch Paper

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Significance of the study: How would research contribute to knowledge?

Psychologists who work with clients suffering from PTSD have noted that the perceptions of the clients regarding the efficacy of the therapeutic interventions they receive are associated with recovery (Polkinghorne, 2005). Many treatments for PTSD are available in the marketplace, however, they have not all been shown to be equally effective with patients experiencing PTSD. There exists a need to continue identifying efficacious treatments for PTSD that can be implemented across venues. The literature also indicates that substantial barriers exist for Veterans seeking a full regimen of effective treatment. A more thorough and comprehensive understanding of the perceptions of patients, who is in this study are Veterans in long-term care, being treated for their PTSD can contribute to the establishment of more robust, effective therapeutic interventions (Polkinghorne, 2005).

Research aim: What is the aim of the study?

The purpose of the current research is to explore the perceptions of Veterans with PTSD who are being treated for their disorder in community long-term facilities. Provision of the results to clinicians and practitioners is indicated in order to support advancements in treatment interventions and efficacious support of Veterans with PTSD (Vive, et al., 2007).

Research Question

This qualitative research is intended to answer the question: What are the perceptions of PTSD treatment in veterans who reside in community long-term care facilities?

Theoretical Nursing Framework

Imogene King's theory of goal attainment supports the type of therapeutic interventions. The tenets of King's theory are a good fit with cognitive behavioral interventions often used by psychotherapists to treat PTSD ("Imogene King," 2013.). Notably, the following propositions apply: The interactions between the nurse and the patient must be perceptually accurate for transactions to occur ("Imogene King," 2013.). When the nurse and the patient perceive that there is congruency between the role expectations and the role performance, transactions will occur ("Imogene King," 2013.). Should either the nurse or the patient experience role conflict, the nurse-client interaction will include stress ("Imogene King," 2013.). A mutual goal setting and goal attainment will occur when the nurse has the special knowledge and skill to communicate appropriate information to the client ("Imogene King," 2013.). Moreover, King's theory holds that people are rational, sentient, social beings, with the capacity to set goals, select the means to achieve their goals, and make decisions ("Imogene King," 2013.). King's theory asserts that individual health is dynamic and requires "continuous adjustment to stressors in the internal and external environment through optimum use of one's resources to achieve maximum potential for daily living" ("Imogene King," 2013.).

Research Design

Qualitative research methods are to be used in the proposed research; specifically, the study will employ a grounded theory research framework.

Data analysis. The constant comparative method will be used for data analysis, as it is particularly appropriate for grounded theory research methods. Glaser and Strauss (cited in Lincoln & Guba, 1985, p. 339) present four phases of the constant comparison method as follows: 1) A comparison of the incidents applicable to each category; 2) the integration of categories and their properties; 3) using the integrated information to delimit the theory; and 4) finally, using the information gathered and analyzed to write the theory (p. 339). Goetz and LeCompte (1981) explain the constant comparison method as a process that "combines inductive category coding with a simultaneous comparison of all social incidents observed" (p. 58). The act of recording and classifying the information is embedded in cross-categorical comparison. This means that as the relationships among the initial observations are discovered, hypothesis generation begins as an element of the emerging themes. The process is iterative such that the data collection and data analysis processes are continuously refined and, in this way, continuously inform the coding of categories. "As events are constantly compared with previous eventsnew relationships, may be discovered" (Goetz & LeCompte, p. 58).

The basis for a constant comparative approach is typically field notes gathered from direct observation and the personal narratives of the research participants, as provided through conversations and informal interviews (Dye, et al., 2000). Constant comparison begins in the absence of theory, although a researcher may have ideas or particular questions in mind (Dye, et al., 2000). The objective of a constant comparison method is to identify emerging themes (Dye, et al., 2000). This is accomplished by reviewing the written documents for categorical indicators, which are given short names or tags and are assigned codes (Dye, et al., 2000; Ralph, et al., 2014). The data analysis processes are intended to identify coalescing categorical codes, such that similar codes are form a loose constellation centered on an emerging theme (Dye, et al., 2000). The researcher typically writes memos in the margins of the documents to record ideas and concepts that seem to be shaping the emerging themes (Dye, et al., 2000; Ralph, et al., 2014). Coding continues until saturation occurs and no new codes associated with particular themes present themselves to the researcher (Dye, et al., 2000). The strength of the categories and emerging themes becomes more apparent as the coding progresses (Dye, et al., 2000). The researcher then examines the categories and themes that may have emerged in order to identify core or central category and axial categories (Dye, et al., 2000).

Participants

The research participants will be Veterans currently residing in community long-term care facilities within the 100-mile radius of the researcher's home. The process of finding Veterans to participate in the current study will be facilitated by working with facility administrators.

Sampling plan and frame. A sampling plan is an umbrella term for the processes that facilitate the identification and establishment of a sample (Savin-Baden & Major, 2013). A sampling frame determines which participants are most likely to provide or enable access to the information that will answer the research questions (Savin-Baden & Major, 2013). This group of potential participants is referred to as the sample unit; the actual research sample is selected from the sample unit (Savin-Baden & Major, 2013). For a variety of reasons, every individual identified in the sample frame will not make it the actual sample (Savin-Baden & Major, 2013). Consider that the members of the sample must agree to participate in the study, and then they must be comfortable with the research conditions and the terms that ensure they give informed consent (Savin-Baden & Major, 2013).

Some selection procedures are designed to delimit the selection of the sample in order to make it manageable size or to ensure that the best match of participants is secured for the research (Savin-Baden & Major, 2013). For instance, research participant selection in qualitative studies may include a process known as snowballing, in which an individual study participant identifies or recommends that another person be included in the study (Savin-Baden & Major, 2013). The decision to include others as research participants is made by the researcher, but sound reasons typically undergird this type of snowball recommendation, such that researchers give them due consideration (Savin-Baden & Major, 2013). The sampling plan includes a determination about how to best contact and communicate with the participants who seem to be a good fit -- this is known as purposive sampling (Savin-Baden & Major, 2013). Triangulation is a way of garnering the same information from different sources (Savin-Baden & Major, 2013). This can be accomplished by asking participants the same questions and identifying where there are similarities in their responses (Savin-Baden & Major, 2013; Polkinghorne, 2005). It can also be accomplished by using different techniques -- such as extant document review and interviews -- within a research method to answer the research questions (Polkinghorne, 2005).

When a participant is asked to review the data that a researcher has collected, along with the conclusions reached based on that data, the researcher has accomplished a member check (Kotler, 2003). Research participants appreciate an opportunity to assess if data associated with them is accurate (Kotler, 2003). The process of completing member checks contributes substantively to trust building (Lincoln & Guba, 1985). Data can be assessed through the use of a data audit, a process that is easiest when the data set is both "thick and rich." When the points in a data set are salient, an auditor can determine how well the research applies to the circumstances and context (Lincoln & Guba, 1985).

Data collection process. In order for researchers to be positioned to accomplish meaningful data analysis, they must be willing to wallow in the data (Glasser & Strauss, 1967). Moreover, during the course of data collection, a qualitative researcher must proceed with exactitude, recording the explicit criteria on which category decisions are made (Dey, 1993, p. 100). Grounded theory data collection utilizes a technique called participant observation, in which the researcher functions as an observer, and to a certain degree, a member of the group that is being studied. When conducting participant observation, a researcher engages… [END OF PREVIEW]

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