Unit-10

INSTRUCTIONS:

The discussion thread will center around qualitative research and your thoughts on the use of qualitative research in our ever-changing world of evidence based practice in physical therapy. Please think about how/when/why you would use qualitative research vs. quantitative research.

There is a two part discussion thread.

For the first part of your post, provide a paragraph on your thoughts on the possible value that qualitative research has to the field of physical therapy.

For the second part of your post review one of the five articles in the qualitative folder of articles. Provide a brief critique of this article. Remember to keep a qualitative lens when viewing the article.

EXAMPLE OF DISCUSSION:

First Part:

Current norms of physical therapy request that patients become dynamic members in treatment, to perform practices at home, to help set objectives, and to help distinguish quality results. In physical therapy, qualitative research can be educated by the therapist’s own understanding, input from the patients, and from the encounters of the clinical act of other health care providers. For example, we do find out about specific conditions by bringing up issues like how might we improve the nature of care? or what can be extemporized in the treatment plan? or what are the obstructions to the changes in the treatment plan? Qualitative research encourages the therapist to comprehend the difficulties that are looked on the regular reason, for example, consistency of the patient towards a home exercise program or why the patient chose not to proceed with therapy? Or was the treatment excessively long or excessively short? Consequently, I accept there is a requirement for qualitative research techniques dependent on different conditions to improve therapists’ understanding of persistent consideration and results.

Second Part:

(Qualitative Critical Review adapted Form by Letts, L., Wilkins, S., Law, M., Stewart, D., Bosch, J., & Westmorland, M.)

Citation (APA 6th edition): Busse, M. E., Khalil, H., Quinn, L., & Rosser, A. E. (2008). Physical therapy intervention for people with Huntington disease. Physical therapy, 88(7), 820–831. https://doi.org/10.2522/ptj.20070346

Study purpose: Busse et al., (2008) plainly expressed the purpose of the study to portray current physical therapy practice for individuals with Huntington Disease (HD), illuminating the advancement of standardized clinical care and future research studies.

In addition, this study highlighted that physical therapy programs implemented in the beginning phases and coordinated toward improving weaknesses, for example, diminished flexibility, coordination, balance, and muscle strength can possibly diminish ailment signs and improve a person’s quality of life.

Research Questions:

What is the nature of physical therapist practice? and

What are the compelling constraining elements important to the arrangement of physical therapy for individuals with HD?

Study design:

Grounded Theory approach was used to influence data gathering and analysis. The motivation behind this methodology, as discussed by Busse, M. E.et al. (2008), was to figure out what physical therapists need to examine from their encounters on working with HD and afterward converting those experiences into the theoretical proposition

Busse, M. E.et al. (2008) viewpoint was to perform semistructured telephone interviews with physical therapists that were specialized in HD management. Additionally, a preliminary questionnaire study was conducted. From the interviews, data was collected from the physical therapists relating to their encounters in the evaluation furthermore, treatment of individuals with HD. Eventually, the information was utilized to create guidelines for physical therapy practice explicitly pertinent to individuals with HD, to settle on proper choices dependent on an accessible proof to move toward patients with various stages of the Huntington Disease, and suggesting outcomes for future physical therapy practices.

Sampling: A purposive sampling strategy was utilized to recruit PTs with a special interest in neurology that was randomly selected from the UK association of chartered physiotherapists. Based on Semi-structured interviews and theoretical saturation point for determining the sufficient sample size, eight PTs were recruited who had experience working with HD patients. The researcher provided with the information that interviewing was ceased after the saturation point was achieved and further investigation of the led interviews affirmed that recurrent themes gave off an impression of being rising in all the interviews.

Participants/Sample: Of the 200 surveys sent, 118 (59%) were returned and included in the examination. Of the 118 respondents, 49 had treated patients with HD during their careers. The respondents had an average of 15.3 a long time of experience. Therapists practiced in a range of settings, including hospitals, outpatient settings, and specialized long-term-care HD units. The larger part of the therapists treated 1 or 2 patients per annum. The therapists mostly assessed and treated patients in the middle and late stages of the disease and only 5.3% of the respondents saw patients within the early stage.

Participants (Physical therapists) for this research study were described in proper detail with their experiences of working with Huntington Disease patients, however, larger purposive the sample would have provided better implications of physical therapy for future trials.

Method: The participants were recruited from the UK association of chartered Physiotherapy. The entirety of the phone interviews was led by one researcher that recorded the audio and field notes were made by another researcher. Unique consideration was given inside the meeting procedure to reevaluating, repetition, and development of the questions as required, in this way upgrading the validity of the data.

The interviewer utilized a preplanned schedule that filled in as a checklist for the questions and as a guide toward the discussion, encouraging a steady and systematic strategy for qualitative data collection. The information acquired from the preliminary questionnaire meant to cover 3 essential topic areas during each interview: (1) evaluation and treatment as indicated by the phase of the condition; (2) the impacts of explicit issues, for example, behavior and dementia on the treatment of HD; also, (3) departmental arrangements to individuals with HD and, explicitly, concerning the potential for creating care guidelines. Open-ended questions were analyzed based on a thematic approach and close-ended questions were analyzed with SPSS version 14. This data was adequate to comprehend the entire picture.

However, the authors failed to discuss certain points; 1) Informed consent from the participants was taken or not 2) whether the researcher was blinded 3) Were the outcomes affected due to low sample size 4) Preliminary questionnaire have no questions related to the stages of HD.

Data Analysis: The interviews were deciphered in full into text. This procedure of full record assisted with reinforcing the reliability of the information by avoiding specific recording of the information. Ensuring reality estimation of the examination, the precision of the records was affirmed by both the interviewer and the researcher also the participants (Physical therapist). Copies of the records were sent to the interviewed participants welcoming them to remark on regardless of whether the records completely spoke to their thoughts or not.

A subjective information investigation bundle (QSR Nvivo, variant 2.0.163) was used to help the authors in the examination procedure for the interview data. Following distinguishing themes, naming, and the layering of associations between thoughts and ideas were performed. Final themes were concurred on by the researchers and were sent to the participants. The Themes were further cross-checked triangulated with the preliminary questionnaire data and with the data acquired from a critical audit. This procedure permitted the authors to affirm the content and the outcomes acquired from the interviews.

Findings: Based on 3 subthemes and master themes, the results were that at the distinctive stages of HD, therapists required different management methodologies, assessments, and objectives. Although preventive strategies should be actualized in the early stages of the malady, with the aim of postponing a deterioration in an individual’s condition, current management is generally supportive in the late stages of the condition. Late-stage management points to reduce the effect of complications. Additionally,

Conclusions: Using a grounded theory approach, this study supports the recommendation that physical therapist management ought to be modified according to the stages of the condition. In spite of the limitations, there are suggestions for future physical therapy trials for HD, stratifying individuals concurring to the stages of the condition and after that evaluating the viability of various management approaches at these stages. Instead of depending on clinical judgment for treatment options, therapists may utilize the data gathered in this ponder to assist them to make better choices based on consensus recommendations from individuals working in the field and legitimized by the currently accessible prove. The information gathered in this consider also may encourage the advancement of standards of care and the plan of future physical treatment trials.

I completely agree with the authors that physical therapy must not be generalized to different stages of HD and a clear understanding of the cognitive, motivational, and behavioral issues that affect treatment at diverse stages of the disease is required. Developing appropriate physical therapy intervention programs for HD is probably going to be complex, however, interventions, factors that impact responses to treatment, and components that may impact results are of primary focus before the commencement of huge scope trials.