How to Better Treat the Patients With Dementia? - Research Proposal

Purpose of Research

The primary motivation of the study is to find the meaning that social workers attached to their work when it came to patients with cognitive impairments such as those with end-stage Dementia or Alzheimer's disease. The study of this meaning would be instrumental in opening the barriers that prevent the creation of a meaningful work practitioner-patient relationship and devise strategies of recreating meaning in the relationship (Chou et al., 2016). The central phenomenon that was to be studied was the meaning that workers in the social field found in their careers as they were working with cognitively impaired patients. Interests in the social work practice with the elderly have reduced dramatically over the years, On the other hand, the numbers of patients with these conditions have kept increasing, and there was the need to improve the quality of service for them; these reasons, therefore, warranted for research.

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The research has a firm foundation and is backed by a firm reason for it; it, however, by the end of the research, they came up with inconclusive results From further analysis, it was clear that the intended lesson was on how to improve the meaning created in work with cognitively impaired patients. The research was relevant to the whole clinical level (hospice social workers and other caregivers in other healthcare settings) to impact positively on the meaning they have with their work, and to identify the training needs they have to improve their practice about cognitive populations.

Research Question

The overall research question was: What are the barriers that affect the capacity of hospice social-based professionals from finding meaning while working with terminal dementia patients, and the operational strategies that could be devised to improve the situation. The research question was present; it, however, had the strategies of improving the meaning created inferred. The research is descriptive research. It is because it seeks to describe the phenomenon of the meaning created in the relationship between the hospice workers and the cognitive patients (Moore et al., 2017). It does not seek to find whether the relationship came to be; effectively, it would shed light on the situation by explaining, describing and validating the characteristic of the hospice social workers (Zeng et al., 2015). Since the research aims at completing a description, the researcher represents the data tool, a form of words embodies the data; arguably, if the later is subjective, then it qualifies as qualitative research. A qualitative methodology would then well fit the research.

Literature Review

The literature review was relevant to the study. It gave a background on end-stage dementia and the care attributed to it. It also introduced the cause of challenges that come with the stage of dementia. There was a balance stricken in the literature review as it covered both the role of the workers and the patients and the characteristics that led to a stricken relationship between the two. Moreover, it also gives insight into the role that social workers have towards these patients. There was however little support lent to the study; it did not provide any gaps in the literature that it covered and did not build upon any previous studies on the topic. Duplication was not characterized since there was no use of previous research on the topic. The sources found in the literature were also falling short as they were not within the range of five years from the year of the research. The sources composed and balanced between primary and secondary sources. Most were from peer-reviewed journals thus proving their credibility.

Theoretical Framework

The theoretical framework of the study was based upon was that of symbolic interactionism. It, therefore, used the principles that; the meaning was the basis of response people give to each other; formation of meanings result in interaction, and their interpretations are dependent on some factors that determine the sense made out of them. The researcher was right in the selection of the rationale because the research question sought to find the significance created in relationships between the social workers and patients; arguably, its creation is through interaction. End-stage dementia patients have no way of communicating with their caregivers, and that was the primary source of lack of meaning in work (Zeng et al., 2015). The barriers to the meaning are therefore based on the interaction and strategies to improve interaction aimed at overcoming the barriers; conclusively, there was justification in choosing the framework.

Methodology

The qualitative method used for the research was focus groups. The choice of selection by the researcher aimed at creating a platform that would maximize on the social networks that are already in place. Responses by social workers would then initiate ideas within the others and thus create a free sharing type of interaction (Keady, 2017). The method was right because the setting was that of a hospice care center and the caregivers had had interactions before. They would, therefore, lack any restraint in the data collection. The other advantages of the focus groups are; not complicated in usage, to measure the reactions of the participants; arguably, they are quicker than interviews and non-verbal cues, and they can be used to get responses. The limitations of the method are that the small size samples would not be a good representation of a more massive majority, discussions are difficult to steer, and they depend on the skills of the moderators.

Recruitment and Sample

Recruitment was done in well-established hospice care facilities large enough to provide a large number of participants. There was no use of any sampling method, and involvement included only the willing participants. The rationale for the recruitment was provided for, and the only inclusion criterion was being a hospice social worker to provide relevance for the study. The participants were informed of the study and given information on the earlier stages. No information is present to indicate informing the participants that the process was voluntary or that their confidentiality was guaranteed. Also, it was also not indicated to be approved by an Institutional Review Board. A total of 43 participants carried out the study with teams consisting of 6-25 employees. There were justifiable reasons for those that did not participate in the event.

Data Collection

The procedure of the focus group is well defined. There was the use of predetermined questions, but the workers were allowed to initiate some. The source of the questions was previous research on the topic. The focus of the questions was also clearly defined by the researcher. Provision of the sample question used for the focus groups and the data collection took place within conference rooms in the hospice facilities and lasted for between 75-120 minutes. The data was recorded using two audio recorders. Field notes were also audio recorded. A professional transcriber used the two audio recorders in the transcribing process. There were five focus groups, each had their allotted time for the focus groups, after that, there was a compilation of field notes of the reactions, impressions, and summaries recorded throughout the sessions; this allowed for the focus group to complete enough data for the conduction of conclusive research.

Data Analysis

The researcher efficiently explained the process of data analysis. The steps involved were reading them line-by-line and organization of open coding within seven broad categories, and finally re-categorization of the categories into two main ones (Moore et al., 2017). The issues that came up in the coding were the discrepancies arising from differentiating what constituted as bias, fear or discrimination; consequently, a discussion between the researchers for a consensus resulted in a solution which involved sieving through the data and deciding which were appropriate for the study. The first categorization involved seven groups, although was later discarded. The final themes were two with three subthemes. The two themes were adequate as they covered all the needs within the research question. One of the themes identified the barriers to creating meaning between the hospice social workers and the cognitive patients and the other sought ways of solving the barriers.

Rigor

From the fact that the research comprised of 5 different stations with a total of 43 respondents, it makes the research confirmable; consequently, there was shown to be a correlation between the data sets corrected from all the stations results in one station painted the same picture as the ones from another station. These similarities show that any data from the stations could be used as a representation of the whole group of hospice social workers, making them transferable. The presence of two professional researchers doing the data collection and the coding makes the data dependable and credible.

Findings

The researcher presents the data in the form of the six categories introduced by the coding process. Their division resulted in two themes which aimed at finding barriers and strategies that create meaning. The categories in barriers to creating meaning are biases, fear, and educational needs. The categories for the strategies of creating meaning are redefining significant interactions, rediscovering the value of silence, and finding the hidden person. These categories are accurate as they comprehensively cover the aspects related to creating meaning according to the research framework. In the barriers of creating meaning, the researcher captures the real expressive approach that the participants use in presenting the ides. There is also the relation between the statement of different workers, and their relations proves that these barriers are prevalent in the cases of each hospice worker. In the strategies of creating meaning, the statement of the workers is not directly implying to the methods. The information is however inferred based on the statement from different workers. The labels therefore from the results-to-evidence approach create a meaningful relationship.

Discussions

The discussion brings the relationship between the background created in the literature review and the results of the data collection. The relation between the two creates a significant introduction into the role that the study findings bring to the field. The social workers in the field had their clinical skills to create a correlation between the data corrected. The study, therefore, proved that these methods could not work correctly for the case with cognitive patients. The findings, therefore, provided improved awareness for the training of the clinical professionals for the end of terminal patients. Identification of the limitation and strength was established from earlier research, and it aided in providing more informed research. The limitations are that they were only based on views of hospice workers and thus should be taken with precaution.

Conclusion

The research did not provide implications it had towards the field of caregiving. The concentration of future study will delve into training the researchers with the aim of equipping them with information on how to better treat the patients with dementia. Imparting information of social workers early in their career would provide an excellent foundation to the practitioners. Further research on imparting communication methods within dementia patients should be done so that it could assist in their communication in the end-stages of the disease (Prince et al., 2016).

References

Chou, W. Y., Waszynski, C., Kessler, J., Chiang, Y. C., & Clarkson, P. J. (2016). Usin...