Health Research: Evaluating Methodologies for Dementia Patient Care

This report critically evaluates the effectiveness of qualitative and quantitative methodologies in addressing healthcare research questions, particularly focusing on dementia care. It explores the use of phenomenology, a qualitative approach, to understand nurses' experiences in caring for dementia patients and descriptive research design, a quantitative approach, to assess their current competency. The report highlights the strengths and limitations of each methodology, providing examples from existing research. It emphasizes the importance of choosing appropriate research designs to explore challenges faced by nursing staff, including ethical concerns and patient-related disabilities. The report also discusses the benefits and drawbacks of phenomenology, such as its ability to provide in-depth analysis and respect individual perspectives, while also acknowledging issues of validity and reliability. The analysis includes a discussion of hermeneutic phenomenology and interpretative phenomenological analysis (IPA) to explore social emotions and cognitions related to dementia. Finally, the report underscores the utility of these methodologies in improving the quality of dementia care and offers insights into the complexities of healthcare research.

Running head: HEALTH RESEARCH-METHODOLOGY
Health research-methodology
Name of the student:
Name of the University:
Author’s note

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Introduction:
The diagnosis of dementia is associated with great disease burden in elderly population
and caring for such patients brings major challenges for health care professionals. This is
because it is one of the most serious mental disorders resulting in many challenging medical and
psychiatric issues in patient. Due to significant decline in memory, visuo-spatial function,
cognitive and social functioning, dementia patients are highly dependent on health care staffs for
their care (Wimo et al. 2013). In the context of primary health care system, the problem is that
many dementia related complications are not easily recognized by health care professionals
resulting in increased risk for patients. Hence, the practice area of specialized dementia care has
emerged (Carduff et al. 2014). However, considering several issues faced in caring for dementia
patients, it has become an active area of research. In order to implement evidence informed
dementia care, researchers are now focusing on research in complex areas of dementia care.
One of the important research areas that needs to be researched in the field of dementia
care includes the inefficiency of nursing staffs in providing care to dementia patient. As more
and more patients are admitted in hospital for dementia related complications, it is necessary to
understand the specific challenges that prevent nurse from providing ideal care (Fukuda, Shimizu
and Seto 2015). Hence, use of appropriate quantitative or qualitative research methodology
would be critical in exploring the challenges faced in extending care to such patients. There
might be moral or ethical concerns for health care staffs or some patient related disabilities that
might be challenging dementia patient (Strech et al. 2013). Therefore, planning specific research
design might help to understand whether staffs faced challenges due to organizational factors or
patients related issue or their incompetency in caring for such patients. In response to the

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research questions of specific challenged facing nursing staffs in caring for dementia patient, the
main aim of this report is to critically evaluate the effectiveness of qualitative and qualitative
methodology in getting answer to health care research question. The qualitative methodology
chosen for the research topic is phenomenology as it will help to describe the lived experience of
nurses in caring for dementia patient (Corbin, Strauss and Strauss 2014). In case of quantitative
methodology, descriptive research design has been chosen as it will give idea about the current
competency of nurse in handling dementia patient.
Overview of qualitative and quantitative research approaches in health care research
Qualitative research approach is a type of interpretative research technique that focuses
on describing and translating naturally occurring phenomena in the social world. Unlike
quantitative research methodology which is deductive in nature and aim to analyse frequency
and trend of any phenomena, the qualitative research methodology gives detailed description and
meaning of a phenomenon (Al-Busaidi 2008). Hence, the main purpose of qualitative research
approach is to collect and interpret data related to experiences and views of participants
regarding a phenomenon. For example, if the research aim is to understand the phenomenon
related to factors challenging staffs in dementia care, then employing qualitative method will be
appropriate in this situation because it will help to get rich data and understand the collective
meaning of the phenomenon in participant’s life (Silverman 2016). On the whole, it can be said
that qualitative research is important to go deeper into the problem and uncover new thought and
opinion about the problem.
There are certain specific characteristics of qualitative research methods in the field of
health care. Firstly, the researcher’s interest is to identify the meaning of phenomena related to

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health care issues and this kind of research is mainly done in the natural setting of participants
(Taylor, Bogdan and DeVault 2015). Qualitative research methodology has greater validity too
because analysis is depended on data collected from in-depth interview or observation. Hence,
there are minimum chances of biasness (Noble and Smith 2015). The uniqueness of this
approach is that it tries to understand a situation in a particular context and also interprets several
interactions within the situation. Another important characteristic of this research is that
researcher is the primary instrument for data collection and data analysis as their judgement
determines the outcome of research. The third characteristic is that qualitative research favors
conducting research in natural setting (Ormston et al. 2014). Lastly, it employs inductive
research strategy which means it used the research data to build abstraction, hypothesis or
theories instead of testing already existing theory. Phenomenology is also one of the important
research methodology used in qualitative research (Alvesson and Sköldberg 2017). It also has the
same characteristics of investigating about a phenomenon without any causal explanation or
comparison with preconceptions or preassumptions (Kafle 2013).
In contrast to qualitative research, the main purpose of quantitative research method is
statistical analysis of data through polls, questionnaires and surveys. It focuses on determining
the relationship between a dependent and independent variable either by means of descriptive or
experimental research design (Walter and Andersen 2013). Unlike qualitative research method,
quantitative research is done with large sample size and structured research instruments or tools.
Clinical trials, surveys with close ended questions and observing and recording well-defined
events are main strategies used for quantitative data collection. Use of relevant research tools and
quantitative analysis software helps to maintain rigour in research (Brannen 2017). Quantitative
research method is considered to have more utility as the research method is easy to replicate

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thus contributing to high reliability. By the method of classifying important features related to a
research topic, numerical data is collected and statistical models are collected to explain the
observation or perceptions of participants (Yilmaz 2013).
Critical analysis of quantitative and qualitative methodology for health care research
Qualitative study:
Among different research methodology, one quantitative research method that can be
useful in conducting research related to dementia care includes the phenomenology approach.
Phenomenology is most commonly used qualitative approach in health care research. The main
purpose of phenomenologic inquiry is to analyze people’s perception about a phenomenon and
find out their view about specific experience (Khan 2014). The usefulness of this methodology is
that it allows researchers to consider a situation from multiple perspectives (Van Manen 2016).
For instance, hermeneutic phenomenological approach was used by Tembo, (2015) to evaluate
about experience of critical illness in people suffering from chronic illness and cognitive
impairment like dementia in the context of daily sedation interruption. Hence, here the main
purpose was to get detailed idea about theexperiences of cognitive impairment (phenomenon)
and uncover the uniqueness of human experience instead of just focusing on measurement and
objectivity. The advantage of using this methodology in the research was that it helped to
conceptualize lived experience of critically ill patient. The study showed that people had feelings
of being disrupted, being blacked out, suffering due to hallucination and inability to remember
past things. This was useful in finding out strategies to minimize sufferings of people in ICU.
However, certain limitations were also found in the methodology. For example, small sample
size was used and this also helped in exploring in detail about the experience of critical illness in

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patients. From the use of phenomenology approach in above research, it is understood that the
methodology is useful in elucidating sufferings of critically ill survivors (Chan, Fung and Chien
2013). The only limitation found in the use of phenomology approach in this research was that it
was done only in a single setting. Hence, generalizability might also arise as quality and
treatment conditions may not be the same in all health care facilities.
One important characteristics of phenomenology methodology is that it tries to give
unified vision regarding the essence of a phenomenon. This indicates the main focus is on
description of experiences rather than explanation or analysis of the experience. The benefits of
the methodology according to ethical view point is that it gives respect to individual perspective
and brings subjectivity in research design. In-depth analysis of phenomenon becomes easier with
such method and rich data can be collected to identify the cause or reason behind any specific
phenomenon (Pietkiewicz and Smith 2014). This is also evident from a research by (Lok,
Gunbayi and Buldukoglu 2015) which used phenomenology approach to study about challenges
faced by carers in living with dementia patient. The study was planned in a phenomenological
pattern by collecting data from participants by means of semi-structured interview. The care’s
perspective on taking care of dementia patient was collected and this helped in categorization of
data into many important domains. For instance, the interview with participants gave details
about concept of dementia, experience in providing care to dementia patient, life before health
care, coping strategies to manage dementia patient and feelings of relative with dementia. Hence,
the research design was successful in identify the perspective related to the phenomenon of
caring for dementia patient and solutions to address the challenges could be identified from
participant’s perspective. Hermeneutic phenomenology thus influences pre-existing experience
of researchers. However, the research also points out to the weakness of the methodology due to

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poor validity and reliability issues. This can be said because use of semi-structured interview
does not guarantees that real facts are obtained and the participants might be lying too being
conscious about the interview (Malcolm et al. 2016)
While conducting health care research, choosing and deciding a methodology is a
daunting task for researchers. If the aim of research is to evaluate an experience or observe
perception of participants, then use of phenomenology is a suitable research approach. The data
collected by this approach also offers a theoretical foundation to the research problem (Crowther
et al. 2017). This research procedure also enables access to participant’s personal world and
analyzes subjective report of participants. Due to the focus on individual experience, it is highly
related to interpretive tradition (Thorne 2016). Hence, this method provides researcher’s the
advantage to critically reflect and analyze the data. Another advantage for researcher is that
small sample size is analyzed saving time and hardship involved in collecting and analyzing the
research data. This is also evident from the study by Aldridge, Fisher and Laidlaw (2017), who
carried out an interpretative phenomenological analysis (IPA) to explore about experience of
shame for people with dementia. Semi-structured interview was conducted in six participants
with early stage dementia. By the use of IPA as a research design, social emotions and
cognitions related to dementia could be identified (Eatough and Smith 2017). In addition, use of
only six samples promoted transparency and better analysis of the findings. This research also
allowed participants to express their unique experience with special emphasis on interpretation
and hermeneutics. In-depth analysis of participant’s response contributed to four themes related
to shame experiences. These four themes included avoidance, negative self-perception,
relationship matters and uncertainty and loss of control (Aldridge, Fisher and Laidlaw 2017).
Such idea can be useful for staffs implementing psychological therapies in dementia patient.

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However, apart from strength, the weakness identified in the methodology was that appropriate
sample criteria was not taken. It excluded people experiencing mood difficulties, however taking
such sample would have given more idea about the phenomenon of shame. Hence, sample
strategy must be chosen with great consideration in this methodology by aligning it with research
objective.
Several research in the field of dementia care also gives an idea regarding the utility of
phenomenology method in improving quality of dementia care. Phenomenology as research
paradigm was used in the study by Dupui et al., (2015) to examine how introduction of research
based drama on experiences of people living with dementia has impact on understanding of
family members with dementia. Informed by phenomenology and use of follow-up telephone
interview, the main aim was to explore experience of participants and find out how those
experience contributed to personal transformation. The result showed that participants had new
awareness and courage to endure and transform practice while caring for dementia patient. The
study findings give an idea about the strength of phenomenology in illuminating how people
apprehend an experience and act upon those live experiences. However, one major concern
associated with this methodology is that there is high likelihood of validity and transferability
issue in this research. The limitation found in study by Dupui et al., (2015) was that play may not
give specific realities about people living with dementia compared to those people who
experience it in reality.
Apart from the strength, certain limitations also affect utilization of phenomenology in
health care research. For instance, phenomenology research approach relies heaving on
subjective data of participants. However, policy makers may give low credibility to such data
because of challenges in establishing the reliability and validity of such information (Leung

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2015). There is also possibility of biasness because individual perception of participants may be
evaluated differently by individual researchers (Cohen, Manion and Morrison 2013). Hence,
there is great possibility that same word will be interpreted in different manner and the actual
meaning of the phenomena may change. Another disadvantage of using phenomenology in
health care research is that the result obtained is highly quantities in nature creating
generalizability issues (Parahoo 2014). Due to qualitative nature of research, the practitioners
may not able to use the findings in an appropriate manner.
Quantitative study:
Quantitative research focuses on establishing connection amongst variables described in
research. Among the four types of quantitative research design available, the descriptive research
design is regarded as useful to gain new insight about phenomenon. The main focus of
descriptive research design in quantitative research is to explore the current status of an
identified variable (Bowling 2014). The main advantage of this design is that it facilitates
systematic generation of data which finally supports researcher in developing a hypothesis. The
success of such research design is highly dependent on careful consideration about sampling
strategy and method of analysis of each variable used in the research (Creswell 2013). In the
field of dementia care, assessment of superimposition of symptoms in dementia patient is an
example of descriptive research design. Another strength was that use of validated tool like
delirium-o-meter helped to assess superimposition of dementia experience in elderly people.
Limitations found in the methodology was inclusion of small sample size and single center for
the study although there was scope to take more larger sample. This affected the rigour as well as
the validity of the data (Morandi et al. 2015).

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Descriptive research design is often confused because it cannot fit in the definition of
either quantitative or qualitative research methodology. This research design can be either
quantitative or qualitative. In case of quantitative research, descriptive design helps in collection
of quantitative information that can be tabulated in numerical form. Such tabulation and
depiction of patterns may help to interpret the factors behind a phenomenon (Clause 2014)
Survey is the most common method used in descriptive design to collect data from participants.
The uniqueness of descriptive research design is that multiple variables can be analyzed at a time
to develop a hypothesis. Use of instrument is essential in this research design to collect data in an
efficient manner. Some example of tools for descriptive research design includes questionnaires,
interviews and observations (Hoy and Adams 2015). Data analysis in such case may be done by
the application of descriptive statistics to identify variation, central tendency and correlation
between each variable. Qualitative research approach with the application of descriptive research
design has been found effective in the field of dementia care because of several challenges in
conducting qualitative research with dementia patient. As dementia patient suffers from memory
decline, cognitive impairment and poor decision making skills, fulfilling ethical requirements
while conducting research will become difficult (Mitchell et al. 2014). For instance, when
planning qualitative study with dementia patient, communication challenges and issues in taking
informed consent for research may arise (Beuscher and Grando 2009). Hence, quantitative
research design helps to overcome some of the challenges.
Another advantage of descriptive research design is that here researchers can easily take
large sample size which was not possible in qualitative research design. This is mainly because
numeric data is analyzed to interpret key variables in research. Descriptive research methodology
has caught attention of researchers as it provides the facility of observing participants in natural

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setting instead of replicating the whole research in a new setting (Vaismoradi, Turunen and
Bondas 2013). Another strength of descriptive research is that it act as a precursor to future
research as the method supports identifying key variable that can be tested. This is found
particularly useful in health care research because in such research many variable causing health
issues is not known and descriptive research design supports researcher to identify specific
variables that has an impact on the health issues (Gravetter and Wallnau 2016). This can be
further explained with example from a research done in the field of dementia care. For example,
Leite et al. (2017) used a cross-sectional descriptive methodology to study about vulnerability in
caregivers of elderly dementia patients. Hence, before the research, it was not clear what factors
contributed to vulnerability for caregivers. However, by the use of descriptive study with
quantitative approach and conducting structured interview with caregivers, important variable
contributing to risk for caregiver could be identified. The researcher used two instruments such
as the socio-demographic questionnaire and the Zarit scale to identify profile of caregiver and
measure their burden from care respectively. The analysis of the interview data revealed that
about 62% participants experience overburden while caring for dementia patient. The reason for
this was impaired performance, unbalanced care and deficits in skills for care of the elderly.
Hence, this gave the evidence regarding the variable that contributes to vulnerability for care
giver.
Apart from strength, health care researchers must also be aware of certain weakness of
descriptive research methodology and adopt strategies accordingly to overcome these issues. The
first limitation is that there is high chance of researcher biasness in this type of research because
there is a possibility that subjects may not be truthful when they know they are being observed
(Neuman 2016). Another issue that may arise is that there might be possibility of error when

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those data are ignored by researcher which is not congruent with the research hypothesis (Richey
and Klein 2014). Hence, descriptive research can be reliable but validity might be questioned.
Conclusion:
The essay gave insight into the importance of different research approaches in
investigating about important research topics in the field of dementia care. The essay focused on
critically analyzing one quantitative and one qualitative research methodology that is useful in
investigating about health care related issues. Qualitative research mainly focus on exploring
experience of participants related to a phenomenon and phenomenology methodology was
mainly described to understand how it has helped to improve quality of care for dementia patient.
The strength of phenomenology was the advantage of in-depth analysis of participant’s
experience in any target setting and this helped to identify areas of improvement. In addition, in
case of quantitative research approach, descriptive research design was found useful in identify
useful variable that can have an impact on the phenomenon. In both type of research methods,
some validity and generalizability issues was identified due to researcher’s judgment in
analyzing the data and issues related to selection of reliable research tools for research. In future,
it is recommended that research put special emphasis on selecting such sampling strategy or
research tools that can be easily replicated and applied by health care professionals in real
setting.

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