THE CONTRIBUTION OF A RESEARCH REPORT IN RELATION TO THE EXISTING BODY OF EVIDENCE THAT UNDERPINS SPECIALIST PRACTICE
THE RESEARCH STUDY
The research study is entitled “Psychosocial and Clinical Aspects of Eating Disorders in Young Females”, by . from the Department of Physiology at the National University of . The study is founded on the working hypothesis that several clinical parameters are correlated with the severity of eating disorders, and various psychosocial factors may be positively correlated with preference for thinness or development of eating disorders. The study aims to test the hypothesis by undertaking clinical measurements and interviews. The sample population of the study are seventeen (17) female outpatients of the Child Guidance Clinic at Health Promotion Board who are below 21 years old and are all Singaporean citizens or living in Singapore. A group of seventeen normal females are also utilized as control group. Findings from the study included the following: (1) patients with anorexia nervosa and bulimia nervosa commonly have low heart rate or bradycardia positively correlated to body mass index and skinfold measurements; (2) blood pressure is also low for the same patients but the effects of body mass index is only on systolic blood pressure and not diastolic blood pressure; (3) triceps skinfold measurement and mid-arm circumference correlates with both systolic and diastolic blood pressure; (4) eating disorders do not necessarily develop in people with stereotyped family background and lifestyle; and (5) the average number of people suffering from eating disorders come from well-to-do families than those in the control group
THE RESEARCH DESIGN
The research study primarily uses quantitative research approach to the topic. The basic purpose of the study is to test the hypothesis that several clinical parameters are correlated with the severity of the eating disorders, and various psychosocial factors may be positively correlated with preference for thinness or development of eating disorders. Quantitative research aspires to determine and analyze the relationship between one variable and another in the population or subjects of the study. The variable in this kind of research are classified as independent and dependent or outcome. There are two kinds of quantitative research: descriptive or experimental. Descriptive quantitative research usually measures the variables in the subjects only once and is aimed at establishing correlations or associations between them. Experimental quantitative research measures variables and subjects before and after treatment and seeks to establish causality ( 2000). Specifically, the research utilizes case-control descriptive quantitative research in addressing the research problem. Case control research involves comparison of cases between a case subject and a control group. The case subjects typically have a specific attribute that is not found in the control group. Comparison is done on the basis that certain attributes or factors have made the case subjects different from the control group (2000). The study utilizes seventeen female patients who are suffering from either anorexia or bulimia nervosa and seventeen healthy females as the controls. The subjects and controls both underwent clinical measurements for height, weight, blood pressure, skinfold, ECG and SAEGG. Afterwards, the results of the measurements are compared and analyzed to test the validity of the hypothesis that certain clinical parameters like low blood pressure, heart rate, body mass index, and skinfold measurements present in the seventeen subjects are not found in the seventeen controls. Furthermore, all the subjects and controls are interviewed regarding personal and social issues and relationships to determine if eating disorder is associated with a particular family or personal background. The researchers are successful in utilizing the research design since they are able to satisfy the validity of the hypothesis. The researchers basically aim to establish a correlation between certain physiological and psychosocial attributes of females with eating disorders with the severity of the disease that would help medical and clinical practitioners to develop more in-depth understanding of the visible symptoms and underlying factors of eating disorders. They are able to deliver results that can help in diagnosis and preventive efforts for the disease.
The research can also utilize the qualitative research method in the conduct of the study as far as the objective is concerned. The researchers are cognizant of the fact that eating disorder is a broad concept and has several types. They are also aware that females and young teenagers in every society are prone to the development of the illness. The broadness of the topic encouraged the researchers to only explore certain areas of it namely clinical parameters that directly or indirectly correlate with severity of the disease and psychosocial factors influencing the existence of the disorder among the chosen subjects. (2006) claimed that qualitative research is basically used to gain better understanding of any phenomenon or issue. It is a research method primarily used to produce new results or perspectives on well-researched matters or acquire more thorough information that a quantitative research design cannot obtain. The study wants to derive a set of clinical and psychosocial parameters that may be used in clinical settings for diagnosing eating disorders or formulating treatment measures. Research problems in qualitative research are usually structured as open-ended questions that support exploration of new information or clarification of exiting data on the topic (2006). The design would be appropriately used by the researchers since they are only after finding answers to the question of possible clinical parameters that would determine severity of eating disorder and psychosocial factors that are deemed contributory to the development of the disorder to form a new body of knowledge that may help future endeavors on diagnosing and preventing the illness. According to (2002) despite the grave consequences and widespread nature of eating disorders, these disorders are often difficult to detect and diagnose. Also, even when diagnosed, patients suffering the illness are hesitant of undergoing treatment. Therefore, health and clinical professionals must be aware of the symptoms and visible signs of the disorder in order to facilitate immediate intervention (p.1). The research would have been successful too by utilizing the qualitative research design in coming up with information on clinical and psychosocial parameters contributory to eating disorders. The clinical parameters include body mass index, skin fold measurements and blood pressure which are all somehow easily obtained through appropriate clinical procedures. Psychosocial factors include family background, relationships with people, hobbies, and difficulties encountered in daily living. The findings of the study would supplement existing knowledge on the signs and contributory factors of the disease and thus, help medical practitioners to easily diagnose it in casual patients. According to Neill (2006) qualitative research analysis aims to produce a complete and detailed description of the topic under study while quantitative research seeks to categorize and measure features and make use of statistical methods to explain and analyze the results of the study. Thus, the research study on eating disorder would benefit from both quantitative and qualitative research designs as far as the research objectives are concerned. Basically, both designs aim to yield an explanation or description of a topic or phenomenon which run parallel to what the study wants to accomplish as well.
The study at hand has time constraints to consider which explains the limited number of samples for data collection. However, it can be further enhanced through grounded theory, a form of qualitative research. (2006) stated that grounded theory is a research method advanced by and works on the purpose of deriving theory from a set of data obtained and analyzed through systematic manners. Grounded theory is founded on the presumption that the developed theory from research data fits empirical settings and situations that both sociologists and laymen would comprehend by providing essential explanations and descriptions of social phenomena. As mentioned, eating disorders is a widely-researched medical concept; thus, the study would benefit from this method since it works around two hypotheses that are basically derived from a much broader body of knowledge on the topic. These hypotheses were satisfied at the end of the study and can be a basis for shaping new theories on eating disorders.
Grounded theory requires longer time for the conduct of the study since it follows a series of steps. The study on eating disorders does not have the luxury of time but certain characteristics in data collection and analysis of grounded theory would be deemed useful for addressing the same problems posed by the present research. Grounded theory basically approaches research through accumulation and reading of literature and textual database in order to extract variables or concepts for determining relationships. The process of extracting or discovering categories from data analysis is called open coding. Open coding is essentially done by studying each property of the topic for the study (2006). The researchers can do open coding since several recordings on eating disorders are existing in libraries, the Internet and other academic sources. The researches can analyze reports or database particularly related to physiological/clinical manifestations of eating disorders and the psychosocial attributes of most girls suffering from the disorder since the research problem revolve around these two concepts. After open coding is done and the categories that support the research problem are extracted, axial coding takes place. Axial coding is the process of determining relationships between the categories or properties of the phenomenon under study through causal relationships. Causal relationships have six elements: (1) Phenomenon or the subject; (2) Causal conditions or the variables that resulted to the occurrence of the phenomenon; (3) Context is somehow related to causal conditions and is usually the researcher’s perspective on the more and less essential components of the causal conditions; (4) Intervening conditions or the mediating variables or properties; (5) Action strategies or the purposeful activities that researchers undertake to address the phenomenon; and (6) Consequences or outcomes of the action strategies (2006). In the study, the phenomenon is eating disorders among young females. Causal conditions are the clinical parameters and psychosocial factors that correlate with the severity and development of the disorder. Context in the study are body mass index and skinfold measurements which the researchers believe to be associated with the severity of eating disorder, and family background which they deem contributory to the development of the disease is the Intervening Condition. Action strategies include the clinical measurements of body mass index, skinfold, heart rate, blood pressure, ECG and SAECG to determine if the seventeen subjects of the study possess lower measurements compared to the seventeen controls. The interview with the subjects and controls asking for family background, personal and social relationships, hobbies and difficulties encountered is also an action strategy that addresses the second research problem of determining the effects of psychosocial factors in development of eating disorders among young females. Finally, the Consequences are the findings obtained which are (1) patients with anorexia nervosa and bulimia nervosa commonly have low heart rate or bradycardia positively correlated to body mass index and skinfold measurements; (2) blood pressure is also low for the same patients but the effects of body mass index is only on systolic blood pressure and not diastolic blood pressure; (3) triceps skinfold measurement and mid-arm circumference correlates with both systolic and diastolic blood pressure; (4) eating disorders do not necessarily develop in people with stereotyped family background and lifestyle; and (5) the average number of people suffering from eating disorders come from well-to-do families than those in the control group.
With regards to the appropriateness of the method of data collection in grounded theory, it does not include a sample population and does not utilize specific data gathering instruments like survey questionnaires or interviews. Thus, this kind of research would not solely address the research problem that Lim and Ho are investigating. The research study wants to establish correlation between clinical parameters and severity of eating disorder, and between psychosocial factors and development of the disorder by utilizing actual persons. The research problem would be best addressed through actual interviews or responses from actual subjects who have eating disorders. The researchers would not be able to gather the essential data on clinical manifestations of eating disorders as well as the psychosocial factors that may contribute to it if they would only rely on broad literature on the topic. In the qualitative research method, on the other hand, the researcher is the data collection instrument. He immerses himself with the setting of the sample population to observe and interpret their natural behaviors and reactions (2006). The research at hand could not derive the needed data merely through observation. Although clinical manifestations of eating disorders can be observable, there is still a need for clinical procedures to ensure that the subjects of the study possess some attributes that are not found in normal teenagers who do not have the disorder. Also, the psychosocial factors that contribute to the disease can not be observed by the naked eye. Thus, quantitative research is still the most applicable method in terms of approach to data collection. This method utilizes a sample population where information regarding the research problem would be derived. It also uses data gathering instruments in order to collect the needed information.
Both qualitative research and grounded theory are time consuming and requires the researcher to immerse themselves or focus on the natural situation of the research subjects. According to (2006) researchers using grounded theory should strictly adhere to the process since this research design emphasizes the dynamic changes taking place in the research setting over time. (2006) added that qualitative research yields richer data that are less likely to be generalized through time consuming observation patterns. Since the researchers of the study on eating disorders emphasized that they are faced with time constraints, grounded theory and qualitative research designs would not be suitable for the research in terms of time and place of the research. The researchers cannot spend longer time with the subjects in the hospital because the time for data collection is very minimal.
Considering the source of data, all the three research designs would be beneficial for the researchers. Quantitative and qualitative research designs both adhere to sample populations and observations as methods of data collection. The researchers are able to identify a group of subjects for the study. If they were given enough time for the conduct of the study, they could have spent some time observing the behaviors of the subjects as they undergo treatment at the hospital. Grounded theory, on the contrary, primarily utilizes existing records of the social phenomenon under study in order to derive the needed interpretations regarding the research problem. The research on eating disorders would benefit from this since the researchers should ensure that their hypotheses are patterned after available literature on the topic. The researchers could not formulate their hypotheses without consulting available data on eating disorders. Thus, in terms of source of data, the research at hand can benefit from qualitative, quantitative and grounded theory research designs.
Finally, qualitative research would supplement the purpose of the study to establish a new perspective on the topic while grounded theory would help the researchers adopt a more systematic and literature-based approach to the problem because of its meticulous process.
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