Research methodology

  Introduction (between 250 to 275 words for the introduction, in the end of the introduction I want you to explain what I am going to write and signposting) ex, Research design in healthcare, qualitative and quantitative will be discussed. Research design in healthcare Currently, there are two research methodologies that include qualitative and quantitative research. More so, medical research studies are divided into five stages that include planning, performance, documentation, and data analysis and journal publication (Holloway & Galvin, 2016, n.p). The Scientific research design is essential in education planning, with the need to enhance quality, reliability, validity, conclusions, and capacity to publish the studies. Holloway and Galvin (2016, n.p) explain that even before the recruitment of volunteers, the study design sets out a plan to fulfill research objectives. Unlike errors experienced in statistical evaluation, design errors cannot be rectified after study completion, thus the need to perform proper planning during study protocol. In addition to being restricted to a particular topic, research design can show an entire plan for all study procedures (Betz, Jones, Petroff& Schwartz, 2013, p. 1578). More so, the study design elements include the research questions to be answered, study population, type of research study, unit used in data analysis, measuring techniques and establishing a sample size. The research design has to adhere to the six elements to help a reader classify, as well as evaluate results presented in publications. It, therefore, means that those that have intentions to perform own studies have to conduct intensive planning on matters research design. Qualitative Research Design in Healthcare Qualitative research is an umbrella that represents numerous interpretative techniques that help in description, decoding, and translation to present meaning and not the frequency of naturally occurring phenomena in the current health environment. For many years qualitative research was not standard in healthcare, but it has now received massive recognition and is utilized in healthcare, specifically those related to social and cultural dimensions. Qualitative research establishes the meaning of a phenomenon using description, thereby developing concepts that help to understand the natural phenomenon emphasizing on actual meaning, experiences as well as participants views. The differences among the researchers choosing qualitative methodology include selecting either ontological or epistemological design, data collection types or evaluation method (Holloway & Galvin, 2016, n.p). Qualitative healthcare research design does not focus on enumeration, but rather focuses more on the structure using observations and interviewing methodology. It is inductive, relies on the purposeful selection of participants, and emphasizes on validity (Strang, 2015). In the health field, Qualitative research methodology represents the best approach as it emphasizes on understanding people's real and lived experiences. The research is well suited to comprehend the meaning person place on activities, procedures, and structures of their lives, as well as perception, assumptions and presumptions'. When conducting an extensive qualitative research, it is important to understand questions of participants' experiences, inquiring about people's meaning and understand their experiences, as well as study the participants on their social and interpersonal environment (Holloway & Galvin, 2016). Additionally, under qualitative research, it was difficult to create a standardized instrument, because of different responses on a particular study topic. The differences occur in opinions among the qualitative researchers on which evaluation criteria to use, a practice of the methods. Quantitative Research Design in Healthcare The quantitative research represents a systematic procedure used in gathering data and statistically analyzing the information that has already been measured by a particular instrument. The tools help to convert information into numerical, with the research design only focusing on quantifiable concepts that could be measured and translated into numbers (Strang, 2015). For instance, the quantitative research methodology in hospitals helped in analysing the healthcare facilities, as well as improves service delivery and positively affects the behavior of health personnel. Quantitative research depends on a structure while using experiments and surveys as data collection and analysis methodology. Strang (2015) indicate that it is deductive design and utilizes statistical sampling method. Other conventional quantitative methods include randomized controlled trials intended for testing. An example involves the effect of an individual treatment or intervention, with the researchers using reliability to verify the validity of qualitative research. Currently, healthcare facilities know that their clients prefer quality services to feel better to get rid of pain or any discomfort. Quantitative analysis, therefore, allows health institutions to conduct patient surveys allowing doctors to understand their patients better and if they are satisfied with the service provided (Strang, 2015). There are different types of the survey that include market research, patient satisfaction surveys or pain, illness and discomfort survey. The information helps the professionals understand the needs of clients and areas that need improvement. Moreover, the pain discomfort survey helps doctors and nurses to know how the patients feel, as well as allow health facilities understand the customer demographics that can assist in improving health facilities and structures. Code of Ethics in Healthcare The Medical Code of Ethics establishes ethical practices of a behavior of health practitioners that define priorities of their work, showing the moral principles related to doctors, patients and all stakeholders affected by the health provision in a community. It represents the rules, as well as policies that oversee right conduct. Every health professional after joining the profession has the responsibility to follow the ethical practice standards as well as conduct required by the job (Strang, 2015). The ethics are rooted in the professionals' commitment, relationships, as well as confidentiality (Jonsen, Siegler and Winslade, 2015). The commitment of a health professional includes committing to enhance and maintain integrity, with once ability to offer quality recognized by a level of personal accountability, moral responsibility to the patients, colleagues, employers, other health care team, doctors, health institutions, and the entire public. Furthermore, the professionals must enhance dignity, show honesty, integrity, respect, and accountability by abiding by the laws and not engaging in unethical behaviour (Jonsen, Siegler and Winslade, 2015). Unethical conduct includes passing false information, fraudulent activities, and deception of any kind. The health practitioners have to take proper actions that abide by the company policy, remain competent, and avoid impaired or illegal practices. The best way to ensure ethical code of conduct is followed includes maintaining membership of the related professional bodies to promote quality, professional growth to avoid seeking personal and financial gains independently with nobody to supervise the health practitioners. Principles of Ethics Any healthcare professional, whether a doctor, nurse, clinical officer or anyone working in a health institution operates in a rewarding as well as challenging field. The medical procedures, treatments, and analysis have merits and negatives, with patients' behavior also affecting the entire process. Jonsen, Siegler and Winslade (2015) explain that the health care principles in Biomedical Ethics used but the healthcare practitioners with the necessary guidelines to decide when faced with complicated matters concerning patient care. The principles include justice, beneficence, autonomy, and non-malfeasance (Jonsen, Siegler and Winslade, 2015). However Jonsen, Siegler and Winslade (2015) explain that apart from the four other scholars add safety and effective service provision. There are several principles in health care ethics. The Six Codes of Ethics Autonomy Freedom in medicine refers to the principle, where the patient has the right to control his or her body. The healthcare professional only has the role of suggesting or offering advice, but any action that leads to persuasion or coercion of the patient in making a decision represents a violation of the principle. According to Faden et al. (2013, p. 22) explain that the final decision is with the patient, whether the medical practitioner believes the decisions do not safeguard the best interests of the patient. Even if the patient's values and beliefs are not the best, if the patient decides to make such a decision then the health professional has to abide. Beneficence and Non- Malfeasance/Patient-cantered The principle indicates that every health care provider must fulfill the role of benefiting a patient no matter the current situation. For instance, all the procedures, treatments and diagnosis recommended must help the patient and ensure a steady recovery. Medical professionals need to develop and provide high skill levels, expertise, and knowledge and ensure that they undergo the best training of current and quality medical practices (Strang, 2015). Moreover, it is essential to analyze a patient's situation, about serve his interests by determining what is right for the patient, because what benefits one patient may not apply to another (Shidhaye, 2016, p. 26). Beneficence rule represents a normative declaration and moral obligation to perform actions that benefit others and help the patients improve their health and continue to live healthy lives by eradicating any harm. Non- Malfeasance means "to do no harm," which represents the principal objective of a health professional role and decision. It, therefore, means that the health practitioners have to weigh whether the decisions they make shall harm a patient or other individuals in society, even if it serves to benefit a patient. The procedure a health practitioner performs must not harm a patient or other affected parties in society (Rensik, 2012). An example includes the infertility specialists that operate under the belief that they do no harm to anyone but promote the overall good of the entire society. However, Faden et al. (2013, p. 16) explain that currently, the assistive reproductive technologies have reduced the success rates causing uncertainty in the overall outcomes, thereby negatively affecting the patient's emotional state. It means that doctors, in particular, have a difficult time successfully applying the do no harm health principle. The two principles relate because many treatments involve a level of harm, with an example of non-malfeasance, which implies harm must not remain disproportionate to the treatment benefits. According to Faden et al. (2013, p. 17), beneficence and non-malfeasance principles, may lead to a health professional not respecting personal autonomy such as their views concerning an individual treatment. For instance, in cases where the doctor has to administer a non famous treatment to stop the development of a more severe medical complication, but it has emotional and unpleasant symptoms to the patient. In situations where the patient has no legal competence to make a decision the health workers have the responsibility to protect the patient's interests (Rensik, 2012, n.p). While doing so, they need to consider both the beneficence and non-malfeasance principles. Justice/ Equitable Distribution of Resources The justice principles imply that every medical decision must be fair, regarding benefits and limitations to encourage equitable distribution of scarce resources and introduced new treatments and procedures. An example includes the health workers abiding by the medical laws and set regulations when they make decisions on heath and directly affect patients and society as a whole (Faden et al. 2013, p. 19). Effective Service Provision Every health professional must always provide services that focus on scientific knowledge to all that could benefit. More so, every doctor has to avoid misuse, overuse of underuse of medications and equipment to ensure clients receive proper medication. The delivered health service must adhere to evidence as well as maximize resources and avoid wastage. More so, Rensik (2012) explain that the health services must be provided promptly, moderate geographical location in a given setting where the skills, knowledge, expertise, and resources meet patient needs. Rensik (2012) insists that to ensure efficient service delivery, the health institution must provide adequate and patient-centered delivery that considers patient preferences, and desires of personalized service users, cultures and community needs. Moreover, equitable healthcare service delivery is necessary to avoid varied quality delivery attributed to features such as gender, race, economic status, and social background, ethnic and geographical location. Safety The healthcare service provided must remain safe and should aim at minimizing risks or causing harm to the patients and other related service users. The medical treatments and diagnosis must continue to be precise and accurate to avoid harming the patient. The same applies to making the right diagnosis to avoid treating wrong ailments (Rensik, 2012). An example of a case involves a patient that had an ovarian condition known as the cyst that was never treated causing kidney failure. The doctor advised the patient to remove the cyst as the best treatment, but she feared needles and was not ready to be injected with anaesthesia (Faden et al. 2013, p. 21). Despite the fact that the surgery is the best choice, the doctor had no authority to force the patient to be injected by a needle as it would be against the principle of non-malfeasance. However, the doctor has the responsibility to analyze the effect of patient choices to others in case the kidney fails completely (Sutton & Austin, 2015, p. 228). Then she will require a dialysis, thereby affecting other individuals that would need similar treatment and use the medical equipment. It therefore before coming up with a final decision, the doctor has to follow the six principles in health care ethical standards. The position that the physician takes must serve the interests of all parties and support the six healthcare policies. Sampling Techniques Sampling methods used in health care research depend on whether the research is qualitative or quantitative. The main reason to conduct research includes an ability to infer or generalize the study objectives from a sample of an entire population. The inference process involves using statistical methodologies that rely on probability theory. According to Holloway and Galvin (2016), a sample represents a subset of a chosen population that is unbiased and could represent the views of the entire community. Research studies that utilize samples are affordable because considering the whole population is not possible (Strang, 2015). Sampling objective, therefore, include ensuring the sample group reflects the accurate representation of the entire population with limited errors. According to Sutton and Austin (2015, p. 226), the sampling errors caused by a type of a sampling plan include biases, as well as errors in random sampling. Sampling errors caused by sampling designs involve biases caused by the researcher when selecting participants, and the random sampling errors. Other errors include non sampling ones that develop after data collection procedures that emerge from measurement, procedural and data collection inaccuracy. Samples must support reliability and validity from the selected probability sampling methods to reduce biases. The most common probability sampling approaches include systematic, stratified, cluster and random sampling techniques (Strang, 2015). Simple random sampling provides every subject an equal selection chance of participating in the study. The researcher prepares a table of randomly selected numbers, which could even be computer-generated. An example includes the study conducted by Kamal et al. (2009) to investigate the level of stroke attacks in Pakistan, led to the researcher using a household list picked from census data then selected a random set from the names. Such prevalence research uses random sampling techniques to create a sampling frame from the provided list. On the other hand, the systematic sample procedure leads to a selection of every k item, which is established by dividing the number of elements of a sample frame (Strang, 2015). The stratified sample is found after separating important relevant subgroups, then use simple random sampling from every stratum (Zapata et al. 15, p.1). Cluster sample emerges from a two-state procedure where the population is separated into groups selected randomly depending on geographical location and applies best in epidemiological studies. Sample size of a Qualitative Research In a healthcare qualitative research, it is important to understand how large a sample size should be, with many numerous suggestions (Creswell, 2013). Nevertheless, before looking at a sample size, it is important to understand how sampling is done in qualitative research. It is less direct because it goes beyond one planning decision, but rather numerous decisions throughout the research. The researcher has to adjust while analyzing the implications of the selected sampling, particularly on interpretation (Strang, 2015). Despite qualitative sampling being complex that was just choosing sample sizes, there is the need for a practical guidance to pick the correct sample sizes. The planning is essential to allocate the right resources, develop feasible funding proposals, create plans for the review boards and conduct systematic research. The systematic analysis encourages empirical research hence the most relevant (Sargeant, 2012). The sample size picked shall depend on the research questions under study and what the researcher is inquiring about. If the research is conducted in an entire country, then the selected participants shall include an enormous sample size and vice versa. Selecting Participants in a qualitative research Participant selection in qualitative research is always purposeful, hence the need to select members that can offer the best information about the research questions and advance the better understanding of the topic under study. It, therefore, means that during the study design, the researcher has to pick the right participants. Decisions on the selection process depending on the research questions, the theoretical frameworks selected and evidence that prompted the research. According to Sargeant (2012), the subjects picked must inform participants on the important facets, as well as perspectives linked to the topic under study. Sargent (2012), provided an example of professional intervention, the representatives considered for the role and if the participants require authority to approve or disapprove intervention, the experience level of the participants and if it meets diversity. It is impossible to predetermine the sample size because the members rely on informed elements of the topic in a study. It means that the sample size remains sufficient when there are additional interviews or even focus groups that fail to identify new concepts or data saturation. When determining data saturation, it is essential to conduct data collection concurrently with data analysis under an iterative cycle (Betz et al. 2013, p. 1570). Data collection and how to collect the data No matter the philosophical standpoint of the research and type of data collection type, the procedure generates large data amounts. According to Sutton and Austin (2015, p. 226), the various study methodologies available are collected in different ways such as recording an interview or focus group, video-recording or take notes. When the researcher audio and video records collected data, it is essential to transcribe verbatim before analyzing data. The researcher could also maintain a file of field notes to complement the audio and video-recorded interviews, hence providing a written document (Betz et al. 2013, p. 1572). Field notes are essential as it helps the researcher to establish environmental context, behaviors and reflect on the nonverbal cues, which are impossible to capture through interviews (Sutton & Austin, 2015, p. 226). Field notes are imperative because they can help to interpret the audio and videotaped data reminding the researcher to analyze the situational factors necessary for data analysis. Semi-structure interview According to Jamshed (2014, p. 87), semi-structured interview represents a data collection method used in social sciences where the researcher is allowed to develop an interview guide in advance that shows the informal topics groupings and questions, which the interviewer can ask in different ways to different interviewees. According to Strang (2015), the semi-structured interviews are in-depth because respondents are required to answer open-ended questions, hence preferred by most healthcare professionals conducting qualitative research. The interviews take 30 minutes to one hour, with the researcher following the interview guide that reflects a schematic presentation of subtopics the interviewer chooses to explore. Interview guides are essential to analyze the participants in a systematic and comprehensive manner. Data analysis According to Ellaway et al. (2014, p.131), before the researcher begins to analyze data, it is essential to identify issues as well as opportunities to collect data. The second state includes selecting problems and opportunities the research provides and then set objectives. Accordingly, the third phase includes planning the methodology. Deconstruction is the fourth step that involves breaking down data into components after going through the interview of the focus group scripts and then categorizing the same data, the code describing the content. The researcher then has to interpret the data to make sense of the encrypted data. It includes comparing the data systems, as well as categorizing across the presented transcripts, as well as across variables (May, Roth & Panda, 2014, p. 182). The last step involves reconstruction of data where the researcher recreates and repackages the codes and identified themes in a way that reveals relationships and insights picked from the interpretation phase. Thematic Analysis The thematic analysis represents a form of qualitative analysis in research, which concentrates more on pinpointing, examination as well as recording patterns and identified themes within the selected data. Items represent patterns established in data sets, which are essential to describe a phenomenon related to particular research questions (Braun & Clarke, 2013, p. 125). It represents a method of identifying; analyzing and recording patterns' within already collected data specifically in qualitative studies. Ever novice researcher uses thematic analysis as a foundational way to analyze and solidify qualitative research design. It permits flexibility in the choice the research theories with the option of offering detailed information. Rigor in Research Rigor in qualitative research represents the openness in data by adhering to philosophical perspectives as well as thoroughness' involved in collecting data. Rigor research includes a trustworthy study that uses proper research tools to obtain the study objectives (Jamshed, 2014, p. 87). An example includes exploratory research, where the researcher answers methodological questions. The tools must ms ensure that the collection techniques offer detailed information on a research question, as well as maximize the ability to identify a broad range of phenomenon. Another focus includes producing data within the discernible patterns. Reflexivity For researchers to remain scientifically technical and offer competent research, they have to reflect deeply on matters practical acts of research. More so, the mental experience that constructs meaning in the health practice remains relevant hence the reflectivity (Strang, 2015). The researcher has to learn the reflection method because it gives him an opportunity to engage in a thoughtful process hence awakening one's lived experiences May, Roth and Panda (2014) provides the example of reflectivity is common in qualitative research, which the researcher uses to legitimize and validate research procedures. The reflection processes are pragmatic, critical, and phenomenological of hermeneutic, allowing in-depth analysis of reflective activity was thereby preparing the researcher. Conclusion (between 250 to 275 words for conclusion)