Review of research approaches
This qualitative research will seek to examine how women with mental health issues integrate and adapt to home and community settings upon being discharged from mental health facilities. This report consists of three sections. Section 1 review of the possible research approaches, section 2 provide an overview of the proposed research design and section 3 justification of the approaches that chosen.
Three possible approaches that can be employed in order to capture the experiences of women transitioning from inpatient to home/community settings are: Focus group, semi-structured interviews and ethnographic approach.
Firstly, focus groups are considered to be techniques used by a researcher to obtain data primarily through group interaction on a particular research topic (Morgan, 1996). Focus group tend to assist researchers understand how and why individuals have a certain belief or perception towards to a topic of interest. This research approach tends to be widely used among researchers (Webb and Kevern 2001). In terms of gathering information on women’s experiences after being discharge from mental facilities, focus groups would make it easier for the researcher to gain a lot of information from the sample within a short time period base on the fact that the women would be able to speak freely on their experience, engage each other and exchange information which would provide valuable data for the researcher. Due to the sample group of vulnerable women the use of focus groups would be useful as it helps with obtaining detailed information on their experiences. Another advantage of focus groups is that is that it would give the researcher the ability to observe interaction on topics related to their experience in their home/community settings. Also, group discussions provide direct evidence about similarities and differences in the participants’ opinions and experiences” (Morgan, 1997). Hence, stimulating women to explain their recovery needs and how well those have been met up on being discharge from a mental health facility. This is important as people are rarely encouraged to reflect on their recovery needs and to articulate them to anyone (Patient and Health Council, 2013).
While this research method proves to be advantageous it has its shortcomings, focus groups are largely limited to verbal behaviour and self-reported data, and since one of the goals of this research is to collect data on women social actions, rather than just the discussion of these activities, the increased naturalism of participant observation is necessary. Secondly, even if focus groups do bring group interaction into the picture, there are still many interactions that cannot be re-created in focus groups. If the interaction of interest does not consist of a “discussion,” then more naturalistic observation is probably preferable (Morgan, 1997). A possible issue with focus groups is that questions may be misinterpreted and hence not answered correctly as well as there might be a problem with getting women to actually attend the group sessions. Focus groups also posed an ethical concern as information that will be provided by the participants would be shared within the group which infringe on participants’ privacy which limits what the researcher could possible pursue. According to Morgan (1998), in some instances focus groups should be avoided if it is determined those participants will not be receptive to cooperating with each other since this would limit the way in which they will openly discuss their feelings.
Semi Structured Interviews consist of questions that were constructed before the start of the interview however the questions can be altered during an interview to suit the conversion. Question wording can be changed and explanations given; inappropriate questions for a particular interviewee can be omitted, or additional ones included (Teijlingen, 2014). This method would be very useful in trying to achieve the aim of this research since the researcher might only get one chance to see a particular participant hence the researcher would be able to cover a wide range of topics in one interview. An advantage of semi structured interviews is that the interviews are carefully managed by the moderator (Ritchie & Lewis, 2003 and Gillham, 2000). This would allow the interview to stay on point and not stray from the experience of participants in their home/community settings. This however relies on the communication skills of the interviewer. Semi-structured interview tends to be a flexible method as it allows depth to be achieved by providing the opportunity on the part of the interviewer to probe and expand the interviewee’s responses” (Alshenqeeti, 2014). This would enable the women to further describe their experiences after being discharged from their respective mental facilities. Also, semi structured interviews provide a one a one settings which encourage participants to feel comfortable enough to discuss matters in depth as well as it allows the interview to be able to observe the actions of the interviewees and being able to determine if the experiences being shared by the women are in line with their expressions. However, it is likely that the interviewer can only ever come to a partial understanding of the females’ point of view. This is may be a result of participants having complex and contradictory perspectives and partly because it is not possible to fully encompass the experience of another person (Partington, 2001).
A final approach that can be utilized by this research is an Ethnographic approach. This approach examines human behaviour and belief within a well-defined community that shares a common culture. The researcher would study a group of women in their natural setting for a long period of time observing their day to day activities to assess how they interact with others and their surroundings. The researcher may be a participant and become involved in the daily lives of the group of women or non-participants observing as an outsider. One main advantage of ethnographic approach is that participants are observed in their natural settings and therefore the researcher is able to see their actual social interactions rather than being told about their experience. However, there are a number of limitations associated with this method such as participants can only be observed for limited time periods (Wilkinson, 2008). Additionally, the act of being an observer may influence the behaviours of the participants under study (Wilkinson, 2008).
In summary, the three research approaches discussed above are quite useful in extracting the information required to satisfy the aim of this research however there are a few drawbacks to the approaches. The following sections consist of the researcher’s proposed design and justification of methods.
Proposed Research Design
A case study will be employed in this research. This qualitative case study is a research design that facilitates exploration of a phenomenon within its context using a variety of data sources (Baxter, 2008). Specifically, the type of case study that will be used in this research is of a descriptive nature. This type of case study is used to describe a phenomenon and the real-life situation in which it occurred (Yin, 1994). Hence, this research will be able to describe the overall experience of women within their homes or communities after leaving a mental facility. The case study method can achieve similar targets as other methods, however in this design a case study can be useful in helping the researcher to generate new knowledge which is of a exploratory nature.
The researcher will use mental health facilities database as the sampling frame to identify women who reside in Nottingham and have left a mental health facility 3-6 months prior to the beginning of this research. A total of ten (10) individuals from the database will be selected to participate in this study. The researcher will seek to recruit a homogenous sample in order to carry out a comparative analysis. Within qualitative research the sample size should be very important and for definite (Guest, Bunce, & Johnson, 2006; Morse, 1995; Sandelowski, 1995)
Data Collection Methods & Instruments
Semi-structured interviews will be utilized as a data collection method in this research. Instruments that will be used to collect the data include questionnaires comprising of open-ended questions. These data collection instruments will be given to participants to communicate their feelings freely, and recorders will be used in order to capture information during conversations with participants. Due to the sample group these methods chosen are suitable in providing information in depth which would be highly valuable (Harrell & Bradley 2009).
Data Analyses Plan
The type of Data Analysis that will be used for this study is interpretative phenomenological analysis (IPA). The aim of interpretative phenomenological analysis (IPA) is to examine in depth how participants are making sense of their surroundings (Smith & Osborn, 2007). Furthermore, IPA involves a two stage interpretation process: 1) The participants are trying to understand and make sense of their world 2) The researcher is trying to make sense of the participants trying to make sense of their world. In this phase, data collected will be read a number of times by the researcher in order to become familiar with the content and to fully understand what was said by participants. Key points will be highlighted and notes will be taken in order to summarize associations, connections or initial interpretations. In the second phase, notes taken will be organized into emerging themes. In the third phase, the themes identified will be listed on a sheet and then ordered in a manner that indicates some form of connections between these themes. The themes identified will be used to guide subsequent cases within this study. In the final stage, themes will be prioritized base their prevalence within the data. These final themes will then be used in the write up stage, where the researcher will seek to explain and transform the theme into a detailed narrative account that will indicate the overall experience of women transitioning into the community/home settings from mental health facilities.
The researcher will seek ethical clearance before undertaking this research. During the data collection process, interviews will be recorded; the recorder and the transcripts will be kept in a safe, where only the researcher will have access. Once the data is collated it will be safeguarded on a personal password protected computer that and was only accessible to the researcher.
I. Participant Confidentiality
Participants are obligated and entitled to the security of his/ her reputation, opinion and life. This therefore means that no personal information will be released about any participant whose mental health information is use in this study. Participants who are participating in the study can expect that their identity will be kept anonymous, Aurelius (2012) states that participants expects that their information will be kept confidential.
II. Author Consent
All data sources and documents that will be used in this research will be properly cited to avert plagiarism. The researchers will also ensure that the information published is not done without permission and specific patents and copyrights. With consent there may be some issues which the sample group, which could include gaining consent from a group of women who are mentally distressed and emotionally unstable (Aurelius, 2012)
Objectivity relates to a lack of judgement and prejudice while subjectivity means being bias and judgemental. Being subjective in inducting this research could potentially affect the accuracy of the findings or conclusion of study. Hence, the researcher will be objective before and during the investigation.
Case studies are in-depth investigations of a single individual or a group of individuals. This research method was chosen because it would allow the researcher to investigate the experiences of women in their home/community settings upon leaving mental facilities in far more detail than might be possible if the researcher was dealing with a large sample. Case studies can be considered a robust research method particularly when a thorough investigation is needed (Zainal, 2007). The flexibility that case studies allow in terms of analysis is another advantage of using this method. Zainal (2007) confirmed that variations in terms of intrinsic, instrumental and collective approaches to case studies allow for both quantitative and qualitative analyses of the data. The in-depth analysis of real life experiences that case studies offers would not only assist in describing the experiences of the women under study but also assist in explaining these experiences. This is usually not the case with quantitative studies.
Although a case study is ideal for this research and has been widely used amongst researchers there are some criticisms to this approach. Yin (1994) considers case studies to be the weaker method to explore. Critics identified three disadvantages of case studies – Lacks thoroughness, results are hardly generalized and the length of study is too long. According to Yin (1984) researchers tend to allow their opinion or beliefs influence the conclusions drawn from a case study. Hence case studies are subjected to observer/researcher bias. Yin (1984) further criticized that case study results does not provide substantial scientific results that can be generalized to the wider population. This is so because case studies usually involve a small number of participants and in some cases the study might involve only one participant. A case study in most cases span over a long period of time in order for the researcher to study the subject (s) in details. Yin (1984) indicated that this might make the study difficult to conduct and produce a large amount of documentation. Additionally, it is imperative that a case study is carried out in a systematic order and data collected is properly organized or else the study might draw wrong conclusion base on faulty data and incorrect interpretations.
Interpretative Phenomenological Analysis (IPA)
As indicated in previous section, IPA is an approach that strives to offer insights into how an individual in a particular setting make sense of a given phenomenon. In this study the researcher would like to find out how women leaving mental facilities relate, interact and adjust to their home or community settings as well as to determine their general attitude towards their home/settings. The IPA is most effective in uncovering this information as it encourages a bonding relationship between the researcher and participants which increases the advantageous elements of this approach (Alase, 2017). According to Alase (2017) IPA would give the researcher the best chance to comprehend the innermost deliberation of the ‘lived experiences’ of research participants. An important aspect of IPA is that it tends to focus on what an experience for a person is like through the telling of their story, rather than questioning what lies underneath their words such as why they are telling the story in this way (Wilkinson, 2008). Another advantage of IPA is that it examines each case in detail and therefore allows the researcher to uncover unexpected themes (Wilkinson, 2008). Based on the homogeneity of the intended sample and the small proposed sample size, it is anticipated that IPA will provide rich information. This is supported by Alase (2017) who stated that because of the homogeneity of the research participants and the size of the sample pool, it is anticipated that IPA research studies will be rich and descriptively deep in its analytical process. Similarly, Brocki, Joanna and Wearden, Alison, (2006) agrees that IPA studies tend to be more concerned with examining divergence and convergence in smaller samples.
While IPA has a number of advantages, there are some drawbacks that have to be taken into account. A researcher’s own understanding and biases may influence their understanding of the participants’ experiences. Additionally, there might also be an issue of generalization since the study will only involve a small number of participants. However, according to Smith and Osborn (2003), IPA is not against providing results from which general claims can be made for larger populations, but is mainly focused on analysing a small number of participants which may lead to generalization.
The aim of this research is to investigate the experiences of women with mental health problems who are transitioning from inpatient forensic mental health settings to community and care home settings. In order to satisfy the objectives of this research a case study will be utilized to study a small sample of women in details. This approach is effective in obtaining rich data for analysis and results obtained from this case study can be used to formulate hypothesis that can be tested in further research. However, caution must be taken when collecting and interpreting data in order to avoid bias and inaccuracy. Additionally, the data collected will be analysed using IPA. This type of approach allows the researcher to understand phenomena from the participants’ point of view.