Reading Research Literature – Week 5

Reading Research Literature – Week 5

Type your answers to the following questions using complete sentences and correct grammar, spelling, and syntax. Click Save as and save the file with your last name and assignment, e.g.,NR439_Reading_Research_Literature_Smith. Submit by 11:59 pm MT Sunday at the end of Week 5. The guidelines and grading rubric for this assignment may be found on the assignment page.

The following questions pertain to:

Velayutham, S. G., Chandra, S. R., Bharath, S., & Shankar, R. G. (2017). Quantitative balance and gait measurement in patients with frontotemporal dementia and Alzheimer diseases: A pilot study. Indian Journal of Psychological Medicine, 39(2), 176-182. doi:10.4103/0253-7176.203132

1. What is the purpose of this research?

The purpose of the research was to measure whether Frontotemporal Dementia (FTD) and Alzheimer Diseases (AD) lead to gait and balance-related problems on the patients. If positive, the results of the study would serve as a biomarker in diagnosing the two disorders. It would also help in coming up with strategies to help prevent patients from falling.

2. What is the research question (or questions)? This may be implicit or explicit.

The research question is, “does Frontotemporal Dementia (FTD) and Alzheimer Diseases (AD) patients develop gait and balance-related problems?”

3. Give a complete description of the research design of this study.

The study used a quantitative correlational research design. This is because the study consisted of 24 study subjects, all men between 50-70 years old. The subjects were divided into three groups. Group one consisted of eight people of probable FTD, group two consisted of eight people too of probable AD, and finally, group three consisted of eight people who were healthy. The healthy group served as control in the study. The gait and balance of members of these three groups were measured. The results of the three different groups were compared.

4. What is the population (sample) for this study?

The study had a sample size of 24 males between the age of 50-70. The sample was divided into three groups, each with eight people. Group one subjects were of probable FTD, group two subjects were of probable AD, and group three were healthy subjects who acted as control. The AD and FTD patients were recruited from Outpatient Department of Neurology and Geriatric Clinic and members of the control group were recruited from the community.

5. Was the sample approach adequate for the research design that was selected and explain why?

The sample approach was adequate for the selected research design. Since the study adopted a correlational research design, recruiting patients of probable FTD and AD from a clinic, measuring their gait and balance, and comparing the results with healthy subject was adequate for the study.

6. Describe the data collection procedure.

The balance of members of the three different groups was measured by Biodex Balance Master Incorp., USA, using dynamic posturography, in single and dual tasks and gait with Biodex Gait Trainer. The equipment provided balance in two situations. The two situations are dynamic balance and limits of stability.  The equipment had a circular platform and monitor that was in front of the participant.  The monitor provided the participants with feedback about their standing status. The platform would become unstable, making the participant to experience wobbling. The change in the center of pressure would be displayed on the monitor.

7. How were the data analyzed after collection?

The researchers conducted the Shapiro–Wilkins test to test the normality of parameters. They also conducted descriptive analysis and paired t-test. One-way ANOVA was also conducted in analyzing the collected data.  

8. Discuss the limitations found in the study.

The limitation found in the study was that the sample size was found to be small. The researchers recommended that the study be repeated in a larger population.

9. Discuss the authors’ conclusions. Do you feel these conclusions are based on the data that they collected?

Based on the collected data, the authors concluded that the study revealed gait and balance problems in FTD and AD patients, and normal elderly participants. Abnormality was much more significant on patients of probable AD and FTD. FTD patients had significant abnormality when it came to step cycle and stride length but AD patients were not affected.  AD patients were most affected in mediolateral balance while FTD patients were uniformly affected in all parameters. The data shows difference in balance and gait impairment between FTD and AD and the difference can be used to differentiate between the two disorders.  The difference can also be used in determining what type of balance or gait training to be given to patients suffering from each disorder.

10.How does this advance knowledge in the field?

The study advances knowledge in the field by providing data that shows FTD and AD patients develop gait and balance-related problems. The problems can be used as a biomarker for identifying these disorders and also in training patients suffering from the different disorders. The study also raises further questions to be investigated.

The following questions pertain to:

Pals, R. S., Hansen, U. M., Johansen, C. B., Hansen, C. S., Jørgensen, M. E., Fleischer, J., & Willaing, I. (2015). Making sense of a new technology in clinical practice: a qualitative study of patient and physician perspectives. BMC Health Services Research, 15(1), 1-10. doi:10.1186/s12913-015-1071-1

1. What is the purpose of this research?

The purpose of the research was to investigate patients’ and physicians’ perspectives on the usefulness of a new handheld technological device used to detect Cardiovascular Autonomic Neuropathy (CAN) in a specialist diabetes clinic.

2. What is the research question (or questions)? This may be implicit or explicit.

The research question in this study is, “is the new technology useful in detecting Cardiovascular Autonomic Neuropathy (CAN) in a specialist diabetes clinic?”

3. Give a complete description of the research design of this study.

The study adopted a qualitative research design. The researchers collected data by observing medical consultations where the CAN device was used, interviewing patients who had undergone the CAN test, and physicians who used the CAN device in reporting test results.  The data was analyzed using qualitative means.

4. What is the population (sample) for this study?

The sample population that was interviewed consisted of nine physicians and 19 patients. Of the nine physicians, three were male and six were female. They all had different levels of experience. Of the 19 patients that were interviewed, six were female and 16 were male. The patients were aged 36-79. Three patients had DM1 while 16 had DM3. The length of illness was between 2-43 years.

5. Was the sample approach adequate for the research design that was selected and explain why?

The researchers recruited the study subjects by personally approaching them after observation, sending email invitations to physicians, and calling patients based on the data that they had. The approach used was adequate for the qualitative design.

6. Describe the data collection procedure.

The procedure for collecting data involved visiting the clinic on the dates when consultations had been scheduled. The researchers would contact the physicians who were conducting the consultation to request for permission to conduct the observations and interviews. A patient coordinator at the hospital would help the researchers in identifying the patients who had come for the consultation.  

7. How were the data analyzed?

The researchers analyzed the physicians’ and patients’ perspective on the new device qualitatively. Content analysis was applied to help make inferences about interpretations and intentions systematically. In data analysis, the authors first separated the statements and data from physicians and patients into actions and statements, sorted it into categories, compared the different categories that had arisen from the data, and recorded the data by the use of proposed themes.

8. Discuss the limitations found in the study?

There were a number of limitations found in the study. One is that there were few people who tested positive for the CAN and this limited the researchers’ insight about the group of patients.  Many patients were unable to recall the test and thus were unable to explain their experience. Another limitation is that few physicians took part in the study. In analysis, the researchers had difficulties in differentiating three key concepts that they had identified. Finally, the researchers did not compare the new technology with other technologies that had been in use for long.

9. Discuss the authors’ conclusions. Do you feel these conclusions are based on the data that they collected?

The authors concluded that it is important to investigate the understanding of a new technology by the physicians and patients during implementation. They also conclude that the study found that physicians had a hard time communicating the result of tests to patients. This is as a result of difficulty in understanding the device’s data. The authors recommend the use of a dialogue-based approach when informing patients about their test results. This would enhance the use of technology in clinics. They also recommend that clinics inform patients about the CAN test. The conclusions are based on the collected data.

10. How does this advance knowledge in the field?

The research does advance knowledge in the field. It draws out the fact that patients and physicians sometimes have limited understanding on new technological devices used in hospitals and that there is need to train them on how to use these devices. It also emphasizes the need to include patients and physicians when developing and implementing new medical technology.