Compare and contrast quantitative and qualitative approaches
This report is has been prepared in context of a debate on “avoiding the use of the opioids for chronic pain would improve patient safety”. Each of the participants were allowed to speak for or against the topic. On the other hand, the second part of the assignment consists of a critical analysis of the different research approaches used in answering the particular clinical issue. The main aim of the second part of the assignment is to critically analyze both the qualitative and the quantitative approaches used in this research. This paper would finally inform how the alternative arguments have influenced my thinking process.
Research can be considered as an academic activity that is mainly done in order to answer an issue. Research refers to defining and redefining of the questions, formulation of the suggested solution or hypothesis, collection, organization and evaluation of the data and finally reaching a conclusion based upon the findings of the research (Allwood, 2012). Research forms the base of medical science and has been classified in to several types based on the better understanding of the different concepts. One of the most important types of researches are qualitative or quantitative research methods. It is mostly applied to the incidents that has to be expressed quantitatively. The qualitative research on the other hand is applicable to phenomenon that is determined by its quality (Allwood, 2012). For example motivation research is an essential qualitative research that is based on in depth interviews. This kind of researches mainly aims to understand the underlying motives or the designs using face to face interviews. Some of the other methods of such researches are word association test , sentence completion tests and story completion test. Qualitative researches are of special importance in behavioral science, understanding the underlying human behaviors (Yilmaz, 2013). Qualitative research method is a process of enquiry that helps to develop an understanding of human and social sciences. It is holistic in nature unlike the quantitative research and is subjective; the perception of the participants might differ from the thought process of the researcher or the actual truth. The qualitative research type is exploratory and inductive unlike the qualitative researches where the research type is conclusive and the reasoning type is deductive. The sampling method used in a qualitative research is purposive, whereas in case of quantitative method random sampling is used (Choy, 2014). Most of the data obtained in quantitative research is measurable. Since qualitative data analysis is mainly done on the basis of the interviews, the data is collected verbally. The methods used in qualitative studies are non-structured techniques, in depth interviews and group discussions, whereas quantitative studies use surveys, questionnaires and observations (Choy, 2014).
Importance of qualitative and quantitative researches surrounding this practice issue
The results obtained in a qualitative research helps to develop an initial understanding. Whereas the results of a quantitative research are straightforward and recommends a final course of action.
Some of the importance of the quantitative research is that the statistics can be used to generalize the findings and reducing and restructuring complex problems to a limited number of variables. Since the topic is based on the use of opioids in treating chronic pain. Randomized control trials have been found quantifying the reduction of the chronic pain in adults by using different numeric scales and then analyzing the findings by using statistical methods (Baumblatt et al., 2014).
A randomized control trial by Chaparro et al. (2013), have been conducted in order to compare the use of opioids compared to placebo or other options in the treatment of the lower back pain. Male and female participants of 18 years of age who have had persistent lower back pain for at least 12 weeks were taken in to consideration. Primary outcome measures like pain ratings, verbal scale ratings, Quebec Back Pain Disability Scale (QBPDS) were taken. Opioids like tramadol has been compared to placebo. The opioids were compared to other analgesics and other drugs The reports on the pain and function outcomes has been measured using standardized mean difference using the risk ratios with a confidence interval of about 95 % . Hence the qualitative research has been successful in comparing the effectiveness of opioids with other drugs. Opioids have long been used to treat chronic nonmalignant pain. A quantitative analysis was done to test the hypothesis that long term opioid treatment for the management of chronic pain that is nonmalignant is effective and the primary problem associated with the safety of such a treatment is that the risk assessment of opioid addiction has been always neglected. As per the findings the safety of the long term treatment of opioid, has not been assessed properly (Kissin, 2013).
Another article by Wilder et al. (2016), have again focused on the risk factors for the opioid overdose risk among the veterans prescribed with chronic opioids for pain or addiction. 90 veterans suffering from chronic pain and under pain medications were made to complete a questionnaire for assessing the risk factors, knowledge and self-estimate for the risk of overdose. Instruments like opioid Overdose Knowledge Scale (OOSK), was the instruments t used. The statistical tests conducted at 5 % type 1 error rate with Bonferroni correction for multiple comparisons were sed. The Chi square test and Wilcoxon rank-sum test was performed to compare the baseline demographics and medications used in two clinics. All these instruments and the tests used in this quantitative study can be useful in identifying the fact that Veterans receiving prescribed opioids for chronic pain might be at risk of opioid overdose risks and do not have any awareness about the risks. Another study has been done to evaluate the standard sedation assessment for the administration of the opioid. In this study quantitative scales such as opioid induced seduction scales has been used (Kobelt, Burke & Renker, 2014). A study by Bot et al. (2014), have aimed at proving a satisfaction level in patients after being treated with opioid medications following a hip surgery. Ninety seven patients were being interviewed and a numeric pain rating scale has been used to understand the pain intensity. Interview is an important aspect of qualitative research used to determine the perception of people about a particular interventions. Initial bivariate and multivariate analysis was used for the identification of the factors associated with pain intensity.
How the alternative argument have affected my opinion?
Although I have always learnt that opioids were safe to use on treating chronic pain such as back pain or chronic nonmalignant pain. But truly there are lack of high quality of evidences about long term opioid treatment of chronic nonmalignant pain. Most of the studies conducted were without any proper control group. Hence, I could not nullify some of the evidences put forward by the opponents speaking against the topic. While investigating about the opioid medication, I have come across a study by Lee et al. (2015) that have proved that post-operative respiratory depression can be significant cause of death among the patients, hence the risk factor related to opioid administration cannot be totally disregarded. Another case control analysis by Zedler et al. (2014), have indicated towards prescribed opioid use and the deaths related to the serious toxicity. Substantial risks for opioid related toxicity and overdose have been found to be associated even at low dose opioids. Although I have come across many evidences in support of opioid medications but the alternative views has made me more alert about opioid administration.
In order to participate in this debate I had to go through a large number of literary sources and valid government websites in order to find out the information about the mode of action of the opioid and their effectiveness in treating chronic pain. This have enhanced by knowledge about the different types of opioids used in treating different types of chronic pain. The information obtained from the opponent members have enhanced my knowledge about the different side effects of opioid medications.
I have understood that when the opioids are prescribed, they come with several risks that are important to understand. One of the risks that I have identified, is the opioid overdose that can be lethal for the patients. This has made me more alert about the dosages of the medications. It is not that I have accepted the facts put forward by the opponents blindly, but have verified them with original references. Hence it is critical that nurses understand the signs and the symptoms of an opioid overdose things to be done if such overdose occurs. I have also learned about opioid tolerance and opioid dependence, that is the body will need higher doses of opioid than before for achieving the safe amount of relief from pain. Furthermore I am well aware of opioid addiction that can occur in the patients taking opioid and can even lead to liver and brain damage. All these knowledge have made me aware of the prescribed guidelines for using opioid medications that would help me in ensuring patient safety during medication administration.
References
Allwood, C. M. (2012). The distinction between qualitative and quantitative research methods is problematic. Quality & Quantity, 46(5), 1417-1429.
Baumblatt, J. A. G., Wiedeman, C., Dunn, J. R., Schaffner, W., Paulozzi, L. J., & Jones, T. F. (2014). High-risk use by patients prescribed opioids for pain and its role in overdose deaths. JAMA internal medicine, 174(5), 796-801.
Bot, A. G., Bekkers, S., Arnstein, P. M., Smith, R. M., & Ring, D. (2014). Opioid use after fracture surgery correlates with pain intensity and satisfaction with pain relief. Clinical Orthopaedics and Related Research®, 472(8), 2542-2549.
Chaparro, L. E., Furlan, A. D., Deshpande, A., Mailis-Gagnon, A., Atlas, S., & Turk, D. C. (2013). Opioids compared to placebo or other treatments for chronic low-back pain. Cochrane Database Syst Rev, 8(8).
Choy, L. T. (2014). The strengths and weaknesses of research methodology: Comparison and complimentary between qualitative and quantitative approaches. IOSR Journal of Humanities and Social Science, 19(4), 99-104.
Kissin, I. (2013). Long-term opioid treatment of chronic nonmalignant pain: unproven efficacy and neglected safety? Journal of Pain Research, 6, 513–529. https://doi.org/10.2147/JPR.S47182
Kobelt, P., Burke, K., & Renker, P. (2014). Evaluation of a standardized sedation assessment for opioid administration in the post anesthesia care unit. Pain Management Nursing, 15(3), 672-681.
Lee, L. A., Caplan, R. A., Stephens, L. S., Posner, K. L., Terman, G. W., Voepel-Lewis, T., & Domino, K. B. (2015). Postoperative Opioid-induced respiratory DepressionA closed claims analysis. The Journal of the American Society of Anesthesiologists, 122(3), 659-665.
Wilder, C. M., Miller, S. C., Tiffany, E., Winhusen, T., Winstanley, E. L., & Stein, M. D. (2016). Risk factors for opioid overdose and awareness of overdose risk among veterans prescribed chronic opioids for addiction or pain. Journal of addictive diseases, 35(1), 42-51.
Yilmaz, K. (2013). Comparison of quantitative and qualitative research traditions: Epistemological, theoretical, and methodological differences. European Journal of Education, 48(2), 311-325.
Zedler, B., Xie, L., Wang, L., Joyce, A., Vick, C., Kariburyo, F., … & Murrelle, L. (2014). Risk factors for serious prescription opioid-related toxicity or overdose among Veterans Health Administration patients. Pain medicine, 15(11), 1911-1929.
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