Understanding The Experiences Of Primary Healthcare Patients In Living With Medically Unexplained Symptoms (MUS)

Importance of the Study

Q1. i) The study is focused on the issue of Medically Unexplained Symptoms (MUS). MUS is a type of illness

ii) The significance of the study is to address the problem of MUS from a medical and problem oriented perspective.

Q2.a) The aim of the research was to analyze and comprehend the experiences of primary healthcare patients on how to learn to live with MMUS. The study was done from the perspective of the patients because previous researchers have only been approaching the subject from the medical and problem-oriented perspectives. Therefore, the study seeks to bridge the missing gap in knowledge (Bryman, 2015).

b) The research design used in the study is called Phenomenological Hermeneutic Method

c) Phenomenological Hermeneutic is an appropriate design because it enabled the researchers to collect accurate and unbiased data whose findings were valid, representational and can be generalized to understand the concept of MUS (Bynner & Stribley, 2010). After using the narrative interviews to collect the data, a thorough analysis and interpretation will be done by following the right procedure.

Q3.a) The participants used in the study were patients who are suffering from MUS. Participation in the research were voluntary because the whole study was done in compliance with all the ethical standards governing research. The participants were chosen based on certain criteria that had been set before the recruitment of the participants(Flick, 2015). It is form the population that the sample was selected and granted a chance to respond to the research questions asked during the interviews.

b) Once the target population was identified, an inclusion and exclusion criteria was set. For one to be included in the study, the participant had to be people with around 50% of MUS cases,  who has no psychiatric cases, and must have had not less than 8 visits to the physician or nurse within the past one year  and aged between the age of 24 and 61 years. Meaning, those who were to be excluded were the people who do not suffer from MUS or any other MUS patient who does not have Social Security Number and do not fall within the specified age bracket.

c) It is important to identify the inclusion and exclusion criteria before the recruitment of the participants. It can help in ensuring that the right caliber of participants is used in the study in line with the research objectives to be accomplished(Denscombe, 2014).

Research Design

d) The sampling technique employed in the research is called simple random sampling technique

e) The sampling technique was appropriate because it was accurate and not bias. It gave each and everyone equal chances of participating in the study(Rubin & Babbie, 2016). Therefore, it helped in selecting a proportionate sample size that would be relied upon to represent the entire population.

f) The sample size was determined by considering the total number of participants who were gotten after the screening process. Once this is done, the participants were given equal chances to participate in the study (Zohrabi, 2013). It is commendable to do this because the findings of the research will be generalized to reflect the entire population.

g) The determination of the sample size was appropriately done because it enabled the researchers to have a proportionate sample size to effectively represent the entire population targeted in the study(Townsend, Loudoun & Lewin, 2016). If the sample size is proportionate, it can eliminate any biasness that might end up making the findings to be invalid and inaccurate.

Q4.a) Data collection was done using a narrative interview technique. Here, the researcher had to schedule an interview with the participant at an agreed time. The interviews which mainly lasted for 21 to 8 minutes were carried out in the university, at home, public library, and healthcare center as was suggested by the participant(Rossman & Rallis, 2016). The participant was assured of confidentiality and encouraged to be truthful n their narrations which were then recorded using a digital recorder.

b) Indeed, narrative interview was an appropriate data-collection tool for the research. It suits the study design and research questions because it is a reliable source of data. It helped n generating accurate and bias-free data. It was done in a conducive environment chosen by the participant(Vayena, Salathé, Madoff & Brownstein, 2015). At the same time, the participant got an ample opportunity to link past experiences and be able to provide trustworthy information regarding their own experiences.

c) Rigor is the process of stringent compliance with and maintenance of consistency with outlined parameters. Rigor is a very important concept in qualitative research in which it is applied in the data collection process by ensuring that it is a thorough process done by complying with certain philosophical principles (Denscombe, 2014).

d) Rigor was a consideration made in this research. To ensure rigor, the following measures were taken. First, the data-collection process was done after the validation of the respondents to ensure that the right participants were identified. Secondly, the research employed the use of simple random sampling technique because it would help in taking unbiased proportionate sample size for the research(Zohrabi, 2013). Thirdly, the data collected was subjected to a thorough coding to ensure that respondents’ answers were properly analyzed. Finally, the research was grounded on two theories:   Kelly’s Personal Construct theory and Antonovsky’s theory of Sense of Coherence. The theories were used in justifying the findings and explaining the behaviors of the MUS patients who were engaged in the research. This implies that there was honesty and sincerity in the collection, analysis, and presentation of the data.

Participant Selection

Q5.a) Data analysis was done by interpretation. The interpretation process was conducted in three main stages: comprehensive understanding, structural analysis, and naïve reading. During the naïve reading, the narrative provided by the patients was read many times so as to grasp the basic information presented by the participants. This was followed by structural analysis in which the narratives were critically analyzed to validate or do away with the naïve understanding acquired earlier (Levy & Lemeshow, 2013). Finally, the narratives were compared, coded, condensed, and grouped into themes and sub-themes for a collective reflection and detailed analysis by different researchers.

b) The data analysis methodology was appropriate because it enabled the researchers to properly interpret the data and synthesize it for an easier understanding by the readers (Peersman, 2014). The use of comprehensive understanding, structural analysis, and naïve reading is commendable because it helped in a thorough reflection of all the data that was gathered from the participants, before coding, analyzing and distinguishing them into respective themes and subthemes.

c) The major finding of the study was that patients suffering from MUS always struggle to interpret the symptoms and cope up with their condition. The patients do engage in a reflective process and seek for answers regarding their health conditions. This can be achieved by expressing themselves to the healthcare providers as well as other people around them. The findings from the participants’ narratives were grouped into different themes(Robson & McCartan, 2016). First, living with MUS is a challenging experience because it overwhelms. Secondly, accepting one’s condition and moving on with life is not easy. It requires a commitment and continuous struggle.

d) The study findings can be used in some other settings. Although the research was exclusively done on the patients with MUS, its findings can be generalized to help in understanding much about other patients. It is a clear depiction of exactly what the patients go through in their pursuit to improve their health. Just like the MUS patients, all the other patients require their needs to be effectively met(Levy & Lemeshow, 2013). This is what the study was seeking to accomplish.

Q6.a) The findings of this research are reliable and should be recommended for implementation in clinical practice. It can help in improving clinical practice in many ways. It can help in addressing the challenge of MUS patients. The policy makers should apply it to improve the quality of services delivered to MUS patients and other patients as well.  The research will fill the missing gap in knowledge because it addresses the problem of MUS from the perspective of the patients. If applied, it can help in empowering the MUS patients to be actively involved in understanding and managing their condition no matter how challenging it might be(Bryman, 2015). Its implementation can reform the healthcare sector and make it effective in addressing the diverse needs of MUS patients that, for a very long time, have not been effectively met. The research was carried out in a strict compliance with all the ethical requirements governing research such as confidentiality, voluntary participation, and safety of the participants. 

References

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Bryman, A. (2015). Social research methods. Oxford: Oxford university press.

Denscombe, M. (2014). The good research guide: for small-scale social research projects.

London: McGraw-Hill Education (UK).

Flick, U. (2015). Introducing research methodology: A beginner’s guide to doing a research project. New York: Sage.

Levy, P. S., & Lemeshow, S. (2013). Sampling of populations: methods and applications. New York: John Wiley & Sons.

Peersman, G. (2014). Overview: Data Collection and Analysis Methods in Impact Evaluation. In Methodological Briefs: Impact Evaluation 10. UNICEF Office of Research: Florence.

Robson, C. & McCartan, K. (2016). Real world research. John Wiley & Sons: Hoboken.

Rossman, G.B. & Rallis, S.F. (2016). An Introduction to Qualitative Research: Learning in the Field. Thousand Oaks: SAGE Publications.

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Vayena, E., Salathé, M., Madoff, L. C., & Brownstein, J. S. (2015). Ethical challenges of big data in public health. PLoS Comput Biol, 11(2), e1003904.

Zohrabi, M. (2013). Mixed method research: Instruments, validity, reliability and reporting findings. Theory and Practice in Language Studies, 3(2), 254.