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5002 Part Two

Introduction

This assignment consists of two parts. In Part One of the assignment, an area of
interest and the effect it had on a particular organisation was identified, and then four
research papers relating to the chosen topic were critically analysed in a brief
synopsis. In this synopsis, the research methods that were used were highlighted
and the results of the research papers were compared to the selected topic and
discussed in relation to the effect this area would have on the chosen organisation.
The topic discussed in Part One was the effect of training and improved knowledge
on Health Care Professionals (HCPs) views towards patients who have a diagnosis
of Human Immunodeficiency Virus (HIV); the organisation targeted was the National
Health Service (NHS). The studies showed that HCPs had poor views on
people/patients living with HIV (PLHIV), but training and improved knowledge made
them more likely to care for these individuals.
In Part Two of this assignment, an area which was considered an aspect of further
research in the four research papers chosen in Part One will be highlighted, a
research question will be created, and a hypothetical research plan will be devised.

Identifying a further aspect of research

From reading the four research papers in Part One (Bekta and Kulaka, 2007;
Stavropoulou et al., 2011; Veeramah et al., 2008; Diesel et al., 2013), it is evident
that one area that has not been discussed in any of the pieces of literature is the
impact on the quality of care delivered to PLHIV by HCPs who have participated in
training and gained an improved knowledge of HIV. Otani and Kurz (2004) state that
greater patient satisfaction increases the likelihood that an individual will return for
continued care; this is important in PLHIV as antiretroviral medication needs to be
strictly adhered to and monitored regularly (BHIVA, 2014). Nolan and Badger (2005)
suggest that patients medication regimes are more strictly adhered to if there is a
positive relationship between the practitioner and the patient. Through bettered
patient/practitioner relationships, the individual receiving care is more likely to have a
better quality of life; this is supported by Juk (2013).

The research question

From the gaps identified in the research papers, the following question for potential
research has been created:

Does further training on human immunodeficiency virus (HIV) improve patient

care?

The research plan

In this section a hypothetical research plan will be discussed including:

methodology, design, sampling, data collection, and data analysis.

Methodology

Andrew and Halcomb (2009) describe methodology as the thinking tool used to
decide on the methods and data analysis that will be used in a study.
This will be a quantitative study using a questionnaire to collect data from
individuals who will have been purposively sampled, although it will contain a mixture
of open-ended and closed-ended questions. Polit and Beck (2012) state that
qualitative methods are preferable as they are cheaper, have high response rates,
and allow for greater depths of information to be procured; although, it would be
advantageous for this study to employ mainly a quantitative method as both
McIntosh-Scott et al. (2014) and Moule and Goodman (2014) explore how this
method enables the researcher to gather large volumes of data efficiently, reducing
time, and allowing for an escape from embarrassing questions which may be hard to
answer in a face to face interview. As three of the research papers from Part One
(Stavropoulou et al., 2011; Veeramah et al., 2008; Diesel et al., 2013) use
quantitative methods, and Bekta and Kulaka (2007) use both qualitative and
quantitative methods, it is reasonable to assume that this technique is very effective
for gathering data in an HIV-related study.

Design

Polit and Beck (2012) describe research design as an overall plan to address a
research question. Although Zaslavsky (1995) states that data collection falls under
the topic of research design, it has been decided that this shall be discussed
separately as an independent topic in further detail; however, it will be briefly
mentioned in the design category.
This study will use a questionnaire to compare whether PLHIV feel that there is a
difference in quality of care provided by HCPs in a healthcare setting where they
would, and would not potentially be prejudiced against. To do this, the questionnaires
would be given to four different departments in a hospital likely to treat PLHIV
entitled Questionnaire One or Questionnaire Two. The departments are: a
genitourinary medicine (GUM) clinic, where vast numbers of PLHIV would be treated
on a daily basis; a serology clinic, where HIV specialists would plan care and offer
advice to PLHIV; a renal unit, as Choi et al. (2010) state that acute kidney injury
(AKI) is common in PLHIV because of the effect of antiretroviral medication; and a
haematology unit, as Ibrahim et al. (2010) discusses the increased predisposition of
lymphoma in PLHIV. These areas would then offer the questionnaires to PLHIV at
the end of their time in that particular department; this would be done as LoBiondoWood and Haber (2012) suggest that for the purpose of this study it would be
advantageous to collect the data post-treatment. The questionnaires would be
collected after a month and the data analysed.
Although it would be unfair to assume that any of the selected areas do, or do not
have training, for the purpose of this study it can be assumed that the renal and
haematology units have no training on HIV (Questionnaire One), whereas the GUM
clinic and serology clinic does (Questionnaire Two), which will allow for a
comparison.

Sampling

This study will use purposive sampling. Polit and Beck (2012) state that purposive
sampling uses specific eligibility criteria to select a particular group of individuals for
a study. In this study, the eligibility criterion for the selection of the sample is defined
as: any person who has had a diagnosis of HIV for more than one year and is over
the age of eighteen years old. Individuals under the age of eighteen are excluded
from the study as the Department of Health (2009) state that those below this age
lack capacity, and therefore cannot consent. Individuals who are HIV positive, but
have had a diagnosis within a year will also be excluded as Agrawal et al. (2012)
suggest that individuals who have been newly diagnosed are at serious risk of

psychological issues. After a year of diagnosis, it can be assumed that this risk has
been greatly decreased, and that the participants have a clearer mind to answer the
questions in the questionnaire effectively.

Data collection

For the purpose of this study data will collected by means of a questionnaire
containing open-ended and closed-ended questions. Although McIntosh-Scott et al.
(2014) suggest that it would be disadvantageous to use a mixture of open-ended and
closed-ended questions as the open-ended questions may be ignored, both Polit and
Beck (2012) and LoBiondo-Wood and Haber (2012) recommend a mixture of both as
it allows for richer perspectives on topics, and a greater depth of discussion. The
closed-ended questions will be in the structure of a Likert scale, as Polit and Beck
(2012) suggest that it is much easier to understand than other types of questions.

Data analysis

From the questionnaires, a content analysis will be taken of the open-ended

questions; Polit and Beck (2012) describe this as a method of highlighting recurrent
themes and clustering them together to create conclusions. Each answer on the
Likert scale will be scored depending on the positivity or negativity of the questions
being asked (Moule and Goodman, 2014); this will then allow for a frequency
distribution chart to be conducted and, as suggested by LoBiondo-Wood and Haber
(2012), the standard deviation, median, mode, and range to be calculated. The
overall score for both Questionnaire One and Questionnaire Two will be compared
and will show whether the treatment provided by HIV-educated areas is of a better
quality than those of a non-HIV-educated area.

Ethics

In line with the World Health Organisation (2011) ethics standards, and as
discussed by McIntosh-Scott et al. (2014), this study will maintain confidentiality, as
all questionnaires will not request a date of birth, or address of the individual
completing the questionnaire. No information will be shared with other parties, and if
the study ends, all questionnaires and details will be destroyed. To participate in the
study, the individual will be asked to sign a consent form which will describe the

purpose of the study, inform them who the results are intended for, and reassure
them that they may withdraw from the study at any time.

Research Governance

The research study will follow the Department of Health (2005) Research
Governance Framework, complying will all regulations before any active research
begins.

Relevance to practice

This study would be relevant to practice as it would enable hospital trusts to identify
the need for HIV training for HCPs, which would potentially improve the quality of
care provided to PLHIV throughout the trust.

Conclusion

In conclusion, from the highlighted gaps in the research papers from Part One, a
questionnaire containing open-ended and closed-ended questions will be given to
four differing healthcare units and offered to PLHIV at the end of their treatment. The
data will then be analysed and the conclusion will be made as to whether further HIV
training improves care. The research will meet all ethical requirements, and follow
the Research Governance Framework. This study may help hospital trusts to decide
whether or not to provide HIV training, and thus, affecting the quality of care provided
to PLHIV.

Word count - 1585

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