DAY 07 Research process.

DAY 07 Research process

E. Selecting the type of study F. Building the Research Framework
DAY 07 E. Selecting the type of study F. Building the Research Framework

Recap ….The Development process
Phenomena stage Conceptualization of the study area Problem clarification stage Problem identification Problem statement Problem analysis Organizing objectives for the research Research questions Building the Research Framework Selecting the type of the research

Development phase Organizing the methodology

III. Methodology Building Research framework
Operationalization of the concepts Developing an argument Selection of a Study design Data collection method Population and sampling Validity and reliability Ethical consideration

1. Research framework

Research Framework Organize a spectacle to do the research
Demarcate the area of research Conceptual frame work Scientific validation Prelude to making the research operational

Categorize causes and effects Use acceptable method
STAGE 02 Categorize causes and effects Use acceptable method Previous studies Discussions These groups become concepts of the research

Medical Clinics in General Hospital Ragama
Stage 2 – categorization Causes Over crowding of the Medical Clinics in General Hospital Ragama patients Space Methods Staff Effects Image Problem Tree

Analyze the problem - Cause & effect analysis
Causes - reasons for the problem Infrastructure – ventilation , light , seating , small waiting and clinic area Human resources – low number , lazy staff , untrained staff Methods – no method , ineffective method , old method Patients – lack of compliance and patience Effects – results of the problem inconvenience, poor quality , image of the hospital , risk for the patients Problem – overcrowding of the medical clinics

Medical Clinics in General Hospital Ragama
Infrastructure Methods Over crowding of the Medical Clinics in General Hospital Ragama Human resource Equipment Supplies Research Frame work

2. Operationalization of the concepts
Development of the variables Indicators

Method The concepts needed to be make it measured to validate the research Organize the variation of the concept Select variables from the sub causes or the sub effects you identified

Indicate the concept Find the variables related to each concept These could be taken from your causes or effects identified in the problem analysis Use the same main causes or main effects Now use the Objective of what do you want to do Only concentrate the areas demarcated by the objectives

Opreationalization of the concept
Variable Indicator Method Human resource Training Attitude Number Methods Appointment system Rules Regulations Facility Lighting Space Equipments Seats Tables Overcording Patietns

List the variable Define the variable Make it independent Find the indicator This could be dine by studying previous research or acceptable methodology Then find each one an indicator Find the method of measurement –later in the data collection Next step is the identifying the best reaserch design

What are Variables ? Variable “Characteristic of a person, object or a phenomena that takes different forms or that varies.” Variable two main types Numerical variables - takes Number form Weight , height ( 23 kg . and 100 cm) Categorical variables - category form Color , Race ( black , white and Sinhalese , Tamils , Muslims )

Selection of Variables
“Uses of variables To operationalize the reserch framework To construct questions To improve the validation of data and form tables To indicate variables in statistical form & treatment

Classification of Variables
According to the type, epidemiological, statistical variety Types Biological , physical, socio- economic ,events & service delivery Epidemiological Dependent Independent Confounding Background

Main factors – Independent
Problem – Dependent Main factors – Independent Effect Lung Cancer Main Causative factor Smoking Other factors Alcohol , occupation Background factors Age, sex , race Confounding –effect both Background – no direct effect

Dependent Independent Confounding Background
Describe the problem of the study Waiting time Independent Describe the direct causative factors Availability of staff Efficiency of the staff Confounding These affects both dependent and independent variables They either weaken or strengthen them poor infrastructure Background Old age Language barrier

Formulation of Variables
Find contributory factors Rephrase Making variable neutral Long waiting time – “waiting time “ Operationailize making variables measurable through indicators 1 hour - good > 1 hour to 2 hours- reasonable > 2 hours - poor Define To ensure consistency and remove confusion and bias “The time patient enters to the OPD clinic, up to seen by the consultant doctor” Scales measurement Mnts. , Hours ,

Variables The factors that have identified in problem analysis may be negative. By rephrasing it has to be made as neutral variable where it can take both negative and positive forms ; Long waiting time (-) - Waiting time Absent of D (-) -Availability FD Lack of supervision Frequency of supervisory visit Poor knowledge of signs, causes and -Knowledge of sign, cause and Consequences TB consequence

b. Operationalizing Variable
Making variable measurable Some variables can be measured easily but some cannot be categorized easily. Measurable categorization of variable presents as ‘Indicators’ ‘Poor knowledge of pregnant mother mother’ Factor Rephrase the Variable- Level of knowledge of pregnant mother Operationalize Indicator Correct answer to < 3Q – poor reasonable > 7 – good Weight/age >80% std - Well nourished I 0-80% std - moderate malnutrition > 60% std severely malnutrition

c. Defining Variables & Indicators
To ensure everyone understand the exactly what has been measured and to ensure consistency in the measurement, definition of variable and indicators are need. Ex. Waiting time – ‘when patient enters the front door of OPD until it is seen and a doctor or register or \ obtain a card’ Experts comments : previous study variable and logical variable should be considered here.

Opreationalization of variables
Concept Variable Indicator Human resource Training Attitude Number Participation for the Methods Appointment system Rules Regulations Facility Lighting Space Equipments Seats Tables Overcrowding Patients

3. Developing an argument
Hypothesis

Main problem becomes main concept
Other groups of causes become the directing concepts This is the basis for the argument or Hypothesis

Based on the conceptual framework you
Develop a logical argument for the research Positive argument – Hypothesis Negative argument - null hypothesis In the research what you do is prove or disapprove the hypothesis

Hypothesis H01 – There is definitive overcrowding of CNTH
H 02 – Human resources will have Direct effect on overcrowding H 03 – Infrastructure will have Direct effect on overcrowding H 04 – Equipments will have Direct effect on overcrowding H 05 – Supplies will have Direct effect on overcrowding

4. Research designs

1. Selection of the study design
Designing the study - Select a type of design Reason Basic and applied Time Cross sectional and Longitudinal- Retrospective , prospective Scope Descriptive , Intervention Experimental , non -experimental Quantification & qualification f C

A. Reason Basic and Applied
This is classified according to the reasons for conducting the research Basic Basic ………………find new knowledge Vaccine for Malaria / AIDS Applied Applied ………….find answers to day to day problems Health needs/ wants

B. Time Cross sectional & longitudinal
This is categorized as per the time span Cross sectional One point of time Snap shot Maximum Months Longitudinal Spread over time long term Years

Cross sectional studies
Quantify the distribution of certain variables in a study population at one point of time ………………(snap shot) It will include Physical characteristics of people, environment; prevent survey of leprosy, evaluation coverage (immunization, ……..) Socio-economic characteristics of people; age, education, marital status, no. of children and income. Behaviour of people ….. and opinion, that may help to explain the behaviours (….. studies) Events that occur in population – death, birth, marital, migration example : census – cross sectional survey covering total population Disease and distribution – prevalence survey Health programmes

Longitudinal studies Retrospective & Prospective
Categorized according to a point of collection Retrospective - ………..Past < Present Collect a group of patients with lung cancer and see the their exposure to smoking Prospective ……………. Present >future Collect a group of people who are smoking and asses the development of lung cancer over period of time

C. Scope - Descriptive & Exploratory
This is categorizes as per the purpose Descriptive Describe the subjects / situation Questions asked and answers are need Exploratory Explore the situation Case studies Limited scope

Descriptive studies They describe relevant situation, people, programme or events Majority of the studies performed are descriptive studies Systematic collection and presentation of data to give a clear picture of a particular problem or situation Questions are asked to find out answers on the above mentioned situations who, when, where, why , & what to do

Descriptive studies Questions asked answers sought
Who? -Personal characteristics Why?-Reason/association Where - Distribution What to do?-Suspect action When -Time/season or future studies

Exploratory studies This is a small scale study performed to clarify a problem or situation. Mostly performed in management problems to analyze a situation. Rapid appraisal method for management. Interviews and comparison of a problem is performed. Ex. Needs of HIV AID patients of various gender groups and to prioritize resources allocating (here the various needs are compared, a rapid appraisal is performed)

D. Experimental & non-experimental studies
This is categorized as per the research design Experimental …….. Interventional Non experimental …………non interventional/ observation Majority are non experimental

Experimental studies Randomly select to two groups.
One is subjected to intervention (or experiment) and the other without intervention. The outcome of intervention is obtained by comparing two groups (the outcome : effect of the intervention on the problem or the dependent variable) These studies actually prove causation

Experimental studies Classical experimental studies have 3 characteristics Manipulation - Researcher does something to one group of subjects in the study. Control -The researcher introduce one or more control groups to compare with the experimental group Randomization -The researcher randomly assign subjects to control and experimental groups (given equal chance for selection to either group)

D. Qualitative & Quantitative Research

Selection The decision of whether to choose a quantitative or a qualitative design is a philosophical question. Which methods to choose will depend on the: Nature of the project, The type of information needed the context of the study The availability of recourses (time, money, and human).

Qualitative research Qualitative Research is collecting, analyzing, and interpreting data by observing what people do and say. Qualitative research refers to the meanings, concepts, definitions, characteristics, metaphors, symbols, and descriptions of things.

Qualitative research Qualitative Research is collecting, analyzing, and interpreting data by observing what people do and say. Qualitative research refers to the meanings, concepts, definitions, characteristics, metaphors, symbols, and descriptions of things. More subjective than quantitative research Uses different methods of collecting information, Mainly individual, in-depth interviews and focus groups. The nature of this type of research is exploratory and open-ended. Small numbers of people are interviewed in-depth and/or a relatively small number of focus groups are conducted.

Quantitative Objective Research questions: How many? Strength of association? "Hard" science Literature review must be done early in study Test theory One reality: focus is concise and narrow Facts are value-free and unbiased Reduction, control, precision Measurable Mechanistic: parts equal the whole Report statistical analysis. Qualitative Subjective Research questions: What? Why? "Soft" science Literature review may be done as study progresses or afterwards Develops theory Multiple realities: focus is complex and broad Facts are value-laden and biased Discovery, description, understanding, shared interpretation Interpretive Organismic: whole is greater than the parts

Quantitative Basic element of analysis is numbers Researcher is separate Subjects Context free Hypothesis Reasoning is logistic and deductive Establishes relationships, causation Uses instruments Strives for generalization Generalizations leading to prediction, explanation, and understanding Highly controlled setting: experimental setting (outcome oriented) Sample size: n "Counts the beans" Qualitative Report rich narrative, individual; interpretation. Basic element of analysis is words/ideas. Researcher is part of process Participants Context dependent Research questions Reasoning is dialectic and inductive Describes meaning, discovery Uses communications and observation Strives for uniqueness Patterns and theories developed for understanding Flexible approach: natural setting (process oriented) Sample size is not a concern; seeks "informal rich" sample Provides information as to "which beans are worth counting"

Combination of both It is a combination of two types of research. It is also called pluralistic research. Advantages of combining both types of research include: Research development (one approach is used to inform the other, such as using qualitative research to develop an instrument to be used in quantitative research) Increased validity (confirmation of results by means of different data sources) Complementarity (adding information, i.e. words to numbers and vice versa) Creating new lines of thinking by the emergence of fresh perspectives and contradictions.

5. Data collection method
Decide how to collect data - Data collation method

Data Collection methods

Data collection A systematic data collection is necessary for the success of the research, Main methods Using available data Observing Interviewing Administering written questionnaires Focus group discussion & Depth interviews Other data collection techniques

A. Using available information
Locating sources of and retrieving information is important starting point in data collection effort. Health information data, census data, published or unpublished data, publication in archives, and libraries Advantages : This method is relatively inexpensive, permits examination of past trends Disadvantages: Not easily accessible for data, incompleteness of data and need to take permission

B. Observing Observation of human behaviour can be done
use for small scale studies Observation can be perform on objects or situations ( cleanliness of a ward) Observation needs defined measurements and standards Adv. It yield, more accurate information on behaviour than other techniques and also can use to verify data collected from other techniques Dis Adv. But it is time consuming and relatively expensive Ethical issues and privacy problems also observer bias seen throughout training of research assistance is done.

C. Interviewing Oral questioning of respondents, either individually or as a group. The responses are recorded. This could be performed with high degree or low degree, flexibility High degree of flexibility: structured or unstructured method of interviewing from. informants. This is good for situation analysis and often used in exploratory studies and case studies. Less flexible method as when researcher is knowledgeable of the answers and used for large scale studies Advantage : Can be used with literates, permit, clarification of Q and expect to have group response > written Q Disadvantage: Presence of interviewer can influence respondents

D. Written Questionnaires
Are presented to study subjects with the response in written form. Also named as self-administered questionnaires. This could be performed by sending questionnaire by post or gathering people to one place and administered by giving written or oral instructions. Also could hand deliver and collect later. Questions can be open ended or close ended (describe in detail later) Advantage : Less expensive, creates honest responses, does not require research assistance, eliminated bias Disadvantage : Cannot be used to literate responses. Questionnaire may be misunderstood , low rate of response

Interviewer & self administrated questionnaires
Interview and self – administered questionnaires are the most commonly used data collection methods. The questions to ask in the development of these are; What do we want to know according to the objectives and variables and do we need any other technique. From whom are we going to ask questions and what techniques to us Do we need to use with loosely structured questions when topic is not understood correctly Is our informants literate or illiterate (if literate it should not be self-administered) How large is the sample to be interviewed (smaller studies open ended and larger studies highly structured, shorter questions)

Types of Questions Open ended Closed ended

Open ended Permit free responses that could be recorded in respondent, own word, the respondent is not given any possibility to choose from. This is useful to obtain information on; Facts with which the research is not familiar with Opinion, attitude and suggestions of information and requirement Sensitive issues

Closed ended Offer a list of possible opinion, or answers from which the respondents must choose. In this one has to ; Offer list of options that are exhaustive and mainly exclusive Keep no. of options minimal as possible Closed questions are useful when the range of possible responses, known Its also used when one only interpret in certain aspects on an issue and does not want to waste time with the respondent. It also could be used to asses respondent, opinion by choosing rating point on a scale (ex. very useful, useful, not useful)

Comparison on Open & closed questions
Open ended Close ended Exploration of issues not known during planning stage Use for sensitive issues More valid answers Skilled interviewer need Analysis time consuming Interviewer bias Needs experienced trained people Answers can be recorded quickly More general issues General comments Used for literate Analysis easy Leading questions can cause bias Use closed questions in combination with open

Steps in designing a questionnaire
This takes in form of several drafts Content Formulating questions Sequencing Format Translation

The method Content 2. Formulating questionnaire
objective and variable 2. Formulating questionnaire Produce one or more questions that will provide the information for each variable. Then check whether each questions measures one thing at a time. Avoid leading question. Formulate control question to cross check* on ‘difficult’ questionnaire. Avoid word with double meaning or defined meaning and emotional words ( ex . Wasting, lazy, unhealthy)

3. Sequence of questionnaire;
Design your interview schedule or questionnaire to be ‘consumer friendly’ Make sequence of questionnaire more logical and make it more natural discussions Background variable should be asked later Start the non-controversial questions and post more sensitive questions later. Use simpler everyday language. Make the questionnaire short as possible. 4. Formatting the questionnaire; Interviewing data : location: name (Optional) respondent and interviewer. Sufficient space for open ended questionnaire. Boxes of pre-categorized answers, placed in consistent manner ((® side of page) Marking for computer codes. Questionnaire should be consumer and user friendly. 5. Translation ; To the local language and cross check.

E. Focus Group Discussions
Group discussion of 6-12 persons, guided by a facilitator. The group interact with each other with relation to concepts, perception and ideas. Uses of FGD, are; Problem analysis in research Formulation of questionnaires To ensure community knowledge, benefit and attitude regarding a problem Development of measures to health education programmes To explore controversial issue Preparation for FGP Recruitment of participant: These people should from similar backgrounds for which the problem to be discussed. Physical arrangements: Place arranged which is conducive for discussions

Physical arrangements: Place arranged, conducive for discussions
Preparation for FGP Recruitment of participant: These people should from similar backgrounds for which the problem to be discussed. Physical arrangements: Place arranged, conducive for discussions Ex. Circular chair arrangement) Preparation off a discussion guide. Written guideline with open ended question Conducting the session A recorder and a facilitator of the group identified The facilitator must introduce the pupil, encourage discussion involvement, build report, empathize, avoid being placed in the role of expert, control rhythm of the discussion. The recorder should note down participation characters, general description of participants, group dynamics, opinions, emotional aspects and vocabulary used

Single person – longer hours – Depth Interviews
Number of sessions 1 ½ hours duration, the number is according to the need Analyze the Results The facilitator and Recorder review Full report is given Categorize each topic Summarize in matrix, flowchart in a meaningful way. Select most useful idea Report writing Single person – longer hours – Depth Interviews

5. Other data collection techniques
Nominate group techniques Delphi Life histories Scale Essay Case studies Mapping

1. Nominal Group Technique
This is good to obtain census from a group in decision making Interventional Individual ideas write on paper Display list produced and then disused Vote and rank the ideas Summarize the ideas Discuss the results Second voted and reviving Voting Selection .

2.Delphi Techniques This is similar to NGT but people do not meet they communicate via questionnaire. Its time consuming and participants should have god written communication skills. 3. Life Stories Interviewing of life stories, suited for reproduction pattern woman feeling about marriage, conceptive and childbirth 4. Scales : These are highly structured interviews and are of high standard. Good for healthy behavior, psychiatric illness and in joint descriptive studies and population survey, in common groups.

5. Essays. These analyst the difference in belief concerning illness, health behavior (prior to intervention). 6. Last Studies : Obtained investigation of few people, commonly or particular situation 7. Manpower : It visually displays relationship and resources its important in pre-stage sampling 8. Rapid Appraisal Techniques (sounding) Quick, low cost, less accurate survey, to clarify unclear areas of a problem (commonly done in pilot phase of research) 9. Participation Research: All status of research is planned and conducted by the researcher and the …….. commonly together Ex. Community Dx - with people and for people

6. Improving the Validity and reliability of data
Population and sampling Validity and reliability Ethical consideration

Validity & Reliability
Deriving Valid and Reliable Conclusions When research design is selected all attempts to make it to be valid and reliable. Validity – means conclusive are true Reliability – means in repeated attempts, conclusion have to be the same

Eliminating threats to validity in selecting research design;
By selecting appropriate design this could be performed Descriptive studies : By sampling, the information is collected and findings used to make conclusion about the population. Proper sampling is the key to success.

Bias in information collection
Defective Instrument Questionnaire : The questions placed in logical order and vaguely phrased. Also fixed/closed questionnaire on the topics less known, open ended questionnaire without guidelines Weighing scale substandard

2. Observer bias In observation & interviews critical information may be missed Therefore to reduce this organizing observation guidelines for structured interviews training & practicing of data collectors

3. Effect of the interviewer on the informant
Respondent may mistrust the interviewer and dodge questions. This bias can be reduce by adequately informing the subject and assuring them about information collected are kept confidential. Careful selection of interviewers is also important.

Ethical Consideration
The data collecting technique should will not effect any emotional or mental harm to study subjects, such as asking sensitive questions that may violate their privacy, observing informats, without their knowledge and failing to respect certain cultural values, traditions etc. Remedy for these are Obtaining permission before study begins, not exploring sensitive questions before developing a good relationship with the informant Ensuring confidentiality of the data obtained. (name and address)

6. Population and sampling
Identify the Population & the sample - Sample selection

6. Population and Sampling

Sampling Population & sample Sampling Study Problem Study population
Selection of number of study units from well defined study population Study Problem Malnutrition in Preschool children in Gampaha Study population All children below 05 years in Gampaha district Study unit one child below 05 year in Gampaha district Representation All important characteristics of the population should be in the selected sample Study frame work All the names of the students below 5years in Gampaha

Representativeness The research draws conclusion to the whole study population Drawing of the sample should be representative of that population from which it is drawn

Questions and definitions
In sampling the following questions should be answered. What is the group of people (or population) from which draw a sample? How many people do we need in our sample? How will these people be selected? Definition of study population is important According to age and residence. Study population consists of study units which we define according to the problem to be investigated.

Sampling Methods Availability of Sampling frame – probability sampling
Listing of all the study units that compose study population. Probably sampling methods Each study unit has adequate chance or at least known probability of being selected in the sample Non-availability of sampling frame – non probability sampling researcher will use non probably sampling methods

Types of sampling Probability Non Probability Simple random
Systematic random Stratified Cluster Multistage Non Probability Convenient Quota

Non probability sampling
Convenient For convenience sake, study unit, that “happen to be available at the time of data collection” are selected in the sample. (Ex. Patients attitude in a Family Planning clinic) Un-representativeness is the main draw back in convenient sampling where over selection, under selection and missed selection seem. These deficiencies are impossible to adjust. Quota It ensures certain number of sample units from different categories with specific characteristics that appear in the sample. The investigator interviews as many people in each category of study unit until his quota is filled. Opinion of the health professionals regarding election

A. Probability sampling
It involves random selection procedures to ensure that each unit of the sample is chosen on the basis of “ chance”. Therefore all units of the study population have an equal or known chance of being selected in the sample. ‘Sample Frame’ is important types Simple random Systematic random Stratified Cluster Multi-stage

1. Simple Random Sampling
Make numbered list of sample units Decide on the sample size Then select the sample by: lottery table of random numbers Computer generated numbers

2. Systematic Sampling Individuals are chosen at regular intervals total sample frame nos. from the sampling frame. First randomly select a number and then the regular choice is performed (according to sample size) Pop – 1200 Sample size ( 1200/100) Sample interval – one in 12th person

3. Stratified Sampling This method is useful when a sample needs to include “Representative groups of study units with “specific characteristics” Urban/Rural/age limits Here the sample frame is divided into groups of “strata “according to the characteristics. Urban / Rural Then random or systematic sample of pre- determined sample size randomly from “each group” ( “stratum” ) Example : “Ethnicity in Sri Lanka” – strata - 80% Singhalese , 12% Tamils ; 6% Muslims; 2% others

3. Stratified Sampling This is only possible if the “proportion of Study population” is known in each group. Advantage of stratified sampling is that we can take relatively large sample from relatively sample group . This allows the researcher to obtain a larger sample that we could draw conclusions (without obtaining a larger group)

4. Cluster Sampling The selection of “groups” in study units instead of “individual study units”. Clusters are often geographic unit (districts, villages) or organizational units, schools, clinics, training units). Groups of students available (ex; villages or schools) Number of these groups are randomly selected. This is useful without of sampling frame Ex. ‘KAP study or FP in rural communities- list of all the villages

4. Multi-stage Sampling Procedure is carried out in phases and usually involves more than one sampling method. This is frequently done in “community studies” Ex. Four stage sampling method for ‘cleanliness of latrines’ district comprised of 6 “wards” and each ward has 6-9 villages Select 3 wards from 6 by simple random sampling For each selected ward select 5 “villages” by simple random For each village select 10 “households” by systematic random sampling

4. Multi-stage Sampling Go to the center of the village
Choose a direction in random way – toss a coin Walk in the chosen direction, select every 3rd household (depending on the size of the village) Decide before hand whom to interview (ex. Oldest)

Selection of Sample size
Rough guide – 10% of population Equations and statistical methods of calculating sampling size

Validity Standardization of the research Validity
How accurate the measured variable ACCURACY Threats to validity History Subject loss Selectivity Hawthorne effect

How to reduce threats of Validity
Control group Randomization Pre-testing Knowledge of events

Reliability Repeated tests should give same results
Standardization of : Measuring instrument and conditions is essential Training of the research staff

II. Implantation phase

Data Analysis Statistical methods Computerized methods

Presentation of Results
Simple approach Statistical significance is important Graphs / tables Indicate key findings in the conclusion

Ethical consideration in research
Before you move any further look at the ethics ……!

Ethical Consideration
War crimes after world war II Nuremberg code- 1940 Guidelines to voluntary consent Withdrawal of subjects from studies Protection of subjects from suffering , injury, disability , and death Declaration of Helsinki – 1960 Human research after laboratory tests Review of research protocols by an independent group Informed consent Conducted by professionals -qualified scientifically / medically Benefits must be more than Risks Revisions in 1975,

Ethical Consideration National Health and Medical Research Council
NHMRC – Australia – “Ethical culture” & “Informed consent” Strong ethical culture should demonstrate honesty and interiority Respect for human participants , animals and the environment Good use of public resources in conducting research Acknowledgement of the others used in research Responsible communication of the results Informed consent Self determination Privacy & dignity Anonymity & confidentiality To fair treatment Protection and discomfort from harm

Ethics in research Autonomy Beneficence Non-malificence Privacy
Confidentiality Veracity Fidelity

1.Principle of Autonomy Humans have the right to non – interference when making decisions about themselves Forms the basis of ideas about privacy, confidentiality, veracity and consent

2.Principle of Beneficence
“I will use treatment for the benefit of the sick, according to my ability and judgment” Hippocratic Oath Conduct is aimed at the good and well being of others Principle requires that practitioners provide both appropriate treatment and an assurance that the treatment will not produce more harm than good

3.Principle of Non-malificence
“Above all do no harm” Hippocratic Oath In health care the ethical issues of non-malificence and beneficence are particularly apparent in decisions regarding the institution of dangerous therapy or withdrawal of therapy that is no longer thought to be beneficial.

4.Privacy Safeguarding areas where patient does not want to reveal :
History Examinations Investigations

5. Confidentiality Not reveling information collected from the patient without her / his consent : Verbally Examination Records Complicated process Harm vs. benefit Individual Social Use your common sense Inform superiors

6.Veracity Revealing truthful information to the patient:
As a professional Cultural /social /Medical Personnel Harm vs. Benefit Complicated process Experienced person needed

7.Fidelty Agreement with the patient Verbal Non verbal

Applying Ethical Considerations in research
In research emotional or mental harm to study subjects Even as asking sensitive questions that may violate their privacy Observing without their knowledge Failing to respect certain cultural values, traditions etc. Remedy : Obtaining permission before study begins not exploring sensitive questions before developing a good relationship with the informant Ensuring confidentiality of the data obtained. (name and address)

Writing the proposal Sample proposal - OUM

Work plan / Budget List the activities Organize the schedule
Gang chart Budget

Obtaining and ethical clearance
IIHS Proposal for ethical clearance

Writing the report OUM BNS guideline

Recommendations Key findings Relate to local environment
Further research

Thank You !

DAY 07 Research process.

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