DETERMINANTS OF GLAUCOMA KNOWLEDGE

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CHAPTER 3 RESEARCH DESIGN AND METHODOLOGY

 INTRODUCTION

This chapter describes the research design and methodology used to assess the level of knowledge about glaucoma amongst the patients that attend the CBN staff eye clinic in Abuja. Research methodology focuses on the process, tools and procedures utilised during the research process (Mouton 2001:55). The selection of the appropriate research design and methodology is the core of a research study and is probably the single most important decision the investigator has to make.
The selection of the research design and methodology for this study was guided by the desire to achieve the specific objectives which were to

• explore and describe the level of knowledge about glaucoma amongst patients who attended the CBN staff eye clinic in Abuja
• create awareness about glaucoma by designing a pamphlet with information about glaucoma for patients who attend the eye clinic
• make recommendations about how eye care service providers can educate and empower patients who come to the eye clinic with knowledge about glaucoma

RESEARCH DESIGN

This section describes the research paradigm as well as the study design. A research design is a blueprint for conducting the study that maximises control over factors that could interfere with the validity of the findings. It guides the researcher in planning and implementing the study in a way that is most likely to achieve the intended goal, objectives and answer to the research question (Burns & Grove 2005:211). Mouton (2001:55) defines a research design as a plan or blueprint of how one intends to conduct the research.
The research design used for this study was exploratory, descriptive and cross-sectional using the quantitative approach. These terms are described below.

Research paradigm

Quantitative research refers to a formal, objective and systematic process to describe and test relationships and to examine cause-and-effect interactions between variables (Burns & Grove 2005:747). This approach was relevant as the researcher sought to explore and describe the knowledge of the respondents about glaucoma. The approach involved the systematic collection of quantifiable information about the respondents’ knowledge on the phenomenon.
The study complied with the characteristics of quantitative research (Burns & Grove 2005:24 & 42), namely:

• It was focused on a limited number of pre-specified variables such as knowledge and glaucoma.
• A structured data collection instrument in a form of a questionnaire was used.
• Objectivity was enhanced by using a structured data collection instrument such as a questionnaire that comprised of pre-specified items with close ended questions.
• Control was imposed by means of pre-testing the instrument.
• Data analysis was carried out numerically using statistical procedures (descriptive and inferential statistics).

Quantitative research cannot however be used to study human experiences such as pain, caring and comfort as these human emotions are difficult to quantify (Burns & Grove 2005:24).

Exploratory

Exploratory research is explicitly designed to probe reality or investigate hunches so as to obtain preliminary evidence that can serve as a basis for more formal and future research (Stommel & Wills 2004:438). Neuman (2000:510) describes exploratory research as “research into an area that has not been studied and in which a researcher wants to develop initial ideas and a more focused research question”.
In this study, the researcher aimed to explore and assess the respondents’ knowledge about glaucoma using a questionnaire to collect data from them. Investigating or exploring the factor of the knowledge level about the disease seems to be critical for the patients to seek treatment or consult for their eye problems.

 Descriptive

Descriptive research provides an accurate account of the characteristics of a particular individual, event, or group in real-life situations for the purpose of discovering new meaning, describing what exists, determining the frequency with which something occurs and categorising information (Burns & Grove 2005:734). Descriptive studies are observational studies which study the amount (frequency) and distribution whether by person, place and time of diseases or events within a population (Araoye 2004:55).
In this study, knowledge about glaucoma and important factors associated with this knowledge were described and documented.

Cross-sectional

Cross-sectional designs are used to examine groups of subjects in various stages of development simultaneously with the intent of inferring trends over time (Burns & Grove 2005:732). Polit and Beck (2008:751) define it as a study design in which data are collected at one point in time. It is sometimes used to infer change over time when data are collected from different age or developmental groups. This cross-sectional study design calls for a single data collection point for all study participants (Stommel & Wills 2004:437). The WHO (2001:17) adds that cross-sectional studies provide a prevalent rate at a particular point in time referred to as point prevalence or over a period of time referred to as period prevalence.
In this study, data was collected from a sample of patients attending the CBN staff eye clinic and the prevalence of glaucoma knowledge in the population was determined.

RESEARCH METHODS

Research methods refer to the systematic procedure for carrying out research (Araoye 2003:118). It is the logical process which is followed during the application of scientific methods and techniques when a particular phenomenon is investigated (Polit & Beck 2008:765).
This section briefly explains the study setting, population, the sampling and sampling technique, the approach to data collection, data analysis, validity and reliability as well as ethical considerations.

Research study setting

Study setting is defined by Polit and Beck (2008:766) as the physical location and conditions in which data collection takes place in a study. In this study, the CBN has a medical facility in Abuja that caters for all its’ staff members as well as their eligible dependants. The clinic provides a variety of health services and programs which includes general out-patient services, antenatal services and family planning services, eye care services and laboratory services. Programmes that are offered are immunisation program and Human Immune deficiency Virus (HIV)/tuberculosis program. The eye clinic at present runs twice a week on Tuesdays and Thursdays. It has a consulting room, a mini theatre and patients’ waiting room. An ophthalmologist, who is the researcher in this study, runs the clinic in conjunction with a staff nurse and a clinic attendant. All three are not dedicated to the eye clinic alone as they are also involved in other health services within the health facility. Services offered at the eye clinic include out-patient consultations, refractions, screening for chronic eye diseases as well as conducting minor out-patient surgical procedures. Patients who have complicated eye conditions and those that require advanced surgical procedures are referred to the National Hospital Abuja which is a tertiary health center. At present, twenty-five patients are seen on each clinic day based on appointment. Table 3.1 shows that attendance at the eye clinic averages 200 patients in a month.

Population

A population is a group of people who share common traits or attributes of interest to the researcher, from whom a sample will be drawn and to whom the findings will be generalised (Burns & Grove 2001:83). Burns and Grove (2005:746) define a population as all elements such as individuals, objects, events or substances that meet the sample criteria for inclusion in a study. A population is the entire aggregate of cases in which a researcher is interested and the elements which show the sample criteria for inclusion in the study (Burns & Grove 2007:549). It is sometimes referred to as a target population. A portion of a target population to which the researcher has reasonable access to is referred to as an accessible population (Burns & Grove 2005:727).
In this study, the population consisted of all persons served by the CBN clinic and includes all CBN staff members in Abuja as well as their eligible dependants.
The eligibility criteria for this study included:

• All male and female adult patients (18 − 60 years) that came to the out-patient unit of the clinic. Sixty years is the official retirement age of the CBN and therefore the results of this study do not pertain to an elderly (> 60) urban population.

Patients were excluded from the study if they had the following characteristics:

• Younger than 18 years of age.
• Previous diagnosis of glaucoma or ocular hypertension.
• History of intellectual impairment or dementia.

The above criteria defined the target population.

Sampling and sample

Sampling involves selecting a group of people, events, behaviour, or elements with which to conduct a study (Burns & Grove 2005:341). A sample is the selected group of people or elements included in a study (Burns & Grove 2005:341). According to Somekh and Lewin (2005:218), a sample is studied in order to understand the population from which it is drawn. A complete coverage of the population is seldom possible and even if it were possible, time and cost considerations usually make this a prohibitive undertaking. Sampling is the science and practice of selecting information from populations in a manner that allows defensive inferences to be drawn from those data (Saks & Allsop 2007:157). The use of samples may therefore result in more accurate information because with a sample, time, money and effort can be concentrated to produce better-quality research information (De Vos, Strydom, Fouche, & Delport 2002:199).

CHAPTER 1 ORIENTATION TO THE STUDY 
1.1 INTRODUCTION
1.2 BACKGROUND INFORMATION ABOUT THE RESEARCH PROBLEM.
1.3 RESEARCH PROBLEM
1.4 AIM OF THE STUDY.
1.5 SIGNIFICANCE OF THE STUDY
1.6 DEFINITIONS OF KEY CONCEPTS
1.7 FOUNDATION OF THE STUDY
1.8 RESEARCH DESIGN AND METHODOLOGY
1.9 VALIDITY AND RELIABILITY.
1.10 ETHICAL CONSIDERATIONS
1.11 LAYOUT OF THE STUDY
1.12 CONCLUSION.
CHAPTER 2 LITERATURE REVIEW
2.1 INTRODUCTION
2.2 THE NORMAL EYE
2.3 GLAUCOMA
2.4 GLAUCOMA AWARENESS/KNOWLEDGE
2.5 DETERMINANTS OF GLAUCOMA KNOWLEDGE
2.6 THEORETICAL FOUNDATION
2.7 CONCLUSION
CHAPTER 3 Research design and methodology
3.1 INTRODUCTION
3.2 RESEARCH DESIGN
3.3 RESEARCH METHODS
3.4 VALIDITY AND RELIABILITY
3.5 DATA ANALYSIS
3.6 ETHICAL CONSIDERATIONS
3.7 CONCLUSION
CHAPTER 4 Data presentation, analysis and interpretation
4.1 INTRODUCTION
4.2 DATA ANALYSIS
4.3 CONCLUSION
CHAPTER 5  FINDINGS, LIMITATIONS AND RECOMMENDATIONS 
5.1 INTRODUCTION
5.2 OBJECTIVES OF THE STUDY
5.3 SUMMARY OF FINDINGS
5.4 SCOPE AND LIMITATION OF THE STUDY
5.5 RECOMMENDATIONS
5.6 CONCLUSION
LIST OF SOURCES
GET THE COMPLETE PROJECT
ASSESSMENT OF KNOWLEDGE ABOUT GLAUCOMA AMONGST PATIENTS ATTENDING AN EYE CLINIC IN ABUJA, NIGERIA