CHAPTER 3 Research design and method
This chapter covers the overall research plan for obtaining answers to the research questions and objectives being studied. The focus of the study was to investigate factors that affect adherence to antiretroviral therapy of HIV positive patients in a community home based care program in rural Uganda. The discussion included the research design and the research methodology on aspects such as study design, research context, population, sample and sampling technique, data collection, validity and reliability, data analysis, scope and limitation and ethical considerations.
Burns and Grove (2005:40) define a research design as a blue print for the conduct of a study that maximises control over factors that could interfere with the study’s desired outcome or findings. Polit and Beck (2008:66) define research design as the overall plan for obtaining answers to the research question being studied including specifications for enhancing the study’s scientific integrity. It is essentially the architectural backbone of the study.
The researcher used a non-experimental quantitative, explorative and descriptive research design, using the survey approach.
It is a formal, objective, systematic process utilised to describe and test relationships and to examine cause-and-effect interactions among variables. It involves investigations of phenomena that lend themselves to precise measurement and quantification often involving a rigorous and controlled design where the researcher is independent from what is being researched (Burns & Grove 2005:747; Polit & Beck 2008:763).
Quantitative research is characterised by the use of structured interviews, questionnaires or observations; scales; or physiological instruments to generate numerical data. Statistical analyses are conducted to reduce and organise data, determine significant relationships and identify differences among groups. Control, instruments and statistical analyses are used to render the research findings an accurate reflection of reality so that the study findings can be generalised (Burns & Grove 2005:25).
The quantitative approach is associated with advantages such as being systematic where research is through a logical process according to a prespecified plan of action, control mechanism are employed to minimise bias and maximise precision and validity and reliability. Empirical evidence gathered through this approach is the basis for knowledge thus findings are grounded in objective reality rather than in the researchers’ personal beliefs or expectations and the numeric information gathered from formal measurements is easy to analyse with statistical procedures (Polit & Beck 2008:16-17).
Some of the disadvantages of the quantitative approach are: inflexibility, inability to answer the “how” and “why” of phenomena, the lack of accurate measures in numerical form of psychological phenomena such as pain. Too much control of the research may sometimes obscure insights into complex environments and qualitative experiences of people (Polit & Beck 2008:16-17).
The quantitative approach is suitable for this study because its aims which are to describe and explore the factors that affect adherence to ART by HIV positive patients which are amenable to statistical analysis. Generalisation of the findings to the target population can be easily achieved with this approach. It is also compatible with the resources available especially time.
According to Babbie and Mouton (2001:79-80), a research is exploratory when the researcher examines a new area of interest or topic especially where a phenomenon under study is persistent. Polit and Beck (2008:20-21) add that exploratory studies are useful if the researcher wishes to assess and understand a phenomenon in a new light, ask questions, and search for new insights. This notion concurs with Burns and Grove’s (2005:357) view about exploratory studies that they are designed to increase the knowledge of the field of study.
The study sought to explore the factors contributing to good or poor adherence to antiretroviral therapy in the study population.
Descriptive research is research is described by Burns and Grove (2005:239) as a research design that provides an accurate portrayal or account of characteristics of a particular individual, situation, or group. It is a way of describing what exists, discovering new meaning, determining the frequency with which something occurs and categorising information. They are usually conducted when little is known about a phenomenon. The purpose of descriptive studies is to observe, describe, and document aspects of a situation as it naturally occurs and sometimes to serve as a starting point for hypothesis generation or theory development (Burns & Grove 2005:26; Polit & Beck 2008:274).
A descriptive design was chosen for the study in order to describe the factors that influence adherence or non-adherence to antiretroviral therapy in the study population.
It is a technique of data collection in which questionnaires or personal interviews are used to gather data about an identified population or it is a design used to obtain information about the prevalence, distribution and interaction of variables within a population. It is a nonexperimental research that obtains information about people’s activities, beliefs, preferences, and attitudes via direct questioning (Burns & Grove 2005:239; Polit & Beck 2008:323, 767).
The researcher chose a survey approach for the study because of its advantages such as its flexibility and broadness of scope which can be applied to large samples of populations. A further advantage is that, it can focus on a wide range of topics and its information can be used for varied purposes like description, exploration and explanation of the phenomena. However, its main disadvantage is that the information obtained tends to be relatively superficial (Polit & Beck 2008:323-324).
The research methodology outlined a logical process of the research and what processes and procedures are followed to answer the research question and achieve the research objectives (Mouton 2001:56). It included the research context, study population, sample and sampling technique, data collection and the data analysis techniques, ensuring validity and reliability and ethical considerations.
According to Polit and Beck (2008:57), a research context is defined as a specific place where data collection occurs. The Aids Support Organisation (TASO) is a non-governmental organisation with branches in all the regions of Uganda that has been providing care and support services free of charge to HIV-infected individuals since 1987. Services provided by TASO to HIV positive patients include counselling, ART and social support.
CHAPTER 1 Orientation to the study
1.2 THE RESEARCH PROBLEM
1.3 PURPOSE OF THE STUDY
1.4 SIGNIFICANCE OF THE STUDY
1.5 DEFINITION OF KEY CONCEPTS
1.6 FOUNDATION OF THE STUDY
1.7 RESEARCH DESIGN AND METHODOLOGY
1.8 ETHICAL CONSIDERATIONS
1.9 STRUCTURE OF THE DISSERTATION
CHAPTER 2 Literature review
2.2 ADHERENCE TO ANTIRETROVIRAL THERAPY
2.3 THEORETICAL FRAMEWORK
CHAPTER 3 Research design and method
3.2 RESEARCH DESIGN
3.3 RESEARCH METHOD
3.4 VALIDITY AND RELIABILITY
3.5 DATA ANALYSIS
3.6 SCOPE AND LIMITATION OF THE STUDY
3.7 ETHICAL CONSIDERATIONS
CHAPTER 4 Data presentation, analysis and interpretation
4.2 DATA ANALYSIS
4.3 SECTION A: GENERAL INFORMATION
4.4 SECTION B: ASPECTS OF CARE RELATED TO THE CLINIC
4.5 SECTION C: INTERPERSONAL RELATIONSHIPS WITH THE CARE PROVIDERS
4.6 SECTION D: KNOWLEDGE AND EXPERIENCE ABOUT HIV/AIDS
4.7 SECTION E: PERCEPTIONS ABOUT THE TREATMENT PLAN
4.8 SCALE RELIABILITY MEASURE OF RESPONDENTS’ PERCEPTIONS OF ART TREATMENT
4.9 SECTION F: ADHERENCE TO ANTIRETROVIRAL THERAPY
CHAPTER 5 Conclusions and recommendations
5.2 OBJECTIVES OF THE STUDY
5.3 FACTORS AFFECTING ADHERENCE TO ART TREATMENT
5.4 RESEARCH POSTER
5.5 SCOPE AND LIMITATION OF THE STUDY
GET THE COMPLETE PROJECT
FACTORS AFFECTING THE ADHERENCE TO ANTIRETROVIRAL THERAPY BY HIV POSITIVE PATIENTS TREATED IN A COMMUNITY BASED HIV/AIDS CARE PROGRAMME IN RURAL UGANDA A CASE OF TORORO DISTRICT