Research Methodology

Introduction

The main aim of the current study is to explore the factors that influence nursing behavioural intentions towards the standards of precautions (personal protective equipment, PPE) of infection control in Saudi hospitals. focuses on healthcare dissertation help. To achieve this aim, the study will apply mixed research methods alongside the theory of planned behaviour (TPB) (Ajazen 1991) in understanding from the participants’ perspective, factors that influence them into using PPE as standard precautions for infection control. Fundamentally, TPB is rarely used with qualitative research because it tends to use quantitative data collection and analysis methods (Ajzen, 2002). However, according to Ajzen (2004), TPB can be used with qualitative studies when researchers are limited to a particular choice of data collection such as interviews, or when it is impossible to conduct a statistical analysis with the available data.

A review of literature by Mynarska (2008) reveals that there is a dearth of research on the use of TPB with qualitative research methods, with little details on methods usable to present obtained results through the TPB framework. However, in this study, the TPB framework is used with qualitative research methods based on the belief that this approach will highlight the significant differences in perceived behavioural controls, attitudes and norms of the participants with regards to the use of PPE as part infection control measures within the hospital setting. Silverman (2016) argues that when using the TPB framework, it is important to define the behaviour under investigation. Therefore, in the current study, the specific behaviour of focus is the use of personal protective equipment such as hand gloves and face masks.

Sample

The study conveniently selected participants in the ICU departments of four Saudi Arabian hospitals. ICU care settings the ICU departments were particularly selected as the source of participants because the ICU care settings consist of vulnerable patients kept for close monitoring usually with one to one patient-nurse ratio (Barrett et al, 2014). Even with the advancement in medical technology, the nurses are always at a high risk of infections that are avoidable by observing a few infection control strategies such as the use of PPE.

The researcher saw it prudent to use convenient sampling for some specific reason. First, nurses in the ICU departments operate under a tight schedule and therefore it was prudent to select the sample based on their availability. Besides, convenient sampling would consume relative less time and resources compared to other sampling methods (Daniel, 2011). Lastly, by using convenient sampling, the researcher would gather useful data that could not be gathered using probability sampling methods (Daniel, 2011).

Data Collection

The study will use interviews as the main data collection method. Brinkmann & Kyale (2015) suggest that interviews should last for at most one hour but because in the proposed study participants will need more time to describe their experiences in more detail, the interviews may last up to one and a half hours per interviewee. The interview will be developed based earlier questionnaires sent to participants to trigger their reflection on the issues to be discussed during the interviews. Nevertheless, the interviews will be recorded and transcribed verbatim.

Questionnaire Development

Fundamentally, the interview process was developed based on the TPB framework designed for this particular study. Therefore, the researcher will develop one or more questions that address each element of the framework including subjective norms, actual behavioural control, perceived behavioural control, attitudes and behaviour of interest. The following table illustrates how the questions will be designed to address these elements:

Meanwhile the researcher will fundamentally follow two steps in designing the questionnaire. The first phase will be the elicitation process, whereby the questionnaire will first be validated through a pilot study of 5 participants. Phase one of the process will entail the development of interview questions based on the theory content. The developed questions will then be passed to the 5 participants to test their feasibility. The feasibility study outcome will determine whether the questions will be revised or not before proceeding to the second phase. In Phase 2, the researcher will develop a standard questionnaire consisting of both open and closed ended questions. The questionnaire will then be taken through a pilot study to examine its feasibility. The feasibility test will also involve seeking the opinion of experts from the same field; before finally sending it to the actual participants for data collection. Appendix 1 illustrates the elicitation process.

As part of the probing during the interviews, the researcher will add questions that seek to identify the confounding factors such as age, availability of PPE and care setting environment that might influence nursing behavioural intentions towards the standards of precautions.

After defining the interview questions, the researcher will group each question into homogenous sections consisting of two sets of questions, namely the self-completed questionnaire that will be sent to the interviewees before the interviews and questions designed for use in the one on one interviews. This is because the self-completed questionnaires will set a stage for the one-on-one interviews, informing the kind of probing the researcher will do during the interviews.

The researcher will use mind-mapping software, MindManager, to ensure that the interview outline fits the qualitative research design. In doing so, the research design will be illustrated in a map that depicts both the elements of TPB and potential confounding variables. This would then be followed by the evaluation of each interview question to ensure they are coherent with the research objectives and design.

Data Analysis

The questionnaire data, as well as the interview data (after transcription), will be gathered in one document for analysis. The analysis will begin with classifying the information provided by participants both through the interviews and questionnaires. Furthermore, the preliminary data analysis involved the collection of participant demographic descriptions to examine any demographic characteristics that might be used to organize the participants according to characteristics that are not associated with their behaviours.

Looking for further insights on Understanding Research Design Types? Click here.

Two data analysis techniques can be adopted for the proposed study, namely interpretive analysis or thematic analysis using qualitative data analysis software such as NVIVO. However, the use of qualitative data analysis software such as NVIVO requires the researcher to make the data homogenous, fragmented and ultimately distance the researcher from the data (Taylor et al, 2015). For this reason, the researcher will use the interpretive data analysis technique to analyse data by grouping the data and analysing them to identify patterns of factors influencing nursing behavioural intentions towards the standards of precautions. The coding process will be systematic and based on a mind map structure, whereby data patterns will be grouped according to exploratory variables such as perceived behavioural control, subjective norms, actual behavioural controls and attitude emanating from the interview questions and questionnaires (Brinkmann & Kyale, 2015).

References

Ajzen, I. (1991). The Theory of Planned Behavior. Organizational Behavior and Human

Decision Processes, 50, 179-211.

Ajzen, I. (2002). Constructing a TpB questionnaire: Conceptual and methodological

considerations. Retrieved October 13, 2008, from the World Wide Web: http://wwwunix.

oit.umass.edu/~aizen/pdf/tpb.measurement.pdf

Ajzen, I. (2004). Frequently Asked Questions [Web page]. Retrieved October 13, 2008, from

the World Wide Web: http://people.umass.edu/aizen/faq.html

Brinkmann, S., & Kvale, S. (2015). Interviews: Learning the craft of qualitative research interviewing (Vol. 3). Thousand Oaks, CA: Sage.

Barrett ML, Smith MW, Elizhauser A, Honigman LS, Pines JM (2014). "Utilization of Intensive

Care Services, 2011". HCUP Statistical Brief #185. Rockville, MD: Agency for Healthcare Research and Quality.

Daniel, J. (2011). Sampling essentials: practical guidelines for making sampling choices.

Thousand Oaks : SAGE Publications, Inc, 2011.

Glaser, B. G., & Strauss, A. L. (2017). Discovery of grounded theory: Strategies for qualitative research. Routledge.

Glesne, C. (2016). Becoming qualitative researchers: An introduction. Pearson. One Lake Street, Upper Saddle River, New Jersey 07458.

Hennink, M., Hutter, I., & Bailey, A. (2020). Qualitative research methods. SAGE Publications Limited.

Silverman, D. (Ed.). (2016). Qualitative research. Sage.

Mihas, P. (2019). Qualitative data analysis. In Oxford Research Encyclopedia of Education.

Mynarska, M. (2008). Qualitative studies and TPB (unpublished presentation). Rostock, Germany: Working Meeting: coordinating comparative qualitative research for the REPRO WP5 European Project, 22-23 September 2008, Max Planck Institute for Demographic Research.

Taylor, S. J., Bogdan, R., & DeVault, M. (2015). Introduction to qualitative research methods: A guidebook and resource. John Wiley & Sons.