PEO Framework in Mental Health Research

Research Question

In framing the research question in this study, the PEO framework tool is to be used. This is because it allows the researcher to analyse likelihood or prognosis of clinical problem which has occurred due to presence of existing condition (Verhoeven et al. 2019). Thus, using this tool in the study, the focus can be created on identifying the prevalence or likelihood of depression among the children of 13-17 years in London due to any pre-existing condition. The PEO framework stands for Population, Exposure and Outcome. The population is referred to people or patients and family members to be focussed in the study which are to be influenced by the identified problem in the research (Doody and Bailey, 2016). The exposure refers to the illness or problematic condition and outcome is referred as the interest of the research (Dillane and Doody, 2019). Thus, based on the characteristics the formulated research question is: How prevalent is depression between boys and girls aged 13-17 years in London?

Introduction

Depression is referred to the mood disorder which is able to impact an individual’s daily performance in life and it is regarded as one of the common mental health problem suffered by people in the UK. It is mentioned that in England, UK nearly 4-10% of people are probable to suffer from depression in their lifetime (digital.nhs.uk, 2018). The depression rate is seen to higher among the youth and the adolescent that is evident from the statistics where children as young as 12 years to adults of 25 years are found to be more vulnerable to face depression as one of the major mental health problems in lifetime (mentalhealth.org.uk, 2018). The condition indicated that prevalence of depression among the children and adults in England, UK is high and effective examination is to be made to understand its extent of influence and prevalence on the population. Thus, the study is developed where aim of the study along with the objectives are to be clarified in relation to adolescent depression in London which is the largest city and capital of England. Moreover, the methodology and the way ethics will be managed are to be discussed. Further, a reflection through critical analysis of the experience in executing the study is to be mentioned.

Background of the study

Adolescent depression is the mood disorder experienced by the children below 18 years and it is not in any other way different from adult depression. However, the symptoms of the depression may be manifested in adolescent in different ways that are apart from adults because of the different developmental as well as social challenges faced by the teenagers (Dardas et al. 2018). The emotional symptoms of adolescent depression include feeling of worthlessness and guilt, trouble concentrating on making decisions, irritability, lack of interest, extreme sensitivity and others. The persistent adolescent depression is seen to lead children in developing suicidal thoughts and cause self-harm (Dardas et al. 2017). The behavioural changes seen among adolescent due to depression include hindrance in remembering information, restlessness, insomnia, loss of appetite, social isolation, substance abuse, tiredness and others. The exact diagnosis of adolescent depression is difficult as it is hard to analyse difference between normal and improper reactions of the teenagers (Asad et al. 2017). In the study of Henje Blom et al. (2016), it is mentioned that feeling of psychological stress stimulates the hypothalamus region of the brain to produce corticotrophin-releasing hormone (CRH). The hormone persuades release of pituitary corticotrophin that stimulates the release of cortisol from the adrenal gland into the plasma. The prolonged psychological stress leads to raise the cortisol level in the blood which is the stress hormone involving reduction of neurotransmitters and serotonin that is the “happy hormone” at the same time making individuals to suffer depression (Gomes et al. 2019). This is because increased cortisol leads to create fluctuations in the mood making people feel depressed and anxious. In case of adolescent, various social and environmental factors act as psychological stressors that are seen to influence the cortisol levels in the blood making the individuals feel depressed (Chuang et al. 2016). The early childhood trauma of being abused and harmed in society contributes to adolescent depression. This is because the incident leads adolescent individuals to feel disconnected from the society, experience shame and guilt and show inability to emotionally connect with others to overcome their psychological stress that gradually contributes to the person to have heightened anger and depression (Ophir et al. 2019).

According to the survey executed by Department for Health in 2017 within the UK, it is reported that 1 in 9 children in the population between the age of 5-15 years is at risk of developing depression and anxiety (mentalhealth.org.uk, 2018). This indicates that prevalence of adolescent depression is quite high in the UK. However, existing studies lack data regarding the extent of prevalence of adolescent depression among the children of 13-17 years of age in London. Moreover, there is existing gap in studies regarding the factors that are influencing the raised prevalence and the impact of the prevalence of adolescent depression among children of 13-17 years of age in London. The existing data also lack information regarding the prevalence of adolescent depression on the basis of gender. Thus, to resolve the gaps the current research is planned to be performed where focus will be identifying prevalence of adolescent depression among boys and girls in London who are within 13-17 years of age.

Rationale of the study

The children in the adolescent stage are found to be vulnerable to abuse, social bullying and others which contributes to their emotional turmoil and disturbed mood making them develop depression (Mehlum et al. 2016). In the UK, it is reported that 10.9% of girls and 7.1% of boys between the ages of 11-17 years are suffering from depression and anxiety as the major emotional disorder (mentalhealth.org.uk, 2018). In another survey conducted by the NHS, it has been revealed that 18% of girls and 12% of boys who are of 14 years of age are reported to suffer from depression (digital.nhs.uk, 2018). This indicates that girls compared to boys in the adolescent stage in the UK are prone to face increased chances of depression. The adolescent depression has become an issue because its influence has led teenagers to develop self-harm or suicidal attitude (Mehlum et al. 2016). This is because depression leads the teenagers to make them isolated from society out of losing meaning of life, in turn, making them choose death rather than living. The adolescent depression has become an issue as many teenagers are unable to perform properly in their academics as well as in social life out of emotion. This is negatively affecting their growth and career development (Faeq, 2016). Thus, effective actions are required to understand the extent of its prevalence so that its impact and challenges for the adolescent girls and boys of 13-17 years in the London can be determined to take appropriate action to lowers its influence on their daily life. The adolescent depression has currently become an issue in the UK as more individuals are found to be suffering from emotional disorder than previous years. It is evident in 1999 only 4.3% of population between 13-17 years are found to be affected by depression but in 2017 it is raised to 5.8% (NHS.UK, 2018). Thus, this study is important to be performed so that prevalence of adolescent depression among the girls and boys of 13-17 years of age in London can be identified to understand the factors and challenges to be controlled to lower the prevalence and ensure better well-being for the children.

Aim

The aim of the study is to identify the prevalence of adolescent depression among boys and girls aged 13-17years in London.

Research Objectives

To explore the concept of adolescent depression

To investigate the prevalence of adolescent depression among the boys and girls aged 13-17years in London

To examine the issues and negative experiences of the boys and girls aged 13-17years living in London due to adolescent depression

To suggest ways of resolving the issues and negative experiences of the boys and girls aged 13-17years living in London due to adolescent depression

Methodology

In nursing and medical research studies, the two most prominent research approaches used are primary research and secondary research. The primary research includes data gathering through scientific study or experimentation or research trial. This indicates that researcher in primary research approach executes experimentation to gather data directly from live participants rather than focussing on the presence of previous data (Kutcher et al. 2017). In contrast, the secondary research executes collection of data from existing primary studies or secondary information presented in previous research. This indicates the researcher in secondary research is dependent on the presence of existing data regarding the topic of their study (Dardas et al. 2016). The secondary research allows large collection of existing data in limited time regarding a topic that is logically and scientifically analysed and presented in previous studies (Das et al. 2016). Thus, secondary research approach will be used in executing the study. The weakness of secondary research is that researcher faces hindrance to gather specific data according to their needs as the exact data may not be highlighted in proper way on the present studies (Stockings et al. 2016). In order to manage the limitation, extensive searches will be made by focussing on keywords determined for the study so that enriched information can be gathered. As argued by Kutcher et al. (2017), strength of primary research is that through the process raw data can be gathered which appropriately suits for smooth execution of the study but the weakness is that with complex statistical and qualitative analysis tool are be used in gathering data which raises the expense for the research. Thus, in this study, primary research will be avoided so that high expenses which is currently cannot be managed by the researcher is able to be avoided.

Searching Literature

The literature search will be executed in the study through the use of electronic database. This is because electronic database offers opportunity to the researchers to reduce data redundancy, ensure effective data integrity as well as independence, increase data collection consistency and ensure gathering of data in secured manner (Ghoneim and O’Hara, 2016). The use of MEDLINE, Google Scholar and CINHAL will be done as electronic database to gather information regarding the study.

Inclusion and Exclusion criteria

The inclusion criteria are characteristics which are to be focused in the study whereas the exclusion criteria are characteristics to be not included in the study as they are going to create hindrance in its execution (Heck et al. 2017). The inclusion criteria for the study will include articles published from 2015-2020, articles presented in English, articles focussing on prevalence of depression among boys and girls of 13-17 years of age in London, UK, fully accessible and academic. The exclusion criteria will include articles published before 2015, articles focussing on adult depression on London, UK, non-academic, not fully accessible and written in languages other than English. The articles in English will be involved as it is can be understood and interpreted properly by the researcher in collecting data regarding the study as they have only knowledge regarding English. The fully accessible articles will be included and others are excluded so that detailed data regarding topic focussed can be gathered. The academic articles will be included as they provide credible and authentic information research the research topic. The studies which have focussed on adolescent depression in London, UK will be selected as it is the key focus on the study.

Ethics and Bias issues

The ethical issues in the study will be controlled so that legal issues can be avoided and an enriched study is able to be produced (Vallejos et al. 2019). In this purpose, the information collected from previous studies will be properly referred with the name and year of the original author so that plagiarised work can be avoided. The data gathered from the previous studies will be analysed and presented as findings by the current researcher and another researcher independent who acts independently of the study. The facts will be compared to ensure no personal influences are used to present the data ensuring credible and reliable information. In the study, no personal details of individuals or any participants from previous studies will be shared to ensure confidentiality.

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