A FAST Campaign to Inform Public about Features and Attributes of Stroke - Research Proposal Example

Date Abstract Stroke is one of the leading causes of death in the world over. In New Zealand about 6000 New Zealanders are diagnosed with stroke annually. The few who service are often left with permanent disability. The study is in line is pat of the FAST campaign which aims at raining awareness on signs and symptoms about Stroke. The study seeks to find out the best approach to maximizing public awareness of the FAST message and whether there is a more effective message for encouraging/raising public awareness other than the FAST message. The study targets patient diagnosed with Stroke and the general public. To answer the research questions, the study will utilize mixed method research design using FGD, semi-structured questionnaires and Key Respondents. The study is aimed at giving more insight into the level of knowledge on Stroke related cases and finding how the best strategy towards sensitization of the same. Problem Background and Problem Definition Stroke is considered one of the principal causes of death in the world over only after heart and cancer as well as other related illness (Banerjee, & Das 2006). Global estimates of people suffering from stroke annually is 20 million out of which five million have no chances of survival except for five million who survive with long lasting disability ( Raj and Rao,2013, p.233). Stroke is believed to be the third commonest root cause of mortality in developed countries including New Zealand (MOH, 2009), where it bring with it huge physical, psychological as well as economical burden on patients, families, relatives and the health institutions and society as whole (Strong , Mathers and Bonita, 2007). The lifetime costs of stroke on yearly basis are approximated to be about $450 million in New Zealand (Brown, 2009). A systematic review of 56 stroke based research (Feigin, Lawes and Bennet, 2009) indicate that the age-adjusted stroke incidence rate in New Zealand is relative on the high increase when compared with the rest of developed nations . It is approximated that about 6000 New Zealanders are diagnosed with stroke annually and close to 2000 deaths cases are as a results of stroke (Brown, 2009) out of the few who survive, about 20% stay in rest homes or private hospitals, about a half reside outside institutional care centers, while a third (30%) lead their day to day lives independently (Feigin, 2005). One of the major reasons for the high rates of stroke related deaths is low or lack of awareness risk factors and associated symptoms (Walker et al., 2000). Inability to recognize stroke simply means a delay medical attention which can have tragic or catastrophic impacts which may even cause brain damage or death. The New Zealanders’ inability to identify the symptoms of a stroke is particularly costing lives and lifestyles. In a study commissioned by the Stroke Foundation research to assess the general public’s ability to recognize the signs of stroke and to act appropriately if a stroke is suspected. The study’s findings were quite alarming as it was revealed that less than a third (27%) of New Zealanders could identify even one symptom of a stroke, and over a third couldn’t make out any symptoms (Stroke Foundation, 2010). These results are disturbing. Based on the foreground, awareness on symptoms is timely. Based on FAST awareness, efforts to enlighten, patients, families and the general populace about stroke symptoms could make a significant difference to the aforementioned grim statistics. It is against the above background that proposed study seeks to enhance awareness on stroke symptoms. The study is also in line with Stroke Awareness Week which takes a FAST approach to stroke symptom recognition message. The FAST is an abbreviation which stands for: Face –has the face drooped? Is one arm weaker? is the speech slurred, jumbled?; and time which means time to act fast (Stroke Foundation, 2011). The FAST strategy has been linked with significant success hence the need for a wide range campaign aimed at sensitization of the public. Research Questions To achieve the set objectives, the study will be guided by the following: 1. What is the best approach to maximizing public awareness of the FAST message? 2. Is there a more effective message for encouraging/raising public awareness other than the FAST message? Proposed Research Methodology For this study, a descriptive, cross-sectional survey will be utilized (Aljeesh, 2003). Drawing on methodological best practice of previous studies, the study will also utilize an integrated research design or mixed method, that is, a combination of qualitative and quantitative strategies in one study (Wilkins et al., 2008) where in the quantitative methods, researcher collect and analyze as well as interpret data in its numerical forms or numbers while in qualitative methods entails collection, analysis and interpretation of data in their narrative forms (Polit, 2010). Johnson and his colleagues (2007) gave a more expanded description, saying that: “Mixed methods research is that type of research where researcher(s) integrates elements of qualitative and quantitative research methods mainly for the sake of breadth and depth of not only understanding but also collaboration “(p. 123). Mixed methods research tends to build on the strengths or benefits (Rauscher et al., 2009) and reduce the major shortcomings (Plainkas et al., 2011) of the two , quantitative and qualitative methods in order to come up with inferences which bring an enhanced understanding of the phenomenon under investigation . The mixed methods approach to research can be distinguished from the traditional triangulation where both quantitative and qualitative methods are utilized in the determination of the extent or degree to which the study findings are reinforcing or irreconcilable (Wilkins et al., 2008). Mixed methods are various advantages. For instance, it enhances chances of achieving a more “wider, or complete results compared to the use of a single approach” (Williamson 2005:9). In addition, the quantitative component collecting large amounts of information while qualitative is facilitates in-depth collection of data, analysis and interpretations (Aljeesh, 2003). More importantly, mixed method research is more suitable to health based studies. Wilkins et al., (2008) strongly recommend this type of research for two major reasons: First, it is most suitable when the study is required particularly in the assessment of both impact and outcome of a given health related interventions, and the second ground for the use of mixed method research is when an understanding of health behaviours is required so that a more suitable nursing practice or interventions can be formulated. In a quick rejoinder, Andrew an his colleagues (quoted in Hayes, Bonner and Douglas, 2013, p.12) believe the versatility of mixed methods research strategy lies in the facilitation of investigation of health problems especially in serious health cases. One major advantage of mixed method research is that it require detailed background information, hence the need to take appropriate precaution. Sample Selection, Data Collection and Data Analysis The study targets the general population and key informants as well as those diagnosed with Stroke or hypertensive patients attending the selected health centers or hospitals’ out-patients clinics. Although there a number of different designs associated with mixed method distinguished according to their implementation approaches, priority and integration of the information gathered (Hayes, Bonner, and Douglas, 2013, p.8-9), for this study, explanatory sequential mixed approach (Tashakkori and Creswell, 2007) is more suitable. The sequential explanatory design is often employed when a researcher seek explanation of the results of the quantitative phase (Creswell et al., 2003). Creswell and Clark (2011) defined explanatory sequential mixed method as one which begins with quantitative phase then following up on the specific results with a second stage , which is qualitative in nature (p. 82) . The second stage is aimed at proving more information about the first phase. In other words, it gives a more in-depth explanation about the quantitative results and more clarification about the findings quantitative phase. Creswell et al. (2003) describes a variant of this design by having a quantitative phase followed by a more dominant, qualitative phase where the quantitative phase may be used to identify participants and produce purposeful sampling for the qualitative phase. In this study, the researcher will use the “quantitative results about the characteristics of the sampled participants in guiding purposeful sampling for the second qualitative stage (Creswell and Clark, 2011, p. 82). This will be beginning by constructing and conducting a study based on quantitative methods followed by data analysis. These quantitative results will be carefully scrutinized to identify key issues which may need more comprehensive assessment or investigation. The strength of the sequential explanatory design is that it is relatively straightforward and is considered the easiest of the mixed methods designs to implement (Doyle et al., 2009). The main weakness is the length of time needed to carry out the research since it entail two phases especially if both stages are given equal priority (Doyle et al., 2009). The first stage will be carried out by gathering and analysis of the quantitative data through the use of semi-structured questionnaires to measure the patient level of awareness on Stroke symptoms. This will be achieved by scoring the questionnaire. The various sections for measuring the level of knowledge in terms of general knowledge, cause of stroke, sign and symptoms will be scored differently to check on the accuracy of the response, with the more correct answer being given the highest score while the incorrect , scored 0. A correct response was either scored, 3, 2, 1 depending on the “accuracy” of the response; a more accurate response was given a higher score, while an incorrect response was scored 0. The second stages will be based on collection and analysis of quantitative data, which is also aimed at explaining expanding and confirming the results. In this case, it also facilitates the building upon how the patient level of understanding is related to their experience. The main advantage of this approach lies in the nature of the design and its ease of implementation through clear and separate strategies are seen as its main strengths (Cresewell, 2009). In terms of sample size, the study seeks to recruit about 50 to 100 patients from selected health units. The sample size is appropriate based on time and resources. It also seek to conduct about six focused group discussion composed of about 10 to 12 members. Three FGD will be composed of only women while the other three composed of men. About five to six Key residents comprise of community leaders and health officials. References ALjeesh, Y.I. (2003). Stroke and non-compliance with the therapeutic Regimen among hypertensive patients in Gaza Governorates. Retrieved September 20th 2005, availableonlinehttp://bieson.ub.uni-bielefeld.de/volltexte/2004/449/pdf/Final_form_for_library.pdf Brown P. (2009). Economic burden of stroke in New Zealand. Three decades of Auckland regional Community Stroke (ARCOS) studies: What have we learned and what is next for stroke care and stroke research? Wellington, New Zealand: Stroke Foundation. Doyle, L., Brady, A.-M., & Byrne, G. (2009). An overview of mixed methods research. Journal of Research in Nursing, 14(2), 175-185. Feigin V.L (2005). Managing stroke: Key principles and updates, NfP Volume, 32(4):241-246 Feigin VL, Lawes CMM, Bennet DA. (2009). worldwide stroke incidence and early case fatality reported in 56 population-based studies: A systematic review. Lancet Neurology, 8, 355–369. Hayes, B., Bonner, A., & Douglas, C. (2013). An introduction to mixed methods research for nephrology nurses Renal Society of Australasia Journal, 9(1), 8-14 Johnson, R. B., Onwuegbuzie, A., & Turner, L. A. (2007). Towards a definition of mixed methods research. Journal of Mixed Methods Research, 1(2), 112–133. Plainkas, L. A., Horwitz, S. M., Chamberlain, P., Hurlburt, M. S., & Landsverk, J. (2011). Mixed-methods designs in mental health services research: A review. Psychiatric Services, 62(3), 255–263. Polit, D. F. (2010). Statistics and data analysis for nursing research (2nd ed.). Upper Saddle River: Pearson Raj, P.V.A., and Rao, R.C. (2013). Molecular and Biochemical Characterization of Ischemic Stroke, Journal of Chemical, Biological and Physical Sciences, Vol. 3, No. 1, 283-288 Stroke Foundation of New Zealand and New Zealand Guidelines Group. Clinical Guidelines for Stroke Management 2010. Wellington: Stroke Foundation of New Zealand. 2010 Strong K, Mathers C, Bonita R. (2007). Preventing stroke: Saving lives around the world. Lancet Neurol, 6(2), 182–187 Towfighi, A., Ovbiagele, B., & Saver, J. L. (2010). Therapeutic milestone: stroke declines from the second to the third leading organ- and disease-specific cause of death in the United States. Stroke (00392499), 41, 499-503 Walker, R.W., Mclarty, D.G., Kitange, H.M., Whiting, D., Masuki, G., Mtasiwa, D.M., Machibya, H., Unwin, N., Alberti, K.G.M.M. (2000). Stroke mortality in Urban andRural Tanzania. Adult Morbidity Mortality Project: Lancet, (355), 1684-1687. Wilkins, K., & Woodgate, R. (2008). Designing a mixed methods study in pediatric oncology nursing research. Journal of Pediatric Oncology Nursing, 25(1), 24–33. Read More