Masters Psychology

3 paper edits for research proposal capstone project.

Running Head: EFFECTS OF CAREGIVING ON CAREGIVERS OF ELDERLY PERSONS WITH PSYCHOLOGICAL DISORDERS 1

PSYCHOLOGICAL DISORDERS AMONG THE ELDERLY 3

Smarthinking Tutor Response Form

Your tutor has written overview comments about your essay in the form below. Your tutor has also embedded comments [in bold and in brackets] within your essay. Thank you for choosing Smarthinking to help you improve your writing!

Hello Ashley! My name is Lisa C. and I look forward to working with you on this Essay Center Review to improve your writing today. Let’s get started!

*Writing Strength:  Ashley, your sentence structures throughout your paper are clear, easy to read, and provide a great amount of variety. You use some simple sentences, some compound sentences, and some complex sentences to add interest to your writing. Keep up the good work!

* 11284804, you requested help with Content Development:    Since these chapters discuss how your research will be conducted, it’s crucial that you be as specific as possible and anticipate questions readers may have. In the “Instruments” section, you describe the various questionnaires you will use to obtain information about care recipients and caregivers. I think you need to be more detailed about what information these questionnaires will collect and how they will collect it.

For example, when discussing the second questionnaire, you mention that it will asses the state of the care recipient and his or her psychological disorder. However, you do not specify whether the care recipient will fill out the questionnaire, or someone else on his or her behalf. Let’s take a look:

The second questionnaire – the Neuropsychiatric Inventory Brief Questionnaire Form (NPI-Q) – is a self-administered questionnaire that has 12 items assessing various physical and psychological states of the care recipient and the level of distress each state gives the caregiver.

Who will fill out the second questionnaire: the care recipient, or the caregiver? It seems like the care recipient may not be able to answer the questions accurately depending on his or her psychological disorder. However, will the research be skewed if it is filled out by the caregiver? Address this point in a few sentences to explain who will be expected to complete the second questionnaire, and whether or not the results will remain valid.

Take a look at the rest of this section, and try to include as many specific details as possible so that the reader has a firm grasp of how data will be collected in a way that will protect the integrity of the data.

* 11284804, you requested help with Use of Resources:    Ashley, I noticed a few sources in your chapter that are cited within the text, but are not cited in the References list. It’s important that every source in the Reference list has been cited within your essay, and that every source cited within your essay has been cited in the References list.

The two that I noticed were Gratao et al. and Baladon et al. However, there could be more than just these two. To check, I would suggest using the “control + F” search option and searching every source from the reference list to see if it has been cited. Then, run the opposite test: search every source from within the essay to see if it has been cited in the reference list.

Also, take a look at my comment in the body of your essay about the rules for using “et al.” to make sure you are using this abbreviation correctly. For more help with APA formatting, see the Writer’s Handbook: APA Style.

Transitions  I noticed that you tend to use the transition “for instance” quite often, particularly in the first half of your chapter. In order to add variety and avoid repetition, there are other transitions that can be used instead. Let’s look at an example:

“Furthermore, the focus of much of the existing studies on caregiver burden has been on specific populations, for instance caregivers of senior citizens with dementia (Gratao, Vale, Roriz-Cruz, Haas, Talmelli, & Ridrugues, 2010; Garlo, O’leary, Van Ness, & Fried, 2010).”

Instead of “for instance” you could use “for example,” “such as,” or “like.”

Furthermore, the focus of much of the existing studies on caregiver burden has been on specific populations, like caregivers of senior citizens with dementia (Gratao, Vale, Roriz-Cruz, Haas, Talmelli, & Ridrugues, 2010; Garlo, O’leary, Van Ness, & Fried, 2010).

You could also break up the sentence into two sentences with a transition such as “One example includes caregivers of senior citizens with dementia.”

Look for other uses of “for instance” and use a synonym to avoid repetition or look for ways to change the structure of the sentence in order to use different phrases or state information in a fresh way. Summary of Next Steps:

· Be detailed in your explanation of what questionnaire’s will be used, what information they will collect, who will fill them out, etc.

· Cite every source cited in the essay in the reference list, and cite every source in the reference list within the essay.

· Avoid repeating “for instance” more than once or twice.

Thank you for submitting your essay for a review, Ashley. I enjoyed helping you with this step in the revision process. Have a good day! – Lisa C.

You can find more information about writing, grammar, and usage in the Smarthinking Writer’s Handbook.

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Please look for comments [in bold and in brackets] in your essay below. Thank you for submitting your work to Smarthinking! We hope to see you again soon.

The Effect of Caregiving on Caregivers of Elderly Persons with Psychological Disorders

Ashley Moore

Capella University

March, 2019

CHAPTER 3: METHODOLOGY

This section explains the method and procedures used to collect data, the reason for the chosen method, how the data collection instruments will be constructed and how they will be administered. It begins by highlighting the study problem before outlining the research design and sampling procedures. The section also describes the data collection tools and delineates the procedures for data handling.

Purpose of the Study

The previous chapter (Review of related literature) has demonstrated that as per recent demographic trends, caregiving for elderly persons by their family members is a common practice that is rather burdensome to the caregivers (Bastawrous, 2013; Chari, Engberg, Kristin, & Mehrotra, 2015). A number of studies undertaken on the effect of caregiving for elderly persons on caregivers are indicative of correlations between caregiving and certain disorders, for instance dementia (Gratao, et al., 2010; Schulz & Sherwood, 2008), Alzheimer’s (Gratao, et al., 2010), and other psychological conditions (Baladon, et al., 2015; Bastawrous, 2013). Other studies have also established associations between caregiver demographic variables and levels of caregiver burden; for instance, that perceptions of high caregiver burden may be higher among young as compared to older caregivers, that white caregivers tend to cave in to depression in comparison with black caregivers, and that caregivers financial status affects both the elderly in care and the caregiver (Chari A. V., Engberg, Kristin, & Mehrotra, 2015; Donelan, et al., 2002; Gratao, et al., 2010). [Since you have already mentioned the “Chari” source once before in a citation, you can reference it from now on using “Chari et al., 2015.” The rule in APA is that if a source has three to five authors, all the authors should be cited in the first mention, while in subsequent mentions, “et al” can be used. If a source has more than five authors, “et al.” can be used with every mention of the source, including the first mention. Also, there’s no need to include the first initials of any of the authors.]

However, there still incongruence in existing research on the association between the two variables and, given the key role played by caregivers, there is need to further investigate and document caregivers’ experiences in the context of caring for elderly persons with psychological disorders with a view to ensuring they have adequate support and fallback mechanisms. [The beginning of this sentence is lacking a verb.] In this chapter, we have explored some of the theoretical considerations on caretaker burden and reviewed some studies related to the current one.

Available studies have returned conflicting findings with some indicating that there is a positive relationship between caregivers’ burden and depression (Kurasawa, et al., 2012), while others maintain that there is no association between caretaker levels of burden and severity of behavioral disorders in the elderly (Bastawrous, 2013). Furthermore, the focus of much of the existing studies on caregiver burden has been on specific populations, for instance caregivers of senior citizens with dementia (Gratao, et al., 2010; Garlo, O’leary, Van Ness, & Fried, 2010). Few studies have highlighted differences for more generic populations, for instance focusing on a combination of psychological disorders, such as depression and depressive disorders, anxiety disorders, dementia and delirium. This demonstrates the need for further research into the phenomenon, especially since few of the studies have focused on psychological disorders of the elderly and how these may affect their caregivers.

Thus, as already outlined in Chapter 1, the research seeks to study psychological disorders among the elderly and explore the relationship between these disorders and the health of caregivers’ health. To this end, the research will profile the elderly psychological disorders that affect the elderly population and then proceed to determine the extent to which providing care for the elderly with psychological disorders affects caregivers’ physical and psychological well-being. This will be done by answering the following research question and testing the hypothesis:

Research question: What is the effect of Effect of Psychological Disorders among the Elderly on Family Caregivers? [Even though this is the title of your essay, it should not be capitalized here, since it is not acting as a title here.]

Research hypothesis: The nature of psychological disorders of the elderly has no effect caregivers’ health.

Research Design

The methodology for this research is based on a quantitative approach. Quantitative (also positivist) research approaches emphasize the significance of observation for the development of knowledge and therefore regard measurement of a phenomenon as necessary to facilitate the development of understanding. The goal of research is to simply describe a phenomenon using what can be directly observed and measured. The assumption behind quantitative methods is that things can be studied as hard facts, and relationships between these facts can be established in order to derive scientific laws (Gelo, Braakmann, & Benetka, 2008; Dannels, 2018).

From an epistemological perspective, positivist approaches assume that the researcher and the study are independent entities thereby emphasizing the distinction between facts and value. The ontological position of positivist approaches is that an objective reality, independent of human behavior, exists and that all real knowledge should be derived from objective, discernible and measurable observation of this reality. Positivists are credited with the introduction of the idea of objectivity in research. As a result, quantitative approaches uphold empiricism – the idea that observation and measurement should be at the core of any research endeavor (Gelo, Braakmann, & Benetka, 2008; Watson, 2015). In the present study, we take the stance proposed by quantitative approaches about the existence of an objective reality that can be studied, measured and described empirically. It is for these reasons that the study has been based on the quantitative approach.

According to Parahoo (2014) and Creswell (2014), the research design should be chosen based on its suitability to achieve the answer to the proposed research question. To obtain the quantitative data required to test the hypothesis, the research adopts a descriptive cross-sectional survey. Descriptive design discovers and measures the cause and effect of relationships between variables (in this case the influence of caring for the elderly on caretaker’s health). The design will be cross-sectional because the data will be collected at a specific point in time as opposed to studying a phenomenon over a long period of time (Dannels, 2018; Bernard & Bernard, 2012).

Target Population and Sample

The study participants (population) will comprise adults aged above 65 years who live in Lorain County in Ohio, are suffering from psychological disorders and who are being taken care of by a caregiver. A sample has been described as a smaller group or sub-group from the accessible population, selected to represent the whole population (Creswell & Creswell, 2017; Parahoo, 2014). For this study, the sample will be drawn from among pairs comprising an elderly individual and a caregiver. The actual sample will be drawn once a sampling frame has been obtained. Sampling procedures will rely on a combination of random and snowballing methods of sampling.

Procedures for Data Collection and Data Analysis

Homes and hospices caring for the elderly persons who suffer from psychological disorders will be contacted and invited to participate and written consent will be sought. Elderly candidates will then be identified with the help of the health attendants from the facility. Letters of notification will then be given to the caregivers of the identified individuals. Every elderly person whose caretaker consents to participate in the study will then be issued with the data collection instruments for data capture. Filled questionnaires will then be collected for coding and analyse.

Instruments

The survey methods for data collection will include self-administered questionnaires and a review of clinical records. Several types of questionnaires will be adapted for this study. The Zarit Burden Interview (ZBI), will be used to measure caregivers’ burden while the Neuropsychiatric Inventory Brief Questionnaire Form (NPI-Q) will be used to evaluate the psychological disorders of the elderly persons under care. Additionally, a researcher developed questionnaire will be used to obtain data on the demographic characteristics of the elderly and their caregivers.

The Zarit Burden Interview was developed in 1985 by Zarit, Orr and Zarit (1985) and used to measure the burden of caregivers for individuals with dementia, cancer and brain trauma patients and most other complications associated with old age with 22 items used to determine the burden level on health, personal, social and financial wellbeing of the caregiver. Each of the items has five-point Likert-scale like scale from never/not at all (0) to extremely/nearly always (4). The burden score is obtained by summing up the scores in individual items. The degrees of burden can be categorized into little or no burden (0-20), mid-to-moderate burden (21-40), moderate-to-severe burden (41-60), and severe burden 61-88). This instrument has been chosen because of its high consistent reliability with a Cronbach’s alpha coefficient of .92 (Herbert, Bravo & Preville, 2000).

The second questionnaire – the Neuropsychiatric Inventory Brief Questionnaire Form (NPI-Q) – is a self-administered questionnaire that has 12 items assessing various physical and psychological states of the care recipient and the level of distress each state gives the caregiver. It was developed by Cummings et al. (1994) and has an inter-rater reliability range of 93.6% to 100%. The third questionnaire will be one developed by the researcher to capture the demographic data of respondents. [What format will this third questionnaire use? Will caregivers check boxes? Fill in blanks? Will the Likert scale be used again? Give more details about the nature of this third questionnaire.] This information will be used in assessing the physical and economic burdens borne by the caregivers.

Study Location

The research will be carried out in Lorain County, Ohio. The population of elderly persons (65 years and above) in Lorain County stands at 13.54% of the population (Population Demographics for Lorain, Ohio, 2019). [In APA, if using a title in a citation, you should format the title according to regular APA rules. For example, book titles should be placed in italics and article titles should be in quotes.] In 2015, Lorain County adults were responsible for providing regular care or assistance to different categories of the population with the percentage of assistance provided for an elderly parent or loved one standing at seven percent (Lorain County, 2016). [I’m not quite sure what the previous sentence means, or how it relates to your research. Was there a particular law in place in Lorrain County about assisting elderly family members? Develop this idea more so that it is clear and relate it to your research question in particular.]

Data Analysis

Quantitative techniques will be used for data analysis. Once the data collection instruments have been returned, they will be checked for completeness in readiness for analysis. The data from the questionnaires will be coded and for ease in computation of descriptive and inferential statistics with the help of a statistical analysis tool such as Statistical Package for Social Sciences (SPSS). Data will be analyzed and reported using descriptive statistics such as percentage, mean and standard deviation. Caretaker burden analyses will be done and measures of association between the dependent and independent variables determined using Mann Whitney U and Spearman’s Rho correlation analyses.

Ethical Considerations

Ethical approval for this study will first be obtained from the university, after which the data collection will commence. Ethical approval for this study will first be obtained from the university, after which the data collection will commence. [Avoid repeating the same sentence twice.] Homes and hospices caring for the elderly persons who suffer from psychological disorders will be contacted and invited to participate and written consent will be sought. The data collection tools will be delivered to the participating homes and health care agencies for data capture and later collected.

References

Bernard, H. R., & Bernard, H. R. (2012). Social research methods: qualitative and quantitative approaches. London: Sage.

Creswell, J. W., & Creswell, D. J. (2017). Research design: qualitative, quantitative, and mixed methods approaches. New York: Sage publications.

Cummings, J., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. & Gornbein, J. (1994). The neuropsychiatric inventory: Comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308-2314.

Dannels, S. A. (2018). Research design. In G. R. Hancock, L. M. Stapleton, & R. O. Mueller (Eds.), The reviewer’s guide to quantitative methods in the social sciences (pp. 414-428). London: Routledge.

Gelo, O., Braakmann, D., & Benetka, G. (2008). Quantitative and qualitative research: beyond the debate. Integrative psychological and behavioural science, 42(3), 266-290.

Herbert, R., Bravo, G. & Preville, M. (2000). Reliability, validity, and reference values of the Zarit Burden Interview for assessing informal caregivers of community-dwelling older persons with dementia. Canadian Journal on Aging, 19494-507.

Lorain County. (2016). Lorain County Community Health Assessment.

Parahoo, K. (2014). Nursing research: principles, process and issues. London: Macmillan International Higher Education.

Population Demographics for Lorain, Ohio. (2019). Retrieved February 22, 2019, from Suburban Statistics: Population Information and Statistics From Every City, State and County in the US: https://suburbanstats.org/population/ohio/how-many-people-live-in-lorain

Watson, R. (2015). Quantitative research. Nursing Standard (2014+), 29(31), 44.

Zarit, S. H., Orr, N. K., Zarit, J. M. (1985). The hidden victims of Alzheimer’s disease: Families under stress. New York University Press, New York.

 
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