Research series: Research and Occupational Therapy *Quantitative research *Grant writing-2

1. Research series:Research and Occupational Therapy*Quantitative research *Grant writing-2 Ay-Woan Pan, Ph.D., OTR/L (U.S.A.), OTC (Taiwan) Associate Professor Department of Occupational Therapy National Taiwan University; Occupational therapist, Department of Psychiatry, National Taiwan University Hospital Adjunct associate professor, Department of OT, Fu-Jen University

2. Philosophical foundation of scientific inquiry • Classicism • Aristotle • Research as a process of going from observations of the natural world to explanation and then back to observation • Theory-observation of natural world • Induction (歸納法） • Deduction（演繹法）

3. Philosophical foundation of scientific inquiry • Modernism • Newton • Correct errors in knowledge • Intuition and creativity in generating theory as necessary process • John Stuart Mill • 4 laws • Agreement • Concomitant variation • Residuals • difference

4. Philosophical foundation of scientific inquiry • Critical Modernism • Theory is a creation of the human mind that makes sense of the world • Thomas Kuhn • Paradigm • Impart meaning • As a schema • Redefine the explanation

5. Philosophical foundation of scientific inquiry • Post modernism • How it is impossible to disentangle the language of a hypothesis from the theoretical system in which it is embedded

6. Post modernism • Wittgenstein • Social constructivism • All knowledge is socially constructed and therefore, relative • Emphasize the right of groups to have their own voice and speak for their own reality • There can be no universals, that absolute truth is an illusion • Promote variety, undermined certainty, promote local, critical thought

7. Summary • Regarding theory • Human creation • First principle is unavoidable • Represent one way of making sense of things • Theorists’ ability to explain the nature world can be improved through research • Ultimate worth, generate solution • Not possible to undertake research without some underlying theory

8. Summary • Regarding research process • Inductive-deductive process • Logic is necessary • All research is embedded in theory • Research does not advance theory toward truth, improve the way

9. Summary • Regarding researches • Impart meaning • Bear all their characteristics on the research process • Part of social community sharing

10. Summary • Regarding the impact of research • Not value free • Tied to particular ideologies • Used for positive ends

11. Research design • Experimental versus quasi-experimental • Single subject design • Field study/naturalistic observation • Survey • Psychometric study

12. Research design • Experimental • Control • Randomization • intervention • Quasi-experimental • Non-randomized

13. Research design • Single subject design • Baseline data • Overtime • Before/after • During alternating period

14. Research design • Field study/naturalistic observation • In actual setting • Qualitative • quantitative

15. Research design • Survey • Large sample • Methods of survey • Psychometric study • Reliability • Validity • Responsiveness • Utility

16. Quantitative • Origin • Astronomy/physics • Assumptions • One objective reality stable overtime across situation • Discover the rules or laws underlying the objective world as a basis for scientific prediction and control • Create theories/test theories

17. Descriptive design • Univariate • Characterize the sample/circumstances • Characterize a problem/phenomenon • Document incidence/prevalence • Norms • Document developmental phenomenon • Document case studies • Frequency • Tendency • dispersion

18. Normative research • e.g., hand strength • Large sample size • Avoid sampling bias

19. Developmental research • Pattern of growth or change overtime within selected segments of a population • Course of disease/disability overtime • Cohort design • Cross-sectional

20. Descriptive case studies • No experimental manipulation • Comprehensive • Lack of control and generalizability

21. Correlational research • Exploratory • Prospective/retrospective • Precursor to regression analysis

22. Group comparison • Probable causality • No design is best for all research questions; each has its advantages and disadvantages

23. Basic experiment • There is one sample that is drawn representatively from one population • There is one categorical independent variable • Study participants are randomly assigned to as many groups as there are conditions to the independent variable

24. Basic experiment • One to one ratio • Randomization • Experiment/control/attention-placebo-usual, standard care • Receive the intervention condition after the experiment is completed

25. Basic experiment • The independent variable is administered as planned • Bleeding • A problem of delivery • A problem of receiving • A problem of enactment

26. Basic experiment • Potentially confounding variables are monitored and otherwise uncontrollable events are equally likely across groups • Confounds, extraneous variables, nuisance variables, source of error, artifacts, source of systematic error

27. Basic experiment • Cannot control • Multi-site/school-year-long • School-based practice • Level of family participation • Community events • Exposure to mass media • Opportunities to sports participation • Growing old • illness

28. Basic experiment • Masking • Blinding • Double • Blind to the group membership when measuring the dependent variable • Blind to group membership when doing statistical analysis

29. Basic experiment • There is one dependent variable on which all subjects are measured or categorized • Validity/reliability • Measure several times • Training • Multiple raters

30. Basic experiment • Masking the judges • Responsiveness • Rating scale structure • Ceiling and floor effect • Identified through field experts • How much difference is required

31. Basic experiment • The experimental hypothesis tested is the probability of a causal effect of the independent variable on the dependent variable within the population • Prediction • Probable causality

32. Start R X O O R

33. S X R O Y O R

34. S R X O R O Y O R Z

35. Evaluating the validity of group comparison designs • Type I error • Natural recovery • Other treatment co-occur • measurement

36. Evaluating the validity of group comparison designs • Type II error • Small sample size • Subtle independent variable • Dispersion • Individual difference • Measurement error • Statistical analysis

37. External validity • Threatened • Artificiality • Unrepresentative sample • Subject selection • Drop out • Careful explanation • Frequent positive communication • Due consideration for the inconvenience

38. Example • Research of QOL for depression

39. Quality of Life in Depression: Predictive Models Quality of Life Research, 15, 39-48, 2006 Ay-Woan Pan, PeiYing Sarah Chan, LyInn Chung, Tsyr-Jang Chen, Ping-Chuan Hsiung

40. Introduction • Etiology • Psychodynamic • Existential • Cognitive-behavioral • Behavioral • Couple and family • Interpersonal relationship • Learned helplessness • Biological

41. Quality of life for depression • QOL was defined by the following index: • life satisfaction, • self-esteem, • general health, • functional status, • socioeconomic conditions, • satisfaction of needs, • one’s experience of life, • self-rated health status

42. Model for QOL in persons with psychiatric disorders • Post et al.: quality of life as health, quality of life as well-being, and quality of life as both health and well-being • Diamond and Becker : QOL needs to be assessed via the client, family and service providers; across time; and across domains

43. Model for QOL in persons with psychiatric disorders • Wilson and Cleary: six independent variables to predict QOL -biological, symptoms, demographics, functions, environment, and general health perception • Hachey and Mercier: three independent variables-individual characteristics, living conditions, and utilization of services

44. Model for QOL in persons with psychiatric disorders • Chan et al.: A predictive model of QOL for severe mental illness in the community containing demographic, clinical, social participation, and self-measured well-being variables.

45. Related factors to QOL • Depressive symptoms, symptom distress • Level of functioning • Social relationship • Insomnia • Gender, education, age • Activity participation • Satisfaction with one’s life • Perceived competence in daily life

46. Framework of the study • Three categories are included in the predictive models: • Clinical variables that reflect the illness aspect such as symptom severity, diagnosis, and onset duration, • Demographics including age, gender, and education of the patients, and • Perceived competence and satisfaction that represents one’s capabilities to engage in activities and satisfaction with performance.

47. Methods-Subjects • Subjects : a psychosomatic ward of a teaching hospital in northern Taiwan from February to May of 2002 in a consecutive order. • inclusion criteria 1) having the admission diagnosis of depression determined by the attending psychiatrists with a diagnostic interview; and 2) the patient’s consent to participate in the study. No exclusion criterion was used. • The patients were admitted to the ward for symptom reduction, functional restoration, and lifestyle adjustment.

48. Methods-instruments • Canadian Occupational Performance Measure (COPM) • Occupational Self Assessment (OSA) • Beck Depression Inventory (II) (BDI-II) • Beck Anxiety Inventory (BAI) • Activities of Daily Living Inventory (ADL) • World Health Organization-Quality of Life –brief version (WHOQOL-BREF)

49. Activities of Daily Living Inventory (ADL) • The inventory includes 12 items covering the basic self-care activities (e.g., grooming and bathing) and the instrumental self-care activities (e.g., medication management and meal preparation).

50. Activities of Daily Living Inventory (ADL) • Preliminary studies examining 267 subjects with and without psychiatric disorders showed that 12 items fit the Rasch measurement model to form a unidimensional construct that all items of the inventory demonstrate acceptable goodness of fit (INFIT MNSQ between 0.6 and 1.4). • The internal consistency of the inventory (Crobach α) is 0.91.