qualitative portfolio

100112120 Qualitative Portfolio. Mathew Mark Aspey

Theoretical Critique.

Critically Evaluate the use of Qualitative Methods in Health

Psychology Research.

Word Count = 1,495 words.

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Theoretical Critique.

Critically Evaluate the use of Qualitative Methods in Health Psychology

Research.

Qualitative researchers suggest that in order to fully analyse and

explain behaviour: figures and statistics simply don’t examine behaviour in

enough detail to achieve these goals. The concern of qualitative research is

therefore, meaning, as researchers are interested in how people make sense

of the world and more importantly how they react to situations Bannister,

Burman, Parker, Taylor & Tindall, 1994).

This is particularly important with regards to health psychology,

particularly with regards to chronic illnesses, as it is often the case that patient

experiences differ from case to case. Therefore a much more individual

approach is required in order to fully understand what is like, for the

individual, to experience these conditions.

Unlike quantitative research, which uses statistics to examine the

incidence of a an event in order to establish population norms, qualitative

research delves much deeper by attempting to gain greater understanding of

an event by exploring it within its contextual setting. Finch (1986) suggested,

“Qualitative research is taken to encompass techniques which are not

statistically based, but are especially suited to small-scale analysis, and in

which the researcher gets to know the social world being studied at first hand”

In the case of quantitative research, there is a heavy emphasis on

using statistics and manipulating variables in order to predict behaviour. The

point of qualitative research, however, is to disregard the shackles of

preconceived variables and attempt to describe and explain events, which

occur naturally within the participant’s own environment.

Psychologists in favour of quantitative research may argue that

qualitative research takes “insufficient account of the need for scientific

replication of data” (Morgan, 1996). That is to say that qualitative research

does not adhere to the criteria, which must always be met when conducting

‘scientific research’. The main focus of this argument rests on the lack of

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reliability found qualitative research; whereas quantitative researchers can

settle disagreements over data by looking at the objectivity provided by

statistics, qualitative researchers, however, to produce the same

interpretations of subjective ‘opinions’ expressed within their data (Morgan,

1998).

Qualitative researchers, on the other hand, suggest that ‘objective

reality’, as proposed by Morgan (1996), is unattainable. They suggest that

qualitative research provides understanding of the human mind, whilst taking

into account the changeability of the social world (Cooper and Stevenson,

1998). Furthermore, Burt and Oaksford (1999) suggested that the ‘scientific

methods’ of quantitative research tend to focus on areas where “theories can

be can be built, tested and applied”. Quantitative research, therefore, ignores

areas that are not easily grafted to objective methods. Qualitative research

provides a much more tangible method of investigating such areas.

There are many advantages to using qualitative research with regards

to Health Psychology. Qualitative research brings much insight into the field

as it enables researchers to gain understanding of health issues that in most

cases are highly specific to the individual. Quantitative research approaches

health research as though all sufferers of respective illnesses share the same

experiences with may be predicted and manipulated. Qualitative research

shows that this is often not the case, the symptoms of illnesses may be

largely generalisable across patient populations, but it is often the case that

people’s interpretation and understanding of their symptoms can vary greatly.

Qualitative research provides patients with a platform on which to voice their

experiences so that greater understanding may be gained.

With regards to healthy behaviours, there have been many models

developed in order to predict the likelihood that people will engage in specific

behaviours, such as the Theory of Planned Behaviour. The success of these

models can be measured statistically using quantitative research. Qualitative

methods investigate behaviour in great detail, with the use of subjective

information, in order to gain the individual’s perspective and attitudes, which

can often be the driving force in most behaviour. This can therefore be used

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to help researchers investigate why some models may be more successful at

predicting healthy behaviours than others within different health settings.

The data gained from qualitative research is highly rich in detail and

topics may often come out of the research that the researcher may not have

thought of. Therefore the use of qualitative methods may be used in order to

explore health issues in greater detail and perhaps identify new avenues of

research, which may enhance our understanding further.

With regards to debilitating illnesses, it may be the case that an elderly

person who is house bound, will experience very different emotional and

psychological responses than a much younger person, who may have bills to

pay and a family to provide for. Quantitative research may find it difficult to

account for this, particularly in cases where illnesses, such as Parkinson’s

Disease (PD), where the vast majority of sufferers are elderly. The individual

nature of qualitative research takes into account the context in which

behaviour is occurring, in order to account for these issues of under-

representation within research.

In spite of these many advantages to the use of qualitative methods,

there are still many quantitative psychologists who remain sceptical about its

validity as a robust methodology. This is mostly due to the many drawbacks

relating to conducting qualitative research.

Qualitative research can often be extremely time consuming,

particularly with regards to research that employs interview methodologies,

whereby data must be transcribed and subsequently analysed. As a result of

this, they can also prove to be rather expensive to administer due to the

extensive labour that must be implemented on the part of the researcher,

whom may often require a research assistant in order to share in the process

of transcription.

Qualitative research often proves to be rather difficult to replicate, this

is largely due to the fact that it deals with highly personal and individual

experiences that they may become difficult to apply to other participants who

may have different experiences with the same illness. This is a common

phenomenon with degenerative diseases such as PD whereby one patient

may experience tremors along with bradykinesia and muscle rigidity, another

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patient may experience bradykinesia and muscle rigidity but have absolutely

no experience of the tremors. This will inevitably make it difficult to make

assertions towards all PD patients based upon the testimony of a few

individual’s.

Due to the intensity of the information being gathered, along with the

aforementioned constraints upon time and resources, it is much more

practical to conduct qualitative research using very small sample sizes. This

makes it extremely problematic when attempting to generalise the findings to

a population based upon individual accounts.

With regards to the methods in which qualitative data is collected, it is

commonly upheld that researcher biases are built-in and therefore are often

unavoidable in many cases. Qualitative research can often become a

collaborative effort between the researcher and participant. In order to gain

the most detailed information possible, researchers may ask questions that

may steer the conversation towards certain points that the researcher is trying

to investigate in greater detail.

It is important, for the advancement of qualitative research, that all

research conducted in this area is conducted in the correct, robust manner.

Lincoln and Guba (1985) suggested four main criteria for producing valid

qualitative research: Credibility (accurate representations of the participant’s

perspective), Transferability (producing findings that are not only specific to

the context in which they are found), Dependability (reliability, taking into

account contextual changes) and Confirmability (minimising researcher bias

in the interpretation of data). Looking at these criteria, it is clear that there is

great importance on qualitative research representing it’s participants in an

accurate manner as inaccurate representations could then lead to us having

an inaccurate understanding of the subject. This could potentially be harmful

to the reputation of qualitative research.

Silverman (1993) stated that “… methods and methodologies aren’t

true or false, good or bad, rather they are more or less useful dependent upon

the aim of the research.” This suggests that there is air of futility in trying to

argue for one method being better than the other, it is therefore much more

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beneficial to select the research method that would provide the most useful

information with regards to the research aims.

To conclude, in many cases it may be beneficial to collaborate the use

of qualitative and quantitative measures in a symbiotic relationship in order to

attain maximum information about behaviour, as each method is appropriate

to different phases of research. In support of this, Nicholson (1995) stated that

when qualitative research is conducted well it is “as scientific as quantitative

psychology” and that employing the use of both techniques in their respective

settings, “is more likely to enhance understanding of the issues being

investigated than hinder them”.

These differing methods of research may help guide one another in

delving much deeper into health issues, quantitative data may be used in

order to map out specific questions which may be tackled in greater depth

using qualitative data and likewise, qualitative research may be employed in

order to produce pilot data, which may then guide qualitative data collection.

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References.

Bannister, P., Burman, E., Parker, I., Taylor, M. & Tindall, C. (1994). Qualitative Methods in Psychology: A Research Guide. Buckingham, Open University Press.

Burt, K. & Oaksford, M. (1999). Qualitative methods: Beyond beliefs and desires. The Psychologist, 12, 332-335.

Cooper, N. & Stevenson, C. (1998). Qualitative research: ‘New science’ and psychology. The Psychologist, 11, 484-485.

Finch, J. (1986). Research and Policy: The Uses of Qualitative Methods in Social and Educational Research. Falmer Press. 1986.

Lincoln, YS. & Guba, EG. (1985). Naturalistic Inquiry. Newbury Park, CA: Sage Publication

Morgan, M. J. (1996). Qualitative research: A package deal? The Psychologist, 9, 31-32.

Morgan, M. J. (1998). Qualitative research: Science or pseudo-science? The Psychologist, 11, 481-483; (& the Postscript, p. 488)

Nicholson, P. (1995). Qualitative research, psychology and mental health: analysing subjectivity. Journal of Mental Health, 4, 337-345.

Silverman, D. (1993). Interpreting Qualitative Data. Methods for Analyzing Talk Text and Interaction. Sage. London. 1993.

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http://books.google.com/books?hl=en&lr=&id=2oA9aWlNeooC&oi=fnd&pg=PA5&sig=GoKaBo0eIoPy4qeqRyuozZo1CqM&dq=naturalistic+inquiry&prev=http://scholar.google.com/scholar%3Fq%3Dnaturalistic%2Binquiry%26num%3D100%26hl%3Den%26lr%3D


Completed Analysis.

“The Gift that Keeps on Taking”: A Young Man’s Experience of Being

Diagnosed with Young Onset Parkinson’s Disease whilst Living in

the public Spotlight.

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Word count = 2,441 words.

“The Gift that Keeps on Taking”: A Young Man’s Experience of Being Diagnosed with Young Onset Parkinson’s Disease whilst Living in the

public Spotlight.

Method: -

Data Collection: -

An extract was used from the book, ‘Lucky Man: A Memoir’ by Michael

J. Fox; in which he describes his experiences with Young Onset Parkinson’s

Disease (YOPD), from dealing with the initial diagnosis through to living with

the disease and having to adapt to it’s symptoms.

Participant: -

At the beginning of the extract, Michael is a thirty-one year old

Hollywood actor at the height of his movie career. He has a wife and an infant

son and a promising future ahead of him until he is diagnosed with

Parkinson’s Disease. The extract chronicles his journey from the initial

diagnosis, through periods of denial, anger, depression and escapism, to the

point where he is beginning to accept his condition and deal with it

constructively. As the extract is taken from the participant’s autobiography,

which has been published for the purpose of public viewing, it is not

necessary to protect anonymity throughout this analysis.

Procedure: -

An extract from pages 140 – 181 was analysed using Interpretative

Phenomenological Analysis (Smith, 1996a, 1999). The extract was read and

re-read numerous times in order to gain an in-depth understanding of the

writer’s account. The process used was identical to that used by Bramley and

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Eatough (2004). During this process, the researcher made notes of any points

they found interesting and produced their own interpretation of what was

being said and picked out relevant quotations from the text in order to

highlight these interpretations. These quotes were then coded invivo, using

examples from the text e.g. quotes that related to solitude were coded under

the heading ‘Solitude’. These were then listed and grouped together in order

to produce Sub-ordinate Themes; these are clusters of quotes, which may

share a common theme, e.g. quotations that shared commonalities were

clustered in order to form sub-ordinate themes such as solitude and self-

loathing. These sub-ordinate themes were then listed and grouped together

further in order to create Super-ordinate Themes, which are clusters of

themes, which may share a similar topic of interest, e.g. the sub-ordinate

themes; ‘Solitude’ and ‘Self-loathing’ are clustered in order to form the super-

ordinate theme; ‘Isolation’. A master table was produced in order to show the

link between quotations and themes within their designated sections (as

shown in Table 1).

Findings: -Table 1: Quotations and their emerging themes throughout the extract: -

Super-ordinate Themes

Sub-ordinate Themes

Quotations Page Line

1. Denial 1. Avoidance 1. “colossal mistake” 141 92. “reasons to disqualify myself” 141 273. “hadn’t (…) surrendered my denial” 147 164. “defy the odds (…) magically

disappearing”147 20

5. “threw myself into a maniacal fitness regime”

153 9

6. “(…) plotted ways to busy myself (…)” 163 197. “don’t I pay someone to take care of this” 167 168. “if I cant fix it, I don’t even want to talk

about it”179 32

2. Alcoholism 1. “when I was drunk, it was all a little easier to ignore”

156 35

2. “(…) ally in my struggle (…) yet another adversary”

160 14

12. Distress 1. Fear 1. “I was losing my franchise” 146 24

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2. “exasperation, frustration and fear were my only companions”

147 27

3. “was I really ready for life without anesthesia?

161 26

4. “fear-based agenda” 162 32

5. “afraid to leave my artificial womb” 170 8

6. “a little boy who’d rather die than admit how scared he was”

175 5

7. “my anxiety was liquid” 176 2

8. “would you love me if you knew I’m afraid (…) about the future?”

180 21

9. Career worries

1. “PD was going to rob me (…) as an actor” 153 24

10. Anger 1. “pissed off at the guy (…) fate was mine” 141 21

2. “acceptance didn’t come without flashes of anger and pain”

177 31

3. “I would punch (…) until I raised bruises” 177 33

4. “no one was to blame (…) project that onto everyone else”

180 27

27. Isolation 1. Solitude 1. “drinking was now about isolation and self medication”

155 18

2. “the distance that my behaviour was opening (…) frightened me “

156 26

3. “you don’t understand” 156 314. “I was still isolating myself (…) turmoil that

I could not comprehend”163 11

5. “our deepening emotional distance” 163 16

6. “no, I’ll get through this on my own” 168 33

7. “the bath tub became my refuge, my hiding place”

169 24

8. “I sure as hell didn’t want company” 170 259. “bad enough I had allowed PD to own me,

(…) I had made them slaves to it as well”180 3

10. Guilt 1. “I put a lot of pressure on a four year old (…)”

171 24

11. Self Loathing

1. “disappoint my family and myself” 170 9

2. “”does she still love me?” and if she did, “how is that possible?””

171 18

13. Hiding Parkinson’s Disease

1. “keep anyone else from noticing” 150 9

2. “the good news was, now I could hide it” 150 27

3. “even as I was growing sicker, (…) healthier than ever”

153 33

45. Labelling 1. Labelled As 1. “forever be locked into a prognosis” 146 5

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as PD Sufferer

Parkinson’s Sufferer

2. “my most trying personal experience reduced to a common laundry list (…)”

146 13

2. Identifying Other Sufferers

1. “I observed what seemed like millions of people with symptoms (…)”

142 14

2. “I tried to remember (…) might have been affected”

143 7

50. Positive Steps

1. Taking Control

1. PD’s brutal assumption of authority (…) still have sovereignty”

160 23

2. “I did, indeed, need help and was ready to accept it”

161 22

3. “thankfully, something deed inside would not allow me to quit”

174 31

4. “I didn’t have to hide in the bath tub anymore”

177 8

5. “claim my Parkinson’s diagnosis” 177 306. “it came down to showing up for my life

(…)”181 7

7. Finding Direction

1. “(…) accounting of where I was in my life (…)”

164 9

2. “I could find some peace, or (…) where to turn next”

171 3

3. “getting results” 176 17

4. “I made a commitment to it” 176 325. “scheduled an appointment myself” 178 36. “beginning to accept my diagnosis” 181 3

13. Finding Peace

1. “the only reward I sought was relief” 174 232. “(…) freed me up to live the rest of my

life”177 2

3. “rediscovering the shower” 177 114. information helped chip away at my

uncertainty and sense of isolation”178 29

68. Support 1. Support Network

1. “she, along with an ever-widening circle of friends (…) live a life without alcohol”

162 1

2. “no red flags warning me that my trust had been misplaced”

176 25

3. “Sam’s going to love being a big brother” 181 17

4. Asking For Help

1. “I have a drinking problem (…) if you know somebody I could talk to (…)”

161 9

2. “I just couldn’t handle this by myself any more”

172 3

6. Vulnerability 1. “this time I didn’t have a clue where to start”

174 26

2. “find myself this beaten down and vulnerable”

174 29

3. “little boy who’d rather die than admit how scared he was”

175 5

4. “defenceless, as if all my skin had been peeled away”

176 6

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Analysis: -The following analysis explores Michael’s personal experience of

Parkinson’s Disease (PD), via the in-depth exploration of one of the six super-

ordinate themes that emerged. This is theme of ‘Distress’. This theme

illustrates his emotional state throughout the period immediately following his

diagnosis and incorporates sub-ordinate themes such as ‘Fear’, Career

Worries’ and ‘Anger’.

Distress: -

Fear: -

When first presented with the news that he has PD, Michael’s first

reaction is fear. When faced with serious illnesses that will inevitably change

their lives, people often go through what is generally considered a textbook

process of coming to terms with their condition. In order to describe this

process, Kübler-Ross (1969) developed a definitive model, ‘The Grief Cycle’,

consisting of five stages: Denial/ Isolation, Anger, Bargaining, Depression and

finally Acceptance. It suggests that when faced with a period of intense grief,

people go through these stages before arriving at the acceptance stage. This

is illustrated throughout the extract. During the period after being diagnosed,

he often reports feeling afraid as he struggles to cope with the implications of

being diagnosed with PD. On page 147, line 27, he says: -

“exasperation, frustration and fear were my only

companions in those early days”

Describing these feelings as his ‘only companions’ suggests that there

is a sense of feeling alone here. In these early days, he has little

understanding of PD or what to expect as it progresses. He rationalises that if

he didn’t fully understand what was happening to him, then how could he

expect anyone else to. At this stage, it appears as though he has resigned

himself to the fact that this is his problem and his alone, which he must deal

with himself. Martinez-Martin (1998) suggested that the frustrations caused by

PD are heavy burdens for both the patient and their family to bear.

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Up until this point, Michael enjoyed a fairly active lifestyle. At the time

of his diagnosis, he is a high profile actor in his early thirties with a wife and

young son to take care of. It may be due to this situation that he reports his

fears towards the prospect of not being able to perform the tasks that he is

used to performing, both in his family life and his professional life. With

regards to his family life, it is clear that he doesn’t know how to tell his wife

that he is afraid; he feels that he must be the strong, patriarch of the family.

He now faces the prospect that one day his condition will prevent him

from providing for his family in the same way that they have become

accustomed, is a huge blow to his masculinity and sense of pride. Gerschick

and Miller (1995) suggest that, when faced with chronic illness or disability,

men are caught between the pressure of dominant masculinity and the

limitations they face as a result of their illness. They suggest that in order to

come to terms with the illness, men must reconcile the pressures of

masculinity with the limitations of the illness. He feels as though he has let his

wife and infant son down and his fear of confirming these suspicions only

serve to fuel these fears. On page 180, line 21, he says: -

“questions like, “does my being sick make you afraid?

Are you disappointed that I’m different now from when

you married me? Are you worried about the future?

would you love me if you knew I’m afraid, I’m

disappointed, I’m worried about the future?” all went

unasked”.

Michael is projecting his own feelings and fears onto his wife. His fears

of what she must be thinking about him appear to be escalated by his

reluctance to address them and discuss them with her. This reluctance is a

result of him being afraid to ask her about her feelings in case his fears are

confirmed; she thinks he is weak, doesn’t love him the same as a result of his

situation, or is disappointed by the man that he has become.

As a way of protecting himself from having to face this, he builds a sort

of self-contained bubble of solitude around himself, which, for him, provides a

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sort of womb-life comfort in order to protect him from facing the prospect of

his own inadequacy. On page 169, line 24 he says: -

“the bath tub became my refuge, my hiding place”

On page 170, line 8, he describes his constant desire to hide himself

from the world and stay in the safety and comfort of his bathtub for hours and

hours: -

“afraid to leave my artificial womb, to go outside

where I could only cause trouble, disappoint my

family and myself. Best, I thought, to stay right here

where I couldn’t fuck anything up”

Here he has established a safe place where he can hide away from all

the disappointment and expectations from his family, as he is sure that if he

attempts to engage in any form of normalcy that he is certain to ‘fuck it up’.

Because he is so reluctant to stray from the sanctity of his ‘artificial womb’, his

fears about disappointing people are never really put at ease and the longer

he distances himself from his loved ones, the stronger his fears and ultimately

his depression becomes. There is a vast body of research into the

relationship between depression and PD; it is becoming evermore apparent

that depression and anxiety share co-morbidity with PD, with great

speculation regarding whether or not depression is in fact a symptom of PD

due to the effects of neuro-degeneration. Research has shown prevalence in

up to 40% of PD patients (Walsh and Bennett, 2001).

Career worries: -

With regards to his professional life, before having PD, he was enjoying

a high point in his movie career. So when he was diagnosed, he began to

worry that the success that he had worked so hard for and the career he had

built over the years was about to be swept from under him. On page 146, line

24, he says: -

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“I wasn’t just losing my brain, I was losing my franchise”

This suggests that he is in a state of panic about the loss of control he

will eventually have over his body, but also the impact this will have on his

‘franchise’; his credibility as an actor. Along with his credibility, PD would also

affect his actual ability to act, as many of the symptoms involve either

involuntary tremor throughout various parts of the body along with diminished

deliberate movements in other areas, particularly in the facial muscles. PD is

a “chronic degenerative neurological ailment” (Bensing et al, 1998) Young

Onset Parkinson’s Disease (YOPD) is the disease that develops in people

under the age of 40. The symptoms of PD include tremor, bradykinesia

(poverty of movement), postural instability, muscular rigidity, and diminished

facial movement, these are known as cardinal symptoms and are common

across all ages. With regards to YOPD, sustained abnormal posturing is also

common, although tremors are uncommon, when they are present, they can

be much more troublesome than in older patients. These physical symptoms,

which would be difficult to disguise, would make a high profile movie career

difficult to maintain. On page 153, line 24, he says: -

“PD was going to rob me of the ability to work in front of

the camera as an actor”

This fear is also compounded by the fact that he has a young family to

provide for; losing his credibility would mean losing the security that he was

striving to provide for them in the future. In order to combat this, he begins to

set up deals that would ensure him well-paid work in exchange for sacrificing

his creative talent. This is described on page 152, line 4: -

“I could simply try to repeat myself, and pray lightening

would strike twice. This meant chasing my tail, playing it

safe by doing formulaic romantic comedies that had a

shot at doing blockbuster business.”

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He later realises that this was not healthy practice in coming to terms

with his condition. On page 162, line 32, he describes his recovery from

alcoholism and how he would use his victories gained from not drinking to

distract himself from having to deal with his condition: -

“I was still pursuing the same fear-based agenda that

had gotten locked into place in the days following my

diagnosis”

He was merely replacing the distraction that alcoholism provided with

the distraction of sobriety. Although his behaviour was, outwardly, a much

more positive step, with regards to the bigger picture he was still hiding from

his disease. In acting out of fear, in both these cases, he was actually causing

more damage to his professional, as well as his personal life, than would

have been caused by PD alone.

Anger: -

In the early days of his diagnosis, Michael reports a great deal of

anger, some of which he aimed towards the diagnosing doctor. After a long

period of denial, convinced that he had been given an incorrect diagnosis, due

to perhaps an error in the tests or just plain incompetence on the doctor’s

part. Once he began coming to terms with the prospect that he had PD, he

refused to follow up with the diagnosing doctor as a way of ‘shooting the

messenger’. On page 141, line 21, he says: -

“I was plain pissed off at the guy for having the balls

to suggest such a fate was mine”

Due to his somewhat meteoric rise to fame, Michael was not used to

things not going his way and it is easy to become accustomed to that sort of

lifestyle. He, therefore, found it difficult to come to terms with what he

describes as “the ultimate no”. In his initial state of shock at his diagnosis, he

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needed to be able account for his anger in some way. Therefore his anger

was indirectly placed upon this doctor, and he would require a second and

third opinion in order to reveal his ‘colossal mistake’.

He discusses how his anger was not aimed at anyone in particular, he

didn’t feel the need to blame someone, moreover, he felt betrayed by life; that

this had happened to him. This began to affect his relationships with the

people closest to him. On page 180, line 27, he says: -

“no one was to blame for my disease, not even

myself, yet it left me with a sense of betrayal – and

in time, I came to project that onto everyone else,

even the person closest to me”

He didn’t feel like the people in his life had betrayed him, but that life

itself had somehow turned its back on him, leaving him with nothing but

anguish. This bitterness towards life spilled out into his interactions with

people until his feelings of betrayal became projected onto his loved ones,

making it seem as though he was blaming everyone else for his condition.

Throughout the extract, Michael takes the reader on a journey down his

road towards coming to accept himself as a sufferer of PD. Even when he

finally does accept that this is his life and it was actually happening to him,

this realisation was met with great anger and emotional pain. On page 177,

line 31, he says: -

“acceptance didn’t come without flashes of anger

and pain, psychic as well as physical”

The physical pain that Michael is experiencing becomes a great source

of emotional pain for him, as the symptoms of PD are so persistent and

continuous, it is difficult for him to find distraction from them, which became a

source of frustration for him.

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As his anger was generally not aimed towards anyone in particular, it

was often the case that in his frustration he would direct his anger inward, or

more directly, at the manifestations of the disease. On page 177, line 33,

when recounting his sessions with his psychologist, he recalls her observation

of how he would deal with his symptoms at that stage: -

“when my arm would tremor violently during

sessions, I would punch it with my clenched fist –

sometimes pummelling it until I raised bruises”

This suggests a great deal of frustration at his inability to control his

own body. The fact that he is displaying this behaviour in front of a third party

may suggest that he was perhaps embarrassed by this as he is willing to

engaged in somewhat desperate behaviour in order to stop these symptoms

from occurring by allowing his anger to manifest itself into violence towards

his PD. In this case the trembling arm is the representation of his entire

disease and he is releasing his anger upon the representation of his disease

as a whole.

In summary, it may be postulated that Michael went through what may

be considered to be ‘text book’ reaction to the initial diagnoses of a major

chronic disease such as PD. Based on the accounts he gives within the

extract, it may be the case that his particular reaction had been exacerbated

by his extremely high profile at the time, along with the pressure that come

with that status.

His journey through PD was not an easy one by any means, the extract

suggests that he was on the verge of, if not in fact having, a nervous

breakdown when faced with the prospect of his happy, successful life being

taken away from him. His journey to acceptance required him to hit rock

bottom in many respects, as he had to face losing the things that really

mattered to him, such as his family, to make him realise that what he thought

he was losing was not all that important in the wider picture than he’d initially

thought.

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References.

Bramley, N. & Eatough, V. (2005). The experience of living with Parkinson’s disease: An interpretative phenomenological analysis case study. Psychology and Health, 20(2): 223–235

Fox, M. J. (2002). Lucky Man: A Memoir. London: Edbury Press.

Gerschick, T. J. & Miller. A. S. (1995). Coming to Terms: Masculinity and Physical Disability. In Sabo, D. & Gordon, D. F. Men’s Health and Illness: Gender, Power, and the Body. (eds). Pp. 183–204. Thousand Oaks: Sage.

Kübler-Ross, E. On Death and Dying. Macmillan, NY, 1969. Retrieved on Tuesday 6th January 2009 from http://changingminds.org/disciplines/change_management/kubler_ross/kubler_ross.htm

Martínez-Martín, P. (1998) An introduction to the concept of “quality of life in Parkinson’s disease”. Journal of Neurology, 245, S2–S6.

Reese, S. Young-Onset Parkinson's Disease Information & Referral Center. American Parkinson Disease Association. Retrieved on Tuesday 6th January 2009 from http://www.yopa.org/page/page/1702947.htm

Schreurs, K. M. G., De Ridder, D. T. D. & Bensing, J. M. (2000). A one-year study of coping, social support and quality of life in Parkinson’s Disease. Psychology and Health, 15, 109-121.

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http://www.yopa.org/page/page/1702947.htm

http://changingminds.org/disciplines/change_management/kubler_ross/kubler_ross.htm

http://changingminds.org/disciplines/change_management/kubler_ross/kubler_ross.htm


Smith, J. A. (1996a). Beyond the divide between cognition and discourse: Using interpretative phenomenological analysis in health psychology. Psychology and Health, 11, 261–271.

Smith, J. A., Jarman, M., & Osborn, M. (1999). Doing interpretative phenomenological analysis. In: Murray M., & Chamberlain K. (Eds.), Qualitative health psychology: Theories and methods, (pp. 219–240). London: Sage.

Walsh, K. & Bennett, G. (2001). Parkinson's disease and anxiety. Postgraduate Medical Journal, 77, 89-93.

Ethical Discussion.

Discussion of Ethical Issues Involved in ConductingQualitative Research.

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Word Count = 724 words.Discussion of Ethical Issues Involved in Conducting

Qualitative Research.

When conducting qualitative research, there are many ethical issues

that must be taken into consideration. Ethical guidelines are in place in order

to protect participants, to ensure that the research that psychologist conduct

does not put them at any risk of either physical or psychological harm. With

regards to psychological research, the British Psychological Society (BPS)

lays out ethics, in this country. The BPS requests that all research proposals

are presented before an ethics committee, who must then approve of its

methodologies before any research may be administered.

Ethical guidelines request that researchers always obtain consent from

participants and in cases where it is possible, informed consent must also be

obtained. This is to ensure that participants are aware of the purpose of the

research and fully consent to the use of their results within the research

findings. When obtaining consent, it is also important to give the participant

the right to withdraw from the study at any time they choose. If a participants

requests to withdraw after they have provided data, then it is important that

researchers either hand all copies of their data back to them or allow them to

witness the data being destroyed.

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In some cases, it may be absolutely essential for the participants to

mislead their participants in some way. Here, it is important for researchers to

make the study as ethically sound as possible, to ensure that the participant

does not feel uneasy about participating once they are informed of the actual

purpose retrospectively. It is also very important to debrief participants, in

order to let them know the exact purpose of the research, as well as what the

research found and how their data contributed to the overall findings.

It is also important to ensure that participants are granted anonymity

within the research data, particularly in the case of qualitative interviews,

where participants may be divulging highly sensitive and personal information

about themselves. It is therefore important to ensure that participants may not

be identified in any way from their data, this may involve allocating them an

anonymous participation number and taking out any information that may

reveal their identity.

Finally, and perhaps most important of, is ensuring the safety of

participants at all times. This can be achieved by ensuring that none of the

question asked will be particularly upsetting to them, this is particularly

important when studying health issues such as illness. Health and safety risk

assessments must be completed to ensure that participants do not find

themselves in an environment in which they may incur physical harm also.

With regards to the research that I conducted; the semi-structured

interview regarding general health issues and the media critique, there were

many ethical issues that I had to take into account.

In the case of the media critique, I used an autobiography, which had

been published for public reading. It was therefore unnecessary to ensure

anonymity, as the writer intended the information to be viewed by the general

public. Had the information have been gleaned from a health discussion

forum, it would have been important to gain consent as people write in forums

under the understanding that they are sharing their experiences with other

sufferers and therefore do not expect their information to be viewed by people

outside of that population. It was also unnecessary to ensure confidentiality,

as the information was a story that the writer had decided to share with the

world prior to my using it within my research.

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In the case of the interview, I was sure to obtain fully informed consent

from the participant, who was completely aware of their right to withdraw from

the study. The questions that were asked were general inquiries about what

they considered to be a healthy lifestyle, and the responses were more or less

participant driven so there was no way that the questioning could cause any

psychological harm in any way. The participant was also allowed to listen to

the recording of their interview and read through the transcript and was happy

that they had not been misrepresented in any way. The participant was also

given complete anonymity as their transcripts were coded with an anonymous

participation number, which only I was aware of and all distinguishing

statements, if any, were removed from the transcript.

Word Count = 724 words.

Reflective Account.

Reflection and Reflexivity on the Experience of Conducting

Qualitative Research.- 24 -



Reflection and Reflexivity on the Experience of Conducting Qualitative Research.

When I was given the assessment criteria for this qualitative portfolio, I

wasn’t sure what I’d have like to research or how I would research it. In

honesty I found myself acting rather tentatively to whole process, I wasn’t

really that familiar with conducting qualitative research, and the few times that

I had, I never really enjoyed it, or was particularly interested in it for that

matter.

I knew that for the interview piece, I wanted to conduct a semi-

structured interview focusing just on general aspects of a healthy lifestyle, I

didn’t really have a particular research question in mind at this point, I was

more interested in seeing what kind of topics came out of the interview when

a participant was given a wide scope, in order to generate their own idea of

what a healthy lifestyle entails. I knew the participant very well and have

interviewed her for a project before so I was aware that she would provide he

with very detailed answers.

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The media article, I knew that this would be a lot trickier. I started to

look around the Internet for media articles and forum discussions, but nothing

really struck my interest. I also felt somewhat uncomfortable with the whole

idea of ‘lurking’ and taking strangers accounts without any form of

participation or consent on their part. I have, however, been interested in

Parkinson’s Disease for quite some time now and a forum discussion I found

was related to this topic. Although I was not particularly engaged by the

discussion, it made me think back to a couple of years ago when I read an

autobiography by Michael J. Fox, in which he recounts, in great detail, his

experience with Parkinson’s Disease. So I thought it would be very interesting

for me if I used an extract from the book to investigate Parkinson’s Disease

from the personal perspective of one patient.

I found this much easier to use as research, as I was using an extract

from a book which had been published, and which I had bought myself. This

was not a random patients experience that they had decided to share with a

group of fellow patients, in an effort to gain their own understanding of their

illness. This was a global celebrity who had decided to she his experience

with the whole world, in an attempt to raise public awareness of an illness that

affects so many, but gets so little attention.

I decided to conduct an Interpretative Phenomenological Analysis (IPA)

on the extract, as I felt this would be most appropriate given the vast amount

of information I was dealing with. As I re-read the extracts for the first time, I

began to realise just how raw, and detailed account it actually was. I quickly

began to build a picture of the many themes that were present within the text

and how they were relevant to what I wanted to find. I found it quite amazing

to discover how the words in the text were beginning to guide me research, as

I initially assumed that my research question would guide the themes that I

would take out of the text.

As I began pulling themes out of the text, I decided that it would be

more appropriate, to base my research on his experience during the period

following his initial diagnosis and how that effected him, being in the spotlight.

I found it very interesting to see how the research evolves as more and

more themes emerge and become grouped together, it is almost as though

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you see yourself progressing as a qualitative researcher, as your research

points become stronger. I think that conducting this kind of analysis made the

assessment much more interesting for me as I felt it enabled me to really

engage with the subject matter. This something that my past experience with

qualitative methods has lacked.

As I read through my finished analysis, I feel as though I had become

deep immersed in the subject, it’s clear that I found it to be engaging. Before

conducting this piece of research, I was not at all confident with qualitative

research. I now feel like my ability to conduct research in this area has grown

much stronger.


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