1.1 Identify the theory / framework proposed by the author, and comment on its suitability for the proposed study (2 marks)
The framework proposed by the author is the concept of access: definition and relationship to consumer satisfaction (Penchansky & Thomas, 1981). This framework of access is suitable here because it summarizes a group of specific aspects that accurately describe the fit between the aged care system and the old age people. Based on the elderly people’s satisfaction and convenience, interview was conducted and the distinguishing validity was investigated of these aspects. The outcome provided the strong support between the aged care system giving access and the old age people having access to it. The proposed study is about the old people having access to the community ages care services. The requirements of elderly people and their satisfaction of having access to the services are the core of this study. The interview gave the outcomes of how many people have the access and what were the enablers and barriers all throughout the process of accessing a care service at community aged care centre or My Aged Care. In health care services research and health policy, access is one of the most important and used concept. The specific aspects used in the study are availability, affordability, acceptability, accessibility, and accommodation (Levesque, 2013). To get outcomes, the above mentioned five points are studies. The health care service provider is accessed on these five dimensions and the results are collected on the basis of answers of elderly people. They are interviewed with their consent and full convenience is given to them. They have full right to deny giving the information on their access to the aged care system services.
1.2 Suggest one other appropriate framework (theoretical, policy, strategy or other models) that could apply to that study and describe in what way(s) it could be applied to the work. Provide key author and published scientific reference for any new framework.
One framework used here is the concept of access that is the most important and used concept in the health care services research and health policy. Another appropriate framework that can be used is a population-based conceptual framework for evaluating the role of healthcare services in place of death. This framework was given by Wie Gao, Sumaya Huque, Myfanwy Morgan and Irene J. Higginson. The method used in this framework is the review and the health services model synthesis which is inclusive of the service component impact on end of lifecare outcomes or the service utilization (Gao et al., 2018).Patient socio-demographics, disease-related variables, family and community support and social care also influence place of death, but they are not the focus of this framework and therefore are grouped as needs and other environmental factors. This framework provides the guidance for analyzing to understand the health care services role in the place of death. It identifies the service factors that can be considered so that the end of life care can be improved.
1.3 Outline 2 key ethical considerations that would apply to the proposed study.
The two key ethical considerations that would apply to the proposed study are the nomenclature and consent. Firstly, nomenclature means the interviewer or any person having a conversation with the elderly people should not address them as “pensioner” or “retired”. The use of such words is considered offensive. The first assumption made during the proposed study is that the older people are not different from other adults rather they are just older adults. They should always be addressed as “old people”, “elders” and “older adults” and such appropriate nomenclature should be used. They should not be made to feel that they are dependent on someone or they have altogether a different category now (Gendron et al., 2016). They should be given names and called as the proper adults that are now old. Older adult is the best suited name given to them that does not make them feel offensive. Secondly, their consent should be the most important thing. The information given by them should be freely given and they should not be forced at any cost. Their consent should be there and a consent form should be signed by older adults before they start to answer (Voltelen et al., 2018). Any information taken or tried to be taken without the consent of old people is not considered valid. These are the two key ethical considerations that would apply to the proposed study of old people having access to old aged care services.
1.4 Provide justification(s) of why you identified those particular 2 ethical considerations.
There are many ethical considerations that can be identified while getting the information from elderly people. Extra care is taken of them and all necessary ethical considerations are made when trying to get the information from them. There are many ethical and practical challenges that are associated with carrying out research studies on elderly people and the aged care services given to them (Wood et al., 2013). The consent and the nomenclature were identified as the two key ethical considerations because they are most important as compared with other considerations such as vulnerability, convenience and so on. For nomenclature, the older adults may get offended with them being called as pensioners or retired or elderly people. It is important to respect them the way they want us to and they should not get hurt. The second ethical consideration identified was consent. The consent is one of the biggest ethical issues in obtaining well informed freely given information from older adults.Their consent should be the first priority to the one who is interviewing or trying to get information through any means. The consent form should always be filled by the older adults so that their consent is confirmed. This is so because many elderly people do not give consent on getting the access to their information. It is necessary to make an ‘informed consent’ by giving all the relevant information prior so that the person signing the consent form knows of all the information related to the procedure (Research Basics, 2019).
2.1 Contrast the proposed interview guide questions and prompts, against the proposed study outline, “project design” section, the “procedures for interviews” and list 3 key differences between them (4 marks)
The questions and prompts of the proposed interview guide are different from the proposed study outline, project design and procedures for interviews. One difference between the question of the proposed interview guide and the proposed study outline is the inclusion and exclusion criteria. According to the proposed study outline, the federal government provides funding to those individual customers that meets the assessment criteria only. Whereas, in the proposed interview guide, there are no assessment questions asked for this scheme. There are few eligibility criteria questions asked but that is for the research study. No assessment question for the availability of the government funded has been put up. Also, who do not meet the inclusion criteria are not informed where they have missed it.
The question and prompts of the proposed interview guide is different from the project design for the type of accommodations question asked. For the type of accommodation, four options are given to choose one out of them. They are:
House or unit in the general community
House or unit a lifestyle community
House or unit a retirement village
In the project design, it is clearly mentioned that the inclusion criteria for the project design is that the individuals must be living in community or lifestyle/ retired community. There is no option for any other type of community. So, if the person is living in some other type, he or she will not be eligible for the same. So, Jan Doe must mention that people falling under the category of others are not eligible for the same and the interview will get over for them.
The third difference between the questions and prompts of the proposed interview guide and the procedure for interviews is the time difference. According to the proposed interview guide, the entire process of interview will take up to 60 minutes. But, in the procedure of interview it is mentioned that the interview may take up to 2 hours. The time difference of about an hour is made which is the key difference between the proposed interview guide and the procedures of interview. It is very important for points in the proposed interview guide to adhere to the points mentioned in the project design, proposed study outline and the procedures for interviews and no extra or missing information should be there. The questions and prompts asked in the proposed interview guide here have the question having missed information, second one having an extra option and the third one having a statement of conclusion missing for the participants that are not eligible for the study.These were the three key differences between the questions and prompts of proposed interview guide and the proposed study outline, project design and the procedures of interview. The contrast identified in the proposed interview guide as compared to the proposed study outline, project design and the procedures for interviews require improvement for better interview and its study.
2.2 Based on point (2.1) above, comment on how the proposed interview guide could be improved (4 marks)
After the identification of three key differences each with the proposed study outline, project design and the procedures for interviews, it is found out that the proposed interview guide is not accurate and needs a lot of improvement to match with the three of them. The proposed interview guide must always adhere to the points and instruction mentioned in the proposed study outline, project design and the procedures for interview. The proposed interview guide can be improved by making following corrections:
There are certain guidelines regarding how to form a proposed interview guide. These guidelines must be followed in order to make a good proposed interview guide and which would not require the improvements. It is very necessary to have a good proposed interview guide to carry out the interview process smoothly and effectively. It enables to produce the great outcomes that are error free and in accordance to the proposed study outline, project design and the procedures for interview. It is always advisable to record and transcribe the interviews so that all the points can be considered again and again in the future. The natural limitations of our memory can be corrected with the video recorded and more thorough examination of what the participants said (Harvard Sociology, 2019). To have the qualitative interview, it is important to have a good proposed interview guide. An interview guide that would be proposed just before the interview must contain all the relevant information and the information must be accurate. The questions and prompts must be in accordance with the project design and the study outline. The interview guide should have all the conditions mentioned prior to taking the interview such as the exclusion criteria, inclusion criteria and all the relevant information. It should have the information of the interviewer and why does he want to take the interview. He should mention all his research requirements and should promise to keep all the information confidential. The interview guide should also ask for the consent and should clearly mention that if there is no consent then the participants are not forced to answer the questions. All the information will be taken according to the convenience especially when the interviewees are the elderly people. It should also have the information regarding what the questions will be about so that the consent is the informed consent and the elderly people already are aware of the upcoming questions.
3.1 Identify 2 specific points across the project design where deliberate reflection could be recommended (2 marks)
Across the project design, two deliberate reflections that could be recommended are as follows. I would not put the age bracket as the 65 years and above. The services provided by My Aged Care are the services which should be accessed by all the older adults crossing 50 years of age. The age bracket of 65 years and above is too high and that majorly includes all the elderly people who by this time requirethe service but the older adults of age 50 years and above will have people that might not require the service so my study would have the variety and diversity.
The second deliberate reflection that could be recommended here is that I would provide with the translators who would atleast translate the local languages into English. Here, the inclusion criterion is that the ones who speak English are allowed for further interview otherwise no translator would be provided. I would have provided them with a translator because it would become convenient for all the elderly people who have accessed My Aged Care because their experience would help me study better about my research. The diversity of people speaking different languages would help in studying and researching better as that would cover the larger population.
3.2 Provide justification(s) of why you identified those particular 2 specific points.
The two particular specific points identified are the too high age bracket and the no provision of translator and only the participants who speak proper English are allowed to participate. The age bar has been identified as the deliberate reflection in the project design because while designing a project, one should always keep the bars flexible so that they can cover wide range of population for effective study. To study the use of people’s aged care service, the inclusion criteria should be kept somehow equal to the assessment criteria of the federal government funded aged c are services. This would help in studying almost all of the people accessing the aged care services provided by the government. All of the people living in one country or specific place do not speak the same language so, only including English speaking people will be biased. When government does not apply this barrier of language to the access to aged service to elderly people then even a study should not restrict on the language basis. They should provide with the translator so that the interviews can be translated into English and recorded. According to Federal Government, the elderly individuals who do not speak English also have access to the aged care services. This would widen the area of study and include more people. Flexibility in the inclusion criteria will not only broaden the population on which the study is being conducted, but also give better outcomes. On a whole, it would be convenient to draw the conclusion because that would match to the actual users of aged care services.
Gao, W., Huque, S., Morgan, M., & Higginson, I. (2018). A Population-Based conceptual framework for evaluating the role of healthcare services in place of death. Healthcare, 6(3), 101-107.
Gendron, T. L., Welleford, E. A., Inker, J., & White, J. T. (2016). The language of ageism: Why we need to use words carefully. The Gerontologist, 56(6), 997-1006.
Levesque, J. F., Harris, M. F., & Russell, G. (2013). Patient- centred access to health care: conceptualising access at the interface of health systems and populations. International Journal For Equity In Health, 12(1), 18.
Penchansky, R., & Thomas, J. W. (1981). The concept of access: definition and relationship to consumer satisfaction. Medical Care, 127-140.
Research Basics. (2019). Ethics and informed consent. Retrieved from https://researchbasics.education.uconn.edu/ethics-and-informed-consent/
Harvard Sociology. (2019). Strategies for qualitative interviews. Retrieved from https://sociology.fas.harvard.edu/files/sociology/files/interview_strategies.pdf
Voltelen, B., Konradsen, H., & Østergaard, B. (2018). Ethical considerations when conducting joint interviews with close relatives or family: an integrative review. Scandinavian journal of caring sciences, 32(2), 515-526
Wood, F., Prout, H., Bayer, A., Duncan, D., Nuttall, J., Hood, K., & Butler, C. C. (2013). Consent, including advanced consent, of older adults to research in care homes: a qualitative study of stakeholders’ views in South Wales. Trials, 14(1), 247.
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