Specific Aims
Disorders associated with the Central Nervous System (CNS) represent some of the major health issues across the globe. In this regard, the current research paper is aimed at underscoring a research proposal that is related to Post Traumatic Stress Disorder (PTSD).
The target population that is in dire need of change in behavior and/or health status is individuals who have Posttraumatic stress disorder (PTSD). The population being studied will be distinguished by the following demographic: African-American/European. The inclusion criteria for participants in the present study is:
- be male;
- self-identify as African-American/European
- be at a minimum age of 18 years;
- have had a history of PTSD related symptoms like anxiety, depression in the last 12 months;
- be drug adductors or abusers.
These individuals engage in several traumatic behaviors which may result in PTSD. These include war, terrorist attacks, sexual or physical abuse, assault, childhood neglect, Natural disasters and the Sudden death of a loved one (Smith & Segal, 2010).
These behaviors may lead to an anxiety disorder that is stimulated by exposure to trauma (Meltzer-Brody et al, 2004). Individuals develop PTSD at a rate of one in four (Meltzer-Brody et al, 2004). There is a need to identify individuals who require a change in the form of remedy or rehabilitation from various corners of health care. Earlier, a study described women attending gynecology clinics. They were evaluated for their clinical history and hygienic conditions which revealed PTSD symptoms. It was found that the majority of women were eligible for considering them under the PTSD category (Meltzer-Brody et al, 2004). The demographic and ethnicity information revealed that they are African American with a mean age of 34 years (Meltzer-Brody et al, 2004). Hence, the target population to be involved in this study would be African American women attending gynecological units at outpatient blocks (Meltzer-Brody et al, 2004).
The exclusion criteria will be set for those patients who are without PTSD symptoms.
Briefly, these criteria include:
- non-African-American/NonEuropean;
- age below 18 years;
- had symptoms unrelated to PTSD.,
- have no history of drug addiction, abuse, assaults
- have not involved in acts that could have lead to trauma in the last 12 months.
Gnanadesikan, Novins, and Beals (2005) reported high-risk PTSD individuals who are American Indian children and adolescents. These are found with a variety of traumatic experiences and sexual trauma. Characteristics like age at first trauma, a number of traumas, sex, and the kind of trauma are considered as they are associated with PTSD (Gnanadesikan et al, 2005). In addition, they are also independent variables described to be associated with PTSD (Gnanadesikan et al, 2005). Therefore, identifying population characteristics is essential in predicting the risky outcome of PTSD.
Hypothesis
With the high rate of PTSD among the African – AmericanIEuropean target group, the best intervention will be the education-based ones that include cognitive therapy, trauma management therapy, stress inoculation therapy, exposure therapy, psycho-education, hypnotherapy and psychodynamic psychotherapy (Robertson, Humphreys & Ray, 2004). This is because of the identifiable flaws in the treatment interventions and particularly the psychodynamic therapy and anxiety treatments of hypnosis which may result to inconsistencies in the treatment techniques (Choi et al, 2010).
Background and Significance
Needs in the target population
Application of the causal inference to the news story
The news article from Science Daily stated that veterans who suffered from post traumatic stress disorder were more likely to suffer from dementia later in life. In this case post traumatic stress disorder precedes dementia.
Changes in the value of A co-vary with changes in the value of B: This particular study, by psychologists at the Veterans Affairs Medical Center, was conducted using a sample of 10,481 veterans whose ages were not less than 65 years, and who had visited the center not less than two times between 1997 and 1999. These veterans were followed until the year 2008. In the course of this period, data on the veterans’ health were collected.
Specifically, the researchers identified veterans who had PTSD, those who had PTSD but lacked injuries sustained from their combat activities, as well as those who had sustained injuries from their combat activities and either had PTSD or lacked it. In order to enable comparisons, the researchers also identified veterans who neither suffered from PTSD nor sustained injuries from combat activities. In general, the researchers found that veterans who had PTSD had double the chances of being diagnosed with dementia in later years as compared to veterans who did not suffer from PTSD.
No other explanation other than A causing B exists: This study strives to show the correlation between post traumatic stress disorder and dementia. It asserts that veterans who suffer from PTSD are also more likely to suffer from dementia in later years. Nevertheless, it seems from the study that PTSD is not the only causal factor of dementia. Indeed, the researchers included other risk factors such as injuries sustained from combat activities and presence of chronic illnesses such as heart-related diseases and diabetes. It therefore seems that there are many variables in the relationship between PTSD and dementia among the veterans. The study therefore violates the third rule of causal inference.
Article 1
“Results of a study reported in the September issue of the Journal of the American Geriatrics Society suggest that Veterans with post-traumatic stress disorder (PTSD) have a greater risk for dementia than Veterans without PTSD, even those who suffered traumatic injuries during combat.
Exposure to life threatening events, like war, can cause PTSD, and there are high rates among veterans. PSTD includes symptoms such as avoiding things or people that remind a person of the trauma, nightmares, difficulty with sleep, and mood problems.
We found Veterans with PTSD had twice the chance for later being diagnosed with dementia than Veterans without PTSD,” said Mark Kunik, M.D., M.P.H., a psychiatrist at the Michael E. DeBakey VA Medical Center, Texas, USA, and senior author of the article. “Although we cannot at this time determine the cause for this increased risk, it is essential to determine whether the risk of dementia can be reduced by effectively treating PTSD. This could have enormous implications for Veterans now returning from Iraq and Afghanistan.”
The study included 10,481 Veterans at least 65 years of age who had been seen at the VA Medical Centre at least twice between 1997 and 1999. Outpatient data were gathered for all identified patients until 2008. Subjects who had been wounded during combat (with and without a PTSD diagnosis) were also identified to provide a group with confirmed injuries and combat experience. A group with two visits, but no PTSD or combat related injuries, was identified for purposes of comparison.
36.4% of the Veterans in this study had PTSD. 11.1% of those with PTSD but not injured, and 7.2% of those with PTSD and injured, had dementia, compared to 4.5% and 5.9% respectively in the non-PTSD groups. These results remained significant after other risk factors of dementia were taken into account like diabetes, hypertension, heart disease, stroke, etc.
Despite the increased risk for those with PTSD, it is noteworthy that most Veterans with PTSD did not develop dementia during the period we studied,” said Salah Qureshi, M.D., a staff psychiatrist and investigator with the Houston VA Center of Excellence and first author of the article. “It will be important to determine which Veterans with PTSD are at greatest risk and to determine whether PTSD induced by situations other than war injury is also associated with greater risk (ScienceDaily, 2010).”
Assessing Needs
The behavioral or health problem of concern
The health problem of concern entails the effortful avoidance and numbing symptoms of post traumatic stress disorder. The research article acknowledges that veterans who suffer from PTSD are also more likely than their counterparts to experience marital instability. The researchers argue that there are disproportionately higher rates of divorce and multiple remarriages among veterans with PTSD than those without the illness. The researchers further argue that couples therapy is important in the treatment of veterans with PTSD as both partners will be actively involved in the process and the partner of the sufferer will grow to better understand her partner.
The Number of People Sampled
In this study, the researchers made use of a sample of six male veterans of the Vietnam War who had been treated for PTSD at the Southeast Louisiana Veterans Health Care Network. The marital partners of these veterans were also included as part of the sample. In total, six married couples were sampled. The inclusion criteria used include: recent diagnosis of PTSD related to combat, disability related to combat and having an intimate partner who was prepared to take part in the study. The exclusion criteria used include: illicit drug dependence and suffering from bipolar or psychotic illness. The mean age of the male participants was 59.2 years while that of their partners was 53.1 years. Four of the veterans were Caucasian and the other two were Black Americans (Sautter, et al, 2009).
Did the results support causal inference?
The results indeed supported causal inference. The results show that the couples who completed the 10 SAT sessions fared much better in the reduction of effortful avoidance and numbing symptoms of PTSD than the couples who did not undergo the 10 sessions.
Article 2.1
Abstract
“This study reports preliminary findings regarding the feasibility and efficacy of a novel couple-based treatment, named Strategic Approach Therapy (SAT), for reducing avoidance symptoms of posttraumatic stress disorder (PTSD). Six male Vietnam combat veterans diagnosed with PTSD and their cohabitating marital partners participated in 10 weeks of SAT treatment. Self-report, clinician ratings, and partner ratings of PTSD symptoms were obtained before the first session and after the tenth session of treatment. Veterans reported statistically significant reductions in self-reported, clinician-rated, and partner-rated effortful avoidance, emotional numbing, and overall PTSD severity. These data indicate that SAT offers promise as an effective treatment for PTSD avoidance symptoms (Sautter et al, 2009, p. 343-349).”
Experimental Research
The behavioral or health problem of concern
The health problem of concern entails mental health problems of children who have experienced a traumatic incident. Such children cannot live full lives because of post traumatic stress disorder related to the traumatic experience. It is thus imperative to identify an effective intervention for such children.
Interventions being contrasted in the study
The interventions being contrasted in the study include: “a 12-session structured program ‘ERASE Stress Sri Lanka’ (ES-SL) and a waiting list (WL) religious class control group” (Berger & Gelkopf, 2009, p. 364).
Data and data collection methods
Data were collected using questionnaires administered by trained volunteers who were not aware of the controlled conditions. Confidentiality was assured in the questionnaires and each participant was given 30 minutes to fill in the questionnaire. The type of data that was collected included: “objective and subjective exposure to the tsunami, experiences of substantial distress, helplessness and horror during the event, major traumatic life events, functional impairment and the number and severity of PTSD symptoms” (Berger & Gelkopf, 2009, p. 365-366).
The findings of the study
The researchers found that students with previous traumatic experience and who were assigned to the ES-EL intervention group recorded substantially lower scores on all the outcome measures than their counterparts assigned to the control group. It was also discovered that participants who showed more PTSD symptoms prior to the intervention gained more benefits than those with few PTSD symptoms. Besides leading to an improvement in the participants’ overall outcome scores, the intervention lacked any detrimental effect on the participants (Berger & Gelkopf, 2009).
Possibility of supporting causal inferences with these results
The results support causal inferences. They show that the ES-EL intervention program significantly reduces PTSD symptoms among children who have experienced a traumatic event.
Article B.2.2
Abstract
- “Background: On December 26, 2004, a tsunami hit the southern coast of Sri Lanka, leaving thousands dead and injured. Previous research has found significant mental health problems among children exposed to major disasters. School-based universal interventions have shown promise in alleviating distress and posttraumatic symptomatology in children and adolescents. This study evaluated the efficacy of a school-based intervention in reducing stress-related symptomatology among Sri Lankan children exposed to the tsunami.
- Methods: In a quasi-randomized controlled trial 166 elementary school students (ages 9–15) with significant levels of tsunami exposure and previous traumatic background were randomly assigned to a 12-session structured program ‘ERASE Stress Sri Lanka’ (ES-SL) or to a waiting list (WL) religious class control group. Students were assessed 1 week prior and 3 months after the intervention on measures of posttraumatic symptomatology [including posttraumatic stress disorder (PTSD) and severity of posttraumatic symptomatology], depression, functional problems, somatic problems and hope.
- Results: This study shows a significant reduction on all outcome variables. PTSD severity, functional problems, somatic complaints, depression and hope scores were all significantly improved in the ES-SL group compared to the WL group. No new cases of PTSD were observed in the experimental group.
- Conclusion: This study adds to the growing body of evidence suggesting the efficacy of school-based universal approaches in helping children in regions touched by war, terror and disaster and suggests the need to adopt a two-stage approach toward dealing with trauma-exposed students, namely, starting with a universal intervention followed by targeted specialized interventions for those still suffering from posttraumatic distress (Berger & Gelkopf, 2009, p. 364-371).”
Significance
The post traumatic stress disorder adversely affects the mental, emotional and psychological health of the sufferers and thus translates into poor quality of life not only for the patients but also their loved ones. PTSD leads to the development of other health problems such as dementia and mental health illnesses for the sufferers. The family members of a PTSD patient also suffer psychologically and emotionally because they have to watch their loved one suffering day in day out. The family also incurs medical expenses through treatment of the patient. If the patient was a breadwinner, it implies that the family loses a source of livelihood. The society is affected by PTSD through the reallocation of resources from productive purposes to the treatment of the PTSD.
The most common solution of dealing with PTSD is medical treatment. However, medical treatment alone is not effective and therefore it should go hand-in-hand with effective interventions. Such interventions may include: a family-based intervention in which the entire family is involved in the management of the PTSD; a couples therapy in which the sufferer and his/her intimate partner are engaged in the process; or a school-based intervention that targets children and adolescents.
An effective intervention not only addresses the pathological issues relating to PTSD but it also improves the general well-being of the sufferer, his/her family and all members of the patient’s community. This helps the community members to understand better the condition and to cope with it more effectively.
Research Design and Hypothesis
Design table
Below is a design table of the project depicting the interrelationships between the variables and outcomes related to Post Traumatic Stress Disorder.
For this study, the independent variables comprise of experimental intervention and the education group. The conditions of PTSD may improve due to the experimental intervention’s use of cognitive behavioral approaches such as anxiety management, reprocessing, removing the sensation of eye movement and exposure therapy. The intervention’s efficacy should have a reduction which is a positive effect on each of the dependent variables that include blood pressure, C-reactive protein and cholesterol levels. Moreover, the participant’s level of work atmosphere should display a positive or adverse effect on his ability to assimilate and incorporate the intervention and its message.
Research Hypothesis
- The experimental intervention will be more effective than the education group intervention in reduction of cholesterol levels, blood pressure and C-reactive protein.
- The effect of experimental intervention will vary by the level of work atmosphere. It will be easier to comprehend, grasp and incorporate this intervention for high level of work atmosphere than for low level of the same since the participants here still need encouragement with regard to their self and world appraisals (Matthews et al, 2009).
Methods
Participants
What are the characteristics of people to be included?
The recruitment will involve people living in California and Arizona States, as these States are associated with crime; have life threatening and unsafe experiences such as drug abuse and rape. These States also comprise of people who have experienced other life endangering experiences such as car accidents and threatening medical diagnosis. One will be considered as an eligible participant if he/she is above the age of 21 years. The sample size will observe gender parity by selecting 15 male and 15 female. More so, the study will ensure that all participants are from diverse ethnic groups and are involved in a committed marriage relationship
How will they be recruited?
The intervention team will carry out the recruitment practice in diverse States apart from the California and Arizona States. The venues for the intervention will be characterized by low crime rate. Hospitals will also be considered as part of intervention venues. The assessment of the participants will be done in every venue, as this will help to evaluate the impact of the intervention in every area. The sampling of the participants will be done by selecting participants from Arizona and California, but who have already demonstrated their point of interest through responding to emails aimed at targeting the victims of Post Traumatic Stress Disorder (PTSD). In order to attract a large sample size, the interventionist will also advertise the selection of participants through the local newspapers. The interventionist will then assess the eligibility of these participants through a questionnaire that will help to determine their age and traumatic events experienced during their lifetime. After eliminating the couples that had no signs of Post Traumatic Stress Disorder, the research approved 16 participants, 8 women and 8 men.
Who should be excluded from the study?
Although all the participants selected had experienced traumatic events, not all of them have developed the Post Traumatic Stress Disorder. The ability to cope with stressing situations determines whether a person develops PTSD or not. Taylor (2004) alleges that individuals who have been exposed to life threatening and terribly frightening unsafe experiences sometimes have a smaller hippocampus than other people who have not undergone traumatic events. This is quite fundamental in comprehending the effects of PTSD and the effect of this disorder. Thus, participants who have ever experienced traumatic events and do not show signs of post traumatic stress disorders, including loss of memory and anxiety, among other signs, will be eliminated from the study because it intends to concentrate on the individual with smaller hippocampus.
How many participants do you think will be needed?
The study will offer diversity of participants because the psychiatrists involved demonstrate diverse theoretical skills. The Holistic Health theory is an essential discipline because it calls for the recognition of the physical, intellectual, social, emotional, vocational, as well as the spiritual needs of humans (Dossey & Keegan, 2008). If the participants neglect this, their ability to tackle stressful situations resulting from the PTSD will be adversely affected. This theory will help the participants to understand how they can enhance their long-term well being by seeking to cater for their different needs. The Strength based psychotherapy theory, on the other hand, is a critical subject since it will help the participants to work together with the therapist in finding out what is going on in the participants’ lives. This will be achieved through focusing on the past and present successes of the victims of PTSD and using them to address the challenges that participants’ face at the present and future moments (Nassar-McMillan & Niles, 2011).
Independent Variable (Interventions) Operationally Defined
Solution-Focused Brief Intervention
The study will adopt the Solution-Focused Brief Intervention in which the intervention for the participants will be based on an attempt to avoid focusing on the posttraumatic events, but instead focus on their future goals. This style of intervention is critical to the study of PTSD because it borrows heavily from the philosophy of personal development. As humans grow, engagement in social interactions necessitates reflecting on feelings and thoughts that lead to mannerisms and certain behaviors. This favoritism toward a particular personality is shaped by observation of behavior, its imitation, reinforcement and generalization, which ultimately define personality (O’Connell & Palmer, 2003).
Nursing is a profession that requires a lot of integrity because it empowers people by helping them to solve their physical, social, and psychological needs. Socialization is the process that determines identity of an individual to be a member of a particular group or culture basing on the cultural behaviors and values. The relationship between health care intervention program and socialization has a great impact on Post-traumatic disorder. The solution –focused brief intervention will aim at enabling the victims of PTSD to recognize their physical, cognitive, and psychosocial heath through a study that is divided in a number of sessions.
The structure of the group intervention involving the victims of PTSD will be offered on an ongoing basis. The intervention will have sessions that will last for six weeks, and a week will hold three sessions. Once the group therapy starts, it will continue indefinitely for the six weeks. The interventionist will use the narrative therapy as a form of theoretical orientation. Through this kind of therapy, the interventionists will try to understand the problems of the participants. Furthermore, the interventionists will also help the victims to get over their traumas, deconstruct their problems, re-author their past negative experiences, and develop new preferred alternate stories (O’Connell & Palmer, 2003).
By developing the narrative approach, the group’s therapist will review the traumatic experiences of each participant in the group. The key techniques to be taught are how to manage anger and stress, understanding the PTSD, health and wellness, and mindfulness (O’Connell & Palmer, 2003). The group therapy will necessitate regular participation and attendance from all the participants in order to achieve successful results. Each session of the group therapy will start with a discussion of the challenges as well as the successes experienced by the participants during the intervention period.
Education on Trauma Management
The other level of the intervention will involve education on trauma management by taking an approach of gaining a sense of superiority of the traumatic events through goal setting. This intervention will necessitate a strict schedule of two hours in a day and for two days in a week. The venue will be in hospitals and community centers within California and Arizona States.
This intervention is crucial, as it employs the philosophy that the function of health interventionist is to guide the victims on their journey of self-exploration in which they seek to increase their level of self-understanding and self-awareness about their health (Robertson, Humphreys, & Ray, 2004). This self-reflection intervention will focus on the interpersonal psychotherapy as well as intervention of the participant’s memory structure.
Dependent Variable(s) operationally defined for each of three dependent variables
Mental Health Measure
The intervention will assess the validity of the intervention by assessing whether the PTSD victims are getting over their fears or phobia that led to the Post Traumatic Stress Disorder. The Clinician Administered PTSD scale will be the instrument used for data collection. It will be used alongside with the Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV) criteria It will also assesses whether the victim have the symptoms of dementia resulting from the effects of PTSD. Even though Antipsychotic medications are commonly prescribed for the management of dementia, these medications often increase risks of mortality and stroke if proper usage is not implemented (Goldberg & Goldberg, 1997). Hence, this intervention is of paramount importance in facilitating mental health of victims suffering from PTSD.
Physical Health Measurement
The intervention will assess the health status of the participants through a demonstration of metabolic syndromes. The level of cholesterol, the blood pressure and the C-reactive protein act as variables for the physical health since they are intervening variables. This means that these variables play a critical role in increasing the level of PTSD symptoms (Brewin, Andrews, & Valentine, 2000). It is also revealed that PTSD is associated with the metabolic syndromes where blood pressure, obesity and insulin resistance play important role (Heppner et al, 2009). Thus, the interventionist will put into account adequate control of blood pressures and weight measures that exceed the recommended levels by using reliable instruments. To achieve this blood pressure will need to be tested in combination with other physical tests like waist-to-hip ratio laboratory based 12-hour fasting lipids, glucose. While assessing hypertension, systolic and diastolic blood pressure values need to be united to reflect one condition. Cut-off values should be utilized for high blood pressure, serum triglycerides, high-density lipoprotein, and plasma glucose concentration. NCEP criteria should be followed for serum triglycerides and WHO and NCEP criteria should be followed for other parameters. These criteria will be for purposes of validity.
Social Health Measurement
The intervention will assess the level of participants’ attitude towards life, marital status, and the level of loneliness that affect the participants and consequently their spouses (Baranyi et al., 2010). Questionnaires will be used to collect information relevant to this assessment. Therefore, the intervention will assess the reliability of the intervention by evaluating on whether the victims have developed self-control or increased association with their loved ones for a particular length of time.
Procedures for delivering the Interventions
Procedures for collecting the data
Pre-intervention – What was the status of the person before receiving the intervention?
The pre- intervention of the study determined the status of the participants through a careful examination of the questionnaire and data collection taken before the intervention. The researcher used observation as a data collection method in assessing the social and the physical health of the participants. Observations were carried out through an appointment for each participant. The mental health assessment was done by interviewing the participants of the intervention, who were accompanied by their spouses, as this facilitated access to information on the social intimacy. All the participants experiencing PTSD portrayed lack of intimacy with their spouses.
In determining the physical health, a number of clinical laboratory assessments were carried out, which showed that the PTSD victims had signs of abnormal blood pressure, high cholesterol levels, and high levels of insulin resistance, and thus the levels of PTSD were high for majority of the participants. In determining the mental health the participants, the Diagnostic and Statistical Manual of Mental Disorders, commonly known as the DSM IV, was used as a tool to identify the characteristics of the participants in order to classify them according to their mental capacities. All participants showed signs of memory loss though the level of the deficiency varied.
Post intervention — What was the status of the person after receiving the intervention?
The participants of the group were evaluated at the end of the intervention. The evaluation was based on a number of factors due to the diversity of the intervention. The first technique that was adopted after the intervention program was active listening, as this allowed the participants to appreciate the significance of their listening skills. It also encouraged openness among participants on matters related to Post traumatic stress disorder and other social issues. The practice was achieved through assuring the participants that they will benefit from each other’s feedback.
The second was linking. Linking allowed the participants to see how their problems and different traumatic experiences connect with the other participants in the group. This made the participants to realize that they all similar concerns. However, the participants who depicted higher levels of PTSD were recorded as having benefited much from the intervention than the participants who predicted low levels of PTSD (Johnson, 2009).
Follow-up – What was the status of the person 6, or 12, or 18 months after the intervention?
The evaluation process will proceed for the next 18 months in order to assess the validity for the intervention. This concept stems from the fact that the intervention of the PTSD takes effect after the participants leave the program. A successful intervention program should provide room for effective collaboration of participants with their spouses in order to facilitate a successful transition of PTSD victim back to their families (Johnson, 2009). The participants, however, demonstrated both short and long-term achievements.
In the short-term achievement- 6 months, the PTSD victims demonstrated a positive change, as the victims showed no signs of phobia. The participants demonstrated this through talking honestly with their spouses. More so, the participants reflected over important issues such as motivation, which is normally developed from the practice of sharing amongst the participants. In the long-term achievement, that is 18 months, the victims of the PTSD demonstrated restructure of memory, and they felt completely safe in the whole environment. This encourages the interventionist to start focusing on confronting the traumatic memories at a group and an individual level.
Procedures for assuring the integrity of Delivery of the Intervention – Quality Assurance
The first precaution that will be taken to ensure that the intervention will be carried out correctly is the nursing intervention. Nursing intervention plays a vital role in PTSD victims since it is concerned with addressing the theoretical as well as the practical problems that are important to health (Videbeck, 2010). Thus, the research area will involve understanding the Victims of PTSD responses to good health in the biological, emotional, and the social aspect of health. More so, experienced medical psychiatrists will handle the Solution-Focused Brief Intervention after being recruited on best practices and being informed on the vital policies that should be considered before, during, and after an intervention program (Johnson, 2009).
The overall program will involve defining a specific time under which the participants should be able to achieve the benefits of the intervention. In order to know whether the objectives have been achieved, it is worthwhile for the program implementers to have a measurable standard such as to reduce the number of PTSD victims to below 2.5% within a speculated period.
More so, the intervention will be carried out in a manner that facilitate proper management of information.This information will, in turn, help the interventionists to assess whether the objective of the innovation has been achieved(Johnson, 2009). The strategy of the intervention will endow the program interventionists as well as the outside support team with skills pertaining to the intervention. The outside support team is of paramount importance in this intervention because it will help the victims of the PTSD to cope with the outside environmental factors after they leave the intervention rooms.
Procedures for assuring the integrity of Delivery of Collection of the data
Data collection methods call for adequate precautions due to their inadequacy. The use of interviews as a data collection method will enhance the intervention since the program will be conducted in a manner that provides access to some sort of natural support, as the interventionist will be able to delve more into the answers provided by the PTSD victims as well as their spouses. The use of observation as a data collection method in the clinical assessment helps the health care workers to come up with precise data of the victims’ health status, as the health workers are skilled in their area of expertise.
Active participation of the victims is enhanced by asking for their consent and compensating them after the intervention. This will play a critical role, as it will eliminate biased response from the participants, thus demonstrating content validity. Content validity is defined as the extent to which a device used in research represents the content of interest for the participants (Creswell, 2003).
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