I. State why you agree with your colleague’s assessment of the
assigned study. Please provide a rationale for your agreement.

II. Consider the ethical implications your colleague has described and
identify any other potential ethical issues your colleague has not
mentioned.

III. If you have an opinion about whether a mixed methods research
design would be useful for your colleague’s research topic,
respectfully share it.

REPLY TO MY CLASSMATE’S DISCUSSION BY ANSWERING THE
ABOVE INSTRUCTIONS WEEK DISCUSSION 1 (Latacha)
(MINIMUM OF 300 WORDS)

What is the research question?

What is the knowledge, beliefs and attitudes towards late-life depression for PCAs
caring for older adults?

What is the experience of Personal Care Aides (PCAs) caring for older adults with
depression?

Both qualitative and quantitative methods?

Yes, the question calls for both qualitative and quantitative methods because the first
question (quantitative) seeks to measure the knowledge, beliefs, and attitudes of the
PCAs regarding late-life depression in older adults. The second question seeks to
understand the experiences (qualitative) of PCAs caring for older adults with depression.

Which type of mixed methods research design was used?

The researchers implemented a mixed methods convergent parallel design for this study
using semi-structured interviews (n=22) to gather qualitative data and an anonymous
online survey (n=87) to collect the quantitative data. They chose this method to
construct a comprehensive understanding of the research problem (Xiang et al., 2020).

What procedures were used to recruit participants?

The procedure used to recruit participants for the quantitative sample was convenience
sampling—the surveyed group. The researchers compiled the names of professional
contacts and private pay home care providers to recruit participants over a 7-month
process, including phone calls, texts, flyers by email, and participant referrals.

Purposive sampling was used to recruit the qualitative sample—the interviewees. To gain
varying perspectives, the researchers chose participants with long work histories and
who came from different agencies. They stopped the recruitment process once the
interviewer reached a saturation point in themes (Xiang et al., 2020).

Appropriate sample sizes?

Both sample sizes were appropriate for this study. To gather quantitative data, the
sample size must be more significant (in this study, n=87) to produce meaningful
statistical data representing a particular population—the opposite stands for the
interviewees. The sample size was n=22 because a qualitative sample size aims to “locate
and obtain information” from a smaller sample yet collect substantial information from
the participants (Creswell & Creswell, 2018).

What ethical considerations?

Section 8.01 of the Ethics Code—institutional approval, research is conducted according
to approved protocols (American Psychological Association, 2017). The researchers
received approval for their study procedures and materials from the University of
Michigan’s IRB. Privacy was also considered as the online survey and the names of the
agencies were kept anonymous—Maintaining confidentiality, as described in Section
4.01 of the Ethics Code (American Psychological Association, 2017).

Ethical considerations not mentioned by researchers?

There was no mention of Section 8.02, Informed Consent to Research, and Section 3.05,
Multiple Relationships. Information was collected from a PCA regarding the health of
Older Adults they were close to. Also not mentioned was Section 8.08 (a),
Debriefing (American Psychological Association, 2017). At an organizational level, this
information would be immensely helpful in developing training opportunities for PCAs.

Would you have designed the study differently?

Except for addressing additional ethical considerations, and based on the research
question, I would have conducted the same study similarly. The researchers were
thorough and methodical in their questioning for both the survey and interviews with
participants. Real-world experience working with the older adult population differs
significantly from reading numbers or accepting broad assumptions. This study
mentioned three things that stood out regarding the research question. One of the
themes from the PCAs centered around individualized care—they used their inner
knowledge of the client to assess “changes in mood and behavior” (Xiang et al., 2020)
Having been in this industry for some time, one becomes particularly good at assessing
the person, group, or family you are working with. It is an essential skill, and it would be
advantageous to design training to do this effectively. Something else that stood out was
that PCAs outperformed a sample of adults with higher education levels on the late-life
depression quiz (Xiang et al., 2020). It’s unsurprising because it’s easy to lack real insight
unless you are intimately engaged with this population. Lastly, the researchers
concluded several knowledge gaps related to training programs and depression in older
adults. Further research is needed to affect policy change to protect all stakeholders
(Xiang et al., 2020).

Would a mixed methods approach be suitable for your research topic?

After reading the case study, I do not believe a mixed methods approach would suit my
research. I plan to use qualitative research using a phenomenological approach to answer
the question, “What is the experience of role reversal for adult children caring for aging
parents?” For five years, I was a caregiver for my father, who passed away from cancer in
2018, and my mother, who was diagnosed with cancer at the top of the pandemic, and I
became her primary caregiver. My whole life was put on hold and changed dramatically
as I fell face-first into the world of “role reversal.” Qualitative research would open the
door to a deeper understanding of the adult child’s experience. Additionally, the findings
of a study like this could be used to affect policy change at the state and federal levels.

References
American Psychological Association. (2017, January). Ethical Principles of Psychologists
and Code of Ethics. https://www.apa.org/ethics/code/indexLinks to an external site.

Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and
mixed methods approaches (5th ed.). SAGE.

Xiang, X., Cheng, J., Zuverink, A., & Wang, X. (2020). Perceptions and practice behaviors
regarding late-life depression among private duty home care workers: a mixed-methods
study. Aging & Mental Health, 24(11), 1904-
1911. https://10.1080/13607863.2019.1636207

I. State why you agree with your colleague’s assessment of the assigned
study. Please provide a rationale for your agreement.

II. Consider the ethical implications your colleague has described and
identify any other potential ethical issues your colleague has not
mentioned.

III. If you have an opinion about whether a mixed methods research
design would be useful for your colleague’s research topic,
respectfully share it.

REPLY TO MY CLASSMATE’S DISCUSSION BY ANSWERING THE
ABOVE INSTRUCTIONS WEEK DISCUSSION 2 (Kimberly)
(MINIMUM OF 300 WORDS)

Research Question:

How do personal care aides’ perceptions of late-life depression affect their caregiving
practices and their ability to address it in elderly patients?

Addressing qualitative and quantitative needs:

Answering this question will require qualitative and quantitative research design
methods. The first half of the question addresses how personal care aides perceive late-
life depression and how those perceptions might influence their behaviors when caring
for elderly patients. This would be a qualitative study through open-ended interview
questions. The second half of the question focuses on quantitative data by studying the
extent of how the perceptions of personal care aides’ relate to how they recognize,
gauge, and address late-life depression in their senior patients (Xiang et al., 2020.)

Research Design:

Researchers used a mixed methods convergent parallel design that included a structured
anonymous online survey taken by 87 people and 22 semi-structured interviews. After
both data sets were captured, the researchers reviewed and analyzed them separately
but in parallel, providing statistical data from the quantitative study and identifying
recurring themes for the qualitative study (Xiang et al., 2020.)

Recruitment and sample size:

Qualitative: Prospective participant information was gathered from Michigan’s private
home health care providers. It took seven months and included various types of
outreach, including phone calls, text messages, emails, and announcements at home care
agency offices. The final sample size was 22 personal care aides. The typical
recommendation for this type of study is 3-10 participants, so this group is a bit larger
than recommended. Since qualitative studies are in-depth and purposeful, the sample
size is typically small (Creswell & Creswell, 2018.) This resulted in three primary sub-
themes – recognition and assessment of depression, attitude toward depression
treatment, and practice behaviors in caring for older adults with depression (Xiang et al.,
2020.)

Quantitative: The survey response list recruited people using convenience sampling. It
does not specify how many people were sent the survey, but 92 clicked on it, and 87
completed more than five questions. Those that answered less were excluded from the
analysis. Respondents were anonymous but gathered from the same pool of personal
care aides in Michigan as well as personal contacts of the researcher (Xiang et al., 2020.)
The survey group was approximately four times larger than the interview pool. However,
since we do not know the number of these aides in Michigan, we cannot calculate the

minimum sample size needed to adequately reflect the population. (Creswell & Creswell,
2018.)

The survey participant list was 94% women and covered a wide breadth of ages (18-67.)
Most participants were white, and there could have been efforts to recruit more
diversity in this pool regarding gender, race, and education (Xiang et al., 2020.) The
survey questions and interview questions were well-structured and comprehensive. The
response to the survey was high (87 of 92 people who clicked it qualified for inclusion in
the analysis.) I do not know if the aides knew the survey length before clicking on it.
Since it took much time, that might have been a deterrent. Another option would have
been two or three shorter quizzes over a set period. The incentive was a good idea to
get people to participate. My question is, how did they deliver gift cards if people’s
responses were being recorded as genuinely anonymous?

Thoughts and potential changes to this design:

Surveys and interviews were suitable research designs for this study. They provided
helpful data and provided researchers with valuable insights from qualitative and
quantitative perspectives. To provide additional validity to the findings, I would expand
the reach to private home care agencies/aides across the United States and not restrict
it to 15 agencies in Michigan. It was valuable to note that the 15 agencies (out of 600)
that participated in this study were motivated to do it, and culture played a part in that
(Xiang et al., 2020.) I would also require demographic data for prospective participants to
increase diversity in gender, race, and education levels of participating aides.

Ethical considerations:

Ethical considerations included getting institutional approval, section 8.01 (American
Psychological Association, 2017), from the research team seeking and receiving approval
for their study process and materials by the University of Michigan Health Sciences and
Behavioral Sciences Institutional Review Board (Xiang et al., 2020.) The study also noted
that they maintained confidentiality, section 4.01 (American Psychological Association,
2017.)

Additional ethical considerations that should be addressed in this study:

• 8.02 – Informed Consent to Research
• 8.08 – Debriefing
• Principle A – Beneficence and Nonmaleficence
• The potential ethical issue of 3.05 – Multiple Relationships, since they noted

that some participants could have been personal contacts of the researcher.

My research topic:

A mixed methods approach is an appropriate fit for my research topic. I am exploring the
experiences and needs of people utilizing medical-related resources on social media
platforms. I could conduct surveys when people are being released from the hospital to
ask if they use social media, know about a healthcare organization’s social media

presence, and what medical-related resources they would use or would like to use from
a healthcare organization. I could also conduct online surveys from prior patient families
to gather similar information. Those surveys would provide valuable quantitative data. I
could utilize quantitative data through semi-structured interviews of patient families. I
could focus on specific departments or programs with a solid social presence to keep the
list manageable. Results could be used as a case for support to expand the social
presence into other departments.

References:

American Psychological Association. (2017, January). Ethical Principles of Psychologists
and Code of Ethics. https://www.apa.org/ethics/code/indexLinks to an external site.

Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and
mixed methods approaches (5th ed.). SAGE.

Xiang, X., Cheng, J., Zuverink, A., & Wang, X. (2020). Perceptions and practice behaviors
regarding late-life depression among private duty home care workers: A mixed-methods
study. Aging & Mental Health, 24(11), 1904-
1911. https://doi.org/10.1080/13607863.2019.1636207