Genetic disorder among children is prevalent around the world and Cystic Fibrosis (CF) is one of the many. According to the CF foundation, CF is a chronic progressive genetic disease without a cure. Over the years with new technologies the rate of survival has increased. The average age of survival has increase form adolescence to young adulthood.  The survival age for CF has risen from 12 years in 1966 to more than 30 years of age in 2004 (Christian & D’Auria, 2006).  Since children with CF are living much longer, they will now need the utilization of new interventions to function physiologically, psychosocially, functionally by learning new  skills how to live with their chronic illnesses in today’s environment, which will continue to increase their life expectancy or to have their the rate of survival remain  constant.

According to Christian and D’Auria (2006) the purpose of the research was to test the effectiveness of interventions to improve the psychosocial adjustment, functional health, and physiological adjustment in children suffering from cystic fibrosis (CF) by teaching them new life skills for managing their chronic illness in their everyday lives. The success of these new interventions, would teach these individuals how to balance living with their chronic illnesses and enhance their functional ability were the researchers intent.

A research design is considered to be the building block of a research study.  “The research design is the overall plan for obtaining answers to the questions being studied and for handling various challenges to the worth of the study evidence,” (Polit and Beck, 2009, Ch 3). Research designs points out, selecting a specific design, how the data will be collected, what types of comparison will be made and study sites.

“Qualitative Research design emphasizes human experiences as it is lived through a collection and analysis of subjective narrative materials using flexible procedures that evolve in the field,” (Polit and Beck, 2009). In addition, qualitative research is a collection base on individual’s experience, interviews and observation. The data maybe represented by concepts, theories and themes.

A quantitative research relies on the numerical data that is collected.  In a quantitative research, data maybe collected through coding, which is the process of translating verbal data into numeric form, or in the preliminary step data, is transfer from written documents onto computer files for analysis (Polit& Beck, 2009, Ch 3).  The data that is collected is then translated into numerical form using statistics, graphs, charts, and tables. Furthermore, “In quantitative studies the research design tends to be highly structured and controlled” (Polit and Beck, 2009, Ch 3). In a randomized control trial, participants are placed in groups at random. “When people are selected at random, to participate in the study, each person in the initial pool has an equal probability of being selected.” (Polit and Beck, 2009, Ch 4) In a randomized control trial, there are 2 groups, an experimental group and a control group. The experimental group will receive the intervention, on the other hand the control will not.

Based on earlier research by the author’s including ( Richardson, 1997) they justified the need for this research by reviewing the literature on qualitative research conducted and the impact it had on children during middle childhood, the problems they faced, and the understanding of their illness, then developed the building life skills (BLS) so that children would be able to improve peer relationships, become more effective peer group members, and increase self-esteem.

The author’s of this research utilized a quantitative randomized control trial to develop their intervention module. Base on this experimental research, the researchers used randomly assigned groups, 58 children were assigned to each with their ages ranging from 8-12 years old. There are 2 variables in this study, the independent variable and the dependent variable.

The dependent variable is the outcome and the independent variable is the cause that influences the dependent variable. The experimental group received social intervention on the other hand the control group participates in normal CF routine. The teaching interventions were modified, but took place in structured environment and home visits in social environments.

Variables identified in hypotheses are usually measured and this can be done with instruments or scales.  “An operational definition of concept specifies the operations that researchers must perform to collect the required information” (Polit and Beck, 2009, Ch 3). Quantitative studies variables are usually operationalized, defined and measured

According to Christian & D’Auria, the collection of the data was done on a three month interval for nine months with different instruments used to measure the variables. Psychosocial Adjustments was measured using; the perceived Illness Experience Scale, which includes peer rejection, the Children Loneliness Scale measure child self loneliness satisfaction with peer satisfaction; the Social Support Scale for Children measures middle school children’s perceived support from peers and classmates; the Self Perception Profile Children measures global self. Functional Health Status uses; the Functional Disability Inventory Scale which measures child self-report of the impact of illness and the Physiologic Health status uses a Pulmonary function and physical growth to measure physiologic status.

The dependent variables of the research were the three hypothesis; 1) psychosocial adjustment, 2) functional health status, and 3) physiological health status, where the findings used the multivariate analysis of variance (MANOVA) as a measure to compare the children in the intervention and control groups. Polit and Beck (2010) explained that MANOVA is the procedure used to test the significance of differences between the means of two or more groups on two or more dependent variables, which is considered on a simultaneously basis (Polit and Beck, 2010, p. 427).  Fain (2009) explained that in comparing data, variance is a measure of variability, which is the average squared deviation from the mean which is a measure of central tendency calculated by summing a set of scores and dividing the sum by the total number of scores, this is also called the average (Fain, 2009, p. 150).

According to Fain (2009), “A framework of concept is based on ideas or notions that have been put together in a unique way to describe a particular area of concern” (p.72). They used a conceptual framework focusing on (Christain & D’Auria, 1997; D’Auria et al., 1997; Saiman & Siegel, 2003) that looked at the clinical guidelines, explanation of CF related differences to peers, dealing with teasing; and keeping up with peers during physical activity.

On completion of the research, the main findings indicated base on the literature and graph illustrates that there were no statistically significant mean differences for any major outcome variables between the children in the intervention and usual care groups (ρ <.05) from baseline to the 9-month period. Overall, the researchers found that, children with CF showed significant improvements in global self-worth and self-competence over time, although between-group differences were not significant. They explained that this was due to the fact that the self is a social construction, children’s perceptions of self and their social world mirror perceptions of self-worth and interactions with others.

The implications of this research is evident that the improvements in the BLS intervention group confirms the value of this problem-solving and social skills intervention for children with CF. In addition, this approach may provide a useful intervention strategy for children with other chronic illnesses. Furthermore, listening to children, we can design interventions to enhance our ability to help children monitor their health, shape their chronic illness course, and improve their quality of life.

References

Christian, B. J., & D’Auria, J. P. (2006). Building life skills for children with cystic

Fibrosis: Effectiveness of an Intervention.  Nursing Research, 55(5), 300-307.

Fain, J. A. (2009). Reading, understanding, and applying nursing research. (3^rd ed).

Philadelphia: F. A. Davis Company.

Polit, D. F., & Beck, C. T. (2010). Nursing research: Appraising evidence for nursing

practice. (7^th ed). Philadelphia: Lippincott Williams & Wilkins.