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In this week’s material on lung function, two diseases tend to emerge as clinically important: COPD and lung cancer. Please go onto the CDC website (www.CDC.gov) to look up facts and figures on one of these two diseases. What is its burden on society? How can you, working on the front lines of disease management, help to relieve the burden of the disease on society?

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Read the case study below. Answer and discuss the questions that follow.

ND is a 82-year-old female who lives in a skilled nursing facility. She suffers from rheumatoid arthritis, coronary artery disease, chronic bronchitis, and hypertension. She is wheelchair bound and tends to spend most of her days in bed. She smoked for 52 years but quit 14 years ago. She has lost 10 pounds in the last month and has had a productive cough for about 2 weeks that has copious amounts of white to yellow mucous. Over the last 3 days, she has refused to get out of bed and has been refusing to eat or drink. This morning she is confused, has a fever, and is coughing continuously. Her sputum now is rust-colored. Her lungs sounds are coarse rhonchi throughout with crackles and diminished lung sounds in her right middle lobe area. Her vital signs are BP 86/54, HR 98, RR 28, and temperature 102.4. She is being admitted to the hospital. 

Pneumonia can be classified many different ways. Which classification of pneumonia best fits ND’s situation? Explain. What is the most probable cause of ND’s pneumonia? Which diagnostic tests would you expect to be done to diagnose ND’s pneumonia?

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When analyzing qualitative data, what are the ways in which trustworthiness can be established? What ethical considerations are unique to qualitative methods?

4. Explain and differentiate between the four different types of qualitative research. What are some advantages and disadvantages of each type?

Expert Solution Preview

Introduction:

In this week’s material on lung function, we have discussed two clinically important diseases, COPD and lung cancer. To further explore these diseases and their impact on society, we will utilize the CDC website to gather facts and figures about one of these diseases. Additionally, we will analyze a case study focusing on pneumonia and discuss the classification, probable cause, and diagnostic tests for the presented patient. We will also delve into qualitative research methods, examining ways to establish trustworthiness and the unique ethical considerations involved. Finally, we will differentiate between the four types of qualitative research and highlight their advantages and disadvantages.

Answer:

1. According to the CDC website, chronic obstructive pulmonary disease (COPD) affects approximately 16 million Americans and is the fourth leading cause of death in the United States. COPD imposes a significant burden on society due to its high prevalence, complex management, and associated healthcare costs. The disease leads to decreased quality of life, increased hospitalizations, and premature deaths. It places a substantial economic burden on society through medical expenses, productivity losses, and the need for long-term care.

As a medical professional working on the front lines of disease management, I can contribute to relieving the burden of COPD on society through various approaches. Firstly, I can emphasize preventive measures such as smoking cessation programs and awareness campaigns to reduce the incidence of COPD. Secondly, I can advocate for early diagnosis and prompt treatment, thereby preventing disease progression and complications. Additionally, I can educate patients and their families about self-management techniques, including medication adherence, pulmonary rehabilitation, and lifestyle modifications. Lastly, I can contribute to research and evidence-based practices that improve outcomes and optimize resource allocation in COPD management.

2. ND’s situation aligns with the classification of community-acquired pneumonia (CAP). CAP occurs when individuals acquire pneumonia outside of hospitals or healthcare facilities. ND’s symptoms, such as fever, productive cough, and rust-colored sputum, along with her living arrangement in a skilled nursing facility, indicate community acquisition.

The most probable cause of ND’s pneumonia is likely a bacterial infection. Her symptoms, including productive cough with copious amounts of mucous, fever, and lung sounds such as coarse rhonchi and crackles, all suggest the presence of bacterial pneumonia. The rust-colored sputum may indicate the presence of blood in the respiratory tract, which can be a sign of a bacterial infection.

To diagnose ND’s pneumonia, several diagnostic tests may be expected. These may include a chest X-ray to visualize lung abnormalities and infiltrates, complete blood count (CBC) to assess white blood cell count, C-reactive protein (CRP) levels to measure inflammation, and sputum culture and sensitivity testing to identify the responsible bacteria and determine antibiotic susceptibility.

3. When analyzing qualitative data, trustworthiness can be established through several methods. These include:

– Credibility: Demonstrating that the findings are internally consistent, believable, and align with the participants’ experiences.
– Transferability: Ensuring that the study’s findings can be applied to other contexts or settings.
– Dependability: Establishing the consistency and stability of the study’s findings over time and across different researchers.
– Confirmability: Demonstrating that the findings are grounded in the data collected and not influenced by the researchers’ biases or preconceptions.

Ethical considerations unique to qualitative methods include maintaining confidentiality and anonymity of participants, obtaining informed consent, ensuring voluntary participation, minimizing harm, and addressing power imbalances between researchers and participants. It is essential to protect the rights and well-being of participants throughout the research process.

4. Qualitative research encompasses four main types: phenomenology, grounded theory, ethnography, and narrative research.

– Phenomenology focuses on exploring individuals’ experiences and understanding the essence of specific phenomena. Advantages include gaining in-depth insights, capturing lived experiences, and developing rich descriptions. Disadvantages may include potential bias in interpretation and lack of generalizability.

– Grounded theory aims to generate theories by exploring and analyzing data. Advantages include theory development directly from data and uncovering novel concepts. Disadvantages can include time-consuming data analysis and potential difficulty in theory development.

– Ethnography involves studying cultural groups and their behaviors, beliefs, and practices. Advantages include cultural immersion, holistic understanding, and uncovering cultural contexts. Disadvantages may include limited generalizability and potential subjective interpretation.

– Narrative research focuses on understanding life stories and individual experiences. Advantages include capturing personal perspectives, highlighting subjective meanings, and uncovering unique insights. Disadvantages may include potential bias in storytelling and challenges in data analysis.

Each type of qualitative research offers distinct advantages and disadvantages, and researchers must carefully choose the appropriate approach based on their research objectives, resources, and the population being studied.

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