Discussion: Assess the Quality of a Research Paper

Discussion: Assess the Quality of a Research Paper ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Assess the Quality of a Research Paper Based upon your reading of Pomeroy, Kiam, and Abel (1999; see the attached .pdf), address the following: Discussion: Assess the Quality of a Research Paper Section I: Critique of the Article’s Introduction/Literature Review (p. 171–174) In your own words, what was the overall purpose of Pomeroy et al.’s research study? Was the literature review adequate and relevant? That is, did it lend support to the current study? If yes, how so? If no, speak to the limitations/weaknesses of the literature review and provide recommendations for how it could be strengthened. Section II: Critique of the Article’s Methodology (p. 174–179) What type of sampling approach was used in general (re: probability or non–probability) and specifically (e.g., simple random, stratified random, etc.)? Identify the research design. That is, would you classify this as a pre–experimental, quasi–experimental, or experimental study? How did you come to that conclusion? Did Pomeroy et al. sufficiently inform their audience of potential threats to the internal and/or external validity of their study that stem from the research design? Briefly explain your response. Section III: Critique of the Article’s Discussion (p. 182–185) Did Pomeroy et al. adequately acknowledge the strengths and limitations of their study? Briefly explain your response. Are there other strengths and limitations that were not identified? Be specific. If you were to build upon this study, discuss how you would handle the sampling strategy and research design in order to enhance causality (re: strengthen enhance your ability to make causal inferences that the intervention is responsible for the outcomes). attachment_1 RESEARCH ON SOCIAL WORK PRACTICE Pomeroy et al. / GROUP FOR WOMEN IN JAIL The Effectiveness of a Psychoeducational Group for HIV-Infected/Affected Incarcerated Women Elizabeth C. Pomeroy University of Texas—Austin Risa Kiam Portland State University Eileen M. Abel University of Central Florida Objective: The effectiveness of a psychoeducational group intervention for HIV/AIDS-infected and affected women was examined at a large southeastern county jail facility. Method: A quasiexperimental pretest-posttest design was used to examine depression, anxiety, and trauma symptoms of women inmates. Results: A multivariate analysis of covariance yielded significant differences between the experimental and comparison groups. Subsequent analysis of covariance for each dependent variable indicated significant differences between groups as well. Effect sizes ranged from moderate to strong. Conclusions: The psychoeducational group intervention appeared to be effective in alleviating depression, anxiety, and trauma symptoms among women inmates infected and affected by HIV/AIDS. The number of women entering the jail and prison systems in the United States escalated by 202% over the past decade. Currently, women inmates account for about 9% of the entire prison population (Stephan & Jankowski, 1991), and women of color make up 57% of this group. One of the increasing health and emotional concerns of women prisoners and prisons themselves is the impact of HIV/AIDS on the jail population. To date, incarcerated women infected or affected by HIV/AIDS have received little interventive attention from corrections personnel. Despite indications that psychoeducational groups for people living with HIV/AIDS have been found to be effective in Authors’ Note: Correspondence may be addressed to E. Pomeroy, School of Social Work, University of Texas at Austin, Austin, TX 78746. Research for this article was supported in part by the Lois and Ann Silberman Award. The authors would like to thank Sandra Davy, M.S.W., for her supervision of students at the Orange County jail and her contributions to this research. We would also like to thank the administration of the Orange County Corrections Department, especially Don Bjoring, for their support for this project. Research on Social Work Practice, Vol. 9 No. 2, March 1999 171-187 © 1999 Sage Publications, Inc. 171 172 RESEARCH ON SOCIAL WORK PRACTICE lessening the emotional stress experienced by these individuals (Pomeroy, Rubin, Van Laningham, & Walker, 1997; Pomeroy, Rubin, & Walker, 1995), few groups for jailed women have been discussed in the literature. Because social workers often are employed in corrections systems, they have opportunities to assess, intervene, and provide needed services for incarcerated women who are infected/affected by HIV/AIDS. This study was developed to evaluate the effectiveness of a psychoeducational group intervention for incarcerated women who are infected/affected by HIV/AIDS. It was part of a larger rehabilitation project within the Orange County, Florida, jail system to provide educational and occupational skills as well as a variety of therapeutic interventions to both male and female inmates. Although AIDS has shown a decline recently in the gay community, an increasing number of people diagnosed HIV-positive (positive for the human immuneodeficiency syndrome) or with AIDS are women. Discussion: Assess the Quality of a Research Paper Since 1981, the Centers for Disease Control (CDC) have reported 92,242 cases of women with AIDS. These figures represent an increase of about 63% in the number of cases of women with HIV/AIDS over the past 3 years (personal communication with CDC, December 29, 1997). According to Hoffman (1993), 90% of women with HIV/AIDS have dependent children, are single parents, may have lost a partner to AIDS, and are often grappling with issues of poverty. Frequently, these families affected by HIV/AIDS are at a pronounced risk of becoming homeless (Reidy, Taggart, & Asselein, 1991). This situation may be due to a multitude of factors, such as discrimination, declining health, loss of employment, and dwindling finances resulting from intravenous drug use, treatment expenses for infected members, and poverty. Initial responses to an HIV/AIDS diagnosis are often “heightened anxiety, retreat into defense mechanisms such as denial, and understandable preoccupation with maintaining health” (Buckingham & Rehm, 1987, p. 7). Often, a woman is asymptomatic and unaware of her HIV status until she becomes pregnant or her baby is diagnosed (Herdt & Boxer, 1991; Tiblier, Walker, & Rolland, 1989). In addition, the pregnancy itself may accelerate the woman’s own disease process. Another threat to immune functioning is the seropositive person’s self-beliefs. Bandura (1990) suggests that “perceived coping inefficacy increases vulnerability to stress and depression and activates biochemical changes that can affect various facets of immune function” and influence health habits (p. 129). Issues affecting HIV/AIDS-infected women participating in a support group included the following: feelings of isolation, stigma, and shame; lack of medical information; and poor self-image (Chung & Magraw, 1992). Regardless of their illness, women were still expected to be the central Pomeroy et al. / GROUP FOR WOMEN IN JAIL 173 caretakers for their families. They worried about infecting other family members through casual contact and feared becoming a burden. Other concerns included if, when, and how to tell their children about their own illness or their children’s illness. Women also processed feelings of loss regarding their sexuality and desirability following diagnosis, resulting in loss of self-esteem and mourning for the loss of reproductive choice (Chung & Magraw, 1992). Mayer and Spiegel (1992) found similar concerns raised in parental support groups conducted in a pediatric AIDS clinic. Women expressed guilt about HIV transmission to their children and feelings of isolation from family, friends, and medical staff. The majority of women infected or affected by HIV/AIDS are members of ethnic minority groups and live in impoverished inner cities where community services are sparse and difficult to obtain. Although the gay and lesbian community has provided overwhelming support for HIV/AIDS infected people in their own cohort, disadvantaged women and intravenous drug users who become infected find little help available in their own communities (Walker, 1991). As the number of women infected with HIV/AIDS has increased, so too has the need for safe, nonjudgmental environments in which women can express their needs and concerns. Support groups for people living with HIV/AIDS, initially composed primarily of gay men, have spread to other subpopulations of infected individuals. Interventions that focus primarily on the gay client (El-Mallakh & El-Mallakh, 1989; Getzel, 1991; Miller & Green, 1985; Morokiff, Holmes, & Weisse, 1987; Rounds, Galinsky, & Stevens, 1991), the gay partner (Carl, 1986), or significant others (i.e., friends, family members, or spouses) (Bowes & Dickson, 1991; Frierson, Lippman, & Johnson, 1987; Greif & Porembski, 1988; Land & Harangody, 1990) have been the foci of most of the existing effectiveness studies. Discussion: Assess the Quality of a Research Paper The literature on women who are infected or affected by HIV/AIDS has been limited to descriptive and anecdotal accounts of this population. Just as there has been little research conducted on interventions for women with HIV/AIDS, there is a proportionate dearth of information on interventions for incarcerated female inmates. Since the beginning of the 1980s, the population of female inmates in the United States has increased by over 200% (Gabel & Johnston, 1995). It is estimated that 25% of all women inmates are HIV positive (Stephan & Jankowski, 1991). The majority of these women are arrested for nonviolent crimes. Typical offenses include fraud, drugs, and/or prostitution (Singer, Bussey, Song, & Lunghofer, 1995). Nearly half of women inmates report that they were physically or sexually abused as children (U.S. Department of Justice, 1991). As many as two thirds of women inmates require mental health services at, or 174 RESEARCH ON SOCIAL WORK PRACTICE soon after, their initial incarceration (James, Gregory, Jones, & Rundell, 1985). Gabel and Johnston (1995) reported that prior to incarceration, one in five women inmates had received some form of mental health treatment. In their recent investigation of female inmates, Singer et al. (1995) found that 64% of their sample fell within the clinical range for mental health problems. The same study found that 83% of the women were in the substance abuse range, and 81% had been victimized at some point in their lives. In an effort to respond to the mental health needs of incarcerated populations, jailbased rehabilitation programs have been established. Most programs that have been established within a corrections setting have been educational and preventative in nature (Coulson & Nutbrown, 1992; El-Bassel et al., 1995) and have focused on providing information to inmates. Recently, a skill building and social support enhancement group was established to prevent HIV/AIDS in drug-abusing incarcerated women (El-Bassel et al., 1995). This pilot study evaluated the effectiveness of a group intervention for reducing the spread of HIV/AIDS among 145 female inmates. The study, “confirmed the feasibility of implementing a skill-building intervention for drugusing women in jail” (El-Bassel et al., 1995, p. 131). Despite the enormous need for interventions targeting women prisoners, there has only been a minimal amount of research conducted in this area. As in other areas of social work, few studies have been conducted that examine the effectiveness of the interventions that social workers employ within the jail system. This study examined the effectiveness of a time-limited, psychoeducational, task-centered group for incarcerated women infected or affected by HIV/AIDS. Three primary hypotheses were tested in this research and are stated as follows: Hypothesis 1: The psychoeducational group intervention will reduce the amount of depression experienced by women inmates. Hypothesis 2: The psychoeducational group intervention will reduce the amount of anxiety experienced by women inmates. Hypothesis 3: The psychoeducational group intervention will reduce the amount of trauma symptoms experienced by women inmates. METHODS AND PROCEDURES Clients The research participants in the study were drawn from the population of HIV-infected or affected women incarcerated at the Orange County jail. Pomeroy et al. Discussion: Assess the Quality of a Research Paper / GROUP FOR WOMEN IN JAIL 175 Announcement of the group was made prior to the initiation of the study, and women had the opportunity to sign up for it. If more than 12 women signed up for the group, the overflow inmates were placed in the comparison group and were given the opportunity to participate in the following group. Each of the nine experimental groups filled to capacity for a total of 108 women. Twentyone women dropped out of the experimental group due to being transferred or released from the jail. The total number of women who completed the group intervention was 87. Fifty-two women were placed on a waiting list for the group intervention and served as the comparison group. Thus, the total sample size for the study consisted of 139 women. Because of strict laws regarding confidentiality and AIDS in the state, we were not allowed to ask the women to divulge their HIV status; however, many women who were HIVpositive shared this information with group participants during the course of the intervention. Due to constraints of the jail system, subjects were not randomly assigned to the experimental and comparison conditions. Psychoeducational Group Intervention The intervention approach used in the current study is based on previous research by one of the authors of a psychoeducational group intervention for family members of people living with HIV/AIDS (Pomeroy et al., 1995). The psychoeducational approach proved to be effective in alleviating the emotional turmoil associated with caring for people living with HIV/AIDS. The authors also examined the effectiveness of a psychoeducational group for heterosexuals with HIV/AIDS and found similar, positive results (Pomeroy et al., 1997; Rubin, Pomeroy, & Gordon, 1995). Because of the prior success of this intervention with other populations, modification of this approach to specifically meet the informational needs and emotional concerns of incarcerated women who are infected or affected by HIV/AIDS and then test its effectiveness with this female target population appeared to be warranted. The educational component of the psychoeducational intervention is based on the assumption that people coping with HIV/AIDS need accurate information about the disease. Due to the wide variety of rare opportunistic infections that may develop as a result of the illness, people affected by HIV/AIDS often develop inaccurate or false assumptions about the disease. Information about medication is also an important issue, particularly in light of the recent advances in treatment with protease inhibitors. Women also need to be informed about their ability to increase their chances of preventing the transfer of this illness to their newborn infants with medication protocols and good prenatal care. People coping with HIV/AIDS are often seeking information that is comprehensible and accurate. 176 RESEARCH ON SOCIAL WORK PRACTICE In addition to education, the intervention provides social and emotional support, the need for which has been well-documented in the literature on coping with a chronic illness (Biegel, Sayles, & Schultz, 1991). A safe, confidential group environment can ameliorate the loneliness, isolation, and emotional distress experienced by people affected by a chronic/terminal illness. People infected or affected by HIV/AIDS, in particular, need this group support due to the high degree of stigma associated with this illness (Cadwell, 1991; Pomeroy, 1994; Powell-Cope & Brown, 1992). Although the psychoeducational approach provides the structure for the group intervention, the conceptual framework also consists of elements of cognitive-behavioral theory and the task-centered approach (Reid & Epstein, 1972). Cognitive behavioral techniques have proven to be effective in the reduction of anxiety and depression as well as trauma symptoms. Numerous studies have indicated the efficacy of cognitive-behavioral techniques in individual or group therapy settings (Rehm, 1995). The basic assumption underlying cognitive-behavioral theory is that dysfunctional cognitions make a person vulnerable to anxiety and depression and lower self-esteem (Hammen, 1995). The task component or homework assignments are seen as a way to help clients work on the emotional impact of HIV/AIDS in their lives between group sessions. Whereas information can be readily assimilated if presented in a coherent manner, making emotional changes can be far more timeconsuming and difficult.Discussion: Assess the Quality of a Research Paper Therefore, it is important for group participants to spend time working daily on the emotional issues with which they are confronted, especially given the time-limited nature of the intervention. Each of the 1.5-hour psychoeducational group sessions consisted of an educational, didactic component and a supportive component. The first part of each session lasted about 45 minutes and consisted of a presentation and/or discussion concerning an educational topic relevant to HIV-infected or affected women. The second part of each session, also 45 minutes in length, focused on supportive group processes using cognitive-behavioral and taskcentered techniques. Some of the topics in the supportive component of the sessions include ways to cope with depression, anxiety, and stress; the importance of social support; self-esteem and empowerment issues; grief over multiple losses; and coping skills (see Table 1). Outcome Measures The dependent variables in this research study were anxiety, depression, and trauma symptoms of the HIV-infected or affected incarcerated women. These variables appear to exemplify the psychological consequences and Pomeroy et al. / GROUP FOR WOMEN IN JAIL TABLE 1: Group Session 177 Psychoeducational Content of Group Intervention Educational Component Support Component Homework Assignment 1 Overview of HIV/AIDS/ Establishing group trust Trust and self-esteem “I am” exercise 2 Opportunistic infections/ Challenging irrational thoughts Coping with depression Automatic thoughts exercise 3 Medication issues/ Recognizing inner strengths Depression (continued) Changing negative thoughts 4 Safer sex/Healthy versus unhealthy relationships Dealing with anxiety Stress reduction exercise 5 Safer sex (continued)/ Decision-making skills Anxiety (continued) Stress reduction exercise 6 Nutritional needs/ Communication skills Coping with anger, grief, and loss Anger management 7 Women and children with Anger, grief, and loss HIV/AIDS/Parenting issues (continued) Anger management 8 Financial issues/ Building confidence Problem solving and goal setting Goal-setting exercise 9 Planning for the future/ Recognizing personal resources Empowerment Strengths exercise 10 Termination Accomplishments in the group Moving out and moving on relationship issues associated with the impact of HIV/AIDS on women as discussed in an earlier section. At the beginning and the end of the group sessions, participants in the treatment group were given scales to measure the above named symptoms.Discussion: Assess the Quality of a Research Paper Participants in the comparison group were also given the instruments at times that paralleled the beginning and end of the experimental group. Anxiety was measured with the state version of the State-Trait Anxiety Inventory (STAI), a standardized scale that has been validated and shown to have coefficient alpha reliability coefficients ranging from .86 to .95 (Spielberger, 1983). Depression was measured using the Beck Depression Inventory (BDI). The 178 RESEARCH ON SOCIAL WORK PRACTICE BDI has been shown to be sensitive to clinical changes, to be valid, and to have reliability coefficients ranging from .74 to .93 (Beck, Ward, Mendelson, Mock, & Erbaugh,1961; Corcoran & Fischer, 1987). Trauma symptoms were measured using the Trauma Symptom Checklist (TSC-33), a 33-item instrument that has been employed in clinical research as a measure of traumatic impact. It has been used in relation to the long-term effects of childhood physical/sexual abuse. The scale has been shown to have internal consistency with an alpha of .89 (Briere & Ruentz, 1989). Research Design A time-limited psychoeducational group intervention was provided to HIV-positive infected and affected women in a county jail system. Due to the varying lengths of stay of the women in the jail, the intervention was conceptually similar to the groups in prior studies (Pomeroy et al., 1995, 1997). The length of the group, however, was modified to 5 weeks with two 90- minute groups per week rather than the 6- or 8-week, once a week format of the prior studies. To test the hypotheses of this study, an experimental/treatment group and a comparison group were established. To have an adequate sample size, the group was held on five occasions for a 5-week period with two intervening weeks to recruit new members. Each treatment group had a comparison group. Two treatment groups ran concurrently with the exception of one occasion. A total of nine treatment groups and eight comparison groups composed the research design. Because the participants were not randomly assigned to the two groups, the study used a quasi-experimental nonequivalent control group design. This type of group design has, as its major weaknesses, the chance of statistical regression and the interaction of … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10