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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.

Thank you all and have a super week!!

Tach Branch-Dogans

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