Research design, sample size, and power analysis in nursing research

¶ … Dying Process

Pain is an inherent component of human life, which can be either useful or unfortunate. In the case of a terminal illness, it is generally assumed that pain will form part of the dying process, which may range from months to a year or sometimes more. How to manage such pain has been the topic of considerable debate, and continues to be so. Short of euthanasia to help a suffering person end his or her life completely, alternatives have been sedation or pain management by means of prescription medication. Some terminal patients have also begun to enter the family setting rather than the clinical setting for their end of life care needs. The purpose of this study is then to create a quantitative research design to determine the connection between physical and emotional pain, its management, and the role of the family in alleviating such suffering.

As mentioned, the research design will be quantitative. This means that statistical parallels will be drawn among various categories of pain and the choices that such suffering leads to. Claessens et al. (2011), for example, found that palliative care that involves sedation could be offered as an alternative to patients who do not wish to enter the highly controversial debate regarding euthanasia, but whose symptoms are nonetheless non-responsive to pain management offered in ICUs and hospices. Family care offers a further dimension to end-of-life care options (Given et al., 2008). It also means, however, that more dimensions of suffering may be added for family members who are ill prepared to care for such a person. Kahn and Steeves (1996) make it clear that suffering concerns more than just physical pain, which is a dimension worthy of exploration for terminal patients.

In this study, the sample will consist of terminally ill patients nearing the end of their lives. Two groups will be compared; those who have been committed to clinical institutions and those who have, for the majority of their illness, received family care. The families of these groups will also be included in the study. The extent and effect of the illness on the patients themselves and their family members will be monitored and investigated, as well as how this correlates with the choice to use sedation as a pain management method towards the end of life. Also, when this option is not used, the number and nature of other types of pain management methods will be investigated. The sample size will be in the range of 100 patients in addition to their primary care-giving family members, which might range between 100 and 200.

A power analysis will be done to determine the divergence of choices from the ones that are expected. In cases where pain management in hospitals have been relatively effective, it is expected that fewer patients and families would opt for sedation, for example, whereas those who remained with their families for as long as possible before the end stage, as well as those for whom pain medication has stopped functioning adequately, are expected to more readily choose this form of pain management.