EDUC 8050 Research design and methods | Quantitative Measure Methods

Introduction

Quantitative measure methods are the primary aspect of any quantitative research method and using this data collection method, researchers can collect data which can be easily measureable. The common quantitative data collection method includes observations, questionnaire, interviews, and physiological measures and so on (Zhang et al., 2013). However, it is important for the researcher to conduct critical appraisal of the chosen data, so that all the strength and weaknesses of the data collection instruments can be determined (Simon et al., 2013). In this assignment, the quantitative measurement tool PHQ-9 will be used and depending on this, the critical assessment will be carried out. Further the final verdict on selection of this data collection method will be addressed.

Discussion

Identifying the instrument

PHQ-9 or the Patient Health Questionnaire 9 is a diagnostic instrument for the people affected with mental disorder. In this measurement tool, there is a depression module which is divided into nine questions and the score varies from 0 (not faced at any stage) to 3 (or nearly every day). This tool is mainly used in primary care centers to determine the presence of depression condition in patients. The measurement approach of the instrument is questionnaire (Malpass et al., 2016). To locate this quantitative instrument, several databases such as PubMed, Medline and CINAHL were searched and using this systematic research measurement tools relevant to nursing professionals were identified. The journals that were included in the search strategy was occupational medicine, journal of interprofessional care, Journal for research. The key words that were used to search for the measurement tool were PHQ-9, Patient Health Questionnaire, measurement tool for depression, depression measurement and depression assessment tool. This instrument was selected as it was completely dependent on the patient’s feelings and mental state and they had to answer 9 questions related to their mental ability and their feelings, which increases the reliability and authenticity of the measurement (Torous et al., 2015).

Instrument availability and access

This instrument was available over internet and did not contain any copyright or legal notice that shortens the array of its usability. Clinicians, therapists and researchers were able to use this tool for their purpose. However, the patients going to use this for their depression assessment should be informed with all the informations so that they can answer honestly to the measurement tool questions (Razikov et al., 2012).

Instrument background

Purpose

The primary purpose of the development of this measurement tool was to determine the presence of depression in patients suffering from adverse effects of depression. It monitors the severity of depression by scoring the responses of patients from 0 to 27 (Torous et al., 2015).

Historical background

The PHQ-9 measurement tool was developed by Dr. Roberts, Dr. Williams, Dr. Kroenke and their colleagues developed this tool back in 1999 and within this 59 question instrument, PHQ 9 was made to determine mental condition by assessing the mood of the patient through their responses (Amtmann et al., 2014).

Content

This measurement tool was designed for the application on patients and hence, it was a self-administered version of another measurement tool namely PRIME-MD. The content or the 59 questions present in this measuring instrument is able to assess 12 mental disorders depending on the mood, level of anxiety, consumption of alcohol and other physiological disorders (Razikov et al., 2012).

Reported Internal Consistency, Reliability & Validity

Reliability and validity of this measuring instrument was determined by Zhang et al. (2013), in a research which they conducted to determine the reliability of this measuring instrument and the study included 959 patients who responded to PHQ 9 questionnaire. The researchers found that inter consistency value was 0.85 and reliability value was found to be 0.87. Therefore, the PHQ 9 showed satisfactory sensitivity and specificity while determining the depressive signs and symptoms in patients.

Data ownership

The data is available in each of the patients using smartphones or internet and they can provide their feedback through their smartphones so that measurement process becomes easier. Further the smartphones can contain application which is necessary for the registration of the answers (Amtmann et al., 2014).  

Variables previously measured

This measuring instrument calculated variables such as the anxiety level, mood swing levels, emotional level and the level of anger in the patients (Hammash et al., 2013).

Sampling

Sampling process is not complicated for this measuring instrument as patients having signs of depression can be included in the study randomly (Simon et al., 2013).

Measurement and analysis

The measurement depends on the patient’s response on the given questionnaire and based upon the response the patient is provided with scores ranging from 0 to 3 and hence, in case of PHQ 9, after giving response to each questions, patients are scored from 0 to 27 scores. Analysis process is simple as patients receiving scores from 15 to 27 are determined as extremely depressed whereas from 10 to 15 are at the verge of developing stressful mind (Malpass et al., 2016).

Instrument strength

The strength pf this instrument is involvement of patients directly in the measurement process. Quantitative measurement tools such as interview, patient behavioral assessment required involvement of the healthcare physicians in the process. However, the chances of biasness, and reliability of the questions to the patient varied. Therefore, PHQ 9 provided the healthcare facilities with an opportunity to determine depression condition in patients (Hammash et al., 2013).

Instrument weaknesses

The weakness of this instrument is also associated with the patients as they might not understand the process and responded to a different question with different perspective, hampering the entire assessment process. Therefore, prior to application of PHQ 9 patients should be provided with verbal and practical training so that they can reply to the questions without making any mistakes (Malpass et al., 2016).

How this instrument can help in proposed study

This instrument is useful in current research studies of any context to determine the mental stability of the sample population. Further it will help in determining anxiety level of the population, hence, determining successful implementation of the research process (Simon et al., 2013).

Conclusion

Application of PHQ 9 quantitative measurement instrument requires patients to be aware of the steps and process they will be going through in the process. However, this is one of the most important measuring instrument which helps to determine the stress and anxiety level of patients, instead of determining the person is stressed or depressed. In this assignment the history, purpose, strength, weaknesses has been mentioned with support to research articles.

References

Amtmann, D., Kim, J., Chung, H., Bamer, A. M., Askew, R. L., Wu, S., ... & Johnson, K. L. (2014). Comparing CESD-10, PHQ-9, and PROMIS depression instruments in individuals with multiple sclerosis. Rehabilitation psychology, 59(2), 220.

Hammash, M. H., Hall, L. A., Lennie, T. A., Heo, S., Chung, M. L., Lee, K. S., & Moser, D. K. (2013). Psychometrics of the PHQ-9 as a measure of depressive symptoms in patients with heart failure. European Journal of Cardiovascular Nursing, 12(5), 446-453.

Malpass, A., Dowrick, C., Gilbody, S., Robinson, J., Wiles, N., Duffy, L., & Lewis, G. (2016). Usefulness of PHQ-9 in primary care to determine meaningful symptoms of low mood: a qualitative study. Br J Gen Pract, 66(643), e78-e84.

Razykov, I., Ziegelstein, R. C., Whooley, M. A., & Thombs, B. D. (2012). The PHQ-9 versus the PHQ-8—is item 9 useful for assessing suicide risk in coronary artery disease patients? Data from the Heart and Soul Study. Journal of psychosomatic research, 73(3), 163-168.

Simon, G. E., Rutter, C. M., Peterson, D., Oliver, M., Whiteside, U., Operskalski, B., & Ludman, E. J. (2013). Does response on the PHQ-9 Depression Questionnaire predict subsequent suicide attempt or suicide death?. Psychiatric Services, 64(12), 1195-1202.

Torous, J., Staples, P., Shanahan, M., Lin, C., Peck, P., Keshavan, M., & Onnela, J. P. (2015). Utilizing a personal smartphone custom app to assess the patient health questionnaire-9 (PHQ-9) depressive symptoms in patients with major depressive disorder. JMIR mental health, 2(1).

Zhang, Y. L., Liang, W., Chen, Z. M., Zhang, H. M., Zhang, J. H., Weng, X. Q., ... & Zhang, Y. L. (2013). Validity and reliability of Patient Health Questionnaire?9 and Patient Health Questionnaire?2 to screen for depression among college students in China. Asia?Pacific Psychiatry, 5(4), 268-275.