HCT343 Research Methods and Data Analysis in Healthcare Assignment Sample
Title: - Correlation of socioeconomic status and health-related quality of life in parents of children with Autism in India
PURPOSE OF STUDY:
The purpose of this study is to determine the correlation between health- related quality of life and socioeconomic status in caregivers of autism children in India.
1) To assess the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of HRQoL using SF 12 in parents of children with Autism in India
2) To evaluate the association between socioeconomic status and Health- related quality of life (HRQoL) in caregivers of children with Autism in India.
• Inclusion Criteria:-
Parents of children with Autism
Child with autism should be from the age of 4 yrs to 18yrs.
• Exclusion Criteria:- Parents of children with autism who have morbidities.
Study design: - A cross-sectional, non-experimental design. The primary variables of interest are HRQoL and socioeconomic status by modified Kuppuswamy socioeconomic scale
• Data Analysis: - Paired sample t-tests will be used to assess the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of HRQoL.
• The Pearson Product Moment Correlation will be used to measure the relationship between socioeconomic status and HRQol in caregivers of children with Autism.
1) There is no correlation between health-related quality of life and socioeconomic status in caregivers of children who are autistic in India.
1. Project laid Summary
Autism is one of the most severe neuropsychiatric disorders that affect children. The subject's Autistic can be characterised by the impairments of interactive social behaviour in a stereotypical manner (Joseph et al., 2022). The absence of the ability to perform tasks properly can impact oral health. The sense and constant care of helplessness drastically affect the quality of life. The respective disease occurs due to the neurodevelopment that is identified at the early stages of growth of the children and prior to attaining three years of age of a child. The presence of the condition Autism delayed the development of social and communication skills and fixed or restricted behavioural patterns. Many types of research are carried out to understand the condition of Autism in India and provide the information that around 18 million people in the country are suffering from the condition of Autism. It is also reported that the number of children affected by Autism is increasing day by day (Divan et al., 2021). Some of the researchers also claim that socioeconomic status and health-related quality of life of the parents of children are correlated with Autism; however, most of them are unable to provide deep information. A lack of primary research is also found regarding Autism to establish a correlation between this and socioeconomic status and health-related quality of life in parents of children for assignment help.
The issue with most of the previous studies is that those consider small sample sizes and also consider healthy parents, so the aim of the research is not gratified. Hence, the respective study aims to investigate the relationship between the health-related quality of life in parents and socioeconomic status in a total of 50 participants. All the participants have at least one child with Autism. The data is collected by using 12 scales of HRQL, and the socioeconomic status of the participants is modified and collected through the scale of Kuppuswamy. The collected data is presented in tabular form, followed by statistical analysis to establish the research objectives.
2. Background of the study
The disorder of Autism is a type of complex disability that is increasing day by day throughout the world and also in the country of India. The disability of children not only brings a financial burden for the family members, especially the parents; it also impacts the social health, psychological health and physical health of the families (Goldberg, McCormick and Virginia, 2021). In most cases, parents with Autism affected children revealed a lower quality of life if that is compared with the other parents who have healthy children and also the parents with physically disabled children.
Physicians and caregivers provide the information that children with the condition ASD not only develop neuro-developmental disorders yet also lead to problems that require proper treatment and medical attention (Keeley, 2021). Hence it can be stated that it impacted the quality of life of the parents due to the pressure of treatment of the child and related expenses. However, the respective disease develops a lifelong disability that limits the child's educational, social, and occupational demands in all stages of life. Hence the children require lifelong support from parents, which is a kind of burden for the family. The World Health Organisation also shows worry regarding the condition of Autism because it not only affects children and families, it also dismantles the growth of society (Grinker, 2020).
The diagnosis process of Autism is also complicated and difficult due to the absence of specific medical tests. There are various tools discovered by physicians to test Autism in children. WHO recommended the requirements for a diagnosis of behaviour and mental conditions. The ICD-10 test is preferable in the UK, while the USA prefers DSM-5. “The Autism Diagnostic Observation Schedule (ADOS)” is used in India (Kim et al., 2022). At the same time, there are various risk factors that are associated with Autism, parental age, heredity or family history and so on. The research provides the information parents who have one child affected through Autism also have the chance of having Autism in a second child also. Consequently, a clear understanding of Autism and its correlation with socioeconomic status and health-related quality of life require enlightenment to change the lifestyle of parents (Prakash et al., 2021). Recommended improvement of quality-of-life families with children of Autism also supports the growth of societies.
a) Data Search
b) Critical appraisal of research literature, Analysis, synthesis and evaluation of research literature
Autism is the third most developed disability in the world. According to Abbeduto et al. (2014), the developed countries, due to a lack of awareness regarding Autism, are affected mostly. Not only lack of awareness, poor diagnosis and lack of primary needs for Autism also increase the risks and numbers of affected people. As per some of the studies, the condition of Autism is developed due to genetic and environmental causes. While some others provide the information that low birth rate, viral infections during the time of pregnancy, metabolic imbalances and family history are responsible for the development of Autism. Detection of Autism in the early stage of childhood is challenging. However, the condition is properly diagnosed at the age of two years. As per Adler and Ostrove's (1999) view, though Autism cannot be diagnosed at an early stage, it can be understood through observation, as most of them develop difficulties in communication and the development of appropriate social relationships. Parents try to hide their conditions of Autism due to a lack of awareness about their mental health. Even many people are unaware that their conditions can impact newborn children. The affected children with age exhibit various abnormal behaviours and are subjected to filthy remarks, humiliation, bullying and so on.
There is no such cure for the condition of Autism in children due to the absence of drugs. However, appropriate awareness is effective for performing and adopting appropriate requirements to manage Autism. Based on the view of Bromley et al. (2014), Cognitive behaviour therapy, occupational therapy, physical therapy, behavioural management therapy and so on. On the contrary, another research provides the information that Autism in children can be managed through medication treatment, school-based therapy, nutritious food and so on. Speech therapy is also considered by the physician in most cases of Autism. There upon it can be stated that the supportive system of Autism requires appropriate investment, which brings huge economic pressure upon the parents and to family. Children with Autism can lead happy lives if they are raised in a proper healthy, and happy environment. However, economic pressure, in most cases, brings disturbance within the environment of the home (Ahmed, Buheji and Fardan, 2020). In some of the cases, it is also observed that parents lose their ability to parent due to the economic pressure of treatment in a place where psychiatric and physical challenges take place.
As opined by Harman (2014), mothers experienced higher levels of stress. Some societies blamed mothers for the condition of Autism. At the same time, some parents try to find out the reason for Autism that, delays the whole process of diagnosis. With the reference of Hicks, Jason, (2018), incorrect diagnosis also increases the issues of the parents and family members. Secondly, children with Autism require support on their everyday chores, which decreases the occupational involvement of parents and ultimately impact economic conditions (Hastings et al., 2005). The schools that are run by the country's government are not effective due to the absence of infrastructure, which ultimately leads the parents to take private support services. Socioeconomic conditions are also impacted because Autism affected children are unable to travel by public transport in most cases for their mental and physical conditions. Thus, it can be stated that socioeconomic conditions are related to the life of parents of children with Autism.
The health-related quality of life means HRQoL is one of the most important measures that are not only effective for understanding the health of people with Autism, but it is also effective for understanding mental health. Based on the view of Algahtani et al. (2021), HRQoL is a kind of approach that is effective in measuring various health outcomes by proper evaluation of an individual's emotional, psychosocial and physical well-being as well. As stated by Meadan, Halle and Ebata, (2010), Paediatric Quality of life systematically addresses various problems such as social functioning, school functioning, and emotional functioning. Further, every domain of this is broken down into various factors. All of this is to support the children with Autism as well as the parents.
Most of the literature focuses on the families and parents with Autism and also disabilities and disorders. However, very few focus on increasing the quality of life of the affected children and their family members (rehab council.nic.in, 2022). While detection of Autism is quite difficult, increasing the quality of life can be able to support the parents and also the affected child. Treatment of Autism has also involved the education of parents and the spreading of awareness and also of caregivers. According to Rizk, Pizur-Barnekow and Darragh (2011), Caregivers are able to support children with Autism. However, lack of knowledge and investments from the sides of Government and infrastructure related to the respective care increase the issues of them. Pharmacological treatment for Autism is mostly preferred and widely practised in developed countries like India.
3. Purpose of study
The aim of the respective study is to evaluate the correlation between socioeconomic status and health-related quality of life in the family members and parents of children with Autism on the basis of a case study of the country India. The aim of the research is to recommend to parents with Autism children some remedies that are effective in maintaining the quality of life of themselves and also of their children.
a) Null hypothesis
There is no such correlation between socioeconomic status and health-related quality of life in the parents of children with Autism in country India.
The objectives of the respective study are as follows:
? To evaluate the correlation of socioeconomic status of life in parents of children with Autism in India
? To evaluate health-related quality of life in health-related quality of life in parents of children with Autism in India
? To develop appropriate awareness in a married couple to manage the risks of Autism in pregnancy
? To recommend some remedies to the parents for managing the lifestyle of Autism Children
4. Research design
The socioeconomic status of the individual is an important parameter for determining the status of the individual in society (Wani, 2019).In this regard, importance is given to occupation, earnings as well as education. Henceforth it can be regarded that these parameters play a pivotal role in shaping the nutritional condition and the subsequent health condition of individuals and families in general (Nielsen et al., 2021). In the current topic, thus, it becomes imperative to determine the socioeconomic status of the parents of the children who are suffering from Autism in India. Thus, this determination of socioeconomic status would help to reflect the quality of life that the parents of autistic children are leading in India. Thus, the correlation study helps to understand the association that exists between socioeconomic status and the quality of life that these parents are leading.
In this regard, it is essential to formulate the categories in which these parents can be classified. These categories would help to understand the exact choice of the participants who will be chosen for conducting this study (Patino and Ferreira, 2018). The inclusion and exclusion criteria for the selection of the participants are as follows
• Parents who have children suffering from Autism
• Parents are strictly from India
• Parents who have given consent to participate in the survey
• The parent can respond to the questions of the survey.
• The different parameters of threw socioeconomic status have been taken into consideration.
b) Exclusion Criteria
• Parents who do not have children suffering from Autism.
• Parents who are residing outside of India.
• Since Autism is a sensitive topic, the parents who have not given consent to participate in the survey have been excluded from the survey.
• The parents who are not in a mental or physical situation to respond to the questions have been excluded from the survey.
• The socioeconomic status of the patients has been considered in this respect, and the other aspects of life, like the physiological or the psychological parameters of the concerned, have been excluded from the survey since the focus is on the determination of the socioeconomic status of the parents and their relation with the quality of life that they are leading.
Thus, it can be inferred that the study is strictly concentrated on evaluating the socioeconomic status of the parents whose children are suffering from Autism. The parents of autistic children are only taken for conducting this survey. Moreover, it can be inferred that the parents' consent was taken before conducting the survey since Autism is a sensitive issue and ethical consideration must be given utter priority in this regard. The parents who have not opted to answer the questions of the survey have not been included in this research study. The study is this directed towards the goal, and it diverts itself from the unnecessary consideration of the aspects unrelated to the survey. For instance, this study avoids focusing on the parents who are residing outside India and thus focuses only on the estimation of the scenario of the parents who are residing in India. Furthermore, the physiological or psychological aspects of the parents have not been considered in this regard. The focus of the study is thus centred on finding the socio-economic status of the parents whose children are suffering from Autism in India.
c) Sample size
In this case, it is essential to determine the appropriate sample size, and this can be determined by the calculation of G power. The sample size is a crucial factor in the determination of the statistical accuracy of the results (Kang, 2021). The difference between the alternate and the null hypothesis is also determined by the sample size, and this can be predicted with the help of G power. Thus, the G power estimation is quite essential in the development of the research design of the scientific study.
The sample of 50 participants was taken by considering the G power of the population. In this case, the previous research has shown that the result of the correlation test has a tendency to have a positive value (Kivimäki et al.,2020). The p-value of 0.05 has been considered in this regard since the 5% level of significance is taken. In this kind of condition, the power of 0.8 is quite instrumental in diminishing the occurrence of the type-II error, and the effective sample size is 0.3. Thus, by considering all the necessary coefficients of correlation(r), the effective size is 0.478, and thus, in this respect, the sample size of approximately 35 would be quite conducive for performing the statistical analysis. Thus, we have considered the sample size of 50, and this is in good agreement with the G power of the sample size. In this respect, it must be noted that the smaller sample size would lead to the depleted statistical accuracy of the calculation that would be conducted, and this would also imply that the standard deviation from the mean would also be low. Thus, an accurate idea about the G power will help in ensuring that the size is adequate and it does not lead to the generation of excessive standard deviation, which can be regarded as an impediment to the accuracy of the statistical analysis. As discussed earlier ethical considerations have been taken into consideration, and thus it is essential to take the consent of the parents. The sample number of 50 reflects the number of participants who have agreed to participate in the study. A total of 62 participants had been approached for the survey, and among them, 12 participants opted to stay out of the survey. Henceforth the sample size of 50 has been considered for conducting this survey.
d) Data Collection
It is essential to evaluate the appropriate research methodology that will be conducive to procuring the research goals and objectives. The two types of research methods that are predominant in the scientific world are quantitative and qualitative types of research (Thelwall, and Nevill, 2021). In this research context, it was essential to evaluate the relationship between the socio-economic status and the healthy life of the parents whose children have been suffering from Autism. Firstly, it can be noted that the survey was conducted with the aid of the randomly chosen 50 parents whose children have suffered from Autism. This survey was conducted to evaluate the correlation between the socio-economic status and the healthy lifestyle of the concerned individuals. Thus, in this context, primary quantitative research has been performed to determine the effect of socioeconomic status on the health-related quality of life of the parents whose children have been suffering from Autism in India.
In this respect, the modified Kuppuswamy scale will be used, and 5the scoring will be done accordingly to measure the different parameters of the socio-economic status of the participants in India. The first aspect of measurement is the educational qualities of the parents of autistic children. In indicating this regard, the highest education is awarded a score of 7, while the illiterate participants are given a score of 1. The occupation of the participants will also be marked accordingly, with the people holding important positions in the government or private sectors getting a score of 10 while the unemployed participants are awarded 1. Again, in the case of income, the people belonging to the highest income categories will be awarded a score of 12, while people earning the least amount will be awarded a score of 1. Furthermore, it should be noted that according to the latest Kuppuswamy scale, the upper classes of the society are awarded a score of 26-29, while the people belonging to the lowest strata of the economic ladder will be given a score of 5. Thus, the higher scores of the participants indicate that they enjoy a better socio-economic position in society than the other participants.
The datasets will be properly estimated with the aid of the appropriate methods, and this will be instrumental in establishing the research goals (Sovacool, Axsen, and Sorrell, 2018). In the current research, the randomly selected parents whose children have been suffering from Autism were chosen, and their socio-economic status was estimated with the aid of the SF-12 and taking the modified Kuppuswamy scale for determining the socio-economic status of the parents. The data was collected after the completion of the survey, and it contained information related to the economics and education of the participants. The appropriate statistical test will help to depict the scores of the participants in the survey.
In this regard, the descriptive statistics will be calculated with the aid of Excel, and this will help to form a comprehensive idea about the responses that will be collected from the participants, and this will reflect the overall socio-economic status of the participants. A blank model 0f descriptive statistics is given below.
Table 1: A blank model of descriptive statistics
The statistical analysis of the data collected from the survey will help to analyze the effect of the socio-economic status on the health-related quality of life. Here in this context, the Excel analysis was performed to conduct the correlation of the data that was collected from the survey (Miot, 2018). Table 2 determines the meaning of the values that are obtained from the statistical analysis of the data set which is available. Again, this relationship can be both; positive and negative (Mat Roni et al., 2020). The positive value determines that the variables in question get increased with the enhancement of the variable. A negative association can also exist, which implies that with the increase in one variable, another variable gets diminished.
Table 2: Meaning of the correlation values
5. Ethical governance and consideration
Ethical consideration has been taken by the Ministry of Health and family welfare under the government of India. In this case, 50 people have been considered for undertaking the survey since it deals with a sensitive issue like child autism. Thus, the parents will be made to sign a petition of consent to affirm that they do not have any issues with sharing the relevant personal information. In this regard, the research design of the study has been made in consideration of the ethical aspects, and the consent forms of the parents will be submitted to the ministry of health and family welfare. The parents will be sent the questions through email, and this inline survey will ensure that the parents won't have to bear unnecessary trouble for participating in the survey. The parents whose children have been suffering from Autism can respond to the questions from the comfort of their homes since the survey will be conducted online mode. Thus, the parents would also feel comfortable sharing their personal details since this project will be conducted under the governance of an appropriate state agency. The reliability of the project would ensure the proper response from all the participants. Moreover, a detailed report about the progress of the survey will be presented to the learned experts after conducting the survey. These experts will review the scenario of the project properly and will also strategize some necessary recommendations that are related to the research study. These recommendations, according to the review of the scenario by then experts in the field, will be submitted to the government organization from time to time. Thus, the project related to the evaluation of the socioeconomic status and the quality of life of the parents whose children are suffering from Autism has been depicted by considering the ethical aspects and the proper governance of the project. The supervision of the concerned experts and the government agency would aid in fulfilling the research goals.