Chapter no 3
Research methodology
Population: clinical patients with chronic pain and depression from different hospitals in
Pakistan were taken as population for this study.
Inclusion criteria: Inclusion criteria are defined as the key features of the target population that
the investigators will use to answer their research question. Typical inclusion criteria include
demographic, clinical characteristics and inclusion criteria of this population include male and
female patients with chronic illness.
Exclusion criteria: exclusion criteria are defined as features of the potential study participants
who meet the inclusion criteria but present with additional characteristics that could interfere
with the success of the study or increase their risk for an unfavorable outcomes.in this population
exclusion criteria includes the patient with acute illness and pain.
Sample: a sample of 70 people with chronic illness and pain was estimated to collect the data for
this research from different hospitals and we got total data of 50 patients.
Sampling techniques: purposive sampling technique is used to select the sample, Purposive
sampling refers to a group of non-probability sampling techniques in which units are selected
because they have characteristics that we need in our sample, so we used for chronic ill patients.
Research design: cross sectional survey research design is used in this sample; A cross-sectional
survey collects data to make inferences about a population of interest (universe) at one point in
time. we use this research design for our research.
Process of data collection: data was collected from clinical population from DHQ
Muzaffargarh, several patients including males and females and some staff member cooperated
and questionnaire are in hard form in Urdu version so that they were easily understandable to lay
man of Pakistan
Introduction to Instruments:
3 scales are used in this research are
1. Beck scale for suicide ideation
2. Pain rating scale
3. Beck depression inventory
Beck scale for suicide ideation: Beck Scale for Suicidal Ideation (BSSI) is a widely used
instrument to assess suicidality, The Cronbach's alpha coefficients of the screening part and the
whole scale were satisfactory (>0.8). This scale is a 19-items instrument that evaluates the
presence and intensity of suicidal thoughts in a week before evaluation. Self-reporting edition of
the scale was introduced by Beck et al., in 1988 (13). Each item is scored based on an ordinal
scale from 0 to 2 and the total score is 0 to 38. Individuals answer to the first 5 items which is
excerpted. If individual's answer to the fifth item is positive (scores 1 and 2), he/she answers the
rest of the items and otherwise the questionnaire is completed. No cut- point was used to
categorize the scores. Hence, we used the scores of the screening part (first fifth items) and the
total scale for data analysis. We used Urdu version of this questionnaire.
British Pain rating scale: to check the intensity of pain, the pain scales are recommended to be
used by GP's and Accident and Emergency staff and may well also prove useful in a wider range
of situations in which the communication of pain is necessary. The pain scale we used are judged
to be easiest to use and best understood of the simple scales available for adults with no
cognitive impairment. The scale assesses different, partly separable, aspects of pain, plus pain
relief. They are not intended to be combined in total or averaged. This scale is available in
different language but we use Urdu version, it has 6 items, 2 for present pain perception, 2 for
past week and 1 for relief percentage, rated at a10 point rating scale rang 1to 10. Because pain
often fluctuates over time, a high index of test-retest reliability is not the goal - it might indicate
insensitivity to change rather than reliability across time. As single item scales, there is no
question of internal consistency, and as self-report, there is no inter-rater reliability.
Beck depression inventory: Beck Depression Inventory (BDI) was created in 1961 by Aaron T.
Beck, a pioneer in cognitive therapy, with the sole purpose of determining the severity and
intensity
level of the symptoms of depression. It is a 21-question multiple-choice self-report inventory,
one of the most widely used psychometric tests for measuring the severity of depression
thoughts. There are three versions of the BDI—the original BDI, first published in 1961 and later
revised in 1978 as the BDI-1A, and the BDI-II, published in 1996. The BDI is widely used as an
assessment tool by health care professionals and researchers in a variety of settings, The
standardized cutoffs used differ from the original:
0–13: minimal depression
14–19: mild depression
20–28: moderate depression
29–63: severe depression
Process of data analysis: in this study correlation and multiple linear regression is performed to
prove the hypothesis, using IBM SPSS Statistic 21 to get up to date results from gathered data.
