NURS2003 Case Study Assessment - Adult (60 years of age or older)

Prelude - Academic Integrity 

Please note that a number of students who have completed this assessment in previous semesters have been found to have breached Curtin’s academic integrity regulations: 

https://students.curtin.edu.au/essentials/rights/academic-integrity. While some students’ plagiarise by  not correctly referencing the sources of published information, a more common issue is collusion.  Collusion “is an agreement between people to act together secretly or illegally in order to deceive or  cheat someone” (Cambridge Dictionary: https://dictionary.cambridge.org). In this context, it means that  one student shares their work with another student so there are similarities between the two case  studies. One of the case studies mayhave been submitted in a previous semester, or the two case  studies may be submitted in the same semester. 

You are strongly advised not to participate in collusion. If you do so, there is a very good chance you will be caught and there will be serious consequences. Breaches of academic integrity are noted on the student’s academic record and virtually all students who engage in collusion fail the unit. 

Introduction 

For this assessment you are required to collect developmental data for a single child, adolescent, or adult closely, and report your findings. By definition, a case study is: “an intensive analysis of an individual unit (as a person or community) stressing developmental factors in relation to environment” (Merriam-Webster, n.d.). The purpose of this project is to consolidate your knowledge and understanding of human development through its specific application to an individual in the context of their family and community. Your challenge is to collect data through a combination of techniques that are currently used in research and produce a written report demonstrating your understanding of biological, psychological, and social processes of development as they apply to a person in the age group you select. You are also expected to demonstrate your ability to use the collected information to formulate reasonable and justifiable predictions about the participant’s future development (n.b. it is best not to use the word “subject” because people find the term demeaning). 

Keep in mind that the purpose of every piece of assessment is to test your knowledge and understanding of the material presented in the unit you are studying. To get the best possible result you should make yourself familiar with the unit outline, lecture notes, textbook chapters, and articles in the reading list. As this unit focuses on research evidence that comes from a variety of different academic disciplines, such as psychology, neuroscience, and epidemiology, it will be important to demonstrate that you have engaged with this evidence-based literature. Use the marking rubric as a check-list to ensure project expectations are met. It is best to read the instructions very carefully before you begin. However, if you need clarification about any part of this assessment, do not hesitate to speak with your tutor. 

First, you will select a suitable participant and obtain informed consent from the person or a parent (or guardian) in the case of a child or adolescent. Second, you will collect data. Third, you will write a report in which you will discuss your findings in the context of recent, evidence-based literature. Each of these steps is explained in some detail in the sections below. 

Participant selection, informed consent, and duty of care 

The person you choose to study must be a child or adolescent 15 years of age or younger or an adult 60 years of age or older. The instructions contained in this document are specific to an adult 60 years or older. If you wish to study a child or adolescent 15 years or younger, see the separate instruction document. 

It is important that you do not know the person or their family well. Do not choose a relative, such as grandparent, uncle, or aunt or a person you interact with regularly. Do not choose a person who has a deficit in cognitive functioning, such as someone with Alzheimer’s disease or dementia. Ask if you can do the case study with the relative of a colleague or an acquaintance. Another possibility is to ask a family member to ask one of their friends to take part. Most people are very interested and happy to participate.

When you have chosen a person for your study, you must first secure their informed consent (see Informed Consent – Assessment – Blackboard). The information sheet explains that you are doing this research for a course in life course development, that the person’s name will not be used in the report, and that the main purpose of the report is to help you see the relationship between textbook knowledge of development and real people. The consent form must be signed by the participant, or the parent/guardian, and student in person. N.B. electronic signatures are not permitted. 

As with all research, you have a duty of care to protect the health and wellbeing of your participant. If you believe on the basis of your assessment that your participant’s level of development differs from that which is typical for people of the same age and the person is not aware of the issue, you should refrain from mentioning it as this may cause unnecessary worry. You should, however, immediately inform the unit coordinator of your concerns. The unit coordinator will follow the matter up with the person as necessary. An assessment with a qualified health professional will be organised if required. 

All students must submit a signed consent form to Blackboard by 4:30pm on Friday at the  end of Week 4. 

Following submission you should allocate your participant and all family members false names (pseudonyms) that you can use in your assessment. For example, if the person’s real name is Stan, call him John and state in your introduction that this is not his real name. This way, there is little chance that the tutor who is marking your assessment will be able to identify the participant and their family. The separation of identifying information (names and contact details) and personal information, such as survey responses and blood test results, is mandatory in research. 

Data collection 

Collect the information for your report by using all three of the following research methods. Naturalistic observation for 60 minutes (Appendix A). 

Accompany the person to their place of study or work, or to a social gathering. Try to be as unobtrusive as possible; maintain some distance from the person and those with whom the person interacts. Begin by describing the environment. For example, if you are observing the participant in his or her workplace, you might consider the following questions: Is it crowded? (How many people in how large an area?) Is it calm or busy? (How many phone calls, how many interruptions in how long a period of time?) On which skills, mental and physical, does the person's work depend? 

Once you have collected some basic information about the surroundings, observe the person for 1 hour and write down, minute by minute, everything the person does alone or with others. Try to be objective, focusing on behaviour rather than interpretation. Thus, instead of writing, "Participant seems well organised," note those factors that are the basis for the observation: "Participant keeps a calendar with notes for telephone calls and tasks to be performed each day." Or instead of noting, "Participant seems well-liked and respected by her co-workers," it is better to indicate, "At 3:05 P.M., a co-worker stopped by the participant's office to ask her opinion of how to solve a deadline problem. The participant came up with possible solutions; the co-worker thanked her and said that the ideas seemed good possibilities. At 4:15 the participant's manager asked her to interview a prospective employee or volunteer." 

When you have finished your data collection, type your observation notes in a table with a separate row for each of the 60 minutes (i.e. your table should have at least 60 rows). Then after the table, summarise the data in 2 ways: (1) Note the percentage of time spent in various activities. For instance, "Talking on phone, 10 per cent; arranging schedules, 20 per cent; conferring with co-workers, 5 per cent; attending meetings, 15 per cent," and so on. (2) Note frequency of various behaviours (e.g. co-workers visited participant's office twice; participant visited co-worker's office once; participant made 3 phone calls and received 2). 

Also note any circumstances that might have made your observation atypical (e.g. participant had just returned from a 5 day, cross-country trip and was tired and had a lot of catch-up work in the office). These examples all relate to the work place, however, the setting could just as easily be a social gathering, such as a church group.

Remember that a percentage can be found by dividing the total number of minutes spent on a specific activity by the total number of minutes you spent observing. For example, if, during your 60 minute observation, the person talked on the phone for periods of 4 minutes, 6 minutes, and 4 minutes, "talking on the phone" would total 14 minutes. Dividing 14 by 60 yields .23; thus the person spent 23 per cent of the time talking on the phone. (If the figure in the third decimal place is 5 or more, round the second decimal place up to the next digit—for example, if your quotient were .246, you would round to .25, which is 25 per cent). 

Label this Appendix A and attach it to your assessment after the reference section beginning on a new page. It will not contribute to the word limit of the assessment. 

Informal interaction for 30 minutes (Appendix B). 

Interact with the person for 30 minutes. Some possible topics for discussion include: the person’s favourite and least favourite activities; experiences from the person’s past that have been most influential to their present life; the influences of family, friends, and mentors in the person’s choice of employment and satisfaction with work; satisfaction with retirement; other factors have been important (partner, education, financial needs, and so on); how does the participant balance work responsibilities and family life; and attitudes and beliefs about current events. 

When you have finished your data collection write a summary of your interaction in 2-3 paragraphs. First, describe the setting and the specific activities you were engaged in (e.g. having a coffee in a cafe). Second, describe how the person responded to you. Did the person seem shy or open, easy going or difficult to get along with, have a sense of humour about him/herself? Did the person accept responsibility for his/her life and actions, or blame others? Did the person seem satisfied or dissatisfied with his/her personal life, family, choice of employment, etc.? Third, describe any additional features you have learned about this person and their development. 

Label this Appendix B and attach it to your assessment after Appendix A beginning on a new page. It will not contribute to the word limit of the assessment. 

Interview and SF36 questionnaire (Appendix C). 

The final aspect of data collection involves an interview with the person. The interview will involve asking specific questions about health and development. It may take place after the informal interaction or at another time and place. Your goal is to learn as much as possible about the participant and their family, work, and neighbourhood environments that influence development. It does not matter if some of these questions were answered in other aspects of data collection. Information that comes from a variety of methods is useful to increase the reliability and validity of your findings. 

The following factors are known through research to be important for human development. They are grouped according to developmental systems theory which is also known as bioecological theory and biopsychosocial theory. In this theory, psychological factors include social and emotional functioning, while social factors are those within the family and community that influence development. Proximal factors (those that happen most recently) are generally more salient than distal factors (those that happen a long time ago), however, a distal factor may be important if it was atypical or notable. For example: a serious illness or an accident in early childhood might be important for an older person if it impacted negatively on their schooling and subsequent job opportunities: the experience of abuse in childhood might be associated with the experience of anxiety and depression in adulthood; warm, loving, and engaged parenting may have been instrumental in helping the person to achieve highly in their career or excel in a sporting activity.

Salient biological factors 

Preterm or low birth weight 

Multiple pregnancy – twin or triplet 

Family history of genetic disorders or health problems e.g. type 2 diabetes 

Disabilities 

Lifetime serious and chronic illnesses 

Health problems e.g. tendency to high BP, high cholesterol, borderline high blood glucose Perceptions of health – see following SF36 questionnaire 

Medications 

Height/weight – BMI 

Physical functioning/limitations – see following SF36 questionnaire 

Physical activity – see following SF36 questionnaire 

Diet 

Sleep pattern 

Smoking 

Alcohol and substance use 

Toxic environmental exposures – home, work, community e.g. passive smoking, asbestos, chemicals. 

Salient psychological factors 

Cognitive functioning: language, memory, problem solving, learning, moral reasoning Literacy and numeracy 

Study achievement 

Tertiary qualifications 

Self esteem 

Body image 

Self-efficacy 

Mental health and mental health problems – see following SF36 questionnaire 

Experience of stress 

Childhood experiences 

Work/life balance 

Life satisfaction 

Salient social factors 

Family demographic characteristics – family composition (single/married/defacto/divorced/ widowed), ages, race/ethnicity, language(s) spoken at home, religious affiliation 

Family socioeconomic characteristics – degree of financial security, levels of education, occupations Family psychosocial functioning – intimate relationship, family relationships, financial strain, life stress, experience of discrimination 

Work/study environment 

Extended family 

Social support 

Residential suburb/neighbourhood resources 

State and national political and economic context 

An abbreviated version of the Short Form 36 (SF36) questionnaire has been placed in the Assessment section of Bb to help with your data collection. The SF36 is suitable for assessing the health and general functioning of adults. It is widely used both nationally and internationally. The SF36 could form part of your interview or you could ask the participant to complete it for you. 

Write down your questions before the interview and the answers you are given during the interview. After the interview type out your questions and answers. Dot-points are appropriate - formal sentence construction is not required. Summarise your findings from the SF36 Questionnaire. Do not scan the completed SF36 questionnaire in to your document. It is unnecessary and it will make your document run slowly. 

Label this Appendix C and attach it to your assessment after Appendix B beginning on a new page. It will not contribute to the word limit of the assessment.

Your report 

Write your report in the style of an academic article using APA (7th ed.) headings, formal paragraphs, 1.5 line spacing throughout (including the reference list), and formal academic English writing in full sentences with correct spelling and grammar. It is not appropriate to write in note form or to use dot-points. It is customary in formal academic writing to use an impersonal writing style (e.g. passive voice and third person). While I suggest you do this when possible, there are times when it is better to use a personal style (e.g. active voice and first person). It is better to say “I” rather than refer to yourself as “the researcher” or “the author”. See the example on page 6. Your writing will need to be precise and concise. The report is limited to 2000 words (10% over the word limit is acceptable), excluding in-text references, the reference list, and appendices. A Word document is required. It is important that you do not attach pdf files or other scanned documents as these will make it run slowly in Blackboard. It  issuggested that you use the following headings and word limits for each section: 

Title page (including name and student id) 

Contents page 

Introduction (100 words) 

Background Information (100 words) 

Biological Factors (500 words) 

Psychological Factors (500 words) 

Social Factors (500 words) 

Predictions for Next Five Years (200 words) 

Conclusion Findings (100 words) 

References 

Appendix A 

Appendix B 

Appendix C 

Use the introduction to tell the reader what your report is about, as well as to describe how you know the participant and why you selected them, and to describe specific details of the observation, interaction, and interview process. You must include sufficient detail – see the marking rubric. Next, report relevant background information, including the: age, ethnic background, specific education level, and specific occupation of person and spouse (if applicable); age and sex of siblings and children; proximity of extended family members including children and grandchildren; and the sociodemographic characteristics of the participant’s residential suburb and neighbourhood. 

Describe all salient aspects of the participant’s biological, psychological, and social development in the three major sections of the report drawing on the data you have collected and presented in the three appendices. Do not simply transcribe information from your appendices. While mentioning all salient aspects of development you should only highlight and discuss in some detail 2-3 aspects of development that are atypical or notable in each section. For example: if the person was not born preterm or low birth weight, is not a twin or triplet, has no family history of genetic disorders or health problems, does not have a disability, and has never had a serious and chronic illness you only need mention this in a sentence; if the person’s BMI indicates that they are overweight or obese, you should discuss this and refer to recent evidence-based literature; if the person is very happy in their relationship with their spouse, you should discuss this and refer to recent evidence-based literature. 

You are required to use at least 8 journal articles that report recent, relevant research findings. You will find that many research articles have a very useful review of evidence-based literature at the beginning. I suggest you first look for articles in your reading list that are relevant to your case study. It is not acceptable to use your textbook (Belsky) as a reference or any other books or textbooks in Psychology, Sociology, Nursing, Human Development, etc. The use of information and downloads from Websites (e.g. Wikipedia, Beyond Blue, HealthInsite, WHO) will not be accepted, with the exception of those reporting demographic or statistical information from the Australian Bureau of Statistics or growth charts from Australian state government sources. The information you find in the journal articles should be woven into your report and properly cited using APA (7th ed.) referencing guidelines. Use the following as examples of how to write up your findings:

1. When we were catting over a coffee Joan told me that she found it difficult to manage her career and her marriage relationship while at the same time regularly caring for her two grandchildren and elderly mother (see Appendix B). According to a recent review of the literature, this is a situation that many women find themselves in as they move toward retirement (Day & Keen, 2014). Joan said that she felt her marriage was suffering as a result of the constant stress she was experiencing and her health was also affected because she had recently been diagnosed with high blood pressure (Appendices B & C). There is evidence that many marriages are vulnerable when couples are alone again after their children leave home (Batty, 2005). As discussed previously, a great deal is now known about the relationship between the experience of excessive, prolonged stress and poor health outcomes (Jones et al., 2012). 
2. It was clear from my observations and interaction with Stan that he missed his recently deceased wife greatly and that he was extremely lonely. They had been together for 45 years. (see Appendices A & B). It was evident in both his words and his body language that he was depressed. These observations were 

supported when he told me that he had started seeing a counsellor and had begun taking anti depressant medication (Appendix C). The death of a spouse is known to be a major life-stressor and it is very common for people in this situation to experience depression (Burt, 2005). Men are especially prone to loneliness because they typically have fewer close friends outside their marriage than their female counterparts (Brian & O’Brien, 2015). While Stan has children and grandchildren, they live interstate, and he sees them infrequently (see Appendices B & C). His wife was his only close friend. Because Australia has a high migrant population and the major cities are so far apart, there are many people who are not able to see their extended family members as often as they would like (Grant, 2013). 

3. I observed that one of Brenda’s legs was significantly longer than the other and that this affected her ability to move freely (see Appendix A). When we were chatting later she told me that her disability was due to a motor vehicle accident that happened when she was 13 years old. Her father was killed in the 

accident and she spent many months in hospital afterwards having surgery and physiotherapy (Appendix B). As a result of the accident she developed post-traumatic stress disorder (PTSD) and was not able to complete secondary school and become a Registered Nurse, as she had hoped (Appendices B & C). Furthermore, she found it very difficult to develop intimate relationships and that is why she never married (Appendix C). While there is no literature specific to this case study, there is a great deal of research about PTSD (Giles, 2010) and the impact of disability on intimate relationships (Gilbert & Waller, 2015). It is not uncommon for an early life event, such as a serious accident, to change a person’s life course trajectory (Kendall, 2016). 

n.b. All above scenarios and references are fictitious. 

In the next section, predict the participant’s development in the next five years. Consider the circumstances/significant events the participant is likely to encounter over the next five years of development. Describe the strengths in the person, the family, and the community that you think will foster optimal development. Also note whatever potential problems you see (either in the person's current level of development or in the family and community support system) that may lead to future difficulties for the person. It is not necessary to include references in this section. Your predictions should be based on information you have provided in the previous sections that is appropriately referenced. 

Finally, write a few concluding sentences about life course human development and your experience of doing a case study, and very briefly outline the strengths and limitations of your case study research methodology that included naturalistic observation, informal interaction, developmental assessment, and interview. 

Please see the marking rubric on the next pages for further information.