Позитивистська парадігма в клінічній практиці: основні принципи та власний досвід роботи

Abstract

Метою дослідження була оцінка ролі позитивістської парадигми при оцінці та інтерпретації клінічних даних у гінекологічній практиці. показано, що застосування підходів позитивістської парадигми вимагає ретельного дотримання алгоритмів статистичної обробки інформації, зокрема дані шкали найменувань доцільно категоризувати для полегшення інтерпретації одержаних даних. для оцінки факторів ризику розвитку міоми матки на ретроспективному етапі запропоновано використовувати базу даних із можливістю категоризації дистракторів. доведено, що застосування принципів позитивістської парадигми дозволяє оптимізувати аналіз ретроспективних даних та може бути корисним для планування подальших досліджень.

Positivism as a research philosophy adheres to the view that only “factual” knowledge gained through observation, including measurement, is trustworthy. In positivism studies the role of the researcher is limited to data collection and interpretation through objective approach and the research findings are usually observable and quantifiable. According to the principles of positivism, it depends on quantifiable observations that lead themselves to statistical analysis. The aim of the study was to evaluate the role of the positivistic paradigm in the evaluation and interpretation of clinical data in gynecological practice. The survey was conducted on the basis of SE “Road Hospital“ of SI “Odessa railway” for 2010­2013 years the first phase (2010­2011 years) was established database that next filled using real time during the whole time performance. On second phase was conducted content analysis of the data obtained scale items and their subsequent codification for further statistical analysis. Database was formed with Oasis (USA). Statistical analysis was carried out in a software environment R (GNU, USA). According to our research in the structure of the incidence of uterine dominated cubserose and intramural localization (38.9 and 53.5 %). Interstitial localization was observed in 30.9 % of cases, subserous , interstitial – at 12.6 % cases. intralihamentary location was observed in 4 cases. The frequency of submucous nodes did not exceed 4.6 %. Localization of the nodes in the body of the uterus was observed in 61.8 % of cases, in the gentle segment – 4.0 % at the bottom of the uterus – 34.2 %. The nodes of 2­3 cm in diameter were found in 195 (9. 8 %) women, 3­7 cm – in 773 (39.0 %), nodes of 7.10 cm in 987 (49. 8 %) cases, and larger ones – in 27 (1.4 %) patients. Duration of disease was ranged from 1 to 12 years (mean 5,2 ± 0,2 years). 439 (22.1 %) was performed by laparoscopic myomectomy access , 684 (34.5 %) – laparotomic access. Laparoscopic access operated single and plural of subserous uterine localization and intramural myomas with placement of signs centerpetal height and diameter of the nodes was not more than 10 cm of laparotomic access mainly used in larger sites. Conversion of laparoscopic intervention into the laparotomic one occurred in 7 (0.4 %) cases. Thus, the application of the principles of the positivistic paradigm to optimize the analysis of historical data and may be useful for planning future research. Mentioned facts are evidence that the application of the positivistic paradigm requires careful observance of algorithms for statistical data processing. Scale data types to categorize expediently facilitating the interpretation of the obtained data and the assessment of the risk factors for uterine fibroids in a retrospective stage. There was found that it is advisable to use the database with the possibility of categorizing dystractors. Improvements in information systems are necessary so that electronic medical records can be robustly queried for quality information for each provider or can directly deposit practice information into quality databases that can be queried for this quality information. The broad measurement categories previously discussed (facility, process, outcomes) are all amenable to measuring quality. The application of the principles of the positivist paradigm to optimize the analysis of historical data and may be useful for planning future research. Positivism which emphasizes objectivist approach to studying phenomena gives importance to research methods focusing on quantitative analysis mainly.

Целью исследования была оценка роли позитивистской парадигмы при оценке и интерпретации клинических данных в гинекологической практике. показано, что применение подходов позитивистской парадигмы требует тщательного соблюдения алгоритмов статистической обработки информации, включая данные шкалы наименований целесообразно категоризировать для облегчения интерпретации полученных данных. для оценки факторов риска развития миомы матки на ретроспективном этапе предложено использовать базу данных с возможностью категоризации дистракторов. доказано, что применение принципов позитивистской парадигмы позволяет оптимизировать анализ ретроспективных данных и может быть полезным для планирования дальнейших исследований.