Research Methods in Health and Social Care – Comparative Methodologies Assignment

Introduction

The purpose of this assignment is to aim to highlight in detail the similarities and dissimilarities between quantitative and qualitative research. The assignment will aim to do this by comparing two different research papers each one using a different style of research method.

According to Tingen et al. (2009) research has a huge impact on current and future growth of the nursing profession. Appropriate research helps to generate new knowledge or expand on pre-existing knowledge which can further help to improve nursing practices. This is in line with the initiative “improving general practice: A call to action” (NHS England, 2014).

The first of the two papers that I will be comparing for this essay is titled ‘Swab and instrument count practice: ways to enhance patient safety’ (Smith and Burke, 2014). The research undertaken in the paper is a quantitative study where the author produced and distributed surveys to the staff in theatre trained in surgery or circulating roles and focused on their perceptions of the policies that are in place at their trust and also the individual competencies of the person completing the survey. I will further refer to this research study as ‘paper A’ during the assignment. To begin conducting a quantitative study researchers first select a topic, a general area of study, issue or professional or personal interest and then narrow it down or focus on a specific research question which can be addressed in the study. A careful review of the research literatures and developing hypotheses is often needed (Neuman, 2014).

The second paper that I will discuss and evaluate is titled ‘An exploration of Operating Department Practice student experiences of placement support during their first perioperative clinical placement’ (Hinton, 2016). This paper focuses on a qualitative research approach where the author conducted a focus group interview question and answer session with well researched and planned questions. This paper will be referred to as ‘paper B’ for the remainder of the assignment.

While both of these research papers aim to enable improvements or changes to be facilitated within the healthcare setting, each style of research has certain strengths or weaknesses to it which can positively and negatively impact on the outcome of the research depending , a point that is raised in the research paper by L.T. Choy, “The Strengths and Weaknesses of Research Methodology: Comparison and Complimentary between Qualitative and Quantitative Approaches”. The paper suggests that both types of research, qualitative or quantitative approach; critics, debates or comments still happen between specialists of the two forms of methodologies. I will therefore aim to address and compare during this essay the differences in the types of research method.

Research Question / aim and core features

Paper A aims to address the processes around swab and instrument counts in theatre and attribute inaccuracies to a number of factors, including team fatigue, the complexity of the operation, if the surgery is an emergency procedure or distractions occurring during surgery.

As a way of recording the issues that are faced during surgery, the author created a survey using open ended and Likert-style questions (McLeod, 2019). Likert-style refer to questions where there are around 5-7 possible answers on a scale; sometimes referred to as a satisfaction scale, that ranges from one extreme attitude to another. Typically, the Likert survey question includes a moderate or neutral option in its scale.

This form of research is a quantitative method approach as it enables the researcher to get raw data from individuals which can be collated and used to form a picture of the overall feelings of staff in the theatre environment.

In addition to the questionnaires observations of the operating environment were undertaken on 15 surgical procedures chosen at random without the staff being made aware which operations were being monitored.

Thirdly the author examined development opportunities and practices in the operating department, as it is thought that by improving and developing workers in the NHS then the care that is given is greatly improved (NHS England, 2016).

By using three different quantitative approaches to the research, the author is able to get a wider range of information, although all three methods would fall into the ‘non-experimental, Descriptive’ type of research method, Non-Experimental research design is one of the broad categories of research designs, in which the researcher observes the phenomena as they occur naturally, and no external variables are introduced (Radhakrishnan, 2013). When accurately reported on, nonexperimental research can make a tremendous contribution for conducting research when experimentation is not feasible or desired. It can also be used as a tool to make recommendations for practice.

One of the recommendations that comes from research Paper A is that staff development and clinical supervision would help to improve and reduce the number of incidents.

Paper B looks at the experiences and feelings new Operating Department Practice (ODP) students after they have had their first clinical placement in a perioperative environment. The author invited students to attend a focus group meeting immediately following their first placement experience with the aim of exploring the different experiences that they faced.

This type of research is a common tool used by qualitative researchers as it allows the participants to discuss events that happened and ‘debrief’ with their peers in a non-threatening environment. There are many advantages of a focus group, including, being useful when obtain detailed information about personal and group feelings, perceptions and opinions, they can save time and money compared to individual interviews and they provide useful material for example quotes for public relations publication and presentations (Evalued, 2006)

The aim of research Paper B is to try and determine what knowledge and support future ODP students would find helpful to enhance their placement learning experiences.

Recruitment and sample

The survey in paper A, was offered to every member of staff in the main and day case theatres, who would undertake either a scrub or circulating role during operations. It did not say if the survey was a paper form, online form or how many questions were asked. All of these factors could have had an impact on if the member of staff completed the questionnaire. According to a study (Ward et. Al., 2014) they found that if anonymity of the respondent was important then the feeling was that online forms would give this better than a paper/pencil version of the same form.

The entire department had 139 members of staff and less than half (65) were scrub or circulating trained. This gave the study a sample size of 65 people, which would in-turn give a good indicator of the general feelings of the whole team. The author reported that just over 72% of the questionnaires were returned (47 out of 65) which is a good rate for comparison. Jack E. Fincham (Fincham, 2008) stated that a survey response rate of 60% or greater was satisfactory for most research.

Likert-style questions do bring issues to research as it is thought that by having a scale there is a risk of as this would significantly increase what is known as a ‘response bias’. Response bias is a type of bias which influences a person’s response away from facts and reality. This bias is mostly evident in studies interested in collecting participants’ self-report, mostly employing a questionnaire format. A survey is a very good example of such a study, and is certainly prone to response biases (Gaonkar, 2018).

The reasons are clear why the author decided to only include those trained in scrub or circulating. To include members of staff that do not have this training or who do not understand the role in theatre would potentially increase the number of un-returned surveys; this is termed a ‘non-response bias’, it is when there is a significant difference between those who responded to your survey and those who did not respond (TRC, 2009) There is also Participant bias which occurs when individuals act or respond in ways they believe correspond with what the researchers are looking for. Behaviour of the individual is uncharacteristic from how they normally would because they are responding in a way they think they are supposed to (Alleydog, n.d.)

Paper B recruited participants to join in the focus group by sending a written invitation to all 24 students from the same cohort. Each student received the same information prior to attending placement for the first time.

Due to the lower response from students who were willing to take part in the focus group, only 6 students agreed to be a part of the discussion out of the 24 students invited to take part (only 25% of the sample size) this meant that only one focus group discussion was held.

It is recommended that a focus group should consist of between six and ten people to be most effective (Howatson-Jones, 2007). Focus group sample size recommendations from books and journal articles range from as few as two focus groups per study to more than 40 groups (Fern 1982; Kitzinger and Barbour 2001; Krueger and Casey 2015; Morgan 1996; Vaughn et al. 1996). One common agreed guideline is that focus group research requires at least two groups for each defining demographic characteristic (Barbour 2007; Krueger and Casey 2015; Ulin et al. 2005), however none of these recommendations are supported by verifiable data. According to these “rules of thumb”, focus group projects most often use homogeneous people as participants, in this case the people taking part were all ODP students, should have a relatively structured interview with high moderator involvement, a group size of 6 to 10 participants per focus group, and normally have a total of three to five groups per project; although in reality, it would be rare for a research project to match all four of these criteria (Morgan, 1997).

Data analysis

Paper A breaks down all of the individual points that are raised in the questionnaires and looks at the statistics surrounding each set of answers. Quantitative research such as in this study has a number of strengths and weaknesses which can impact on the results.

Some of the strengths of quantitative research are that the study can be administered and evaluated quickly, it is also not necessary to spend time at the organization prior to administering the survey. This means that one survey can potentially be used across multiple hospitals saving time. Also responses from participants can be tabulated within a short timeframe because all of the respondents will have given answers that fit into a select number of fields.

Any numerical data obtained from a quantitative survey like this one can facilitate comparisons between organizations or groups if the survey is completed at multiple theatre settings for example (Yauch and Steudel, 2003: 473).  This would therefore provide a better level of feedback for the researchers and give a more in-depth idea as to how the count practice is followed in other hospital trusts.

Some weaknesses preventing quantitative research from being as effective as possible are the need for a large sample size; the bigger the sample then the more data that can be obtained, conversely, having a sample size too large can result in otherwise small differences in the results obtained (Faber and Fonseca, 2014) in this study the number of trained and qualified staff members in theatre was limited, accordingly a very small sample could potentially undermine the validity of the study (Faber and Fonseca, 2014). More weaknesses include the lack of resources which can often make large-scale research impossible and in many settings interested parties undertaking the research may lack the skills and resources needed to conduct a thorough quantitative evaluation (Dudwick, Kuehnast, Jones and Woolcock, 2006: 3).

Paper B had a very thorough approach to analysing the information firstly the authors read the transcript of the focus group a number of times to give familiarity, they then followed a framework devised by Colaizzi (Colaizzi Method of Analysis, 2015) which allows them to reveal emergent themes and their interwoven relationships (Wirihana et al., 2018). By following a distinctive seven-stage framework developed by Colaizzi (Morrow et.al., 2015), gives a methodical approach to interpreting the information from the study, before then using ‘Thematic Analysis’ to produce three main themes from the data; ‘Information’, ‘Placement’ and ‘Learning Experiences’. The author of the study then goes onto evaluate the information at the start of each section, before highlighting the responses of the participants.

One of the drawbacks of qualitative research, such as preformed in Paper B, is that researchers have a robust theory which underpins the way the research is conducted, often called methodology. Researchers need to have a high understanding of methodologies, to ensure alignment between their own bias or stance, research questions, and objectives. Some clinicians feel that qualitative research is inherently subjective or biased and that it does not produce generalizable findings (Austin and Sutton, 2014).

Philosophical Principles

Looking at the two methods employed by the researcher in papers A and B it is important to first realise the ontological and epistemological principles that the researchers followed. Ontology and epistemology are two different ways of viewing research. Ontology is knowing the reality, something that research is going to prove or the view point towards the reality. Whereas Epistemology is how to prove the view point or carry out the study in order to prove the view point which will contribute towards reality.

In paper A the research method was focused on the opinion of the person completing the survey and the responses they gave. Likewise, paper B was the subjective opinion of the students that participated in the focus group activity. Both of the papers displayed a good understanding of the ontology around the respective subjects and gave a good introduction and background of the current and historic issues or concerns, and the reasons for the studies to take place. They both gave an impartial non-bias response to the question being asked and attempted to highlight the issues that are known.

“Historically, qualitative research has been viewed as “soft” science and criticized for lacking scientific rigor compared to quantitative research, which uses experimental, objective methods. Common criticisms are that qualitative research is subjective, anecdotal, subject to researcher bias, and lacking generalizability by producing large quantities of detailed information about a single, unique phenomenon or setting (Bodenreider, Smith and Burgun, 2004).

The research in both studies then followed clear guidelines and aimed to highlight the points raised in the initial question, paper A by looking at the results of the survey and comparing this to national guidelines, paper B by putting the answers into concise short paragraphs, before including the responses from each participant in the study.

“However, qualitative research is not inferior research, but a different approach in studying humans. Qualitative research emphasizes exploring individual experiences, describing phenomenon, and developing theory” (Cope, 2013).

Paper B also highlights the known limitations of its own study pointing out that there were factors that would have potential impacts on the study; such as the small number of participants, purposively sampling instead of random sampling and the potential for coercion of the participants by the facilitator and moderator of the study (Hinton, 2016).

Conclusion

By comparing the two different types of research method, namely qualitative and quantitative you can see the individual strengths and weaknesses of both which can impact on the outcome of the research.

Paper A and the Quantitative research approach in my opinion has the least amount of weaknesses facing the study. Because the author was limited to only using members of staff that had knowledge of the area, and because they only applied the study to one hospital, there was limited amount of respondents available for this study which meant that the results were very limited. The main strength of this type of research however is that the information can be collected and facilitated quickly giving results on an almost real-time bases if the online version of the form is used.

Paper B and the Qualitative research approach had in my opinion more weaknesses, but was a more in-depth study over all. The weaknesses of the small amount of participants to the study and only being able to have one focus group meant that it would have been harder to get a non-bias evaluation as all of the results are coming from just one group of people. The data from this research is very open to bias as all of the focus group questions were open for interpretation by the participants and so open to opinion, this is a point raised by other researchers.

The main strength of this form of research is the fact that the information can be recorded and listened to a number of times by a large selection of facilitators and researchers and because it is a group discussion there is engagement so you are able to better judge the overall opinion of the group.

Therefore the type of research completed is very dependant on the type of information required from the study.

I think because both paper A and B focused on the opinion of people rather that factual physical evidence (for example equipment stability) I feel that either a quantitative or a qualitative study would have been appropriate in either of these two studies and would possibly have yielded the same types of answers.

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Effective nursing practice is built upon a solid foundation of knowledge, skills and compassion as well as maintaining the ability to care for patients and their families in an efficient, effective and helpful way. Nursing care is rooted in research and theories that are applied into practice in order to provide the best patient care possible (Saleh, 2018). This paper will explore the Roy’s Adaption Model and describe how the theory has evolved by using the theorists’ voice. This paper will describe the four stages of the evolution of the theory which include theorizing, syntax, theory testing and evaluation. I have chosen this theory as it is the foundation of the nursing process and utilized in every aspect of nursing practice. It also resonates with me as I believe that people’s behaviors are influenced by their environment and that they can achieve optimal health if they are able to adapt successfully to challenges.

The first step is theorizing, which includes understanding how the theory was developed. I, Sister Callista Roy, created the Roy’s Adaption Model in 1964 when my professor, Dorothy E. Johnson, challenged me to define the goal of nursing. My theory was created because I believe that nurses have the ability to help patients deal with difficulties in the environment by adapting to change and to move effectively towards health. My family, religion, mentors, clinical experiences and education all had an influence on the development of the model. While I was at my pediatric clinical rotations, I would observe and gather data from the patients and families for my research. I started thinking like a researcher even as a student (Roy, 2011). Within the model, the key concepts comprise of the person, health, environment and nursing. Nursing is the practice and science that increases adaptive abilities and supports person and environment conversion. The goal of nursing is to encourage adaption within the four adaptive modes for individual patients or in groups or populations. The four adaptive modes include the physiologic needs, self-concept, role function, and interdependence. The nurse assesses the behavior and aspects that impact adaptive abilities and intervenes to assist with the development of those abilities in order to improve environmental interactions. Adaption helps the person to find purpose and meaning in life and increase their holistic well-being. The outcomes of adaption are health, quality of life and death with dignity (Dixon, 2002).

Within the Roy’s Adaption Model, the person is defined as a bio-psycho-social human-being who is in continuous interaction with an altering environment. Environment refers to internal and external stimuli that surrounds and influences the person or group’s behavior. Health is the goal and is defined as a state of being and becoming whole. The process of health is demonstrated by a health-illness continuum and is the result of adaptation (Dixon, 2002). Adaptation is defined as the process and result of the person thinking and feeling, using conscious awareness and intention to generate human and environment combination. There are three levels of adaption which include integrated, compensatory and compromised. An integrated life process may transform into a compensatory process, which acts to restore integrity. If the compensatory processes are insufficient, compromised processes will occur. There are two coping mechanisms including innate and acquired. Innate coping mechanisms are generally unconscious responses and are inherently determined. Acquired coping mechanisms are learned behavior or develop through expected responses. Further in coping processes are the terms of regulator and cognator subsystems applying to the person, and stabilizer and innovator subsystems applying to groups. These life processes are demonstrated in person and group behaviors (Dixon, 2002). As stated previously, the four adaptive modes include physiological-physical, self-concept, role-function and interdependence. Within the physiological-physical mode, the behavior is the cell-level in the body. Five basic needs exist within the person including oxygenation, nutrition, elimination, activity and rest, and protection. The physiological adaption occurs within the senses; fluid, electrolyte and acid-base balance; neurological function; and endocrine function. The self-concept adaption mode includes components of the physical self and the basic need is for one to know oneself and exists with a sense of unity. The role-function mode focuses on the roles the person plays within society and within a group. The basic need is for social integrity, knowing who the person is within society and to behave within their role. The interdependence mode relates to relationships and the basic need is to feel secure within nurturing relationships (Dixon, 2002). These concepts are integrated into the development of Roy’s Adaption Model and influence the way it is utilized in research and nursing care.

Roy’s Adaption Model is widely utilized in research and applied to multiple different populations and areas of health care practice. Between the years of 1970-1994, there were 163 studies utilizing Roy’s Adaption Model as a basis for research studies as well as five middle-range theories that were developed between 1995-2010 (Roy, 2011). One study evaluated the effect of their education, exercise and social support within a randomized- controlled clinical trial on 43 adult patients with heart failure. The result of the study revealed that the intervention group positively adapted, and their quality of life was increased (Bakan & Akyol, 2008). Another study evaluated the effects of patient education in a medical semi-experimental research study on 59 adult hemodialysis patients. The results revealed an increase in adaption among the physiological, self-concept and role modes (Afrasiabifar, Karimi, & Hassani, 2013). Another study appraised the outcome of utilizing holistic care in conjunction with Roy’s Adaption Model among a patient undergoing breast conserving surgery. The study revealed positive adaption among the patient (Ursavas, Karayurt, & Iseri, 2014). Finally, another study revealed the positive outcomes of implementing Roy’s Adaption Model among pediatric patients (Saini, Sharma, Arora, & Khan, 2017). These studies just name a few of the many research studies employing Roy’s Adaption Model into patient care. As evident, implementing care based upon the model produces favorable patient outcomes of positive adaption, which results in optimal health.

The Roy Adaption Model is frequently used in nursing practice. The nursing process has evolved over many decades and guides nursing care worldwide. The nursing process is one of the basic functions that nurses’ implement daily and is considered evidence-based practice as it has been widely researched (Toney-Butler, & Thayer, 2019). In order to use Roy’s Adaption Model in practice, the nurse is guided by Roy’s six-step nursing process which includes assessing behaviors, assessing stimuli, developing nursing diagnosis, creating goals, implementing interventions, and evaluating attainment of adaptive goals. The beginning two aspects of the nursing process involves the nurse assessing the patient’s behaviors and stimuli. Behaviors may include observable, such as a heart rate, or non-observable data, such as subjective data from the patient. In this phase, the nurse implements observational skills, instinct, measurements, and interviewing skills to gather all the information needed. In addition, the nurse considers internal and external environmental factors associated with the behaviors. The examination of the data collected is reflected in the nursing diagnosis and indicates the patient’s adaptive state. When creating a nursing diagnosis, the nurse creates language consistent with current mannerisms and stimuli (Daley, 1996). The next step is the planning process, which occurs when the nurse generates goals for the patient or group. The goals include the behavior observed and how they will adapt and have a measurable time frame for the goal to be achieved. The next step is implementation, and this happens when the nurse utilizes the interventions into the nursing process. The interventions are adjusted to encourage adaption by modifying the stimulus and promote coping mechanisms. Finally, the evaluation process appraises the interventions’ success upon the patient’s adaptive goals. Determining the effect of the intervention, the same process is utilized by the nurse in examining all data collected (Daley, 1996).  Along with using the Adaption model in the nursing process, the nurse can implement evidence-based practice in other areas of care as well. These areas include creating assessment and documentation methods that utilize areas of the model that are consistent with the patient population served; developing training tools based on the model into educating patients, families and/or team members; addressing any issues that arise in communication or role status; executing a committee to address any resistance to change; and raising awareness and promoting positive change through conferences, meetings and educational modules (Senesac, n.d.).

In summation, Roy’s Adaption model is extensively researched and executed within nursing education and practice. Nurses have the ability to encourage patients to positively adapt to their environment or stressors in order to achieve optimal health by utilizing the Roy’s Adaption model. This paper has explained how Sister Castilla Roy created the theory and defined the concepts within the theory. Furthermore, this paper has included multiple research studies that the Roy Adaption Model has been utilized as well as how the model is used within current nursing practice. As evident, Roy’s Adaption Model provides a necessary framework for all nurses to provide patient-centered, appropriate care within all populations for patients to attain optimal health and well-being.

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Abstract

Arthritis is one of the pain problems that cause the disability of elders. To overcome this issue, total hip replacement surgery is introduced to improve the quality of life for patients who have this problem. In this report, with aid of software, SOLIDWORKS 2018, the hip prosthesis is tested with 500 N, normal to the femoral head with fixed femoral stem.

Furthermore, the diameter of femoral neck is adjusted to be four different diameters. Consequently, stress, strain, and displacement can be obtained using static simulation in SOLIDWORKS. According to the results, the change of diameter of femoral neck affects the value of stress, and strain, which these two values rise up as the diameter is reduced. However, fatigue is also needed to be taken into account for the hip prosthesis, because the weight of patient can also fluctuate. To withstand in the long term, fatigue is one of the factors that needed to be taken into consideration.

Keywords – Total Hip Replacement, Hip Prosthesis, SOLIDWORKS, Stress, Strain

I. INTRODUCTION

Arthritis is one of the main problems that cause the disability to elders. Furthermore, in the case of older people, they face with osteoarthritis, while other cases may face with rheumatic arthritis, post-traumatic arthritis, and avascular necrosis which cause hip pain [1]. To overcome this disability, the total hip replacement surgery is introduced to improve the quality of life for these patients, as they can live near normal condition as possible [2]. The term total hip replacement is defined as the removal of hip joint part and replaces with artificial ball and socket joint, which also called as hip prosthesis [3],[4].

In this report, the hip prosthesis is tested with the force 500 N, normal to the femoral head, with fixed femoral stem using simulation in SolidWorks 2018. The femoral neck diameter is also adjusted to be 4 different diameters, which leads to the relationship of femoral neck diameter and stress, strain of the hip prosthesis.

II. LITERATURE REVIEW

A. Type of Total Hip Replacement

From the Journal of Mechanical Engineering, Vol SI 5(5), 205-215, 2018, the total hip replacement can be categorized into three types, cemented, uncemented, and hybrid [2]. Cemented implant use fast-drying bone cement between femoral stem and bone, while cementless implant use porous coating on the stem [2]. Drawback of the cemented implant is it will have loosening effect for long term, unlike direct penetration, which introduces osseointegration that finally bone and hip prosthesis will combine as one piece [2]. If the patients are old, they need have the cemented implant as the bone is less active to grow around the stem [2].

B. Biomaterials in Hip Joint Prosthesis

From International Journal of Materials Science and Engineering, Volume 4, Number 2, June 2016, It stated that during daily activities, mean load on hip joint is about three times the body weight, while the peak load during jumping may be up to 10 times the body weight [4]. Therefore, the biomaterials that are fabricated to be the hip prothesis needs to be able to withstand high load, but also need have high wear resistance, which is one of the critical issues of implant failure [4].

Three main materials, metal, polymer, and ceramic are used to craft the hip joint, which mostly are in form of Titanium based alloy, Highly cross-linked UHMWPE, and Alumina respectively [4]. Firstly, Titanium based alloy has high specific strength, high corrosive resistant, complete inertness with biocompatibility, while offers low density [4]. Secondly, Highly cross-linked UHMWPE has high wear resistance . which permitted the use of larger femoral head, allowing greater range of motion [5]. Lastly, Alumina, which has low friction, chemically inert, resistant to corrosion, and stable in long term use, but it is poor fracture [4].

C. Normal Stress- Normal Strain

From Mechanics of Materials Principle, Russell C.

Hibbeler, 9

^th

edition, normal stress is the ratio between load and perpendicular area to that load, which can written as following

[6]

F σ =

(1)

A

From the same source, normal strain is defined as the ratio of change in length to the original length [6].

ε =

<sup>δ



l</sup>

(2)

l

D. Force Analysis

From 18

^th

International Conference on Applied Mechanics and Mechanical Engineering, 2018, it can be assumed that during slow walking, the weight of the body is supported by one leg [7]. From the data published by Miller and Nelson, Biomechanics of sport, 1990, the weight of one leg can be assumed as 0.16 of body weight (W

_b

) [8]. The forces equilibrium equations in X-Y axis, and moment equation about z axis, where the reaction force pass through this point are as below [7].

Σ F

_x

= M x cos (70˚) – R

_x

(3)

Σ F

_y

= W

_b

– 0.16 x W

_b

– M x sin (70˚) – R

_y

= 0 (4)

Σ T

_z

= 10.8 x W

_b

– 3.2 x 0.16W

_b

– M x sin (70˚) (5)

By solving the equations above, the values can be found as following, M = 1.57 (Muscular force) W

_b

, R

_x

= 0.54 x W

_b

and R

_y

= 2.31 x W

_b

, which the magnitude of reaction force can be obtained by

√R

_x


²

+ R

_y


²

which is equal to 2.37 x W

_b

[7].

Fig. 1. Force Diagram of One Leg [7]

E. Fatigue Analysis

From the same paper of force analysis, the authors tested cyclic loading, which is one of the factor that cause fatigue [7]. In this section, Titanium alloys, Ti-6Al-4V, and Cobaltchromium alloy are used to be the material of hip prosthesis [7]. Table 1 and 2, showing the maximum pricipal stress at the fixation level from FE simulations and experimental testing, and mechanical properites of the prosthesis hip joint.

Table 1. Maximum principal stress at the fixation level from FE simulations and experimental testing [7]

Experimental	Ansys	Siemen NX
Max. principal stress	166.16 MPa	164.08 MPa	171.15 MPa
% Error	–	1.25	3

Table 2. Mechanical properties of the prosthesis hip joint [7]

Material	Young’s modulus (GPa)	Poisson ratio	Yield Strength (MPa)
Ti-6Al-4V	110	0.32	800
Cobaltchromium alloy	220	0.30	720

III. METHODOLOGY

There are 3 main steps in this lab, the first step is assembly the hip joint which has three main parts, and the second step is static simulation, which the values of stress, strain, and displacement can be obtained. The last step is to change the diameter of the femoral neck, and repeat the simulation.

A. Assembly the artificial hip joint

All parts of the hip prosthesis can be downloaded from My Dundee as shown in the figure below. The hip prosthesis can be divided into 3 main parts, femoral component, articular interface, and articular cup.

Fig. 2. Hip Prosthesis Parts in My Dundee

After downloaded the files, to assemble them, “Mate” function is used, by assembly from the top of the hip prosthesis, i.e. the acetabular cup with articular interface, then assemble with femoral head, femoral neck, and femoral stem respectively. The “Mate” function is circled as the Fig. 3.

Fig. 3. Mate Function for Assembly

B. Setting the materials

The materials need to be customized according to the lab manual, which stated that the for femoral stem, and femoral neck, material is Titanium TMZF, and for others is Bio-ceramic Al

₂

O

_3.

The values for properties for both materials are provided in the lab manual.

C. Simulation of the hip prosthesis

To find stress, strain, and displacement of the hip prosthesis, there are several steps, which provided in detail with figures below.

1. Click on the SOLIDWORKS Add-Ins, and click on SOLIDWORKS Simulation as Fig. 4.

2. Click on New Study and select Static as Fig. 5 and Fig. 6.

3. Fix the femoral neck with fixture function, type 500 N in the external force, and select the femoral head to be the testing area, with normal direction.

Fig. 4. SOLIDWORKS Simulation

Fig. 5. New Study for The Static Simulation

Fig. 6. Select static simulation

D. Change the diameter of the femoral neck

The diameter of femoral neck is needed to be change into three different diameter, which in this lab, diameter of 3mm, 3.5 mm, and 4 mm are chosen. After change the diameter, repeat step A and step B for each diameters.

IV. RESULT

After run the simulation for four times with different diameters of the femoral neck the values of stress, strain, and displacement are shown below.

A. Stress (N/m

²

)

Table 3. Maximum stress for each diameters of femoral neck

Original diameter (6mm)	4 mm	3.5 mm	3 mm
1.067 x 10 7	1.715 x 10 7	1.992 x 10 7	2.703 x 10 7

Fig. 7. Stress value of the femoral head at diameter of 3 mm

B. Strain

Table 4. Maximum strain for each diameters of femoral neck

Original diameter (6mm)	4 mm	3.5 mm	3 mm
4.794 x 10 -5	1.055 x 10 -4	1.244 x 10 -4	1.507 x 10 -4

Fig. 8. Strain value of the femoral head at diameter of 3 mm

C. Displacement

Table 5. Maximum displacement for each diameters of femoral neck

Original diameter (6mm)	4 mm	3.5 mm	3 mm
1.147 x 10 -3	2.068 x 10 -3	2.472 x 10 -3	3.185 x 10 -3

Fig. 9. Displacement value of the femoral head at diameter of 3 mm

Fig. 7, Fig. 8, and Fig. 9, are the representatives for other diameters result. By the way, the pictures of stress among four different diameters look exactly the same, which are also in the same manner for strain and displacement. For stress and strain, the peak values are on the lower curve, which is the peak bending of the femoral neck.

V. DISCUSSION

From the result in part A and B, which shows both table and figures, the data analysis will be conducted into two parts. The first part, analysis of the data from Table 3, and 4 and Fig. 7, and Fig. 8, The last part is fatigue analysis. In addition, stress and strain that are discussed in this section mean normal stress and normal strain as mentioned in Part D, literature review.

A. Analysis from Data in Tables and Figures

From Tables 3 and 4, they can be observed that trend on the stress, and strain, rises up when the diameter is thinner, which goes along with equations 1 and 2 in part D, literature review. As the diameter reduces, the cross-sectional area is also decreasing. As stress is the ratio between the force to perpendicular cross-sectional area, which in this case, force is fixed to be 500 N, so it can be derived that stress is directly inverse variation to the cross-sectional area. For strain, the reduction of diameter can also be taken into consideration as the reduction of circumference. Therefore, from equation 2, the numerator of the equation, or the difference of length after the external force is applied and the original length is higher. Consequently, the strain also rises up.

As the Fig. 7 and Fig. 8 are the representatives for other diameters, the maximum stress which is in red, with similar manner to maximum strain. All results from SOLIDWORKS static simulation provide the exactly same pictures as shown in Fig. 7, and Fig. 8. For the reason that they have the same pictures, the results demonstrate that the maximum stress, and strain are at the curve on the femoral stem that connected from the curve of lesser trochanter, which from the force analysis in Fig. 1, reaction force (R) is the same force which is applied on the femoral head which cover the femoral stem. Not only this reaction force that needed to be taken into consideration, but the muscular force (M), by inspection, also contributes on the bending at the stem too. Therefore, if the patients have more weight, the hip prosthesis is required to have better requirement for withstand more load, also the fatigue which is analyzed in Part B.

B. Fatigue Analysis

According to the lab manual, the materials are Titanium TMZF, and Bio-ceramic Al

₂

O

₃

, which can be compared with Part F in literature review. As 18

^th

International Conference on Applied Mechanics and Mechanical Engineering, 2018, the author used the material of hip prosthesis to be the uniform Ti6Al-4V, which is also Titanium alloy. However, in this lab, the materials are separated into two parts, so the values of maximum stress in this hip prosthesis is different from table 1. Since Bio-ceramic Al

₂

O

₃

is poor fracture, so it leads to less stress, and strain property.

VI. CONCLUSION

Hip replacement is the alternative option for patients who have severe arthritis, and affected by it in their daily life. To have better quality of life, hip prosthesis is introduced for this hip surgery, and with the aid of software, the simulation of the hip prosthesis can be done to estimate the stress, strain, displacement, and other engineering values. In this report, the simulation of the hip prosthesis is run using SOLIDWORKS 2018, to estimate the values of stress, strain, and displacement. Also, from the simulation results, with inputting several diameters of the femoral stem, it can be seen that, the diameter is one of the factor that affects the stress, strain, and displacement.

From the results, the highest stress, strain, and displacement are on the same spot, which can be explained by the force analysis, in Fig. 1, that reaction force (R), and muscular force (M), act on the femoral head, and the curve of greater trochanter respectively. Therefore, these two forces provide the bending moment at the curve on the femoral stem, that connects from the curve of lesser trochanter.

Furthermore, as every patients may increase or decrease their own weight, hence, the hip prosthesis should be able to withstand this fluctuation. For this reason, the hip prosthesis is still need to be developed further to be able to overcome this disadvantage.

REFERENCES

[1]
http://morphopedics.wikidot.com/total


–


hip


–


arthroplasty


.

Accessed date: [26

^th

January 2017].

[2] Solehuddin Shuib, Nur Faiqa Ismail, Muhd Azman Yahya, and Amran Ahmed Shokri, “ANALYSIS OF AN IMPROVED HYBRID STEM DESIGN FOR TOTAL HIP REPLACMENT (THR),” Journal of Mechanical Engineering, vol. SI 5(5), pp. 205-215, 2018.

[3] Stuart J. Fischer, “100 Questions & Answers About Hip Replacement,” pp. 2-28, 2010.

[4] Sachin G. Ghalme, Ankush Mankar, and Yogesh Bhalerao, “Biomaterials in Hip Joint Replacement,” International Journal of Materials Science and Engineering, Volume 4, Number 2, June 2016.

[5] Jaramaz, B., Nikou, C., Digioia, A. M., “Effect of combined acetabular/femoral implant version of hip range of motion,” Transactions of 45

^th

Annual Meeting of QRS, 1999: 926.

[6] R. C. HIBBELER, MECHANICS OF MATERIALS, NINTH EDITION. Prentic Hall, 2014.

[7] Hisham Kamel, “MODELING AND SIMULATION OF A HIP PROSTHESIS IMPLANTATION,” 18

^th

International Conference on Appled Mechanics and Mechanical Engineering, pp. SM26-SM37, 3-5 April, 2018.

[8] Miller, Doris l., et al., ” Biomechanics of sport : a research approach.,” Philadelphia: Lea & Febiger, 1990.