【桑葛石原研翻译系列】医学研究中的案例研究介绍与分析

案例研究是对一个人、群体或事件的深入研究。在一个案例研究中，几乎分析了研究对象的生活和历史的各个方面，以寻找行为的模式和原因。案例研究可以用于心理学、医学、教育、人类学、人类学和社会工作。

案例研究往往是高度主观的，有时很难将结果推广到更多的人群中。虽然案例研究侧重于个体或群体，但他们遵循的格式类似于其他类型的心理学写作。一个案例研究，遵循美国心理学会格式的规则是很重要的。

优势和劣势

案例研究可以既有优势也有其劣势。研究人员必须在决定这些研究是否适合他们的需要之前考虑这些利弊。

案例研究的最大优势之一是它允许研究人员研究那些很难在实验室中获得，并且不可能复制的东西。

案例研究的优势：

• 允许研究人员收集大量的信息

• 让研究人员有机会收集有关罕见或不寻常病例的信息

• 允许研究人员发展出可以在实验研究中探索的假设

劣势：

• 不一定能推广到较大的人群中

• 无法证明其因果关系

• 可能不够严谨

• 可能会导致偏差

如果研究人员对探索一种独特的或最近发现的现象感兴趣，他们可能会进行一个案例研究。从这些研究中获得的见解可以帮助研究人员发展出更多的想法和研究问题，然后可能在未来的研究中被探索。

案例研究的实例

在心理学史上已经有许多著名的案例研究。弗洛伊德的大部分工作和理论都是通过使用个别案例研究而发展起来的。心理学案例研究的一些很好的例子包括：

安娜奥：

安娜奥是一位伯莎·帕彭海姆的女性的笔名，她是约瑟夫·布鲁尔的医生的病人。虽然她从来都不是弗洛伊德的病人，但弗洛伊德和布鲁尔广泛地讨论了她的案例。这名女性经历了一种当时被称为歇斯底里的症状，她发现谈论她的问题有助于缓解她的症状。她的案例在谈话治疗作为一种心理健康治疗方法的发展中发挥了重要作用。

菲尼亚斯·盖奇：

菲尼亚斯·盖奇是一名铁路雇员，他经历了一场可怕的事故，一场爆炸使一根金属棒穿过了他的头骨，损坏了他大脑的重要部分。盖奇从事故中恢复了过来，但在个性和行为上都发生了严重的变化。

精灵：

精灵是一个遭受可怕的虐待和孤立的年轻女孩。精灵的案例研究使研究人员能够研究即使错过了语言发展的关键时期，是否可以教授语言。她的案例也成为了科学研究如何干预治疗并导致进一步虐待脆弱个体的一个例子。

这样的案例证明了案例研究如何被用来研究研究人员在实验环境中无法复制的东西。在精灵的案例中，可怕的虐待剥夺了她在发展的关键时刻学习语言的机会。

这显然不是研究人员可以在道德上复制的东西，但对精灵进行案例研究使研究人员有机会研究不可能复制的现象。

类型

心理学家和其他研究人员可能会使用以下几种不同类型的案例研究：

集体案例研究：这些都涉及到研究一组个体。研究人员可能会在某种环境下研究一群人，或者观察整个社区的人。

描述性案例研究：这些涉及到从描述性理论开始。然后观察受试者，并将收集到的信息与已存在的理论进行比较。

解释性案例研究：这些案例通常被用来进行因果调查。换句话说，研究人员对研究可能实际导致某些事情发生的因素很感兴趣。

探索性案例研究：这些有时被用作进一步、更深入的研究的前奏。这使得研究人员可以在发展他们的研究问题和假设之前收集更多的信息。

仪器案例研究：当个体或小组允许研究人员理解比最初对观察者更明显的东西时，就会发生这些情况。

内在案例研究：这种类型的案例研究是当研究人员对案件有个人兴趣时。让·皮亚吉对自己孩子的观察是一个很好的例子，说明了一个内在的演员研究是如何促进心理理论的发展。

所使用的案例研究的类型取决于情况的独特特征以及案例本身。

如何进行一个案例研究

也有不同的方法可以用来进行案例研究，包括前瞻性和回顾性案例研究方法。前瞻性案例研究方法是指观察一个个体或一组人以确定结果的方法。例如，一组人可能会被观察很长一段时间来观察某一特定疾病的进展。

回顾性案例研究的方法包括研究历史信息。例如，研究人员可能会从一个结果开始，比如一种疾病，然后回头研究个人生活的相关信息，以确定可能导致疾病发病的风险因素。

何处查找数据

研究人员可以使用许多不同的来源和方法来收集有关个人或群体的信息。研究人员已确定的六种主要资料来源是：

档案记录：人口普查记录、调查记录和名单是档案记录的示例。

直接观察：这种策略包括观察主题，通常是在一个自然的环境下。虽然有时使用单个观察者，但更常使用一组观察者。

文件：信件、报纸文章、行政记录等是经常用作来源的文件类型。

访谈：访谈是案例研究中收集信息的最重要的方法之一。面试可以涉及结构化的调查问题或更开放式的问题。

参与者观察：当研究人员作为事件的参与者并观察行为和结果时，它被称为参与者观察。

物理工件：工具、对象、仪器和其他工件经常在直接观察该对象的过程中被观察到。

第一节：案件史

本节的结构和内容如下：

背景信息：论文的第一部分将展示客户的背景。包括年龄、性别、工作、健康状况、家庭心理健康史、家庭和社会关系、毒品和酒精史、生活困难、目标、应对技能和弱点等因素。

当前问题的描述：在案例研究的下一部分中，您将描述客户出现的问题或症状。

描述客户报告的任何身体、情感或感觉症状。与症状相关的想法、感觉和感知也应该被注意到。所使用的任何筛查或诊断评估也应详细描述，并报告所有分数。

诊断：提供诊断，并提供适当的诊断和统计手册代码。解释如何达到诊断的，客户的症状如何符合该疾病的诊断标准，或在达到诊断时可能出现的任何困难。

第二节：处理方案

本节将讨论所选择的治疗方法，这也可能包括所选择的治疗的理论基础或任何可能存在的支持为什么选择这种方法的证据。

认知行为方法：解释认知行为治疗师将如何处理治疗。提供有关认知行为治疗的背景信息，并描述治疗过程、客户反应和这类治疗的结果。注意您的客户在治疗过程中遇到的任何困难或成功。

人文方法：描述一种可以用来治疗客户的人文方法，比如以客户为中心的治疗。提供有关您选择的治疗类型、客户对治疗的反应以及此方法的最终结果的信息。解释为什么治疗会成功或失败。

精神分析方法：描述精神分析治疗师将如何看待客户的问题。提供精神分析方法的背景并引用相关参考。解释如何使用精神分析治疗来治疗客户，客户对治疗的反应，以及这种治疗方法的有效性。

药理学方法：如果治疗主要涉及使用药物，请解释使用了哪种药物以及为什么。提供关于这些药物的有效性的背景，以及单一疗法如何与药物与治疗或其他治疗相结合的方法进行比较。

案例研究的这部分还应包括有关治疗目标、过程和结果的信息。

讨论

撰写一个案例研究时，还应该包括一个讨论案例研究本身的部分，包括研究的优势和局限性。应该注意到案例研究的结果可能如何支持以前的研究。

在讨论部分，还应该描述案例研究的一些含义。哪些想法或发现可能需要进一步的探索？研究人员该如何在额外的研究中探索这些问题呢？

更多提示

案例研究的格式，需要注意一些额外的情况：

永远不要把案例研究的主题称为“客户”，而是他们的名字或假名。

• 阅读案例研究的例子，获得格式的概念。

• 在引用时记住使用美国心理学会格式。

总结

案例研究可以是一个非常有用的研究工具，但它们需要被明智的使用。在许多情况下，尤其在实验困难的情况下使用。案例研究有助于观察独特的情况，并允许研究人员收集大量关于特定个体或群体的信息。

【原文】

What Is a Case Study?

A case study is an in-depth study of one person, group, or event. In a case study, nearly every aspect of the subject's life and history is analyzed to seek patterns and causes of behavior. Case studies can be used in a variety of fields including psychology, medicine, education, anthropology, political science, and social work.

The hope is that learning gained from studying one case can be generalized to many others. Unfortunately, case studies tend to be highly subjective and it is sometimes difficult to generalize results to a larger population.

While case studies focus on a single individual or group, they follow a format that is similar to other types of psychology writing. If you are writing a case study, it is important to follow the rules of APA format.

Benefits and Limitations

A case study can have both strengths and weaknesses. Researchers must consider these pros and cons before deciding if this type of study is appropriate for their needs.

One of the greatest advantages of a case study is that it allows researchers to investigate things that are often difficult to impossible to replicate in a lab. Some other benefits of a case study:1

• Allows researchers to collect a great deal of information

• Give researchers the chance to collect information on rare or unusual cases

• Allows researchers to develop hypotheses that can be explored in experimental research

On the negative side, a case study:

• Cannot necessarily be generalized to the larger population

• Cannot demonstrate cause and effect

• May not be scientifically rigorous

• Can lead to bias

Researchers may choose to perform a case study if they are interested in exploring a unique or recently discovered phenomenon. The insights gained from such research can then help the researchers develop additional ideas and study questions that might then be explored in future studies.

Case Study Examples

There have been a number of notable case studies in the history of psychology. Much of Freud's work and theories were developed through the use of individual case studies. Some great examples of case studies in psychology include:

Anna O: Anna O. was a pseudonym of a woman named Bertha Pappenheim, a patient of a physician named Josef Breuer. While she was never a patient of Freud's, Freud and Breuer discussed her case extensively. The woman was experiencing symptoms of a condition that was then known as hysteria and found that talking about her problems helped relieve her symptoms. Her case played an important part in the development of talk therapy as an approach to mental health treatment.

Phineas Gage: Phineas Gage was a railroad employee who experienced a terrible accident in which an explosion sent a metal rod through his skull, damaging important portions of his brain. Gage recovered from his accident but was left with serious changes in both personality and behavior.

Genie: Genie was a young girl subjected to horrific abuse and isolation. The case study of Genie allowed researchers to study whether language could be taught even after critical periods for language development had been missed. Her case also served as an example of how scientific research may interfere with treatment and lead to further abuse of vulnerable individuals.

Such cases demonstrate how case research can be used to study things that researchers could not replicate in experimental settings. In Genie's case, her horrific abuse had denied her the opportunity to learn language at critical points in her development.

This is clearly not something that researchers could ethically replicate, but conducting a case study on Genie allowed researchers the chance to study phenomena that are otherwise impossible to reproduce.

Types

There are a few different types of case studies that psychologists and other researchers might utilize:

Collective case studies: These involve studying a group of individuals. Researchers might study a group of people in a certain setting or look at an entire community of people.

Descriptive case studies: These involve starting with a descriptive theory. The subjects are then observed and the information gathered is compared to the pre-existing theory.

Explanatory case studies: These are often used to do causal investigations. In other words, researchers are interested in looking at factors that may have actually caused certain things to occur.

Exploratory case studies: These are sometimes used as a prelude to further, more in-depth research. This allows researchers to gather more information before developing their research questions and hypotheses.

Instrumental case studies: These occur when the individual or group allows researchers to understand more than what is initially obvious to observers.

Intrinsic case studies: This type of case study is when the researcher has a personal interest in the case. Jean Piaget's observations of his own children are good examples of how an intrinsic cast study can contribute to the development of a psychological theory.

The type of case study that is used depends on the unique characteristics of the situation as well as the case itself.

How to Write a Case Study

There are also different methods that can be used to conduct a case study, including prospective and retrospective case study methods.

Prospective case study methods are those in which an individual or group of people is observed in order to determine outcomes. For example, a group of individuals might be watched over an extended period of time to observe the progression of a particular disease.

Retrospective case study methods involve looking at historical information. For example, researchers might start with an outcome, such as a disease, and then work their way backward to look at information about the individual's life to determine risk factors that may have contributed to the onset of the illness.

Where to Find Data

There are a number of different sources and methods that researchers can use to gather information about an individual or group. Six major sources that have been identified by researchers are:

Archival records: Census records, survey records, and name lists are examples of archival records.

Direct observation: This strategy involves observing the subject, often in a natural setting. While an individual observer is sometimes used, it is more common to utilize a group of observers.

Documents: Letters, newspaper articles, administrative records, etc., are the types of documents often used as sources.

Interviews: Interviews are one of the most important methods for gathering information in case studies. An interview can involve structured survey questions or more open-ended questions.

Participant observation: When the researcher serves as a participant in events and observes the actions and outcomes, it is called participant observation.

Physical artifacts: Tools, objects, instruments, and other artifacts are often observed during a direct observation of the subject.

Section 1: A Case History

This section will have the following structure and content:

Background information: The first section of your paper will present your client's background. Include factors such as age, gender, work, health status, family mental health history, family and social relationships, drug and alcohol history, life difficulties, goals, and coping skills and weaknesses.

Description of the presenting problem: In the next section of your case study, you will describe the problem or symptoms that the client presented with.

Describe any physical, emotional, or sensory symptoms reported by the client. Thoughts, feelings, and perceptions related to the symptoms should also be noted. Any screening or diagnostic assessments that are used should also be described in detail and all scores reported.

Your diagnosis: Provide your diagnosis and give the appropriate Diagnostic and Statistical Manual code. Explain how you reached your diagnosis, how the client's symptoms fit the diagnostic criteria for the disorder(s), or any possible difficulties in reaching a diagnosis.

Section 2: Treatment Plan

This portion of the paper will address the chosen treatment for the condition. This might also include the theoretical basis for the chosen treatment or any other evidence that might exist to support why this approach was chosen.

Cognitive behavioral approach: Explain how a cognitive behavioral therapist would approach treatment. Offer background information on cognitive behavioral therapy and describe the treatment sessions, client response, and outcome of this type of treatment. Make note of any difficulties or successes encountered by your client during treatment.

Humanistic approach: Describe a humanistic approach that could be used to treat your client, such as client-centered therapy. Provide information on the type of treatment you chose, the client's reaction to the treatment, and the end result of this approach. Explain why the treatment was successful or unsuccessful.

Psychoanalytic approach: Describe how a psychoanalytic therapist would view the client's problem. Provide some background on the psychoanalytic approach and cite relevant references. Explain how psychoanalytic therapy would be used to treat the client, how the client would respond to therapy, and the effectiveness of this treatment approach.

Pharmacological approach: If treatment primarily involves the use of medications, explain which medications were used and why. Provide background on the effectiveness of these medications and how monotherapy may compare with an approach that combines medications with therapy or other treatments.

This section of a case study should also include information about the treatment goals, process, and outcomes.

Discussion

When you are writing a case study, you should also include a section where you discuss the case study itself, including the strengths and limitiations of the study. You should note how the findings of your case study might support previous research.

In your discussion section, you should also describe some of the implications of your case study. What ideas or findings might require further exploration? How might researchers go about exploring some of these questions in additional studies?

More Tips

Here are a few additional pointers to keep in mind when formatting your case study:

Never refer to the subject of your case study as "the client." Instead, their name or a pseudonym.

• Read examples of case studies to gain an idea about the style and format.

• Remember to use APA format when citing references.

A Word From Verywell

Case studies can be a useful research tool, but they need to be used wisely. In many cases, they are best utilized in situations where conducting an experiment would be difficult or impossible. They are helpful for looking at unique situations and allow researchers to gather a great deal of information about a specific individual or group of people.

If you have been directed to write a case study for a psychology course, be sure to check with your instructor for any specific guidelines that you are required to follow. If you are writing your case study for professional publication, be sure to check with the publisher for their specific guidelines for submitting a case study.