Nursing Pain Management in Hospitalized Patients with Cancer - Dissertation Example

Table of Contents Table of Contents 2 2 Introduction 2 ment of the problem 3 Justification 4 Literature Review 4 Methodology 5 Critique on sampling 5 Critique of Research Design 6 Result Findings 7 Discussion 8 Critique of the Conclusion 9 Bibliography 11 Nursing Pain Management in hospitalized patients with Cancer Title The Title of the article is clear and elaborate. The reader can easily identify the key phenomenon, which in this case is pain management in hospitalized patients with cancer. The reader can also identify the target group, which is under study, which in this article are hospitalized patients with cancer under pain management. According to Wood & Kerr (2011:67), the focus of the research is essential considering that management of pain in hospitalized patients with cancer, is critical in ensuring patient’s comfort and quick recovery. Abstract The abstract in this research article is concise and clear with well-summarized features of the main report. The research by has outlined the strengths of research in a manner by showing the used methods of pain management and the factors that contribute to pain in cancer patients. Presentation in the abstract is excellent. However, there is a weakness in the abstract in that it does not show clearly some of the expected experiences of patients in pain. It focuses only on strategies for pain management, but does not outline whether there is pain related to cancer treatment. An abstract should provide a brief description of the whole study without leaving out essential details (Polit and Beck 2010, p.54). This makes this research less favourable for use by nurses in such a scenario. Introduction The introduction for this research is quite elaborate and clear. It has a clear purpose statement, and it is logical and straightforward. However, there are some weaknesses in that there is a lengthy citation at the opening, which seems too broad for the research purpose. The statistics used to give details about cancer are too many and are striking and conflicting at times. The literature review that is significant to this study forms only a small portion of the introduction. The introduction has mentioned that there are many factors, which contribute to pain in cancer patients, but it is not specific which factors it will cover or explore for better management pain in hospitalized patients with cancer. The citations used are also too old dating back to the year 1994. These might not give up to date information required for pain management in cancer, in the 21st century. The more recent citation used in the introductory part is 2000, which is quite far considering that new methods of pain management have come up in the last one decade. The use of old research studies in this study shows that there has been no significant change in techniques for pain management, which is not true. The weak support provided by old studies makes this research study unfavourable in a nursing practice. Statement of the problem The problem statement in this study is clear and unambiguous, and this makes the reader identify it easily. The researcher clearly explains the purpose of the study, the reason of carrying out such a study, the target group, and interest in helping in management of pain in hospitalized patients with cancer (Holland & Rees, 2010:45). The strength in this problem statement is that it shows how the study is significant to nursing practice. It elaborates the best methods in earlier studies, to help the present nurses in managing pain in such patients. It also shows that apart from pain, other factors that contribute to such pain needs intervention to prevent the occurrence of pain. In general, it gives information about a holistic approach to pain management in such patients. This helps the nurses to provide adequate management to such patients. The statement of the problem also matches the methodology used in this study. This is essential as it helps the reader or the nurses to identify the methods before the practical application. It also helps them to assess the patient’s situation even before intervention (Boswell & Cannon, 2011:69). Justification The justification in this research is appropriate. It elaborately gives the importance of having such a study in helping in the management of pain in patients with cancer. It shows clearly the purpose of the study, its significance in oncology, and its application in nursing practice. The study shows that the nurses need to identify the various factors that contribute to pain in cancer. It also mentions the need for using the strategies in the study to overcome such factors (Munhall, 2012:98). The study also mentions the need to revive some old practices in cancer management. It suggests that these had a more holistic approach than the ones in the current nursing practice in oncology. There are however weaknesses, in this justification. The old work used for reference is not appropriate in this 21st century study. Advanced techniques have come up, and the use of such reference can lead to poor practice in an era where techniques in oncology have improved so much (Loiselle, 2011:95). Literature Review The Literature review in this article is adequate. The basis it lays for the study is solid. Polit and Beck (2008:36), explains that the literature review should clearly and concisely elaborate the ideas of a previous similar research study and relate them to the current research study. This is to enable the reader to assess the outcomes from both studies and understand the reasons why a further research of a similar kind is essential. This literature review lays a basis for study in that it can compare the objectives from the past studies with the objectives targeted in the new study. The reader can easily identify the ideas in the previous studies, and why the researcher thinks there is a need for improvement on the same ideas. The weakness in this study is that the previous studies used are quite old. The researcher should have used more recent research works and try to improve on them. This takes the reader to an era when there was no advancement in some aspects in oncology and pain management (Aveyard, 2010:34). Methodology Critique on sampling The research describes the setting of sample collection adequately, by mentioning the Norwegian hospital. It also describes the sample group, which will consist of cancer patients. The sample size of 18 used in this study is small and convenient. The convenient sampling used, was the best method to use, since the participants would come from a specific group of patients in this case the cancer patients in the oncology wing of the hospital. According to Holly et al (2012:29), such a study does not require a large sample but just a small sample that provides adequate information on the aspects the researcher expects to explore. The study had elaborated clearly, that it would use a small size for convenience. The study shows how it has used an inclusion and exclusion criteria in identifying patients with pain in the oncology department of a hospital. The study shows how it used the help of professional nurses to identify the patients in severe pain. It further shows the pain analysis done by nurses to identify such patients. A medical chart review together with information on pain analysis gathered by nurses came in hand for inclusion of patients in pain. These are strengths in sampling methodology, as there is provision of details of methods used for selection. There are details on how the sample would be helpful in determining the group of patients, whom the findings of the study might be useful. The downside of this sampling methodology is that it does not show how the researcher arrived at such a small sample size. It is small and convenient, but there is no provision of arriving to such a convenient size. The researcher has used only one oncology hospital in Norway and does not describe the environment of this hospital. This makes it difficult to make a general analysis beyond the one hospital. This means that transferability and external validity is impossible, and this lowers the quality of the sampling methodology used (Brockopp & Hastings-Tolsma, 2003:64). Critique of Research Design The methods used in the study in the collection and analysis of data were congruent with phenomenology. The design of the study aims to evaluate the existing methods of pain management and come up with better methods. This is an appropriate choice because it intends to improve pain management in patients with cancer. However, there are weaknesses in this design. The fact that the research involves one person, who conducts all the evaluation and interviews the nurses and patients, reduces the degree of research corroboration. (Stommel & Wills, 2004:124). If several independent researchers participated in this study, then there would be a comparison of notes after such evaluations and interviews. Since there was only one researcher, then the results obtained go direct to interpretation. This can lead to errors since there is a likelihood of increased probability of an unseen variable. This can have a significant impact on the collected data and reduce the credibility of such results (Houser, 2012:27). The collection of data took place for a short period since the patients required some rest and could not be engaged through out. This reduces credibility since only the nurses provided most information and there was no prolonged engagement with the patients. According to Moule & Goodman (2008:56), the researcher should spend more time in the collection of data, in order to provide a credible assessment for the reader to have an acknowledgement of rigour and saturation. Another weakness is that the study involved only the professional nurses and this can make it lack the balance that would have come out if it involved other professionals like oncologists and physicians. There was no description of any procedure, which the researcher would use to safeguard the rights of patients. Factors such as confidentiality and consent missed out in this study. According to keele (2011:39) such details should not miss. The study also does not explain the documentation of the collected data, procedures and additional information. Even though the design is appropriate and has noble intentions, its overall rigor saturation rates in the medium category because of lack of some key elements (Debisette & Vessey, 2011:92). Data Analysis Data analysis is the process of breakdown of data, examination of the data, comparison of the data and conceptualization and categorising of the data (Macnee & Mccabem, 2007:142). The strategies used to analyse data were efficient and compatible with the type of data that the researcher collected. There was thorough exploration of perceptions of nurses and patients. The thorough exploration of the aspect of phenomenology as is always required, shows that the method of data collection, which in this case was through interviewing nurses and patients, was appropriate (Brink et al, 2007). The researcher adequately shows the data analysis criteria used by explaining the qualitative content analysis method used to analyse the collected data. This analysis provided results, which adequately described the experiences of patients suffering from cancer. Result Findings According to Tappen (2011: 86), the result findings of a study should clearly reflect the themes identified from such the data collected. The themes should have supportive evidence from the excerpts found in the original source of data. The results of this research showed the two aims of the study came into a combination since there was interrelation of patient’s response concerning how they felt, and the nurse’s responses regarding the techniques they use to manage pain in these patients. This shows that there was no appropriate clarity during the process of data collection. The first aim, which targeted the patients, has its results analysed using two tables, which showed the patient characteristics and the levels of pain the patients felt. The information from these results is weak since the researcher spent little time with patients and changes in pain levels can occur any time. The researcher would have evaluated pain levels of these patients for a longer period to make the data more significant (Bettany-Saltikov, 2012:107) The third table describes the methods used by the nurses to evaluate and to manage pain. This table is more clear and meaningful. One weakness of these findings is that the methods in the literature review are too old than the ones being used by the nurses. The table also has a disadvantage in that the factors that increase pain and strategies for management are in a listed form. This can create confusion since the data could have come from patients who were not suffering from cancer. The results do not describe the actual experiences of patients. This leaves the readers with inadequate information since the reflection of all the themes identified during data collection, misses out. The researcher should have included more details to separate the two aims in order to increase the clarity (Speziale & Carpenter, 2011:46). These results did not have any new compelling findings. Discussion There is a clear and logical discussion of the findings in this study. There is a clear discussion of the identified themes. The researcher noted that the nurses played an enormous role in ensuring the patient’s comfort. On the other hand, the patients were not sure when describing the contributions made by the nurses. The patients were not sure when explaining their pain experiences and most said that there were periodic changes in levels of pain in a spun of short durations of time. With the limited time, the researcher spent with the patients there was a whopping likelihood of missing this observation. The researcher should spend more time in data collection to build credibility (Nieswiadomy, 2008). This highlights one of the strongest weaknesses of this study. The theme expected to describe more adequate techniques that are relevant in pain management missed out altogether. The researcher diverts out of focus and concludes that the patients suffered more pain from neglect and poor provision of care. The theme concerning gathering information and using the required methods was consistent with other research studies that this research lacks the meaning and the purpose of its conduction. This discussion in overall, spend a lot of time defending the limitations found in the study. Critique of the Conclusion This conclusion is not adequate since it describes the study as essential in helping the nurses to increase their awareness in managing pain. The research study did not give any description about experiences of pain that the patients underwent. The conclusion does not give any examples about the findings that it has pointed out as essential in pain management. It further states that since the patients did not manage to describe the role the nurses play in pain management, then there is a likelihood that the nurses use a narrow scope when attending the patients. However, there are no findings to support this explanation and makes it a speculation. In this case, the study should have considered exploring factors such as improving the nursing culture in order to make nursing practice in such a scenario effective. There are no pharmacological treatments highlighted in the conclusion. Instead, it has highlighted the non-pharmacological treatments, which are missing in the results part. The recommendation for increasing the scope of nursing in pain management, for the role of nurses in such a practice to become visible, has no support in the study itself. The conclusion lacks solid explanations and findings. According to Watson et al (2008:90), a study should never plagiarise conclusions of other similar studies. This research gives and an overall view is that this study might have drawn conclusions from other people works. Bibliography Aveyard, H. 2010. Doing a literature review in health and social care: a practical guide. Maidenhead, Mc Graw-Hill - Open University Press. Bettany-Saltikov, J. 2012. How to do a systematic literature review in nursing: a step-by-step guide. Maidenhead, Open University Press. BOswell, C., & Cannon, S. 2011. Introduction to nursing research incorporating evidence-based practice. Sudbury, Mass, Jones and Bartlett Publishers. Brink, H., Van Der Walt, C., & Van Rensburg, G. 2007. Fundamentals of research methodology for health care professionals. Kenwyn, Juta. Brockopp, D. Y., & Hastings-Tolsma, M. T. 2003. Fundamentals of nursing research. Boston, Jones & Bartlett. Debisette, A., & Vessey, J. 2011. Annual Review of Nursing Research, Volume 28 Nursing Workforce Issues, 2010. New York, Springer Pub. Co. Holland, K., & Rees, C. 2010. Nursing research and evidence-based practice skills. Oxford, Oxford University Press. Holly, C., Salmond, S. W., & Saimbert, M. K. 2012. Comprehensive systematic review for advanced nursing practice. New York, Springer Pub. Houser, J. 2012. Nursing research: reading, using, and creating evidence. Sudbury, MA, Jones & Bartlett Learning. Keele, R. 2011. nursing research and evidence-based practice ten steps to success. sudbury, ma, jones & bartlett learning. Loiselle, C. G. 2011. Canadian essentials of nursing research. Philadelphia, Wolters Kluwer Health/Lippincott Williams & Wilkins. Macnee, C. L., & Mccabe, S. 2007. Understanding nursing research: using research in evidence-based practice. Philadelphia, PA, Lippincott Williams & Wilkins. Moule, P., & Goodman, M. 2008. Nursing research: an introduction. London, Sage. Munhall, P. L. 2012. Nursing research: a qualitative perspective. Sudbury, MA, Jones & Bartlett Learning. Nieswiadomy, R. M. 2008. Foundations of nursing research. Upper Saddle River, N.J., Pearson Polit, D. F., & Beck, C. T. 2008. Nursing research: generating and assessing evidence for nursing practice. Philadelphia, Wolters Kluwer Health/lippincott Williams & Wilkins. Polit, D. F., & Beck, C. T. 2010. Essentials of nursing research: appraising evidence for nursing practice. Philadelphia, Wolters Kluwer Health/Lippincott Williams & Wilkins. Speziale, H. S., & Carpenter, D. R. 2011. Qualitative research in nursing: advancing the humanistic imperative. Philadelphia, Wolters Kluwer Health/Lippincott Williams & Wilkins. Stommel, M., & Wills, C. 2004. Clinical research: concepts and principles for advanced practice nurses. Philadelphia, Lippincott Williams & Wilkins. Tappen, R. M. 2011. Advanced nursing research: from theory to practice. Sudbury, MA, Jones & Bartlett Learning. Watson, R., Benner, P., & Ketefian, S. 2008. Nursing research designs and methods. Edinburgh, Churchill Livingstone/Elsevier. Wood, M. J., & Kerr, J. C. 2011, Basic steps in planning nursing research from question to proposal. Sudbury, Mass, Jones and Bartlett. Read More