Traditional Chinese Medicine and Acupuncture - Research Paper Example

Critical appraisal of Benson and Britten (2007) This work pertains to a critical appraisal of Benson and Britten (2007). Research Aims. The aim of the study is “to describe the ways in which patients taking antihypertensive drug balance reservations against reasons for taking them” (Benson and Britten 2007, p. 1). In particular, the study sought to “describe the range of reservations and reasons to take drugs that patient expressed and the way that they balanced these” (Benson and Britten 2007, p. 1). Appropriateness of qualitative methodology. Qualitative research is appropriate for the subject matter. Although, it is also possible to do the research using quantitative methods, qualitative methods would allow free-flowing description of the ways patients balance reservations against reasons for taking them. In contrast, a quantitative research done on the same subject will tend to use pre-determined categories experienced, pre-studied, or identified by prior research. In contrast, qualitative research does not have to use pre-determined categories formulated by the research based on researcher’s prior experience. The researcher can rely on participants’ descriptions of the “ways in which patients taking antihypertensive drug balance reservations against reasons for taking them”. Qualitative research is appropriate for the study because the information needed for the study will not require statistical procedures or other means of quantification (Straiss and Corbin 1998, p. 10-11). Appropriateness of research design. As described by Benson and Britten (2007, p. 1), the research design is “qualitative study using detailed interviews”. Cresswell (2007a, p. 20) calls this design as the “narrative design” of qualitative research. In my interpretation of the Benson and Britten (2007) write-up, the authors probably used semi-structured interview. This is highly appropriate considering that the objective of the research is “to describe the ways in which patients taking antihypertensive drug balance reservations against reasons for taking them” (Benson and Britten 2007, p. 1). Meanwhile, Cresswell (2007b, p. 6-10) identified the narrative design or approach as one of the five approaches that are frequently used in qualitative research. According to Cresswell (2007b, p. 6-10), the five designs or approaches frequently used are the narrative, phenomenology, grounded theory, ethnographic, and case study approaches or research design. Holstein and Gubrium (1997, p. 113) had described the use of interviews in qualitative research as a way of generating data on how people view their life. By extension, it follows that interviews in qualitative research can be used to describe how people consider antihypertensive medicines to be useful for their lives. Marshall and Rossman (1995, p. 41) pointed out that interviews in qualitative research are also fine for exploratory studies where the qualitative study intend to investigate little-understood phenomena, identify important variables, or generate hypothesis for future research. In relation with the aims of the study, a researcher may want to identify the variables that motivate patients to take antihypertensive drugs despite their strong reservations. I Appropriateness of recruitment of study participants. Benson and Britten (2007, p. 1) described the recruitment of participants in their study to have been based on “maximum variety sample of 38 interviewees receiving repeat prescription for antihypertensive drugs”. I find the recruitment based on “maximum variety” highly appropriate for descriptive qualitative research because participants or respondents may describe differently how they balance reservations against the reasons for taking antihypertensive drugs. Indeed, the Benson and Britten (2007) study has selected a variety of participants that are differentiated based on age, gender, years of taking the antihypertensive drugs, types of antihypertensive drugs taken, number of antihypertensive drugs prescribed, number of other drugs prescribed, and regularity of drug collection. Recruitment of participants based on age apparently covered all the possible range although the category “less than 50” may be misleading because “less than 50” may actually cover from 40 to 49 years old. Among the participants, the types of antihypertensive taken includes beta blocker, diuretic, angiotensin converting enzyme inhibitor, calcium antagonist, alpha blocker, nitrate, and “others”. We are not sure if “others” covered all the other possible antihypertensive but we are informed by research report material of Benson and Britten (2007) that there are 3% using other antihypertensive covering 19 individuals. Collection of data and research issue. Based on Table 1 of Benson and Britten (2007, p. 1), the participants included those from the general practitioner registrar training practice, non-trainers patients, general practitioners full time equivalents, participating general practitioners, and those who received prescriptions from patients. The interviews were conducted in patients’ homes (Benson and Britten 2007, p. 1). According Benson and Britten (2007, p. 1-2), they analysed transcripts of the interviews in five steps: theme-identification, generation of codes, revision of themes and code based on accumulated data, application of revised codes to final data set, and re-check of the themes within and among patients. Consideration of relationship between researcher and participants. The research report does not describe whether there is adequate consideration on the relationship between the researcher and participants. An impression is created that there is absolute absence of a relationship between the researcher and participant based on how the sample for the research are chosen. Nevertheless, the best interests of transparency in research are served better if explicit statements are raised regarding the presence or absence of possible relationship between the researcher and participants. Other than serving the interest of transparency, the presence or absence of relationship between the researcher and participants affects on how participants would respond to the research inquiry and would likely affect the validity of the research findings. Consideration of ethical issues. The researchers conducted the data gathering only after a committee for research ethics gave their approval. This is highly indicative of the researchers’ deep concern for the observance of ethics in research. However, I believe that while it is important to consider an ethics committees approval prior to the research, it is best for researchers to assess whether ethical issues are compromised in the execution of research and their assessment be expressed in the research report. Further, it may be best to report what ethical issues that a research ethics have considered prior to the grant of approval for executing the research. I believed this approach would best promote transparency in the research process as well as provide an example of how ethical issues can be addressed should an ethics committee be non-existent in specific research settings. In other words, the research report provided no details on how readers can assess the research with regard to whether research ethics or ethical standards have been adhered. Rigour of data analysis. There is an indepth discussion of the analysis process. This is clear in how the thematic themes were described to have been developed by the researchers. However, it is doubtful whether all the possible range of respondent or research participant characteristics were really covered by the researchers as per claim. The researcher should have covered or discussed additional details on this matter of the research. On findings. According to Benson and Britten (2007, p. 2), most patient taking antihypertensive drugs 29/38 or 76% expressed reservations in taking the medicines but all of the 38 patients took antihypertensive drugs just the same. Some of the reservations expressed consisted of the following: 1) taking drugs were not for them or that medicines are best avoided; 2) medicines are unnatural or unsafe; 3) medicines can make the body resistant to the medicine and takers will be risking addiction to the medicines (Benson and Britten 2007, p. 2). Some patients derived their reservations from their or others’ adverse experiences while others mentioned that their upbringing discouraged the use of medicines (Benson and Britten 2007, p. 2). Some patients expressed reservations because they have observed that that their doctors were too ready in prescribing medicines (Brenson and Britton 2007, p. 2). One patient expressed preference for herbs rather than the conventional medicines. Nevertheless, as mentioned, many of the interviewee had taken the antihypertensive medicines despite their reservations. The reasons expressed for taking the medicines despite of reservations. Value of research. I am deeply convinced of the value of the research. However, it does not seem that the researcher have elaborated on this matter enough. For example, would the findings of research enable doctors to improve their approach or system on how they can prescribe the medicines better to their patients? Would the findings of the research be relevant for patient education programs? Would the findings of the research be most relevant for drug companies on how they can label their medicines or put educational materials in the medicine packets for patients? These are some of the potential applications of the research. Will the relevance of the research be for antihypertensive patients and antihypertensive medicines only or relevant for all types of illnesses and for all types of medicines. Unfortunately, the researchers did not enumerate the possible relevance of their research efforts given the big concern for patients to take their medicines. Nevertheless, I could see the high relevance of the research even if the researchers failed to elaborate on this affect of the research. Conclusion. Overall, the work of Benson and Britten (2007) is an excellent work on qualitative research. Nevertheless, there is room for improving the research. In particular, one of the shortcomings of the research lies in its ability to fully identify its worth and relevance in the field of medicine. References Benson, J. and Britten, B., 2007. Patients’ decisions about whether or not to take antihypertensive drugs: qualitative study. BMJ, 325 (October), 1-5. doi: 10.1136//bmj.com/cgi/content/full/325/7369/873 Cresswell, J., 2007a. Research design: qualitative, quantitative, and mixed methods approaches. Thousand Oaks: Sage Publications. Creswell, J., 2007b. Qualitative inquiry & research Design: Choosing among five approaches. 2nd Ed. Thousand Oaks: Sage Publications. Holstein, J. and Gubrium, J., 1997. Active interviewing. In: Silverman, D., ed., Qualitative research: Theory, method, and practice. London: Sage Publications, 113-129. Marshall, M. and Rossman, G., 1995. Designing qualitative research. Thousand Oaks: Sage Publications. Miller, J. and Glassner, B., 1997. The “inside” and the “outside”: Finding realities in interviews. In: Silverman, D., ed., Qualitative research: Theory, method, and practice. London: Sage Publications, 113-129. Silverman, D., (ed.)., 1997. Qualitative research: Theory, method, and practice. London: Sage Publications. Straus, A. and Corbin, J., 1998. Basics of qualitative research. Thousand Oaks: Sage Publications. Read More