Ostomy Patients' Perceptions of Quality of Care - Literature review Example

Running Head: RESEARCH CRITIQUE Research Critique of Ostomy patients perceptions of quality of care [ISSUES AND INNOVATIONS IN NURSING PRACTICE] ABSTRACT The aim of the present study was to assess the quality of care in ostomy patients. It intends to gather data which is seen from a patient’s perspective. Two different groups of patients were studied: those with a permanent colostomy created because of rectal cancer and those with a conventional ileostomy created because of ulcerative colitis. In this research critique, the research conducted by Persson, Eva PhD RN ETN; Gustavsson, Bengt PhD MD; Hellström, Anna-Lena PhD RN; Lappas, George BSc and Hultén, Leif PhD MD entitled Ostomy patients perceptions of quality of care [ISSUES AND INNOVATIONS IN NURSING PRACTICE] would be assessed to see if the researchers have followed the criteria for making a qualitative nursing proposal. The discussions are based on the researchers’ ability to demonstrate an understanding of the qualitative paradigm and the particular qualitative method being used, if the problem clearly delineated with an appropriate rationale for using a qualitative approach, if the purpose for the study one of discovery and description, conceptualization (theory building), illusions, or sensitization, if the researcher-respondent relationship is understood and if the role of the researcher as "research tool" is apparent. This research critique carefully assessed the importance of a research paper for the improvement of the quality nursing care given to Ostomy patients. Recommendations would not be effective unless the process before setting up a recommendation is to be found true, correct and free from any bias. Centuries had already passed and compared to the world way back centuries ago, people today are more knowledgeable, and curios about the things going on around us. Compared to the lifestyle of the olden days, there are things which they believe is indescribable and even tuberculosis has no cure. Today, there are many things that science can do. It is no doubt then, that today’s technological era has been achieved by the careful research of scientists, engineers and concerned people who aims to improve something which is inline with their forte. Through thorough research, things have been achieved which changes the world, that is why, careful and truthful research is essential. Can you imagine a world being deceived by false research? It could not only harm the world and the society, malicious research, especially medical researches could cause death to patients instead of nursing them to make them better. In the research conducted by Persson, Eva PhD RN ETN; Gustavsson, Bengt PhD MD; Hellström, Anna-Lena PhD RN; Lappas, George BSc and Hultén, Leif PhD MD entitled Ostomy patients perceptions of quality of care [ISSUES AND INNOVATIONS IN NURSING PRACTICE], the researchers aim to improve the nursing practices towards Ostomy patients to be able to provide them with quality care. They have fully understood and identified the needs of Ostomy patients, though following the qualitative research, it lacks the identification and thorough explanation of what Stoma is all about. They should have clearly defined Stoma and give a narrative explanation which would enable readers to picture out the severity if this illness. Through this, the reader would understand how and why it is important to focus on issues and innovations in nursing practice with regards to the quality care given to Ostomy patients. Before continuing with the research, the researchers should have also explained in clear, straightforward terms, all aspects of living with a stoma, including ways to feel more comfortable with it, and helps you overcome any embarrassment a patient may feel when talking to doctors and other healthcare professionals, to be able to get the best possible help and support. For those who have stoma, the surgery is life-saving, but they can be hard to adjust to, and even though no-one may know that a person have stoma it can make a patient feel self-conscious and different. While it is being stated in Ostomy patients perceptions of quality of care [ISSUES AND INNOVATIONS IN NURSING PRACTICE] that; “the general characteristics of ileostomy patients vs. colostomy patients are very different, and in some respects are quite opposite. Commonly, patients undergoing ileostomy have ulcerative colitis, are young adults, have acute episodes and/or chronic diarrhoea and often suffer years of painful illness on drug treatment with frequent contacts with doctors before the stoma operation is ultimately performed. In contrast, most colostomy patients have malignant disease, are mostly older, and have a shorter period of diffuse, mild symptoms (Blackely 1998)” the aims of the research had neglected to identify the age range of young adult patients and older patients. With this, the scope is considered vague and not clearly stated although the times frame for conducting the research is enough. The introduction part of the research talks about the quality care that patients should have but the authors haven’t discussed beforehand about how stoma operations can be very beneficial for ostomy patients which brings out the topic that quality care should be improved. According to Dr. Craig White, a Clinical Psychologist, from his book “Living with a Stoma”, stoma operations are usually life-saving operations. They are almost always performed because there is no alternative. Medical staff recommends a stoma operation if a disease or physical problem is going to worsen without the operation. The fact that stoma operations are life-saving can make it easier for some people to get used to the stoma. However, I know some people who have had a stoma operation and, despite the knowledge that they would be dead without the stoma, they still find it difficult to live with. In other words, just because it saved your life does not necessarily make it easier to live with. Indeed, just because it saved your life does not mean that you have to like it. Life with a stoma can be difficult — even if it has saved your life. While the research paper focused only on quality care and changes of stoma operation to the patient’s life, the details had somehow made the research paper insufficient and incomprehensive. Other than that, major definitions had not been stated, identified nor defined. The context of the study has been adequately described but there has been no stated plan for gaining entree to the setting given. In the research, particularly in the study context and participants, it is stated that; “ET nurses evaluated all stoma patients postoperatively on the surgical ward and subsequently at the outpatient clinic. Stoma-related complications such as skin irritation, stenosis, granuloma, leakage because of low stomas, rectraction, necrosis, prolapse and parastomal hernia were documented in the medical records”; and “A postal questionnaire was sent to all patients who attended stoma outpatient clinics in Göteborg, Sweden and had been operated for ulcerative colitis (….) a reminder was sent to those who had not returned the questionnaire within 4 weeks. However, according to the title and aims of the research, this paper reports a study whose aim was to assess the quality of care in ostomy patients seen from a patient perspective. In this case, the researcher-respondent relationship had been misunderstood and the role of the researcher as "research tool" is not apparent. When the researchers’ aims to improve and innovate the quality care that nurses can give to the patients, the respondents should have been the patients who have had stoma operation and is still admitted to the hospital. If the respondents had been outpatients, how can these people still clearly remember the quality of nursing care that has been given to them during their admission at the hospital? This wrong identification of respondents can lead to the wrong identification of results where in the research, it is stated that stoma-related complications, which occurred in 71% of the ileostomy patients and in 43% of the colostomy patients, had no impact on these results. In this research, the number of samples had not been identified. According to Dr. Craig White, there is an approximately 52,000 people in the United Kingdom having a stoma and around 15,000 new stomas are formed by surgeons in the UK each year. Among these statistics, these researches should have also identified how many of ostomy outpatients had been in the clinics records to be able to get their sampling size. As for the research tools, when a stoma operation causes profound changes in a patients life because of resulting physical damage, disfigurement, loss of bodily function, and change in personal hygiene, a proper tool should be used. According to Bargh, J. A., McKenna, K.Y.A., & Fitzimons, G. M. who wrote Can you see the real me (2002), due to the anonymity and lack of face-to-face and physical interaction through the internet, it is argued that it is more likely that a person will show its true self during internet rather than face-to-face interaction. If a stoma operated patient lacks self confidence due to physical damage, a questionnaire with the use of internet will help him respond truthfully because of the anonymity of the process of extracting personal and rather embarrassing facts from him. While this research is important for the improvement of the quality nursing care given to Ostomy patients, recommendations would not be effective unless the process of the research as a base for setting up a recommendation is to be found true and correct and free from any bias. REFERENCES Bargh, J. A., McKenna, K.Y.A., & Fitzimons, G. M. (2002). Can you see the real me? Activation and expression of the "true self" on the Internet. Journal of Social Issues, 58 (1), 33-48. Persson, Eva PhD RN ETN et. Al (2005) Ostomy patients perceptions of quality of care [ISSUES AND INNOVATIONS IN NURSING PRACTICE]. Journal of Advanced Nursing Volume 49 (1) White, Craig MD (1997) Living with a Stoma. Sheldon Press Book Read More