An Area of Nursing Care - Case Study Example

Introduction This paper critiques the article - Pressure ulcers and their treatment and effects on quality of life: hospital inpatient perspectives. This paper was chosen because it discusses an area of nursing care that I can effectively address through my vigilance as a healthcare giver. As a nursing student it is important for me to appreciate and filter out information on healthcare. This critique appraises the research from its essay body, which includes the publisher, the author, the title, the abstract, introduction, related literature, methodology, analysis, and presentation of data. Then it goes on to assess the discussions put forth in the research by portraying its strengths and weaknesses, its reliability, flaws, and limitations. Finally it makes a concluding judgement about the article and puts forth recommendations for other studies and for professional practice. The following are terms essential to this paper. These are: research, critique, and pressure sores. Research is the process of “careful enquiry, experimentation, study, observation, analysis and recording to discover new facts, knowledge, and information…” (Workers’ Compensation Board, 2008). Critique is defined as an analytical “examination of a work of literature or art; a critical dissertation or essay…” (Hyperdictionary, 2007). A pressure ulcer “is an area of reddened skin that progresses to breakdown of skin and underlying tissue to form sores and ulcers” (Ngan, 2003). They are also known as bed sores, decubitus ulcers, and pressure sores. Body The publisher is an international and creditable scientific journal. In a speech by research editor Dr. Debbie Kralik, she declared that JAN “has a reputation for being at the cutting edge of international debates on, and in, nursing. It has created an international platform for sharing the latest advances in nursing research and advancing nursing scholarship” (Kralik, 2003). The paper indicates that the authors have the academic and competence to undertake this research. Their degrees, their research background, and their Universities are clearly indicated in the research. They are also not involved professionally or personally in any of the centres chosen for the research. The title of this research plainly and succinctly communicates what this study is all about. A good title “indicates subject and scope with some accuracy” (Robinson, 2007). It conveys that this study was taken from the perspective of hospital inpatients-not from the caregivers’ or hospital staff’s perspective. The abstract includes information from relevant sections of the research. “Good abstracts are easy to read, clear, and concise (Shapiro & Donaldson, n.d.). The abstract of this paper clearly and accurately shows us a picture of the objectives, the research methodology, the major findings, and the conclusions of the study. A good introduction should present “the central issue and the viewpoint…that the rest of the paper will support in detail (Saba, n.d). The introduction of the paper gives the reader the important initial information he needs in order to understand and appreciate what the rest of the paper wishes to convey. It defines pressure ulcers, their prevalence on the national and international scene, and the limitations of previous researches covering pressure ulcers. The literature review is merged into the background of the paper. It satisfactorily provides both background information and a literature review to build the research paper on. The literature review gradually swelled into the topic subject of this research. A literature review’s purpose “is to convey to your reader what knowledge and ideas have been established on a topic and what their strengths and weaknesses are” (Taylor, 2008). The paper stresses that not many studies were taken discussing pressure ulcers from the perspective of inpatients. This research was quick to point out the shortcomings of previous researches -that they only discussed community-dwelling patients, not hospital inpatients. The limitations of these studies were shown in order to highlight the need for this research. This research is a qualitative research. Qualitative research purposively uses a chosen few for its target population. The qualitative method of research lends flexibility in how data is elicited from respondents. It allows the researcher to observe respondents-how they answer to the questions and the reactions that may be triggered by the interview questions (Cook & Reichardt, 1979). This method was accurately and fittingly chosen for this research. It allowed for the freedom of qualitative research-which was tempered by a certain structure where it was essential. The data collection was undertaken by two of the authors. Both interviewers were academically and professionally qualified as researchers to conduct the interview (Polit, et.al, 2001.). “Protecting the confidentiality of information collected about individuals is…vital to fulfilling…ethical responsibilities…” (American Educational Committee, 2002). The consent of respondents was sought before the interviews were conducted. They were also assured strict confidentiality. The researchers minimised their possible influence on the outcome of the interview by checking with the patients the meaning of the words they used in the course of the interview. They also maintained the accuracy of the participants’ responses by transcribing the interview verbatim and by importing them into a qualitative data analysis management software program. The setting for this paper was vaguely mentioned. It did not specify what centres were involved in the research. The criteria that the participants had to meet in order to be considered for this study covered their sex, their age, reason for admission (acute event, chronic condition, or pressure ulceration), and anatomical location of their pressure ulcer. The criteria were accurately chosen for their relevance in answering the questions raised in this paper. Each respondent represented a different profile or description of possible patients suffering from pressure ulcers. The sample size of 23 however is not quantitatively representative of the bigger population of patients who suffer pressure ulcers. The method of data analysis was thematic. The themes emerged from the questions asked in the questionnaire which, in turn were based on the specific objectives that this study aimed to answer (Miles & Huberman, 1994). The coding of the data was done by two of the researchers in order to validate the accuracy and trustworthiness of the data (Polit, et. al. 2001). The themes clearly captured the meaning of the narratives of the respondents. The presentation of the data was very thorough. Tables clearly depicted the characteristics of the respondents, the reason for hospital admission, summary of findings, and conclusions reached by this research. The chronological and logical order of research was followed and labelled via headings and sub-headings. Discussion The research is strong in portraying substantive information answering the specific questions posed by this research. It depicts that pressure ulcers do not only have a physical effect on patients. Pressure ulcers have emotional, social, and mental effects on patients. Pressure ulcers affect the recovery of patients; they increase hospital stay, and result to additional treatments aside from the ones they are already undergoing. This research also depicts that hospital staff often do not recognize and appreciate the pain and emotional distress that patients with pressure ulcers are suffering. The above information established by this research is trustworthy. They were established through valid, reliable, and ethical means. Research ethics was observed by the researchers when they gained the approval of participating centres and respondents. They explained to participants what their involvement in the research would mean and how their responses would be used and disseminated. The researchers also informed the participants of their right to stop the interview any time without giving a reason. Patients were also informed that their participation or lack thereof would not affect any aspect of their care. Patients who refused to be a part of the interview were not compelled to participate. Written consent was sought and respondents’ confidentiality and anonymity were ensured. The Data Protection Act requires that data “shall not be kept for longer than is necessary” (Okey, 2006). The act also makes provisions for preventing reuse and sharing of data without respondents’ consent. Indications of duration for data storage, reuse and sharing of data were not made clear in the research. Funding for this research was provided by the National Health Service which in turn is a publicly funded entity. The influence of this funding entity in the course of research seems to be non-existent. The authors mention that the findings of the paper do not necessarily reflect the opinion of the NHS. Reliability in this qualitative research was achieved “by documenting the succession of moves through the stages of data production, analysis and interpretation. This can be achieved by explaining the methodological framework and the range of strategies that have been used within the study” (Morgan and Drury, 2003). This was accomplished by authors of the study when they noted the process of research from the time they established their data until their interpretation of such data. Validity focuses on “…firstly, whether the means of measurement are accurate. Secondly, whether they are actually measuring what they are intended to measure” (Winter, 2000). Validity was ensured in this study by entering the data gathered into the qualitative data analysis management software package. In order to establish rigour, two researchers coded the data gathered. By quoting the patients verbatim, the readers are also given an accurate glimpse of the accounts of patients regarding their pressure sores. In the means taken to ensure validity and reliability, bias was prevented. This research is a bit weak in using the medical and scientific basis to support the testimonies of respondents. This research does not make use of scientific or pathological facts to complement the information narrated by respondents. The testimonies of respondents are taken to be conclusive and sufficient to answer the research questions. The responses are taken at face value and are correlated to other similar researches without firm basis on pathology and nursing theories. This study is also weak in terms of the number of respondents it has covered. The respondents are not truly representative of the bigger population of patients with pressure ulcers. The information established by this research contributes to nursing practice in the sense that it compels us to look into the problem of pressure ulcers. The information established by this research can help educate patients and nurses on preventive measures that may be undertaken. It can also help health care givers recognize patients who may be at risk for pressure ulcers. The methodology used in this paper is similar to methods used in other nursing researches. This method is common because “qualitative research in nursing…can help…explain the complexity and meaning of human behaviour by addressing questions such as why some patients require more postoperative pain relief than others and why nurses respond differently to verbal aggression” (Morgan & Drury, 2003). Research covering unstable patients over a longer period of time need to be undertaken. There is a need for research or maybe a case-study following the progress of development, care, and treatment of patients with pressures ulcers. This research can show the quality of life of respondents with pressure ulcers and the cost of healthcare maintenance for these patients. These recommended studies imply need for more studies on pressure ulcers. In my future professional practice, I know now to be more vigilant about my duties to my patients, especially to those who are at risk for pressure sores. My role as a healthcare giver is very important in the prevention of pressure sores. There are simple remedies that I can adapt and these can go a long way in reducing hospital stay, reducing hospital cost, and speeding the recovery of patients. Conclusion This article is a good piece of research. It is both substantive and innovative in approach. It satisfactorily answers the questions posed in this paper. This research implies that there is a need to conduct more researches on pressure sores-focusing on how the healthcare industry can be cost-effective while improving the quality of lives of patients. I recommend that these findings be implemented in nursing practice-especially to patients at great risk for pressure sores and imposed upon healthcare professionals handling patients with pressure sores or who carry the risk of developing pressure sores. Reference American Educational Research Center (2002) National Human Resources Protection Committee: Confidentiality. Retrieved July 4, 2008 from http://www.aera.net/aera.old/humansubjects/NHRPAC_Final_Confidentiality.pdf American Medical Association (2004) Influence of Funding Source on Outcome, Validity, and Reliability of Pharmaceutical Research. Retrieved July 4, 2008 from http://www.ama-assn.org/ama/pub/category/14314.html#funding_source_and_outcome Cook, T. & Reichardt, C. (1979) Qualitative and Quantitative Methods in Evaluation Research. Volume 1. Sage Publications, Inc., California. Hyperdictionary (2007) Meaning of Critique. Hyperdictionary. Retrieved July 4, 2008 from http://www.hyperdictionary.com/dictionary/critique Kralik, D. (2003). Australian Researcher Debbie Kralik Joins JAN as an Editor. Journal of Advanced Nursing. Retrieved July 5, 2008 from http://www.journalofadvancednursing.com/default.asp?file=pressdetail&id=6 McRoy, R. (n.d). Qualitative Research. University of North Carolina website. Retrieved July 6, 2008 from http://www.uncp.edu/home/marson/qualitative_research.html Miles, M. & Huberman, A. (1994) Quality in Qualitative Health Research, 2nd Ed. BMJ Books, London. Morgan, A & Drury, V. (2003). Legitimising the Subjectivity of Human Reality Through Qualitative Research Method. Retrieved July 4, 2008 from http://www.nova.edu/ssss/QR/QR8-1/morgan.html Ngan, V. (2003). Bedsores. Dermnet New Zealand. Retrieved July 3, 2008 from http://www.dermnetnz.org/reactions/bedsore.html Okey, A, (2006) Data Protection and Research: Briefing Notes. Lancaster University website http://www.lancs.ac.uk/depts/studreg/docs/Data_Protection/DP-research-notes.pdf Polit, DF, Beck, CT & Hungler, BP. (2001). Essentials of Nursing Research: Methods, Appraisal, and Utilization (5th Ed.). Lippincott, Philadelphia. Robinson, W. (2007). Research Title. University of Tennessee website. Retrieved July 6, 2008 from http://web.utk.edu/~wrobinso/540_lec_title.html Saba, R. (n.d). College Research Paper. Florida International University website. Retrieved July 6,2008 from http://www.fiu.edu/~sabar/enc1102/Research%20Paper%20Advice.htm Shapiro, S & Donaldson, N. (n.d). How to Write an Abstract. San Jose State University School of Nursing website. Retrieved July 5, 2008 from http://www.sjsu.edu/nursing/PDF/How to Write An Abstract.pdf Taylor, D. (2008). The Literature Review: A Few Tips on Conducting It. University of Toronto website . Retrieved July 4, 2008 from http://www.utoronto.ca/writing/litrev.html US Department of Human and Health Services (2002) National Human Research Protections Advisory Committee. Retrieved July 3, 2008 from http://www.hhs.gov/ohrp/nhrpac/documents/nhrpac14.pdf. Winter, G. (2000). A Comparative Discussion of the Notion of Validity in Qualitative and Quantitative Research. Retrieved July 4, 2008 from http://www.nova.edu/ssss/QR/QR4-3/winter.html. Workers’ Compensation Board (2008) Research definitions. Retrieved July 3, 2008 from http://www.wcb.ab.ca/research/definitions.asp Read More