Psycho-Social Factors Affecting Elders Maltreatment in Long-Term Care Facilities - Research Paper Example

?Critiquing the Article “Psycho-social factors affecting elders maltreatment in long-term care facilities” The of the article is succinctly stated as it is brief, clear, and slightly precise in construction. The article matched the criteria of Wood and Kerr (2011) stating that a research title should have three significant items such as clarity, significance, and documentation (p. 68). The article clearly describes the main point or what the research is about and implied importance not only to the health profession but to the population as well because maltreatment in the elderly is an emerging concern. Documentation or construction of the title is brief, logical and slightly precise. Loiselle, McGrath, Polit, and Beck (2010) stated that a good title must reflect the key variables and the population being studied (p. 359). In this case, the article reflects psycho-social factors and maltreatment as variables under study and the elderly as the study population instead of Israeli elderly. Abstract An abstract should correctly summarize the problem, methods, design, results, conclusion, and implications of the study, must be convenient to the reader, and reflects the worthiness of the article (Taylor & Kermode, 2006, 86). Almost all of the contents of the abstract are correct and concise except for the method section. The abstract stated that a quantitative correlational method was used whereas the methodology section identified a quantitative correlational study which made the methods used conflicting. The author also thinks that the abstract of the article is too brief. Upon analysis of the article, the author noticed the following: the aim of the study is too general and stated that the study will examine and analyze ‘major variables’ affecting maltreatment of elderly when the title specifically stated that psycho-social factors will be studied; theoretical frameworks should not be included in the aim and must be included in a separate subheading; the statistical methods were not stated in the abstract; and the conclusion and recommendations did not summarize or recommends anything as it only stated that it is first study to examine elder maltreatment in the long-term care population of Israel. Introduction Statement of the Problem. In my own words, the research problem should be stated as: “What are the psycho-social factors affecting Israeli elders’ maltreatment in long-term care facilities? What are the relationships of each psycho-social factor in Israeli elders’ maltreatment in long-term care facilities? What psycho-social factor has the major impact in Israeli elders’ maltreatment in long-term care facilities?” These are the research problems which came in my mind upon reading the article as it intends to examine and analyze psycho-social factors especially major factors that affect elders’ maltreatment in long-term care facilities. In addition, I have read in the discussion that relationships were identified for each psycho-social factor so the problem could be stated in a way that would illustrate the relationship between psycho-social factors and elders’ maltreatment. According to Loiselle, McGrath, Polit, and Beck (2010), the statement of the problem must be easy to identify, has clear concepts and study population, has significance for nursing, and matches with the paradigms and methods used (p. 359). The article only implied that elderly maltreatment is common in long-term care settings and include various behaviors but did not establish a problem statement; thus, it was not easy to identify. Concepts and population under study are clear and established a cogent and persuasive argument for the new study as the full prevalence of elderly maltreatment in long-term care facilities is unknown. The problem has significance for nursing as it will address the factors on the side of the nurse that leads to maltreatment, leading to prevention. The article matched with paradigms such as the theoretical model for predicting causes of elder maltreatment in long-term care facilities and the theory of reasoned action as these paradigms seek factors and the reasons affecting maltreatment in the long-term care facilities. The quantitative correlational method is appropriate as this method examines and identifies the relationship between psycho-social factors and maltreatment. Hypotheses or Research Questions. The hypotheses and/or research questions are not explicitly stated; instead, they are implied. Taylor and Kermode (2006) stated that if the study goes beyond description, hypotheses should be stated (p. 87). In addition, research questions are used if the purpose of the study is descriptive and exploratory and rarely has theoretical frameworks while hypotheses when predicting relationships between variables and expected outcomes (Funnell, Koutoukidis & Lawrence, 2009, 44). Thus, absence of hypotheses and/or research questions cannot be justified. In line with this, the author made hypotheses in relation to the study which were stated as: There is no significant relationship between psycho-social factors and elderly maltreatment among Israeli patients in long-term care settings; or Psycho-social factors have no significant effect to elderly maltreatment among Israeli patients in long-term care settings. These hypotheses are consistent with the literature review staff traits, patient traits and features of the facility and on conceptual framework for predicting causes of elder maltreatment in long-term care facilities and theory of reasoned action. Literature Review. All of the literature reviews came from primary sources; most of them are journal articles and a few books. The year of publication of the journals ranges from 1998-2007; some of them are up-to-date while some are not. Journals included in the literature review must be scholarly articles or literatures. Scholarly journals are works written and edited by the professionals in the discipline (e.g., Journal of Elder Abuse & Neglect, The Gerontologist, Annals in Long-Term Care, Geriatrics, or Nursing Older People) and are published five years before the present time in order to build an updated and strong foundation or evidence (Schmidt & Brown, 2012, 94). The article has provided effective articulation of summaries of evidence concerning the research problem but not a very strong basis for the new study as majority of the sources are more than five years old. Conceptual/Theoretical Framework. The theoretical framework Theory of Reasoned Action and conceptual framework Pillemer’s Conceptual Model were used in the study. The theory and the concepts of Pillemer involving work environment at the facility, patient traits and staff traits were defined individually. Method Protection of Participants’ Rights. Undertaking research in health a healthcare facility and which involves human subjects must seek approval from the International Research Board (IRB) or ethics review board (Funnell, Koutoukidis & Lawrence, 2009, 44). The study has conducted appropriate procedures to safeguard the rights of the participants which were reflected in the research procedures. Consent was obtained first at the Ministry of Health and Ministry of Social Affairs to conduct a study in the facilities under their supervision. The directors of the facilities and the local ethics committee were sought also of approval to distribute questionnaires to the subject by guaranteeing subject’s anonymity and research purpose-limited findings. The study has gained approval from the ethics committee, indicating that the study was able to maximize the benefits of the participants and was able to minimize the risks involved in the study. Research Design. Given the purpose of the study which is to examine and analyze the major factors affecting elderly maltreatment in long-term care settings, the quantitative descriptive design perfectly fit the study. Since the study is retrospective in nature, appropriate comparisons of elderly in long-term care facilities since 2007 of data collection were made in order to enhance the interpretability of the findings and the number of data collection points. Comparisons are often the central focus of the study, reflects the issue under investigation, and affects the interpretability of findings (Polit & Beck, 2008, 205). In an attempt to minimize biases and threats to the internal and external validity of the study, the study used content validity and internal consistency reliability. Content validity is crucial for tests of knowledge and is also relevant in measuring psycho-social traits; internal consistency reliability measures error in psycho-social errors and is evaluated by computing coefficient of alpha (Cronbach’s alpha) which range from .00 to + 1.00 (Polit & Beck, 2009, 321-324). Examples of content validity in the study was the utilization of MBI – HSS (Maslach Burnout Inventory Human Services Survey) scale which has 22 items question that are closed-ended and examines three scales of burnout: emotional fatigue (nine items) a = 0.87, personal ambitiousness (eight items) a = 0.78 and depersonalization (five items) a = 0.76. Meanwhile, the level of reliability was set to 0.89 using the scale of KAMA (Knowledge and Management of Abuse) scale to examine knowledge and work methods resulting in maltreatment perpetrated by workers caring for elders. With the level of reliability almost close to +1.00, the more accurate the measure will be. Population and Sample. The population includes staff working at 24 of the 300 long-term facilities for the elderly in Israel from different geographical regions. The study utilized stratified random sampling as it divides the population into geographical regions and randomly selects samples from each subgroup and thus, ensured the representativeness of the characteristic of the sample and minimized biases (Heavey, 2011, 65). There were no any power analyses stated in the study to determine whether the sample size is adequate or not. Power analysis calculates sample sizes and if sample size is too small, a greater chance of type error might occur that may not find a statistical difference even if there is; meanwhile, when the sample is too large, time and money are wasted and greater is the chance of committing type 1 error (Heavey, 2011, 94). Data Collection and Measurement. Dependent variables include the existence of maltreatment and its various manifestations such as physical violence, mental abuse, sexual violence, financial exploitation, mental neglect and physical neglect (Natan, Lowenstein & Eisikovits, 2010, 116). There were no operational or conceptual definition of congruently identify. Self-reports or participants’ responses to the researcher’s questions were used to operationalize the key variables. Instruments used in data collection and measurement such as Iowa Dependent Adult Abuse Nursing Home Questionnaire, KAMA (Knowledge and Management of Abuse) scale, Likert scale, and MBI – HSS (Maslach Burnout Inventory Human Services Survey) scale were adequately described in the article and are being subjected and proven to be valid and reliable. The study stated that the self-report measures might affect the reliability of the data collection methods but the Cronbach’s alpha of KAMA and those of the three scales of burnout provided evidence that the collection methods were high on reliability and validity. Procedures. The intervention is properly described and implemented. Most of the participants allocated to the intervention group received it as evidenced by the 85% return rate of the 600 questionnaires. Biases were minimized in the data collection and staff are adequately trained. Results Analyses of each hypothesis were appropriately employed using the SPSS 14, Kolmogorov-Smirnoff test, non-parametric test, Mann-Whitney tests, and Spearman coefficient correlations. The statistical and clinical significance were addressed and findings are adequately reported and summarized. Discussion All the major findings are interpreted and discussed. The causal inference of the reasons for elderly abuse was justified. The interpretation of the study is consistent with the results and study limitations and addressed the issue of the generalizability of the findings. The study suggested that the generalizability of the findings is limited to the retrospective nature of the study, to the Israeli facilities, and to the self-report of staff members. Global Issues The report was well-written, organized, and sufficiently detailed for a critical analysis. There was no CONSORT flow chart to show flow of participants in the study but findings are accessible to practicing nurses as the study is available online. The researchers’ have enough clinical, substantive and methodologic qualifications and experience as reflected on their endeavor for doctorate degree; thus, enhance confidence in findings and interpretation. Despite a number of limitations, the study appeared to be valid because of theoretical and applied significance which are the foundation of nursing practice. References Funnel, R., Koutoukidis, G. & Lawrence, K. (2009). Nursing Research. Tabbner’s Nursing Care: Theory and Practice (5th ed.) (p. 37-52). New South Wales: Elsevier Australia. Heavey, E. (2011). Sampling Methods. Statistics for Nursing Research: A Practical Approach (p. 63-72). Massachusetts: Jones and Bartlett Learning, LLC. Heavey, E. (2011). Sample Size, Effect Size, and Power. Statistics for Nursing Research: A Practical Approach (p. 87-98). Massachusetts: Jones and Bartlett Learning, LLC. Loiselle, C.G., McGrath, J.P. & Beck, C.T. (2010). Critiquing Research Reports. Canadian Essentials of Nursing Research (3rd ed.) (p. 344-367). Philadelphia: Lippincott Williams & Wilkins. Polit, D.F. & Beck, C.T. (2008). Planning a Nursing Study. Nursing Research: Generating and Assessing Evidence for Nursing Practice (8th ed.) (p. 195-218). Philadelphia: Lippincott Williams & Wilkins. Polit, D.F. & Beck, C.T. (2009). Quantitative Research Design. Essentials of Nursing Research: Appraising Evidence for Nursing Practice (7th ed.) (p. 221-325). Philadelphia: Lippincott Williams & Wilkins. Schmidt, N.A. & Brown, J.M. (2012). Finding Sources of Evidence. Evidence-Based Practice for Nurses: Appraisal and Application of Research (p. 89-116). Massachusetts: Jones and Bartlett Learning, LLC. Taylor, B. & Kermode, S. (2006). Reviewing the Literature. Research in Nursing and Health Care: Evidence for Practice (3rd ed.) (p. 72-97). Australia: Cengage Learning. Wood, M.J. & Kerr, J.C. (2011). Critical Review of the Literature. Basic Steps in Planning Nursing Research: From Question to Proposal (7th ed.) (p. 63-77). Massachusetts: Jones and Bartlett Publishers, LLC. Read More