A Critique on Negative Pressure Wound Therapy: Patient Perspectives - Essay Example

? A Critique on Negative Pressure Wound Therapy: Patient Perspectives College Lecturer A Critique on Negative Pressure Wound Therapy: Patient Perspectives Introduction In the following essay, the author reviews the Bolas and Holloway’s report, ‘Negative pressure wound therapy: a study on patient perspective’. The main reason for selecting this particular report is that it focuses on determining the effects of NPWT on the lives of patients going through this form of treatment. This topic is important to the field of nursing because since its advent, NPWT has become a preferred method of treatment for many patients and physicians. The essay analyzes the work done by Bolas and Holloway, organizing the analysis into a critique of the justification of their study, literature review, design of the study, data collection, data analysis, and the summary. Negative pressure wound therapy is a form of treatment whereby a physician exerts pressure on uniformly on a wound in order to cause the wound to heal (Stansby et al. 2010). This form of treatment is modern and a lot more non-intrusive as compared to other pre-existing methods of healing wounds. Even so, like any other treatment plan, NPWT leaves a mark on the lives of those who take it up as a preferred method of treatment. Several researchers have attempted to study the effect of NPWT on the lives of the patients. Is the treatment more desirable than other forms of treatment that have been there before? Does it leave a lasting positive impact or is it in the end scaring to its recipients? Bolas and Holloway’s in their report, Negative pressure wound therapy: a study on patient perspective’ set out to establish the impact of NPWT on the overall lives of patients that receive this form of treatment. Research and Evidence Based Practice The study conducted on NPWT is important in nursing because of its nature as a modern form of treatment. Evidence based Practice demands that conducting the development of clinical practices should be based on the most current evidence and research (Pierson & Schelke, 2009). For this reason, the study conducted is important in the nursing field. The title’s clarity lies in the fact that by reading it, the average reader can deduce that it is a report on patients’ views on NPWT. The definition given in the essay makes the concept of NPWT clear to readers. Precision and clarity of this nature can be found throughout report. This is perhaps a product of the fact that both authors are prominent professionals in the field of nursing, with Bolas being a clinical nurse specializing in tissue viability, and Holloway a senior lecturer on wound healing at the school of healing. One can, therefore, trust in the credibility of the information provided in the report. The abstract of the report clearly outlines the organization of the study as statement of the problem, the research process, and the overall findings warranting a similar structure in the analysis. Importance of the study More patients are opting for NPWT than before. Some of the benefits that this form of treatment presents to patients include fewer dressing charges, the enhanced hygiene standards and ultimately, the faster healing of wounds (Moffatt et al. 2011). NWPT presents patients and nurses with convenient options that were previously not available. Even so, as Bolas and Holloway clearly state, there are not sufficient studies conducted on the impact of NWPT on human lives. The problem stated at the beginning of the essay clarifies what the study is about to the reader and bears connection to the research topic. This is one of the qualities of a good problem statement as Ryan, Coughlan and Cronin (2007) point out. In a bid to gain insight into the effect that NWPT has on the lives of patients, the study sought to find out what hinders the patients’ use of the therapy. In addition, they wanted to determine the best way to enable the patients to overcome the challenges they contend with due to the treatment regime. These aims are relevant to the problem stated. The overall purpose of the study is supported by the specific objectives. For example, one can draw a conclusion on the impacts of NWPT on the patient’s life from finding out the barriers to their use of this treatment method (Wallin et al. 2001). These objectives, in addition to being relevant to the problem under study are measurable using dummy variables, and are especially effective in instances whereby all the respondents are asked similar questions (Ryan, Coughlan and Cronin 2007). The null hypotheses in these instances would be testable. Literature Review The authors of the report cite the reviews of literature clearly. The literature review for this report was intensive. The authors’ focus was on studies conducted on specific aspects of the effects of NPWT on the lives of the patients. The review divides the effects into three different categories, that is, the effect on the quality of life of the patient and the levels of pain, the effect on the physical functioning of a patient under treatment, and finally, the effect on the anxiety and stress levels of the patients. All the studies reviewed in the report were recent, all conducted after the year 2005. This would imply that the authors picked literature that was relevant to the current condition of NPWT in medical practice. The reviews were able to paint a clear picture on the three sectors of a patient’s life mentioned earlier. The findings presented by the reviewed literature implied a general difference in the lives of the patients under NPWT and those opting for different methods of treatment. This backs up the claim that Campbell (2010) makes concerning the growth of NPWT as a preferred method of treatment with far more positive effects than the alternatives. The review confirmed that previously conducted research found that patients on the NPWT method of treatment healed faster. In addition, there was no consensus as to whether the treatment increased or reduced stress in patients. This is because some of the patients experienced alleviated stress levels due to the speed of healing, while some patients faced elevated levels of stress because they were limited in their choices of physicians, owing to the fact that many physicians were not familiar with the NPWT method of treatment (Keskin et al. 2008). Despite the literature review being intensive, it lacked extensity. For all the three aspects of a patient’s life examined, the research seemed to focus on the findings of only one study at a time. For example, to measure the effect of NPWT on the physical functioning of the patients, the review focused on the work of different researches. Munyati (2008) emphasizes in her work the importance of studying a wide range of literature for the review section. One of the ways to avoid bias in the paper and gain a clear perspective of the studies undertaken is to read on a variety of literature gathered on a given topic. The literature review in the report by Bolas and Holloway can therefore be potentially misleading. In addition to this issue of non-extensive research, the review failed to cover work done on the effect of NPWT on the economic lives of the recipients. An example of a report of this nature could be one conducted by Othman (2011), where she establishes that some of the recipients of the NPWT treatment could face potential financial paralysis because some of the materials applied to this treatment are costly. Overall, the review fulfills its objectives. For one, the review informs readers of the findings of research conducted in the same field. Secondly, it is clear that there are research gaps that need filling on the effects of NPWT on the lives of the patients. Study Design and Ethical Issues The authors of the report were clear on the theoretical framework adapted in the study. This based on the approach adopted by Glaser and Straus (1967) on grounded theory. The strategy of the authors may not have been to base their work on existing theories as much as it was to create a theory of their own. The theoretical framework acting as the basis for this study is gaining insight into the lives of each of the patients. Clearly, the authors are not out to prove or disapprove any theories but to adopt their own stance. This may be because there is not much work done on the topic on which they are conducting research. The report has its philosophical underpinnings in Heideggerian interpretative phenomenology, which is based on studying and comprehending individuals according to their contexts, their formative experiences, cultural and social backgrounds. The philosophical approach has been identified and explained aptly. The reason behind choosing this particular philosophy could be that the study is based largely on the opinions and settings of patients chosen to be part of the sample under study. Other than a clear philosophical framework, the sample size for the study was six people of varying age groups and genders. Six people, much as it implies a compact study sample, small and cheap to work with, may on the other hand have been too small and thus potentially dangerous to the study (Vishnevsky & Beanlands 2004). The participants also suffered different injuries. The sample was chosen depending on who was willing to participate in the study, and was therefore not random. This could have both positive and negative implications for the results. Willing participants are more open with information and can therefore give information that is more accurate on their ailments and experiences. On the other hand, willing participants could create a bias in the study (Denzin & Lincoln 2003). The fact that the participants in the study all suffered injuries and were on the NPWT made them suitable candidates for the study. Bolas and Holloway (2012) maintain that informed consent for the study was obtained from the relevant authorities and from the participant. Obtaining the consent also entailed reassuring them of protection against the repercussions of pulling out of the study. In addition, the use of pseudonyms for the participants served to protect their identities. Data Collection and Rigor The study, according to Bolas and Holloway (2012) involved the use of interviews covering the same questions for all six participants. The modes of interview have been described satisfactorily, including the period for the interviews (40-60 minutes). The report also touches on audio recording to increase the efficiency of collection of data from the participants. The authors however admit that their methods of collecting data, though similar for all the six respondents, varied slightly. This is because the course of every conversation was determined by the responses they got from the individual participant. The researchers also outline the method by which data was analyzed. The data analysis process seems to have been airtight, with the data collected going through several stages in terms of analysis through the Interpretative phenomenological analysis process, a method that involves four stages, ensuring a systematic approach to analysis (Hoye & Serverinsson 2007), and finally through the authors, one at a time. Rigor refers to the level of trustworthiness of the findings, especially as applies to qualitative research (Denzin & Lincoln 2003). This, in the report studied, was achieved by taking the data collected through all the aforementioned steps. In addition, the participants had their credibility and dependability tested by having to confirm that the experiences they articulated was their own. Data Analysis The analysis of the data then led to the findings that the participants let on about themselves. According to the findings, the participants in general felt that the treatment altered their self-images physically and emotionally. None of the participants felt positively concerning this. Secondly, the treatment paved way for the patients to experience technology in a way that was different from that to which they were accustomed. This was negative for some and positive for a few of the respondents. Finally, the study revealed that brought a feeling of physical and social restriction on the recipients of the treatment. The findings of the study have been presented in a manner that is clear and simplified for the average reader. They are well organized in the presentation. In the discussion section of the findings, the authors place their findings in the context of previous findings by other researchers. For example, the authors acknowledge that they were aware of the social and physical restrictions with which the patients have to contend. Summary of Critique The purpose of the study was to establish the effects of NPWT on patients. It is true to say that the researchers/authors met this goal sufficiently. The authors then proceed to outline the importance and implications of the studies that they conducted. They, for example, suggest that medical practitioners obtain the relevant treatment on negative pressure wound therapy in order to enhance service to patients taking up this form of treatment (Bolas & Holloway 2012). This is in relation to their findings on the patients’ experiences, whereby some of the patients complain that as they walked into hospitals in search emergency attention with their NPWT, they could not find a physician that knew what to do. The authors do not make recommendations as to how the findings of the research can be developed further. It is however worth noting that the material used in the study is well-referenced. All the books, journals, and websites that aided the authors in the course of the research have been listed neatly and in a manner that allows the reader to refer to them easily should the need arise. The referencing format used was consistent throughout the list. Most of the materials listed were from recent years, perhaps because NPWT is a new treatment. Conclusion The research conducted was a very thorough. The paper was written properly, organized in a systematic manner, creating a flow from one point to the next. It is commendable that the authors practiced precision and clarity in their delivery of the report. Even so, the authors could have improved on the literature review and expanded it to cover a wider variety works conducted on the effects of NPWT on the patients. In addition, a slightly larger sample frame could have been more representative of the population that is currently on the NPWT treatment regime and their attitudes towards it. This critique serves to demonstrate the importance of building a research report on concrete facts. Even though qualitative research is at times considered difficult to critique, it is important that researchers protect their work against negative criticism by sticking to the guidelines for effective writing provided. This should see to the development of more productive research conducted on nursing in future. References Bolas, N, Holloway, S 2012, “Negative pressure wound therapy: a study on patient perspectives”, Br J Community Nurs vol. 17 no. 3, pp. S30–S35 Denzin, N & Lincoln, Y 2003, Strategies of Qualitative Inquiry, 2nd edn. Sage, Thousand Oaks, CA. Othman, D n.d. “Negative Pressure Wound Therapy Literature Review of Efficacy, Cost Effectiveness, and Impact on Patients' Quality of Life in Chronic Wound Management and Its Implementation in the United Kingdom”, Plastic Surgery International, vol. 2012, Article ID 374398, 6 pages. Glaser, B, & Strauss, A 1967, The discovery of Grounded Theory: Strategies for Qualitative Research, Aldine, Chicago. Hoye, S & Severinsson, E 2007, “Methodological aspects of rigor in qualitative nursing research on families involved in intensive care units: a literature review”, Nurs Health Sci vol. 9 no. 1, pp. 61-8. Keskin, M, Karabekmez, F & Yilmaz, E et al. 2008, “Vacuum-assisted closure of wounds and anxiety” Scand J Plast Reconstr Surg Hand Surg, vol. 42 no. 4, pp. 202–5. Moffatt, C, Mapplebeck, L, Murray, S, & Morgan, P 2011, “The experience of patients with complex wounds and the use of NPWT in a home-care setting”, J Wound Care, vol. 20, pp. 512–17. Munyati, S 2008, Literature Review, Lilongwe, Research Support Center. Pierson, M & Schelke, S 2009, “Strengthening the use of evidence-base practice: Development of an independent study packet”, The Journal of Continuing Education in Nursing, vol. 40 no. 4, pp. 171-176. Stansby,G, Wealleans, V, Wilson, I & Morrow, D 2010, “Clinical experience of a new NPWT system in diabetic foot ulcers and post-amputation wounds”, J Wound Care vol. 19, no.496–502 Ryan, F, Coughlan, M & Cronin, P 2007, Step-by-Step Guide to Critiquing Research, Part 2: Qualitative research, Dublin, School of Nursing and Midwifery. Vishuevsky, T & Beanlands, H 2004, “Qualitative research”, Nephrol \hirs J vol. 31 no. 2, pp. 234-8. Wallin, A, Bostrom, L, Ulfvarson, J, & Ottosson, C 2001, “Negative pressure wound therapy — a descriptive study”, Ostomy Wound Manage vol. 57 no.6, pp. 22–9 Campbell, P 2010, The Positive Uses of negative Pressure Wound Therapy. [Accessed 3 May 2013] . Read More