The Practice of Nursing Care on Cancer - Research Paper Example

Research Article Critique The emphasis of nursing care at present is very much on evidence-based practice. With evidence-based practice, research is now a crucial player in the care of the patient. With research as a vital health care tool, there is a need for nurses to be discerning about the various research studies in circulation. She needs to be critical about these researches. This paper critiques two nursing researches on cancer. One is a qualitative research entitled, “Living with Incurable Cancer at the End of Life-Patients’ Perceptions on Quality of Life; and the other paper is a quantitative research entitled, “Dance and Movement Program Improves Quality-of-Life Measures in Breast Cancer Survivors.” The qualitative research discusses the perceptions of incurable cancer patients about the quality of life at the end of life. The quantitative research discusses how dance and movement improves the quality of life of breast cancer survivors. This critique breaks down the different parts of the paper according to the critique guidelines set by Burns and Grove and by other nursing research authorities. It reviews the process of research which includes the problems and purposes, hypothesis, variables, literature review, framework of the study, study design, adequacy of the samples, directness of measurement, measurement of error, level of measurement, reliability and validity, statistical tests, findings, and implications. These elements shall be reviewed in terms of their adequacy, clarity, and completeness in answering the research question posed by the papers. Problems and Purposes In the qualitative research, the research problem was clearly explained and stated in the introductory paragraph. The researchers explained how the problem came about and why they saw a need for the research to be conducted (Polit & Beck, 1997; Burns & Grove, 2001). The problem chosen is significant to nursing because it provides new ideas on how to care for the incurable cancer patient. The quantitative research also clearly stated the research problem and purpose in the introductory paragraph. After discussing the background of the study, the paper stated clearly the purpose and research problem. The problem is very much significant to nursing practice because it offers interventions on how to improve the quality of life of the cancer patient (Polit & Beck, 1997; Burns & Grove, 2001). Research Objectives, Questions, and Hypothesis In the qualitative research, the research objectives were incorporated in the study background. There was a smooth and easily comprehensible flow of thought from the significance to the purpose, objectives and problem statement of the research. It was easy to see why the research was needed, why it was undertaken, what it will be about, and finally what the research wanted to accomplish. In the quantitative study, the research objectives and problems were incorporated in the background of the study, but not clearly labeled as such. There was a need for the reader to deduce the research problem from the introductory paragraphs. However, they were easily comprehensible and inferable to the reader. And, the flow of thought in the introductory paragraphs, from the background, the research objectives, and finally to the research question was smooth and well transitioned (Polit & Beck, 1997). The research hypothesis for both studies was not clearly discussed, and as far as this reader is concerned, was not mentioned in both papers. The lack of a formal hypothesis was compensated in both researches by sufficient background information that hinted a possible outcome from the researches. Variables in Published Studies The variables in both studies were appropriate to the problem. The variables chosen were important and relevant to the issue or problem that the researches were seeking to answer. In the qualitative research, there were very few variables, but the variables used were sufficient for the research. Qualitative research “does not require well-defined variables or causal models. The observations and measurements of qualitative scholars are not based on subjects’ random assignment to experimental groups” (Denzin & Lincoln, 2005). In the quantitative research, the variables chosen were also sufficient in studying the research problem. The inclusion boundaries for the research were also sufficient in establishing data needed for the paper. The relationship between the independent and dependent variables were properly exemplified in the study and seen in the tables. The Literature Review The literature review for the qualitative research was incorporated into the background of the study and discussions portion of the paper. Reviews of related literature in qualitative research are usually done after the gathering of data or while the research is progressing in order to avoid influencing the outcome of the research (Burns & Grove, 2001). The time of data gathering for the review of related literature was not mentioned in the paper making it difficult to determine when the data was gathered. The review showed gaps in knowledge and showed the significance of undertaking the research (Polit & Hungler, 1998; Burns & Grove, 2001). Studies used in the qualitative research were all relevant to the study. In the quantitative research, the literature review was presented before the results were presented, implying that it was conducted before the start of the research. This is expected in quantitative researches in order to determine the elements of the research (Burns & Grove, 2001). The studies chosen to be included in the paper were adequate to support and establish the need for the research. The review critically evaluated related studies and compared them with some of the findings established in the paper. Framework of the Study The framework or conceptual framework for the qualitative research was specified to be palliative homecare. It is a concept, not a theory. This is the usual case in qualitative researches according to Burns and Grove because qualitative researches usually develop theories, they do not prove them. Qualitative researches are usually subjective because they focus more on describing, discovering, understanding, and interpreting behavior. In the quantitative study, the researchers presented theoretical bases on how dance can help the healing process. The framework presented is sufficient basis for the paper to be grounded on. It is not specifically stated as a theory, but the reader can easily deduce it from the paper. The framework fits the problem well and includes all relevant variables in the study. Study Design The study design used for the qualitative research is content analysis. It was appropriate in order to adequately answer the questions posed by the research. Threats to validity and reliability were controlled by the researchers throughout the conduct of the study. Reliability and validity shall be discussed in detail in succeeding paragraphs. The study design for the quantitative research was the randomized control trial. It was appropriately used in the paper to study the problem adequately. The choice of design allowed the variable to be measured and manipulated (Burns and Grove, 2001). This method of data collection is the most useful way to explore the questions raised in this research. Threats to reliability and validity were also controlled by the researchers all throughout the study. These methods shall be discussed in detail. Adequacy of the sample The sample in the qualitative research is limited but adequate. The authors admitted that the sample size was small. However, “small samples of subjects are likely to appear in qualitative research where interview approaches observational methods, or case studies aim to gain depth of enquiry from a smaller group of respondents” (Ingham-Broomfield, n.d.). The inclusion and exclusion criteria for the qualitative research was also adequately explained and discussed in the paper. In the quantitative research, the sample population was adequate for the study. It was representative enough of the overall population of cancer sufferers. The sample population also fulfilled the inclusion criteria for the paper. Randomization was done by computer-generated random numbers in order to ensure that each member of the population had an equal opportunity to be chosen (Burns & Grove, 2001). The sample also possessed characteristics which were compatible with the target population. As a result, the outcome of the research was expected to be more applicable to a larger group (Polit & Hungler, 1998). Directness of the Measurement In the qualitative research, the statistical measurement of the outcome is not the main focus; instead, results are interpreted and analyzed without using statistical tools. According to Burns and Grove, this is the usual trend and practice in qualitative researches. In qualitative research, many of the factors involved in the study are not measurable data; they are concepts and abstract variables that cannot be reduced to inches or other levels of measurement. This sometimes makes qualitative research less reliable because its results cannot be numerically quantified. In the quantitative research, the data was measured via direct interaction with the respondents. In measuring the improvement in the quality of their life by virtue of the dance movement program, the data was measured directly in terms of shoulder range of motion and body image. The shoulder ROM was measured by the researchers in centimeters. The Body Image Scale was personally rated by the respondent. After the data was subjected to SPSS analysis, the data was measured and interpreted. The measurement tools used were appropriate and reliable measures for the purpose of the research. Measurement Error In the qualitative research, the measurement error in the paper was reduced by the authors by listening to the tapes and reading the texts of the interaction with the respondents several times. Since there was not much data to quantitatively measure, errors of measurement were not seen much in the qualitative research. The weakness in qualitative research is the interpretation of responses. Words and meanings are difficult to measure and equate with each other. Different authors may have different interpretations to responses, and patients may mean things which are different from what listeners perceive. The researchers in the qualitative research avoided this dilemma by listening to the tapes several times. Also, by writing key words, they reduced bias in interpretation and increased the validity and reliability of the research. In the quantitative research, errors in measurement were avoided by running the data through SPSS analysis and repeated ANOVA testing. The margin of error was reduced through repeated tests with similar results. Level of Measurement In the qualitative research, the level of measurement used was not based on defined nominal, ordinal, ratio or interval scales (Burns & Grove, 2001). These levels of measurement are not applicable in this study; instead the responses of the patients were classified to themes to express how patients perceive the quality of their lives in living with incurable cancer. In the broad sense of the term, these themes, may be defined and classified as nominal data. In nominal classification, names are assigned to data as labels (Burns & Grove, 2001). In this instance, the data gathered are assigned labels or themes. And these labels or nominal classification were appropriately used in the research. Content analysis is appropriate for this paper because it interprets the answers of the respondents, and does not classify them according to numerical scales. This is both a strength and weakness of qualitative research because the responses of the patients are not reduced to numbers; they are put out into the world verbatim for the readers to understand and to listen to. It is subject to various forms of interpretation depending on the reader, and yet it still speaks of true feelings unfiltered by labels and classifications. In the quantitative research, levels of measurement used were nominal, ordinal, and interval. Other statistical tools were also appropriately used for the research. These tools were applied to the different variables of the research in order to assess the responses of the patients- subject of the research. Levels of measurement accurately sorted the data into categories for easier comprehension and analysis. Reliability and Validity Reliability in the qualitative research was adequately ensured. Reliability was ensured by listening to and reading several times the tapes and the texts of the group sessions. All the authors of the research did this in order to reduce biases and differences in interpretation. Clarifications in meanings of the respondents’ words were also done in order to avoid any misinterpretations. This is important to ensure consistency or accuracy (Polit and Hungler 1998). Ethical considerations like informed consent were properly observed in the conduct of the paper. The researchers also gave the respondents an opportunity to refuse answering questions asked of them. The data retrieved was limited because of the limited samples. Nevertheless, data gathered was properly ensured to be reliable-although not applicable to a greater population. This is the weakness of this paper. Validity in the qualitative research was ensured through the verbatim translation of the responses of the subjects-patients in this research into the texts of the paper. In the quantitative research, reliability was ensured by repeatedly subjecting the data to the applicable statistical tools and analysis. Data was transformed through computer generated and SPSS software. The consent of the respondents was properly sought before the conduct of the research. There is greater reliability in the quantitative research because of the larger number of respondents, hence applicability of the results to a bigger population. Validity was also ensured through appropriate measurement tools used in the analysis and interpretation of the phenomena. Statistical Tests-Quantitative Research The quantitative research makes mention of the statistical tools used in the conduct of the research. They are all appropriate tools to measure and portray the central tendency in the responses of the subjects of the study. The study also describes how these statistical tools were used in the study. The sample population used in the research is also adequate for the statistical ad data analysis used in this research. Findings/Significance The findings in the qualitative study were divided into themes and subthemes. This manner of presenting the findings is appropriate for this research. The findings of the study were adequately and thoroughly discussed in relation to the research problem and the objectives of the study. Descriptions of how the results related to the concepts and other studies presented in the review of related literature were also sufficiently made. The research offered new perspectives which were not established by previous researches. This is the strength of the research because it offered new information which was not previously known in the care of the cancer patient. The findings in the quantitative study were also adequately and thoroughly discussed in relation to the objectives and the research problem. The researchers described the step-by-step process in the dance movement program that the respondents would undergo in the course of the research. They also related their findings with the theories established about the relationship of dance with healing. And they also made a critical evaluation of what other studies lacked and what their research offered in terms of new information valuable to nursing practice. Implications The implications set in the qualitative research were very much based on what the entire research was all about. The implications were sound and logical, and evidence-based. The implications were also seen several times in the discussion and naturally transitioned to be included in the implications for the study. In the quantitative research, the implications were not discussed thoroughly. They were discussed as part of the future recommendations, and even then, were not substantially discussed for the reader to glean viable implications from. This is one of the weaknesses of this research. Generalizing the Findings In the qualitative research, the researchers admit that the findings cannot be generalized to a larger population. The sample size is too small and they admit that a larger sample size may provide different results. They recommend further studies into the topic with a larger sample. This is one of the weaknesses of the qualitative research. But this is to be expected sometimes in qualitative researches where content is the focus-not statistically-based results (Burns & Grove, 2001). In the quantitative research, the findings are generalizable to a larger population. The statistical tools filtered through the wealth of data and reliably arrived at the results for the study (Burns & Grove, 2001). This is the strength of the quantitative research. There are more respondents to work with. More respondents mean a greater probability that the findings are applicable to other patients. Conclusion The qualitative and quantitative researches subject of this critique fulfills the requirements of qualitative and quantitative researches. The expected strengths and weaknesses of qualitative and quantitative researches are exemplified by both researches. The qualitative research typically lacked applicability to a larger population; however, it produced information vital to nursing practice. It showed us a more personal glimpse into the lives of patients with incurable cancer that would not have been gleaned from statistical figures. The quantitative research showed results that are applicable to the majority-not just to the small population. It showed more universal results. However, it also reduced the respondents to numerical figures in the tables, not patients with individual needs. Both researches adequately complied with the components of research. Their weaknesses are not substantive enough to discredit their outcome and their recommendations for better nursing practice. Reference Burns, N & Grove, S. (2001) The Practice of Nursing Research: Conduct, Critique, and Utilization. Philadelphia: Saunders Denzin, N. & Lincoln, Y. (2005) The SAGE Handbook of Qualitative Research. Thousand Oaks: Sage Publications. Ingham-Broomfield, R. (n.d) A Nurses’ Guide to the Critical Reading of Research. Australian Journal of Advanced Nursing. Retrieved 26 September 2008 from http://www.aja.com.au/Vol26/26-1v2_Ingham-Broomfield.pdf Polit, D & Beck, C. (1997) Essentials of Nursing Research: Methods, Appraisal, and Utilization. Philadelphia: Lippincott Williams & Wilkins Polit, D & Hungler, B, (1998) Study Guide to Accompany Nursing Research: Principles and Methods. Philadelphia: Lippincott Williams & Wilkins Read More