Review of Research Articles about Nursing - Annotated Bibliography Example

Review of Research Articles: RRL 3 s) of the first assigned article: A.Elaine Bond, Christy Rae Lee Draegar, Barbara Mandleco, and Michael Donnelly. 1. What is the purpose of this study? This study attempts to discover the stressful experience, anxiety, and vulnerability of family members of patients with severe traumatic brain injury, admitted to an intensive care unit (ICU). 2. Describe the process used to obtain the sample. A convenience sample of family members of patients admitted to an 11-bed neurological ICU in a level I trauma centre was collected after approval of appropriate institutional review board. Family members, who met the prescribed criteria of inclusion, were contacted by one of the researchers and a consent form got signed by the participants. 3. Were inclusion or exclusion criteria used? If so, what were they? Yes, inclusion criteria were used in this study. The criteria include: (1) one family member of a patient with a diagnosis of severe traumatic brain injury who was at least 18 years or older; (2) the patient had a GCS score of 8 or less upon hospitalization; and the patient was hospitalized in the neurological ICU for at least 24 hours. 4. What type of sampling design is this? Bond et al (2006) used an exploratory qualitative descriptive design, and adopted purposive sampling technique for this investigation. 5. Is the sampling design a probability or non-probability technique? Since it is an exploratory study non-probability sampling design technique is used, because it is cheaper than probability sampling. 6. What was the consent rate? From the article it is difficult to ascertain the consent rate because the survey was conducted in an 11-bed ICU ward and only seven family members have been involved in the study. There is no indication as to whether all the 11 beds were occupied or not, and if it were fully occupied why there remaining four were not included. In addition it is stated that “recruitment of participants continued until saturation of the initial data occurred” leaving some gap in target sample size. (Bond, et al, 2003). What was the mortality rate? The mortality rate was above 57% (4 out of 7 participant’s relatives died).This data has much relevance with the research outcome, because the data reinforced the seriousness of severe traumatic brain injury and the extreme need to support families of such patients during the patients’ ICU stay”. 7. What was the sample size? Is this size adequate for the type of study (qualitative or quantitative)? The data size was seven family members, with dissimilar relationship, of patients with severe traumatic brain injury. Their ages ranged from 41 to 61 years. Since this is a qualitative study the small sample (7 participants) size can provide “insights about a particular group or patients” and “can illustrate qualitative findings.” 8. What was the setting for the study? The study was conducted at an eleven-bed neurological ICU in a level I trauma centre. Initial data collection was held in the privacy of a nearby waiting room, and subsequent interviews were conducted either at the hospital or by telephone, at the participant’s convenience. 9. If this was an experimental or quasi-experimental study (i.e., the IV was manipulated by the researcher), describe the experimental treatment? Describe the control treatment? This study was quasi-experimental one aimed to formulate hypothesis for further research and except using inclusion criteria there were no independent variables that have to be controlled, and content analysis was used to identify common themes. 10. How many data collection instruments were used? Name all of them and indicate the variable that the instrument measures. Though interview method was the primary instrument of data collection, its variations like personal interview, additional daily interview, telephonic data collection, appropriate follow-up, and probing questions were included as required. Interviews were recorded on audiotape and were transcribed verbatim. 11. Describe a maximum of three data collection instruments: Basic data collection instruments are group techniques, questionnaires, and interviews. a. Instrument 1 i. Name of the instrument: Interview method was used in this research as the instrument for data collection. ii. Indicate the type of instrument (self-report, scale, observation, biophysiologic measure, existing record, demographic data, other): It was observation of experiences of family members of their trauma from the traumatized family member with severe brain injury admitted in an ICU. iii. For quantitative instruments, provide answers to these items: The purpose of research is to develop and refine scientific knowledge for use in practice. Quantitative research is a formal, objective, systematic process using numerical data to obtain information about the world, and it is used to “describe, examine relationships, and determine cause and effect.” (Burns & Grove, 2002, p.21). Understanding nursing research. Elsevier Health Science. There are four types of quantitative research, namely descriptive, correlational, quasi-experimental, and experimental. Since it is qualitative descriptive analysis there are no measurable items, and thereby no scale, sub-scale, score, or range specified in this study. For qualitative instruments, provide a description of the data collection instrument (e.g., what questions were asked during an interview): Qualitative research is a systematic, subjective approach used to describe life experiences and give them meaning. The knowledge generated from qualitative research will provide meaning and understanding of specific emotions, values, and life experiences. Four types of qualitative research methods generally used in nursing research are phenomenological, grounded theory, ethnographical, and historical. The researchers used four common theses, such as: need to know; need for consistent information; need for involvement in care; and need to make sense of the experience. ‘Need to know’ was the common phrase used by every participant and they wanted know the ‘truth about patient’s condition even if the information conflicted with or compromised with their need for hope’. Second factor reported by the models were inconsistency in information received from the doctors, and suggested delivery of condensed information delivered by a single doctor to all of the family members. Family members felt excluded from the caregiving process, and they were put to while away their precious time outside the ICU that compounded their emotional distress. Finally inconclusive prognosis, even after spending 11 to 22 days in the ICU observation, and increasing uncertainties were the most exacerbating experience reported by family members. 12. How and when were data collected? The data were collected through face to face interviews and telephone contact during a 4-month period from January to April, 2001. There are many types of interviews, such as conversational interview; general guided approach; standardized, open-ended interview; and closed, fixed-response interview. In an informal, conversational interview no predetermined questions are asked, and the interviewer remains open and adaptable to the interviewee’s nature and priorities. The guided approach is intended to ensure that the same general areas of information are collected from each interviewee, and this provides more focus than the conversational approach. Under the standardized, open ended interview same open-ended questions are asked to all interviewees. This approach facilitates faster interviews that can be more easily analyzed and compared. Whereas, in closed, fixed-response interview all interviewees are asked the same questions and asked to choose answers from among the same set of alternatives 14. Describe the methods used to safeguard the ethical rights of the subjects It is ethical on the part of an interviewer to gain consent of the interviewee for reporting on personal information. Whenever a researcher is focusing and reporting on personal information about a research subject, he or she should obtain permission from the subject to do so. They should understand what interviewer is doing with them in the study and how any information associated with them will be reported. It is also necessary to clearly conveying the terms of confidentiality regarding access to the report. The interviewee should have the right participate or not and an informed consent form should be got signed from them.. a. Review by IRB (sic): Approval of the appropriate institutional review board had been obtained for conducting the study, which is the prerequisite for any research initiative. b. Informed consent process: Informed consent was obtained from the participants, by getting signed a consent form. The researchers had also explained the objective, the risk, the benefits, and the time constraint of participating in the study. Thereby steps had been taken to ensure ethical rights of the subject. c. Measures to maintain anonymity and measures to maintain confidentiality: Though it is mentioned in the article that measures were taken to ensure anonymity and confidentiality, what steps were taken to achieve this objective is not elaborated in the article. d. Is the sample part of a vulnerable population (explain): Though the study address specific population of traumatized family members it cannot be valid to consider the sample as part of a most vulnerable population that is socially representative. (White, et al, 2003, p.177-189). 1. What is the purpose of this study? The purpose of the study was to “describe the health-related quality of life (HRQL) and overall quality of life (QoL) of family caregivers in the initial two years following stroke and to examine the impact of stroke survivors and caregiver characteristics on HRQL and QoL” (White, et al, 2003). 2. Describe the process used to obtain the sample. The study by White et al (2003) is derived from the Montreal Cohort Study by Mayo et al (2002), which examined the long term impact of stroke on individuals experiencing stroke. For advancing the understanding of family caregiving for stroke survivors, evolution and impact of stroke caregiving experience over a longer period (over a 2-year period) was examined. Caregivers were recruited to the parent study only if stroke survivors were unable to provide study data independently. Only those caregivers interviewed in both the first and second years of their caregiving role were included in the study. 3. Were inclusion or exclusion criteria used? If so, what were they? Exclusion criteria were used for finalizing sample for the study. Caregivers who underwent only one interview, and those caregivers who underwent two interviews but were paid for being a caregiver as well different caregivers attending the same stroke survivor were excluded from the study 4. What type of sampling design is this? It is qualitative cohort analysis that examined subgroups to identify those individuals who may be at risk for negative consequence of health-related quality of life (HRQL) and overall quality of life (QoL) from long-term caregiving of stroke survivors. 5. Is the sampling design a probability or non-probability technique? Non-probability sampling design was used. 6. What was the consent rate? Since the sample selection was done by the researchers on prescribed norms and purpose of the study was informed in advance and written consent obtained from the model it has to be construed that there was 100% from the participants. 7. What was the mortality rate? Mortality aspect is not a part of this study. 8. What was the sample size? Is this size adequate for the type of study (qualitative or quantitative)? The initial sample size was 181, and after filtering under exclusion norms the sample comprised a total of 97 caregiver/stroke survivor dyads. Since the study being follow-up of previous study the sample size is adequate for formulating valid hypothesis that may be used for further research. 9. What was the setting for the study? The study was initiated while the stroke survivors were in the hospital setting and further information gathered after discharge 10. If this was an experimental or quasi-experimental study (i.e., the IV was manipulated by the researcher), describe the experimental treatment? Describe the control treatment? Overall QolL as the dependent variable and HROL as an explanatory variable were used in the study. 11. How many data collection instruments were used? Name all of them and indicate the variable that the instrument measures. Data was collected from face-to-face interviews at the hospital and telephone interviews after discharge. It is stated that “telephone interviews were found to provide information comparable to that received from face-to-face interviews” (cited by White et al, 2003) 12. Describe a maximum of three data collection instruments: Name of the instrument: Face-to-face interview and telephone interview were used. Interviews averaged 30 minutes. Indicate the type of instrument (self-report, scale, observation, biophysiologic measure, existing record, demographic data, other): The interviews were completed by health professionals who underwent specific training to improve the reliability of the interviewing process. For qualitative instruments, provide a description of the data collection instrument (e.g., what questions were asked during an interview): To assess a stroke survivor’s functional status, a caregiver completed the Barthel Index (Granger et al, 1979 cited by white et al, 2003), a measure of basic activities of daily living. To measure the presence of physical symptoms caregivers completed a checklist (Yes/No) of 24 physical symptoms that they might have experienced over the past 30 days. To estimate the stress associated with caregiving, caregivers completed the Burden Index, a 22-item measure with high internal consistency and fair test-rated reliability, designed to assess feelings of anger, frustration, and stress. HRQL was measured using the Medical Outcome study36-item short form health survey, a well known generic scale of perceived health status. QoL was measured using a 0-10 numerical rating scale. ‘t tests were used to compare the computed mean scores of caregiver characteristics variable, sex-matched norms, and published age. A series of linear regression models, developed for both the first an second years of caregiving, were used to measure HRQL and QoL impact of both patients and caregivers. The impact of patient characteristics and caregiver characteristics of HRQL (MCS and PCS) and overall QoL was estimated using a series of linear regression models. 13. How and when were data collected? The initial interview was planed for 6 months following stroke, but the first interview was done after 7 months following stroke and subsequent interview on average 23 months after stroke. 14. Describe the methods used to safeguard the ethical rights of the subjects a. Review by IRB (sic): Approval of the appropriate institutional review board (IRB) had been obtained for conducting the study. b. Informed consent process: Informed consent was obtained from the participants, by getting signed a consent form while in the hospital or shortly after discharge. The researchers had also given information of the study to the participants. Thereby steps had been taken to ensure ethical rights of the subject c. Measures to maintain anonymity: Since the study was initiated with face-to-face interview of participants in a hospital setting, and particularly stroke care department, information bias may creep up from exchange of ideas between caregivers. How anonymity and confidentiality will be maintained has not been detailed in the article. References Bond, A. Elaine., et al. (2003). Needs of family members of patients with severe traumatic brain injury. Critical Care Nurse, 23, 63-72. Retrieved March 19, 2009, from http://ccn.aacnjournals.org/cgi/content/full/23/4/63 Burns, Nancy., & Grove, Susan K. (2002). Understanding nursing research. Elseiver Health Sciences. 21. Retrieved March 19, 2009, from http://books.google.com/books?id=77dhcRrc7ToC White, C.L., et al. (2003). Evolution of the caregiving experience in the initial 2 years following stroke. Research in Nursing and Health, 25, 177-189. Read More