Studies Supporting Nursing Interventions - Assignment Example

Running head: QUANTITIVE ARTICLE CRITIQUE Quantitative Article Critique: End-of-Life Care Number) (Date of Submission) Quantitative Article Critique: End-of-Life Care Introduction In the past years, a heightened emphasis on Evidence-Based Practice (EBP) prompted the need for more studies supporting nursing interventions. However, an inevitable effect of this boom is the difficulty in determining the integrity and validity of these studies’ findings. Thus, as means of establishing credible evidences, article critiques were developed for evaluating research studies (Beyea & Slattery, 2006). In relation, this paper will conduct a critique of a study by Maida, et al. (2010) regarding the treatment preferences of patients with advanced cancer. The details of the mentioned study were published in a nursing article in the tenth volume of the BMC Cancer Journal. One of the major problems that became apparent in the article was that the study problem was not explicitly stated in the study’s abstract, and it was not until in the later parts of the Background that the reader becomes aware of the study’s intent to analyze patient preferences on conservative palliative management (CPM) versus active and aggressive medical management (AAMM) in end-of-life care. In fact, only the study’s aims were mentioned, and the research problems as well as hypotheses were not clearly stated in the paper. Nevertheless, the chosen topic in the study is very much significant in the field of nursing since it provides a medium for guaranteeing “Patient-Centered Care” (PCC), one of the primary advocacies of nursing (Mitchell, Bournes, & Hollett, 2006). Indeed, this emphasis on PCC served as among the basic justification for the study, and the highlighting of PCC was used as part of the basic conceptual framework of the study, albeit this framework was rather implied, and not explicitly stated. Still, the PCC framework was linked to the research purpose by serving as the primary motivation for the study and review of literature. In relation, most of the literature reviewed can be considered recent, with 90% of the studies cited conducted from 2000 to present. However, the remaining percentage involved older studies, with the oldest study dated 1984. Nevertheless, a strong point of the study is that its review of literature flowed logically and although it was brief, the literature review was able to adequately justify the need for the study. Methods In terms of methodology, another weak point of the study is in the fact that it failed to comprehensively discuss its study design. In fact, the research design was not mentioned at all in the study. Instead, the reader has to infer what possible design was utilized for the study. At a first glance, the study appeared to have utilized a qualitative design; however, upon analyzing further the purpose of the study, it can then be inferred that the study utilized a quantitative design. This design fortunately meets the purpose of the study since although the study emphasized the exploration of the patient’s preferences on end-of-life care, it actually attempted to create a correlation between these preferences and the demographic characteristics of the respondents who chose either CPM or AAMM. Thus, this design determined the need for a large sample and both inferential and descriptive statistics (LoBiondo-Wood & Haber, 2006). The study sample consisted of cancer patients who were referred to a palliative program in Toronto, Canada. The paper provided a brief discussion of the sampling procedures, and thus, the authors failed to provide a justification of the size of the sample. Despite this weakness, the authors were able to clearly and concisely describe the study protocol, data measurement, as well as the instruments used in the study (i.e. questionnaire, Palliative Performance Scale [PPSv2], etc.), which were successfully able to measure the data they were supposed to measure. With these, the authors were able to present enough details for replication. However, the authors failed to address the reliability and validity of the instrument, as well as the external and internal validity of the study design. Still, the researchers provided adequate support for ethical approval. Results Despite the problems in the study’s methodology, the authors somehow redeemed themselves in the presentation of the results of the study. Indeed, the study findings were presented in a logical and cohesive manner, beginning with the characteristics of the respondents. The attributes of the sample were discussed clearly using numbers and percentages, wherein the gender, age, race, specific cancer diagnosis and other characteristics were considered. However, a minor glitch in this almost-perfection is the fact that because the authors failed to present a specific hypothesis, they had no tangible guide for the presentation of their results (Hoskins & Mariano, 2004). Nonetheless, the objectives of the study allowed the researchers to present their findings separately and more understandably. The authors primarily gathered quantitative data, such as what number of people preferred the specific methods under CPM or those techniques involved in AAMM, as well as what kind of people chose those forms of end-of-life care. In addition, Maida, et al. (2010) also provided a comprehensive discussion of the procedures used for data analysis, such as the use of PPSv2, the Charlston Comorbidity Index (CCI), and, more importantly, the creation of a database using Microsoft Access 2007. These procedures made possible the establishment of the patients’ preferences, their certainty in their decisions, and a lot others. The presentation of results was also made clearer by the authors’ use of tables that summarized the study data. What is more, the textual discussion presented by the authors supplemented the data presented in the tables. Finally, the study found that a majority of the respondents (42%) prefer the use of conservative measures for palliative care, rather than more aggressive ones. However, the authors found that those who preferred AAMM were more likely to be younger, to have a significant other, to have a higher PPsv2 score and to be non-Caucasian. Discussion/Implication In the discussion section of the paper, the authors related the study findings to the research purpose or objective, but they failed to relate it to their hypothesis, because no clear hypotheses were set in the first place. Nevertheless, the researchers provided a clear discussion of the study findings, and this discussion was facilitated by the fact that they mentioned at the very start that their study is among those pioneering in exploring the preferences of patients in their end-of-life care by comparing the inclination towards CPM versus AAMM. However, previous studies exist regarding the preferences of patients in terms of the care for the terminal stages of their disease, but only a few truly explored the trend or shift of preferences towards less aggressive method towards more conservative methods. Still, Maida, et al. (2010) also included these previous studies in their discussions, actually discovering that some of these old studies supported the findings of the study by Maida, et al. (2010). In fact, these older studies were effectively used by the authors to explain the study findings, such as why a specific race, gender, or age group preferred more aggressive methods, or why another group of respondents favored more conservative methods. However, although the authors provided strong support to the study findings, they failed to discuss previous literatures that contradicted the data of the study. Nonetheless, although this considerably weakened the discussion of the study, the authors made it up by presenting the limitations of the research. However, these limitations somehow diminish the value of the study, especially since it was revealed that the instrument was not tested for validity, there was no randomization in the samples, some other significant factors were not considered, and others. Still, these limitations do not change the fact that the study’s potential for use in nursing practice is immense, especially in terms of patient-centered care. Overall Presentation and Final Summary In analyzing the overall presentation of the paper, some issues and problems, as well as strengths were also observed. One of these major problems is seen in the fact that the title failed to accurately describe the type of the study, its major variables, and its target population. Although the title specified that the target population involved cancer patients, it failed to specify that only a single palliative program was involved. More importantly, the study title failed to include the type of the study, wherein readers have to keep guessing whether it was a quantitative or qualitative study. This is a significant issue especially since upon first reading, the study would appear like it was qualitative article because it explored the preferences of cancer patients in their end-of-life care. However, it is in here again that one can see that the study failed to include the major variable involving the demographic characteristics of individuals preferring CPM or AAMM. Indeed, the exploration of the said variables was among the most vital purposes of the study, but the title made it appear that the study on focused on whether CPM or AAMM is more preferred than the other. On the other hand, the authors were able to formulate an abstract that accurately represents the study, although the abstract could have been improved with the inclusion of the study’s research design. Also, the study report was able to remain logically consistent, keeping the same tone, voice and perspective all throughout the paper. Indeed, one of the strength of the study report is that the writing style remained concise/clear throughout the paper, although the authors failed to include some major details (i.e. study design). Finally, this paper is related to this writer’s EBP project since it provides a strong basis on what choices to provide for the patient at the end of a terminal condition. More importantly, the chosen study supplied the nurse an opportunity to center care on the client, one of the most important aspects of nursing. References Beyea, S. C., & Slattery, M. J. (2006). Evidence-based practice in nursing: a guide to successful implementation. Marblehead, MA: HCPro. Hoskins, C. N., & Mariano, C. (2004). Research in nursing and health: understanding and using quantitative and qualitative methods. New York, N.Y.: Springer Pub. Co. LoBiondo-Wood, G., & Haber, J. (2006). Nursing Research: methods, critical appraisal, and utilization. St. Louis, Mo.: Elsevier Mosby. Maida, V., Peck, J., Ennis, M., Brar, N., & Maida, A. R. (2010). Preferences for active and aggressive intervention among patients with advanced cancer. BMC Cancer, 10, 592. Mitchell, G. J., Bournes, D. A., & Hollett, J. (2006). Human Becoming-Guided Patient-Centered Care: A New Model Transforms Nursing Practice. Nursing Science Quarterly, 19 (3), 218-224. Read More