Family Bereavement Experiences after Sudden Cardiac Death - Essay Example

Family Bereavement Experiences after Sudden Cardiac Death Introduction The aspect of critiquing an article written about a particular research is important in the quest to establish whether the intended goals of the article have been achieved. Such an aspect of analysis is crucial in evidence-based research. Nursing research involves the use establishment of evidence to support nursing services. Consideration of this important aspect of critique writing led to the choice of the Critical Appraisal Skills Programme framework. CASP is a crucial part of the evidence-based research whose main aim is to identify flaws in the literature work granting the consumers a chance to make informed decisions about the use of the presented data. CASP tool provides a series of questions whose answers require critical scrutiny of the article without biases. In this piece of critique writing, CASP will be applied in the quest to analyze the family bereavement due to SCD. Also, this being the first piece of critique writing; the tools provide better foundation and understanding of what is entailed in a critique essay (CRITICAL APPRAISAL SKILLS PROGRAMME 2011). The article of analysis is titled ‘Family bereavement after Sudden Cardiac Death’ written by Mayer. It is an article about a qualitative research to understand the predicaments faced by families that are victims of SCD. It was written on 28 July 2012 and later revised on 17 may 2013. Several outcomes were found pointing out the hardships faced by these families. The article came from Elsevier website. In this article, the CASP tool will be utilized to scrutinize an article about family bereavement and SCD. It is a qualitative research. Qualitative research is a form of research designed to help generate an explanation for a certain behavior among a group of people and if possible state the stimulus causing the various behaviors (Denzin and Lincoln 2005). Qualitative research is applied in many disciplines due the many advantages that come with the technique. Stating the aim of the research What is the goal of the research? The goal or rather the main objective of the research is to illustrate the bereavement of family members after the departure of a dear one due to sudden cardiac death. Death of a family member brings about the distortion of the stability of several aspects in the family. The gap left by the departed person affects the family members in different ways that the author of the article has classified into themes. Five themes formulated by the researcher provided guidance to the search of the specific things to look for in the bereaved families. The five themes include; actual occurrence, saying goodbye, emotional reactions involved; life has to go on but, of course, not the same, and the meanings in losses. The outcome of the research shows some similarities and differences with the author analyzing them separately. The use of direct speech in the article gives the reader an opportunity to feel the intensity of the matter affecting the affected families (SPEZIALE & CARPENTER 2007). The author completes the article by stating suggestions especially to the nurses and other physicians. Why it is important Yes, the research is important. The collected data helps identify the obvious challenges that face families who are victims of sudden cardiac death. The article presents the information well and indicates the hardships the affected families face when trying to adapt to life without the departed crucial family members. It is an unplanned circumstance and many a times after the burial ceremonies, little concern is paid to provide emotional care and support to the affected family members. Sudden cardiac death is spontaneous and thus a circumstance that require immediate adjustments between the family members. The article also contains information about the importance of giving a listening ear the bereaved family and allowing them to share their stories. This aspect is evident during the collection of data where the family being interviewed appreciates the concern shown by the researcher in trying to understand their predicaments (SEALE 2004). Relevance of the research The research is relevant in the quest to establish methods of helping bereaved families unload the burden that comes with an abrupt loss of a loved one. Physicians including the nurses can learn a lot from this research literature regarding their roles in helping the bereaved families. The nurses and doctors should not shy off from explaining over and again the cause of death and what could have caused it. Some family members do have feelings that it is their fault without knowledge that they could have nothing to change the situation. The research is relevance as it highlights the challenges faced by this family in terms resource management and control of emotions thus forming the basis for the establishment of the relevant solution to the problem. Appropriateness of the methodology The use of qualitative research is appropriate in this type of research. The theory or nursing practice targets issues that improve the quality of care nurses give to the patients. Care should be not only physical but also emotional which extends to the bereaved family members. The methodology used in this research clearly portrays the nurses' role and how they can aid in providing emotional support to the victims of SCD. Listening to the questions frequently asked by the family members about the death of their loved ones helps them move on with life even though things have changed. The other aspect that shows the relevance of the method used is the flexibility associated with qualitative research. Several families were interviewed, and even though the cause of death of their loved was similar, every family had a different story. Flexibility grants the researcher the freedom to make alterations and obtain the required information (Bryman 2008). The interviewing of the participants yields several results with minor differences displaying how individuals and families deal with the situation. The use of direct quotes such as participant speaking with a cracked voice elaborates the pain that comes with the loss of a loved one. The researcher explains these reactions and explains response to the follow-up questions in some aspects such as saying goodbye and the adjustments that had to be made after the departure of a certain member of the family. The narrative approach grants the reader a chance to have a feeling of what these families are going through when facing life after sudden death of a loved one (Qual.auckland.ac.nz 2015). A good example of the interpretation is when the author interprets information to derive a conclusion about the roles of physicians in this scenario. Anna and Diane seek detailed information about sudden cardiac death that attacked one of their family members. Physicians should be ready to give the required information anytime to the family for them to be able to move on with their lives. Addressing aims of the research The design and structure of a research method highly depend on the objectives or rather the purpose of carrying out the research. The methodical approach of a research technique should be able to provide results that can be analyzed and provide answers to the research questions. In some occasions, the research should be able to disagree or agree with the formulated hypothesis thus help the research create useful conclusions. In this particular literature, the researcher explains in details the choice of the research method. To begin with, the researcher talks about the earlier empirical research whose main focus is individual bereavement after the death of a spouse. The consideration of theories such as symbolic interactionism and the theory of family systems provided the need undertake the research and understand the predicaments facing families after the sudden death of family members due to sudden cardiac death. The system provides a chance to view a family and therefore the need to investigate hardships faced by the members of a particular family after the death of a member (MARSHALL and ROSSMAN 2005). The researcher chose descriptive design of qualitative design of the narrative analysis. The author of the article indicates the reason of the choice indicating its appropriateness as it allows the participants to share stories without limitation on specific areas concerning the topic under research. The technique allows for necessary knowledge and conclusions to be drawn as the narrator shares the story with the researcher. However, the information given regarding the choice of design method is not enough. The author gives a brief description of the choice and goes on to elaborate the methods used in the choice of participants and sampling techniques. Explanation on the choice of research method is important as it allows for the readers of the article understand the rationale behind the choice. It helps equip the reader with the knowledge regarding choice of research techniques and why it was a suitable method to use in this particular research (CRESWELL 2003). Relevance of recruitment strategy to the aims of the research The researcher explains the choice of participants with precise details on the sampling techniques used. Several methods were used in the research that is appropriate in such kind of research. Professional referral is one of the techniques used. Cases of sudden cardiac death are confirmed by a doctor especially after autopsy as in many cases the victims die before getting to the hospital. Therefore, medical professionals have information regarding the affected families and most probably locations and contacts. Snowball sampling is also another technique used by the researcher. It is a sampling type where the respondents are involved in the identification of other potential respondents (Connaway and Powell 2010). Snowball sampling has a limitation of geographical area coverage and thus limits diversity when collecting information that varies from place to place. The other sampling technique used by the researcher and appropriate in this research is purposive sampling. It is a type of sampling mostly used in qualitative research. It involves the choice of samples based on the knowledge of the research regarding the participants and the reason behind carrying out a particular study (Connaway and Powell 2010). The researcher has gone further to give an explanation about the chosen families and the composition of the selected families. Also, elapsed time since the death of a member of the family is crucial in this research. A mean time of 2.1 years was considered. The elapsed time is crucial as it affects the emotional recovery of the family and the adaptation to living without certain members of the family. There is information given in the literature regarding failure of some members to participate in the research. The participants were issued with the consent forms and therefore participated in the research willingly. Considering the aim of the research, the choice of participants was limited. Data collection and how it addresses aims of the research The literature clearly states the setting as a subheading in the literature that shows the reason behind choice of such a setting. There is a structure of what the researcher refers to as a family. It comprises of a group of people living together or in contact with each other especially during sendoff and after departure of their loved ones. The interviews are carried out in the participants' home with the available family members. Connections with distant family members were made possible by the use of speaker phones and gave them an opportunity to share their stories regarding issue in question. Communication to the busy family members was made possible by the use of phone interviews that was recorded. Scheduling of personal interviews was made during the family interviews. The article contains information about data collection. Personal interviews about emotional issues require trust and confidence towards the researcher from the participant. The confidence was built by the provision of information about the researcher regarding on being a victim of the same. Digital recorders were used in this research thus saving time as transcription would be done later. In order to work within the objective, interview guides were used and tested to ensure efficiency before application in the field. The researcher does not specify the method of data collection e.g. focus group but explain the reason behind starting with family and interviews before proceeding to individual interviews. A specific period is allowed to elapse between the family interview and individual interviews for emotional purposes of the family members. The researcher has justified starting with family interviews before personal interviews with references to materials by other researchers such as Gilbert (2002). Systematic follow up this procedure in research enables the researcher to identify family dynamics. It also helps one have the knowledge on the family collective understanding of sudden loss of a loved one. The technique and method used during the interviewing are explained. A digital recorder was used to record the interview and was later played in a quiet environment and analyzed by experts (Guest, Namey and Mitchell, 2013). Topic guide is used as discussed earlier in this review where it was tested with a family that had not suffered any loss due to sudden cardiac death. Field notes were recorded after every interview and the thoughts of the researcher about a particular interview were noted don in a reflective journal. Through the research especially on the part of data analysis, no complaints are made regarding clarity and flow of information which indicate the data collection method was successful. Consideration of the relationship between researcher and participant The author of the article touches a bit on the establishment of a crucial relationship between the researcher and the participant. It is critical to establish a good relationship with the participants before undertaking such type of qualitative research for several reasons. The first reason is building of trust that ensures honesty while conversing to the person affected by the situation under investigation. Also, the built trust enables the participant to concentrate fully on the topic thus not worry about other things that would distract the emotional display of the respondent. Application of this kind of research requires analysis of the emotional well-being of the families as displayed in the article. Some respondents show anger, and pain by tears and broken voices while talking (Guest, Namey and Mitchell, 2013). The data collection methods applied in this research is explained by the author. Digital recorder was used which was later on transcribed verbatim. The people doing this are experts in this field to ensure every bit of the recorded voice is noted and recorded with what it means. Also, the formulation and testing of the research guide is mentioned thus giving the reader a chance to understand that the data collection follows a certain order. The research comprised of family interviewing followed by individual interviewing. It was done sequentially to ensure the researcher had a better chance to understand how the family as a whole deals with cases of a sudden departure if a family member due to SCD. The researcher starts with building emotional confidence by sharing a brief description of own experience with a case of sudden cardiac death. Undertaking such a measure helps the participant share the stories freely with deeper feeling as one feels it is a channel to release some emotional load. However, the article has a weakness in that information regarding the formulation of the research questions is not disclosed to the reader. The author of the article gives examples of the question used such as "Please tell me the story of …….'s death." Such a question's politeness also helps in the ensuring trust and respect between the researcher and the participant thus free exchange of information. Consideration of ethical issues Ethical issue must be taken into consideration while undertaking such kind of research. The author of the article has briefly explained the ethical consideration while undertaking the research. The first ethical practice is authorization by a recognized institution and in this case the research was granted approval by the University Institutional Review Board. It is done to ensure certain rights and rules and is not violated by either the researcher or the respondent. The ethical approval also maintains the reputation of the institution involved on the research process. Violation of the rights of either party involved in research can result in legal action as there are laws regarding the violations. Acquisition of the ethical approval also grants the researcher a chance to press charges in case there is a violation by the respondents in a way such as physical harm and insults (Holloway, 2002). Another aspect of the ethical issue is the presentation of consent forms to the participants. It is issued to the participant a few days prior to the interview. It is meant to request the allowance or the permission of the potential participant to be involved in the research based on the laid terms and conditions. The participants who were interviewed through phone were mailed a consent form which was to be returned prior to the interview. The other aspect of ethical issues is the disclosure of the identity of the respondent. Only the individual conducting the research in this case knows the identity of the respondent contrary to other researches where even the research does not know the identity of the respondent. The use of pseudonyms is applied in this research where fake names are used to ensure that the identity of the respondent is not disclosed to any other person except the researcher. The researcher is also bound by term and conditions of confidentiality as explained by Duane Monette (59) in his book "Applied Social Research: A Tool for the Human Services." Data analysis and it relevance The author grants a chance to understand how the data was analyzed by providing a subtopic mainly on data analysis. Three techniques were used in data analysis to ensure required information is drawn from the research outcome. It is crucial to employ relevant data analysis techniques that highly depend on data collected and the objectives if the research. The first method is narrative analysis. One of the main characteristics to note about this method is that it does not consider whether the narrated stories are facts or fiction. Opinion and experience are highly considered in this case. The method is used to establish the difference in meaning of the same event among the families that in this case is SCD (Hays and Singh 2012). The meanings of loss due to SCD varied between one family and another. Meaning of loss is one the themes generated during the research, and this technique of analysis proves helpful in the quest to prove this theme. The other applied technique which is well discussed by the author is structural analysis. Narrations of the experience matter a lot in coming up with solid conclusions regarding the matter. Different families have varied experiences before, during, and after the occurrence of SCD. The difference can be explained by structural analysis and thus help provide information about the developed themes. The other technique applied is thematic analysis of the research outcome (HOSKINS & MARIANO 2004). Thematic analysis is used to determine the contents of the data collected which in this case is the recorded conversation during the interview. The author of the article explains the importance of structural and thematic analysis in noting the difference between the experiences of the families on falling victims of SCD (Nursingplanet.com 2015). However, the researcher does not give clear information on the criteria used to select the data to be presented. A description of the analysis techniques requires the use of certain data chosen to act as a representation of the total samples used in data analysis. The other thing that the researcher fails to analyze at the data analysis stage is the availability of contradictions among the data that is analyzed. The researcher's contributions to the observations and outcomes are handled by reviewing of field notes and reflexive journals that indicate the thoughts the interviewer (Staff.bath.ac.uk 2014). Is there a clear statement of findings? The information on the findings is presented systematically with a brief introduction on how the response helped in confirming the cause of death was SCD. The findings are presented according to the themes identifies during the research. The identified themes help associate the findings with the emotional effects of sudden death of the members of the family. The author has explained in details other aspects that can be drawn from the research. Some families display dissatisfaction in the information regarding the actual cause of sudden death of their loved ones (RAWNSLEY 2009). Such information indicates the failure in roles supposed to be performed by physicians in providing sufficient information until the family members are satisfied (WATSON 2012). The best thing about discussion on the findings in this article is that it is systematic according to the suggested themes thus allowing the reader understand how the achievement of the objectives is achieved in such kind of research (HOLLOWAY 2010). How valuable is the research? The purpose of undertaking a particular research is to obtain information regarding a certain unknown variable. The author of the article presents the information first by acknowledging that it adds knowledge to certain works by earlier researchers. Also, the article identifies the challenges facing the bereaving families. The discussion identifies the loose ends left by various professionals in ensuring such families experience less trauma after SCD. The author has indicated the need to undertake more research. One of the suggestions is to perform a longitudinal research that can help establish ways in which the families tackle the management of disruptions due to SCD and several other reasons. The article's writer acknowledged several weaknesses in the research and thus the limitation of the application of the result. An example of such a scenario in the article is the fact that the sample size used was small to provide dependable data to be used in general conclusions. An indicator of a poor choice of sample is seen whereby the sex of the victims of SCD contradicts the national statistic of the individuals most affect by cardiac diseases that lead to sudden death. Conclusion Critical review the article enables on one gain vast knowledge about the challenges faced by families faced with SCD. The emotional torture and roles of the family members has to be adjusted. One learns a lot about nursing research in terms of roles of the nurses in helping the society. Personally, handling of patients faced with such challenges would be different and be part of a follow team to provide emotional support to the bereaving families. 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