Experiences of Patient Death in an Acute Medical Setting - Essay Example

Research Critique Introduction This paper aims to critique Wilson’s research article, “Ward Experiences of Patient Death inan Acute Medical Setting.” In this article, Wilson (2014: p37) sets out to investigate how healthcare support workers, nurses, and other ward staff in the acute medical setting experience the death of a patient. Caldwell et al.’s (2005) research framework will be used to critique the article, in which several critique questions will be used to determine the weaknesses and strengths of the research article. Moreover, since the research report has been identified as a qualitative study, the paper will critique the justification of the methodology and research design used, the identification of major concepts, identification of the study’s context, sampling of participants, and auditability of data collection method, creditability of data analysis method, the presentation and transferability of results, and comprehensiveness of the conclusion. Research Critique Does the title reflect the content? According to Caldwell et al (2005: p4), a research title must be concisely, clearly, and accurately written, while also being grammatically correct and brief and reflecting the content and emphasis of the paper. The research article’s title must, therefore, concisely, clearly, and accurately reflects the paper’s content and importance in one sentence. In this case, the title reflects the paper’s context within the hospital ward’s acute medical setting, while also reflecting the importance of the paper with regards to how nurses in these setting react to the death of patients. Are the authors credible? The job title and qualifications of the author can be used as a useful indicator of the knowledge of the researcher in the area that they are investigating (Caldwell, 2005: p4). The article identifies the author, Janet Wilson, as a senior lecturer at Sheffield Hallam University in the faculty of Health and Wellbeing and has worked for more than thirty years as a healthcare professional (Wilson, 2014: p37). Moreover, she has also worked as a supervisor, counsellor, and group facilitator in supporting bereaved persons, while has also authoring various articles on nursing practitioner roles and the bereavement process, which makes her views on grief especially relevant. Therefore, the qualifications of the author make the research article more reliable and valid. Does the abstract summarize the key components? According to Parahoo (2014: p26), research articles should include an abstract that briefly states the purpose/problem of the research, indicates the experimental or theoretical plan utilized, summarizes the key findings, and identifies relevant major conclusions. The research article does provide an abstract that explores the purpose of the paper, which the article refers to as the aim. In addition, it also provides for the research plan used that is identified as the Heieggerian phenomenological approach, as well as briefly providing the major findings of the study and a conclusion. Is the rationale for undertaking the research clearly outlined? The rationale of a research study specifies the researcher’s reasons for conducting the study based on current knowledge, while it also provides a well documented problem/need on which the project is based, why this problem exists, and probable solutions (Parahoo, 2014: p41). The researcher identifies the fact that ward staff play a critical role in caring for dying patients, as well as that all ward staff experience the death of a patient at one time or the other. Quoting several research studies, the article notes that the experience of caring for dying patients and the death of patients is demanding and stressful. Noting that more than 245,000 patients die in acute hospital settings each year, the researcher justifies his study by arguing that ward staff should be sufficiently supported when caring for dying patients. Is the literature review comprehensive and up-to-date? The main purpose of a literature reviews in research studies are to develop or define the identified research question, the identification of appropriate data collection methods, and to identify literature gaps that need to be filled (Blaxter et al, 2009: p34). By including literature related to coping and defence mechanisms, emotional labour and intelligence, grief, and healthcare policy, the researcher is seeking to identify current knowledge that will contribute to answering the research question regarding how ward staff experience patient death, support mechanisms available to deal with patient death, and the implications for healthcare policy. Is the aim of the research clearly stated? Every research study needs to state the aim of the research, in which the researcher should concisely point out their desired outcomes and the accomplishments they expect from the study by focusing on the long-term intended outcomes of the research and associating the aim with several objectives necessary in achieving the aim (Blaxter et al, 2009: p37). The article clearly states its aim as the exploration of how ward staff experience death in acute medical settings, after which the results will contribute to existing knowledge about the relationship between patient deaths and ward staff grief, as well as to influence current healthcare practice and policy. Moreover, the researcher also includes five objectives to be used in achieving this aim. Are all ethical issues identified and addressed? Lacey and Gerrish (2010: p55) identifies four crucial ethical principles that must be included in a research study, which are justice, beneficence, non-maleficence, and autonomy. One thing that is noted about this study is that the ethical issues sections is very brief and does not properly cover all these aspects of ethical considerations. The study does state that the acute facility’s managers were provided with information about the study and permission for the study obtained, which involves the principle of autonomy. However, none of the other three principles are mentioned in this section. Is the methodology identified and justified? A research study must clearly identify the research strategy that is to be used, for example whether it is a qualitative or quantitative research methodology, while also providing the rationale for choosing the research methodology (Lacey & Gerrish, 2010: p57). The study clearly identifies that a qualitative methodology will be used, although there is no justification given for why a qualitative methodology is utilized. Instead, the study gives justification for the research approach. Are the philosophical background and study design identified and the rationale for choice of design evident? According to Burns and Grove (2012: p33), it is essential for any research study to identify the design of the study, as well as its appropriateness to the objectives of the research. The researcher identifies the study design as Heideggarian phenomenology, which is an interpretive approach that seeks to reveal human experience and understand the “Why” of human experience. Are the Major Concepts Identified? A researcher conducting any study must ensure that the audience of the study understands what the concepts they use in the study mean, which is usually done by clearly identifying the terms or concepts used in the study, although it is not mandatory to define the concepts (Burns & Grove, 2012: p42). The current research study identifies the major concepts used in the study, which are disenfranchised grief, staff grief, patient death, and emotional support. However, these terms are not defined by the researcher, although, as mentioned, this is not critical for the study. Is the Context of the Study Outlined? In conducting a qualitative research study, it is important that the researcher clearly and concisely describes the context of the study, as well as how the study locations and the participants were selected and recruited respectively (Kumar, 2014: p40). While the study does identify the location of the study as two acute medical wards caring for patients suffering from respiratory issues, the researcher fails to provide information on which hospital facility these medical wards are located in , as well as why this location was selected. The study also identifies the recruitment of the participants and states that they were selected in a manner that would allow the researcher to answer the research question. Is the selection of participants described and sampling method identified? The degree to which the selected participant sample is reflective of the population from which it was drawn is decisive in the determination of a research study’s adequacy, while the participants should be selected due to their relevant knowledge and experience in the concepts covered by the research question (Kumar, 2014: p47). In qualitative studies, however, representativeness is not a criterion. As such, the study uses purposive sampling by selecting the participants based on their ability to adequately and satisfactorily inform the research question. This was achieved by selecting a sample of 13 (5 healthcare support workers and 8 RNs) participants from the acute medical wards, specifically those who had worked in the ward for at least two years, thus giving them experience with dying patients. Is the Method of Data Collection Auditable? According to Jolley (2013: p44), every qualitative research study should describe the methods used to collect data, while also providing evidence to show that the auditability of the data collection method, which is establish by the reader’s ability to follow the steps of data collection and the researcher’s thinking behind their data collection methodology. From the study’s description of data collection, the researcher describes the collection of data using individual interviews beginning with open-ended questions to collect data on the participants’ experience with patient death and followed by prompts to explore parts of the study objectives that the participants did not cover in the first section. Is the Method of Data Analysis Credible and Confirmable? In qualitative methodology, the research study must also identify the strategy used for analyzing the collected data, as well as the processes used by the researcher to identify themes and patterns in the data that helped to arrive at their findings (Jolley, 2013: p55). Moreover, the researcher is also required to identify the manner in which they have addressed the confirmability and credibility of the data analysis method used. The study identifies that data analysis was conducted in two phases; initial analysis of transcripts and phenomenological reflection using thematic analysis. Are the Results presented in a way that is appropriate and clear? It is important for any research study, whether qualitative or quantitative, to ensure that the data is presented in a consistent, easily interpretable, and clear manner (Creswell, 2014: p29). The researcher ensures that the results are presented in such a manner by presenting her findings under the preliminary themes that were derived from the data collected during the interviews, including responses, influences, and support. This is helpful to the reader in determining whether the presented results are actual answers of the research question. In this case, the researcher uses a table to summarize the results, which enhances the presentation of findings. Are the Results Transferrable? It is important to ensure that the results of a qualitative study are compared and contrasted with those from previous results in related research studies on the same topic in a balanced and objective way (Creswell, 2014: p39). In this case, the researcher compares the results with those from previous studies on pressures and coping strategies for ward staff, although this is only done using two previous research studies. This should have been improved and could be biased towards the results of the current study. Is the conclusion comprehensive? Any conclusion to a research study, according to Cutcliffe (2011: p51), must be based solely on the findings of the present study, while it is also important for the researcher to identify any limitations to the study and recommend future research pursuits and implications for practice. Although the limitations of the study are not provided in the conclusions sections, they are provided in the previous section. Moreover, the researcher also makes recommendations for healthcare organizations and its managers to ensure recognition of staff grief and to provide necessary support mechanisms, while also noting the implications of the research findings for clinical practice, specifically in the provision of support for grieving ward staff. Conclusion The current study by Wilson (2014) meets the threshold for publication as its strengths far outnumber its weaknesses. All the elements required of a research article in relation to the theoretical dimension, methodological dimension, ethical dimension, and interpretive dimension are all covered by the researcher. Perhaps the only element that is not fully covered is the ethical dimension, which is too brief to allow for the reader to ascertain whether the research study was conducted in an ethical manner. Overall, the information provided by the study is authentic, while the findings are credible enough to enhance the study’s importance. References Blaxter, L., Hughes, C., & Tight, M. (2009). How to research. Maidenhead: Open University Press/McGraw-Hill Education. Burns, N., & Grove, S. K. (2012). The practice of nursing research: Conduct, critique, and utilization. St. Louis, Mo: Elsevier/Saunders. Caldwell, K., Henshaw, L., & Taylor, G. (January 01, 2011). Developing a framework for critiquing health research: an early evaluation. Nurse Education Today, 31, 8, 1-7. Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches. Thousand: Sage. Cutcliffe, J. R., & Ward, M. F. (2011). Critiquing nursing research. London: Quay Books Jolley, J. (2013). Introducing Research and Evidence-Based Practice for Nursing & Healthcare Professionals. London: Routledge. Kumar, R. (2014). Research methodology: A step-by-step guide for beginners. Los Angeles: SAGE Lacey, A., & Gerrish, K. (2010). The research process in nursing. Chichester, West Sussex: Blackwell Pub. Parahoo, K. (2014). Nursing research: Principles, process and issues. Basingstoke: Palgrave Macmillan Wilson, J. (2014). Ward staff experiences of patient death in an acute medical setting. Nursing Standard, 28, 37, 37-45. Read More