Feelings of Day Surgery Patients - Book Report/Review Example

Introduction The process of evaluating a medical and healthcare literature should be undertaken in a systematic manner, based on evidences, findings and professional recommendations made in the paper. This study attempts to conduct a critical appraisal of an article “Day surgery: patients’ felt abandoned during the preoperative wait” by Jo Gilmartin and Kerrie Wright, published in the Journal of Clinical Nursing, Volume 7. It aim of this paper is to critically examine the article and find out whether the article can be applied to the researcher’s nursing/clinical practice and or patient care. The critical appreciation is conducted by following various questioning techniques. The research hypothesis and the validity of the data taken for the article were given major importance. Further, the outcomes and the discussion on the results were evaluated to find out whether this study was relevant in the contemporary day surgery set-up or not. (Gilmartin, Jo & Wright, Kerrie, 2008). Summary The main aim of the article is to find out patients’ experiences of contemporary day surgery and whether they feel neglected or abandoned during the preoperative stage. Gilmartin and Wright believes that due to the increase in day surgeries, the nursing intervention is such cases have also increased manifold. This has led to dependency on nurses to provide information about the patient’s health, managing the pain etc. Further, issues such as gauging the experience of the patients from the time of their admission to their discharge and studying the anxieties of the patient before the operations were also included in this article. The study uses hermeneutic phenomenological approach to find out about the experience of 20 adult patients regarding contemporary day surgery. Gilmartin and Wright use unstructured interviews to collect the data and then transcripts the interviews to interpret the findings using the phenomenological method. They also provide samples of conversations to highlight on their discussions. The study focuses on the themes of feeling empowered during the preparation stage for the operation or feeling of abandonment and apprehensions the patients underwent during the preoperative stage. It was found that most of the patients felt that they were abandoned during the preoperative stage and that nurses did not provide them with sufficient psychological support. Thus, the article recommended that together with providing physical cure for the disease, the patient should also receive emotional and psychological support, especially during the preoperative stage, as increase in patient anxiety before the operation might impact the surgery as well. (Gilmartin, Jo & Wright, Kerrie, 2008). Critical appraisal The process of examining the evidences presented in a research paper in a systematic manner in order to access the findings, validity and relevance of the paper that could be applied in a current setting for making a decision is known as critical appraisal of a research literature (Hill & Spittlehouse, 2003). Several tools are being developed over the years to help researchers conduct quality appraisals through the use of qualitative research method. Some of these criteria includes finding out whether the research has been conducted in an ethical manner or not, whether the research is relevant in the current setup and whether the researcher had used appropriate methods to cross check the data collected and reported the findings in a coherent manner (Cohen & Crabtree, 2008). Some of the other criteria used to evaluate an article include addressing the issue of reliability of the data collected, the validity of the research and the elimination of biasness in the research. It is believed that a scientific paper should follow a rigorous methodology and must present a true interpretation to be considered as a benchmark for further research (Dixon-Woods et al, 2007). The first and the foremost step towards conducting a critical appraisal of a research paper involve studying the title of the paper. In this case, the title “Day surgery: patients’ felt abandoned during the preoperative wait” clearly suggests that the study would focus on patients who have undergone day surgery to find out whether they felt abandoned during the preoperative stage. The researcher being a nursing study needs to understand the nuances of providing emotional support to patients during the preoperative stage as it might help in reducing the number of sessions with the psychologists post the operation to come out of the trauma and stress felt by the patient during the preoperative stage (Harden, 2008). In order to establish the authentication of the paper, the researcher also needs to find out about the credentials of the authors of the paper. Further, it is also important to examine the credibility of the journal in which the paper is published and whether the paper has been peer reviewed or not (Morse et al., 2002). In this instance, the credentials of the authors are not given in the paper; in fact the paper does not even mention the affiliations of the authors. However, the paper is being published in the Journal of Clinical Nursing which is a trusted journal in the field of nursing and healthcare. The researcher could not also establish whether the article was peer reviewed or not. As far as the importance of the research topic is concerned, the paper is relevant in the contemporary surgical setup. It has been found that the number of day surgery has increased considerably in the past few years, which has also resulted in the increase in nursing interventions as well. However, not much study has been undertaken to find out whether patients are given proper care during the preoperative stage. Thus, the study is relevant to identify the underlying issues and list various recommendations to improve quality of care during the preoperative stage. However, this study is not original, i.e. the idea of the study is not that original. It is just an extension of previous studies conducted on a similar line. For instance, some previous studies examined the satisfaction levels in patients with preoperative care during day surgery and found mostly positive results (Yellen & Davis 2001, Barthelsson et al. 2003, Sharma et al. 2004). The authors have extended this idea to find out whether the patients feel abandoned during the preoperative stage. With regards to the research hypothesis, the paper does not state it clearly. The study aim only highlights that the paper would describe and interpret the experience of patients in the contemporary day surgery set-up. As the title of the paper indicates, this study is supposed to focus on finding out whether patients undergo the feeling of being abandoned during the preoperative stage or not. However, the research hypothesis does not address this issue clearly. Research components In order to critically analyse a qualitative study, it is important to use certain appraisal instruments as indicators or methods to find out the level of procedural relevance of the research paper. Some of these critical instruments include analysing the research design, data collection and analysis methods used, the sampling strategy, presentation of the data, possible biasness of the authors in the findings of the research, justifications for the assumptions used and the general flow of the article. However, in order to conduct such an in-depth qualitative research, the researcher should also be aware of these techniques and should have sufficient knowledge about the subject matter being reviewed (Morse et al, 2002). The researcher should also be confident enough to carry forward the critical analysis of the selected article and establish its relevance in a fair and unbiased manner. The foremost research component discussed in this paper is the study design used by the authors. The authors present a descriptive report on 20 patients who had undergone day surgery to find out their experiences during the preoperative stage using a hermeneutic phenomenological approach. Such an approach was appropriate for this study as it helped in finding out the variety of human experiences that the patients underwent during the preoperative stage (Bidwell, 2004). The authors used the relevant technique of unstructured interviews to collect the data. This helped the authors in encouraging the patients to talk about their experience without being bound by the constraints of multiple-choices. The authors also asked probing questions to further understand or to seek clarifications about certain beliefs of the patient. The authors also used the technique of active listening, non-verbal cues and probing effectively to get appropriate responses for their questions. The authors undertook the interviews at the home of the participants, providing a very relaxed atmosphere to the participants. The appropriateness of the study design should also be analysed to arrive at the relevance of this research for the current study. While conducting the critical appraisal of the article, it was found that the sample was highly selected. The authors have picked 20 participants, consisting of gynaecology, urology and general surgery patients. Further, the authors claimed to have conducted discussions with the day surgery nurses and clinician for the day surgery to find out the validity of the data collected from the participants. It has been seen that authors undertake purposeful sampling so that only participants who have undergone that particular situation would be studied for the research (Holloway & Wheeler 2002). The authors used a diverse group of people for this research with diversity in age and gender. However, the sample taken by the authors were too small and findings related to diversity could not be established. In a scientific study, it has been seen that most authors conduct the research using a substantial number of individuals, which often crosses several thousands (Spencer et al., 2003). Such a huge number of participants usually give a sound basis to prove the research hypothesis. However, using a small survey size although might be easier to interpret, but would give many diverse results which would not help in establishing the hypothesis of the paper. Further, this study did not include any control group. The authors only used participants who have already undergone the operations. It is a standard practice in any scientific paper to study a control group to find out the relevance of the assumption in a controlled environment. In this case as well, the participants have already underwent the surgery and it is possible that their responses about the preoperative stage might be based on the care they received post the surgeries (Thomas et al., 2004). There is a possibility of biasness of opinion in such cases. However, in a control group, the authors could have studied the reactions of the patients at the preoperative stage itself and could have recorded the true impression. Further, no follow-up study was also conducted by the authors for this particular research. Relevance This study focuses on finding out whether day surgery patients felt abandoned during the preoperative stage. Such a research is relevant to find out whether proper care had been given to patients before the operation to decrease anxiety and stress in such patients. This in turn can reduce the number of sessions the patient might have to undergo with a psychiatrist to come out of the trauma of the surgery. As a nursing student, this study would be relevant for the researcher as it would provide him with a perceptive on how to care for patients during the preoperative stage. As this study especially highlights on the feeling of abandonment, the researcher can incorporate the suggestions given by the authors to remove such a feeling from the patients under his care during the preoperative stage. Therefore, the researcher would apply the recommendations provided in the paper in his own nursing setup to provide better care to his patients. Could you please put in text reference here Conclusion The article analysed by the researcher focused on finding about the feeling of abandonment experienced by day surgery patients during the preoperative stage. However, on analysing the article, it was found that the article did not dwell only on this particular subject, but gave a broad understanding on how preoperative patients are being cared for. This resulted in the dilution of the findings as apprehensions about the surgery and recovery after the surgery were also described, which were not related to the subject line. The paper also considered only 20 participants which might not be a big number for a medical research or to establish the hypothesis. Nonetheless, the paper presented various viewpoints and opinions of the patients interviewed, which can provide good understanding about their experience during the preoperative stage. Therefore, the researcher would be using the suggestions given by the author to understand the patients in the preoperative stage in a better manner. (Gilmartin, Jo & Wright, Kerrie, 2008). Reference: Barthelsson C, Lutzen K, Anderberg B & Nordstrom G (2003). Patients’ experience of laparoscopic cholecystectomy. Journal of Clinical Nursing 12, 253–259. Bidwell SR (2004). Finding the evidence: resources and skills for locating information on clinical effectiveness. Singapore Med J, (45), 567-73. Cohen DJ & Crabtree BF (2008). Evaluative criteria for qualitative research in health care; controversies and recommendations. Annals of Fam. Med, 6 (4), 331-39. Dixon-Woods M, Booth A, & Sutton AJ (2007). Synthesizing qualitative research: a review of published reports. Qual Res 7, 375-421. Gilmartin, Jo & Wright, Kerrie (2008). Day surgery: patients’ felt abandoned during the preoperative wait. Journal of Clinical Nursing, 17, 2418–2425. Harden A. (2008). Critical Appraisal and Qualitative Research: Exploring sensitivity analysis. ESRC Research Methods Festival, St. Catherine’s College Oxford, 30th June-3rd July, 2008. Hill A & Spittlehouse C. (2003). What is critical appraisal? Evidence-Based Medicine, 3(2), 1-8. Kavanagh J (2004). Integrating qualitative research with trials in systematic reviews. BMJ, 328,1010-1012. Morse JM, Barett M, Mayan M, Olson K, & Spiers J (2002). Verification strategies for establishing reliability and validity in qualitative research. International Journal of Qualitative Methods 1(2). Sharma A, Hayden JD, Reese RA, Sedman PC, Royston CMS & O’Boyle CJ (2004). Prospective comparison of ambulatory with inpatient laparoscopic cholecystectomy: outcome, patient preference and satisfaction. Journal of Ambulatory Surgery 11, 23–26. Spencer L, Ritchie J, Lewis J et al. (2003). Quality in Qualitative Evaluation: a framework for assessing research evidence: a framework for assessing research evidence. Government chief social researcher’s office 2003. Thomas J, Harden A, Oakley Am Oliver S, Sutcliffe K, Rees R, Brunton G, Yellen E & Davis GC (2001). Patient satisfaction in ambulatory surgery. AORN 74, 483–498. Read More