Day Surgery - Patients Felt Abandoned during the Preoperative Wait - Essay Example

Critical Appraisal of the article: “Day surgery: patients' felt abandoned during the preoperative wait” Name of the student: Student Number: Course Code: Course Title Word count: 2071 Introduction The articles published in scientific journals have far reaching impact in the medical community as well as in the psyche of the patient. The findings are often covered in the media, which amplifies the relevance of the article manifold. Various new studies are being conducted on a regular basis and diverse suggestions are being given for managing diseases. However, even before implementing the suggestions provided in these articles, it is imperative to conduct a through critical appraisal of the articles (Makela & Witt, 2005). In this paper, the researcher would attempt to critically appraise the article “Day surgery: patients’ felt abandoned during the preoperative wait” written by Jo Gilmartin and Kerrie Wright. This article published in the Journal of Clinical Nursing, would be analysed to establish the quality and relevance of the article for the research stream chosen by the researcher. The paper would use various appraisal techniques such as finding out the validity of the study results, evaluating the methodology used for the research and discussing the findings of the research to understand whether this paper can be implemented in the researcher’s current setup of nursing practice. Brief summary Due to the rise in day surgery in the contemporary medical practice, nursing interventions for these surgeries have also witnessed an increase. However, research has found that proper attention and care has not been provided to the patients, especially during the preoperative period. The study conducted by Gilmartin and Wright (2008) focuses on this issue and attempts to find out whether patients suffer from the feeling of being abandoned before the operation take place. The authors of the article collect the data with the use of an unstructured interview method and thereafter interpret the findings from the study to come out certain suggestions. The authors use the hermeneutic phenomenological approach to find out about the experience of the patients. The study focuses on a variety of findings, some of them relevant to the research, others providing additional information. For instance, the study highlights on the anxiety faced by the patients and their feeling of being abandoned during the time they wait for their operation in the waiting room. However, the results also revealed the patients’ experiences regarding care received during the recovery stage as well. This study concluded that most of the patients agreed to the fact that they felt being abandoned in the waiting area prior to an operation and suggested that better care should be given to patients about to undergo surgeries. They highlighted on the fact that the nurses did not understand the importance of providing psychological support to the patient. Critical appraisal A qualitative study attempts to find out the complex relationship between care providers, patients, physicians and policy makers involved in the healthcare industry. However, a badly designed study or research that provides inadequate data may result into improper applicability of the research in the decision-making stages, while creating healthcare policies or conducting future research on similar subject line. Thus, it is important to conduct a through critical appraisal of an article before utilising it for further research or implementing it in practice (Mayer, 2004). It has been seen that medical research no longer remains a part of a journal. Due to the expansion in media, even the common man is being aware of the findings of scientific researches. Without proper scientific knowledge, analysis of these findings would be difficult for the common reader and many may incorporate the suggestions given by the authors without doubting their validity. Therefore, it is important to conduct an in-depth critical appraisal of the articles before considering it for incorporating in future studies or practical implementation (Peat & Barton, 2005). Critical appraisal can be undertaken by analysing the article part by part (Knottnerus et al, 2002). First of all, the title of the article needs to be analysed. In this case, the title “Day surgery: patients’ felt abandoned during the preoperative wait” appropriately highlights the fact that the article is about analysing whether patient feel they are being abandoned during the preoperative period before undergoing a day surgery. The next stage in critical appraisal is to find out about the authors and their credibility in the medical community. In this case, the biographies of the authors are not given in the article and therefore, in order to establish their credibility the researcher has to undertake further research (Belsey, 2009). The abstract of an article provides a concise overview about the study and focuses on the relevance of the study in the current scenario. However, in this case, the abstract does not provide a clear picture about the study. In fact, there is no formal abstract given in the study, only the background and the structure of the study has been defined. This is also not been done properly and it does not provide a reader about the motivations behind the study (Juni et al, 2001). The introduction of a study focuses on the problem statement and the importance of undertaking the research. The aim and objective of the study is clearly defined in this section. The hypothesis for the study is also being clearly presented in this section. As this is an important part of the study to establish the relevance of the study, the researcher should emphasise on examining this section critically (Moore, 2009). With the regards to the current article, it was found that the researcher undertook a thorough literature review on the subject and presented the various findings of other authors on the matter. However, the authors were not able to establish a research hypothesis for the study. The title although clearly mentioned about researching on the topic of feeling of abandonment in patients during the preoperative period, the study did not mention it as a research hypothesis. Instead, it only provided an aim of the study which focused on finding the experiences of patients’ regarding the contemporary day surgery scenarios. This is clearly a mismatch between the study objective and the actual study. As far as the relevance of the study is concerned, the authors have addressed the issue well. The authors have clearly defined that due to the increase in day surgeries, the nursing intervention has also increased. This has resulted in providing poor care facilities to the patients, especially during the preoperative period. Thus, the authors have undertaken this study to prove their hypothesis and present suggestions to overcome this situation. The findings provided by the authors can be extended to the current nursing practice to provide better healthcare services to the patients. Fundamental research components Even before applying a study for further research or to implement it in the current medical practice, it is important to access the validity of the study result. However, even before accessing the validity of the results, it is important to find out whether the study used a relevant study design for the research. An appropriate study design helps in understanding the research question and proving the hypothesis (Schwartz & Hupert, 2005). In this article, the authors used qualitative analysis to find out about the experiences of the patients during preoperative period. The authors used hermeneutic phenomenological approach to analyse the experiences. Further, the data for this research was collected through the use of unstructured interviews. Further, phenomenological method was used to find out the prevalent themes from the findings of the study (Parkes et al, 2004). The authors choose 20 participants for this study from the urology, general surgery as well as gynaecology divisions. These patients were chosen purposefully so that a diverse sampling can be done. Further, the clinician and the nurses present during the surgeries were also interviewed to find out about the other side of the experience as well. Although, the authors conducted in-depth study with these participants, due to the small sample size used for this study, it was not possible to come out with some common trends. The analysis suggests that diverse findings came out of the research, which may or may not be valid for this study. For instance, the outcome about the dynamics of recovery is not relevant for this study, but the authors included it in the findings to provide diversity of results in the research paper. Another important emphasis is on the use of purposeful sampling for this paper, as the authors claimed to provide diversity in the results for the study. However, again due to the small size of the sample, it was not possible to draw out a trend from the results. In fact, most medical researches focus on at least considering a sample size of a few hundreds to draw out trends from their findings (Whiting et al, 2004). Further, the authors also did not conduct any controlled trial or used a control group for this research. All the participants were patients who have already undergone the surgeries and were presenting their experiences about the preoperative care. However, the authors did not consider interviewing patients who were about to undergo a surgery. Study of such a control group would have helped the authors in getting a first-hand view about experiences of the patients in an unbiased manner (Moore & McQuay, 2006). The findings highlighted in this article mostly focused on the experiences of the patients, i.e. their direct quotes. However, emphasis was not given to the central theme of the study, which is finding about the feeling of abandonment in the patients during the preoperative period. The findings were based on a variety of other issues as well, such as the feeling of the patient during the preparations of the operation and post operative care. Such findings were not relevant to the study and could have been avoided by the authors (Jones, 2003). The discussion of the study also highlighted on various themes instead of the central one. It provided discussions on all the themes that the researcher encountered while undertaking the research. As the sample survey of the study was very small, a trend analysis could not be conducted. Instead, the discussion section provided a varied range of analysis of the findings. Also this section provided various suggestions that one may consider while undertaking such a survey. Although, these suggestions are relevant for the current nursing setup, they were not linked with the previous literature review undertaken by the authors. Similarly, the conclusion of the study also presented too many themes and did not tie-up the study properly. Relevance of the study In the contemporary medical setup, the nurses have been accorded with higher responsibilities and are often required to undertake various observatory roles to help the medical practitioners (Schlosser et al, 2007). In this study as well, the central theme is to find out about the experience of the patients during the preoperative period, focusing on the day surgeries. It has been found that day surgeries have increased in the recent past and has also resulted in the increase of nursing intervention as well. However, due to the considerable increase in day surgeries, nurses often ignore the psychological needs of the patients during the preoperative period. This may result in increasing number of patients seeking psychological advices post an operation. Therefore, the findings of the study would help nursing professionals to put extra effort while dealing with preoperative patients and provide them with ample psychological support. The study is also relevant for the researcher as he can implement the findings in his own nursing practice while dealing with preoperative patients. Conclusion The study analysed for this paper provided too many themes and did not put much emphasis on the central theme, i.e. the analysis of the feeling of abandonment in preoperative patients of day surgeries. The study instead focused on various other themes as well, and some such as dynamics of recovery were totally irrelevant to the study objective. Further, the study did not provide any clear hypothesis or abstract. The discussions and the findings were also not done properly. The sample survey undertaken for this study was too small to provide any concrete trends. However, although being fraught with so many loopholes, the study is relevant in the current nursing setup. It can help the researcher to apply certain findings such as using psychological counseling and reassuring patients who are about to undergo a surgery to avoid psychological complications in the later stages. Overall, it is an average article and the researcher might consider implementing the findings in his nursing practice. References Belsey, J. (2009). What is evidence-based medicine? London: Hayward Medical Communications. Gilmartin, Jo & Wright, Kerrie (2008). Day surgery: patients’ felt abandoned during the preoperative wait. Journal of Clinical Nursing, 17, 2418–2425. Jones, JM (2003). Making Sense of Critical Appraisal. Nurse Researcher. Juni, P, Altman, DG, & Egger, M. (2001). Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ 323, 42–46. Knottnerus, JA, van Weel C, & Muris, JWM (2002). Evidence base of clinical diagnosis: evaluation of diagnostic procedures. BMJ, 324, 477-480. Makela, M & Witt, K (2005). How to read a paper: critical appraisal of studies for application in healthcare. Singapore Med J 46(3), 108-115. Mayer, D (2004). Essential Evidence-based Medicine. Cambridge University Press. Moore, A, & McQuay, H. (2006). 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