Research methods in nursing and healthcare - MyAssignmenthelp.com

Question: Discuss about the Research methods in nursingand healthcare. Answer: Introduction Critical appraisal is an important process to implement evidence based practice. Critical appraisal skill can help a person to evaluate the effectiveness of a research study and the judge the article for applicability in real setting (LoBiondo-Wood Haber, 2017). In case of health care studies, reviewing the quality of clinical research is necessary to ascertain its validity, credibility and generalizability for real setting or target group (Holloway Galvin 2016). The process of critical appraisal is the systematic process to judge the trustworthiness, value and relevance of the evidence in a particular context (Elwood, 2017). This essay paper is mainly concerned at looking at the evidence regarding the issue of low back pain in nurses and it mainly aims to critically appraise the article by Abedini et al., (2014) to understand the strength and weakness of the article in presenting the findings. The CASP (Critical Appraisal Skills Programme) tool for qualitative research article has been used to critically appraise the article and find its utility in evidence based practice. Critical appraisal of qualitative research article Statement of the aim of research The main aim of the research study by Abedini et al., (2014) was to examine the risk perceptions of non-specific low back pain (LBP) among nurses in Bandar Abbas City, Southern Iran. Research in this area was considered important because LBP has become a serious health issue among nurse and it is the main reason for absenteeism at work. The issue has been found to increase risk of chronic disease among nurses as well as increase the burden of the health care system (Traeger et al., 2014). This research is considered useful because it focuses on getting better understanding about nurses perception related to LBP and this knowledge will prove useful to effectively implement interventions for nurses. Different perception of pain and individualized experience may help to determine how pain education or other interventional program can be implemented for nurses. The study is found relevant to address performance related challenges for nurses and address barriers that affect workflow in he alth care setting. Critique of qualitative methodology To collect data related to risk perception of non-specific low back pain among nurses, Abedini et al., (2014) used qualitative research approach by conducting semi-structure interview with nurses. Quantitative research methodology is considered appropriate for research when the main aim is to study about behavior, experiences and attitudes of people in different context. This research approach helps in getting in-depth information about human behavior and finding the behavior of people in different context (Jirojwong, Johnson Welch, 2014). As Abedini et al., (2014) also aimed to study about nurses perception related to LBP, the use of qualitative methodology is a good decision by researcher. The inductive nature of inquiry facilitated collecting lived experience of participants. The decision to not go for quantitative research methodology is also right because quantification of nurses belief cannot give any new insight or useful data. Appropriateness of research design In accordance with COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist, Abedini et al., (2014) specified the methodological orientation for the study and also explained the reason for selecting those approaches. For instance, qualitative content analysis design was used for the research and the researcher justified the decision by explanation on situations during which qualitative methods are adopted in research and is relevance with purpose of the research. The justification provided is correct because evidence has also showed that qualitative content analysis is mostly used in nursing science research (Polit Beck, 2012). Qualitative content analysis is one of the methods to analyze and interpret research data. The advantage of using this approach is that the objective means of explaining any phenomenon helps in dividing the concepts to different categories or conceptual map (Elo et al., 2014). However, the validity of such research is determined by the manne r in which results were developed and analyzed. Effectiveness of recruitment strategy As per COREQ checklist, the article by Abedini et al., (2014) has specified about recruitment strategy, method of approaching participants and sample size too. For instance, purposive sampling technique was employed to recruit participants and their sample size was determined after confirming data saturation. Participants has face-to-face interview which were recorded and transcribed. Hence, by the use of this strategy, about 30 nurses were selected for the study. Purposive sampling strategy is a non-probability sampling technique and it is found useful when the aim is to collect data from target sample quickly. This kind of sample may not be representative of the whole population, however it is found useful when population is very large (Etikan, Musa Alkassim, 2016). Abedini et al., (2014) wanted to get wide range of individual experience and perception, so they recruited participants based on diverse criteria such age, gender, work experience, marital status, different degree of p ain and positions. Use of such heterogeneous purposive sample is commendable because it helped in getting diverse range of cases, related to risk perception of nurses regarding LBP (Robinson, 2014). The quality of qualitative research paper is understood when the author gives clear idea regarding each strategy taken and the rational for it. Quality and trustworthiness of research also becomes evident when clinical reality is appropriately analyzed (Mantzoukas, 2008). Abedini et al., (2014) work is also found to be high quality evidence on the basis of these criteria because the authors were explaining the reason for any strategy whenever it was mentioned in the article. For instance, the main inclusion criteria for sample selection was one year experience in nursing, however the author justified why wide range of samples were taken. However, the author did not give wide explanation around recruitment. Instead, the discussion mainly centered around questions used for interview and ethical requirements before recruiting samples for the study. Method of data collection According to COREQ checklist, a quantitative research articles must have details on interview guide, repeat interviews, method of collecting data, duration, field notes, data saturations and return of transcripts by participant. Abedini et al., (2014) provided detail on development of interview guide, however no repeat interviews were carried out. The study was conducted in Bandar Abbas, but the author gave no detail regarding the setting. Despite the above mentioned shortcomings in the article, the strength of the data collection section is that the researcher has explicitly covered the method of conducting interview. For instance, the process used to prepare interview guide was discussed and it was based on protection motivation theory. This theoretical basis was useful to effectively evaluated risk perception. Semi-structured interview was conducted and interview data were converted into audio transcripts. Another important aspect that was considered by the researcher was saturation of data. All such discussion makes reviewer clear about the method of collecting data. However, there were no such instances of repeat interview and return of transcripts. The researcher did not clarified regarding the duration of interview too (Abedini et al., (2014). Hence, method of data collection that is conducting interview to collect data was found useful because it had the potential to directly address the aim or research question. Minor shortcomings were present, however this had negligible impact on study result. Relationship between researcher and participants The validity of any qualitative research is understood when author demonstrate self-reflexivity in data collection and data analysis process. This means while formulating research question and sample recruitment strategy, the author examines their role in contributing to biasness (Borbasi, Hengstberger-Simis Jackson, 2008). In case of the study by Abedini et al., (2014), the authors focused on minimizing biasness during formulation of questions for interview. This can be said because questions were not independently framed by researcher. Instead, great rigor was seen in preparing interview guide because literatures related to LBP, protection motivation theory and other qualitative approach was reviewed before preparing interview question. In addition, the questions are finalized only after taking feedback from health education and behavioral specialist. This process validated the research and eliminated chances of biasness too. However, the same thing cannot be said regarding the us e of purposive sampling strategy. This is because purposive sample is taken based on judgment of researcher; hence there is increased chance of selection bias (Robinson, 2014). The alertness of researcher to reduce potential bias and influences is also understood when they effectively respond to unpredictable events during the study. This is also reflective of the reliability of the study because such explanations clearly show that the researcher is taking note of all changes that can affect the study results. The study by Abedini et al., (2014) lacked all such discussion because at no point the researcher explained about any changes in research process due to unpredictable events. However, the author focused on establishing relationship with participant by informing them about research purpose, rational for recording the interview and voluntary participation process (Tong, Sainsbury Craig, 2007). This helped in getting appropriate response from participants during the research. Consideration of ethical issues in research While conducting qualitative research, researchers have the responsibility to fulfill certain ethical requirements before starting the research. This includes maintaining anonymity and confidentiality of client information and taking informed consent from participant. Abedini et al., (2014), also maintained ethical standards in research by giving all information to participants related to research purpose, voluntary participation and confidentiality of participants identity. Besides this, they were also made aware about the how research will be conducted by informing about data collection method and reasons to record the interview. Hence, by the above justification, it becomes clear that confidentiality and informed consent requirements were maintained. Despite this, one very important and vital aspect of ethics was missing in the research which was taking approval from the Research Committee regarding conducting the research. Missing such important point can give a bad impression to reviewers. Critique of data analysis The validity of the study is finding is determined by the way data is analyzed. In case of interview with nurse regarding LBP, data collected from the interview records were analyzed. The text transcribed in the Microsoft Office Word was also transferred into a qualitative data analyzing software, MAZQDA10 version 10. This software analyzes and categorize qualitative data in a systematic manner. Deductive content analysis of data was done by extracting key concepts assigning primary codes to each sentence. By this way of primary coding, main category and sub-category was analyzed (Abedini et al., 2014). Hence, it can be inference that thematic analysis was followed which helps in in-depth exploration of data. The researcher also focused on reducing bias by maintaining the accuracy of verbal cues. For instance, this was done by comparing the audio tapes. This is also revealed the process by which data collected from original sample were analyzed. On comparison of the article according to the COREQ checklist, it can be said that coding was used and themes were derived. Appropriate software was also used to manage the data, however participants feedback on findings was not present. Despite taking only 30 samples, the data can be sufficient because diverse range of participants were recruited to make the sample inclusive. Statement of findings With respect to the original research question, the subcategories were developed on the basis of perceived severity and perceived vulnerability. The key subcategories emerging in perceived severity includes impact of LBP on confronting challenges in profession, inefficiencies in job performance, physical and psychological consequences and financial problems. Subcategories under perceived vulnerability included challenges in hospitals working system and nature of nursing job (Abedini et al,. 2014). The main conclusion from the finding is that nurses mainly have the perception that LBP negative affects their life and disrupts personal nursing performance. Some categories were found consistent with past studies, however some new subtopics such as affect on married life also emerged which was not covered in past studies. Although the themes were linked back to research question, however the quality of article is evident from the utilization of triangulation method to validate the finding s. Many themes were cross-verified from more than two sources (Carter et al., 2014). Besides this, use of direct quotation from nurses helped to enhance the credibility of data. Importance of research The outcome of the study by Abedini et al., (2014) will have great implications on nursing practice and key policy makers. This is because the findings were also analyzed in relation to current practice and on this basis several flaws in work environment and nature of working profession was found which contributed to LBP. Therefore, to effectively implement interventions related to work environment and rules and regulation for research, the study gave direction for future research ideas too. This includes doing more research on work related factors contributing to LBP in nurses. By giving this statement, the researcher gave the idea that the research can be used to improve the quality of nursing care and address the problem of LBP. Conclusion From the critical appraisal of the article by Abedini et al., (2014), it can be said that the evidence is a good quality qualitative research articles as it adopted suitable research process and data analysis process to get answer to the original research questions. Although certain shortcomings were found in the article according to the COREQ checklist (such as no participant feedback, transcript returned, duration of interview, detail of setting and personal characteristics of interviewer), however these were negligible mistakes that would have little impact on study results. The research gave wide area regarding risk perception of nurses regarding LBP, hence the recommendation of narrowing down the research with work related LBP in future was a commendable advice by the researcher. Reference Abedini, S., Morowatisharifabad, M.A., Enjezab, B., Barkhordari, A. Fallahzadeh, H., (2014). Risk perception of nonspecific low back pain among nurses: a qualitative approach.Health promotion perspectives,4(2), p.221. Borbasi, S., Hengstberger-Simis, C. Jackson, D., (2008). Quantitative research: summing it up.Navigating the maze of nursing research 2e: an interactive learning adventure.(Eds S Borbasi, D Jackson, R Langford) pp, pp.103-150. Carter, N., Bryant-Lukosius, D., DiCenso, A., Blythe, J. Neville, A.J., (2014), September. The use of triangulation in qualitative research. InOncology nursing forum(Vol. 41, No. 5). Elo, S., Kriinen, M., Kanste, O., Plkki, T., Utriainen, K. Kyngs, H., (2014). Qualitative content analysis: A focus on trustworthiness.Sage Open,4(1), p.2158244014522633. Elwood, M. (2017).Critical appraisal of epidemiological studies and clinical trials. Oxford University Press. Etikan, I., Musa, S.A. Alkassim, R.S., (2016). Comparison of convenience sampling and purposive sampling.American Journal of Theoretical and Applied Statistics,5(1), pp.1-4. Holloway, I., Galvin, K. (2016).Qualitative research in nursing and healthcare. John Wiley Sons. Jirojwong, S., Johnson, M. Welch, A.J., (2014). Research methods in nursing and midwifery: pathways to evidence based practice [metadata only]. LoBiondo-Wood, G., Haber, J. (2017).Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences. Mantzoukas, S., (2008). A review of evidence?based practice, nursing research and reflection: levelling the hierarchy.Journal of clinical nursing,17(2), pp.214-223. Mhaskar, R., Emmanuel, P., Mishra, S., Patel, S., Naik, E. Kumar, A., (2009). Critical appraisal skills are essential to informed decision-making.Indian journal of sexually transmitted diseases,30(2), p.112. Polit, D.F. Beck, C.T., (2012). Trustworthiness and integrity in qualitative research. InNursing research. Generating and assessing evidence for nursing practice(pp. 582-601). Wolters Kluwer Health, Philadelphia. Robinson, O. C. (2014). Sampling in interview-based qualitative research: A theoretical and practical guide.Qualitative Research in Psychology,11(1), 25-41. Robinson, O.C., (2014). Sampling in interview-based qualitative research: A theoretical and practical guide.Qualitative Research in Psychology,11(1), pp.25-41. Tong, A., Sainsbury, P. Craig, J., (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.International journal for quality in health care,19(6), pp.349-357. Traeger, A.C., Moseley, G.L., Hbscher, M., Lee, H., Skinner, I.W., Nicholas, M.K., Henschke, N., Refshauge, K.M., Blyth, F.M., Main, C.J. Hush, J.M., (2014). Pain education to prevent chronic low back pain: a study protocol for a randomised controlled trial.BMJ open,4(6), p.e005505.