Nursing Research

The objective of the following assignment is to analyse and critique a chosen research article, using a particular critical framework as guidance the student will critique and justify the article’s relevance and current nursing pratice. Nursing research will briefly be defined and its importance and how it plays an essential part in nursing pratice will be explained. In accordance with the Nursing and Midwifery Council, (NMC) Code of Professional Conduct (NMC, 2005) regarding safeguarding patient information no names or places will be divulged.

The piece of research chosen to be critiqued is Mclaughlin D, McKenna H, Leslie J, (2000), ‘The perceptions and aspirations illicit drug users hold towards health care staff and the care they receive’, Journals of Psychiatric and Mental Health Nursing 7 (5), 435-44 (appendix 2).

The rational for the choice was the student was hoping to complete her Diversity of Care module at a drug rehabilitation centre.

The critical framework used to critique the article is by Benton and Cormack (2001), (appendix 2). Parahoo (2006) will be used to compare any findings and support any arguments. This will analyse the validity of the research article used, and will guide the student through a step by step analysis leading to an unbiased and concise conclusion of the article. The students choose Benton and Cormack as her critiquing framework as she found it the easiest one to use.

There are many definitions of nursing research, Benton and Cormack (2001) defines nursing research as an attempt to increase the sum of what is known this process of research consists of a series of steps, which need to be followed logically.

Benton and Cormack (2001), state that it is important to make the title explicit and reasonably brief when describing the study. Parahoo (2006) agrees with this statement by stating that too much information in the title can make it long and maladroit, but Parahoo also states the title of the research article should draw the readers attention to the precise study and make reference to the specific group from whom the data was collected, Mclaughlin, McKenna and Leslie (2000), maintain this statement as the title is clear to the point in its explanation of the content of the study and the subjects being observed.

Benton & Cormack (2001) questions academic and professional qualifications of the authors by stating that research is enhanced if the authors have a background and expertise in the particular area that the research is set. Whilst Parahoo (2006), does not provide any criteria for critiquing the authors professional and academic qualifications.

D F Mclaughlin is a Community Psychiatric nurse, mental health nurse and also holds a Bachelor of Science (HONS), M McKenna is a registered general nurse, mental health nurse and Head of School Health Sciences. C Leslie is Professor of psychology at the University of Jordanstown, County Antrim. In the readers opinion these authors have more that the relevant qualifications to research this subject and the reader has every confidence in their article.

INDRODUCTIONAccording to Benton and Cormack (2001), an introduction to the research should include a discussion of its importance and the need for it to be researched Parahoo (2006) fails to identify a system for critiquing an introduction in a research article, Although Polit & Hungler (2001), state that the purpose of the introduction is to set the scene for the a description of what the researcher did and what the researches discovered. In the reader’s opinion Mclaughlin, McKenna & Leslie (2000) give a brief introduction which outlines their results but fail to clearly identify any format.

LITERATURE REVIEWThere was no title to indicate where the introduction ended and the literature review began therefore the reader found it hard to distinguish where one began and the other started. According to Benton & Cormack (2001) a good literature review should provide far more than the critical appraisal of a series of articles it should create a structure upon which further research can be based. Parahoo (2006) states the importance of up to date, relevant clear information to be brief and logical within the research article. Mclaughlin, McKenna & Leslie (2000) demonstrate the logic behind the research though most of their references are more than five years old they appear to the reader to have relevant information , Parahoo (2006) states that if a reference is five years old or more you should ask yourself if there is more relevant up to date material on the topic available. References to various other studies are made in the literature review, according to Parahoo (2006) describing other people’s studies indicates that the researcher has made clear a link between previous knowledge which informs the reader of the background of the study.

Benton & Cormack (2001) advocates the literature review should start with an introduction which should contain some reference to the sources discussed as well as an indication of the amount of previous work published. The reader feels that Mclaughlin, McKenna & Leslie (2000) demonstrate this and that the rational is clearly stated and the main body of the review consists of critiquing of pervious work, they found several strong evidence which prove that illicit drug users where treated very badly or ignored by health care workers. McLaughlin & Long 1996 found that research over the past ten years seems to indicate that illicit drug users were often loathed and feared by health care staff.

Throughout the study references are made to pervious studies, Parahoo (2006) states that describing and referring other people’s studies indicates the researchers have made a clear link between previous knowledge.

HYPOTHESISAccording to Benton and Cormack (2001), a hypothesis is a proposition that identifies a relationship between two variables and sometimes advances the explanation for that relationship. It is an educated guess and not a written question. Parahoo (2006) agrees with that statement, apart from stating the hypothesis should be one sentence. Mclaughlin, McKenna & Leslie (2000), do not clearly identify the hypothesis within the study as a hypothesis in not needed in qualitative research.

METHODOLOGYMclaughlin, McKenna & Leslie (2000) clearly state the research approach used during the study, it was decided that a qualitative focus group method was the best method of data collection as research had shown that groups encourage and support each other and a group of illicit drug users would talk frankly about their feelings. Parahoo (2006) describes focus groups as an interaction between one or more researchers and more than one respondent for the purpose of collecting data. Benton and Cormack (2001) states the major disadvantage of this type of data collection is one observer might interpret the discussion differently than another. Mays and Pope (1995), cited in Parahoo (2006) criticise qualitative as” the research is so personal to the researcher that there is no guarantee that a different researcher would not come to radically different conclusions”.

Both Benton and Cormack (2001) and Parahoo (2006) both agree that if the observer gets too involved they cannot be objective, the reader could not find any reference in the article to how many observers would be present in the discussion group.

The reader agreed with this method of data collection was appropriate for the sensitive nature of the study. Mclaughlin, McKenna & Leslie (2000) clearly state they were using open questions and that after the pilot study some of the questions where reworded. Benton and Cormack (2001) emphasise the need for a pilot study to iron out any weaknesses improving the validity of the study, they also believe that a pilot study gives the researcher the experience of data collection and identify any problems which can be rectified before the actual study. Parahoo (2006) fails to identify any criteria for a pilot study.

SUBJECTS

In the reader’s opinion Mclaughlin, McKenna & Leslie (2000) do not clearly identify the subjects involved in the study until the results, the reader found this confusing. Mclaughlin, McKenna & Leslie (2000) do however identify them as illicit drug users, though the age of the subjects or length of time they had been using illicit drugs is not mentioned in the research. Although the authors do state that all participants were over 18.

SAMPLE SELECTION

According to Benton and Cormack (2000), a system of sampling system is needed to ensure the researcher has no influence on the selection procedure. Mclaughlin, McKenna & Leslie (2000) do state their sample size also the sex, age and marital status of the subjects, they also briefly identify how the samples were selected. The reader found this information gave her insight to the type of subjects taking part in the study.

Benton and Cormack (2000), indicates that there are no simple answers to the question of how big a sample selection should be. However according to Polit and Hungler (1995), cited in Parahoo (1997) ‘the larger the sample the more representative of the population it is likely to be’. The sample size therefore fails to generalise the results.

DATA COLLECTIONMclaughlin, McKenna & Leslie (2000) clearly describe the data collection procedure used within the study. Careful attention was paid to the location to ensure comfort, safety and privacy, the subject’s election to take part in the study were asked to give verbal consent, an audio recorder was placed in the middle of the room, the researcher then began the discussion by welcoming the subjects and thanking them for their attendance. When all the questions were addressed by the group to the researchers satisfaction the focus group were given an opportunity to discuss any issues they thought were important to the subject area, then the group was brought to a close.

Benton and Cormack (2000), implies that the actual collection of data is a phase, which offers a wide range of means. Parahoo (1997), emphasises the importance of the reliability and validity used for data collection to be noted. In the readers opinion the method of data collection used was the most reliable with the particular subject group. Benton and Cormack (2000), states that no method of data collection is prefect! Each has its own limitations and strengths.

ETHICAL CONSIDERATIONSBenton and Cormack (2000), states that ethical issues are a integral part of all phases of the research process. According to Byrne (2001) the relevant ethics committee must approve all research that includes people before pilot work or data collection begins.

Mclaughlin, McKenna & Leslie (2000), sought ethical approval from the University of Ulster Ethical Committee, confidentiality was essential due to the nature of the study as many of the issues discussed where of an illegal nature, therefore verbal rather that written consent was sought. Researchers are required to give assurances of confidentiality and anonymity in all cases Parahoo (1997). Mclaughlin, McKenna & Leslie (2000), also state that all subjects were fully informed of the nature and purpose of the research. Parahoo (1997), emphasises that research principals of veracity highlight the obligation of the researchers to tell the about the study to gain consent.

RESULTSBenton and Cormack (2000), states that the form of presentation of the results depends on the nature of the study and the type of data collected. Mclaughlin, McKenna & Leslie (2000), present their results in paragraphs which the reader found hard to interpret, and may have understood the results easier if they were presented in a graph or bar chart. The reader understands that in Qualitive research the results are based on the subject’s feelings and thoughts, which would be hard to record in that form, but according to Parahoo (1997), diagrammatic presentation of data is designed to attract the reader’s attention. The reader also noted that the results only refer to certain focus groups this confused the reader even more as there were seven focus groups mentioned previously in the study.

DATA ANALYSIS

Mclaughlin, McKenna & Leslie (2000), state a content analysis approach was used which is defined by Polit and Hungler (1995) as procedure for analysing verbal communication in a systematic and objective fashion. Mclaughlin, McKenna & Leslie (2000), state that process was overseen by two experienced researchers, Parahoo (1997), suggests that no two researchers can assimilate and react to the incoming information in the same way. Although in most cases the qualitative researchers have a feel for what eventually emerges even before the transcripts are read Benton and Cormack (2000).

DISCUSSION

Mclaughlin, McKenna & Leslie (2000), acknowledge the weaknesses in their study as being the number of drug users is growing, but the number willing to speak to researchers on this occasion was small. They also compare their finding with earlier research. Parahoo (1997), states that one of the first tasks of the critical reader is to find out if the research questions set at the start of the study have been answered, in the readers opinion Mclaughlin, McKenna & Leslie (2000), confused their findings by stating in their discussion that ‘participants admitted that they lied, manipulated and withheld information from professional carers’. However later in the discussion they state that in the present study credibility was achieved by undertaking a well designed search of the extant data-base. Mclaughlin, McKenna & Leslie (2000), go on to state that most of the findings were confirmed through comparing them with those from other well designed national and international studies.

CONCLUSIONIn conclusion the reader believes the validity of the results, as two researchers were involved in the data analysis, whereas one researcher could have influenced the results by interpreting them with preconceived ideas, values and beliefs. Mclaughlin, McKenna & Leslie (2000), identify that a lot of important issues have been raised for health care staff in relation to this study, and go on to list several areas that identify how health care workers can improve the care of illicit drug users.

REOMMENDATIONS

Mclaughlin, McKenna & Leslie (2000), suggest that there are several areas of the study that warrant further investigation, and that the study be replicated, and the lessons learned used to educate Health care professionals to understand the needs and issues of illicit drug users.

IMPACT ON FUTURE PRACTICE

After researching this article, the reader now understands the impact that research can have on future practice. The National Institute of Clinical Excellence (2002) States that evidence-based practice can be defined as using contemporaneous best evidence ensuring actions are clinically appropriate cost effective and result in positive outcomes for patients (NICE 2002). Therefore every healthcare team member has to critique evidence, assess its reliability and application before combining it with their own clinical expertise. Before critiquing this article the reader did not understand the reasons behind research or understand why nurses had to review articles, she now has a greater knowledge of the subject the readier understands how important it is to future pratice.

The authors discovered some important issues concerning the treatment of illicit drug users. This leads the reader to believe that this research will hopefully play an important part in the future treatment of drug users, and hopefully will have an impact on the reader’s future practice, as an nurse on an adult ward illicit drug users will inevitably need healthcare.

REFERENCES

Benton, D. C. Cormack, D. F. S. (2000). Reviewing and evaluating the literature. IN D. F. S. Cormack (Ed.). The research process in nursing (4th ed). Oxford. Blackwell ScienceMclaughlin, D. McKenna, H. Leslie, J. (2000). The perceptions and aspirations illicit drug users hold towards health care staff and the care they receive. Journals of Psychiatric and Mental Health Nursing 7 (5), 435-44National Institute of Clinical Excellence. (2002) Principles of Best Practice in Clinical Audit. London: NICE,Nursing and Midwifery Council. (2005). Code of Professional Conduct. London: NMC.

Parahoo, K. (2006). Nursing research, principal, process and issues. London: Macmillan Press.

Polit , D. Hungler, B. (2001). (4th ed) Essentials of nursing research, methods, appraisals and utilization. New York: Lippincott.

Pope, C. Mays, N. (1995). Qualitative research in healthcare. London: Macmillan Press