Critical Appraisal of Qualitative and Quantitative Research Journal

Guidelines for Qualitative Study and Quantitative Critical Appraisals The aim of these assignments is to demonstrate critical appraisal skills at a masters-level. Search the bibliographic databases for a qualitative research article and a Randomized Control Trial that addresses your EBP problem. Get preapproval of articles to critique from the Professor. Read Burns and Grove Chapter 18 and write the critique following the critical appraisal guidelines that includes the three major steps listed on p. 434. The expected paper length is 2 pages, excluding title and reference pages. You may use these critiques in your EBP paper, Chapter 2 Review of Literature. Submit a paper copy to the professor by due date. Summarize the study by identifying: 1. The research elements (Authors, Year, LOE, design, purpose, study variables, sampling, measurement, main results, and findings or conclusions) 2. Determine the study strengths and weaknesses (p. 439); 3. Evaluate the credibility, trustworthiness, and meaning of the study for its applicability to your PICOT (p. 443). Sample paper – Qualitative Research Critique Citation: Bakitas, M. A. (2007). Background noise: the experience of chemotherapy-induced peripheral neuropathy. Journal of Nursing Research Vol 56, No 5 Synopsis The researchers want to have understanding of how cancer patients use noise as a response to painful stimuli from side effect of neurotoxic chemotherapy agents. They want to explore how cancer patients use background noise as a means of unfamiliar stimuli in expressing pain. In examination of this vulnerable population and the use of background noise in expressing pain, the study can further explore how chemotherapy induced peripheral neuropathy can be minimized to relieve burden on physical, emotional and social functional abilities of the day-day activities of these patients. Throughout this critique chemotherapy induced peripheral neuropathy will be referred as CIPN. The researchers want to provide a detailed description of life experiences of cancer patients suffering from side effects of chemotherapy drugs. They want to explain how cancer patients make unfamiliar noises to express painful stimuli that are erroneously observed as existing medical condition rather than unusual side effects of neurotoxic chemotherapy drugs. Data was collected through open-ended and semi structured patient interviewing. The investigator conducted 21 interviews in a private cancer center ages 46 -81, 6 interviews in patients home setting and 1 interview via telephone. The interview lasted between 25 to 90 minutes depending on how the investigator asked questions and how the patient answered them. A clinician selected 28 qualified participants with specific qualifications that are: have had cancer and received neurotoxic chemotherapy agents and are experiencing some unusual side effects. After the participant selection they were promptly required to complete a form with two related symptoms of CIPN and their medical history, age, marital status, profession and type of cancer on a demographic medical information form (DMI). The interview had broad open-ended question for example tell me about sensations you are having in your feet since starting your chemotherapy and how have these symptoms influenced your every day life (Bakitas 2007, p 325). The researchers controlled their bias and misconceptions by educating the researches in conducting interviews that were credible and reliable without bias. They used member checks and atlas in tracking assigned researchers. Expert opinions, evidence of field notes, clinician observations and discussions notes, written responses and agreements from participants were all credible information to control misconception and bias. The study included non-participants that had cancer and have experienced CIPN symptoms after receiving neurotoxic chemotherapy agents. Open ended questioning was broad and flexible allowing participant to feel at ease in answering questions. A professional transcriptionist analyzed the interview word-by-word and coded data in vivo. Through out the study they avoided research rigor of precision in generalization but rather applied measurement that will enhance scientific rigor and trust worthiness in data collection that was dependable and credible (Bakitas 2007, p 325-326). There were some direct quotes that were specific for example one patient described her symptoms as I still have trouble trying to figure out when to listen to the pain, and how to interpret the pain and when to just tune it out. When I get kind of loud from down there Ive kind of learned to just not listen to it (Bakitas 2007, p 326). Analyses of CIPN initially led to the discovery of back ground noise and four themes: theme 1 becoming aware, theme 2 learning new lyrics, theme 3 functional, emotional and social role cacophony & theme 4 learning to leave with it. Despite the fact that the participants learned to live with CIPN many had hard time coping with the side effect of neurotoxic chemotherapy drugs. This prompted the researchers to change their description of CIPN from the misconception of nausea and vomiting, pre-existing medical condition to awareness of unfamiliar sensations affecting functional roles (Bakitas 2007, p 325-329). This study applied a theoretical point of view of naturalistic inquiry and interpretive descriptive approach. According to Bakitas (2007) an interpretive descriptive approach gives in depth accounts of the impact of everyday clinical event and life experiences from the viewpoint of those impacted. Naturalistic inquiry focuses endeavors on how people behave in natural setting while engaging life experiences (Bakitas 2007, p 325). The main findings of the study revealed that the side effects of CIPN was the main cause of functional disabilities that caused physical, emotional and social distress in cancer patients. Another finding was that CIPN caused cancer patients to experience strange sensations that were unfamiliar to them and they made loud noises in expressing what they were feeling. This could be erroneously be compared to treatment related systems and pre-existing disease. Participants were annoyed with CIPN symptoms and viewed it as interrupting, irritating and troublesome (Bakitas 2007, p 325). Credibility The study was published in a peer review of the Journal of Nursing Research, which is a reputable publisher to discuss a phenomenon that little is known off. The CIPN self measure report and Common Terminology Criteria for Advance events (CTCAE) measured toxicity by grade was appropriate for the study. This measure provided reliable information that CIPN is associated with neurotoxic chemotherapy drugs and functional disabilities. The study provided literature review from reputable sources. The method used was Qualitative research in describing experiences related to CIPN through interviewing. They used a small audience in constructing their hypothesis and their results are not predictive like quantitative research but rather it was descriptive. The study was a non-numeric way of collecting data using personal interviews describing a phenomenon (Melnyk & Fineout-Overholt 2011, p 609). Open ended questioner and semi structured interviewing was used to interview a small audience of 28 cancer patients. This allowed the participants to open up and respond freely without been pressured to respond. The length of the interview lasted 25-90 minutes allowing participants enough time to respond to the interview (Bakitas 2007, p 324). The sample of observation and interviews were persistent and appropriate for the study. The participants interviewed came from diverse population with different diagnosis of cancer CIPN related symptoms was also appropriate for the study. The study used both open and semi structured interviewing in data collection showing a variation in their style of interviewing (Bakitas 2007, p 325). An effective and detailed data collection method was used to obtain data. The investigator stated that open -ended and semi structured interviewing was used that lasted 25-90 minutes depending on the patient respond to the interview. The investigator provided broad questions via Open-ended and semi structured interviewing. In this study, the researcher provided evidence of field notes, expert opinions, clinician observations and discussions that is varied enough for the purpose of the study (Bakitas 2007, p 326). The interviews were transcribed word by word by a professional transcriptionist. During data collection analysis and coding of the research took place at the same time. Audio tapes were reviewed for accuracy and truth telling, provided evidence of field notes, clinician observations and discussions and transcripts were reviewed by professionals. The interview was 700 pages long. It was dynamic where scientific software was purchased for coding varied interview. They used code labeling and themes in analyzing data. A scientific data base was established for credibility. They analyzed their data in four themes (Bakitas 2007, p 326) The data was well presented. The researcher gave detailed account of the participants explanation of their symptoms of CIPN in themes. The first theme becoming aware: Some of the participants were initially medically not advised to watch out for unfamiliar symptoms of CIPN and treatment plan to decrease their pain. They were confused between CIPN symptoms and relating it to pre-existing medical condition. Theme two learning new lyrics was about difficulty in explaining their symptoms. Theme three: functional. Emotional, and social role cacophony: this theme was about how CIPN affected participants day to day activities. Some had difficulty managing their ADL; basic needs like cooking, walking, working, performing family role and relationships. Theme four: Learning to live with it. This was the saddest part where the participants learned to cope with CIPN by blocking symptoms and learning new ways like making noises just to cope with it. Data as the researcher explained was well organized and easy to understand what was happening. Data provided proved how CIPN affected the lives of cancer patients and their functional abilities. It brought awareness of accessing patients pain level and how symptoms of CIPN can disrupt physical, emotional and social well fare and wellbeing of cancer patients. Health care professionals and society should be aware of CIPN and functional related disabilities. The study findings are very credible based on many factors. It was published in a peer review Journal of Nursing Research, which is a reputable publisher. They also used interviews that were literature reviewed and educated their researchers by providing extensive research training including member checks for research reliability. Scientific research data was used for coding and retrieval of data. Real time interviews were conducted and memos were also used. Data was analyzed using in vivo coding to ensure that participants own wording are transcribed. 45 clinical trials was conducted and concluded that CIPN occurred in 10% -100% of cancer patients receiving neurotoxic chemotherapy agents. Clinical Significance The study findings were not hard to understand. It was arranged in sections giving a flow of information making it to easier for the reader to understand. They gave feedback in verbatim of the participants respond making the reader have some sense of feelings as how CIPN actually affected cancer patients emotionally, physically and socially. Their findings were actually very rich in information. They gave awareness as to how some cancer patients use noise as a comfort measure to block unfamiliar sensations that they were experiencing. This information brings awareness to healthcare to pay attention to strange noises that patients make in assessments. The study provided detailed information in regards to coping mechanisms used by participants when they experienced these unfamiliar sensations in the results and discussion sections. It was very vivid and informative. It makes the reader have some feelings of what is actually happening to the patients. I think it brings awareness that CIPN is real and something should be done about it. Applicability This study brings awareness to healthcare to recognize symptoms of CIPN and put management plan in assisting cancer patients with physical, emotional and social wellbeing and welfare needs. Nurses should be informed about CIPN and related side effects and care plan strange noises during treatment planning. The study findings give nurses information to be aware of CIPN related symptoms and put comfort measures in place to assist them. We all have one life to live and deserve to live it with dignity. argue that cancer patients are members of society and CIPN is a poor outcome that requires healthcare involvement in relieving the burden on them. References Bakitas, M, A. (2007). Background Noise: The experience of chemotherapy-induced peripheral neuropathy. Journal of Nursing Research Vol 56, No 5 Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence based practice in nursing and healthcare. (3rd Ed). Philadelphia: Lippincott Williams
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