Research on the Quality of Nursing Work - Essay Example

Quantitative Research Report Introduction According to Polit et al (2001), research can be described, "as a systematic inquiry that uses disciplined method to answer questions or solve problems (p.4). The purpose of this paper is to critically analyze a chosen piece of nursing research work and assess its validity and utility, using a critical framework as guideline. Research, by intent, is suppose to create new knowledge in relevant fields, to develop, refine and expand the horizon of knowledge in such a chosen field (Polit et al, 200:4-5). Furthermore, research in the nursing field refines and expands what is known in practice of the nursing profession and in the process, empowers the professional to capably foresee and manage the complex and constantly changing challenges facing the profession, as this is paramount for the continuous social relevance of the nursing profession. Critiquing a research work, therefore, involves a careful examination of all aspects of the study, to assess its strength, limitations, meanings and relevance, in a bid to gain adequate up to date knowledge, improve practice and provide essential data necessary for further studies (Hek, 1996; Burns and Grove, 1999). 1. Problem Statement: The study was conducted to evaluate patients' satisfaction with two different routes of follow-up monitoring care for patients with Rheumatoid Arthritis - Primary care settings involving a General Practitioner and/or practice nurse, and Secondary care settings involving a specialist team within hospitals and including case management by a Rheumatology Nurse Specialist (RNS). This research problem is of great importance to the nursing profession, as it evaluates patients' satisfaction to specialized nursing service delivery. 2. Study Purpose: The purpose of the research was to compare Rheumatoid Arthritis patients' satisfaction with a General Practitioner led primary care and a Rheumatology Nurse Specialist (RNS) led secondary care settings. The nursing profession is known to do very well in the areas of empathy, information provision, and general patient satisfaction. This study is significant as it further strengthens the validity of this contention. 3. Research Question: Although the research question was not explicitly stated, it can be inferred from the study aim that the research question would be something like: Are patients more satisfied with primary care or secondary care settings for follow-up care and monitoring 4. Hypothesis/Hypotheses: Hypothesis is a statement, which predicts the performance of a verifiable occurrence in certain conditions, based upon theoretical considerations (Stevens et al, 1993).The hypothesis of this research was not stated, also; however, the main hypothesis the research appear to be testing was: Rheumatoid Arthritis patients undertaking disease modifying antirheumatic therapy (DMARDS) are more satisfied with follow up monitoring and care provided by specialized nurse-led secondary care settings. 5. Study Variables: The two main variables of the research, as identified by the researchers are: primary and secondary monitoring of patients with Rheumatoid Arthritis undertaking DMARDS. 6. Conceptual/ Theoretical Framework: This study was guided theoretically by the former exploratory study carried out by the same authors, which indicated factors such as attitude and empathy, information provision, continuity of care etc influenced patients' satisfaction with care received. The present study sought to explore these qualities within the context of primary and secondary care. 7. Review of Related Literature: According to Massey (1995), the essence of a literature review is to analyze what has been said so far and thus demonstrate what is known about a research problem, and, in the process establish the need for the current study. The authors of this study contend that there was a lack of adequate literatures that relates to the satisfaction of rheumatology patients with monitoring follow-up. They identified and reviewed only three articles. However, one can argue that, though the said lack of adequate literature emphasizes the need for the present study, sourcing for and reviewing more literatures would have added a wider perspective to the research. Three literatures are inadequate for the literature review of a scientific research report. 8. Study Design: The study design was a survey method, using closed ended, self administered questionnaires to collect data from the research subjects. The instrument used was the Leeds Satisfaction Questionnaire (LSQ) which has been validated in a previous study, and have the added advantage that it was created specially for study on rheumatoid arthritis patients. Internal threats to the validity of this method includes, inability of the patients to adequately understand the survey question and two, the tendency to tick 'agree' to all the questions in the question. External threats include influences on the response of the research subjects or subjects responding just to please the researcher. 9. Sample and Setting: The study under review used a convenience sample of 80 patients undertaking DMARDS in the outpatient department of a hospital. While the context under which data were collected was appropriate for the study, the sample size and distribution cannot be said to be representative of the target population, considering the small sample size and distribution. 10. Identification and Control of Extraneous Variables: The researchers identified and controlled for two extraneous variables. One was the tendency for subjects to tick 'strongly agree' boxes on all the survey questions, a situation which they referred to as 'response acquiescence'. This was controlled by balancing equal numbers of definitive positive and negative statements in the questionnaire. The second was the tendency for subjects to respond in order to please the researcher; this was controlled by employing the service of an impartial assistant, unknown to the subjects, for data collection. 11. Study Instruments/Tools: The instrument used for the research under review was the Leeds Satisfaction Questionnaire (LSQ). This instrument is specifically suited for the research since it has been validated by a study of the follow-up care of rheumatology patients and was created with the consideration for the special situation of patients with rheumatoid arthritis. 12. Data collection Methods: Data for the study was collected through questionnaires. To ensure privacy and confidentiality, approval was first received from the local research ethics committee to collect personal data of the subjects; subjects were approached individually and the questionnaire was administered by an assistant. However, on the negative side, the researchers did not mention if the subjects where appropriately informed about the purpose of the research, or if they were made to sign a written consent form before data were collected from them. 13. Data Analysis Procedures: The research data was analyzed using the Statistical Package for the Social Sciences (SPSS) which is an appropriate tool for analyzing this kind of research data. The chi-square test was used to analyze the demographic data of the subjects, while the t-test was used to compare the satisfaction of the patients in the two groups with the monitoring and care they were receiving. Since t-test compares and indicates any statistical difference between two groups of data, it can be seen as an appropriate tool for analyzing the research data. 14. Strengths/Limitations: The strengths of the study includes the validity of the data used, since a data collection tool specifically created and validated for use with rheumatoid patients, was employed for data collection. Secondly, though the sample size was not large, there was almost 100% response rate from the sample surveyed, cutting across several genders and ages. However, the limitations of the study were, one, subject's personal knowledge of the disease was not evaluated, which s a factor that can influence subjects expectation and preferences for monitoring, and hence satisfaction. Two, primary knowledge of the GPs and practice nurses about rheumatoid arthritis was not evaluated, which could have also influence the service delivered to the patients. 15. Implications for Research: As indicated by the researchers, the indication that patients are more satisfied with secondary monitoring and care revealed by this study calls for further researches on a wider scale to evaluate whether this is a general trend, and to reveal the underlying factor. Moreover, further studies should examine if patients are more satisfied with one RNS rather than a potential team, as is the case in primary settings. For policy making, it should also be examined whether this trend will cause a shift in the trend towards primary care in recent healthcare policies. References Burns, N and Grove, K.S. (1999). Understanding Nursing Research (4th ed) United States of America: W.B. Saunders Company Hek, G. (1996). Guidelines on Conducting a Critical Research Report, Nursing Standard, 11(6): 40-43 Massey, V.H. (1995) Nursing Research: 2nd edition, Springhouse, PA: Springhouse Polit, F.D, Beck, C.T, and Hungler, B.P (2001). Essential of Nursing Research: Methods of Appraisal, and Utilization, 5th edition, Philadelphia: Lippincott Stevens, P.J.M. Schade, A.L. Chalk, B. and Slevin, O.D'A (1993) Understanding Research: A Scientific Approach for Health Care Professionals: Edinburgh: Champion Press Read More