Respecting Dignity in Care in Diverse Care Settings: Strategies of UK Nurses - Essay Example

? Critical Appraisal of a Research Article Introduction to Research (HS526) This is a critical appraisal of Baille and Galagher(2011), “Respecting dignity in care in diverse care settings: Strategies of UK nurses” in the International Journal of Nursing Practice, 17, 336-341. Introduction The following discussion is a critical appraisal of the research conducted by Baille and Galagher (2011) in a bid to identifying strategies used by UK nurses in respecting the dignity in care across diverse settings and backgrounds. According to Brockopp et al (2003), critical appraisal process refers to the concept of providing a summary of a research article whilst identifying the key aspects in a bid to evaluate the quality and merit of such studies. Evaluation of quality and merit of research articles via the critical appraisal technique is based on predetermined criteria (Brockopp et al, 2003). Baille and Galagher (2011) used qualitative multisite case study within seven organizations in their quest to finding out nurses’ views on dignity issues across the UK health-care background. From prepositions of Gangeness and Yurkovich (2006), there is no doubt that Critical Appraisal Skills Programme (CASP) is a better and more effective framework for analyzing the qualitative research by Baille and Galagher (2011). Critical appraisal of this research is aimed at providing various scholars, researchers, as well as health care practitioners with adequate assessment regarding validity and reliability of the study. Reliability and validity of the research will help establish whether the results of can be effectively used in making decisions or understanding UK’s health care settings. Amongst the many frameworks, Critical Appraisal Skill Programme (CASP) is the main framework identified by this appraisal to be not only effective but suitable for establishing and attaining objectives of this appraisal. From the ten questions of CASP, it will be easier to have a deeper understanding of the research or study as an assessment and interpretation of the research is conducted systematically (Polit and Beck, 2008). Systematic analysis of this paper through CASP will take into account soundness, results, and their relevance to UK’s healthcare settings. Baille and Galagher (2011) applied the qualitative multisite case study in order to answer their research questions and attain research objectives. Through semi-structured interviews, Baille and Galagher (2011) obtained the necessary data for analysis and carrying out discussion, which is meant to influence perception and knowledge of various stakeholders on views of nurses’ dignities across the UK’s health care settings. As provided by the Public Health Resource (2008), CASP will suitably apply on the study by Baille and Galagher (2011) through stages. RESEARCH METHOD Newell and Burnard (2006) assert that interviews are a method and instrument for obtaining adequate data within qualitative research design. In addition, unlike quantitative research methodology, Newell and Burnard (2006) strongly confirm that qualitative research methodology is suitable for researching in fields or subjects requiring understanding of people’s feelings as in this case is the nurses’ views on dignity across divergent health care settings. Walsh et al (2004) add that through interviews researchers are able to not only analyze obtained results but also develop a sense of sensitivity, which make the whole research effective, efficient, reliable, and valid. Whilst interviewing different participants from seven organizations, Baille and Galagher (2011) used qualitative research methodology to obtain data given that their research was aimed at establishing and evaluating views of nurses in respect to dignity in diverse care settings. Through qualitative research design, Baille and Galagher (2011) were able to employ thematic analysis thereby providing an understanding on their research or study topic. On this basis, the only suitable and effective framework for critically appraising this study is Critical Appraisal Skills Programme in the context of its ten questions for purposes of systematic appraisal. 1. WAS THERE A CLEAR STATEMENT OF THE AIMS OF THE RESEARCH? In order to conduct an effective, reliable, and valid study, there is need to have a clear statement of the aims, which identifies what the study or research is all about. In this perspective, Baille and Galagher (2011) wanted to identify the views of nurses on patients’ dignity across various UK’s health care settings. Since there is no need of having a complicated statement of aims of the research (Newell and Burnard, 2006), Baille and Galagher (2011) developed an aim, which was explicitly described within the abstract, introduction, and throughout the methodology. Complicating the statement of the aims of research is likely to compound problems associated with data collection, analysis, and presentation (Duff 2008). Once there are problems with the data it is possible that such studies may not be valid or reliable. What’s more, Parahoo (2006) and Holland et al (2010) state that statement of aims within research must be provided not only for the sake of users of the results but also to act as a guiding framework for carrying out the research. Holland et al (2010) add that statement of aims within a study is the pivot or fulcrum highlighting the whole research. Baille and Galagher (2011) clearly and precisely stated the statement of aims, which was to identify views of nurses on patients’ dignity. The statement of aims in this study was relevant and important to the researchers as well as health care practitioners and all individuals who were going to benefit from the study. In this study, Baille and Galagher (2011) identified that respect for patients’ dignity is an essential professional practice within the nursing fraternity. Respect for patients’ dignity is not only important or essential within national perspective but also internationally as well. Therefore, it is obvious that this study was to benefit nursing fraternity across the globe. On the perspective of patients, there is need to have dignified treatment that aims at satisfying their health care needs (Baille and Galagher, 2011). It is on this basis that Baille and Galagher (2011) clearly stated the statement of the aims of this research thereby setting a framework or stage for conducting the main study. In summary, the statement of aims for this research was clearly, explicitly, and precisely stated within the study. 2. IS A QUALITATIVE METHODOLOGY APPROPRIATE? In order to achieve the aim of this research, Baille and Galagher (2011) employed the use of qualitative multisite research design, which effectively helped in data collection via structured interviews. Since the research aimed at evaluating the perceptions and views of nurses with respect patients’ dignity, it was logical and effective to apply qualitative research design. The research focussed on a sample of participants who were interviewed on their views on patients’ dignity whilst providing required treatment (Baden-Savin and Major, 2010). LoBiondo-Wood and Haber (2006) state that whenever participants within the study are human beings who need to provide their views or perception then the best research design is that of qualitative. In addition, Gilmour et al (2003) agree that through employing qualitative research design in this study, Baille and Galagher (2011) can effectively attain their thematic analysis objective or mission. Thematic analysis arises from different themes or aspects of views amongst the participants. Unlike quantitative research designs, qualitative research designs are effective in finding out specific views of themes that correspond to a particular study. Therefore, there is no doubt that employing qualitative research design in this scenario was an appropriate move by the two researchers, Baille and Galagher (2011). 3. WAS THE RESEARCH DESIGN APPROPRIATE TO ADDRESS THE AIMS OF THE RESEARCH? Every study must have well developed research design that aims at attaining or addressing aims and objectives. Baille and Galagher (2011) applied multimedia qualitative case study design that involved interviews and direct observations of both documentary evidences and physical environment. According to the researchers, other than the main theme of identifying dignity within health care settings in the UK, there were minor themes that included recognizing vulnerability to loss of dignity, enhancing privacy and confidential, enhancing communication between patients and health care practitioners, and improving care environments, as well as addressing individual matters and issues (Baille and Galagher, 2011). Attaining all these themes was only possible through application of qualitative data obtainable from qualitative research design. The themes and subthemes required qualitative data only obtainable through the designed structured interviews. Moreover, since the aims and objectives required the use of interviews and direct objectives, it is true that through the multimedia qualitative research design, Baille and Galagher (2011) were able to fulfil their mission in respect to studying aspects of patients’ dignity within various UK health care settings. The multimedia qualitative research design allowed for the researchers to interview in addition to directly observing participants from different settings hence attaining the objective or aim of finding information across a diverse UK health care setting (Burns and Grove, 2005). It is therefore undisputable that the qualitative research design applied by Baille and Galagher (2011) was congruent with the aims and objectives of this study. 4. WAS THE RECRUITMENT STRATERGY APPROPRIATE TO THE AIMS OF THE RESEARCH? Recruitment strategy involved the sampling procedure since the researchers could not study the whole population. Due to the multiplicity of the study settings, the researchers decided to use embedded analysis in order to conduct the study (Boswell and Cannon, 2011). Every organization was studies through a campaign lead. It is the campaign lead that recruited various interviewees where applicable criterion involved serious and extensive involvement within the campaign (Casey and Houghton, 2010). Since the campaign lead within the organization had extensive knowledge on the nurses who could participate in the study, there is no doubt that the selected participants were effectively chosen and that they represented the population without any biasness or exaggerations. Through this process, a total of 51 participants were recruited; approximately five to nine from each study site. Recruiting participants via this method was not only effective but time saving since the researchers, who had no information on every the nurses within the study organization were not involved rather campaign lead who had all information necessary to performing the recruitment. 5. WERE THE DATA COLLECTED IN A WAY THAT ADDRESSED THE RESEARCH ISSUE? Fawcett and Garity (2009) confirm that data collection is a vital and essential component of research. Without data, it becomes difficult to make necessary analysis, discussions, and conclusions. Nevertheless, Loiselle et al (2010) confirm the need for a proper structure for collecting data, which will ensure that analysis, discussions, conclusions, and recommendations are carried out as required and planned by a given study. On the same note, Holzemer et al (2010) agree that it is important to lay down a proper structure and instruments of data collection, which will correspond to issues being addressed within the research. Some of the effective ways of collecting data as identified by Polit and Beck (2008), and LoBiondo-Wood and Haber (2006) include direct observation, questionnaires, and use of interviews where participants are asked questions aimed at collecting relevant data. In this regards, Baille and Galagher (2011) collected data from participants through interviews that lasted for approximately 30 to 60 minutes. The interviews were open-guided as well as guided by conversation approach that researchers believed was congruent to case study designs. The obtained data in this study illuminated care setting in respect to particular issues that were of interest to the researchers. Such issues formed the main and sub themes that Baille and Galagher (2011) used in order to attain the objective of the study. Therefore, collected data in this study was done in a way that addressed the issues of the research. The issues of the research formed the main themes as well as sub themes, which were the basis of conducting the study. No doubt therefore, obtained data in this study addressed various research issues that Baille and Galagher (2011) aimed at establishing with respect to dignity. 6. HAS THE RELATIONSHIP BETWEEN RESEARCHER AND PARTICIPANTS BEEN ADEQUATELY CONSIDERED? Qualitative research designs usually portray a positive relationship between participants and the researchers (Maltby et al, 2010). This is because researchers are involved in the participants in order to either directly observe them or interview them with an aim of obtaining required information or data for purposes of answering research questions (LoBiondo-Wood and Haber, 2006). Researchers and participants had to maintain a strong and positive relationship whilst conducting the study in order to prevent inaccuracies within the data collected (Keele, 2011). There was a possibility of having inaccurate data in the event that a sour relationship existed between researchers and participants (Houser, 2008). Despite maintaining ethical standards between participants and researchers, there was need to have the mutually understanding and positive relationship in order to assist collecting accurate data. One way of enhancing such positive relationships was to obtain consent of the participants through informing them on the basis of the study. Payne et al (2007) confirm that providing information to participants on how the research or study is meant to be carried out is not only ethical but healthy in terms of collecting adequate and accurate data from participants without any exaggerations and biasness. For purposes of validity and reliability, Polit and Beck (2008) state that researchers must engage in positive relationship with the participants in order to enhance credibility of their study. Baille and Galagher (2011) enhanced a positive and mutual relationship between them and the participants thereby making it possible to obtain required data and information. 7. HAVE ETHICAL ISSUES BEEN TAKEN INTO CONSIDERATION? Ethical issues are vital in conducting studies especially those that use human beings as participants. Some of the ethical issues that studies must adhere to include identifying impact on human participants, fabrications and falsification of data, privacy and confidentiality, seeking informed consent from participants, and governance from different principles and concerns (Moule and Goodman, 2009). Baille and Galagher (2011) maintained the required ethical practices and code of doing research. The research proposal was for instance taken to the NHS Ethics Committee to approve of the same if it had met ethical requirements. NHS Ethics Committee proved that the research proposal had adhered to ethical provisions hence it was not possible for the actual research to be insensitive of the research ethical issues and concerns. What’s more, Baille and Galagher (2011) carried out the research in accordance with the provisions of UK research governance framework. From the study, Baille and Galagher (2011) identified that every campaign lead sought for local permission indicating that consent was obtained from participants before the study was conducted. By giving every participant information letter, Baille and Galagher (2011) ensured that they adhered to ethical principle or standard requiring the need to have informed consent from participants. In addition, every participant signed the consent form before engaging in the research process. Treating all data with needed confidentiality and being kept secure were some of the steps taken by Baille and Galagher (2011) in ensuring that they adhere to ethical issues, standards, and principles. Therefore, the research conducted by Baille and Galagher (2011) adhered to provisions or requirements of research ethical standards and issues. 8. WAS THE DATA ANALYSIS SUFFIECIENTLY RIGOUROUS? Koch (2006), Parahoo (2006), and Polit and Beck (2008) strongly believe in data analysis as the only way of proving the view or stand taken by researchers while carrying out their study. It is important to have adequate and efficient data analysis tools, which will provide discussable and analyzable results for purposes of making conclusions and recommendations (Black, 1999). After audio recording the interviews, there was transcription of the information from storage devices (Baille and Galagher, 2011). Data analysis was done in various stages through coding and application of relevant themes. Within the sites of study, there were data analyses conducted in order to analyze each site’s result. Later on the data was analyzed collectively with research aims and objectives in mind (Baille and Galagher, 2011). From the data, the researchers identified final themes as RCN campaign, campaign enablers and challenges, impact on practices involved during the campaign, as well as the strategies involved in respecting dignity of patients within healthcare facilities (Baille and Galagher, 2011). Therefore, Baille and Galagher (2011) had data analysis, which was not only sufficiently rigorous but also focused towards the aims and objectives of the study. 9. IS THERE A CLEAR STATEMENT OF FINDINGS? After evaluating every theme within the results, Baille and Galagher (2011) engaged in serious discussion on the study, its data, and well as the analysis of the same. The discussion and clearly stating of findings followed prepositions of Fawcett and Garity (2009) and Newhouse et al (2001) who strongly believe that findings are essential within a given study or research. Every researcher must analyze data and provide findings, which will effectively attain the main aims or objectives of the study (McNee and McCabe, 2008). In this study, Baille and Galagher (2011) provided an extensive and inclusive section on findings, which precisely discussed the data and how relevant it was with respect to aims and objectives of the study. Hence, Baille and Galagher (2011) provided a clear statement of findings. 10. HOW VALUABNLE IS THE RESEARCH? The value of research depends on the validity and reliability attainable throughout the study from inception to the last part of making conclusions. Baille and Galagher (2011) developed an effective study systematically through following all the requirements. In addition to have the outlook value, the research had inward value in respect to the topic of the study. Baille and Galagher (2011) used this study to evaluate the need for patients’ dignity across different UK health care settings. Indeed, this study is valuable to practitioners as well as other interested stakeholders on issues regarding patients’ dignity in the UK’s health care settings. CONCLUSION From the above critical appraisal, it is evident how qualitative research designs are effectively applied by researchers in order to obtain qualitative data or information, which will make it possible for not only researchers but also other stakeholders in identifying specific solutions to problems that societies in the contemporary environment face. Nonetheless, there is need to adequately and effectively follow requirements of a study in order to attain prescribed aims and objectives. While focusing on the structure of a study, researchers should not forget the fact that there is need to adhere to all ethical issues and concerns as provided for within carrying out studies. From the analysis, it is also true that CASP is an essential and effective framework for evaluating a study in a bid to identifying validity, reliability, and value of the research. Therefore, CASP has been effective framework for critiquing researches or studies. REFRENCES Baden-Savin M, Major C, (2010). New approaches to qualitative research. Wisdom and uncertainty. First edition. Routledge Publishers Ltd. UK. Baille and Galagher (2011), “Respecting dignity in care in diverse care settings: Strategies of UK nurses” in the International Journal of Nursing Practice, 17, 336-341. Black, T. R. (1999). Doing quantitative research in the social sciences: An integrated approach to research design, measurement, and statistics. Thousand Oaks, CA: Sage Publications, Inc. USA. Boswell C, Cannon S, (2011). Introduction to nursing research: Incorporating evidence based practice. Second edition. Jones and Barlett Publishers International. London. UK. Brockopp D, Hastings-Tolsma M, (2003). Fundamental of nursing research. Third edition. Jones and Bartlett Publishers International. London. UK. Burns N, Grove S, (2005). The practice of nursing research. Conduct, critique and utilization. Fifth edition. Elsevier Saunders. USA. Casey D and Houghton C (2010) Clarifying case study research: examples from practice Nurse Researcher 17(3) 41-51. Cormack D, (2000). The research process in nursing. Fourth edition. Blackwell Publishing Ltd. Oxford. UK. Duff P (2008) Second language acquisition research Boca Raton: FL Press. Fawcett J and Garity J (2009) Evaluating nursing research for evidenced based nursing practice Philadelphia: Davies Company press Flick U, (2007). An introduction to qualitative research. Sage Publication Ltd. London. UK. Freshwater D, Maslin-Prothero S, (2005). Blackwell’s nursing Dictionary. Second edition. Blackwell Publishers Ltd. Oxford.UK. Gangeness J E and Yurkovich E (2006) Revisiting case study as a nursing research design Nurse Researcher 13, 4 7-18 Garrity K and Lacey A (2010) The research process in nursing. Sixth edition Oxford: Wiley-Blackwell Gerrish K, Lacey A, (2010). The research process in nursing. Sixth edition. Wiley-Blackwell Publication. West Sussex. UK. Grbich C, (2007). Qualitative Data Analysis: An Introduction: Sage Publications Ltd. London. UK. Holland K, Rees C, (2010). Nursing: evidence based practice skills. Oxford University Press. Oxford .UK. Holloway I, Wheeler S, (2003). Qualitative research in nursing. Third edition. Wiley-Blackwell Publishing Company. Oxford. UK. Holzemer W, The International Council of Nurses, (2010). Improving health through nursing research. Wiley Blackwell Publishers Ltd. UK. Houser J, (2008). Nursing research. Reading, using and creating evidence. Jones and Bartlett Publishers International. London. UK. Keele R, (2011). Nursing research and evidence based practice: Ten steps to success. Jones and Bartlett learning international. London. UK. Koch T (2006) Establishing rigour in qualitative research the decision trial 53 (1) 91-103 LoBiondo-Wood G and Haber J (2006) Nursing research – Methods and critical appraisal for evidence-based practice. 6th Edition USA: Mosby Elsevier. LoBiondo-Wood G, Haber J, (2006). Nursing research: Method and critical appraisal for evidence based practice. Sixth edition. Mosby Elsevier Publishers. USA. Loiselle C, McGrath A, (2010). Canadian essentials of nursing research. Third edition. Wolters Kluwer Lippincott Williams and Wilkins. Canada. Maltby J, Willams G, Day L, McGarry J, (2010). Research method for nursing and health care. Pearson Nursing and Healthcare Publishers. USA. McNee C, McCabe S, (2008). Understanding nursing research: Reading and using research in evidence based practice. Second edition. Wolters Kluwer/ Lippincott Williams and Wilkins. USA Moule P and Goodman M (2009) Nursing research an introduction London: Sage publications. Newell R and Burnard P (2006) Research for evidence- based practice. Oxford: Blackwell publishing Newhouse .B.N.J, Niebuhr.L, Strout.T, Newhouse.E (2001) Living alone with Dementia innovation support programme. Parahoo K (2006) Nursing research – principles, process and issues Second edition London: Palgrave Macmillan Payne S Field D Rolls H Hawker S Kerr C (2006) Case study research methods in end of life care: reflections on three studies Journal of advanced nursing 58 (3) 235-245 Polit D F and Beck C T (2008) Nursing research – generating and assessing evidence for nursing practice Eight edition Philadelphia: Lippincott Williams and Wilkins Public Health Resource Unit (2008) Critical Appraisal Skills Programme (CASP) Available online at www.phru.nhs.uk/casp.htm Walshe C E Caress A L Chew-Graham C Todd C (2004) Case studies: a research strategy appropriate for palliative care? Palliative Medicine 18, 677–684. Read More