Critique Nursing

Essay preview The purpose of this assignment is to critique and evaluate the chosen article in terms of strengths and weaknesses, to demonstrate an understanding of the research process. According to Polit and Beck (2004) the aim of critically appraising an article is an attempt to determine its strengths and limitations. Therefore, the research critique should reflect an objective and balanced consideration of the study’s validity and significance (Polit and Hungler 1999). The task of critiquing is, according to Lo Biondo-Wood and Harber (2006) a challenging one and can only be effectively achieved through much practice and skill.
For the purpose of this critique, the frameworks of Parahoo (1997) and Polit and Hungler (1999) have been used as a guide. This will assist in producing an organised sub-headed piece of work. Title The title of an article is the first part of a study to be encountered and Parahoo (1997) states that a title should draw the reader’s attention to the precise area of study and make reference to the population from whom the data is collected. Cormack (2000) and Marshall and Kelly (2007) agree, stating a title should be concise and reflect the content of the study.
The chosen article is titled ‘Perceived barriers and facilitators to implementing research findings in the Irish practice setting’. This title utilised by Glacken and Chaney is concise, consisting of 13 words in bold print. Rumrill et al (2000) state that a standard length title is 12 – 15 words. However, the title does not reflect the population of the sample group i. e. Registered Nurses. Although the title still provides insight into what the article is trying to accomplish. Author(s) According to Cormack (2000) researchers must be qualified to commence a esearch study. The researchers qualification and credentials in the article are clearly stated and easy to find. They both have initials after their names, one of which has a PHD, which indicate that they have an educational background. A search using Glacken and Chaney using the ProQuest database identifies several published articles by Glacken. According to Lo Biondo-Wood and Harber (2002) this enhances the credibility of a study placing confidence in the findings. The article was submitted for publication on the 1st July 2003 and was accepted on the 9th January 2004.

This illustrates that it was still relevantly recent and not dated when published which could have posed questions regarding validity and reliability. “The Journal of Clinical Nursing” has published the article. This also adds to the credibility of the research study, as all published articles are double bind peer reviewed. Abstract The purpose of the abstract is to provide a short comprehensive synopsis of an article (Rumrill et al 2000). According to Parahoo (1997) it should quickly focus the reader’s attention on the main points of the study.
Langford (2001) also states that a well-presented abstract should be accurate, self-contained and readable. This abstract gives a brief summary of the study and within the first few lines identifies what the study is trying to achieve – to ascertain what registered nurses perceive as barriers to the utilisation of research findings and discover what they perceive would facilitate the implementation of these findings. The remainder of the abstract provides a summary of approach (cross-sectional survey), the population (registered nurses) and overall findings.
One limitation noted is that the researchers do not give the exact sample size in the abstract. By reading this summary it is believed that the reader would be able to make an informed choice about the relevance of the article for their purpose. The keywords used within the abstract were – barriers, clinical practice, facilitators, Republic of Ireland, utilisation. It is vital that researchers choose appropriate keywords for their articles in order to aid literature searching through databases (Webb 2005).
The keywords used by Glacken and Chaney are all relevant to the research study. Introduction The purpose of the introductory section is to clearly identify the problem and give a rationale for the study been carried out (Cormack 2000). Poilt and Hungler (1999) agree by stating that the introduction should explain the research problem and why the study is important, worthwhile and relevant. Russell (2004) also states that the introduction should thoroughly describe the background of the research problem so that the need for the study is apparent.
The introduction given by Glacken and Chaney builds a cause from existing literature that the problem is of adequate value to justify further research. The author of this critique believes the research problem is in the last sentence of the introduction. It states that there are many difficulties involved in achieving evidence – based practice and many barriers that may impede research utilisation. If this is in fact the research problem, the researchers comply with Russell’s (2004) recommendation that the research problem should flow directly from the introduction and conclude this section.
However one would feel that this introduction deals more with the importance of research rather than explaining that the remainder of the article will focus on the barriers that impede research. According to Cormack (2000) an introduction should also state the study’s limitations. This particular introduction does not make the study’s limitations explicit to the reader. Literature Review/Background According to Parahoo (1997) a literature review serves to put the current study into the context of what is already known about the subject.
Cormack (2000) states that the literature review is a critical review of previous literature relating to the research topic. Therefore this section aims to provide the reader with an understanding of what the current state of evidence is in the selected area of study. This review is organised by heading that correspond to the key study concepts, which makes the review easy to follow. The researchers attempt to review previous studies relating to the topic, thus preparing the ground for new research. The studies presented highlight the significance of the problem under investigation.
It was difficult to identify the exact research question, as there was no definite question asked. Although Valente (2003) states that sometimes researchers may hide the research question within the purpose of the study. The final statement of the literature review is therefore the purpose of this study – ‘it is timely that perceived barriers… are identified and acknowledged’. Therefore as you read the review it moves from broad to specific relevance with the last section of the review clearly outlining the need for the study. Due to the article been published in 2004, it is expected that the references used will be relevantly recent.
From reading the reference list, it can be seen that this is the case and only three references before 1994 have been used. There was a need for these older references as the original author who employed the Barriers scale did so in 1991 and the purpose of the 1978 reference was to illustrate that access to research reports has been a problem for many years. Also noted is that the articles included in the reference list are clearly related to the topic under study and include international resources, all nursing – related. http://repository. uwc. ac. a/xmlui/bitstream/handle/10566/308/RoweBlendedLearning2012. pdf? sequence=3 Method According to Polit and Hungler (1999) the heart of the research critique is the analysis of the methodology decisions adopted in addressing the research question. Cormack (2000) suggests the method section should clearly state the research approach to be used and asks whether the method is appropriate to the research problem and whether the strengths and limitations of the approach are stated. Although not written in text it is clearly pointed out that the article is of a quantitative approach.
Burns and Groves (1997) describe quantitative research as a method used to gain more information, test relationships and uses numeric data to answer problems. In reviewing the methodology section which is under the subheading “Methods”, the researchers clearly demonstrate that the design method is a cross – sectional survey using a non – probability sample. According to Polit and Hungler (1999) a cross – sectional design involves the collection of data at one point in time. This descriptive study uses the established 29 – item Barriers 5 point Likert scale, after firstly gaining permission from the main author to employ the instrument – S.
Funk. Therefore a strength of this article is related to the measurement tool. The researchers used an already developed measurement device in which the reliability of the tool would have been determined. They reinforce this fact by saying that the scale is recognised to be psychometrically robust. A further quantitative research tool – a questionnaire, was selected as the method to solicit opinions regarding the barriers to research. Cormack (2000) believes that questionnaires are the most widely used method of collecting data.
However he recognises that if participants are aware that they are partaking in a study, it is natural that they might alter their response – the Hawthorne Effect (Cormack 2000). The researchers do not state how they minimised this Hawthorne Effect. In addition to the questionnaire, a demographic information sheet was utilised. This is in line with a descriptive design, as the purpose of such is to gain more information about the characteristics of a group (Vitale 2003). The research participants were a convenience sample of registered nurses who enrolled in a nursing focused academic course in Trinity College, Dublin.
All who enrolled were invited to participate in the study. However the recruitment process is not described in much detail. It is not until the Findings section that the size of the sample is revealed – 169 participants responded. According to Thompson (1999) the sample size in quantitative research is preferably a large sample. Vitale (2003) states that the general rule regarding sample size is ‘sample error decreases as sample size increases’. It is harder to generalise a sample of this size. It is recognised by the researchers in the Discussion section that the particular mode of sampling employed may introduce bias into the findings.
This may result in the findings becoming less reliable. A limitation noted in the method design used by the researchers was the lack of an explicit framework. The researchers did not identify if they used one. When researching the other studies that used the Barriers scale the vast majority used a framework. Ethical Consideration Ethics is an important part of nursing and nursing research. It is about researchers doing what is fair, decent and moral and is underpinned by values and believes of the community (Crookes and Davies 2004).
There is no designated section allocated to ethical considerations, however Hek (1996) states that ethical issues may be integrated throughout the article. This article addresses ethical issues in both the abstract and under the method section. The researchers clarify that the ethical issues of a persons right not to be harmed, right of full disclosure, right of self-determination, right of privacy and confidentiality were respected. According to the researcher all participants provided their consent to the study by the returning of the completed questionnaire.
Consent is vital as it respects the autonomy of individuals, their right to privacy and their right to choose (Tingle and Cribb 2002). Results Cormack (2000) states that the results should be presented clearly and in enough detail so that the reader is able to judge how reliable the findings are. Polit and Beck (2004) agree by stating that the most critical element of any study is getting your results across and understood by your readers. Valente (2003) believes that the researchers should repeat the research question before delving into the findings.
The researchers in this case presented the data in succinct form with little discussion at the start, but organise their findings under subheadings. According to Russell (2004) researchers frequently organise their findings by research question to facilitate readability. The aim was to quantify the barriers to research implementation. The authors of this article present their findings systematically, utilising a variety of graphs and tables. Figure 1 shows a graph depicting that 38% of the participants consulted journals more than twice a month.
Table 1 presents the barriers to research utilisation in descending order of importance. Results were also explained and summarised alongside which according to Clifford (1997) is a form of descriptive statistics. According to Russell (2004) if a descriptive design was used the reader should find descriptive statistics such as mean, mode, median and standard deviation. All these statistics are included within the results section. The target audience (professional nurses) are more than likely to be able to interpret the figures within each table and, thus, judge hoe reliable the results are.
It is important that results are presented in such a way that they are clearly understood (Cormack 2000). Parahoo (1997) is an advocate of comparing results with other similar studies. The researchers adopted this style and compared the top 10 barriers with those found in three recent studies (Table 3). The researchers showed their findings to be very similar with the studies undertaken in both Northern Ireland and Australia. Discussion/Conclusion The discussion section should flow from the data results and place the study’s findings in context with what is already known (Parahoo 1997).
Valente (2003) believes that under this section the researchers should summarise their major findings and conclude their application to practice, research, and theory and knowledge development. The researchers state that this section will discuss the findings in comparison with other studies undertaken. Valente (2003) states that author(s) should compare and contrast their results with other studies and interpret the findings. The discussion is unambiguous and supported by the results obtained. Again the researchers used subheadings to ease readability. There are many implications to practice identified by the researchers.
According to Valente (2003) implications should describe how the results of the study could be applied to nursing practice. For example the researchers discovered that their study and many other studies identified nurses’ perceived lack of authority as the most common barrier to research. Therefore they exposed a need to implement some change into the organisational setting. Also, more support from managers was noted to be the top ranked facilitator of research implementation. The researchers also suggest a further research study, which would explore the reasons why nurses do not access research journals on a regular basis. General Impression
Overall the article was interesting with clear aims and use of methodology. It was quite simple to interpret and has provided interesting fact regarding this topic. The study contains few flaws and represents a valid example of descriptive quantitative research. The results have addressed the aims of the study and are both informative and descriptive. It is recommended that it should contain a section of ethical consideration however the ethical issues are evident throughout the article. In the introduction the article stresses the importance of research in nursing and health care. This builds a good case for continuing the study.
Research is an essential part of every nurse’s role. But as this study revealed there are many barriers for nurses to overcome to properly utilise and implement research. This study has brought these barriers to the foreground and identified ways to overcome them. The findings were interesting, although it might become more reliable if the study was replicated using a larger, random sample group. The top ranked barrier to research utilisation was surprising to read, as it was made known to be nurses’ perceived lack of authority. The article was very good overall and a lot of interesting facts emerged from the study. References