Norms of Academic Research - Essay Example

Critique of Research Reports 2008 Article 1: Quantitative Research The purpose of this essay is to critique a quantitative research article to see whether it follows the normally accepted norms of academic research and contribute to the knowledge base in the subject. Critical review of research articles involves studying it closely to understand the efficacy of the research and find out whether it has been conducted with all due diligence and care. A quantitative research in nursing should ideally incorporate all possible variables so that it plays a crucial role in furthering clinical practice. In the process, the research design should be robust and follow ethical norms while conducting the research. It is important to critically review existing literature on the topic so that the reader can not only discern between good and bad research but can also evaluate the findings in order to develop clinical understanding on the subject and use it for further research (Taylor, Kermode and Roberts, 2006). In this essay, the research under study is the article “Pressure Ulcer Risk in Long-term Units: Prevalence and Associate Factors” by Capon, A, Pavoni, N, Mastromattei and Di Lallo, D, published in Journal of Advanced Nursing, Vol 58 Issue 3, 2007, pp 263-272. The critique will begin with a review of the clarity of the title of the article and the credentials of the authors and the journal. This will be followed by a critique of the abstract, the introduction and the literature review, research design, methodology and validity of the research process, ethical practices followed while conducting the research, findings of the research, its implications, limitations and recommendations. Finally, the critique will be concluded with an evaluation of the reference list of the article. The quantitative research article was published in Journal of Advanced Nursing, an international peer-reviewed scientific journal aimed at advancing evidence-based nursing, midwifery and healthcare (Blackwell Publishing). All the four researchers are accomplished specialists in their fields: A. Capone (ScD) and D DiLallo (MD) are epidemologists, N Pavoni (MD) a hygienist and A Mastromattei (MD) a geriatric doctor. The study, designed and drafted by Pavoni and Capone, was conducted with data collected and analyzed by Pavoni. Mastromattei and DiLallo provided critical revision to the paper while the latter oversaw the entire project. Since pressure ulcers are a typical problem with long-term care for geriatric patients, the combined experience of the specialists is expected to contribute greatly to evidence-based learning on the subject. Besides, since the paper has already been peer-reviewed before publication, it is expected to be of high quality. The abstract of the paper clearly sets out the aim of the research in the background of high incidence of pressure ulcers among long-term institutionalized patients, resulting in high morbidity and mortality. The method of study involving 571 patients from 10 institutions in Rome, Italy is detailed in the abstract as are the findings on the relationship between pressure ulcers and individual clinical factors of patients. The abstract is also candid in concluding that although the prevalence of pressure ulcers among different types of patients is statistically analyzed in this research, further research is needed to identify ways of preventing it. The introduction of the article sets out the problem related to evidence-based nursing. The paper does not report any primary sources but research done in institutional settings of various countries in Europe, Australia and the United States over the last decade. The literature review includes research undertaken in various contexts including home-care assistance programs, acute care units and long-term units. The authors also report research on preventive possibilities for pressure ulcers and note that none of the existing research have related pressure ulcers to individual clinical factors of patients and risk scale scores. The last is the point of departure for the present research and thus sets out the hypothesis and setting of the study. The research design and methodology is clearly stated out at the beginning of the study. The method of data collection was clearly stated. Data collection was conducted in 601 beds across 10 institutions, with 571 patients on the day of the data collection as well as the previous day. Data was collected discretely across the institutions in the ratio of 20 beds a day. Nurses were trained to collect all personal data of the patients including their medical history, diet, posture, previous clinical setting, functional assessment on the Activity Daily Living (ADL) index, short portable mental score questionnaire (SPMSQ) and so on. The risks of pressure ulcers were analyzed by the Braden Scale that includes sensory perception, skin moisture, physical activity, morbidity, friction and shear. However, the authors do not justify the suitability of this scale over any other possible scales. Also, they do not report the details of the patient samples and any possible bias in the sampling at this stage although this is elaborated in the table presented later. The sampling is random and the methodology does not report the ratio of different clinical settings and patient characteristics. Nurses who collected the data were adequately trained to do so at a seminar. The data analysis has been conducted with due care to validity and reliability of the variables. Two models have been used for the purpose of the study. In the first model to study the relationship between the risks for pressure ulcers and the prevalence of the disease statistically, multivariate analysis has been conducted but ADL is deliberately excluded since it is known to be strongly correlated to the Braden scale. Alternatively, a number of variables like age, sex, previous care settings, number of medications per day, length of stay, consumption of psychotropic drugs, pathological and neurological states have been considered at length. The findings of the study are reliable as they have been statistically tested through various tools in the STATA statistical software version 8. In the second model, the variables, including Braden and ADL scores, have been tested through univariate models before beginning the full-scale multivariate analysis. This takes into account inter-cluster correlations as well as the reliability of the multivariate model. The variance is further reduced by creating the design effect (DE), which is the ratio of the observed variance and the anticipated variance. Higher the ratio, higher would be the necessity to reduce the standard error. While both models relate SPMSQ to cognitive decline, the second model clearly relates this to age groups. The researchers have mentioned the ethical issues in conducting the research briefly. The ethical committees of the institutions have been informed and the patients enrolled have done so voluntarily. The researchers have protected the confidentiality and anonymity of the patients sampled. However, it is not clear whether the patients who have undergone various degrees of cognitive decline are all able to understand the requirements of the study. The findings of the study are elaborated in language as well as in tabular form, making it easily comprehensible. The paper also relates it to the previous research in the are and the requirements for further research. In a tabular form, it lays out the existing knowledge in the area and what this particular paper adds to it. This is unusual in academic research and is an innovative and useful presentation. Finally, the researchers have reported the existing literature in full detail. Article 2: Qualitative Research Article The purpose of this essay is to critique a qualitative research article in nursing practice. For qualitative research, it is essential to be elaborate in the preliminaries, which includes the background of the study. For the purpose, I will study “Influences of Spatial Practices on Pressure Ulcer Management in the Context of Spinal Cord Injury”, written by S. Wellard and C Rushton and published in International Journal of Nursing Practices, Vol 8, pp 221-227. Wellard is Associate Professor of School of Nursing, Deakin University, Melbourne, Australia and Rushton is a Research Associate of the same school. Both are adequately qualified to write an academic paper in nursing practices and the paper has been published in an academic journal. Hence, it may be expected to have been critiqued already and free of any possible errors. In this essay, I will critique the paper formally, analyzing the abstract, introduction, literature review, study method and design, results, limitations and scope for further research. The abstract of the paper summaries the aim as well as the results of the research undertaken. The authors investigate the service delivery for the management of pressure ulcers of patients with spinal cord injury. The study is made from the perspectives of the consumers of service in terms of the space and setting in which the delivery was made. The qualitative study is focused on patients in both rural and metropolitan areas. This paper aims at a different perspective from the usual ones, typically quantitative ones, that are done from a biomedical or economic perspectives, of the causes of pressure ulcers and the management of the same. The authors report that most research have found that pressure and shearing factors are the main causes of pressure ulcers though there are a host of other factors. This research is limited to patients with spinal cord injury, for whom pressure ulcers are formed as a result of changes in nutrition, mobility, motivation and socioeconomic factors among others. Socioeconomic factors of pressure ulcer management are the least focused area in the discipline that the authors aim to study. The authors do report on the few qualitative research that has been conducted over the previous decade or so on the socioeconomic parameters. They follow LeFebre’s conception of space in the social perspective in a manner that space determines social relations. The authors also report Foucault’s post-structuralist ideas of space and medical treatment in which power plays a crucial role. However, the authors do not explain in which context Foucault’s ideas are used in this particular study. The methodology of the research is clearly set out by the authors. They follow the questionnaire laid out by a previous study which is referenced properly in order to interview people who have experienced hospital stay of over 10 days for the management of community-acquired pressure ulcers in 1997 and 1998. The sample was drawn from all such patients in the state in rural and metropolitan hospitals. However, only 15 people were finally chosen, eliminating those with mental illness and those who cannot communicate in English. This, in a way, limits the study since it may be just as likely that pressure ulcers are just as prevalent among non-English speaking marginal communities. A socioeconomic study should have focused on marginal communities in particular. Interviews were conducted with patients as well as their families with regard to the medical history, the physical and social conditions of the patients’ lives, the range of services available to them and perceived barriers to service availability. The research design does not appear to be very rigorous in the analysis. All that the authors have done with the questionnaire survey is to arrange the answers thematically. The results that are reported include various parameters of spatial management in institutional care that act as barriers to management of pressure ulcers. The most important element is, of course, removal of home setting, which imposes a psychological barrier. At home, patients with spinal cord injury could modify the setting so that they could be most comfortable. This was not possible in the institutional setting where they were confined to their rooms, limiting movement. Besides, hospitals aimed at providing service with minimum staff and hence patients were denied of family care as well as professional help. Patients lost their independence and some even their identity as they had to follow hospital norms. Perceived lack of cleanliness and privacy were also found by patients to be hindrances. Some patients even found being disconnected socially as punishment. The study concludes from the questionnaire interviews that spatial practices followed by nurses and healthcare professionals are an important factor in the well-being of the patients. It obviously follows from that there is much room for improvement. However, the research methodology and discussions are not specific with respect to pressure ulcers or to patients of spinal cord injury in particular. The discussion could be equally applicable to all institutionalized patients. In the Foucaultian perspective, the hospital is in a sense the panopticon, in which social behavior is monitored and controlled. This aspect is also ignored except noting that lack of social connectedness and privacy affects the proper management of pressure ulcers although the exact causal relation is not explained. In what Foucault calls 'genealogical', he analyzes history as 'the present time, and of what we are, in this very moment' in order 'to question … what is postulated as self-evident … to dissipate what is familiar and accepted' (Foucault 1988: 265). At the heart of this is lies the analysis of the changes in the nature and execution of power denoting the shift to modern society. In the context of management of pressure ulcers of patients with spinal cord injury, the self-evident relationship between healthcare professionals and the patients could have been analyzed in more details of the social and power settings. This aspect of study is missing from this paper. Works Cited Blackwell Publishing, Journal of Advanced Nursing, http://www.blackwellpublishing.com/aims.asp?ref=0309-2402 Taylor, BJ, Kermode, S and Roberts K L, Research in Nursing and Healthcare, Thomson Learning Nelson, 2006 Foucault, Michel, Politics, Philosophy, Culture: Interviews and Other Writings, 1977-1984, L. Kritzman (ed.), London: Routledge, 1988 Read More