The Knowledge and Understanding of Critical Appraisal of Research - Essay Example

Running Head: Critical Appraisal of Published Papers Critical Appraisal of Published Papers Course Code Name Student Number Tutor Date Critical Appraisal of Published Papers Introduction Through applying a systematic approach to gathering, confirming and building upon information Nursing and other Health Professions can develop a body of knowledge which is fundamental to their practice. This body of knowledge enables these professionals to apply up-to-date relevant evidence to their area of clinical expertise. In order to achieve this Nursing and other Health Professionals must be able to support, participate in, apply and evaluate research findings related within their field (Susman and Evered, 2008). This paper presents a number of evidences in relation to this highlighting the various weaknesses and strengths of such evidences. The paper includes a critical review and appraisal of articles and the relevance of these articles in the day to day clinical practice. The paper demonstrates the knowledge and understanding of critical appraisal of research by showing how to appraise published papers by use of appropriate tools. Finally the paper provides the ability to read and interpret literature in a scholarly manner. The high specialization level in health care practice, explosion of information related to healthy care and high change rate within the clinical practice develops a situation where we have so much information as well as clinical/medical knowledge that requires health practitioners to be aware of all best and current practices and significant research studies (Carr and Kemmis,2007). Discussion A number of approaches have been sought to try and improve health care, but the efforts have failed or yielded partial results and the results vary along the approaches (Titchen and Binnie, 2003). These negative results have led many recommendations by different authors. One of the recommendations was the intervention of research on the targeted health professionals. It is recommended that any intervention in healthcare be investigated through research. Professionals’ involvement in intervention is important in order domesticate the intervention to the local context and incorporate the users perspectives. Qualitative research helps to explore complex- phenomena that are encountered by, health-care providers, clinicians and policy makers in health care. Studies that are poorly designed and inadequate are likely to lead to lack of appropriate application of qualitative-research in decision making, health policy and health care. Qualitative research is need driven and does not focus on pre-intervention and the context analysis. However, only a few researches have considered the pre-intervention stage in order to identify the solution to a health care problem in its context. On another view, not much is known by clinical officers or health experts on how pre-intervention study-results can be integrated into the intervention of healthcare solution itself. Through qualitative research health care professionals are able to integrate the pre-interventions to the intervention of a health care solution itself (Gilmartin and Wright, 2008). Formal research guidelines have been constituted for qualitative research. These will target to develop the quality of research and allow readers to understand better the design, analysis, conduct and findings of all published studies. In order to improve success in research in the health care, there is need for the involvement of the target professionals and the target setting (Ong, 2006). Normally involvement of medical professionals in research and planning is rarely done or it’s done at a limited scope. Various research studies that saw the participation of health professionals have been carried out not only in the United Kingdom but in other parts of the world too. A research project meant for the elderly health care in France was developed; pre-intervention was conducted in order to systematically conduct data on the issues, current practices, healthcare managers and professionals’ expectation in order to find out the defining features for a successful-intervention (Pandit, 2006). The research was conducted between the tear 2004 and 2006 using grounded-theory approach, a purposive sample of 56-healthcare managers and professionals in Paris, France. The evidence was derived from four sources namely; focus groups, documentation, interviews and observation. It was found out the stepwise-approach had three phases and each of the phase provided its specific results. The first part of the pre-intervention data is gathered on perceived issues, practices and expectations from the health-care managers as well as professionals. The second step comprised of holding focus-groups so as to define the characteristics of developing the pre-intervention of the medical care of the elderly. The third step enabled the justification of the findings. Using these steps the research on the elderly care that fulfilled the manager’s and professional’s expectation was easily conducted. This article shows an in-depth pre-intervention research that led to the designing and developing of an interventional relationship with local health-care managers and professionals. This step by step approach provides skillful strategy for to develop a tailored-intervention especially in serious cases like chronic care. This is because it describes the importance of searching the insight of health-care managers and professionals and emphasizes the importance of the intervention of the medical professionals at different levels of establishing the cure of a disease. However, this is not the end of the involvement of the medical staff in research; they are still needed to come up with a thorough understanding of the results of these strategies depending on the last outcomes of the intervention implementation. Though the involvement of health professionals is important as a way of informing their areas of practice, they are always faced with certain difficulties (East and Robinson, 2004). One such difficulty is the limitation of time that mainly arises from their busy schedule. This means that the professionals do not have sufficient time to access any form of research and thus need critical as well as major appraisal skills (Cheek et al, 2005). As a result of this, there arises a need to have modifications in the various approaches to education as a way of emphasizing the development of certain generic skills that will help in accessing information as well as in appraisal within a constantly changing research environment and information (Haynes & Haines, 2008). One such modification and skill could be the use The Web Resource Appraisal Process (WRAP). This process is concerned on how to implement a structured-review process and also aims at providing the basis for well structured searching and an appraisal of those databases that contain research-evidence conducted by the post-graduate students. It is worth noting that WRAP contains rich separate pathways meant for use to any individual have an interest in particular specialty. For instance, students who would wish to carry out research on age-care can decide to choose tutorials in the case where particular attention is focused to dynamic sources of information like professional-discussion groups for aged-care. In addition, more resources have been developed to synthesize and appraise information that is related to age-care services provision-projects. As a result WRAP is used to enable easy access to research and also help in work place innovation considerations. Most of these WRAP projects are short-lived and are in use in local areas and consequently the outcomes of projects that are successful are not communicated to the wide community. WRAP therefore promotes consideration for such small studies while it maintains emphasis on the appraisal. In care for the aged for instance, there is clear need to increase information exchange about projects that are successful, an improvement of dissemination of research findings and sharing of information on the best practice in provision of services (Cheek et al., 2005). Such information sharing provides speed to drive sustainable-changes an improvement on the health -care services for the aged people. When undertaking a research, a researcher starts by developing a research design. For instance the research undertaken in France for the healthcare of the elderly, the pre-invention study had a base on the grounded- theory building approach. This involves developing through an iterative process and based three major basic components; categories, concepts and propositions (Pandit, 2006). According to Pandit, characteristics that define an intervention are called the propositions. The qualitative research was conducted by a three step project lasting for one and half years and that each step had an objective. The first step of the research included recruiting participants for interviews in order to determine their perceived issues, current practices and the expectations on the elderly care. This was followed by analyzing the contents of the interview. The second step was concerned with holding focus-group discussion of four of the participants in order to refine findings and to define the expected features from the intervention. This was followed by the presentation and analysis of the focus group discussion. The final step was presenting the results to all participants for validation and discussion using a questionnaire that had five Point Likert-scales. The second procedure in research is; research sampling and setting. Using the example of the research conducted in Paris, the sample population was the Paris’ sixteenth borough that has the highest population of old people (75 years and above). Every hospital, social service, community based health facility in the borough had the invitation to participate. Purposive-sampling strategy followed by snowball-sampling was used to select potential participants so as to ensure that there was good representation of health-care managers and professionals who should be major stakeholders in research. In this case fifty eight participants were selected, and contacted, they were asked to participate in an individual face to face interview. All participants made a positive response through verbal consent. The third stage in medical research is data collection. In the case of this research in Paris that focused on data collection, this is done through interviews, observations, focus group and documentation. After the data is collected all focus groups and interviews are recorded and transcribed. These transcripts are produced, coded and read by two researchers and validated by a researcher to make sure that the validity of the coding was adhered to (Street & Robinson, 2005). This process enabled to define the features of the intervention in elderly-care that came to the expectations of the major stakeholders in the health sectors who are the health managers and the professionals. From the research important issues such as the challenges faced in the health care of the elderly were identified. For instance, the participants outlined that health care for older people with multidimensional chronic-conditions was an increasingly complex task (Meyer & Bridges, 2008). The involvement of health care professional in medical research has had a wide range of positive impacts. The involvement of the staff of a medical organization in research has facilitated closer partnership between the users and the staff (Hart and Bond, 2005). According to the authors, a study that focused on the participation of the staff in healthcare research within a ward of teaching hospital in London has proved to ensure closer partnership between users and staff. This study used a variety of methods, observations and documentary analysis to generate data on the perception of health professionals on participation in health care and difficulties face in the change of practice. In the study, professionals expressed positive views about staff and user involvement. According to a study done by Wright and Gilmartin as away ion trying to interpret the experience of patients on day surgery, most patients felt left out before operation while at the same time the nurses lacked awareness on the significance of offering psychological support. It was therefore found crucial to enhance on the importance of offering care that is person-centered as well as emotional support during the surgery. It is from this study that it was found important to have professionals facilitating the person centered care and a continuous care all through the surgery experience (Wright and Gilmartin, 2008). Conclusion From the above discussion it worth to conclude that through applying a systematic approach to gathering, confirming and building upon information Nursing and other Health Professions can develop a body of knowledge which is fundamental to their practice ( Tong, Sainsbury and Craig, 2007). This body of knowledge enables these professionals to apply up-to-date relevant evidence to their area of clinical expertise. In order to achieve this Nursing and other Health Professionals must be able to support, participate in, apply and evaluate research findings related within their field. The discussion presents a number of evidences in relation to this highlighting the various weaknesses and strengths of such evidences. The discussion includes a critical review and appraisal of articles and the relevance of these articles in the day to day clinical practice. A case study of health care for the elderly people in Paris, France has been used to illustrate how research is conducted. The paper demonstrates the knowledge and understanding of critical appraisal of research by showing how to appraise published papers by use of appropriate tools to design research. Finally the paper provides the ability to read and interpret literature in a scholarly manner. References Carr, W. & Kemmis, S. (2006) Becoming critical: education, knowledge and action research. London: Falmer Publisher. Cheek, et al. (2005) Using Education to Promote Research Dissemination in Nursing. International Journal of Nursing, 2 (1): 2-8. East, L.& Robinson, J. (2004) Change in process: bringing about change in health care through action research. J Clin Nurs , 3: 57-61. Gilmartin, J. & Wright, K. (2008) patient perspectives Day surgery: patients’ felt abandoned during the preoperative wait. Journal of Clinical Nursing, 17: 2418– 2425. Hart, E. & Bond, M. (2005) Action Research for Health and Social Care. A Guide to Practice. Buckingham: Open University Press. Haynes, B., & Haines, A. (2008). Getting Research Findings into Practice: Barriers and Bridges to Evidence Based Clinical Practice. British Medical Journal, 317, 273-6. Meyer, J. & Bridges,J. (2008) An action research study into the organisation of care of older people in the accident and emergency department. London: City University. Ong, B. (2006) Rapid appraisal and health policy. London: Chapman Hall. Pandit, N. (2006) The Creation of Theory: A Recent Application of the Grounded Theory Method. The Qualitative Report, 2:1-20. Street, A. & Robinson, A. (2005) Advanced clinical roles: investigating dilemmas and changing practice through action research. J Clin Nurs, 4: 343-357. Susman, G. & Evered, R. (2008). An Assessment of the Scientific Merits of Action research. Administrative Science Quarterly; 23:582-603. Titchen, A. & Binnie, A. (2003) Changing power relationships between nurses: a case study of early changes towards patient-centered nursing. J Clin Nurs, 2: 219- 229. Tong, A. Sainsbury, P. and Craig, J. (2007) Consolidated criteria for reporting qualitative research. International Journal for Quality in Health Care, 19 (6) : 349-357. Read More