Comparing and Contrasting Published Nursing Document - Literature review Example

Comparing and contrasting published nursing research articles xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Name xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Institution xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Tutor xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Date Comparing and Contrasting Published Nursing Research Articles There is increasing demand for effectiveness in the clinical setting as the political climate changes. This demands that nurses engage in EBP (evidence based practice) to enhance success rate in interventions implemented (Parahoo 2006). Research is unavoidable and more emphasis has been placed on the effectiveness of research methods applied in order to eliminate bias and enhance the accuracy and precision of the results attained. This paper compares two research articles drawing their similarities and difference. Strengths and weaknesses of the research designs and methodologies used in the two articles The research method applied in any research highly determines the accuracy of the results obtained. Though Nursing research is bound to face many ethical issues since one is dealing with the life of human beings, there is need to establish accurate and precise results from which a firm conclusion can be draw. In the study on Dietary and fluid compliance: an educational intervention for patients having haemodialysis, the design applied is randomized trial. One advantage of this design is that the reliable quantitative data is collected which can be used to draw conclusions. The fact the samples were randomly placed in the two groups eliminates some biases that come with sample selection (Cook, 1985). This is because randomization ensures an equal chance for each sample to be included in any group. The exercise of control through the application of random sampling and a well defined inclusion and exclusion criteria ensures that the conclusions made are not in erroneous. As a result, firm conclusions can be made in reference to the results obtained. The results obtained and conclusions drawn can be generalized to a wider population as the method increases the internal validity. One of the limitations of this research method is that if the samples are not willing to be in a particular group, they may not respond positively to the intervention hence limiting the extent to which the study was representative. The fact that those to be involved in the research had to be informed so as to get their consent may result to some refusing to be involved. According to Torgersonn and Sibbald (1998), this limits the extent to which obtained data can be generalized. This research method does not consider the uniqueness of individuals with regard to social, psychological and physical traits (Cook, 1985). For instance, a person who does not easily and comfortably intermingle with others may be included in the group learning through group discussions. Though willing to participate in the study, this person may not learn much since she or he is not comfortable. In the same way, a person who has a low concentration span may be in the group learning through watching the video while in real sense this person would have learnt more in the group discussions. This method also limits a group of people with various disabilities such as the blind. This does not however mean that the blind do face same challenges as those who can see. In this regard, results obtained cannot be generalized to a wide population that includes people with disability. The assumption that every one in need of learning does not have any other challenge apart from dietary fluid compliance is biased. This means that the results obtained are also biased. In addition, patients may fail to comply not because the teaching method applied was ineffective, but because they are not ready to embrace change. This means that the comparison between the two methods may not be precise and accurate since the results obtained may be as a result of other factors (Parahoo 2006). Another weakness of the methodology applied is that there was no monitoring done in the process and one may have gotten sick and the results indicate that this is as a result of the sickness and not no-compliance. The results obtained in this case cannot stand if scrutiny through the use of rigorous statistical methods. Many factors may have affected the results including the possibility of one group being more motivated or intelligent that the other group. This means that the method used may have been very effective but failed due to the fact the group members comprised of less intelligent persons. In addition, the results obtained in this method are not enough to come up with firm conclusion. For instance, though there was an improvement of in the observed calcium levels in the group taught through the use of video, this is not enough evidence that the increase was as a result of the knowledge or information obtained din the video class. This is despite the increase in statistical significance after education. Another disadvantage of this method is that results were assessed after two moths thus limiting the assessment of after how long an education program is effective in adaptation of new behavioral habits. Though teaching has been found to be effective in impacting compliance in patients, its effectiveness may be dependant on the length of time it is practiced (Cook, 1985). The results may thus fail the test of precision and accuracy since other individuals may try to implement teaching as a mode of enabling compliance but fail if it is short term. The application of quasi-experimental, one-group design in assessing fluid compliance among patients having haemodialysis has the disadvantage of having unnatural circumstances as the people involved act differently due to the awareness that they are being observed. In this case, the samples are informed of the research and may act differently from the way they do in real life thus impacting on the final results. Measurements were taken before and after the dialysis for each session attended, this kind of monitoring is very useful as it helps in discovering the rate at which change is being adopted. It is easier to place people in one group since there is no randomization involved. Continuous testing makes it possible to determine the extent to which change has taken place (Cook and Campbell 1979). In this case, it is the extent to which clients have complied after engaging in learning. However, this method is time consuming as patients have to be tested before and after every dialysis. In addition, the patients involved in the research must be informed of the purpose of the research for them to accept to be involved in the research. Randomization is not possible in this case and thus application of quasi experimental design enables establishment of trends. This method does not however take into consideration the factors that existed before the condition came about. i.e., it does not consider the reasons for non compliance other than lack of information on the importance of compliance. Data Collection and Analysis Weaknesses and Strengths of Data Collection The data collection methods involved the collection of scientific information such measurements of Blood Urea Nitrogen (BUM), uric acid, creatinine, albumin, phosphate, calcium, sodium and serum potassium. In both articles, these measurements were taken following scientific procedure and were necessary for drawing statistical comparisons to determine change. This data is also analyzed following scientific procedures hence increasing its accuracy (Parahoo 2006). One of the strength evident in both articles is that in both researches, the samples were asked to sign the informed consent form before being engaged in the research. This solved the ethical problem of extracting information without due knowledge of the person being involved. However, thus can have a negative impact in that the samples may put up a show and thus manipulating the results. In the Journal on Fluid Compliance among Patients Having Haemodialysis quasi-experimental design is applied. The data is collected through repeated measures making it more sensitive in determining existing statistical difference. In addition, the subjected needed to come up with scientific findings are few. In the research, 26 samples are used and these are enough for this kind of research. If another method was to be applied, the sample size would have been considered to be too small. The main disadvantage of this method is that it is very tiring as the nurse involved has to take 56 tests every time the samples come for dialysis (i.e. two tests per person per dialysis session held). The data collected included information on any other medical condition that the samples has as this would have interfered with the intervention. Social demographic information was very important in eliminating any bias in data collection (Cook, 1985). Data was also collected after the intervention during the follow-up sessions. This is important as it makes it possible to observe individuals in their natural settings. Patients are likely to comply when they are aware of some one observing them but may change when they are aware that no one is observing them any more. There was a weakness in data collection regarding both researches since there was no any control group used. As a result, precision and accuracy of results obtained is questionable since it is possible that the results obtained would have been influenced by other factors rather than the education program. The data obtained in both researches was analyzed using SPSS and the difference in fluid compliance in relation to gender was determined. This information is important in explaining why some patients comply more easily than others. In the journal on dietary and fluid compliance, data is collected and assessed for the two months. This makes it hard to determine the impact of the length a teaching program implemented on compliance of patients to diet and fluid restriction. In addition, there was no information collected on the knowledge that the patients already had. Both articles agree that educating patient directly impacts on the patient’s compliance to a diet or fluid restriction. However, these results are questionable since none of the research had a control group. This means that the results could have been influenced by other factors rather than the education programs (Polit & Beck 2009). While the research by Baraz et al (2009) indicated that there was no significant relationship between gender and compliance to fluid restriction, Barnett et al (2007) indicated that a significant difference existed explaining that women were more likely to comply with fluid restriction after the education sessions as compared to men. Weaknesses and Strengths of Data Analysis Methods Used In both articles, SPSS was used to analyzed data where by statistical procedures were followed. However, different commands were used since the methods of data collection were different and the information required to draw conclusions was different. For instance, on the article on Dietary and fluid compliance, the command on compare means was used since there was need to compare the effectiveness of the teaching methods while else in the article Barnet et al (2007) there is nothing to compare. Analyzing if the results supported or refuted the aims of the study Results obtained in the research by Baraz et al (2009) supported the aims of the study which was to determine whether teaching had any impact on compliance behavior. The results indicated that though other factors such as educational level were associated with compliance level, the possibility of complying with the regime was found to be directly proportional to learning. This is indicated by the fact that 63.5% of the people involved in the research were found to be diet compliant after the teaching lessons. The research on fluid compliance among patients having haemodyalysis met the aim for which it was intended. This researched focused on the effectiveness of education in attaining fluid compliance. Though only one group was studied, it was effective in determining how effective education is in enhancing compliance. For instance, the non compliant patients recruited for the research were found to be compliant after the education sessions. In addition, other social demographic factors relating to compliance were also determined. The evidence of change as a result of the education program was indicated by the statistical significance obtained indicating a reduction in IDWG mean. The significance in this case was 2.64. Contribution of the Articles to Nursing Knowledge and Clinical Practice This research was very important in the nursing knowledge and clinical practice because it bring out the importance of teaching patients to enhance compliance to any medication or dietary practice with the aim of speeding up recovery and lowering mortality rate. The research is important as it clearly indicates the role of education in enhancing treatment efficacy (Polit & Beck 2009). Nurses can thus apply this knowledge to improve on the time span taken by a patient to recover from any disease. In addition, the researches identify existing gaps where more research needs to be done in order to improve on the performance in the nursing career. For instance, there is a need for research to be carried out on the impact of a longer learning period and cultural issues that impact on compliance in any form of treatment. Bibliography Baraz, S, Parvardeh, S, Mohammadi, E, & Broumand, B, 2009, Dietary and fluid compliance, an educational intervention for patients having haemodialysis, journal of advanced nursing, 10, July, 2009. Barnett, T, Yoong, T, Pinikahana, J, & Si-Yen, T, 2007, Fluid compliance among patients having haemodialysis, can an educational programme make a difference? Jan original research, 12 October, 2007. Cook, D, 1985, "Postpositivist critical multiplism. In R. L. Schotland and M.M. Mark (eds.) Social science and social policy. Beverly Hills, CA: Sage, pp. 21-62. Cook, D, and Campbell, T, 1979, Quasi-experimentation: Design and analysis for field settings. Boston, MA: Houghton Mifflin. Parahoo, K, Nursing Research, 2006, Principles, Process and Issues 2nd edition, London, Palgrave Macmillan. Polit, D, and Beck, C, 2009, Essentials of Nursing Research: Appraising Evidence for Nursing Practice, Philadelphia, Lippincott Williams and Wilkins. Torgerson, J, & Sibbald, B, (1998) What is a patient preference trial? British Medical Journal 316: 360. Read More