Quantitative Study: Kuhlenschmidt et al. (2016).
Section 1
Background
The article has an elaborate introduction that covers a substantive portion of the entire paper and defines the problem being investigated as well as the purpose of the paper itself. The problem is defined as the common occurrence of falls amongst hospitalized cancer patients. These falls not only cause anxiety among the patients and their loved ones but also lead to injuries that result in expensive extra treatment. The hypothesis on which the research is based is that these falls can be extenuated if better training on awareness of falling risks is given to patients. This would make more patients aware of their propensity for falling, thus making them much more careful and by extension reducing the occurrence and severity of falls. It is to ascertain this fact that the research was carried out.
Review of Literature
The authors relied on tens of sources, both primary and academic to evaluate the problem, justify their methodology as well as the basis of the study. Based on the literature used and cited, 3.34 falls per 1,000 patient care days happen in average. Out of this, the anticipated stay at the hospital is sometimes elongated, the cost of treatment increased and positive outcomes diminished. On a more specific perspective, the literature review then zeroes in on the Seidman Cancer Center to assess the impact of the fall. It showed that 8 out of the 24 reported falls had actually led to further injury, a substantive percentage. This statistics not only justified the research but also reflected its significance to nursing and care.
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Discussion of Methodology
The methodology is outlined, discussed and elaborated in a straightforward manner. 91 patients were selected from a bone marrow transplant center, 44 of whom were placed in the intervention group and 47 in the control group. The difference between the two groups will be an additional rigorous training on the problem of falls in the hospital, its risk, and consequences on the intervention group. The control group, on the other hand, will get the normal sensitization on falls that patients at the institution face. The assessment made will be based on the awareness of the patients about the risk of falls at the hospital and whether they intend to take extra steps to extenuate on these falls. All other factors would be kept at a constant.
Data Analysis
The data analysis systems include Wilcoxon, chi-square, and Fisher’s exact tests used to determine the informational and perceptional differences between the two groups. The general idea behind the data analysis system as defined in the article was to establish if the group that got more information about the falls would be more alert about the subject and, therefore, less likely to fall. This would be based on an analysis of survey volunteered by the patients.
Researchers’ Conclusion
The conclusion given by the authors is quite elaborate and fully addresses the hypothesis on which the research is based. It follows an extensive discussion that clearly draws the roadmap on how the conclusion itself was arrived at based on the results of the research. This conclusion is that a higher level of training, information, and sensitization on the subject of hospital falls will lead to an exponentially higher level of understanding and awareness of the risks and consequences of falling. This understanding and awareness will lead the patients to be more careful, thus reducing the propensity for falling and the consequences thereto.
Section 2: Justification of the Conclusion
As per the research, every patient at the hospital receives some form of sensitization, information, and training about the subject of falls. Yet an inordinately high number of falls do happen and with devastating consequences for the patients and their loved ones. The patients who were exposed to additional training and information showed a higher awareness of the problem. The patients who only got the normal training had a mundane understanding of the subject and, therefore, faced a higher risk. Clearly, a higher level of training enhanced the awareness of the patients and this made them more careful thus less at risk. The conclusion made by the researchers is, therefore, justified.
Section 3: Protection of Human Subjects and Data Cultural Considerations
The particulars and identities of the patients who participated in the study were absolutely omitted from the published article. This protects their privacy since they came into the study based on their having a particular health problem that needed a bone marrow transplant. Further, entry into the study was voluntary and based on an informed consent of each patient. Finally and from a cultural perspective, demographic information was collected and used in the study but their particulars were not divulged in the study.
Section 4: Strengths and Limitations of the Studies
The validity and reliability of the study are greatly enhanced by the research method used. This method was simple and straightforward without manifest ambiguities. Anyone studying the article would, therefore, be able to connect the problem being researched on with the results realized. However, the research scope was wide, based on all cancer patients but the sample used was narrow as it involved only cancer patients who need a bone marrow transplant. This may not be reflective of all cancer patients generally. Finally, the study is based on information and may have been affected by the information given as part of the informed consent process.
Section 5: How the Evidence Informs Nursing Practice
An important part of caregiving, one of the most important aspects of nursing is patient protection. This research entails protecting patients from falling while in the care of nurses. Whereas nurses may take all the necessary precautions, this study reveals that the patient also has an active role to play. By properly training the patients, nurses can mitigate the problem.
Qualitative Study: Arnold et al. (2017).
Section 1
Background
The background information as given by the authors is elaborate yet concise and seeks to explain why the study was essentially necessary. It begins by stating a well-known fact that the use of antiretroviral therapy has been known to be very effective in mitigating the adverse effects of HIV/AIDS. Yet, the authors pose that it beats logic why, despite the fact that antiretroviral drugs can create the difference between life and death, a segment of patients decline or neglect to use them. The specific group referred to is the men who have sex with men and women (BMSMW). The purpose of the research is then introduced as seeking to establish what social and/or economic grounds would cause the BMSMW not to take antiretroviral drugs even when HIV positive.
Review of Literature
The article reviews a total of 32 other articles when establishing the grounds of the study, qualifying the research methodology, and also discussing the results so as to arrive at the conclusion. The selection of the specific target group of BMSMW in America as well as basing the research on economic and social factors are defined. Further, literature is used to confirm that antiretroviral therapy helps HIV patients and to outline that this fact is well known, more so to HIV patients. This enables the researchers to arrive at the question of why then the BMSMW HIV patients will ignore such help, yet it is readily available. Finally, the discussion leading to the conclusions indicated also follows a careful evaluation of relevant literature.
Discussion of Methodology
As with all qualitative research, there are no active numbers on which to base the results, thus leaving the bulk of the work to the method used to collect data as well as the analysis thereof. The data collection method is outlined elaborately. Indeed, the research team conducted actual interviews on HIV patients who have sex with both men and women. They relied on the Bruthas Project which has been running similar projects. As per the defined method, a large sample was collected through which as a smaller accurate sample of HIV positive men who are BMSMW was arrived at. In exchange for a pecuniary token, the men were interviewed by a well-trained panel and the results of the interview recorded verbatim.
Data Analysis
The researchers were very precise in defining their data analysis method. This is the proprietary Dedoose cloud-based analytic program. A code for the data collected in the interview was developed and the data was coded. The top researchers then tested the code to ensure veracity. The data was then analyzed using the aforementioned technology.
Researchers’ Conclusion
The researchers’ conclusion is arrived at upon a careful analysis of the data as well as elaborate discussion. Poverty was mainly blamed as the reason why the specific target group was not getting proper access to antiretroviral drugs. As men, they find their situation embarrassing which inhibits the development of a good relationship with healthcare providers. Other poverty based standards such as lack of a designated residence were indicated. The research challenged healthcare institutions to not just provide medication but seek to improve the socioeconomic status of the target group as this was a bearing factor on whether or not they access the provided mediation.
Section 2: Justification of the Conclusion
The researchers actually spoke to the affected parties themselves that is BMSMW HIV patients. These men indicated an awareness of their status as well as awareness of an awareness of how much help they can get from antiretroviral drugs. However, they were unable to access the same as they were too busy seeking for more urgent basic needs such as food, clothing, and shelter. Had these needs been met, they might have been more consistent in taking their medication. Further, these men indicated shyness based on their unfortunate situation which made them unable to relate properly to mainstream society. The conclusion that socioeconomic issues are the hindrance to these men’s access to retroviral drugs is, therefore, accurate.
Section 3: Protection of Human Subjects and Data Cultural Considerations
The researchers had actual contact with the subject group as they conducted actual interviews. Yet, a careful perusal of the journal article does not leave any clues at all about the identity of these individuals. This reveals that from the questions asked to the handling of the data, steps were taken to ensure absolute privacy. The cultural consideration relating to the sample target being BMSMW was revealed as it was material to the research but their identities were protected.
Section 4: Strengths and Weaknesses
The research entails the sensitive subjects of HIV/AIDS as well as BMSMW. These are issues that individuals involved will find hard to share about. The hallmark of the study lies in the fact that these individuals actually accepted to give interviews to the researchers. Getting information directly from the affected parties enhances the validity and the reliability of the research. The most complex part in qualitative research is data analysis. The other strength of the research is the use of advanced software to conduct data analysis. Among the main limitation of the interview is the minute size of the sample group.
Section 5: How the Evidence Informs Nursing Practice
As aforementioned, the administration of drugs is mainly a nursing obligation. The nursing profession can be said to have failed when people die because of an ailment for which a viable medication has been developed and availed. Through the instant research, nurses can understand why an important patient segment is unable to approach them for necessary drugs. An understanding of the problem can help initiation of research in how to solve it.
References
Arnold, E. A., Weeks, J., Benjamin, M., Stewart, W. R., Pollack, L. M., Kegeles, S. M., & Operario, D. (2017). Identifying social and economic barriers to regular care and treatment for Black men who have sex with men and women (BMSMW) and who are living with HIV: a qualitative study from the Bruthas cohort. BMC Health Serv Res , 17, doi 10.1186/s12913-017-2011-z
Kuhlenschmidt, M. L., Reeber, C., Wallace, C., Chen, Y., Barnholtz-Sloan, J., & Mazanec, S. R. (2016). Tailoring Education to Perceived Fall Risk in Hospitalized Patients With Cancer: A Randomized, Controlled Trial. Clinical journal of oncology nursing , 20 (1)
