The article Long-term outcomes and health care utilization after prolonged mechanical ventilation evaluates the relationship between the outcomes of prolonged mechanical ventilation (PMV) in an intensive care unit (ICU) and the associated mortality, healthcare costs after critical illness, and healthcare utilization. The paper examines this topic of interest due to the projected increase in patients admitted to ICUs as a result of the aging of a vast population. The study also seeks to identify the factors that cause mortality following weaning of patients from mechanical ventilation. The study utilized a quantitative research approach whereby data was collected from health administrative databases in North America such as the Discharge Abstract Database (DAD) of the Canadian Institute of Health Information, the National Ambulatory Care Reporting System, the Ontario Health Insurance Plan, and the Ontario Registered Persons databases (Hill et al., 2017). The analysis involved a population cohort of patients receiving PMV in the larger Ontario province of Canada. The data obtained were statistically analyzed using chi-square test, student’s t-test, Kruskal-Wallis test, log-rank test, and multivariate regression models (Hill et al., 2017). The study’s findings indicate that prolonged mechanical ventilation highly correlates with higher mortality, healthcare utilization, and total health costs compared with patients who take shorter periods of time on mechanical ventilation.
The article Person-centered care during prolonged weaning from mechanical ventilation, nurses’ views: An interview study is a study that sought to establish if intensive care unit (ICU) nurses in Swedish hospitals provide person-centered care to patients under prolonged weaning program. The paper also investigates the evidence of barriers to person-centered care for patients who have been under prolonged mechanical ventilation and now undergoing prolonged weaning. This study is founded on the understanding that prolonged weaning is associated with such disadvantages as mortality, longer hospital stays, increased complications, accumulating healthcare costs, and psychological problems such as depression, agitation, etc. (Cederwall et al., 2018). The study employed a qualitative research design where the authors undertake a secondary analysis of interviews conducted on 19 critical care nurses. Qualitative interview data were collected from semi-structured interviews was analyzed critically and thematically and themes deduced. The study found three overlying themes in person-centered care, namely partnership initiation where a person behind the patient is identified, shared decision-making whereby the patient is involved or has control over weaning decisions, and the impact of patient involvement whereby the partnership is safeguarded in a sense that adopts standard routine and strategy as well as addressing the patient’s needs during the weaning process (Cederwall et al., 2018). The study also identifies inadequate nursing resources and a lack of team collaboration as the barriers to person-centered care that would ensure positive short- and long-term weaning outcomes.
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I find the research based on qualitative method easier to understand. I attribute easier understanding to the fact that the research is based on in-depth experiences from nurses that is holistic in a way that does not limit their experiences, hence easy to draw inferences from the data. The unstructured interviews used in qualitative approach are less controlled as opposed to the close-ended, structured interviews utilized by quantitative designs (Blais & Hayes, 2016). In the qualitative research study described above, the theoretical thematic analysis identified patterns from which themes arose “the data may be the transcription of an unstructured interview, and the analysis looks for patterns and themes that come from the narrative data by using an inductive approach” (Blais & Hayes, 2016, p. 189). The quantitative research method, such as the one used in the first study above, is constrained by the statistical analysis wherefrom the findings are summarized, described, and used to test relationships among variables, unlike the qualitative approach that is flexible.
In my own research project, I would first evaluate my research questions so as to determine which research design best suits the question. The choice of a quantitative approach would match a situation where one is conducting a research whose findings have a broader generalizability and applicability, in which case one has to select a sample that is representative of a population of interest “… the researcher needs to select a sample that is representative of the population of interest so that findings from the study are applicable or generalizable to that group” (Blais & Hayes, 2016, p. 190). In a quantitative study, it is easier to determine one’s study strengths and limitations, thus offering an opportunity for future research on the gaps identified (Blais & Hayes, 2016). A qualitative approach would befit a situation where the research question seeks to analyze the qualitative aspect of an issue. It becomes viable if a content analysis is critically performed and inductions reached without bias. Its flexibility should be a source of bias but an in-depth into information which would otherwise be missed. Also, the qualitative approach will be favored where research resources and instruments are inadequate.
References
Blais, K., & Hayes, J. S. (2016). Professional nursing practice: Concepts and perspectives (6th ed.). Boston, MA: Pearson.
Cederwall, C., Olausson, S., Rose, L., Naredi, S., & Ringdal, M. (2018). Person-centred care during prolonged weaning from mechanical ventilation, nurses’ views: an interview study. Intensive and Critical Care Nursing . doi:10.1016/j.iccn.2017.11.004
Hill, A. D., Fowler, R. A., Burns, K. E., Rose, L., Pinto, R. L., & Scales, D. C. (2017). Long-term outcomes and health care utilization after prolonged mechanical ventilation. Annals of the American Thoracic Society , 14 (3), 355-362. doi:10.1513/annalsats.201610-792oc
