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NRS 433V Rough Draft Qualitative Research Critique and Ethical Considerations

NRS 433V Rough Draft Qualitative Research Critique and Ethical Considerations

Assessment Description

In this assignment, you will write a critical appraisal that demonstrates comprehension of two qualitative research studies.

For this assignment, use the nursing practice problem and two qualitative peer-reviewed research articles you identified in Topic 1 (or two new articles based on instructor feedback in Topic 1). In a 1,000-1,250-word essay, summarize two qualitative studies.

Use the “Research Critique Guidelines – Part I” document to organize your essay.

Attachments

NRS-433V-RS-T2-ResearchCritiqueGuid

NRS 433V Rough Draft Qualitative Research Critique and Ethical Considerations

      Cognitive behavioral therapy is a psychotherapeutic approach that has largely been used in the management of mental health problems. The intervention has shown to be effective in the management of mental health problems such as depression, post-traumatic stress disorder and generalized anxiety disorder among others. Cognitive behavioral therapy has also proven effective in improving stress management skills among the vulnerable populations. Despite its efficacy, its use in reducing and enhancing the management of job-related stress in my organization has not been explored. Therefore, the purpose of this paper is to explore qualitative studies that have investigated the use of cognitive behavioral therapy in stress management among nurses. The PICOT question for the project is, in registered nurses working in the emergency department, does the education on cognitive behavioral therapy reduce job stress when compared to no intervention within 8 months?

            As noted above, the focus of the proposed project is on examining the effectiveness of cognitive behavioral interventions in reducing job-related stress among nurses working in the emergency department. The qualitative studies by Asplund et al., (2019) and Terp et al., (2019) have been selected for this analysis. The study by Terp et al., (2019) explored the experiences of nursing students with cognitive behavioral therapy-based stress management intervention. The problem that necessitated the need for this study was the fact that most of the studies about stressors in nursing are quantitative in nature. A gap in qualitative studies that investigate the subjective experiences of nurses and nursing students with stress and stress management exists. As a result, the authors aimed at bridging the gap to inform nursing practice. The importance of this study to nursing is that nurses can use it to develop, implement and evaluate interventions that are utilized to improve the management of stress by nurses and nursing students. The research question was note explicitly stated in this study. However, it can be inferred to have been, what are the experiences of nursing students with cognitive behavioral therapy-based stress management intervention?

The purpose of the study by Asplund et al., (2019) was to capture the experiences of participants with an internet delivered and work-focused cognitive behavioral therapy for stress management. The need for this study was informed by the fact that no study has explored the experiences of workers with internet-delivered treatments that focus on stress and work situation. The importance of this study to nursing is that it will inform the interventions that will be utilized in nursing to improve the experiences of nurses with stress management. The treatment also informs the utilization of technology in stress management with cognitive behavioral interventions. The research question was not stated explicitly. However it can be inferred to have been, what is the experience of the participants with an internet delivered and work-focused cognitive behavioral therapy for stress management?

How they Support the Clinical Issue

            The selected articles will be used to answer the PICOT question in a number of ways. The article by Terp et al., (2019) will be

NRS 433V Rough Draft Qualitative Research Critique and Ethical Considerations
NRS 433V Rough Draft Qualitative Research Critique and Ethical Considerations

used to show that cognitive behavioral interventions are effective in reducing the stress levels among nurses. The study will also be used to demonstrate the feasibility and acceptance level of the intervention. The study by Asplund et al., (2019) will be used to show that cognitive behavioral interventions strengthen the development of effective coping knowledge and skills by the nurses. It will also be used to show the wider acceptability of the intervention in stress management.

The interventions in the selected studies are similar to the proposed intervention for the project. The interventions largely focused on the use of cognitive behavioral therapy for stress management. The study by (Asplund et al., 2019) however focused on the internet delivered cognitive based interventions. The other difference is that the study by Terp et al., (2019) used nursing students while that by Asplund et al., (2019) utilized a mix of workers, including nurses. Despite the differences, the study is effective in showing the effectiveness of cognitive behavioral interventions in stress management among nurses.

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Methods

            The study by Terp et al., (2019) utilized a descriptive qualitative study design. Semi-structured interviews were conducted with data analysis done using inductive content analysis. The study by Asplund et al., (2019) was a qualitative follow-up of a randomized controlled trial that examined the experiences of the participants with work-focused and internet-based cognitive behavioral treatment for stress. The participants was selected using criterion-based sampling with data collected using semi-structured interviews and thematic analysis used in analyzing the obtained data. The descriptive qualitative study design is associated with the advantage of ensuring the transparency of the interpretations of the researchers. It is however associated with the disadvantage of verifying the truthfulness of the information that the participants give. The advantage of the follow-up of randomized controlled trial is that it confirms the results obtained in the quantitative study. It however has the disadvantage of recall bias and challenge of verifying the accuracy of the information given by the participants.

Results

            The study by Terp et al., (2019) showed that cognitive behavioral stress management intervention was associated with significant benefits to the participants. The benefits could be seen from themes that included participants being more in touch with reality, increase in their self-confidence, improvement in communication skills, and providing them with a new way of reflecting. The study by Asplund et al., (2019) showed that the intervention was associated with positive effects on the mental health and wellbeing in both work and life of the participants. The implications of the findings of the articles are that cognitive behavioral interventions are effective in stress management in nursing. Nurses should explore the ways in which the interventions can be used to optimize on their health outcomes. Nurses should also advocate the adoption of the interventions to ensure that their mental health needs are met.

Ethical Considerations

            One of the ethical considerations in research is informed consent. Informed consent should be obtained from the study participants. Informed consent symbolizes the protection of rights of the participants. It also ensures that their autonomy is maintained. The other ethical principle is ensuring data integrity. The privacy and confidentiality of data of the participants should be protected in a research. The data should be kept away from access by third parties. The identity of the participants should also be kept anonymous (Roth & Unger, 2018). The researchers in the two articles took the above ethical considerations into account in their researches. They obtained informed consent from the participants prior to seeking information from them. The participants were informed about the need and importance of their participation in the research. The other way in which they took into account the ethical considerations is that they kept the identity of the participants anonymous. They assigned codes to the participants, thereby, making it hard to identify the participants with the information they gave.

Conclusion

The reviewed qualitative studies have demonstrated that cognitive behavioral therapy is an effective treatment strategy that can be used to minimize and enhance stress management among nurses. Cognitive behavioral strategies promote the development of effective coping skills among the nurses. The use of cognitive behavioral therapy interventions are feasible in clinical settings. However, it is important that ethics of research be considered in undertaking investigations on the effectiveness of cognitive behavioral therapy in stress management among nurses.

References

Asplund, R. P., Jäderlind, A., Björk, I. H., Ljótsson, B., Carlbring, P., & Andersson, G. (2019). Experiences of internet-delivered and work-focused cognitive behavioral therapy for stress: A qualitative study. Internet Interventions, 18, 100282. https://doi.org/10.1016/j.invent.2019.100282

Roth, W.-M., & Unger, H. von. (2018). Current Perspectives on Research Ethics in Qualitative Research. Forum Qualitative Sozialforschung / Forum: Qualitative Social Research, 19(3), Article 3. https://doi.org/10.17169/fqs-19.3.3155

Terp, U., Bisholt, B., & Hjärthag, F. (2019). Not Just Tools to Handle It: A Qualitative Study of Nursing Students’ Experiences From Participating in a Cognitive Behavioral Stress Management Intervention. Health Education & Behavior: The Official Publication of the Society for Public Health Education, 46(6), 922–929. https://doi.org/10.1177/1090198119865319

Qualitative research is important in the provision of relevant information for a number of reasons. Firstly, qualitative research often provides a more detailed and nuanced picture than quantitative research. This is because qualitative methods tend to uncover peoples’ opinions, motivations, and emotions – giving us a greater understanding of why people do what they do. Secondly, qualitative research is often conducted with smaller samples than quantitative research. This allows for a more in-depth exploration of the issue at hand, as opposed to a broad overview provided by quantitative methods. Finally, qualitative methods are typically more flexible than their quantitative counterparts. This means that they can be adapted to changing circumstances and new information – allowing us to get the most accurate picture possible. The two qualitative articles considered for the study include: Article I, “Missed infection control care and healthcare associated infections” by Bail et al., (2021), and Article II, “Challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings” by Lowe et al., (2021). The purpose of this assignment is to analyze qualitative article I and II including summary, study design, results of the studies, and the ethical considerations.

Qualitative Studies

Background of Study

Qualitative article I found that missed infection control care and healthcare associated infections are a significant problem in hospitals across the United States. The study’s main problem was that gaps in infection control care were leading to increased rates of healthcare associated infections. The purpose of the study was to identify those gaps and to develop interventions to address them. The objective was to reduce the incidence of healthcare associated infections by 50%.To achieve this objective, the researchers conducted a survey of hospital infection control practices nationwide. They then used the data from the survey to create a toolkit designed to help hospitals improve their infection control care.

This article is important to nursing because it discusses missed infection control care and how this can lead to healthcare associated infections. The authors point out that errors in infection control are often made due to nurse fatigue and lack of oversight. They suggest that more research is needed in this area to find ways to improve infection control in order to reduce the incidence of healthcare associated infections. This article is significant to the research quest because it identifies a potential area of improvement for nursing care. The main research question in this article is: How does nurses perceive missed infection control in healthcare settings?

Qualitative article II found that infection prevention and control (IPC) is a critical issue for healthcare facilities in conflict-affected settings. Due to the increased risk of transmission of communicable diseases, IPC measures are essential to protect patients, staff, and visitors from infection. However, hospitals in conflict-affected settings face numerous challenges in implementing effective IPC measures. The purpose of this article is to summarize the key challenges and opportunities for IPC in hospitals in conflict-affected settings. The objective is to facilitate a better understanding of the unique context within which IPC must be implemented in these settings, and to identify potential solutions that can improve IPC practices. The main problem in many conflict-affected settings is the lack of basic infrastructure and supplies necessary for effective infection prevention and control (IPC). Without functioning water and sanitation systems, it is difficult to prevent the spread of bacteria and other pathogens. And without proper healthcare supplies, such as gloves, masks, and disinfectants, nurses are often unable to properly clean and disinfect hospital wards and equipment. The main research question is: What are some of the challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings?

How the Two Articles Support the Nurse Practice Issue

There are two main ways that the articles can be used to address the issue of using a daily chlorhexidine bath to prevent acquisition of methicillin-resistant Staphylococcus aureus (MRSA). First, the articles can be used to support the efficacy of chlorhexidine baths in preventing MRSA acquisition. This is particularly relevant given that some experts have questioned the effectiveness of chlorhexidine in preventing MRSA infections. Second, the articles can be used to provide evidence-based recommendations for how best to implement chlorhexidine baths in order to maximize their ability to prevent MRSA infections. The information provided by these two articles is therefore critical in addressing different aspects of the PICOT question.

There are a few key ways in which the interventions and comparison groups in these articles compare. First, as noted in the PICOT question, chlorhexidine is applied via baths, whereas the control group does not receive this intervention. Second, the patients in the study are divided into two groups: those who receive daily chlorhexidine baths and those who do not. This allows for a direct comparison of the effects of this intervention. Finally, as mentioned in the PICOT question, the primary outcome being measured is incidence of bloodstream infection (BSI). This is an important objective measure that allows for a clear understanding of whether or not chlorhexidine bath prevention is effective.

Method of Study

For article I, authors used a retrospective observational study design to examine the relationship between missed infection control care and healthcare associated infections. In their study, they looked at data from 454 ICUs in England between January 2013 and December 2015, and found that there was a positive association between missed infection control care and healthcare associated infections. For qualitative article II, the study was conducted using a qualitative methodology, with interviews being the primary data collection method.

There was the use of retrospective observational study design in article I. One benefit of retrospective observational study design is that it is less expensive and time consuming than other types of study designs. A limitation of retrospective observational study design is that it can be difficult to accurately recall information about past events. For article II, one benefit of qualitative methodology with interviews is that the researcher can obtain rich and in-depth data from participants. This allows for a greater understanding of the phenomenon being studied. Additionally, the interviewer can build rapport with participants, fostering an open and honest exchange of information. A limitation of qualitative methodology with interviews is that it can be difficult to generalize findings to a wider population. Additionally, because interviews are time-consuming and resource-intensive, they may not be feasible for every research project.

Results of Study

From the article I, it is clear that missed infection control care and healthcare associated infections are major problems in the healthcare industry. There are a number of factors that contribute to this problem, including understaffing, lack of resources, and insufficient training (Bail et al., 2021). The article also found that, both at the organizational and individual clinician levels, infection control care is neglected. Neither standard safeguards nor fundamental caregiving tasks were performed, according to nurses.

Qualitative study II found that there are a number of challenges to infection prevention and control in these types of settings. These include: insecurity and Violence, which can make it difficult to access healthcare facilities; population movement, which can increase the risk of transmission; economic hardship, which can lead to patients skipping treatment or not being able to afford necessary medications; and a lack of trained personnel, which can make it difficult to provide sufficient care (Lowe et al., 2021). The two articles are different in terms of study methodology that have been applied.

There are a few implications of the two studies on healthcare acquired infection and prevention in nursing practice. First, it is clear that healthcare acquired infections are a serious problem in the hospital setting. Patients who contract these infections are at risk for serious complications, including death. Second, both studies underscore the importance of infection control measures in preventing the spread of these infections. Nurses play a vital role in infection control, and it is important for them to be up-to-date on the latest evidence regarding best practices. Finally, the studies highlight the need for more research on this issue. As healthcare providers strive to provide quality care and keep patients safe, it is critical that we continue to learn more about how to prevent healthcare acquired infections.

Ethical Considerations

When conducting research, it is important to consider two main ethical considerations: informed consent and protecting participants from harm. Informed consent means that participants must be given information about the study before they decide whether or not to participate. This includes information about the purpose of the research, what will happen during the study, and any potential risks or benefits. Participants should also be informed that they are free to withdraw from the study at any time. Protecting participants from harm is also important. Researchers must take steps to ensure that participants will not be harmed physically or emotionally as a result of taking part in the study. This may include ensuring that there are no physical risks involved and providing psychological support if needed.

The researchers in the two articles applied informed consent in different ways. In the first article, the researcher obtained informed consent from all of the participants before they took part in the study (Barbosa & Milan, 2019). This ensured that all of the participants were aware of the risks and benefits associated with participating in the study. In addition, the researcher also took measures to protect the participants from potential harms by ensuring that they were not exposed to any unnecessary risks and by providing them with support if they experienced any negative consequences as a result of taking part in the study.

Conclusion

Qualitative article I found that missed infection control care and healthcare associated infections are a significant problem in hospitals across the United States. Qualitative article II found that infection prevention and control (IPC) is a critical issue for healthcare facilities in conflict-affected settings. Due to the increased risk of transmission of communicable diseases, IPC measures are essential to protect patients, staff, and visitors from infection. The two articles are important in addressing different aspects of the PICOT question, they provide insightful information that are critical in understanding infection control in healthcare.

 

 

 

 

 

 

 

 

 

References

Bail, K., Willis, E., Henderson, J., Blackman, I., Verrall, C., & Roderick, A. (2021). Missed infection control care and healthcare associated infections: A qualitative study. Collegian, 28(4), 393-399. https://doi.org/10.1111/jan.14909

Barbosa, S., & Milan, S. (2019). Do not harm in private chat apps: Ethical issues for research on and with WhatsApp. Westminster Papers in Communication and Culture14(1). https://doi.org/10.16997/wpcc.313

Lowe, H., Woodd, S., Lange, I. L., Janjanin, S., Barnett, J., & Graham, W. (2021). Challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings: a qualitative study. Conflict and Health, 15(1), 1-10. https://conflictandhealth.biomedcentral.com/articles/10.1186/s13031-021-00428-8