NURS 8201 Week 11 Using Qualitative and Quantitative Methods to Inform Evidence-Based Practice

For as long as I can remember, working here in the government hospital that provides a multidisciplinary centered care towards a multicultural population (i.e. Micronesians, Asians, etc.), I can safely say that most nurses are well representing their patient when it comes to homeopathic medication regimens. I have noticed that some patients have asked the nurses and the physicians about the incorporation of homeopathic medications into their regimen and most physicians are not well adapted into accepting into their current practice. In addition, about 50% of the nurse ratios understand the importance of accepting the incorporation of homeopathic medications into their regimen, just as along as it does not complication or provide an adverse reaction with their current plan of care. Overall, I wanted to understand the importance of combining conventional therapies alongside alternative practices to help control uncomfortable symptoms and understand why most healthcare physicians are not susceptive to accepting integrative medicine.

The homeopathic medications are considered alternative or complementary forms of therapy that some patients use. According to Eldridge (2021), homeopathic medicine are considered “like cures” in small amount may provide protection and/or reduce symptoms from their current illness. Some examples of homeopathic medications include the use of multivitamins, over the counter medications, immunity supplements, and the use of essential oils (Micronesian islands). Although, the ideas of implementing these homeopathic medications in their current medical regimen while being treated in an acute care setting can be frowned upon, as a DNP prepared nurse, it is our role to determine what may work best for our patients and would increase medical compliance.

Treatments of chronic diseases has become an enabling a holistic approach and improving the patient to physician relationship of therapy that would assist in chronic disease ailments. However, there is still little studies done on homeopathy in treatment of acute disease; often due to lack of study and a knowledge gap that is responsibility for the inability and fear in treating acute disease processes. I understand how physicians feel about incorporating homeopathic therapy in a fast paced environment that deals with life and death, with little time to act, however, what initially sparked my interest is that a physician that I worked with in the ICU is not opposed to incorporating homeopathic therapies that may help the patient feel comfortable. Also, there is now an increasing dissemination worldwide on various types of complementary and alternative medicine; ones that should and can be used as complementary treatment in all healthcare fields. As a nurses, we often are in the middle or representing our patients on their road to recovery, as long as their believed homeopathic treatments do not interfere with western medicine.

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Appropriate research development in homeopathy and the nature of its existing research evidence needs to be examined objectively and with transparency. One way to approach this study is through a mix method approach. It is a type of research method in which researchers collect and analyze both quantitative and qualitative within the same study. According to Shorten & Smith (2022), mixed methods draw potential strengths on both qualitative and quantitative methods, both allowing to explore diverse perspectives and uncover relationships that exist between the intricate layers of multifaceted research question. This an essential step in the mixed method is the data linkage and integration at an appropriate stage in the research process.

In a mixed method systematic review done by Mathie et.al. (2017), individualized homeopathic treatment versus placebo evaluation of interventions allocated to each participant. Quantitative studies were done using systematic literature of about 533 record search to identify different randomized control trials (RCT) that compared homeopathy with a placebo, for any clinical condition. The qualitative part of the study included two sub groups that included N=75 participants of random data including demographics: gender, age, and medical condition; in a six month trial. This study included 54 different randomized trials of homeopathic medication use and of the 31 continuous trials; none had an effect statistically significantly favoring homeopathy and no trials favored the placebo. In the 23 trials of dichotomous data, about six had an effect statistically significant favoring homeopathy. As a result, all subgroups favored homeopathy as an investment when dealing with their acute or chronic diseases.

Reference(s):

Eldridge, L. (2021). What homeopathic medicine? VeryWell Health. Retrieved from

https://www.verywellhealth.com/homeopathic-medicine-description-2249111

Mathie, R., Ramparasad, N., Legg, L., Clausen, J., Moss, S., Davidson, J…McConnachie, A.

(2017). Randomized, double-blind, placebo-controlled trials of non-individualized homeopathic treatment: Systematic review and meta-analysis. BMC Journal. 6(36). Retrieved from https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-017-0445-3

Shorten, A. & Smith, J. (2022). Mixed methods research: Expanding the evidence base. BMJ

Journals. 20(3). Retrieved from https://ebn.bmj.com/content/20/3/74

The mixed-method encompasses both qualitative and quantitative methods. The mixed-method has become common in recent times due to the growing complexity of nursing (Campbell, Tam-Tham, Dhaliwal, Manns, Hemmelgarn, Sanmartin, & King-Shier, 2017). An example of a mixed-method can be demonstrated by research conducted to determine the stress levels of nurses in a psychiatric ward. The research would first involve a quantitative approach, which will entail the collection of data based on the level of stress of the participants. A 5-point Likert scale could be deployed to measure the level of stress. The data could then be analyzed using quantitative statistical methods such as mean, mode, standard deviation, and t-test to determine whether the stress levels are normal. Once the quantitative study has been completed, a qualitative study could be carried out to assess nurses’ experiences in the psychiatric ward that could result in escalated stress levels. Data could be collected using interviews. The data analysis could involve determining topics and drawing relevant themes (Campbell et al., 2017).

The mixed method has several advantages in research. First, the research can quantify data and further explore other relevant themes that a quantitative study cannot determine. This results in better enrichment of evidence and a comprehensive understanding of the research question (Oliveira, Magalhães, & MisueMatsuda, 2018). The other advantage is that participants can give more details in a mixed-method hence more accurate research. The mixed method also has several limitations. The first limitation is its complexity. The method requires thorough training to ensure researchers conduct the exercise effectively. The other limitation is that it might require more resources. Additional personnel and lengthy research periods could be witnessed in the mixed method compared to the single methods. A multidisciplinary team might also be required to conduct the research. The multidisciplinary team might not be readily available.

References

Campbell, D. J., Tam-Tham, H., Dhaliwal, K. K., Manns, B. J., Hemmelgarn, B. R., Sanmartin, C., & King-Shier, K. (2017). Use of mixed methods research in research on coronary artery disease, diabetes mellitus, and hypertension: a scoping review. Circulation: Cardiovascular Quality and Outcomes, 10(1), e003310.

Oliveira, J. L. C. D., Magalhães, A. M. M. D., & MisueMatsuda, L. (2018). Métodos mistos na pesquisa em enfermagem: possibilidades de aplicação à luz de Creswell. Texto & Contexto-Enfermagem, 27(2).

Integrating homeopathic medicine in the ICU