The task (2000 words) – Essay format

This assignment is designed to help you become critical consumers of evidence based nursing research. For this assignment you are asked to critically evaluate either a quantitative or a qualitative research report.
There are steps you need to follow in this assignment are:
1.     Select an appropriate peer-reviewed original research article within last five years (you may select the topic)
2.     You may choose from either QUANTITATIVE or QUALITATIVE research
3.     You MUST NOT choose literature reviews or systematic reviews or mixed method studies. Do not use the practice article given below to do this part.
4. Critique the article using the guidelines in your textbook (Schneider, Z., Whitehead, D., LoBiondo-Wood, G., & Haber, J. (2013). Nursing and midwifery research: methods and appraisal for evidence – based practice. (4th ed.). Sydney: Elsevier Australia. Chapter 15).

Assessment Criteria
1. Evidence of appropriate interpretation of the assignment task, i.e. demonstrated ability to critique scholarly literature
2. Demonstration of understanding of the terms used in the selected papers
3. Demonstration of engagement with the literature, reading and unit resources;
4. Attention to structure and logical sequencing of information; clearly identified introduction, body and conclusion;
5.     Attention to referencing and acknowledgement of other sources – others’ ideas paraphrased and interpreted rather than directly quoted, correct academic referencing and in-text citation, using APA style
6.     Written expression: Clear, succinct written expression, using correct spelling, grammar, punctuation and syntax (sentence structure).

(Copy of Exemplar HD student paper)

Table of Contents
Introduction…………………………………………………………………………………………………… 1
Title of article ……………………………………………………………………………………………….. 1
Abstract of article ……………………………………………………………………………………………2
Introduction of article ………………………………………………………………………………………3
Method of article………………………………………………………………………………………………4
Results of article……………………………………………………………………………………………….8
Discussion of article ……………………………………………………………………………………….. 8
Conclusion of article ……………………………………………………………………………………….. 9
References of article………………………………………………………………………………………….10
Conclusion …………………………………………………………………………………………………….. 10
References ……………………………………………………………………………………………………… 11
Marking Rubric ………………………………………………………………………………………………..12

A CRITIQUE OF THE LITERATURE – ASSSIGNMENT TWO
Health care professionals are required to critique the literature in order to assess the strengths and weaknesses of research, so that patients receive assessment and treatment based on the best evidence available (Richardson – Tench 2011). As a student nurse critiquing the literature is necessary to evaluate the quality of research, and develop critical thinking skills in order to apply knowledge and draw conclusions about the legitimacy of research (Benner, Hughes, & Sutner, 2008). According to Richardson-Tench (2011), when critiquing a research study it is necessary to assess both the general quality of the article as well as the quality of the research undertaken. This includes the significance of the findings, the methods used, whether the design was appropriate, and identification of logical links between the purpose, the findings and any conclusions drawn (Richardson-Tench 2011). This paper will involve the critiquing of a peer- reviewed quantitative research study by Liu et al. (2008) using a systematic framework provided by Richardson-Tench (2011).

Title

According to Caldwell, Henshaw and Taylor (2010) the title of a research study should be succinct and indicate the focus of the study. The title of the research paper by Liu et al. (2008) is concise and informative, and includes the topic of the research and the target population.

Abstract

According to Richardson-Tench (2011) abstracts should provide an overall summary and need to be concise. The article by Liu et al. (2008) includes a very concise and easy to read abstract. The use of sub- headings makes it easy to find information and it provides a very good summary of the content, method and findings of the study, including the relevance of the article to clinical practice, which is important when deciding whether the article is worth reading (Caldwell, Henshaw & Taylor 2010).

Introduction

The introduction of the article by Liu et al. (2008) provides context for the research study and moves from broad concepts, such as kidney transplantation as an optimal treatment for end stage renal disease, to more specific ideas such as the impact of variables such as an individuals demographic on health related quality of life (HRQOL) after kidney transplantation. The introduction of the article by Liu et al. (2008) provides a rationale for the need to do the research due to inconsistencies in previous studies, and according to Richardson-Tench (2011) this is necessary to provide background information on why the research is worthwhile. Also described in the article is how the research could be used clinically to improve HRQOL after kidney transplantation (Liu et al. 2008). As described by Richardsen-Tench (2011) the research answers the ‘so what’ question.

Literature Review

According to Richardson-Tench (2011) characteristics of a good literature
review include identification of a relationship between previous research and the current research project, a summary of the search strategy used, identifying trends and gaps in the literature and using primary sources rather than secondary sources. The article by Liu et al. (2008) provides a summary of previous research and highlights the inconsistencies in the results of previous studies and also the lack of research into the interaction effects of age and gender on HRQOL. The literature reviewed is relevant to the topic of HRQOL and uses primary sources rather than secondary sources. The literature review however does not include the search strategy used for locating previous research, which helps the reader determine if the literature review is comprehensive and unbiased (Houser 2008).
The conceptual framework used in the research paper by Liu et al. (2008) is health related quality of life. HRQOL is an appropriate health care framework evolved from the WHO (1948) definition of health as physical, mental and social well being and is an appropriate framework for this study. The author has linked the conceptual framework to the research question by using it as a measure. The literature review also includes research that has been undertaken using the same conceptual framework, which improves credibility and without such a framework it limits both the ability of the research to be applied to clinical practice and the development of further research based on the results (Houser 2008)).

Aim and Hypothesis

The article by Liu et al. (2008) has a clearly stated aim but not a
hypothesis. While hypothesis are not necessary in qualitative studies as the researchers are open to what might emerge throughout the study, Richardson- Tench (2011) explains that it is customary to devise hypothesis in quantitative research which speculates about the relationship between two variables. The two variables in this research paper are age and gender, and while the authors articulate the main variables, they do not state the presumed relationship between them. Caldwell, Henshaw & Taylor (2010) further explain however, that in survey research a hypothesis may be provided; however it is not essential.

Methods

As Richardson-Tench (2011) highlight, the method of a study should provide enough detail for the study to be replicated. The study by Liu et al. (2008) provides information about the design and sample, the measurements used and the tools used for data analysis.

Sampling

The author identified the target population and the sampling process of
convenience sampling and rolling recruitment was used (Liu et al. 2008). Although a probability sample would have been more representative of the population, as Richardson-Tench (2011) highlights this is not always possible in medical studies where there is often not enough people to form a probability sample. Another way the study could have reduced sample bias is to use subjects from a number of kidney transplant hospitals rather than using subjects from a single hospital where the population may have a biased concentration of a particular variable (Richardson-Tench 2011). The sampling process and size is important so that the reader can determine if the sample is representative of the population and whether bias can be eliminated (Caldewell, Henshaw & Taylor 2010). The sample size is discussed in the results section, and in order to ensure an adequate number of participants were selected to ensure valid results, a power analysis was conducted (Liu et al. 2008). The authors also considered ethical considerations as participation in the study was voluntary, and the consent procedure was provided (Liu et al. 2008).

Design

The design of the study was a cross- sectional design which is a study
conducted at a defined point in time using a cross-section of the population (Richardson-Tench 2011). A longitudinal study whereby a subject is studied at various points over time to identify changes could have been used which excludes variables such as cultural differences, however the disadvantage of longitudinal studies is that they are time consuming (Liamputtong 2010) and so for the purposes of efficiency a cross-sectional design was appropriate.
Threats to internal validity in the study were overcome by the use of randomly coded survey packs that contained no personal identifying information (Liu et al. 2008). This ensured that the investigators were not aware of an individual subjects age or gender when conducting surveys or collating results and so could not influence the results. As explained by Richardson-Tench (2011) this threat to validity is known as the experimenter effect where the experimenter may consciously or unconsciously affect the results of experiment. In addition, confounding variables, which are variables that are known to have an effect on the independent variable but are not being measured by the study, were overcome by the use of the data analysis technique, a multivariate analysis of covariate (MONOVA) (Liamputtong 2010).
The eligibility criterion in the study by Liu et al. (2008) was included, however the exclusion criteria were not. The exclusion criteria is important as subjects may not be appropriate for a study even though they may meet the inclusion criteria (Houser 2008).

Instruments/Measurements

The procedure of the study was designed to protect the privacy of the
participants, as access to the survey data was secured and restricted to a small number of investigators (Liu et al. 2008). The instruments used to gather data were described and included a rationale of the suitability of measurement tools i.e. the survey has been used successfully in other research studies (Liu et al.). As explained by Liamputtong (2010) researchers should select instruments that have been shown to be reliable in the population of interest. The researchers also modified the scale used in previous research to measure overall health status to ensure a more valid result (Liu et al. 2008). Differences in instruments are a major threat to the validity of a study (Richardson Tench 2011) and this was overcome by using the same survey for all subjects participating in the study.

Data Analysis

Data was collected using a self-administered survey. Although the
authors of the study did not explain why they chose this method it is commonly understood that questionaries are more cost effective and time effective than interviews (Ingham-Broomfield 2008).
The purpose of statistical tests in research is to determine whether the results are statistically significant (Liamputtong 2010). The study by Liu et al. (2008) used appropriate tests to measure the relationship between the two variables being tested (age and gender). A chi-square test was used which is appropriate for measuring categories rather than numbers (Richardson-Tench 2011). A two-way multivariate analysis of covariance was also used, which is appropriate as there were two dependent variables (age and gender) and one covariant (time after transplantation) (Liamputtong 2010).
Details in the method that were omitted by Liu et al. (2008) were the training the data collectors received. Data collection procedures and data analysis procedures were however explained in detail. The study was reviewed and approved by a review board of the university medical centre (Liu et al. 2008). As explained by Liamputtong (2010) an ethics committee’s role is to ensure the research conforms to accepted scientific principles and statements should be made within the research about ethical considerations which was achieved by Liu et al. (2008) by discussing how the privacy of subjects would be protected and by gaining participants consent to participate in the study.

Results

The results of the study by Liu et al. (2008) are concise and presented in predominately table form. As highlighted by Richardson-Tench (2011) graphs are the preferred method of displaying categorical data, as they are easier for the reader to interpret. All results relevant to he research question have been included. Statistically significant results and marginal effects were highlighted in the results table, which is important to ensure they stand out (Richardson-Tench 2011). The levels of significance were provided which is important for determining if the results are statistically significant rather than the results occurring simply by chance (Richardson-Tench 2011).

Discussion

According to Richardson-Tench (2011) the discussion of a research paper should be concise and discuss the significance of the findings rather than simply summarise the findings. The discussion in the research conducted by Liu et.al (2008) compares the results of the study to the general population and to the findings of previous studies that were outlined in the literature review. The authors summarise previous research relevant to this research and demonstrates that the current research is consistent with previous research findings. The article by Liu et al. (2008) also describes how this research differs from previous research and explains why these differences may have occurred, for example the use of different instruments to measure HRQOL in other studies. It extends from previous research by reporting on the interaction effect of age and gender (Liu et al. 2008).

Limitations

The research paper by Liu et al. (2008) does not highlight the strengths of the study, however the weaknesses have been addressed by explaining the limitations based on the type of sampling used, in addition to limitations of the breakdown of data. Excluded data, which may have influenced the subjects HRQOL such as socioeconomic status, education level and social support, was also included as an appropriate limitation. The research paper by Liu et al. (2008) also highlights how weaknesses could be addressed in further studies such as the use of longitudinal data and larger sample sizes. Limitations that were omitted included the use of a broader sample to include kidney recipients from more than one hospital. Limitations in a research paper are important to when considering the validity of the study and can also suggest how future research could be improved (Liamputtong 2010).

Conclusions

The authors draw conclusions that are in line with the overall plan and methodology of the research and the findings of the research (Richardson-Trench 2011). Conclusions included implications for nursing practice, and the article provided recommendations on areas that need to be focused on in clinical practice to improve kidney transplant participant’s HRQOL (Liu et al. 2008). In addition, areas for future research such as developing and testing appropriate interventions were briefly mentioned (Liu et al).

Summary

In summary, the study by Liu et al. (2008) was thorough and well researched according to the criteria set by Richardson-Tench (2011). The information was presented in a logical sequence and was coherent and concise. In addition, the method and design was appropriate, there were logical links between the purpose, the findings and the conclusions drawn, and the findings were significant for clinical practice.

References

Benner, P, Hughes, R & Sutphen, M (2008), ‘Clinical reasoning, decision- making, and action: thinking critically and clinically’, in R, Hughes (ed), Patient Safety and Quality: An Evidence-Based Handbook for Nurses, vol. 1, Rockville: Agency for Healthcare Research and Quality.
Caldwell, K, Henshaw, L & Taylor, G 2010, ‘Developing a Framework for critiquing health research: an early evaluation’, Nurse Education Today, vol. 31, no. 1, p. 1.
Houser, J 2008, Nursing Research: reading, using and creating evidence, Jones and Bartlett Publishers, United Kingdom.
Ingham-Broomfield, R 2008, ‘A nurses guide to the critical reading of research’, Australian Journal of Advanced Nursing, vol. 26, no. 1, pp. 102-109.
Liamputtong, P 2010, Research methods in health: foundations for evidence based practice, Oxford University Press, Australia. Liu, H, Feurer, I, Dwyer K, Speroff, T & Shaffer, D 2008, ‘The effects of gender and age on health related quality of life after kidney transplantation’, Journal of Clinical Nursing, vol. 17, no. 1, pp. 82-88, 2012, via CINAHL.
Richardson-Tench, M, Taylor, B, Kermode, S & Roberts, K 2011, Research in Nursing: evidence for best practice, , Cengage Learning, Australia.
World Health Organisation (WHO) 1948, Constitution of the World Health Organisation, WHO, Geneva.

Assignment Three Rubric