GRAD 695 Research Methodology And Writing

Quantitative Article Critique

Thomas, R. E., & Lorenzetti, D. L. (2014). Interventions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Database of Systematic Reviews. DOI: 10.1002/14651858.CD005188.pub4.

Results: Data Analysis 

1. In order to access the projected aim of the paper, the authors undertook systematic research approach and analyzed the wide array of articles from MEDLINE, Embase, CINAHL, WHO, ERIC. For ongoing studies, clinicaltrial.gov from 7^thDecember 2017 was selected. Only randomized control trials (RCTs) were selected.
2. Proper statistical analysis was used in order to compare the data from the RCT studies.
3. the was no mention of the confounding variable used in this particular study. According to Onghena and Noortgate (2014), lack of proper control over the confounding variables decreases the overall strength of the research.
4. There were no significant indications of the type I and type II errors. According to Mertler and Reinhart (2016) lack of proper initiatives to minimize the type I and type II error lead to the generation of false positive results.
5. The authors did not perform intention-to-treat analysis in an adequate manner.
6. Each article was analyzed separately under a tabular format

Findings 

The information about the statistical significance was not presented in a significant and in an ordered manner. However, there were proper information about the effect size and the confidence intervals. The RCTs, which had confidence intervals of greater than or equals 95% were only selected for the systematic reviews. According to Hopkins (2017), selecting articles for with higher confidence intervals help to deduce proper outcomes of the aim of the study.

All the findings of the study were accurately summarized. The authors of the paper provided a detailed elaboration of each of the selected papers for the systematic review in a tabular format. This tabular representation of the data contained methods, number participants, interventions used and the outcomes. Martone et al. (2015) is of the opinion that the proper representation of data in a tabular format makes the research paper data rich, helping the readers to understand the information in a single go.

Discussion: Interpretation of Findings 

1. All the major findings were interpreted and were discussed within the context of the prior research. The main content of the prior research that was selected in order to satisfy the research aim are the RCTs and cluster-randomized trials of interventions that helped to increase influenza vaccination among the people who are 60 years old or above. The study mainly recruited 61 RCTs studies and assessment of the studies was done based on low risk of bias for randomization, high blinding, allocation concealment and selective reporting. This selection criterion helped the researcher to highlight the major findings that falls within the scope of the research.
2. Causal inference was justified via drawing a conclusion from the causal connection based on the prevailing conditions of the occurrence of an effect.
3. The issue of the clinical significance was discussed in detail in the rationale of the research. According to Thomas and Lorenzetti (2014), conducting this systematic review will help to increase the range of vaccination of influenza among the older adults (60 years and above). This increase in uptake of the effective influenza vaccination will help to eradicate the chances of occurrence of this infectious disease among the older adults. Since older adults are more prone to get affected by this disease, effective strategy to increase the vaccination intake will help to reduce the overall disease burden and subsequent eradication of the disease (Centers for Disease Control and Prevention (CDC), (2012).
4. According to Venkatesh, Brown and Bala (2013) larger is the sample population more is the generalizability of the findings. Venkatesh, Brown and Bala (2013) further opined that the generalization is a act of reasoning that deals with extraction of broad inferences from specific observations and is acknowledged as one of the quality standard in quantitative research. Thomas and Lorenzetti (2014)ensured the generalizability of the research via including 61 RCTs of 1,055,337 participants who were 60 years old or above.

Implications/Recommendations

The researcher adequately discussed the implications of the research. The main implications highlighted by Thomas and Lorenzetti (2014) is, elucidation of the effective interventions to increase the rate of influenza vaccination rates among the older adults who are over 60 years of age. Thomas and Lorenzetti (2014) are of the opinion that at present there are no effective vaccinations discovered against the control of the influenza infection among the older adults. However, in future, when effective influenza vaccination will be discovered, then the results highlighted in this study will help the healthcare professionals to increase the rate of influenza vaccination among the older adults at the community level. 

General Issues: Presentation 

1. The report is well-written and is represented in a an organized manner through tabular representation along with justified critical analysis.
2. In the intervention studies, the authors of this study provided a detailed flow diagram stating the pattern of the selection of the prospective articles and how the redundant articles were excluded from the research. A detailed PRISMA diagram was used in order to represent the flow of the study.
3. The entire representation of the report was done majorly through tabular representation, which made it easier for the nursing professionals to access the results.

Researcher credibility 

Thomas and Lorenzetti (2014) employed two review authors in order to independently assessed the risk of bias for each study via using the guidelines outlined in the Cochrane Handbook for Systematic Reviews of Interventions. This use of two separate reviewers helps to enhance the confidence (Heale & Forbes, 2013).
Summary Assessment 

The results conducted by Thomas and Lorenzetti (2014) highlighted there  interventions like post cards, phone calls and personalized home visits as an important means to increasing the overall rate of vaccination of influenza among the older adults. The highlighted results have confidence in the truth value because the results was extracted from the systematic reviews of already selected articles. The study indeed contributes to an meaningful evidence. Elucidation of the effective interventions in the domain of increasing the rate of the influenza vaccination will help the nursing professionals to encourage the older adults towards taking the vaccination dosage of influenza. The result is also useful for the nursing discipline as according to American Nursing Association (2017) it is the duty of the nursing professionals to educate the patients towards taking proper medication and vaccination in order control the spread of the disease.

Qualitative Article Critique

Carusone, S. C., Loeb, M., & Lohfeld, L. (2006). Pneumonia care and the nursing home: a qualitative descriptive study of resident and family member perspectives. BMC geriatrics, 6(1), 2. doi:10.1186/1471-2318-6-2

Discussion: Interpretation of findings

1. Findings of the study conducted by Carusone, Loeb and Lohfeld (2006)was mainly directed towards the a special group that is nursing home residents who are treated for pneumonia and the their family members.  According to Martínez-Mesa et al. (2016) selecting a target population under special social and the cultural context help to control and co-ordinate the generalisability of the research. Such that the elucidated findings can be applied over that selected focus group in order to achieve the desired outcomes.
2. The major findings to the study indicated that the both the residents and the family members preferred pneumonia to be treated in the nursing homes where applicable. This is because they felt that the key aspects of care are more easily accessible under the nursing home settings. However, residents and their family members also felt that the doctors and the staffs are the one who must make the decision whether to hospitalize the patients or not via taking assistance or concern from the family members. This finding goes in sync with the previous findings, which also states that the it is safe to treat patients of pneumonia in nursing homes other than hospitals due to its cost-effectiveness and long-term care facilities (Carusone, Loeb & Lohfeld, 2006).
3. the interpretations are not comprehensively consistent with the study. This is because, the study itself highlighted that the at times it became difficult for the respondents (patients to answer their interview questions in a succinct manner due to their ill health and difficulty in collating thoughts. This difficulty in taking the interview created a barrier to identify specific context of their descriptions and thus creating problems in generating themes. However, the study is based on the thematic analysis as described by Miller and Crabtree (Carusone, Loeb & Lohfeld, 2006).

Implications/ Recommendations

Yes. Researcher did mentioned the implications of the study for further research. They highlighted that their study will create further provision to explore the views of broad range of family members and residents via employing a variety of methods like observations, interviews and surveys in order to comprehensively investigate the factors that influence the preffered choice for the place of treatment of pneumonia care residents and their family members. These implications are reasonable and complete as it creates further provision to undertake research upon individual and contextual variables of the residents in the domain of choice of the place of treatment (Carusone, Loeb & Lohfeld, 2006).

General Issues:  Presentation

The report is well-written and organized under different subheadings which maintain the flow of the information. It also provides detailed critical analysis. According to Smith (2015), a proper presentation of the information helps to increase the overall quality of the qualitative research.

Researcher credibility

Yes. The researcher here has selected open-ended interview followed by thematic analysis as the main qualitative research framework. According to Smith (2015), thematic analysis is one of the common form of qualitative analysis. Few of the advantages of the thematic analysis is, it helps in pinpointing patterns based on the response provided by the interviewee.

Summary assessment

1. The study findings are trustworthy as the excerpts of the interviewee, which were used for the generation of the themes was discussed and highlighted specifically in the entire course of the research paper. However, I do not have comprehensive confidence over the truth-value of the results as the authors have themselves accepted that at times patients were unable to answer the interview questions in a succinct manner due to the ill health. Thus at times the generate themes might have failed to adequately capture the actual emotions and the mindset of the patients who are being treated for pneumonia in nursing home.
2. The study contributes meaningful evidence that can be used under nursing practice. For example, the study highlighted that the residents and their family members feel that the caring and attention are two prime aspects of nursing home settings. This is indeed a significant factor of the nursing code of conduct. The study also revealed that the family members wanted to be part of the decision making process in the domain of patient care. According to the American Nursing Association, encouraging patients and their family member in the decision making process helps to increase the overall participation of the patient’s party in the care plan and thereby helping to increase the quality outcome.

Enhancement of trustworthiness

1. In order to increase the trustworthiness of the study, the researcher followed the proper ethical guidelines of conducting interview based qualitative research. The researcher also compared the audio tape of the interview with the written transcript in order to iron out the transcription error (Carusone, Loeb & Lohfeld, 2006).
2. In order to enhance the trustworthiness of the study, the researcher strictly analyzed the credibility, transferability, dependability and conformability.
3. The findings are auditable and confirmable because the recorded interview has audio tapes along with the thorough documentation of the excerpts from the interview which helped in the formation of themes
4. There are no significant evidence of the researcher’s reflexcivity
5. There were thick description of the participants, findings and the context in the methodology section. This rigorous description helped to support the transferability of the research (Houghton et al., 2013).

Results: Data analysis

1. The data management and data analysis method was discussed adequately. The author used Miller and Crabtree method for thematic analysis.
2. The data analysis strategy is compatible with the research tradition and the nature of the data gathered. According to Braun, Clarke and Terry (2014), the analysis of the data via doing the thematic analysis is the best possible way of extract results from the qualitative research conducted via open-ended interview over the specific focus group.
3. The analysis helped in the generation of thematic pattern
4. The analytic procedure may indication of bias because the same researcher who conducted the interview tallied the generated transcript with the audio tape and then the same researcher was used to analysis of the data. This may lead to the generation of bias results (Braun, Clarke & Terry, 2014).

Findings

1. Findings were effectively summarized with the good use of excerpts and supporting arguments. The findings of the research contained direct quotes from the respondents thus acting as effective supporting arguments
2. Themes adequately captured the meaning of the data. It also appeared that the researcher satisfactory conceptualized the themes via employing Miller and Crabtree editing styles and the identification of the themes
3. The analysis of the data  helped to reveal the thought process of the residents and their family of carers in the domain of receiving care for pneumonia in the nursing homes. The study also highlighted a meaningful picture about how the family members of the residents are in favor of the participation in the decision making process while transferring the patients to hospital for further checkup.

Theoretical integration

1. The theme patterns were logically connected for example first theme  highlighted the choice of the focus care, the second theme focused good quality of care procured by the preferred choice of care followed by the reason of preferring nursing homes and concept behind the decision making process.
2. no figure of maps were used to denote the association and inter-relation between the two themes. According to Pietkiewicz and Smith (2014),  lack of proper conceptual map help to decrease the quality of the thematic analysis.
3. Theme were linked in a cogent manner but pictorial relationships were not provided.

References

American Nursing Association.  (2017).Code of Ethics for Nurses With Interpretive Statements. Access date: 13^th July. Retrieved from: https://www.nursingworld.org/coe-view-only

Braun, V., Clarke, V., & Terry, G. (2014). Thematic analysis. Qual Res Clin Health Psychol, 24, 95-114

Carusone, S. C., Loeb, M., & Lohfeld, L. (2006). Pneumonia care and the nursing home: a qualitative descriptive study of resident and family member perspectives. BMC geriatrics, 6(1), 2. doi:10.1186/1471-2318-6-2

Centers for Disease Control and Prevention (CDC. (2012). Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP)–United States, 2012-13 influenza season. MMWR. Morbidity and mortality weekly report, 61(32), 613.

Heale, R., & Forbes, D. (2013). Understanding triangulation in research. Evidence-Based Nursing, ebnurs-2013.

Hopkins, W. G. (2017). A Spreadsheet for Deriving a Confidence Interval, Mechanistic Inference and Clinical Inference from a P Value. Sportscience, 21.

Houghton, C., Casey, D., Shaw, D., & Murphy, K. (2013). Rigour in qualitative case-study research. Nurse researcher, 20(4).

Martínez-Mesa, J., González-Chica, D. A., Duquia, R. P., Bonamigo, R. R., & Bastos, J. L. (2016). Sampling: how to select participants in my research study?. Anais brasileiros de dermatologia, 91(3), 326-330.

Martone, P. F., James, D., Liu, J., VanOrman, R., Wang, J., & Tariq, S. (2015). U.S. Patent No. 8,984,433. Washington, DC: U.S. Patent and Trademark Office.

Mertler, C. A., & Reinhart, R. V. (2016). Advanced and multivariate statistical methods: Practical application and interpretation. Routledge.

Onghena, P., & Noortgate, W. (2014). Confounding Variable. Wiley StatsRef: Statistics Reference Online.

Pietkiewicz, I., & Smith, J. A. (2014). A practical guide to using interpretative phenomenological analysis in qualitative research psychology. Psychological Journal, 20(1), 7-14.

Smith, J. A. (Ed.). (2015). Qualitative psychology: A practical guide to research methods. Sage.

Thomas, R. E., & Lorenzetti, D. L. (2014). Interventions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Database of Systematic Reviews. DOI: 10.1002/14651858.CD005188.pub4.

Venkatesh, V., Brown, S. A., & Bala, H. (2013). Bridging the qualitative-quantitative divide: Guidelines for conducting mixed methods research in information systems. MIS quarterly, 37(1).