NURS 237 : Nursing Research
Question:
a) What sampling method was used by the authors in this study?
b) What are the potential biases of this sampling method?
c) What was the final sample size and what was the acceptance rate?
d) Was a power analysis conducted? If so, describe it here.
e) Describe the inclusion and exclusion sample criteria.
f) Calculate the refusal rate.
g) Calculate the attrition rate.
h) Is the sampling method going to produce a sample that is representative of the study population? Explain your answer.
i) Briefly discuss the institutional review board approval and informed consent obtained for this study.
j) Briefly describe the setting and indicate whether it was appropriate for conducting this study.
a) List and briefly describe the measures / instruments / tools used in the study.
b) Who administers each measurement / instrument / tool?
c) How do the subjects complete each measurement / instrument tool?
d) How is each measurement / instrument / tool scored?
e) How do the authors describe the PAST reliability of each measurement / instrument / tool?
f) How do the authors describe the reliability of each measurement / instrument / tool for THIS STUDY?
g) How do the authors describe the PAST validity of each measurement / instrument / tool?
h) How do the authors describe the validity of each measurement / instrument / tool for THIS STUDY?
i) Did the authors develop a measurement / instrument / tool for this study? If so, describe the development process.
j) Did the authors use any physiological measurements in this study? If so, how did they describe the methods for collecting and recording the data?
a) Briefly describe the data collection process used in this study.
b) Is there more than one data collector for the study? If so, describe what the authors did to train the data collectors. Do you think there was adequate training to ensure inter-rater reliability (IRR)?
a) What descriptive statistics are used in this study?
b) What inferential statistics are used to examine the data obtained from the subjects? **Hint: for help recognizing names of statistical tests, look at Figure 21-7.
c) What is the level of significance set at for this study?
d) Are tables or figures used to present the results of the data analysis? List and briefly explain the content of each table or figure.
a) What are the key findings from this study (as stated by the authors)? In parentheses next to each finding, indicate whether the finding is significant, non-significant, or unpredicted / serendipity.
b) Which of the key findings that you listed in 13a were consistent with what the authors were expecting?
c) Which of the key findings from this study were identified by the authors as being clinically significant / clinically important?
d) List the study’s limitations as described by the authors. Did you find any other limitations not mentioned by the authors?
e) Do the authors generalize the findings to other populations? If so, who are they? Is this appropriate?
f) What implications do the findings have for nursing practice?
g) What suggestions have the authors made for future studies?
a) Identify one strength of the study related to the content in this assignment (find the strengths in the sample, measurement methods, data collection, or data analysis)
Pick two of the guidelines and provide an answer (your choice).
Answer:
9.
- All participants had to be at least 18 years
- They must be cognitively able to provide consent for participation
- They must speak, write and read in English.
The exclusion criteria for the study were as follows:
- Patients on isolation were excluded
- Patients on contact precautions were excluded
- Non-elective orthopaedic surgical patients were who had not completed testing at Euclid hospital were excluded (Gallagher et al. 2018).
Refusal rate= Number of refusals/ Number of samples originally desired to be achieved
= 91/200
=0.45%
Attrition rate= Number of participants lost/ number of participants at the beginning
=37/200 =0.18%
10.
- The instruments that were used in the study included iPad, a REDCAP database, point numeric rating scale and the Rogers Happy/Sad Faces Assessment Tool. The iPad was used to provide the music therapy. The point numeric rating scale was used to score pain, anxiety and nausea and the Rogers tools was to assess mood of patient (Gallagher et al. 2018).
- Music therapist administered the iPad and REDCap database and the research assistant administered other tools used in the study
- Patients had to give a rating of 0-10 point on the numeric rating scale to assess pain, anxiety and nausea. In addition, they had to give a rating of 0-4 for mood assessment.
- The Rogers tool and the point numeric rating scale were scored by means of numerical ratings.
- The limitation in reporting about the tool is that no discussion has been given regarding the validity or efficacy of the tool and its use in future research. Brief description was provided only for REDCap database
- Nothing has been mentioned regarding the reliability of the tools used in the research
- The past validity of each tool is missing
- The description regarding the validity of the tool for research is not present
- There were no tools that were developed for the purpose of the study. The music therapy session was only individualized by collaborating with patients regarding individualized goal for the session.
- Physiological measurements were taken for the analysis of pain, anxiety and mood of the participants
11.
- Data related to patient demographics were collected. Secondly, the Happy/Sad Face Assessment tool was used to measure mood and the point numeric rating scale was used to manage pain, anxiety and nausea.
- Yes, there are more than one data collectors in the study. The first is the music therapist and the second is the research assistant. However, the study lack inter-rater reliability as thedata collectors were not trained.
12.
- For description of patient characteristics, statistical test like two-sample t tests, Fisher’s exact test and the Pearson’s chi square test were used. Linear effect mixed model was used to detect change in scores and the results from the logistic regression model were characterised using the SAS software.
- The two-sample t tests, Fisher’s exact test and the Pearson’s chi square test were some inferential statistics used to examine the data obtained from the subjects.
- The level of significance set for the study is greater than 0.001.
- Gallagher et al. (2018)provided 5-6 tables in the research. The contents of each table are as follows:
- Table 1: Details for patient demographics
- Table 2: Details for follow-up summary statistics
- Table 3: Summary of statistics on admission outcomes
- Table 4A: Day 1 outcome summary for control group and experimental group
- Table 4B: Day 2 outcome summary for control group and experimental group
- Table 4C: Day 3 outcome summary for control group and experimental group
- Table 5: Comparison of survey scores and patient level outcomes (Gallagher et al. 2018).
13.
- The key findings from the study are as follows:
- Significantly better outcomes were found for pain anxiety and mood among the experimental group and the control group compared for Day 1, Day 2 and Day 3. The score for nausea only varied on Day 3 (Significant)
- Music therapy produced immediate improvement in pain and anxiety scores and in nausea occasionally (significant)
- The first finding is not consistent with author’s hypothesis because it was hypothesized that music therapy would have positive effect on patient’s score of pain, anxiety, mood and nausea. However, the same outcome were not achieved for nausea.
- The findings related to positive impact of music therapy on decrease in anxiety and pain was regarded as clinically significant outcome by the author.
- The author has mentioned that not blinding the patients to the intervention was one limitation of the study. Another limitation identified was conducting the research only in one tertiary care center. Other limitation found in the work is that the author has not justified the rational for using the tools and not provided any details on reliability of the tool (Campbell and Stanley 2015).
- The findings has not been generalized to other setting because the research was done only in single health care center
- The finding presented in the study can provide nurses the strategy to address pain and anxiety of patients. As the study has used wide variety of intervention, the nurse can use it to provide individualized session as per individual patient’s preference.
- A future research implication given by Gallagher et al. (2018) was to research regarding the impact, value and efficacy of music therapy in health care institutions.
14.
- The strength of the study is the data analysis method as it helped to get analyse and compare outcomes by inferential statistics and several statistical test. Two sample t test, chi square test and Fisher’s exact test helped to compare patient characteristics as well as outcomes on several days.
- One weakness of the study is the poor reporting of reliability and validity of the tools used in the research. As the results obtained from the tools determines the outcome of research, it was necessary to provide proper justification and evidence regarding the efficacy and reliability of the tools used in research (Noble and Smith 2015).
15. Overall, the findings of the study by (Gallagher et al. 2018) can be considered significant as it provides a solution to address discomfort of people with total knee replacement. Although the study lacked generalization because of conducting research in single center, it provided direction to improve the efficacy of the intervention. By conducting future research on efficacy of music therapy in other setting, it may help to decrease patient’s hospital stay as well as recovery time.
References:
Campbell, D.T. and Stanley, J.C., 2015. Experimental and quasi-experimental designs for research. Ravenio Books.
Gallagher, L.M., Gardner, V., Bates, D., Mason, S., Nemecek, J., DiFiore, J.B., Bena, J., Li, M. and Bethoux, F., 2018. Impact of Music Therapy on Hospitalized Patients Post-Elective Orthopaedic Surgery. Orthopaedic Nursing, 37(2), pp.124-133.
Gray, J., Grove, S. and Sutherland, S. 2017. Burn’s and Grove’s The practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Elsevier. ISBN978- 0-323-37758-4
Noble, H. and Smith, J., 2015. Issues of validity and reliability in qualitative research. Evidence-Based Nursing, pp.ebnurs-2015.
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