Nursing – assessment of 4 journal articles (night nursing; older patients etc) 1500 words

Bailey V (2007) Satisfaction levels with a community night nursing service. Nursing Standard 22, 5, 35-42. Date of acceptance: May 25 2007.

 

 

The title of the paper reads “Satisfaction levels with a community night nursing service” and while it does seem to refer to the main body of the research, it is slightly ambiguous as to the location and the orientation of the study population. The abstract clearly sets out the summary of the paper in an orderly manner under the titles “Aim”, “Method”, “Results” and “Conclusion”. However, the abstract is slightly ‘over-mathematical’ going directly to cite the Kruskal-Wallis test as a means of measuring satisfaction of patients. The synopsis of the article is summed up appropriately under the heading of “conclusion” in the abstract.

 

 

The introduction is clearly set out yet the references used here date back to 1991.The aims and objectives are clearly set out too and do to some extent identify the concepts and population under study. However, at this stage it seems to the author of the critique that “satisfaction” can be measured perhaps more appropriately through a qualitative study and cannot be solely calculated as an affair of figures and frequencies. The choice of a quantitative framework seems to have the obvious advantage of measuring the responses of a more diverse population sample base. In fact in this case the type of methodology deployed seems to link the research problem and the paradigm in a solid way. Unlike the introduction, the literature review seems to be more up to date and uses sources from the past five years, although some references go  back to the mid nineties. Such old sources perhaps cannot make a good contribution to an article being written in 2007. At the same time, a large part of the introduction is devoted to what could have been a part of the literature review. The conceptual framework is easy to identify and understand here. Despite the above it was felt in particular that the literature review was rather insufficient in size and did not address the competing points of other authors or the existence of other recent studies in the area. The same can be said about the structure of the paper, which seems to have muddled up the objectives and research questions.

 

Overall the main shortcoming of this article is its failure to relate to “satisfaction” as a qualitative concern and not something which can be explained by measurements. However, the method for survey questionnaires and their design is well tested and credible. The authors use the McKinley design supplemented by yet another credible analytical tool, the Kruskal-Wallis test. Finally, in the conclusion the authors have indicated that the overall problem of satisfaction was the issue of communication with the patients. This, it is believed could have been adequately dealt with through qualitative research which would have allowed the researcher to better identify the future health policy implications through a better use of qualitative methods and an investigative approach.

 

 

 

Clegg A, Bee A (2008) Community matrons: patients’ and carers’ views of a new service. Nursing Standard. 22, 47, 35-39. Date of acceptance: March 10 2008.

 

The title of this paper is fairly relevant to the content and the abstract is short but informative for the lay reader. There is appropriate reference made not only to secondary academic research but also to the relevant Department of Health publications. The literature review is brief but is able to address the hypothesis appropriately and refer to the most recent sources. The greatest gap remains here that there is no separate discussion of the methodology or the techniques employed based on their shortcomings and limitations. There is a heading which reads “limitations” which attempts to discuss the problems in the methodology and secondary research, but for an article of this nature there should have arguably been a brief but effective discussion of the survey methodology which sought to elicit semi qualitative responses through a survey administered by post.

 

The main strength of this study is that it is able to address its own weaknesses, as in its admission that it does not take account of mortality and its importance for future researchers: i.e. when it states that in future, research papers could preferably focus upon randomised controlled trials rather than before and after studies for the determination of effectiveness of assessing the role of the community matron. The ethical compulsions, survey design and the survey process are properly laid out (p. 38). The author was unable to find the research questions or hypotheses clearly stated yet it seemed that they were made a part of the introduction and the literature review due to limited publishing space. The rather brief reference to the methodology of the paper is nonetheless clear and addresses the reason for this choice of study, and at the same time one can discern evidence of appropriate comparisons to address the interpretability of the findings (p.36-7).

 

However, bearing in mind the need for an appropriate supplementary qualitative response in the light of the discussion intensive survey, it was felt that a corresponding qualitative effort might have added to the internal validity of the paper (p. 38). The paper is though commendable for its use of the sufficient analytical tools as well as the summarisation of the findings through the use of tables and figures (p. 38-39). Also the design of the questionnaire was able to elicit personal responses from the respondents to aid to the results of the overall numerical survey, but the article failed to explain the methodology in the required detail. The author has though successfully interpreted the responses in their proper social context especially in terms of the responses from the elderly parts of the sample population.

 

 

 

 

 

 

 

Penny, Pickard, Sheaff and Boaden (2007) Patient and carer perceptions of case management for long-term conditions Health and Social Care in the Community (2007) 15 (6), 511–519

 

The title of this study reads clearly and concisely and one is conveniently able to identify from the abstract the aims and objectives of the research. The abstract however reads too long for a brief nine page article, but bearing in mind the diversity of the analytical outcomes this is well mandated. The topic is of great interest internationally and is a recent concern due to the 2004 reforms to GP contracts which has led to an emphasis on nurse-led case management programmes. This qualitative study has duly conformed to the ethical considerations arranging interviews through a third party, and has carefully encouraged the selection of willing participants. This does have a danger of threatening the internal validity of this study because of a set location for the choice of the sample population as well as the way they have been rounded down for the interview. The aim and method of the research clearly correspond to each other and the choice of a qualitative study is a good choice to judge the perceptions of patients and carers in a thorough one-to-one manner. The author has ensured attention to all the minute and necessary details like the description of the sample population (p. 513) and their location. Commendably a note has also been made of the approval of the research from the Multi-site Research Ethics Committee. The external validity of the study is strengthened through careful attention to pilot studies and a marked organisation in the structure of the interviews. The authors have clearly stated their use of “grounded theory” analysis and have clarified that these interviews were analysed properly after being transcribed by the authors too. The results are discussed in detail in their cultural and social contexts. The discussion of the results has been given its due attention and space due to the detailed amount of data (interview transcripts), which needed to be processed, and these points have been properly linked with the relevant literature. Interestingly, the introduction reads like a literature review so one cannot identify the literature review separately from the introduction here. However, the length, breadth and the strength of the discussion (p. 516-518) make up for the lack of a separate literature review discussing the role of community matrons and community led nursing from patient and carer perspectives.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Green, Forster, Young, Small and Spink (2008) Older people’s care experience in community and general hospitals: a comparative study 34 nursing older people July vol 20 no 6 2008

 

This article has a clear title, which is easy to understand and relate to the main content. The methodology deployed is a qualitative study seeking to compare patient reviews with the carer’s perspectives to gain a better understanding of  older people’s care experience in community hospitals. The abstract adequately sums up the conclusions.

 

Pertaining to the main content of the article, the layout is unorthodox to say the least. There is no typical organisation of a comprehensive literature review, yet the analysis of the interviews makes good social and cultural sense. As always, the danger with interviews is their bias whether it comes from the patient or the carer. Despite this danger then, perhaps it can be said that by addressing views of both carers and patients this article can lay a greater claim to sound internal and epistemological validity of its research; the interview transcripts have been quoted by the writer in large chunks in the main article. This is a rarely used and unconventional approach, and allows the reader to gain a better understanding of  interview perspectives.

 

On occasion,  it was felt by the author that the patients, due to their different backgrounds or even out of sheer politeness, were being conscious that their thoughts were being recorded and perhaps were not ‘speaking their mind’. However, the majority of the responses clearly made sense here especially in terms of communication and freedom issues. There is evidence of the use of recent secondary research within the analysis and discussion, which seems to run concurrently with the discussion of the relevant literature. Some of the references were felt to be slightly out-of-date or even obsolete. Despite its unique and unconventional layout, the authors have duly described the population size and sample characteristics by adequately summarising them in a table (p. 35). Finally, the main strength of the article, despite the lack of a visible literature review and research aims, is the way the responses have been listed categorically in line with the main problems identified as perceived by the patients and carers.

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References

 

  1. Polit D, Beck C and Hungler B. (2006) Essentials of nursing research: Methods, appraisal and utilization. 5th Edition. Philadelphia: J B Lippincott.

 

 

  1. Bailey V (2007) Satisfaction levels with a community night nursing service. Nursing Standard 22, 5, 35-42. Date of acceptance: May 25 2007.

 

 

  1. Clegg A, Bee A (2008) Community matrons: patients’ and carers’ views of a new service.Nursing Standard. 22, 47, 35-39. Date of acceptance: March 10 2008.

 

 

 

  1. Penny,Pickard,Sheaff and Boaden (2007) Patient and carer perceptions of case management for long-term conditions Health and Social Care in the Community (2007) 15 (6), 511–519

 

  1. Green ,Forster ,Young,Small and Spink (2008) Older people’s care experience in community and general hospitals: a comparative study 34 nursing older people July vol 20 no 6 2008