Tool selection
Implications of public health practice involve the multiple determinants of health. This constitutes the population as well as the environment, which share linkages as well as relationships that need to be emphasized. In order to achieve desired outcomes in the field of public health, multiple strategies are needed to be implemented (Friis and Sellers 2013). Keeping this in mind, this paper aims to discuss the importance of the study dealing with the implications of public health and critically appraise the studies using the critical appraisal tool namely the CASP tool. Additionally the paper will elaborate on the ethical issues that are needed to be considered for the respective studies and the summary obtained from the two studies that will be discussed in this paper.
This paper aims to appraise two studies, one being quantitative study and the other being qualitative study, therefore two different critical appraisal tool is being used in the paper. In order to appraise the qualitative study, the Critical appraisal skills program (CASP) tool is being used (Brice 2018). Similarly for the quantitative study, the study quality assessment tool is being used. To be specific, the quality assessment for case- control study is being implemented (Nhlbi.nih.gov 2018). These tools were used in order to discuss the strengths and the limitations of the articles that is being discussed. These critical appraisal tools are used to provide an over-all appraisal of the studies.
For qualitative study,
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Was there a clear statement of the aims of the research? |
There was a clear aim or objective of the article presented, that included the investigation of the impact of separation from members of family on the psychological health and wellbeing in case of refugees from Sudan in Australia in addition to the impact of the strategies of coping. |
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Is a qualitative methodology appropriate? |
The qualitative method of study for this was appropriate since it employed an in depth interview method in order communicate with the Sudanese family in addition to the representatives and health workers. Additionally the primary and mental health care professionals and the managers of health service and makers of policies were also investigated. |
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Was the research design appropriate to address the aims of the research? |
The study used a thematic research design in order to conduct the search interviews which was appropriate for the study as all the factors that had an effect were determined through this. |
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Was the recruitment strategy appropriate to the aims of the research? |
The recruitment strategy was appropriate since not only were the Sudanese families interviewed but also the individuals from Australia and other English speaking countries were considered in order to gain a variety in the sample. However the sample size was less in this case. |
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Was the data collected in a way that addressed the research issue? |
Yes the data was collected in a way that addressed the issue of the research as the data was collected through semi-structured interviews which involved the mental health needs along with experiences of resettlement. |
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Has the relationship between researcher and participants been adequately considered? |
The study considered the relationship between the researcher and the participants in an appropriate way as the interviews have been taken by the researcher which were further audio-recorded. |
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Have ethical issues been taken into consideration? |
The paper failed to take into consideration the ethical issues as no such aspect was mentioned I the article. |
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Was the data analysis sufficiently rigorous? |
The data analysis was conducted in a rigorous way using the method of analyst triangulation, according to which the most of the authors were involved in reviewing the findings. |
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Is there a clear statement of findings? |
There was a clear statement present of the findings present in the paper which showed that family separation can become a continuous condition of stress and grief for refugees in countries especially like Australia |
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How valuable is the research? |
This research is quite valuable as there is an important implication of the research in terms that there was an impact of separation from family, which continues to have an impact on the refugees’ lives in countries of resettlement. |
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Was the research question or objective in this paper clearly stated and appropriate? |
There was a clear presentation of the research question or rather the objective present in the paper which involved application of evidence-informed decision-making (EIDM) amongst health service managers, in order to improve the healthcare provision. |
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Was the study population clearly specified and defined? |
There was no specific definition of the study population provided in the given study. It was only stated that the competence of 25 managers were investigated by applying the EIDM in their job roles. |
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Did the authors include a sample size justification? |
In the study no such sample size justification was provided and it also lacked a clear mention of the undertaken sample size. |
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Were controls selected or recruited from the same or similar population that gave rise to the cases? |
The controls were selected from the similar population that it gave rise to the cases. |
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Were the definitions, inclusion and exclusion criteria, algorithms or processes used to identify or select cases and controls valid, reliable, and implemented consistently across all study participants? |
No there was no such definitions, or inclusion and exclusion criteria. |
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Were the cases clearly defined and differentiated from controls? |
There was no differentiation clearly present between the controls. |
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If less than 100 percent of eligible cases and/or controls were selected for the study, were the cases and/or controls randomly selected from those eligible? |
There was no random selection of the sample population since all the participants were volunteers and not selected. |
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Was there use of concurrent controls? |
There was no such use of concurrent control in the given study. |
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Were the investigators able to confirm that the exposure/risk occurred prior to the development of the condition or event that defined a participant as a case? |
Yes the investigators were able to confirm that the exposure or risk that occurred before the development of the condition or event that defined a participant as a case. |
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Were the measures of exposure/risk clearly defined, valid, reliable, and implemented consistently across all study participants? |
There was no such exposure or risk which is clearly defined, or is valid and implemented consistently across all study participants. |
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Were the assessors of exposure/risk blinded to the case or control status of participants? |
There was no such scope of blinding of the sample population while the study was being carried. |
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Were key potential confounding variables measured and adjusted statistically in the analyses? If matching was used, did the investigators account for matching during study analysis? |
There was a statistical adjustment present in the analysis of the given study. The researchers were successful in matching of the statistics of the study analysis during the conduction of the study. |
The strength of the study lies in the fact that the study is able to identify the experience of the refugees through the conduction of the qualitative study. The study was able to successfully highlight that the separation from family as well as the community can prove to be significant in determination of mental health in case of the refugees in countries such as Australia. In spite of the awareness that existed among the issues of the service providers which might be low, the services were well placed in order to support adaption of the refugee by helping the refugees to obtain security of appropriate employment as well as linkage to the community as well as the social support networks. It also facilitates the access to ICTs along with the programs that are involved in supporting the refugees’ abilities in using the ICTs. It also involved the advocacy in cases of family re-unification (Savic et al. 2013).
In terms of limitations, additionally the research is required to investigate on how the mental health impacts of separation, in addition to the coping strategies, will be able to manifest at the various stages of refugee resettlement. It would also require that and the job role of provided services in increasing the worry due to stress. Another limitation that is imposed involves that the in-depth interviews in particular that could be conducted involving the recent refugees those who are not responsible or involved in providing services. However by contrast, they are the users of these services provided.
The study by using a 360° subjective assessment along with a case study based objective assessment, was able to investigate on the competence of mid-level managers. It involved managers from two Victorian hospitals which was able to demonstrate the competency of EIDM that was assessed. The study analysis was able to confirm that the mid-level managers were competent enough, especially in areas which were requiring guidance in addition to improvement in order to enhance their competence. The study was also able to confirm that the areas that require improvement in the EIDM practice showed variation between organizations and the individual managers (Liang, Howard and Wollersheim, 2017).
Critical appraisal
There were various limitations that were present in the study which involved that the in this study there was only focus on mid-level HSMs and at two local hospitals only. The participants involved were mainly volunteers, therefore there was no scope of random selection of the sample population. Additionally the sample size was too small, however the sample was enough to be able to detect differences that were significant between the several assessment types and between the two hospitals. The limitation was also present in the fact that the lessons that were learnt from the study which needed to be investigated in more detail in the case of a larger and presence of a more diverse population (Zhang, Mol and He, 2016).
According to the National Statement on Ethical Conduct in Research, the ethical guidelines involve a range of relationships that exists between the researchers and the participants, which gradually develops result of the duration and interaction nature. In cases where there is a possibility of compromise of the role of research, there is a need to consider the modification of the relationship or attempts must be made to discontinue or in case modify the research. Additionally the researchers should ethically accept to exercise their skills. It is also the duty of the researchers to ensure that they inform the participants when they are acting in a professional role that is non-research (Nhmrc.gov.au 2018).
In case of the qualitative research, there should emphasis given on the significance of particular contexts along with the settings. It is always not necessary to be able to provide generalized results of qualitative research. In cases where there is a sampling strategy present, purposive sampling should be carried out. In addition to this, while random sampling, there should be presence of specific aims of the research question in the study. For a qualitative study, the rigour of the research should not be determined on the on sample size. In cases where the sampling is proper, in addition to the objectives and basis of theory of the research should be determined by the size of the sample along with the sampling strategy. The research proposals should include the sampling needs to clearly mention the recruitment strategy. There is a need to maintain the rigour of qualitative research which should be assessed by criteria of quality along with the credibility of collection of data and analysis (Nhmrc.gov.au 2018).
In the discussed study, some of the ethical considerations which are given according to the National Statement on Ethical Conduct in Research have not been addressed. In accordance to the given guidelines, the study failed to consider provision of a letter of consent to the participants, which is required in order to acquire a complete and accurate interview transcript. This needs to be verified by the participants who are relevant before analysis is completed. The consent should be implied by the participants of the study that includes the return of the survey in addition to answering a verbal question through the interview (Armstrong et al. 2013). Similarly in case of the quantitative studies, there should be measures applied in order to access the quality and credibility of data collection especially by criteria. The quantitative methods needed to be applied in the research designs to improve the validity of the research that was missing in the study.
Strengths and limitations of the Qualitative study
From the qualitative study discussed, it can be seen that the study was successful in considering the experience of a multiple stakeholder in the study. The study was able to show and provide significant insights into the process of mental health recovery as well as practice. This study also significantly provides an insight into the effect of the global on the landscapes of the local scenario in the lives of the refugees. The implications of the study show that there is an effect of separation from family that has a continuous effect on the live of the refugees especially in the countries of resettlement (Connelly 2014). It might seem to be difficult to modify the path of the circumstances that are monumental as well as cause migration in a forced way. In addition the service providers are able to support the coping abilities of the refugees by trying to understand the existing global-local intersections.
From the qualitative study it can be summarized that there are not only improvements in the specific aspects of evidence informed decision-making (EIDM) that is present amongst the managers of health service that are required, in addition there are more changes of systematic nature. This is especially at the organizational and the level individual management that are important to acquire competent evidence-informed decision-making practices for the health service managers (Cacciattolo 2015). The implications of the study involves the competence in case of the mid-level managers while applying the competency of EIDM which has been assessed. This paper also discusses the domains of improvement that has been identified in improving the level of competence of EIDM amongst mid-level managers in the group in addition to the organizational and individual levels. This study also showed that the managers who had participated in the assessment were competent enough in applying EIDM into their job roles. However they require guidance along with improvements. There were strengths as well as weaknesses of the managers while applying EIDM into their job roles which varied between the organizations.
References
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