Literature Review
Qualitative Article Review
Williams, V., Hardinge, M., Ryan, S., & Farmer, A. (2014). Patients’ Experience of Identifying and Managing Exacerbations in COPD: A Qualitative Study. NPJ Primary Care Respiratory Medicine, 24(1).
a. What is the health issue that provides the focus of this study?
The major health issue under focus in the study is the self-management of exacerbations at home that are associated with chronic obstructive pulmonary disorders (COPD). The article seeks to investigate the issue of COPD among patients and how they manage it themselves at home.
b. Generally, what have been the results of previous studies of this issue?
A review of past studies on the topic reveals numerous researches on self-management of chronic obstructive pulmonary disorders. Studies on the management of exacerbations that result from chronic obstructive pulmonary disorders have yield similar results as those outlined in the article under review. Nici, Bontly, ZuWallack & Gross (2014) revealed that when compared to usual care, self-management of COPD led to about 49% reduction in frequency of hospitalisations. Warwick, Gallagher, Chenoweth & Stein-Parbury (2010) in their study also found increased and better outcomes with self-management of COPD. Similar results have also been noted in Labrecque et al. (2011) whose study found reduced ED visits, frequency of hospitalizations and improved health-related quality of life on self-management of COPD.
c. What is the significance of the study?
Chronic obstructive pulmonary disorder is a disease of the lungs which makes it hard for patients to breathe. The effective management of the diseases is critical for reducing critical conditions which can increase instances of hospitalization. The article provides significant evidence-based practice that can help patients to self-manage and thus improve quality of health life.
a. What was the aim of the research?
The research was carried out with the aim of examining the understanding of the patients, their experiences in management and identification of chronic obstructive pulmonary disorders exacerbations in their homes.
b. What research design was used?
In order to meet the aims and research objectives, the researchers employed qualitative research design.
c. Describe the main characteristics of the research design identified.
Qualitative research design is a research methodology that involves the researcher as instrument of study and the researcher goes to the location or natural setting to collect data through observation and recording (Terry, 2017). According to (Suresh, 2014) qualitative research design is explorative in nature whose characteristics include the researcher acting as instrument of study, it is holistic in nature, involves ongoing data analysis, is flexible and elastic, involves multiple data collection strategies and emergence of study design as the study progresses.
Research Design
d. How did the research design chosen meet the aim(s) of the study?
The research study met the aims of the study through the use of interviews to help the researcher gain an understanding of the experience of patients and their management of COPD. The study recruited patients as part of clinical trial from using admission records in hospital, the COPD rehabilitation programmes as well as the records from respiratory practice nurses (Williams, Hardinge, Ryan & Farmer, 2014). The research eliminated bias in its sample selection through the use of purposeful sampling strategies.
a. What were the characteristics of participants in this study?
The study employed human subjects that consisted of 27 male and 17 females. The major characteristic of the research participants is that they were patients diagnosed with chronic obstructive pulmonary disorder. The participants were also aged 71 and had symptom duration of 1 year.
b. What are the inclusion and exclusion criteria of the sample?
The choice or exclusion of research participants was based on a criteria that included patients aged over 41 years, patients with MRC dyspnoea of equal or greater than 2, the absence of other diseases of the lungs, patients without heart failure, patients classified under (Grade IV) as having severe forms of COPD, those having over three months of life expectancy, those able to give informed consent, those with an understanding of written and verbal English, those with smoking of less than 10 pack years and those with respiratory volume and COPD patients registered with general practice nurse with exacerbations.
c. Why is it important to have these criteria identified before recruitment starts?
The inclusion and exclusion criteria is important to be identified before the start of recruitment because it allows the researchers to get rid of inappropriate participants and get useful study participants that would help inform the research question.
d. What sampling technique was used in this study?
Sampling techniques are often employed by researchers in recruiting of research participants. Sampling strategies vary depending on the research design chosen for a particular study. In the study under review, the researchers employed purposeful sampling strategies in recruiting participants from the trial sample.
e. How was this sample appropriate for meeting the research aim?
According to (Houser, 2011) research sample should be representative and appropriate to help strengthen study credibility. The research employed appropriate sample as it met all the inclusion and exclusion criteria and helped to meet the research aims since it consisted of individuals who could participate fully on the study with the characteristics that were desired in the study.
Data Collection
a. How were the data collected?
The main aim of the research was to examine how patients suffering from chronic obstructive pulmonary disorders manage the disease at home. In order to collect information for the study, the researchers employed interviews with the patients. The interviews were carried out at the settings of the patients, which was their homes. The research data was collected by the first author carried out the research owing to his vast experience the on qualitative research.
b. What specifically did the researchers do?
The data collection process specifically involved the use of a semi-structured guide and the interview questions that were focused on how the participants (patients suffering from COPD) experienced, identified and managed COPD exacerbations in their homes.
c. How did this data collection method fit the aims of the study?
The use of interviews fitted with the research aims as it allowed the researchers to ask patients questions that regarded how they experienced, identified and managed COPD in their homes. Interviews provided the researcher with an opportunity to gain first hand insight into the participant experiences and ask questions that might not have been possible to ask with the use of other methods such as questionnaires.
d. What might have been some advantages and disadvantages of this method of data collection?
The use of interviews as a method of data collection provided some advantages and limitations. For instance the method ensured a holistic study of self-management of COPD (detailed information), provided higher reliability and allowed the researcher and participant to seek for clarifications on issues that are deemed unclear (Houser, 2011). However, it is time consuming, narrow responses giving rise to validity issues and could lead to bias that arise from participants who may be unwilling to corporate with research process.
e. From your understanding of the weekly readings, what if any, are some alternative methods of data collection that these researchers could have chosen?
From the weekly readings and understanding gained in class, other than interviews, the other methods of collecting qualitative data that the researchers could have chosen are the use of focus groups (group dynamics) and telephone interviews.
a. How were the data analysed?
According to (Sargeant, 2012) qualitative analysis is performed to interpret data and attain an understanding of phenomenon under investigation. It allows researchers to draw inferences and make conclusions regarding the research question. In the research study the researchers analysed the data using NVIVO 10, qualitative data analysis software.
Data Analysis
b. Was the data analysis method appropriate for the study question and the research design?
In making the choice of qualitative data analysis technique, the researchers must ensure the method allows them to draw meaningful conclusions from the research data. In addition, the method must the one which is appropriate for the kind of data being analyses (Terry, 2017). In the research study, the chosen method of data analysis was appropriate since the method allowed analysis of data that was collected, which allowed to the researchers to make meaningful conclusions.
c. What did the researchers say about the rigour of their analysis?
The researchers pointed that data analysis was rigorous as this was achieved through coding that was done by a qualified researcher from outside the project. Rigour was also attained through an in depth discussion by the project team, of the analytical process throughout the research process.
d. How did the researchers describe the significance of the results?
The study recognised that the “expert patient” knowledge can be employed by clinicians and healthcare professionals to integrate such knowledge into the patient care plans in order to encourage early recognition and treatment of COPD exacerbations.
e. Into which other settings can these results be generalised?
Although the research study was carried out among patients older that 41 to determine how they identified, experienced and managed exacerbations associated with COPD, the results of the study can be generalised in other settings. The results can be extended in the study of self-management of chronic asthma in homes among patients aged 41 years and older. This can be used to determine how recognition of symptoms and their management can used to reduce hospital admissions among patients suffering from chronic asthma.
References
Houser, J. (2011). Nursing Research: Reading, Using and Creating Evidence (2nd ed.). Sudbury, MS: Jones & Bartlett Publishers.
Labrecque, M., Rabhi, K., Laurin, C., Favreau, H., Moullec, G., Lavoie, K., & Julien, M. (2011). Can a Self-Management Education Program for Patients with Chronic Obstructive Pulmonary Disease Improve Quality of Life?. Canadian Respiratory Journal, 18(5).
Nici, L., Bontly, T., ZuWallack, R., & Gross, N. (2014). Self-Management in Chronic Obstructive Pulmonary Disease. Time for a Paradigm Shift?. Annals of the American Thoracic Society, 11(1), 101-107.
Stevens, B., Yamada, J., & Ohlsson, A. (2001). Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Of Systematic Reviews.
Suresh, S. (2014). Nursing Research and Statistics (2nd ed.). New Delhi: Elsevier Health Sciences.
Terry, A. (2017). Clinical Research for the Doctor of Nursing Practice (3rd ed.). Burlington, MA: Jones & Bartlett Learning.
Warwick, M., Gallagher, R., Chenoweth, L., & Stein-Parbury, J. (2010). Self-management and Symptom Monitoring Among Older Adults with Chronic Obstructive Pulmonary Disease. Journal of Advanced Nursing, 66(4), 784-793.
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