ROUGH DRAFT QUALITATIVE RESEARCH CRITIQUE AND ETHICAL CONSIDERATIONS NRS 433

ROUGH DRAFT QUALITATIVE RESEARCH CRITIQUE AND ETHICAL CONSIDERATIONS NRS 433

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The main topic of interest is the management of type 2 diabetes. Type 2 diabetes mellitus is one of the health problems that affect a significant proportion of people globally. The increasing rates of type 2 diabetes has made it one of the leading cause of mortality across the globe. The management of type 2 diabetes is therefore the main concern for the healthcare professionals. From the study, there is an investigation on whether the lifestyle changes and the behavioral interventions can lead to the better treatment outcome compared to the use of medication alone. The main reason for undertaking the study about type 2 diabetes is to determine the best intervention processes aimed at reducing diabetes complications among the vulnerable patients. Also, the topic is of great interest because it attempts to highlight some of the best treatment that can be used to prevent type w diabetes among the vulnerable populations. The research in this topic is also significant in understanding of the processes that are critical when it comes to the management of other complications associated with the type two diabetes. The PICOT question for the study is: In adult patients with type 2 diabetes mellitus, does the use of lifestyle and behavioral interventions with medications result in better treatment outcomes when compared to the use of medications alone in a period of six months?

Article 1

Følling, I. S., Solbjør, M., Midthjell, K., Kulseng, B., & Helvik, A. S. (2016). Exploring lifestyle and risk in preventing type 2 diabetes-a nested qualitative study of older participants in a lifestyle intervention program (VEND-RISK). BMC public health, 16(1), 876.

Background Article 1

The main problem that led to the formulation of the study is the increasing deaths attributed to type 2 diabetes. Also, the problem of diabetic patient overcrowding in the healthcare institution led to the research on some of the best intervention strategies in the management of type 2 diabetes. The main objective of the study was therefore to determine the best interventions when it comes to the type 2 diabetes management among the patient, both in the communities and within the healthcare settings. The establishment of the study significance was based on the need to establish some of the best interventions when it comes to the management of type 2 diabetes. The high cost of treatment of type 2 diabetic condition, increased patient’s suffering, as well as the increasing number of diabetic conditions led to the establishment of the study. The purpose of the study was to establish the best interventions when it comes to the management of type 2 diabetes. Behavioral interventions and lifestyle changes are some of the interventions that formed part of the study. Some of the research questions identified in the process of study included:

• In what ways do the older adults perceive their lifestyle as well as being at risk of type 2 diabetes while participating in a lifestyle intervention program?
• Does the lifestyle changes are behavioral interventions the best strategies for managing types 2 diabetes?

The purpose of the study and the research questions are related to the problem under the study. The main problem in the study is the increasing cases of the type 2 diabetes. Therefore, the research questions and the purpose of the study are geared towards addressing the research problems. 

Article 2

Rygg, L. Ø., Løhre, A. & Hellzèn, P. O. (2017). Lifestyle changes in diet and physical activities after group education for type 2 diabetes – the active ingredient in the education. A qualitative study. Open Journal of Nursing, 7(10): 79907, 1181-1195. doi: 10.4236/ojn.2017.710086 

Background Article 2

The main clinical problem under the study was the increasing cases of type 2 diabetes as well as lack of the best intervention strategies for managing the increasing population of the diabetic patients. Management of the increasing number of diabetic patients have become a problem for different healthcare institutions. Also, the increasing number deaths from type 2 diabetes has become one of the main concerns when it comes to the management of diabetic patients. The establishment of the study significance was based on the need to determine whether lifestyle changes in diet and physical activities are some of the best interventions when it comes to the management of type 2 diabetes. Also, costs of the treatment processes and the increasing complications associated with the type 2 diabetes led to the study significance. The purpose of the study was to explore the experiences of the participants in diabetes self-management education in relation to physical activity and diet. Some of the research questions identified in the qualitative study included:

• What are the experiences of the participants in diabetes self-management education in relation to physical activity and diet?
• Does physical exercise and diet management reduce the cases of type 2 diabetes?

Relationship to Nursing Practice

The findings in article 1 and 2 relevant in the answering the PICOT question. Information contained in the two qualitative research studies will be analyzed to determine the best interventions when it comes to the management of type 2 diabetes. The perceived experiences of the participants with the lifestyle interventions targeting dietary modification and physical exercises are some of the best information that can be used to answer the PICOT question. The interventions and comparison groups from the two qualitative article, Article 1 and Article 2 are comparable to the ones that have been identified in the PICOT statement. There is a similarity between the comparison and the intervention groups in all the four articles identified for the study. The comparison in the groups in the two research articles serves as a source of counterfactual causal inference.

Method of Study

Article 1

The method of study established in article 1 was case study. There is the investigation of phenomenon within the real context. Also, the study is descriptive and explanatory analysis of the intervention processes when it comes to the management of type 2 diabetes. Semi-structured interviews were conducted with the participants who were newly diagnosed with type 2 diabetes. The participants also had history of difficulties in regulating their blood sugar levels alongside expressing interest to attend the program. The audio-recorded interviews were transcribed verbatim and thematic analysis performed. The sample size used in the study was 16, in other words, study 16 respondents were identified. The sample was appropriate and adequate for the study. It reflected the characteristics of the entire population under the study. According to Green and Johnson, (n.d), an appropriate sample size should be a reflection of the population under the study. The main data collection tool used in the research was the questionnaires to record essential information from the respondents. The data was sorted through the use of Microsoft Excel where extraneous or outliers were removed. The process of data analysis involved measurements of the levels of interventions processes and identification of the best approaches. There was no bias in the process of the study. Literature review involved analysis of the past research outcomes to formulate an appropriate theoretical framework. Some of the sources of information used included quantitative research processes. The author only cited quantitative studies relevant to the study. The literature review contained adequate information to build on the logical argument in the research process. According to Green and Johnson, (n.d), articles older than five years may contain irrelevant information that may be used in the study process.             

Article 2

The study was phenomenological, it focused on the commonality of live experience within the diabetic patients under the study. The sample consisted of 32. They included 22 participants who attended the program and 10 providers who implemented it. The sample was adequate and represented the true characteristics of the entire population. According to Green and Johnson, (n.d), an appropriate sample size should be a reflection of the population under the study. In the process of study, questionnaires were used to collect data from the respondents. Sorting the data involved elimination of the extraneous variables and irrelevant information. Data analysis was done based on the relevance of the articles used. Controlling the biasness involved adherence to the research guidelines. Literature review involved analysis of the past research outcomes to formulate an appropriate theoretical framework. Some of the sources of information used included quantitative research processes. The author only cited quantitative studies relevant to the study. The literature review contained adequate information to build on the logical argument in the research process. According to Green and Johnson, (n.d), articles older than five years may contain irrelevant information that may be used in the study process.              

Results of the Studies

            The findings of the article 1 revealed that the lifestyle and behavioral program was acceptable for use in the prevention of type 2 diabetes. However, it should be structured to address the cultural needs of the different participants. There is also the need for the provision of resources and facilitation of the participants at the locality or general practice level. Despite these challenges, the participants reported that the lifestyle and behavioral interventions increased their level of awareness on preventive measures for type 2 diabetes mellitus. For article 2, the perceived experiences of the participants with the lifestyle interventions targeting dietary modification and physical exercises. The intervention processes are critical in nursing practice. In other words, the two studies provide knowledge on nursing practices when it comes to the management of type 2 diabetes.

Ethical Considerations

While undertaking the study, researchers employed ethical practices that included confidentiality of information and respect for human dignity. In both the studies, researchers were able to protect participant’s data and information obtained (Liang, 2019). Also, they managed to do their studies in line with the standards that protect human dignity, particularly for the study participants (Woodfield & Iphofen, 2017). All the researchers adhered to the confidentiality standards and respect for human dignity. Also, the protection of privacy was involved in the study process. According to Green and Johnson, (n.d), research respondents need to be protected; their privacy need to be observed at all costs.   

Conclusion

Article 1 provides insights into the acceptability and effectiveness of lifestyle intervention programs in the prevention and management of type 2 diabetes. As a result, it shows the enhanced effectiveness of the proposed intervention in this project, hence, its relevance to the PICOT statement. For article 2, the study reveals that the lifestyle interventions were effective in empowering the participants engage in healthy eating habits and physical activity. Therefore, it supports the PICOT question by showing the benefits of lifestyle interventions in the prevention and management of type 2 diabetes mellitus. The findings are critical when it comes to the management of type 2 diabetes. In both the two research articles, thesis statements are in line with the research questions and the study findings. Findings from the two articles are critical when it comes to the management of diabetic patients.

References

Green, S. & Johnson, J. (n.d.). Research ethics and evaluation of qualitative research in Helbig, J. (n.d.) History and process of nursing research, evidence-based nursing practice and quantitative and qualitative research. From: https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/2

 Liang, J. (2019). Qualitative research methods: collecting evidence, crafting analysis, communicating impact: by SJ Tracy, West Sussex, UK, John Wiley & Sons, Ltd. 368 pp., $115.50 (hardback), ISBN: 978-1-4051-9202-3.

Woodfield, K., & Iphofen, R. (2017). Introduction to Volume 2: The Ethics of Online Research. Bingley: Emerald Publishing Limited, 1-12.

Rygg, L. Ø., Løhre, A. & Hellzèn, P. O. (2017). Lifestyle changes in diet and physical activities after group education for type 2 diabetes – the active ingredient in the education. A qualitative study. Open Journal of Nursing, 7(10): 79907, 1181-1195. doi: 10.4236/ojn.2017.710086

Assessment Description

In this assignment, you will write a critical appraisal that demonstrates comprehension of two qualitative research studies. 

For this assignment, use the nursing practice problem and two qualitative peer-reviewed research articles you identified in Topic 1 (or two new articles based on instructor feedback in Topic 1). In a 1,000-1,250-word essay, summarize two qualitative studies. 

Use the “Research Critique Guidelines – Part I” document to organize your essay.

You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Results of Study

The two articles make critical findings that demonstrate the effectiveness of using the Fall TIPS model to reduce and prevent the occurrence of falls in older patients. In their study, Vincenzo et al. (2022) found that older adults do not engage in fall prevention because of reasons related to self-perceived severity of their condition, susceptibility to falls and lack of limited self-efficacy. They also do not get sufficient information on fall prevention from their medical and healthcare providers. The article asserts that facilitating fall prevention strategies requires ensuring that older adults have knowledge, get engaged, and socialize with the providers. The researchers also emphasize the need to engage families, friends and other healthcare professionals to deliver cues to action and materials.

The article by Carter et al. (2020) Fall TIPS is essential to reducing falls among the targeted patient population. The article asserts that Fall TIPS improves nurses’ overall motivation, enhances patients’ understanding of their roles and the overall integration of the model in the workflow process for the organization. The article also identifies barriers to implementation of Falls TIPS like poor engagement practices, use of residual fall prevention approaches, especially the one-size-fits-all approach.

The two studies have serious implications for nursing practice. Firstly, they indicate that nurses must engage their patients concerning the type of fall prevention strategy that they want to implement in their practice so that they attain a buy-in for better implementation. Secondly, they should provide information for patients and their families to make informed choices and decisions. Thirdly, the articles are categorical that Fall TIPS and its implementation requires the involvement of all stakeholders for better outcomes.  

Ethical Considerations

Ethical considerations are essential in conducting nursing research in any setting. Ethical considerations ensure that research subjects are not harmed by the actions of the researchers. Through these considerations, researchers get approval from institutional review boards (IRBs) to conduct research and attain the expected credibility and validity of the studies. The two ethical consideration include informed consent and confidentiality of participants’ information. Informed consent implies that researchers should seek participants’ voluntary consent by offering sufficient information based on the principles of beneficence, non-maleficence, autonomy, and justice. Confidentiality means that the researchers will not disclose personal information or data related to the research subjects to protect their overall identity. This ensures that research outcomes are validity and reliable.

The researchers in the two articles considered informed consent and confidentiality in their studies. Firstly, they sought approval from the IRBs to ensure that they will follow all the protocols. Secondly, they do not reveal any names of the participants and make an ethical declaration in their works. These imply that they adhered to the expected ethical considerations and need for reliable outcomes.

Conclusion

            Research is an essential part of delivering quality care to patients in diverse conditions. The critique of the two qualitative research articles on using Fall TIPS model to prevent and reduce falls among older adults demonstrates that it is effective and requires providers to engage the patients where necessary. The Fall TIPS model as an intervention is evidence-based practice approach that allows providers to enhance overall response to falls for patients in diverse settings.

References

Carter, E. J., Khasnabish, S., Adelman, J., Bogaisky, M., Lindros, M. E., Alfieri, L., … & Dykes,

P. (2020). Adoption of a patient-tailored fall prevention program in academic health systems: a qualitative study of barriers and facilitators. OBM Geriatrics, 4(2), 1-21.

DOI: 10.21926/obm.geriatr.2002119

Centers for Disease Control and Prevention (CDC) (2023). Older Adult Fall Prevention.

https://www.cdc.gov/falls/index.html

Rogers, C., Shamley, D., & Amosun, S. (2021). Older adults’ experience of an exergaming

intervention to improve balance and prevent falls: a nested explanatory qualitative study. Applied Sciences, 11(24), 11678. https://doi.org/10.3390/app112411678

Vincenzo, J. L., Patton, S. K., Lefler, L. L., McElfish, P. A., Wei, J., & Curran, G. M. (2022). A

qualitative study of older adults’ facilitators, barriers, and cues to action to engage in falls prevention using health belief model constructs. Archives of gerontology and geriatrics, 99, 104610. https://doi.org/10.1016/j.archger.2021.104610