Article Critique

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Course Title:

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April 27^th, 2021

Understanding the purpose and the problem

This assignment will focus on the critical evaluation of an academic article using a critiquing framework. The primary purpose of the critique is to establish whether the findings in the report are useful in nursing and the entire medical field. The article to be critiqued is an article written by Susan Kirk and Claire Fraser from Manchester University that based upon a medical study conducted in 2014 titled “Hospice support and the transition to adult services and adulthood for young people with life-limiting conditions and their families: a qualitative study” (Kirk & Fraser, 2014). Being able to think critically of articles such as this allows healthcare professionals to understand and implement evidence-based practice effectively. Evidence-based practice can be defined as combining extensive, reliable research with the expertise of professionals and the results of medical trials (Malloch, K. 2010).

Several key areas will be discussed in this assignment to evaluate the reliability of the article. The first will be analyzing the question at the center of the article as well as the aims and objectives of the study. Next, the design and methodology of the survey will be evaluated. Thirdly, the subjects, how many people participated, and how the issues were chosen will be assessed to ensure that there were not factors causing the study to lack reliability. The data collection method will then be discussed to analyze whether it was the most effective method for this particular study. The data analysis and results will then be reviewed to ensure accuracy and reliable results. Finally, the last section of the article to be evaluated shall be the experiment’s ethics, questioning whether or not the study was conducted ethically. This article is titled “Hospice support and the transition to adult services and adulthood for young people with life-limiting conditions and their families: a qualitative study.” This title is very informative and gives readers a great deal of information around what the purpose of the article as a whole is. However it has been noted that informative yet short titles attract more readers(Grant, 2013). The researchers aimed to interview young people with life-limiting conditions and their families and hospice staff who have experienced the transition from pediatric to adult services to gain an insight into their experiences and identify areas that need improvement. The main reason for undertaking this study is clearly outlined in the article. This is due to all the medical advances made over recent years, more young people who have life-limiting conditions are surviving into adulthood. The main reason why I settled on this article was the fact that palliative care is a type of care that helps people live better lives while they are undergoing treatment for a severe illness by offering practical, emotional, and spiritual support. When someone with a severe disease reaches the end of life, hospice care is palliative care that focuses on relieving symptoms. It is unfortunate that, this service focuses on the elderly, leaving the young adults out. Evidence-based practice is fundamental to delivering safe care to patients. Providing safe care relies upon healthcare professionals’ ability to critique medical studies, such as the study at the center of this assignment, and assess their reliability. This allows them to decide whether or not it would be beneficial and safe for patients to receive the care discussed in the article (Horntvedt et al., 2018).

In 2013 it was estimated that 55,721 adults aged 18 to 40 years old with a life-limiting condition in England alone, and these numbers are likely to increase over the coming years this is according to the Care Quality Commission (2014). Due to these numbers rising, the availability and quality of services available to these young adults must be increased. Providing young people with a well-coordinated transition to adult services is critical as bad changes have been shown to have a direct, negative impact on the health of young people with life-limiting conditions (Campbell, F. et al., 2016).

Determining if the design and methodology are used properly

The following section has to do with the design and methodology of the study. This section is critical because it helps in establishing what was done and the cause and effect relationship. The technique used in the study was a qualitative study that was based on structured interviews. The author hoped to come up with generalized knowledge about a specific situation that is aimed at getting findings that other researchers can replicate. The structured interviews are important because the researcher can easily compare the responses from the 39 respondents. For example, participants were asked to describe how their or the child’s needs changed as they grew older and what support the participants were aware of to contact for support. If the researchers used an alternate method to collect data from participants, such as a survey, they would have limited the participants’ responses and not have been given as much detail as they received by conducting interviews to collect data.

The respondent’s responses include objective and equal criteria for ranking replies. This is quite important because it helps ensure that the interviewer does not experience the pressure of having to think of questions on the spot. The main disadvantage with having a structured interview is the fact that the pre-planned set of questions might be revealed, and as a result, the interviewers end up not giving honest opinions. Also, the questions might not be relevant to each interviewee (Austin& Sutton, 2014). The 39 respondents who were interviewed consisted of young people with life-limiting conditions, their families, and hospice staff about their experience of transitions between childhood and adult healthcare services. This helped in increasing the reliability of the study. The variation in study participants increases the chances of the overall result being an accurate representation of the entire population. Despite this, the same size is too small to represent the people they are researching, which could question the reliability and validity of the study (BMJ, 2021). The main aim of the interviews was to establish how young people with long-term illnesses and their parents experience transition, secondly, to identify the perceptions of families and hospice staff on family support and during the transition to adulthood, and finally, identify the implications of the children’s hospices. The Cormack’s Framework that is used to critique the article seeks to establish the following: (See a sample of the framework attached in the appendix).

• If this section of the article states the approach the authors used and, in this case, it does, Kirk and Fraser (2014) clearly state that they used a qualitative approach, in this case, an interview, to obtain their data.

• Suppose the chosen method corresponds with the issue at the heart of the research. As the overall results of this study had to be formed from a general opinion of all participants, using interviews to obtain qualitative data was the appropriate method to choose.

The Framework also seeks to understand the participants that are used in the study. According to Kirk and Fraser (2014), out of seventy-four people asked to participate, thirty-two people from twelve separate families and seven members of staff agreed to take part in the study. The Framework goes a long way in establishing if the selection of participants was consistent with the study method. In this study, all participants were young people with life-limiting conditions who had experienced the transition. The young person’s family member or a member of staff all belonged to one facility. The Framework aims to establish how the participants were chosen. The article is not captured at all which one weakness I have noted under the design and methodology. It is clear that the sample size used in Kirk and Fraser’s research was minimal, and the subjects came only from one particular hospice. I feel that the study should have used more participants as this would have paved the way for more reliant findings or, instead results. Small, limited samples tend to undermine the reliability of medical studies such as the one at the center of this assignment.

The research questions were well-formulated and captured the purpose of the study. The research questions aimed to establish how young people with long-term illnesses and their parents experience transition. Secondly, to identify the perceptions of families and hospice staff on family support and during the transition to adulthood, and finally, identify the implications of the children’s hospices. However, one area that the researchers failed in is that they did not provide the hypotheses for this study. Hypotheses are essential because they go a long way in establishing the data collection and analysis by responding to the research question. A hypothesis allows researchers to discover and forecast a relationship between variables based on theoretical guidance or empirical evidence.

The instrument that was used was the questionnaire. The researchers developed this tool and the topic guides were designed from literature for the participant groups. Also, the questions raised by the interviewees were captured in the questionnaires. It is evident from the research that before conducting their study the researchers sought approval to proceed from a University Research Ethics Committee. Seeking support from ethics committees is crucial when undertaking any medical examination to ensure that all participants’ safety, health, and dignity are maintained. By seeking this approval the researchers confirmed that fully-informed consent was received from all the people who chose to participate in this study as well as guaranteeing that all names and locations involved in the study were kept confidential to maintain privacy and to adhere to. They were receiving informed consent before including a participant in a medical study such as this one is also crucial because, as her article explains (Arnott et al., 2020), children are still classed as a vulnerable group, so consent must be gained from them personally or by their legal guardian. If informed consent is not obtained correctly and the child or their guardian was not fully aware of what the study would entail, they could take legal action.

Data Analysis and Results

Researchers use research data analysis to reduce data to a tale and analyze it to extract insights. It makes sense that the data processing process aids in the reduction of a big chunk of data into smaller pieces. The researcher analyses the results well since he captures the characteristics, numbers and percentages. This enables one to understand the consequences. The researchers also captured the key themes as being the following: transition to adult services, moving to the young adult unit, changing support needs, and consequences for hospice staff. The study results reveal that overall; the transition from childhood to adult services has several shortcomings. Some examples of flaws identified were that parents felt unsure of where or how to get emotional support for themselves now that their child was no longer a paediatric patient. Supporting the parents of children with life-limiting conditions is also a crucial part of care. It has been recorded that when healthcare professionals support parents effectively, it will help motivate them to participate in their child’s care, which will have a positive impact on their child’s health (Miller, S., 2010). Cormack’s Framework outlines several areas to assess when reviewing data analysis. The main demerit of the data analysis and findings is that the data collected in this research was not quantitative and not plotted as a statistic, therefore, makes it challenging to analyze the data correctly and be in a position to identify trends and variations in data. However, the used approach was appropriate for the qualitative research since the researcher’s main aim was to explore the personal opinions of people who have experienced transitioning between services so using the method of interviewing was a suitable choice.

Conclusion

The research was necessary because it has contributed to knowledge by being able to bring to the forefront the experiences and the support needed by the patients, the parents/ caregivers, and the hospital staff and the implications of their training needs and roles. Based on the findings, it is evident that a lot is missing in terms of support, and most specifically, the emotional needs are not being catered to. This was occasioned by less interaction with the hospice staff and peers who typically offered the help. Through this research, it was evident that no efforts have been made to research the psychosocial needs of young adults under palliative care. Therefore, there is a need for psychosocial support (Kirk & Fraser, 2014).

The small sample size cannot provide representative data for the country. As stated in the article, data was only collected from 39 people from just one hospice. As only one hospice was used,, data will not represent the feelings of young people, families, and staff from other hospices across the United Kingdom who have alternate transition experiences. For this reason, more participants from more hospices would need to be interviewed, and more data would need to be collected before forming an overall opinion to put at the center of evidence-based practice (Kirk & Fraser, 2014).

As stated earlier, it is unfortunate that, this service focuses on the elderly, leaving the young adults out more often than not. Evidence-based practice is fundamental to delivering safe care to patients. Providing safe care relies upon healthcare professionals’ ability to critique medical studies, such as the study at the center of this assignment, and assess their reliability. This allows them to decide whether or not it would be beneficial and safe for patients to receive the care discussed in the article. The design used in the study was a qualitative study that was based on structured interviews. One of the significant gaps in the research was that the researcher failed because they did not provide the hypotheses for this study. Hypotheses are essential because they go a long way in establishing the data collection and analysis by responding to the research question. A hypothesis allows researchers to discover and forecast a relationship between variables based on theoretical guidance or empirical evidence. The data analysis and findings are that the data collected in this research was not quantitative and not plotted as a statistic. Therefore, it makes it difficult to analyse the data properly and be able to identify trends and variations in data. I feel that the research should have been quantitative (Austin & Sutton, 2014).

References

Arnott, L. et al (2020) ‘Reflecting on three creative approaches to informed consent with children under six’, British Educational Research Journal, 46(4), pp. 786-801. doi: 10.1002/berj.3619

Austin, Z. and Sutton, J. (2014) ‘Qualitative Research: Getting Started’, The Canadian Journal of Hospital Pharmacy, 67(6), pp. 436-440. doi: 10. 4212/cjhp.v67i6.1406

Benton, D. C. and Cormack, D. F. S. (ed.) (2000) The research process in nursing. 4th edn. Oxford: Blackwell Sciences Ltd.

BMJ (2021) 3. Populations and Samples. Available at: https://www.bmj.com/about-bmj/resources-readers/publications/statistics-square-one/3-populations-and-samples (Accessed: 7/1/2021)

Campbell, F. et al. (2016) ‘Transition of care for adolescents from paediatric services to adult health services’, Cochrane Database of Systematic Reviews, pp. 3-4. doi: 10.1002/14651858.CD009794.pub2

Care Quality Commission (2014) From the Pond into The Sea, Children’s transition to adult health services. Available at: https://www.cqc.org.uk/sites/default/files/CQC_Transition%20Report.pdf (Accessed: 5/1/2021)

Faber, J. and Martins-Fonseca, L. (2014) ‘How sample size influences research outcomes’, Dental Press Journal of Orthodontics, 19(4), pp. 27-29. doi: 10.1590/2176-9451.19.4.027-029.ebo

Grant, M. (2013) ‘What makes a good title’, Health Information and Libraries Journal, pp. 259. doi: 10.1111/hir.12049.

Great Ormond Street Hospital for Children (2020) Advice and guidance on getting Ethical Approval from a Research Ethics Committee. Available at: https://www.gosh.nhs.uk/research-and-innovation/information-researchers/joint-rd-office/research-governance/advice-and-guidance-getting-ethical-approval-research-ethics-committee (Accessed: 5/1/2021)

Horntvedt, M-E et al (2018) ‘Strategies for teaching evidence-based practice in nursing education: a thematic literature review’, BMC Medical Education, 18(1), pp. 1-2. doi: 10.1186/s12909-018-1278-z

Jamshed, S. (2014) ‘Qualitative research method-interviewing and observation’, Journal of Basic and Clinical Pharmacy, 5(4), pp. 87-88. doi: 10.4103/0976-0105.141942

Kirk, S. and Fraser, C. (2014) ‘Hospice support and the transition to adult services and adulthood for young people with life-limiting conditions and their families: A qualitative study’, Palliative Medicine, 28(4), pp. 342-352. doi: 10.1177/0269216313507626

Malloch, K. (2010) Introduction to Evidence-Based Practice in Nursing and Health Care. 2nd edn. London: Jones and Bartlett

Miller, S. (2010) Supporting Parents. Improving outcomes for children, families and security. Berkshire: Open University Press

National Institute for Health and Care Excellence (2015) Transition from children’s to adults’ services. Available at: https://www.nice.org.uk/guidance/ng43/documents/transition-from-childrens-to-adults-services-full-guideline2 (Accessed: 31/12/2020)

Nursing and Midwifery Council (2008) The Code. Available at: https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-old-code-2008.pdf (Accessed: 5/1/2021)

Appendix

An example template to effectively implement Cormack’s critiquing framework that has been completed to critique Kirk and Fraser’s article.