What is the problem the study was conducted to address?
The study was conducted to address the problem of post traumatic stress disorder (PTSD) among emergency room nurses. It presents the reasons why they may experience PTSD and the effect of tailor made solutions to PTSD. The research linked this problem to young nurses who are not used to the ER and who do not necessarily know how to deal with the traumatic events that they witness and experience in the ER.
Why is the problem an important one for nursing to study?
The problem is an important one in nursing study because it has direct implications on the lives of nurses and the patients. PTSD is a psychological condition that can extensively affect nurses` qualities of life. This also means that their ability to work and deliver as expected is effected by PTSD. Studying the issue therefore opens up the path towards a clearer understanding of PTSD, its origins among nurses and the ways through which nurses can prevent and overcome it. Dissecting the problem and getting the best solutions to it is therefore one way of improving patient care and assistance to the families of patients. These are hallmarks of nursing practice and it is important for them to be improved on a constant basis.
What is the purpose of the study?
The purpose of the study was to establish the different ways through which nurses who experience situations that predispose them PTSD in the ER can be assisted to overcome trauma so that they do not suffer from PTSD. In order to achieve this aim, the researchers identified and described the traumatic events that nurses in the ER go through, the symptoms of PTSD, the activities that nurses currently engage in to prevent and establish the best out of the tested activities.
What are the research question(s)?
Though not outlined out rightly, the research questions are inferable from the objectives of the research and therefore they are as stated below
1. What are the traumatic events that new nurses go through in the ER?
2. What are the PTSD symptoms that ER nurses may experience?
3. What support activities are in place for nurses who work in the ER? and
4. Which among the uncovered activities are the most propitious?
Are the questions stated broadly enough for a qualitative study? Explain WHY.
The questions are indeed stated broadly enough for a qualitative study because they give directions for the collection of qualitative information. They are not overly restrictive because they are not structured and they largely enable the researchers to investigate the phenomena being explored broadly as suggested by Mason (2002). The questions have a formidable breadth to support the qualitative study.
What specific qualitative method is used?
Qualitative data collection methods used included interviews and a sociodemographic questionnaire. The interviews were however the main tool used to collect information about the main research questions. Some of the questions asked during the interview were open ended and therefore responses were opinionated and in turn qualitative in nature.
Provide a clear description of the qualitative method utilized
Creswell (2009) and Wood & Ross-Kerr (2010) noted that interviews are data collection methods in which the interviewers use sets of questions to elicit responses from the interviewees. Creswell (2009) noted that interviews can be characterized by closed ended/ structured or open ended questions/unstructured or both (semi-structured) depending on the nature of the study. In this case, the researchers utilized both closed and open ended questions because the participants were expected to give unrestricted responses to some questions and not in others. The responses were opinionated and therefore they were coded qualitatively but some quantitative data was also collected.
In what way is the method used an appropriate one for this study? Clearly justify your answer.
The use of interviews with open ended questions for any study is justified by the topic, the sample and the nature of information needed as outlined by Flick (2009). First, the topic being studied and the set research questions call for the collection of qualitative information. Interviews therefore stand out as a good option. Second, the researcher selected a purposive sample of only 12 nurses and this number is easily manageable through the use of interviews. Third, it was necessary to collect as much information as possible with regard to their experiences and therefore closed ended questions may have locked out information that was imperative for drawing conclusions.
Identify the philosophical/theoretical basis of the study.
The study is based on one major theory widely used to understand psychological well being. The used psychological theory which is Neuman`s system theory links trauma with psychological well being. This model links both intrinsic and extrinsic reactions to experiences that people go through in different settings.
Describe/discuss the references cited to support the philosophical or theoretical approach used.
To support the model used as the basis for this research, the researchers cited a text that was written by Neuman in 1995. The selection of this source adds value to the basis of the research because the text written by Neuman is a primary source outlining the major tenets of the theory. The reference used is therefore quite old considering it was written over 10 years ago but it is credible because it is a primary source.
Is the philosophical or theoretical basis of the study clearly linked with the study assumptions, data collection procedures and analytical and interpretative approach. How? If not, describe what is missing.
The theoretical basis of the research is linked to its assumptions and data collection procedures because the authors clearly state that the model outlines primary, secondary and tertiary levels of preventing the negative effects of traumatic events that determine wellness. The researchers sought to examine the activities at the different levels that are meant to prevent PTSD among ER nurses. The researchers therefore outlined an analysis of the tenets that they applied in the research.
How is the framework related to the body of knowledge in nursing?
The framework is related to the body of knowledge in nursing because its tenets seek to outline the importance of wellness among both patients and the nurses in the health care setting. It outlines links that cannot be dispensed from the body of nursing knowledge.
Are the articles relevant with previous studies and theories described? Justify your response.
The article is relevant with previous studies and the theory described because the authors established clear linkages between them. For instance, Neuman`s theory has had its major tenets linked to aspects of the research as discussed earlier on. The researchers also outlined findings of previous researches whose findings are similar to theirs.
Are the references current? What are the number of sources within past 10 years? What are the number of sources within past five years?
Nine out of 27 sources that were used were written within the last five years. This constitutes one third of the total. 20 out of the 27 sources were written within the past 10 years. The oldest source is dated 1989. It can therefore be stated that the researchers made a conscious decision to use recent sources.
Describe the current knowledge about the research problem.
Current knowledge about the problem does not cover all possible aspects of knowledge that are there to be covered. This is deductible from the number of studies the researchers outline under the section they dabbed -previous studies of PTSD and ER nurses. Only five studies are presented as have similar findings to the one carried out.
Specify the gap in the literature that justifies the need for the research.
The research covers the events that cause PTSD among ER nurses because not much has been written on this subject. It also focuses on the activities that can help nurses to prevent PTSD and deal with it.
Describe the subjects and the setting.
The researchers chose to involve 12 participants from a University Medical Center (UMC) based in Quebec. Those selected were workers of the UMC alongside 128 other nurses at the UMC. The selected participants worked in either two of the ERs in the UMC.
In what way is the method of obtaining subjects appropriate? Justify your answer.
The method of obtaining subjects was appropriate because they were selected purposively. They had to be working in the ER and had to be young and fairly new to the profession. The sample could not have come from nurses working in other sections of the hospital because that way the sample would not have been homogenous.
In what way is the size of the sample used adequate? Justify your answer.
The sample used is adequate because only a few nurses can work at the ER at specific times. Despite the high cumulative number of all nurses, only few could be selected and therefore 12 was adequate as a purposive sample.
In what way was the setting in which data were collected an appropriate one for this study? Why? Justify your answer.
The setting for data collection was appropriate because the interviews were conducted in closed rooms with minimal interference. The interviews were therefore not interrupted and this increased response objectivity.
Indicate the type of consent obtained and institutional review board approval.
Consent was obtained from the participants who were informed about the project and its purpose. They were taken through informational sessions before they gave consent to take part in it. The research was also approved by the UMC administration and its ethics committee.
In what way were the steps taken to protect the rights of subjects adequate?
The right of choice is the first one because they were given the option of choosing not to take part. They were also assured of confidentiality and were offered psychological support.
Identify the data collection procedures used and provide a description of how the data was collected.
Data collection involved filling up sociodemoraphic questionnaires and answering interview questions that were either structured or structured in a closed room. The interviews were one-on-one they were recorded after which they were transcribed for analysis.
In what way were the data collection procedures used consistent with the purpose of the qualitative approach selected? Clearly justify your answer.
Data collection involved the use of interviews and some of the questions were open ended. Participants were therefore able to share qualitative information about on the questions posed to them. The use of audio recorders is evidence that most of the data collected was qualitative.
Define data saturation.
Data saturation refers to that point at which researchers may feel that they are not collecting any new information from participants and therefore the data collection process may as well end there (Denise & Beck, 2010).
What evidence is there that data saturation was achieved? Describe fully.
Data saturation was achieved because of the experiences the nurses went through. The nurses worked in similar situations and dealt with the same cases at the ER in some instances and therefore there was a high chance of data saturation. The participants were asked the same questions and they had undergone similar experiences. It is stated that towards the end of data collection, the researchers did not feel like they were getting any new information about the first and second objectives.
Identify the qualitative data analysis procedures used to examine the data
Data was analyzed using Miles and Huberman`s data analysis which is characterized by collection, reduction, presentation, verification and conclusion. Information coding of symptoms and traumatic events was qualitative.
Define the qualitative data analysis procedures used.
Collection refers to accumulation of information. Reduction refers to classification into major themes and in this case coding was used. Presentation involved putting the information together logically. Verification involves confirming the data through validation by the participants and researchers and conclusion involves drawing valid inferences from the collected data.
In what way(s) are the data analysis procedures appropriate for the data collected? Clearly justify your answer.
The data analysis procedures are appropriate for the collected data because they facilitated classification of varied responses that may have been one worded, phrased or expressed through sentences. Selecting major themes was therefore appropriate for the research.
In what way(s) are the data analysis procedures consistent with the qualitative method used? Clearly justify your answer.
Data analysis procedures were consistent with semi-structured interviewing as a method of collecting data because the major themes were already captured in the questions and it was possible to code them further and select those that were relevant to the study.
Define decision trail.
Decision trail refers to the documentation of the choices of analysis which researchers make throughout the research course (Denise & Belck, 2010).
Was a decision trail developed? Was it reported in sufficient detail? Clearly justify your answer.
A decision train was developed and was reported in detail. This is evidenced by the fact that the researchers went through the transcripts and revised them. They also gave the participants chances to validate their responses.
In YOUR OWN WORDS, what are the outcomes of the study? What did the study reveal? Provide a DETAILED response of at least ONE FULL PARAGRAPH as this is worth 8 points!
The findings established that ER nurses are traumatized by what they see, what they experience as victims and stressful contextual experiences such as work stress and witnessing friends, family members and patients in distress. It was established that indeed trauma in the ER leads to PTSD among nurses and the symptoms included distress, dissociation, unresponsiveness, hyperarousal, avoidance and revival. Findings also revealed that several activities assist in reducing PTSD symptoms and those that were founds to be most effective included support from colleagues, ER simulations and psycho-education. It therefore revealed that the Prevalence of PTSD among ER nurses is high but it can be prevented and managed through the named methods.
What are two major strengths of the scientific merit of this study? (This does NOT refer to outcomes of the study). Address credibility and confirmability.
The research was conducted using a participant sample with recent first hand ER experiences. It has its basis on established theories and its findings find high applicability in nursing research and practice.
What are two major limitations of the scientific merit of this study?
Though the sample was appropriate, it limits the extent to which the results can be transferable to other settings. 12 is a pretty small number. The research also had 10 out of 12 of the participants being female. Gender may therefore be an aspect that affected the findings since males and females are known to have different reactions to traumatic events in some instances.
To what extent are the study findings valid? Justify your answer.
The findings were internally valid to a great extent because the participant group was purposively sampled, were working in the same hospital and had a minimum of 7 years work experience in the ER. External validity may be limited due to the sample size and the institution where they work. The results are however generalizable to a limited extent.
How did the researcher generalize the findings? Where in nursing can the results be applied?
The researchers generalized the findings by outlining implications to practice and policy. The implications included supporting ER nurses recognizing the effects of trauma on ER nurses and coming up with activities that would help them to get over their trauma.
What did the researchers say the relevance of the data was? Describe the researchers` interpretation of the findings.
Findings were found to be relevant for practice and policy formulation. They outlined the need to come up with and adopt practices that help nurses to prevent PTSD and deal with. They also highlighted the need to come up with policies that support such activities.
What suggestions for further study were identified?
The researchers suggested that more research should be conducted to evaluate the effectiveness of strategies meant to prevent PTSD among nurses in the ER setting and the impact on organizations and individuals.
Is the description of the study sufficiently clear for replication? Why or why not?
The description of the study is sufficient for replication because the number of participants, their demographics, the setting and procedures are clearly outlined.
Reflect on your newly developed understanding of QUALITATIVE research. What has this experience meant to you? How will this make a difference in your practice of nursing? at least two full paragraphs. Please respond in reference to understanding qualitative methodology and not the specific focus of the research study.
What has the experience of reading and critiquing a qualitative study meant to you? How will understanding and using qualitative research findings make a difference in your practice of nursing?
The experience was educational to me because I have better understood methodology selection for qualitative research. I have also understood the importance of activities that need to be undertaken to ensure ethics is upheld during qualitative research. Furthermore, I understand the importance of methodology and selection in ensuring research is successful and that the results are as valid as possible. I have also comprehended better the meanings of some terminologies such as “data saturation” and “decision trail” and their application to qualitative studies. I am more informed than I was prior to the experience and can come up with a credible research plan for a qualitative study.
The understanding and use of qualitative research findings will improve my practice of nursing because I will engage in evidence based activities and will make decisions basing on real time findings. Qualitative research findings, as it turns out, have immeasurable implications for nursing practice and theory and therefore they will serve as reference points for my actions. In this sense my practice of nursing is bound to improve constantly.
Creswell, J. (2009). Research Design: Qualitative, quantitative, and mixed methods approaches (3rd edition). Los Angeles: Sage.
Denise, P. &Beck, C. (2013). Essentials of Nursing Research: Appraising Evidence for Nursing Research. Philadelphia: Lippincott Willians & Wilkins.
Flick, U. (2009). An Introduction to Qualitative Research. London: SAGE.
Lavoie, S., Talbot, L. & Mathieu, L. (2010). Post-Traumatic Stress Disorder Symptoms among Emergency Nurses: Their Perspective and a “Tailor-made” solution. Journal of Advanced Nursing, 67, 1514-1522.
Mason, J. (2002). Qualitative Researching. London: SAGE.
Wood, M. & Ross-Kerr, J. (2010). Basic Steps in Planning Nursing Research: From Question to Proposal. New York: Jones & Bartlett Learning.
Qualitative Critique Qualitative Critique
What is the problem the study was conducted to address?
What is the problem the study was conducted to address?