Quantitative Research Report Nursing Article Critique (Article Critique Sample)

Quantitative Article Critique
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Abstract
Palliative care has been noted to be of importance in the care of patients suffering from serious diseases. However, it is not very clear when it is best to introduce palliative care to patients. In recent times professional bodies such as the American College of Surgeons Commission (2012) have suggested the early and continuous employment of palliative care. The article under review by Harden & Schembri (2015) reports on research done on the effect of introducing palliative care early on the knowledge level of patients on palliative care.
This critique assesses the quality of that study focusing on several indicators such as the background and rationale of the study, the methods employed in the research as well as the findings and recommendations made by the research. This text gives a balanced and practical review of the strengths and weaknesses of the research focusing on the aforementioned indicators.
Advised by the large number of literature supporting the early introduction of palliative care, Harden & Schembri (2015) undertook a study to determine the effect early introduction of palliative care would have on the level of knowledge and ease of access to palliative care for the recipients. This study was done in the form of a quality improvement program at the University of Michigan health system during which early palliative care was started even before the admission of patients who were to undergo hematopoietic stem cell transplantation (HSCT).
Background
Harden & Schembri (2015) begin by highlighting the literature that has been in support of the early introduction of palliative care and the full integration of palliative care in the normal oncology care offered by nurses in practice. For example, The American College of Surgeons Commission (2012) on Cancer included palliative care in its recommendations on cancer care suggesting that Palliative care be offered throughout the whole treatment process beginning at diagnosis continuing all the way to bereavement where applicable. However, the study noted that previously conducted research showed that a majority of patients (70%) do not have knowledge on palliative care but once they did most of them (95%) affirmed that the knowledge is important. A large majority of them (92%) also were of the opinion that this knowledge should be made easily accessible to patients suffering from serious illnesses and their families.
In the guidelines published by the National Comprehensive Cancer Network (2014), certain patient characteristics were identified which qualify a patient to consult early with a palliative care specialist. These characteristics identified in the guidelines were noted by Harden & Schembri (2015) to be common among HSCT patients. However a defined system of identifying and offering early palliative care to HSCT patients was absent at the University Of Michigan Health System. As this was also possibly the case in other institutions handling HSCT patients, the quality improvement project and the resulting study results would be filling the gap in practice between the guidelines by the NCCN and the palliative care services offered to HSCT patients. This study was therefore well guided in its intent and its results could be used to guide the practice of medical practitioners in dealing with HSCT patients.
Methodology-Sample, Data Collection And Analysis
The project together with the study was spearheaded by a multidisciplinary project team consisting of a staff nurse, a clinical nurse specialist, the nurse practitioners as well as a chaplain. The population of the study was made up of HSCT patients receiving treatment at the University of Michigan Health System. The inclusion criteria required that the patient be admitted on a case of an allogeneic HSCT and the patient be diagnosed with hematologic malignancies that were either serious or life-threatening. The sample was then randomly selected out of the eligible patients. The selected patients were contacted before admission to request for an initial meeting which was used to assess their knowledge on palliative care. 32 patients were chosen to join the project. However, only 25 were able to complete the project. Six were excluded from the project due to a number of reasons including a relapsed disease, missed appointments and their refusal to participate.
The sample size of 25 used by the study was rather small. However, since the area of study is a specialized area, it could be taken to be satisfactory and hence the results could still be applicable widely. In the same breath, the eligibility criteria used was reasonable and necessary especially considering that there were financial constraints that limited the project. Otherwise, as noted by the authors, they would have run the project to cover all HSCT patients.
Data was collected from participating patients using a questionnaire which was applied as a post test. This is probably the area that the study to a great deal did not impress. It would have given a more conclusive result on improvement of the patients’ knowledge if the questionnaires were issued as both a pretest and a posttest. Information was gathered from the palliative care team through an exit interview conducted at the end of the project. The palliative care givers were asked preset questions to disclose their perceptions on the meetings with the patients. They also gave their observations on the change among the patients and gave their recommendations advised by this change. The questions asked during the interview were a little bit too open-ended. The personal opinion of the practitioners would greatly affect their reported observations hence reducing the credibility of the study. A well structured questionnaire would be more credible. However, a questionnaire would not allow for the practitioners to successfully express their concerns and observations in detail. The choice to use interviews can therefore be justified.
Raw data collected from the patient questionnaire was analyzed in charts to show the knowledge gained by patients on palliative care as well as the increase in knowledge as a result of the project. Most of the patients showed a significant increase in knowledge. However, the study does not provide indicators of the reliability of the questionnaires as a research tool. For example, no details on the Cronbach’s alpha are given. While this does not necessarily discredit the resul...