Critical Appraisal of Cossette, Frasure-Smith, Dupuis (Essay Sample)

Critical Appraisal of Cossette, Frasure-Smith, Dupuis, Juneau and Guertin’s Study
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Introduction
The researchers have expressed the aim of the study in a clear and concise way. In this case, the aim of the study is to determine if nursing engagement focusing on individual opinion of patients with critical coronary syndromes of their disorder and diagnosis would raise rehabilitation admissions. Specifically, the study hypothesized that efficient Coronary Care Unit (CCU) changes nursing engagement into rehabilitation admission within six weeks after a patient suffering from critical coronary syndromes was admitted in the hospital. Cardiac disorders have been described as the main cause of deaths along with hospitalization in developed nations. Moreover, cardiac disorders have been established to be the main contributor to hospital admissions and the cause of most deaths. In the United States, these diseases continue eroding the quality of American life. In fact, more than five million people across the United States suffer from these illnesses, which made this field necessary to study. The researcher also introduces the fact that cardiac rehabilitation is important in order to insure reduction of duration of hospitalization. Moreover, it increases patient’s chances of survival. The definition of research purpose is clearly indicating that there existed lack of sufficient evidence for the factors that could trigger rehabilitation. The purpose of the survey was also to offer enough information on the ordinary care that can be used to examine if the referral to rehabilitation was standard. The study purpose that was illustrated was practical considering the skills of the authors, all subjects involved and equipment presented along with the ethical standards illustrated by the subjects (Arthur et al., 2010).
It is evident from the study that the researchers substantially accomplished the problem definition for this research. They clearly state the problem as; low rehabilitation enrollment despite its significance to acute coronary syndrome patients. However, while examining the research problem, it becomes evident that it ought to have been reinforced and explained strongly by associating the independent determinants of hospitalized patients suffering from acute coronary syndromes with rehabilitation enrollment. Moreover, the inferred discussion concerns the idea that there is the element of RCTs determining the influence of interventions on rehabilitation (French, Cooper, & Weinman, 2006). Generally, when reading the article, the research question was evident owing to clearly outlined aims and objectives as well as the fact that authors explained the importance of completing this study. That makes the problem of the study appear a bit weak, especially due to the fact that it failed to link the independent variables.
Literature Review
The use of randomized controlled trials was a fundamental part of this study since it increased the rehabilitation enrollment. The study can be moved within other nations and settings due to the evidence that it can be applied to numerous situations where rehabilitation enrollment was required. Researchers have admitted the limitations of the work and opine that it is necessary to conduct further researches with larger sample sizes. Even though the steps taken to guarantee credibility were insufficient, results presented were detailed and described appropriately using quotes from all participants. The research states that "results should include the participant’s actual words rather than summaries of what was said" (Cossette, Frasure-Smith, Dupuis, Juneau, & Guertin, 2012). The literature is arranged systematically in order to show the development and a clear way of that research. The use of 67 countries with over 597 randomized patients having been hospitalized with acute coronary syndromes is a clear indication that the research was detailed and the topic was widely covered.
According to Arthur et al. (2010), a complete summary of the background should demonstrate what is known about the issue and determine insufficiency of knowledge with regard to it. The research did not find any difference between the controls and experimental groups, while the secondary results indicated a higher level of patients undergoing at least a single course of rehabilitation. If patients had attended more rehabilitation sessions, probably a variation would have been noted in the controls and experimental groups in both results. Another demerit of the work is the excessive reliance on empirical literature. If the scholars utilized more theoretical literature, more up-to-date research would have been found, expanding the knowledge base (French et al., 2006). It was also difficult to comprehend whether the increase in admission was a result of liaison component or referral because there was no report.
Methodology
The major strengths of this section is that there was no systematic biasness and the research followed the research conduct guidelines because eligible patients consented by signing a form as well as filling a baseline questionnaire. In addition, the qualitative descriptive method which examines the phenomenon was best suited to the study as the aim was to examine rehabilitation enrollment of patients with acute coronary syndromes at the CCU or a hospital ward of critical cardiac hospital intervention. The reliability of the participants is also well-established in this research due to their proximity to the hospital, namely the distance of at least 50 meters. In that case, the techniques that were applied in measuring are well-established and easily applicable in interventions and ratio determination. Moreover, the processes of testing and reliability measurement are well-presented due to the use of the examination methods. The application of self-regulation model of Leventhal was critical in this research as it proposes techniques that illustrate behavioral alterations in relation to the cardiovascular risk element management (Arthur et al., 2010). The theory also reinforced the second outcomes which included illness perceptions, family support, and anxiety level as well as medication adherence which the theory proposes.
However, the study showed some weaknesses like the inadequate sample size of 242 participants which raises doubts whether the results attained from the research are trustworthy since the study only targeted a small group of patients who fitted under the peculiar inclusion criteria implying that the end application will be based on mere generalization. Moreover, there are weaknesses relating to inclusion and exclusion criteria which were somehow contradicting and unclear. For instance, in the eligibility criteria section, the researchers indicated in the respondents’ section that those who were to qualify as participants should not be unable to speak French or English which was confusing since there was no explanation as to the base of such eligibility criteria. It is also complex to examine the reliability of the measurement methods that were used in this research process. That means that major conclusive statements would appear invalid in case the authors failed to determine whether the study adhered to all norms and satisfied all requirements. Initially, the authors had insured that all standards of research were followed through repetition of measures within the research process. However, the first and second results match and are related, which strengthens the level of confidence in the presented measurements. In fact, reliability and validity of research require serious consideration in order to determine if the major instruments used for research met the desired criteria throughout the study process (Williams, O'Connor, Grubb, & O'Carroll, 2011).
Framework
The study has a definite framework that applies various theories appropriately. The self-regulation theory of Leventhal is used to describe the changes in behavior that are beyond cardiovascular risk factor management; it implies that emotional as well as cognitive processes dictate the illness perception and consequently the state of action during illness. On the other hand, the concept of planned character was applied in the letters sent to the patients, which were composed of sentences aimed at improving the patients’ perceived control, stressing the subjective state and improving certain feelings towards the practice of rehabilitation enrollment. According to French et al. (2006), the use of an appropriate framework can make a research study more effective and useful. The main aims of this study are linked to the theory that is quite evident in this research, especially in framework illustration, variables expression and the entire study design. It is closely connected to the rehabilitation referral explained within the research, including empirically verified methods to reduce the time a patient with cardiovascular diseases is hospitalized (Hackam et al., 2010).
In this study, the practical definitions of all determinants are well-expressed and defined despite the fact that more articulated and conceptual illustrations would have strengthened it to the greater extent. The lack of more clearly articulated definitions, therefore, makes it difficult to intertwine the concept with many variables used in form of controlling data along with making it complex to follow the authors’ concepts ranging from the concept of self-efficacy to the entire formation of the research (Mosleh, Kiger, & Campbell, 2009). Consequently, that leaves the reader with several questions such as what concepts refer to since they have not been well- articulated in the study.
Objectives, Questions, Hypotheses
The scientists proposed a hypothesis that "the experimenta...