Research Critique- Day Surgery-Patients’ Perceptions Of A Nurse-Led Pre-Admission Clinic

 Introduction

Research critiques are meant to identify the precision and correctness with which research studies have been conducted. They also evaluate the relevance of the researches conducted. This research critique paper analyzes and critiques a research conducted by Jo Gilmartin (2003). The research evaluates the perception of sampled patients about the provision of pre-assessment in nurse-led pre-admission clinics that offer day surgery. The critiqued article appeared on the Journal of Clinical Nursing, volume 13, in 2004; under the title Patient Involvement in Clinical Nursing: Day Surgery-Patients’ perceptions of a nurse-led pre-admission clinic.


Initial Reactions

The article is interesting because it explores an important requirement in day surgery, whose importance may have been highlighted before, but whose research has been long overdue. Notably, the researchers explored the importance of the research as detailed by Young and Munro (1995) and Green (1995). However, these earlier researches were based on identifying the importance of pre-assessment rather than its present status of application and efficiency. This left a question as to whether, this research was a pioneer research in establishing the efficiency of present pre-assessment or was it in the follow up of earlier related studies of efficiency assessment.


Descriptive vividness

The description of the study was very clear and precise, because it established the significance of the phenomenon under study by highlighting the importance of pre-assessment and connecting the importance to the need to establish how efficiently pre-assessment was being administered. Through literature review the researcher was able to establish that pre-assessment was necessary and important, and thus linked it to his research in a bid to find out its application and efficiency. The aim of the research is also clearly stated-to establish the perceptions of patients about pre-assessment preparation received prior to day surgery (Pg 1). However, there was a lack of interpretation of quotes that may have needed expounding (e.g. defining the research methodology and day surgery).


Methodological congruence

The sampled participants were well described in terms of gender, type of medical conditions necessitating surgery, the age range and racial background. However, in the analysis of results there was no clear outline of the definition of sampled patients that responded in a certain common manner. This would have been essential in establishing which group got satisfied or dissatisfied on a certain aspect, and whether there was any common thing about the group under consideration (Strauss & Corbin, 1990).


The sample selection lacked research logic because it would not serve the purpose of generalizability because it was greatly limited. The selected sample lacked the representative ability to make the research’s conclusion a generally acceptable finding that applies to all clinics in other areas. The only basic criteria common for the sampled patients was that they were to undergo day surgery. There was no consideration of how to introduce variation in patient aspects in order to establish a representative picture. Lack of proper sampling waters down the research results as a whole (Burns & Grove, 2007).


The researcher described the research context and location clearly, however from closer evaluation it was evident that the narrowed sampling used would offer limited generalizability.

Procedural approach

The theoretical base of the study was established through the reviewing of earlier documented research literature on the importance of pre-assessment for day surgery patients. This was exemplified by highlighting research conducted by Young and Munro (1995) and Green (1995). The researcher failed to state his assumptions as to whether there was sufficient pre-assessment or not in order to establish the stand to be proved. All he did was to state the importance and link it to his research.


The research procedure conducted via an interview and the sampled patients had been selected by the medical staff. The process was explained to them and they voluntarily agreed to participate. The interviews were scheduled in the patients’ homes and this followed procedure seemingly created trust. The interview was conducted by stated research questions, however at some instances the researcher asked confirmatory questions on information offered. The research process of data collection was vividly described: the researcher collected information by use of audio recording equipment as well as personal notes during the interview which would serve to aid in making personal observations. The time spent with interviewees was quite adequate, with part of the time being dedicated to preparing the interviewee for the session by clearing the tension of establishing conversations. The researcher also used a good approach in accessing the patients via their doctors and nursing staff. The trust that the patients had in their doctors and nurses was probably what drove them to accept participation. Direct approach by the researcher may not have yielded acceptance. The researcher described the importance and details of the research to the sampled patients, but there are no details on whether he made known, his credential as he played the role of the interviewer during the interview sessions.


Adherence to ethical standards

The participants were fully informed about their rights and they were promised that they would be adhered to: they were offered voluntary participation, the right to withdrawal and anonymity in the research. This was all conducted after obtaining permission from relevant local authorities (NHS trust ethics committee). The general observance of this protocol ensured that the rights of the participants were protected.


Ability of the research to be audited

The sequence of the research can be clearly followed procedurally from literature review to conclusion, and his findings can be linked to the collected and analyzed data. However, there were no enough participants to substantiate the obtained results and draw a generalization due to the few participants sampled as well as the fact that they were sampled from one locality, thus greatly limiting the sample. The data presentation was also not done in an in-depth manner. For example the data presentation on different groups’ stands does not indicate the details of patients in groups with different views so as to determine whether the differences among groups result from inherent differences within certain participants. However, the researcher was able to state and explain about different elements within the phenomenon under study. Notably, the experiment was structured in a relevant and easy to replicate manner. However, modifications may be necessary in any future cases to give relevance to the research-the replication of a study is essential in any medical research and any research that lacks the element also lacks relevance (Burns & Grove, 2007).


Analytical and Interpretive Preciseness

The research data analysis was comprehensive because the collected data was reviewed by at least ten participants to establish its credibility by ascertaining that it contained their actual views. Additionally an independent critical reviewer went through the data analysis to establish whether the analysis was correct. This gives the processed data and findings credibility. The findings did not however depict the causes of the apparent differences within the sample despite a majority indicating that they were contended with the pre-assessment. The research report does not also indicate whether the results were taken back to the specific clinic for review of the results.


Philosophical or Theoretical Connectedness

The data, though lacking proper sampling considerations can be connected to the practice of nursing. The researcher appropriately identified the theoretical basis of the research to earlier research theories that had indicated the importance of the phenomenon under study.  The literature reviewed was also appropriately cited to establish the connectedness. However, consistency on theory on theory and assumptions cannot be established because the researcher failed to highlight his assumptions.


Heuristic relevance

Intuitive Recognition: The phenomenon is highly recognizable because in most clinics there are an ever increasing number of day surgery patients, and as a result; the efficiency of pre-assessment delivery is ever dwindling as nurses rush to attend to as many patients as they can. The findings represent the opposite of this statement, however; the stand needs to be proved wrong because this research, would not disapprove because of its inherent weaknesses in the structure of the research.


Relationship to the Existing Body of Knowledge: The researcher sufficiently explored literature on the importance of the pre-assessment in day surgery. However, he never highlighted anything about earlier research, or the lack thereby; of research assessing efficiency of pre-assessment in clinics. As a result, the researcher had no other research to compare with his findings, or at least he did not state if there was none to compare with. Therefore, it is not possible to determine whether his results are consistent with earlier similar researches.


Applicability to education, Nursing Practice and Research: The findings find relevance in the field of surgery considering that psychological preparedness as well as after surgery care information bear a lot of significance on the healing process. The research is concluded by the identification of further research pertaining to cancellation cases and how to effectively handle them without inconveniencing the patients.


References

Burns, N. and Grove, S. (2007). Understanding nursing research: Building an evidenced-based practice. St. Louis, MO. Elsevier.

Green, D. (1995). Patients Assessment for Day Surgery. The British Journal of Theatre Nursing, volume 5, pp 10-12.

Jo Gilmartin (2003).Day Surgery-Patients’ perceptions of a nurse-led pre-admission clinic. Journal of Clinical Nursing, volume 13.

Strauss, A. & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park, CA: Sage.

Young, S. J. and Munro, S. J. (1995). Some Patient’s Pre-operative Anxiety in Day Surgery. The Journal of one day surgery, volume 5, pp 21-22.





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