Rough Draft Qualitative Research Critique and Ethical Considerations

Rough Draft Qualitative Research Critique and Ethical Considerations

Quantitative Research Critique

Quantitative Study

“Chun-Hung, L., Jui-Hsiu, T., Shihn-Sheng, W., Yang-Pei, C., Yen-Hsia m W., Jian-Shing, L. & For-Wey, L. (2014). Quantitative comorbidity risk assessment of dementia in Taiwan: A population-based cohort study. Medicine, 97(15), e0298. doi: 10.1097/MD.0000000000010298”

Background of Study

The article contends that although dementia is acknowledged to be a burdensome ailment among elderly patients, management efforts have been hindered by limited knowledge on the multiple risk-factors for dementia. This is a source of concern since medical personnel can simply focus on controlling the risk factors to effectively manage dementia. The need for this information is further enhanced by the awareness that elderly persons suffer from age-based declines that make them prone to chronic ailments. Based on this knowledge, there is a need to develop a good understanding of the specific comorbidities for dementia among elderly persons with the intervention of presenting a simple, rapid and appropriate predictive tool. To facilitate the efforts, regression analysis fitted with Bayesian inference approach is discussed as a good tool for comparing multiple variables as is the present case. In this respect, the article quantitatively explores the comorbidities linked with dementia. Rough Draft Qualitative Research Critique and Ethical Considerations.

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Methods of Study

The research applied a quantitative approach that used a population-based cohort design. In this case, 4,749 dementia patients were recruited into the study. These participants had been diagnosed with the dementia between 2000 and 2009, based on the International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic criteria (ICD-9-CM 290, 294.1–294.2, A210, A213, or A222). They were older than 64 years in 2000. Another inclusion criteria was that the participants had to have inpatient files for dementia. All the participants were recruited from the Taiwan National Health Insurance Research Database. Once the participants’ data was collected, it was subjected to a logistical regression model that applied Bayesian supervised learning inference. The model intended to assess the quantifiable effects of six comorbidity risk factors and socio-demographic features for dementia in elderly persons as identified in the Taiwan national longitudinal population-based database. The six comorbidity risk factors included senile cataract, diabetes mellitus, hearing loss, severe head injury, vascular disease, and depression. Rough Draft Qualitative Research Critique and Ethical Considerations. Other than the six comorbidity risk factors, analysis was also conducted for socio-demographic factors that included gender, age, monthly income and urban residence.

The research methodology is appropriate. That is because it allowed the study to access a large sample who were then recruited for the research. This implies that the right data could be collected and subjected to statistical analysis before interpretation. In essence, the methodology allowed for a true assessment of the factors that could influence depression parameters among elderly patients. In addition, the comprehensive exhibition of the research methodology expedites research replication efforts. Also, there is an indication that researcher bias was minimized by using data collected from a previous national survey so that the researcher did not need to prepare new data collection tools and only had to ‘copy and paste’ data that was already available. The only notable shortcoming that can be discerned in the methodology is that the authors do not mention if an independent third-party was approached to conduct verification and accuracy checks Rough Draft Qualitative Research Critique and Ethical Considerations. A second shortcoming is that there is no mention about the software that was applied for data analysis. This makes it difficult to verify the results in terms of truthfulness. The mentioned shortcomings are an indication that there were opportunities for bias in the research.

Results of Study

The study recruited 4,749 participants who met the inclusion criteria. Statistical analysis results from the model indicated that advanced age, female gender, urban residence and low income are socio-demographic risk factors for dementia among elderly persons. In addition, the results indicated that the odds of dementia had a direct correlation with the comorbidity and socio-demographic risk factors. This implies that one factor had lower odds ratio when compared to two or more factors with the odds increased with every increase in the number of factors that are present.

These results are valuable to nursing practitioners since they present evidence that support efforts to profile dementia. They show a clear correlation between the dementia and factors under review so that nurses will have evidence to support advice offered to patients with a plurality of factors, particularly when the advice is in relation to dementia management. Although the study does not make suggestions for future studies, it identifies limitations present in the current study. Addressing the mentioned limitations is an opportunity for future research. Rough Draft Qualitative Research Critique and Ethical Considerations.

Ethical Considerations

There is evidence to show that the research was carried out following ethical considerations. In fact, the study mentions that approval for the research was sought and received from all affiliated institutions. In addition, it mentions that although the requirement for informed consent was waived despite the research involving human subjects, seeking informed consent was unnecessary. That is because the data used was collected from a database and had been de-identified. The approval from the affiliated institutions shows that they were convinced that the research would not harm the participants and sufficient measures had been put in place for their protection. The four measures show that the research was conducted in an ethical manner.

Conclusion

The research sought to develop a good understanding of the specific comorbidities for dementia among elderly persons with the intervention of presenting a simple, rapid and appropriate predictive tool. This is based on the understanding that although dementia is acknowledged to be a burdensome ailment among elderly patients, management efforts have been hindered by limited knowledge on the multiple risk-factors for dementia. To facilitate the efforts, a quantitative approach was applied to include regression analysis fitted with Bayesian inference approach is discussed as a good tool for comparing multiple variables as is the present case. The participants had been diagnosed with the dementia between 2000 and 2009, and were recruited from the Taiwan National Health Insurance Research Database. In addition, they were older than 64 years in 2000 and had inpatient files for dementia. The model intended to assess the quantitative effects of six comorbidity risk factors and socio-demographic features for dementia in elderly persons to include senile cataract, diabetes mellitus, hearing loss, severe head injury, vascular disease, depression, gender, age, monthly income and urban residence. 4,749 participants who met the inclusion criteria were recruited Rough Draft Qualitative Research Critique and Ethical Considerations. The statistical analysis revealed that advanced age, female gender, urban residence and low income are socio-demographic risk factors for dementia. It also showed that odds of dementia had a direct correlation with the comorbidity and socio-demographic risk factors. These results are valuable to nursing practitioners since they present evidence that support efforts to profile dementia. They show a clear correlation between the dementia and factors under review so that nurses will have evidence to support advice offered to patients with a plurality of factors, particularly when the advice is in relation to dementia management.

 

Qualitative Research Critique

Qualitative Study

“McDermott, O., Orrell, M. & Ridder, H. M. (2014). The importance of music for people with dementia: the perspectives of people with dementia, family carers, staff and music therapists. Aging & Mental Health, 18(6), 706-716. doi: 10.1080/13607863.2013.875124” Rough Draft Qualitative Research Critique and Ethical Considerations

Background of Study:

I originally began this study on ways that pets could have a positive impact on the treatment of symptoms for the those that suffered from Alzheimer’s and Dementia, however discovered there was little known research even though I have witnessed the positive outcomes a fur baby can inflict on those suffering from such a brutal disease.  There was, however more to be said about how music therapy can positively impact the lives of these individuals.

The research study was conducted with the goal of identifying the value of using music-based interventions to treat dementia. The authors identified that music-based interventions are beneficial for managing dementia, particularly its psychological complications. Of interest is the fact that music features that include dancing, singing and listening are easily accessible and have presented positive results for home care of dementia patients since music can be enjoyed in its own right and as a social activity. In addition, it is noted that the cognitive functions related to music do not deteriorate for dementia patients. Despite this awareness, it is noted that previous studies on the value of music-based interventions in dementia management is that they do not provide a good link between theoretical frameworks and the applied model. The implication is that there is a need to contextualize research outcomes by developing a model for music use in dementia management. Based on this awareness, the present research approached dementia as a process of cognitive decline that worsens over time so that music is presented as an intervention that influences the process. Still, it concedes that experiences with music influences specific psychosocial fixed and tractable factors so that a study of the impact of music on dementia should evaluate the psychosocial factors with a focus on the how and why for the model. Rough Draft Qualitative Research Critique and Ethical Considerations As such, three goals are presented to include exploring the meaning and value of music for dementia patients, investigating how music is perceived for treating moderate to severe dementia, and exploring the link between dementia and psychosocial factors to guide the development of a theoretical model.

Method of Study:

The study applied a qualitative methodology that involved using interviews and focus group discussions as tools for collecting primary data. In fact, the two tools were managed by the lead researcher and presented to four group of participants. The first group of participants are dementia patient living in care homes as well as their family members. The second group of participants are staff at the care homes. The third group of participants are dementia patients visiting day hospitals. The final group of participants are music therapists. The study participants were recruited from two National Health Service care homes where the lead research was engaged as a music therapist. The two homes consented to be part of the research study. 69 residents in the two homes were persons with dementia, of which the first home had 45 dementia patients while the second home had 24 dementia patients. The dementia patients were approached for recruitment in the study with invitation letters sent to invite them and their family members. The participants were then subjected to individual interviews that included the family members for the patients who had cognitive impairment and unclear speech that could easily be misinterpreted. The focus group discussions were held for the four groups of participants within the two care homes. During the course of the study, music therapists with a minimum of four years’ experience were recruited from post graduate music therapy programs and asked to use an active model that entail the patients exploring musical instruments and voice-use during the therapy. The use of the active model was tailored for each patient based on individual needs as well as each the music therapist’s capabilities and experiences. The interviews and focus group discussions divided the participants into two groups. The first group was the dementia patient who were asked what music meant to them, what they thought about music therapy and if it was important to them. The second group comprised of family members, care home staff and music therapists who were asked the changes they observed in the patients following the use of music therapy, and how they knew whether music was meaningful for the patient. The primary data collection phase terminated when no new emerging themes could be identified in the interviews and focus group discussions. The focus group discussions and interviews were audio recorded before being subjected to thematic analysis. Rough Draft Qualitative Research Critique and Ethical Considerations.

Results of Study

The research approached 44 families that met the inclusion criteria of which 19 sent a reply. 15 of these families consented to participate in the study by attending the focus group discussions and interviews. Overall, 53 study participants were recruited to include 12 dementia patients who were residents in one of the two care homes, 4 dementia patients who visited day hospitals, 15 family carers, 14 care home staff, and 8 music therapists. These participants were divided into 17 interviews and 6 focus group discussions conducted at times convenient for the participants. The collected primary data was subjected to thematic analysis. The first theme used 61 transcription cards to note that music was a readily available medium that caused mental stimulation and an emotionally meaningful experience whether used for the immediate or short-term engagement. The second theme used 48 transcription cards to note that music relied on personal and cultural identity to facilitate memory retention, particularly when the lyrics are linked to personal history. The third theme used 40 transcription cards to show that music therapy is a novel experience that can build and sustain relationships while maintaining music connectedness. The fourth theme used 30 transcription cards to identify effects of music on the mood that included short-term mood improvement. The fifth theme used 21 transcription cards to note that music had an effect on the care home environment. The final theme used 34 transcription cards to note that music therapy improved communication. The article concluded that music therapy is more effective in dementia management when supported by personal music history, especially when the music and interpersonal connectedness is sustained to maintain the quality of life.

Ethical Considerations

The article presents details on the ethics procedure applied during the study. It first notes that ethical approval was sought from the National Research Ethics Service Committee for London East. Prior to inclusion in the study, informed consent was sought from all the participants to include the patients, family members, music therapists, and facility personnel. In this respect, the participants were protected during the course of the study with care taken to ensure that the research procedure was not harmful Rough Draft Qualitative Research Critique and Ethical Considerations.

Conclusion

The study applied a qualitative approach that relied on focus group discussion and interviews to collect primary data from selected participants. The intention was to identify the value of using music-based interventions to treat dementia. It concedes that although music therapy is acknowledged as effective, no acceptable theoretical model has been presented to explain the relationship. As such, the collected data was subjected to thematic analysis, which concluded that music therapy is more effective in dementia management when supported by personal music history, especially when the music and interpersonal connectedness is sustained to maintain the quality of life.

Alternative Therapies for Patients with Alzheimer’s and Dementia

As a nurse currently working on a Neuro floor, the devastation to family and loved ones trying to understand, as well as care for a their loved one that has been diagnosed with Dementia or Alzhiemers is most often times heartbreaking.   Nurses who are caring for this patient population are at the forefront and witness the devastation this disease brings to the family and their loved ones.  Often times treatment and or care for these patients results in using medications and, at times, restraints in order to keep the patient safe from harming themselves or others.  As a witness to so many tears cried, and questions asked, there is a definite need in finding ways to bring comfort and a sense of humanity back to this population of patients to have what every individual deserves, and that is to be able to leave this world with compassion and integrity. Rough Draft Qualitative Research Critique and Ethical Considerations.

The efforts of the NIA, (National Institute of Aging) is relentless as they continue to research the causes of this sad disease and hopes that by 2025 Prevent and Effectively Treat Alzheimer’s Disease.  The goals are to optimize quality of care and efficiency, reach out to more support to the families effected by Alzheimer’s and Dementia, increase public awareness, as well as be able to track the progress of the individuals who are suffering from this sad and crippling disease (nia.nih.gov)

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Proposed question for this research assignment:

Can the use of alternative therapies, such as pets therapy have a more positive outcome with patients that have been diagnosed with Alzheimer’s and Dementia.

Setting includes:   hospital, long term care facilities, and in their own home with family members.

Age and demographics:  Both male and female patients ranging from ages 65 and older, even though signs and symptoms can present at an earlier age. Rough Draft Qualitative Research Critique and Ethical Considerations.

Outcome is that the use of alternative methods such as pet therapy will show a positive impact on the quality of life for patients and families that live with the disease of Alzheimer’s and Dementia and leads to a better quality of life, even if only for brief moments of time.

Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. It is the most common cause of dementia in older adults. While dementia is more common as people grow older, it is not a normal part of aging. Alzheimer’s disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people (nia.nih.gov).  Unfortunately, this disease can not be pre-diagnosed and once symptoms begin to show there seems to be little that can be done to minimize the impact it has on not only the patient but their families.

 

About Paws for People. (n.d.). Retrieved from http://hai.tufts.edu/paws/about-paws-for-people/

Abstract:   Tufts Institute for Human-Animal Interaction is located at Tufts University in Medford Massachusetts.  The program Paws for People was first developed in 1998 by Dr. Gary Patronek of Tufts Center for Animals and Public Policy and started with only 10 volunteers.  Since then, with the ongoing support from the Tufts Center for Animals and Public Policy, Paw for People has grown and consists of over 100 animal/handler teams, who visit a variety of programs including elder care facilities, hospice centers, at-risk youth, adult and adolescent mental health care, hospitals, public schools, libraries, and others.  Continuing on with educational and research aspects of the human-animal bond has developed a strong and thriving program and has brought much interest from many to research more on the positive outcomes a pet can have on elderly patients with Alzheimer’s as well as those with other social and medical conditions.

 

Alzheimer’s Disease Fact Sheet. (n.d.). Retrieved from https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet

Abstract:   The only way that Alzheimer’s disease can be diagnosed is only after death, by linking clinical measures with an examination of brain tissue in an autopsy which treating and caring for this population of patients is even more complicated.  Other ways the medical professionals may be able to determine if a patient is suffering from this disease is to ask the person and a family member or friends questions that pertains to their overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality.  Issue tests that consist of recalling simple information, problem solving, and language. The use of certain medical tests, such as lab work or urine samples as well as performing brain scans such as CTs, MRIs or PET scans to rule out other possibilities for the presenting symptoms. Rough Draft Qualitative Research Critique and Ethical Considerations.

 

How Caregivers Can Use Pet Therapy to Care for Their Loved One. (2013, December 20). Retrieved from http://blog.alz.org/how-caregivers-can-use-pet-therapy-to-care-for-their-loved-one/

Abstract:  Pet therapy began in the 1860s, but unfortunately studies only began to be taken seriously was in 1980s. While the medical community is still waiting for scientific data that shows pet therapy can have long-term or behavioral change benefits, even famous nurse Florence Nightingale recognized that animals provided a level of social support in the institutional care of the mentally ill over 150 years ago. In an effort to prove the therapeutic benefits of pet therapy, the National Institutes of Health has funded grants to study scientific evidence-based research in therapeutic effects of not only children but of the elderly that suffer from Alzheimer’s and Dementia.

 

https://www.brightfocus.org/alzheimers/article/alzheimers-disease-magic-pets ntia.

Abstract:  There was a study conducted in 2002 on an Alzheimer’s special care unit, where researchers set out to determine the effects of a resident dog and a visiting dog and how they impacted the behavior of the patients.  Resident’s behavior during the day and during the evening were evaluated during the week before the dog was placed on the unit, and then for four weeks following the dog’s arrival. Even though there was little or no significant behavior changes that happened on the evening shift, there was a significant change in the behavior of those patients during the day shift. Rough Draft Qualitative Research Critique and Ethical Considerations.

 

Authors, N. (n.d.). Nonpharmacologic Interventions for Agitation and Aggression in Dementia – PubMed – NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27099894

Abstract: Even though there have been several different trials done to determine effective nonpharmacologic interventions for agitation/aggression in dementia, which is an important topic, it has been found through evidence base is weak because of the different types of comparisons, measurement issues, and other methodological limitations. When there was sufficient evidence to draw conclusions about the effectiveness of interventions in a group, agitation/aggression outcomes were most often similar to those of control groups. Further research is needed to assist providers and caregivers in finding effective interventions for agitation/aggression in dementia.

Churchill M , et al. (n.d.).  – PubMed – NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10218187

Abstract:  The use of a therapy doge can improve socialization skills in persons with Alzheimer’s.  Exposure to therapy dogs and cats can decrease the amount of agitation in persons that are institutionalized and suffer from Alzheimer’s disease, even during the period of agitation known as sundown syndrome. Use of therapy animals can be used along with other calming interventions Rough Draft Qualitative Research Critique and Ethical Considerations.

 

Rough Draft Qualitative Research Critique and Ethical Considerations instructions 

Use the practice problem and a quantitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.
In a 1000-1,250 word essay, summarize the study, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.
Refer to the resource \”Research Critique Guidelines\” for suggested headings and content for your paper.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to Turnitin Rough Draft Qualitative Research Critique and Ethical Considerations