Qualitative Research Critique

Qualitative Research Critique

Background of Study

The article highlights that patient manifesting psychological and physical symptoms express their feelings verbally enable practitioners to interpret the meanings of their behavior reliably. However, mechanically ventilated patients are restricted in their ability to communicate and thus exhibit anxiety and agitation, undermining their comfort and stability. Thus, the article begins by exploring anxiety and agitation along with their potential adverse outcomes for patients. This article is significant to nursing practice since the incidence and pervasiveness of anxiety and agitation within the healthcare setting is vital to understanding the occurrence and management of the condition (Tate et al., 2011). Thus, the article aims to define strategies that will enable healthcare practitioners to manage anxiety and agitation within the clinical care setting. Similarly, the purpose of the study is to increase awareness among clinical practitioners regarding the crucial need to make reliable interpretations of anxiety and agitation are emphasized as they effectively correlate to positive health outcomes.

How do these two articles support the nurse practice issues?

The article will be used to answer the PICOT question by investigating how patients experience agitation and anxiety. Similarly, it explores the behaviors characterizing the patient’s exhibiting anxiety and agitation. For instance, anxiety is characterized by the inability to communicate, lack of sleep, and the inability to communicate. In contrast, agitation is characterized by restlessness which interferes with healthcare outcomes and increases their risk of developing complications. Similarly, the potential consequences of the condition are explored, which include increased oxygen intake and medical device disruption (Tate et al., 2011).

Furthermore., prolonged exposure predisposes the patients to pneumonia, lung injury, malnutrition, and long-term adverse outcomes, significantly impacting their health outcomes. The article also highlights how practitioners can measure anxiety when patients self-report their complications. In this regard, the behavioral manifestation of psychological states is described in-depth detail to ensure that standard psychological instruments capture the condition appropriately, thus enabling practitioners to intervene. Finally, the model developed by the researchers to illustrate the process of recognizing and managing the behavioral manifestation of anxiety and agitation offers strategies that clinicians can effectively implement to prevent, relieve and control symptoms exhibited by the patient (Hunt, 2002).

The intervention in the article shares similarities to those identified in the PICOT questions. Foremost, the anxiety agitation model in the article highlights the necessary intervention that clinicians must employ to alleviate the condition. Similarly, an assessment of psychological, behavioral, and physiologic responses enables the implementation of the appropriate intervention (James, 2016). In contrast, the PICOT questions raised by the research question attempts to discern and interpret the patients’ symptoms to inform their decision regarding recognizing and managing the condition. In addition, the interventions of the PICOT questions rely on understanding the patient’s unique history and responses to guide clinical intervention (James, 2016). 

 Method of Study

The article adopts an ethnographic study comprising of 30 patients who have been subjected to prolonged mechanical ventilation use. The data sets adopted during the cohort study include an observational, interview, and medical record data which totals 655 days. A qualitative analysis was selected as a tertiary intervention for a variety of reasons. Foremost, the frequency of anxiety and agitation in the data sets is significantly high. Secondly, the observable data set is extensive, and the adopted dataset maximizes the study's vulnerable participation. Thus, the analysis expands the research questions to include important psychological, behavioral, and physiologic events within the mechanical ventilation duration (Tate et al., 2011). The sample patients in the study are also observed whereby their variability of condition, chronic health, neurological status, medical diagnosis, gender, sex, and ethnicity is recorded.

Similarly, a formal interview is conducted by practitioners during a 4-day duration whereby the effects of anxiety and agitation are specified. Data analysis of original data sets involved coding the data with keywords that serve as indicators of anxiety and agitation. Similarly, additional data from the samples' medical records and medication administration is also documented and analyzed using dimensional analysis techniques (Tate et al., 2011). The benefits of the method and analysis adopted during this study enable the researchers to describe contextual factors and clinical interventions, enhancing their ability to understand the condition thoroughly. Similarly, the researchers conducted weekly analysis meetings, which enhanced the credibility of their study. Lastly, the study sample offered descriptive data and in-depth context on anxiety and agitation, enabling transferability (James, 2016).

Results of Study

The article highlights that out of the 30-patient sample, 22 of them expressed instances of anxiety and agitation, whereas the remaining eight patients demonstrated agitation at least once during the study duration. Thus, the study demonstrates the prevalence of agitation and anxiety among mechanically ventilated patients. The study also demonstrates that interaction is a core process during recovery, and when patients are inhibited from verbal communication, behavior indicative of agitation is exhibited. Similarly, increased non-vocal interaction from patients induced cooperation and lowered discomfort attributed to physiologic reactions triggered by respiratory distress.  The study demonstrates that increased interaction with their environment directly lowered incidences of anxiety and agitation, which made them more cooperative during daily care activities (Tate et al., 2011). Verbal reassurance strategies from caregivers alleviated incidences of agitation and anxiety since they responded to verbal stimuli and touch.

Ethical Considerations

There are various ethical considerations that researchers must employ while conducting research studies. Foremost, researchers need to provide participants with sufficient information regarding their study to decide whether to participate. Thus, the researcher should ensure that participants voluntarily participate in the study and give explicit consent to participate in the study (Hunt, 2002). In this regard, the researchers should not attempt to deceive or persuade the participants to gain their trust. Secondly, the researchers have to protect the privacy of the research participants that voluntarily agree to participate in the study (Hunt, 2002). Thus, all private information regarding participants should be removed from the study to ensure their anonymity. The researchers of the article observed the highlighted ethical considerations while performing their research. During documentation and sampling of medical record data, the researchers removed all identifying markers that could compromise the participant's identity (Hunt, 2002). The researchers also enacted protocols for data analysis which ensured that the patient's family members were part of the study to ensure that the participants were not persuaded but gave explicit consent to participate in the study.

Conclusion

This study has made significant contributions to intensive care practices by illustrating the correlation between practitioners' interpretations of patient responses. Similarly, the study offers strategies to assess and manage agitation and anxiety among mechanically ventilated patients to improve their health outcomes. In addition, clinicians' and nursing practitioners' awareness regarding the crucial need to make reliable interpretations of anxiety and agitation are emphasized as it effectively correlated to positive health outcomes. Lastly, the study offers a basis for developing and refining clinicians' language to improve patient care within intensive care facilities.

References

Hunt, M. (2002). Clinical Nursing Practices Clinical Nursing Practices. Nursing Standard, 17(11), 29–29. https://doi.org/10.7748/ns2002.11.17.11.29.b196

James, N. (2016). Nursing Research Using Historical Methods: Qualitative Designs and Methods in Nursing Mary de Chesnay Nursing Research Using Historical Methods: Qualitative Designs and Methods in Nursing 236pp £65.95 Springer 9780826126177 0826126170. Nurse Researcher, 24(2), 8–8. https://doi.org/10.7748/nr.24.2.8.s5

Tate, J. A., Devito Dabbs, A., Hoffman, L. A., Milbrandt, E., & Happ, M. B. (2011). Anxiety and Agitation in Mechanically Ventilated Patients. Qualitative Health Research, 22(2), 157–173. https://doi.org/10.1177/1049732311421616