Research, in as much as it provides information extracted directly from the field, it is performed by human beings who are susceptible to errors or omissions which are sometimes unavoidable. Omissions render the authenticity of the research questionable and thus critiquing (Vance, Talley, Pearce, Christian &Azuero, 2013). This paper will critique a quantitative research paper right from the introduction to the last part where recommendations are given basing on the data garnered.
Problem statement
This research is about nurses’ attitude on controlling pain in patients suffering from refractory problems through palliative sedation. The problem under study as given in the research article is Flemish palliative care nurses' attitudes to palliative sedation. The problem statement is not clearly stated in the article and requires one to read the introduction section in the article. The independent variables however when analysed from the study title is nurses' attitude while the dependent variable is palliative sedation. The research involves respondents giving their opinions on controlling patients' pain in medical institutions through temporary or permanent termination through sedation; it, therefore, provides empirical testability as the importance of this procedure can be determined.
The statement problem though not clearly stated is explained in the introduction part. The population to be studied are patients suffering from refractory problems and nurses who are taking care of the patients either at home or medical institutions. It is relevant to medical practitioners in the nursing field since most patients would consult them on matters related to their health and pain. In most cases the patients trust them to give professional prescriptions on how to manage pain and they may be forced to make choices that are detrimental to the patients' life expectancy. Therefore seeking to investigate on their attitudes is fundamental to the nursing career. The aim of this study is to examine the attitudes of nurses on the administration of palliative sedation. It also aims at assessing the influence of demographic variables that is religion and world view, experience in the field, age, and gender. The ethical attitudes of nurses from these perspectives are to be put into consideration.
Literature review
The literature reviews the independent and dependent variables, which is palliative sedation and nurses’ attitude, adequately basing on different research studies performed by different researchers. No consensus on the said topic has been arrived at since researchers have different contexts in which they carry out their research, these contexts as highlighted in the review can be the aims of their research, methodology used and the definitions or key areas of focus and even their target population.
The decision is not an easy task as it involves making virtuous decisions that deny the patient the sense of feeling, acting and interacting with people. It is considered inhumane by most health professionals according to the literature. Some medics argue that is somewhat a way of taking life out of helpless human beings who have no power on making proper judgements. Others, however, believe that this is action carried out with the best of the best interests at heart. Religion and world view is also seen to influence these medics' judgements on this action. Those who are very religious consider it immoral and condemn it with the strongest terms possible nonetheless those who are not tied to religion consider a better alternative for saving patients from uncalled for anguish and discomfort.
Seal accessed the connection between religious standings and medical decisions that have to be made about a patient to end his or her life painlessly. Research done by Curlin et al. indicates that those who are highly religious argue that this action amounts to taking life out of a person due to an incurable condition which is not acceptable. Inghelbretch et al., however, came up with a different notion from their research and argued that religion had no influence on medical decisions; they further add that nurses view palliative sedation as the only process that ensures suffering in patients due to pain is brought under control.
Though research on these two variables is still debatable, the data used in the literature review qualifies as current information. Palliative sedation causes great impacts on nurses who are charged with the responsibility to care for them; they act as informants to these patients' family members and friends about the reached palliative sedation decision; this sometimes becomes rather difficult for the nurses.
It can also burden nurses emotionally as they feel more attached to patients, there is thus a relationship between the two variables as brought out by the review. The literature includes conceptual and data-based literature as it brings into account different concepts brought in by different researchers and the results they gathered out their researches. There is nonetheless, no synthesis summary of the literature and summary of gaps as both concepts were discussed in combination of one entity.
Theoretical framework
A theoretical framework is brought out from the different findings researchers collected; most of them found out that religion played a big role in influencing nurses’ attitudes towards palliative sedation.
Hypotheses/ Research question
Research questions and hypothesis were not included in this study. Therefore, no reference can be made from them since they are non-existent.
Design
Additionally, no specification of a design used to review the literature was specified.
Sample
The sample selection process involved probability method as respondents were randomly selected. Questionnaires were delivered to medical institutions randomly; the researchers didn’t know the number of nurses working in these units. This method would carry some bias concerning selecting respondents thus leaving out others who though not directly involved with nursing can give very substantial opinions on palliative sedation. The sample could be a representative of the population since 70.5% of nurses in the palliative care units returned their filled questionnaires. For eligibility purposes, the questionnaires were delivered with a letter of request for distribution, therefore, proving that the practice was in order.
The sample size was not identified as the number of nurses working in medical institutions was unknown such that calculation of a sample was a clueless mission. There was, therefore, no procedure for determining the sample size. From the letter of request for research questionnaire distribution, there was some level of security assured to every participant.
Data collection
The data was collected using questionnaires, and this method was appropriate as it gave nurses a chance to give the opinions willingly and from a clear conscience. The collection procedure was similar; all respondents were given the same questionnaire with similar questions. Reliability and validity test did not take place before the study; thus, the probability of the instrument being valid cannot be determined.
Data analysis
Data analysis for the research was carried out using the latent-class analysis and it was appropriate as the research instrument questions were structured into clusters. Descriptive was reported on the participants’ religious background, 66 were atheists, 64 were doubters of church doctrine, 102 were church goers, 64 were religious but don't go to church, and devout church members were 60.
Inferential statistics were also given in the evaluation and out of the population that participated (11.8%) were males while (88.2%) were females, the average mean for the respondents was 43.6 with a standard deviation of 8.9. The inferential statistics were appropriate since it brought the population of the sample size. The level of significance and reliability reported to the current study was not determined.
Discussion
This study lacked a research question and hypothesis. The results obtained were however in the context of the research problem as opinions from nurses were gathered with regards to palliative sedation. Generalizations have been made on research findings where those with similar opinions were generalised under one factor, and those with divergent opinions were also grouped separately. Under the factors that affect nurses’ attitude, only religion was considered for discussion. There were tables and graphs used to show results in clusters.
Conclusions, Implications, and Recommendations
The results collected are supportive of the literature which brought out different positions of the two variables so as to show their relation to each other. This is clearly reflected in the results as nurses’ attitudes on terminating a patient’s life due pain, or controlling pain by administering drugs that could render him or her functionless were identified. According to the results, palliative care nurses, are in support of the idea of administering palliative sedation to control pain in patients who are suffering from refractory problems. Nurses prefer the latter to Euthanasia. Additionally, nurses preferred administration of continuous or profound sedation to irregular sedation. However, others had divided opinions and considered recurrent sedation to being better than a deep one. From the results, nurses' attitude to palliative sedation is in line with the policy and practices dictated in Palliative Flemish guidelines.
This research had several limitations as identified in the study; the validity of the research results is questionable as data was collected before the Flemish Palliative Care Foundation issued the guidelines to this solution in the medical field. The guidelines might have influenced the nurses' opinions thus giving false responses. Additionally, there was no investigation carried out on the nurses' attitude to recalcitrant psych-mental patients. The questionnaire did not tackle this concept, and the questions were long thus several issues could not be dealt with. To add on to that, no assessment of the permanent effect of palliative sedation that is quick death was done from the nurses’ perspectives.
This research recommends future research about the influence of religion on nurses attitude as this was not tackled in this research. Future researchers examine the association between palliative clusters that is age, religion and views from the world and the years of experience. This research didn’t look into these clusters which also have great impacts on nurses’ attitude.
References
Vance, D., Talley, Pearce, Christian, &Azuero, A. (2013).Conducting an article critique for a quantitative research study: perspectives for doctoral students and other novice readers. Nursing: Research and Reviews, 67. http://dx.doi.org/10.2147/nrr.s43374
