Critique of a Quantitative Research Article
The critique of a research project is the objective and critical evaluation of the content of a research report for its scientific merit as well as application to practice. It entails asking questions about whether every step in the research process meets the set standards (LoBiondo-Wood & Haber, 2014). This paper will critique the research report by Caicedo (2014) entitled “Families with special needs children: Family health, functioning, and care burden.” It will examine the strengths and weaknesses of the study, identify the enablers and barriers to the project, discuss the expected outcomes of the project, and evaluate the overall contributions the project will make to healthcare service, nursing, consumers, and society.
The title of the article conveys accurate information about the key concepts and variables studied. It, however, contains no information about the study methods (Kaplan, 2012). The abstract section is short and representative of the article. It briefly summarizes the purpose of the study, study methods, results, and conclusion. It provides a comprehensive view of the variables of the study that are physical health, mental health, family functioning, and care burden of parent caregivers of children with medically complex and/or technology-dependent conditions. The remaining part of the abstract offers a synopsis of the background, methods, result, and conclusion sections of the study. Generally, the abstract is well-presented, concise, accurate, specific, coherent, readable, and self-contained.
The introduction section of the article is brief. It, however, provides a background picture of the area of research as well as its significance to practice (Polit & Beck, 2014a). The literature review provides statistics on the magnitude of the problem being studied. It cites data from the Data Resource Center for Child and Adolescent Health (2013) that suggests that there are 11.2 million children in the United States (US) with special healthcare needs or one in every five US households cares for at minimum one child with special needs. The authors also cite previous research findings by authors such as Rapheal, Zhang, Liu, & Giardino (2010), Chen, Hao, Feng, Zhang, & Huang (2011), and Scarpelli et al. (2008) that informed the purpose of their study. These findings suggest that parent caregivers of children with special healthcare needs or chronic medical conditions have a lower health-related quality of life (HRQOL) and higher stress levels than parents of healthy children or children at risk for impaired HRQOL. The purpose of the research is, according to the authors, informed by the fact that there is little reported information on the physical as well as mental health of parent primary caregivers to children with medically-complex medical technology-dependent conditions. On the significance of the study, the authors posit that understanding the impact pediatric chronic conditions have on the mental and physical health of parent caregivers is essential for provision of mental and other care services to affected families. The purpose of the study is clearly stated at the end of the introduction section. The study sought to examine the physical health, mental health, family functioning, and care burden of parents who are the primary caregivers of children with complex medical conditions that are or are not dependent on medical technology over a period of five months. Generally, the introduction presents the problem being studied in a manner that provides a base and direction for the purpose statement.
The research design of the study is clearly identified as a longitudinal study design. The sample for the study consisted of parents who were also the primary caregiver of a child with a complex medical condition and/or medical technology-dependent condition. The sample was identified using convenience sampling whereby families of children with special healthcare needs were recruited from primary care pediatric practices, specialty physician practices, long-term/residential care settings, and medical day care settings in South Florida. Parents with any physical or mental disability that could interfere with their participation in the study or their ability to complete the study instruments were excluded from the study. Children with medical conditions affecting only one body system were also excluded from the study. In total, 84 parents volunteered and were included in the study. No information is provided, however, on the acceptance rate for participation in the study. The attrition rate is reported as 9.5%. The use of convenience sampling may have introduced bias into the study as it is possible that the characteristics of the parents who declined to participate in the study are different from those of the parents who consented to the study. For instance, the bulk of participants in this study were Hispanics.
Approval to conduct the study was sought from the institutional review board of the Florida International University. Informed consent was sought from all parents who agreed to participate in the study. The parents were given an information sheet that detailed the background and purpose of the study. A site contact then visited the parents at their homes during which he or she answered any questions they had and obtained written consent from one parent. Data collection was done in the homes of participants or via telephone. Data was collected five times over a period of five months. The Pediatric Quality of Life (PedsQL) Family Impact Module was used to measure parental physical and mental health as well as family functioning. On the variables, each variable that is parental physical health, mental health, family functioning, and care burden is clearly defined. The PedSQL Family Impact Module questionnaire consists of 36 items and assesses the impact of pediatric chronic health conditions on the physical and mental health of parents as well as family functioning. Questions from the section of the 2005-2006 National Survey of Children with Special Health Care Needs that measure the impact on the family was used to assess care burden. Demographic information of the participants was collected using the PedsQL Family Information Form. The authors reported that a high internal consistency reliability for the Parent HRQOL Summary scale (.92), Total Family Impact (.94), and Family Functioning Summary Scale (.82) that was comparable to that reported by other studies such as those by Chen et al. (2011) amongst others. Overall, the procedures of the study are described in a step-by-step manner. The use of a self-reporting tool may have, however, introduced social desirability bias.
The discussion section of the study contextualizes the findings of the current study with those of previous studies (Burns & Grove, 2011). For instance, Hatzmann et al. (2008) and Brehaut et al. (2011) had similarly established that parents with children with chronic medical conditions and complex medical conditions report poorer physical health. The authors also describe the strengths and limitations of their study. The main strengths of the study are the fact that it employed a longitudinal study design and it assessed a number of health and functioning variables. The limitations of the study cited included the use of a convenience and small size sample, lack of a control group, and the relatively short follow-up period. Although it is not included by the researchers, the fact that the majority of the study’s respondents were Hispanics limits the extent to which the findings of the study can be generalized (Polit & Beck, 2010b). In the implications section, the authors posit that poor parental physical and mental health compromises the functioning and health of children with special healthcare needs. They posit that advanced practice nurses can help meet the physical and mental health needs of parents of children with special healthcare needs during home visits. The implications provided by the authors are congruent with the findings of the study (Gerrish & Lathlean, 2015).
On the issue of enablers and barriers to the project, enablers included support from private practices, approval from the Florida International University Institutional Review Board, the availability of the Pediatric Quality of Life (PedsQL) Family Impact Module, and willingness of the community to participate in the research project (Bakken, Lantigua, Busacca, & Bigger, 2009). The researchers were able to recruit study participants from local primary care practices and specialty physician practices amongst other settings. Therefore, there must have been support from local healthcare providers for the project. A normally encountered hurdle in research is getting approval from an institutional review board. The researchers were, however, granted approval to carry out their study by the institutional review board of Florida International University. Researchers also encounter problems getting reliable tools able to measure all research variables. In this case, the researchers found an instrument appropriate for the study purposes that is, the Pediatric Quality of Life (PedsQL) Family Impact Module. A proportion of the community members were also willing to participate in the study. On the issue of barriers, sociocultural issues such as race and language can be identified (Bakken, Lantigua, Busacca, & Bigger, 2009). Majority of the study participants were Hispanics which suggests problems in recruiting a representative sample. Some potential participants could also not be included in the study because of language barriers. The use of random sampling instead of convenience sampling could have helped in the recruitment of a more representative sample. With permission from appropriate authorities, the researchers could have searched electronic databases and identified all parents and children who met the inclusion criteria. Random sampling could have then been used to identify a sample for the study. Language barriers can be overcome through use of translators.
Regarding the implications of the study, the authors posit that their study will help elucidate the impact pediatric chronic conditions have on the physical and mental health of parent caregivers and in so doing, inform provision of mental health care to such families. They posit that a decrease in parental physical/mental health would have a deleterious effect on the quality of care they provide to their children. They also propose that advanced practice nurses can help promote the physical and mental health of parents caring for children with special needs during health care visits. They can build rapport with parents, routinely conduct objective assessments to detect clinical depression in parents, and make appropriate referrals to community-based services for psychosocial and mental health needs.
On the issue of the overall contributions the study might have, the findings of this study will inform nursing practice and the manner in which healthcare services for children with special health care needs are provided. The national goal in Healthy People 2010 proposed that care for children with special healthcare needs should be shifted to from hospitals to homes because of a number of reasons. These reasons include high escalating hospital costs, decreased payer reimbursement, an increase in the number of children with chronic conditions, and the recognition that extended hospital stays are deleterious to family health and functioning and normal child development. However, there is little data on the impact care for children with special healthcare needs have on their parents’ mental and physical health. Therefore, the findings of this study will inform future research and practice on care of children with special health care needs.
In summary, this paper has critiqued the research report by Caicedo (2014). The article reports on a qualitative study whose purpose was to examine the effects of complex and/or medical technology-dependent pediatric conditions have on parental physical and mental health, family functioning, and care burden. The title of the article is informative. The introduction section offers a synopsis into the area of research and significance of the study to practice. The researchers employed a longitudinal study design. The sample was recruited through convenience sampling. The questionnaire used to collect data had high internal consistency reliability. The findings of the study are clearly presented in the text and tables. The discussion section compares the findings of the study with those of previous studies. The strengths, weaknesses, and implications of the study and its findings are examined. Factors such as support from local healthcare providers were enabling factors while sociocultural factors such as language barriers prevented inclusion of some potential participants. The findings of the study have important implications for future research and practice with regards to management of chronic pediatric medical conditions.
References
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