Quantitative Study
Vamos, E. P. et al. (2012). Association of systolic and diastolic blood pressure and all cause
mortality in people with newly diagnosed type 2 diabetes: retrospective cohort study.
British Medical Journal, 1-10. Retrieved from: http://www.bmj. com/conte nt / bmj/345/bmj.e5567.full.pdf
Research Problem and Purpose
Vamos et al. (2012) posit that maintaining a blood pressure of 140/90 mm Hg is recommended for the population diagnosed with hypertension, and an even lower blood pressure of 130/80 mm Hg is recommended for people with chronic conditions such as diabetes and cardiovascular diseases. However, clarity on the effects of the blood pressure on all-cause mortality is currently lacking.
Hypotheses and Research Questions
The study hypothesizes that low blood pressure of 130/80mm Hg or below was associated with increased risk of all cause mortality in patients newly diagnosed with diabetes mellitus with or without an established cardiovascular disease.
Literature Review
The study conspicuously lacks a literature review. A literature review involves the critique of studies and other academic materials related to the research question. There is no integrated summary of current knowledge in the introductory section either and no explicitly mentioned literature review section.
Theoretical or Conceptual Framework
This study doesn’t utilize a conceptual framework. Using a theoretical framework in a research study is important, as it defines a structure of the research, in addition to providing a background for supporting and justifying the research (Polit and Beck, 2012)
Population
The population had to have registered with Participating practices for not less than 12 months. Patient under 35 years who had been prescribed insulin in the past three months were excluded. Patients over age of 18 years newly diagnosed with diabetes type2 between January 1 1990 and December 31 2005 were included. The sample was arrived at using a diagnostic and management Read and Oxford Medical Information System code for diabetes. A total of 126,092 participants qualified for participation into the study.
Protection of Human Research Participants
The researchers indicate that no ethical approval was required for this study, although no explanation is offered as to why no approval was required. Seeking ethical approval for human participants ensures that the confidentiality of the participants is protected.
Research Design
Retrospective cohort study – Involves comparison of a group of individuals who share similar exposure to a factor believed to be a cause of an observed outcome to a group of individuals with similar characteristics, but not exposed to the factor.
Instruments and Strategies for Measurement
Longitudinal primary care records and databases, which included demographical, clinical, laboratory and prescription data of the patients, were used for data collection. No information was provided on the reliability and validity of the measurement instruments.
Data Collection
Procedures used for collecting data were analysis of the longitudinal records and databases containing the pertinent information.
Data Analysis
Statistical analysis, including chi square and t-tests were used for normally distributed data, while Mann-Whitney tests were used for skewed and continuous variables. These methods were appropriate for the design and hypothesis of the study.
Interpretation of Results
The study provides sufficient information for the interpretation of the results of the data analysis. The results indicated that low blood pressure was associated with increased all-cause mortality risks.
Discussion of Findings
The researchers comprehensively discuss the findings of the study, although they do not relate to a framework, as none was used. These were the expected findings. The findings are consistent with previous studies. The research doesn’t provide for accidental findings.
Limitations
The researchers clearly report the limitations of the study. For example, the authors mention that the results of the study could have been affected by other factors, other than the blood pressure.
Implications
The conclusions and implications of the study are warranted by the study findings as they relate to the hypothesis. Sometimes, it is easy for researchers to veer of the hypothesis when making an implication, especially when the results do not match the hypothesis.
Recommendations
Research Utilization in Your Practice
The current clinical practice guidelines recommend that patients at a high risk of cardiovascular disease should maintain a blood pressure of 130/80 mm Hg, but this study confirms that maintaining this level of blood pressure doesn’t offer any cardiovascular benefits. In fact, according to the study, the low blood pressure is harmful and increases risk for all-cause mortality among these patients. These findings can inform practice when dealing with patients with chronic illnesses, although a pilot study among patients with exact characteristics as those described in the study may have to be done before implementing the findings into practice. Utilization of this research may trigger changes in the management of blood pressure in patients with chronic illnesses such as cardiovascular diseases and diabetes.
QUALITATIVE RESEARCH CRITIQUE
Hudon, C., Chouinard, M. C., Diadiou, F., Lambert, M., & Bouliane, D. (2015). Case
management in primary care for frequent users of health care services with chronic
diseases: A qualitative study of patient and family experience. The Annals of
Family Medicine, 13(6), 523-528.
URL: http://www.annfammed.org/content/13/6/523.full
Research Issue and Purpose
Researcher Pre-understandings
The article doesn’t contain a disclosure of the researchers’ professional and personal perspectives on the research problem. Disclosing researcher pre-understanding indicates the researchers’ understanding of the topic.
Literature Review
The literature review has been integrated within the introductory section. The literature review is current, although it seems to be merely reported, rather than critiqued. There is no integrated summary of the current knowledge base.
Theoretical or Conceptual Framework
The study identifies a conceptual model; dimensions of service integration by the National Collaboration of Integrated Care Support. The model is used as a guide for the implementation of care services in healthcare, and for evaluation of the outcomes and experiences of the participants with the implemented services. This model is suitable for this study, as the study focuses on capturing the experiences of participants with case management.
Participants
Participants were patients with chronic illnesses, who are frequent users of healthcare services. The study group is adequately described in the study, and the sample was selected using a maximal variability sampling approach. 25 patients in total were selected for participation in total. The sampling strategy used was adequate for the research question. The researchers do not stipulate that information redundancy was achieved. The researchers do not mention the study settings.
Protection of Human Research Participants
The researchers do not report any protection of human research participants.
Research Design
This study adopted a case study type of research design. It is not indicated if the design was modeled from a previous research or pilot studies.
Data Collection/Generation Methods
In-depth individual interviews with the participants, in addition to questionnaires were used for data collection. Triangulation was not used.
Credibility
The generated data was credible, as it not only related to the research question, but it was also gathered by trained personnel.
Data Analysis
Mixed codes methods as identified by Miles and Huberman were used for the analysis, which was done by two independent professionals. The evidence provided that the researchers’ analysis was accurate and replicable is that the analysis was done by independent professionals. They provided the credentials of the data analysts.
Findings
The participants felt that the use of case management made healthcare services more accessible. The participants felt that case management was beneficial to their health, as it brought services close to them.
Discussion of Findings
The discussion of findings is related to the framework used, and they were the expected results. The findings are also consistent with previous studies, although accidental findings were not described.
Limitations
The researcher reports limitations. They mention time as a limitation, which may have impeded the achievement of full potential of the interventions. Time also limited the in depth exploration of family experiences with the interventions.
Implications
The implications and conclusion of the study is informed by the findings of the study. Aligning the implications of the study with the findings is imperative in showing the importance of the study.
Recommendations
The researchers do not provide recommendations for further study. However, the description of the study is clear and complete, and can allow for replication
Research Utilization in Your Practice
This research is significant for practice in that case management can be considered a good practice for helping people with chronic illnesses manage their conditions. Therefore, these findings are appropriate for practice setting and situation. This study may not require pilot studies before implementation, as there are no medications involved in the intervention. Utilization of this research may trigger more use of case managing nurses in practice to improve the quality of health of people with chronic illnesses.
Contrast of Types of Information Gained from examining the two different Research Approaches
An examination of the two research approaches revealed that data gathered in a quantitative approach helps to quantify an observation, which facilitates generalization of the results into a larger population. The examination also revealed that data gathered from a qualitative research approach provides insights into an observed situation by evaluating the opinions and perspectives of participants. Quantitative research approaches gather numerical data, while qualitative approaches gather non-numerical data.
General Advantages and Disadvantages of Qualitative and Quantitative Research
The evaluation of the two articles show that quantitative research approach allows for the broader study of subjects, as it accommodates more participants compared to the qualitative data (Polit & Beck, 2012). For example, the quantitative study utilized 126,092 participants, compared to 25 participants by the qualitative study. The nature of the quantitative research approach, requires unnatural settings, which may affect the generalizability of the study For example, the qualitative approach used in this paper doesn’t analyze external factors that may affect the outcomes, such as diet of the participants.
Qualitative research provides for a deeper understanding of an event, as it allows for collection of data regarding feelings and attitudes of the participants (Polit & Beck, 2012). Qualitative research also gives the researchers an opportunity to explore the research questions in a variety of dimensions, since the interview questions do not limit the answers of the participants. Qualitative research also helps participants explain their individual experiences. However, analysis of qualitative data is challenging, due to the large volume of data gathered via this approach (Polit & Beck, 2012). Generalizability of qualitative studies is also challenging, as feelings and attitudes differ among individuals.
Response to the claim that Qualitative Research is not real Science
There are claims that qualitative research is not real science. In response to these claims, qualitative research, when carried out meticulously and supported by a relevant theoretical framework, is real science. If a research study adopts the quantitative approach but fails to adhere to the standards of a quantitative research, it fails as real science. However, if the standards and all steps of research are followed, either approach can be considered to be real science.
General Insights that both Quantitative and Qualitative Studies can provide to Researchers
Quantitative researches provide important information to researchers regarding the prevalence of an observed situation (Cantrell, 2011). The numerical data gathered from quantitative studies facilitate the statistical analysis of a situation. On the other hand, qualitative studies can inform the researchers about the opinions or perspectives of a population towards a certain observation (Cantrell, 2011)
References
Cantrell, M. A. (2011). Demystifying the research process: Understanding a descriptive
comparative research design. Pediatric Nursing, 37(4), 188.
Hudon, C., Chouinard, M. C., Diadiou, F., Lambert, M., & Bouliane, D. (2015). Case
management in primary care for frequent users of health care services with chronic
diseases: a qualitative study of patient and family experience. The Annals of
Family Medicine, 13(6), 523-528.
Polit, D. F., & Beck, C. T. (2012). Nursing Research: Generating and assessing evidence for
nursing practice .(Laureate Education, Inc., custom ed). Philadelphia, PA: Lippincott
Williams & Wilkins.
Vamos, E. P. et al. (2012). Association of systolic and diastolic blood pressure and all cause
mortality in people with newly diagnosed type 2 diabetes: retrospective cohort study.
