Rough Draft Qualitative Research Critique and Ethical Considerations

Write a critical appraisal that demonstrates comprehension of two qualitative research studies. Use the “Research Critique Guidelines – Part 1” document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples, and reference content from the studies in your responses.

Use the practice problem and two qualitative, peer-reviewed research articles you identified in the Topic 1 assignment to complete this assignment.

In a 1,000–1,250 word essay, summarize two qualitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

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.

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Solution

PICOT

P- Hypertensive patients

I-Physical activity and diet modification

C- Hypertensive medication (usual care)

O- Reduced mortality rates, increased quality of life, and reduction in systolic pressure

T- 6 months

PICOT statement- In hypertensive patients (p), how does physical activity and diet modification(I), as compared to the usual care of hypertensive medication (C), reduce the systolic pressure, increase the quality of life, and reduce the mortality rate (O), within a 6 months period (T).

Background of Study

Obesity is considered as more than or equal to 20% of the above weight one should have according to their gender, height, and age. Through the Body Mass Index (BMI), it is easier to identify if a person is overweight or obese considering their weight and height. A BMI level of 25.9-29 is considered as overweight, while that of 30 and above is considered as overweight. There is an in the obese and overweight population in the world as the year pass (CDC, 2021). In the year 2016, the worldwide count of adults over the age of 18 that were overweight was at 1.9 billion and of this population, 650 million were obese. This translates to 39% of adults in 2016 being obese where the percentage of men is at 11% and that of women is at 15% (World Obesity Federation, 2016).

Prevalence in obesity numbers has increased with the days with a tripling amount from the year 1975 to 2016. Additionally, recent statistics from WHO have shown that an estimate of 38.2 million children of the ages under 5 are above the required weight (World Health Organization: WHO, 2021). The prevalence of an obese and overweight population is linked to deaths worldwide compared to those of an underweight population. WHO has defined globesity as a worldwide pandemic and there is has been a steady increase over the years (World Obesity Federation, 2016). This is due to the fact that obesity leads to the risk of many diseases including hypertension, Diabetes, and other cardiovascular disorders. Cardiovascular disorders are particularly the leading cause of obese mortality rates.

There is a need to educate a population in the need to take care of themselves through diet and physical activity so as to ensure that they keep fit. However, this activity has not been happening and numerous people get aware of the risks of being overweight and obesity after they are already diagnosed with hypertension. Physical activity and diet modifications are known to reduce the systolic pressure over time in hypertensive patients. Even so, people’s perceptions and attitudes towards this life modifications are not up to the needed standards as the population is not knowledgeable enough about the condition. Several qualitative studies show that there is a gap in the knowledge people have on hypertension, management, and risk factors that needs to be addressed by healthcare professionals worldwide.

The objectives of the research critique is to find out on the different issues that lead to obesity and overweight issues within a population. Another objective is to find out on the different knowledge and attitude gaps that people have on the management of obesity-hypertension. The research questions presented by the different qualitative articles include what are the views of HTN patients on their disease state and issues related to optimizing BP control, what were the experiences of life prior to developing hypertension, and did culture through diet  contribute to the lifestyle behaviors that lead to hypertension.

How do the Articles support the N.P Issue Chosen?

Qualitative studies are an efficient method of study that enables the researcher to get the full insight of participants through in-depth interviewing with open-ended questions. In this the PICOT chosen on obesity hypertension, there are many quantitative studies that build up the statistical evidences but even so, the qualitative ones help in getting the first hand information from the chosen part of the population Shamsi et al. (2017), set out a qualitative study to investigate the life of hypertensive patient prior to being diagnosed with the condition. The study is in line with the PICOT as it sets out to find out the lifestyle behaviors that may have led the participants to be diagnosed with HTN. The PICOT sets out to investigate if the use pf physical activity and or the use of diet modification may decrease the chances of one suffering from HTN, improving the quality of life, or reducing the systolic pressure. The study shows that culture and beliefs that are rooted on things such as diet influenced the HTN patients to get the condition as they are observed as risk factors. Further on, the study also evaluates the knowledge gap in which people have concerning HTN and the risk factors to getting the condition. Nutrition and lifestyle is marked as the main category in family life that is associated with patient experiences that drove them to being diagnosed with HTN (Shamsi et al., 2017). Obesity is the main cause of hypertension and this comes from nutrition and lifestyle modifications and in a bid to reduce the systolic pressure, the PICOT uses the intervention of physical exercise and diet modifications that help to improve the quality of life, reduce systolic pressure, and reduce the mortality rate of people diagnosed with HTN.

A study conducted by Boitchi et al. (2021), was also evaluated to show its significance to the Nursing Practice issue on obesity hypertension. According to the study, findings showed that there was a gap in knowledge on the risk factors, symptoms, management, and in the treatment of hypertension.  The study participants showed preference to home management of the condition compared to drug adherence and being in hospital for management of the condition. The study relates to the nursing practice issue in that it shows that most women participants preferred to be under home management that is inclusive of physical activity and diet modification as opposed to taking medication and being under hospital management for HTN (Boitchi et al., 2021). This shows that there is a need for education on how people can manage the condition effectively at home and being enlightened on the risk factors that may lead to the condition being worse. However, the study also evaluates that there are several issues that may lead to poor home management such as financial instability, gender-based negligence, and practices that lead to the condition being worse.

Method of Study

Boitchi et al. (2021), chose to use in-depth interviews as a way to collect data from the participants. The use of purposive snowballing technique was also used to select the participants of the study.  Through purposive snowballing, the researcher was able to discretely identify participants but also highly regarded their opinion on who else could be interviewed regarding the study. The use of in-depth interviews also helped the researcher to gain a better opinion concerning the issue through the chosen words by participants and also the tone used while giving their opinions. This is method of data collection and sampling is different from the study done by Shamsi et al. (2017), who used purposive sampling to get the participants. Through purposive sampling the researcher through own judgment identified the participants to take part in the study and did not regard other participants opinion on who else could be selected to take part in the study. However, the method of data collection was similar to that of Boitchi et al. (2021), as there was the use of in-depth interviews.

In-depth interviews are of advantage as they help get the full opinion of the participant through their tone and word choice. This helps the researcher to get a clearer picture of the issue under study (Busetto et al., 2020). However, in-depth interviews have a limitation in that they are very time-consuming due to the time needed for the interview for each participant, the need for transcription, analysis, and reporting (Busetto et al., 2020). Purposive sampling is has an advantage in that it helps a researcher reach the precise research results through the gathering of qualitative responses. However, the sampling techniques also has a limitation in that it is prone to researcher bias as they choose participants through their own judgement (Busetto et al., 2020). Purposive snowballing technique is limited in that it is slower in data collection as each participant recommends the other slowing doe the process. Even so, the sampling technique has as advantage in that the odds of researcher bias are minimized.

Results of the Study

The study by Boitchi et al. (2021), showed that there was a significant gap in the level of awareness that participants had concerning HTN. The study participants preferred the use of home care management of HTN as compared to drug adherence and hospital management but failed to have adequate information concerning the condition. Additionally, the knowledge gap was not the only hindrance to self-care but other factors such as financial instability, culture, and gender-based negligence are also factors that lead to participants not being able to control hypertension. Shamsi et al. (2017), also identified the need for education on both hypertension and non-hypertensive patients. The study results showed that before participants were diagnosed with HTN, they lacked knowledge on the condition and also risk factors associated with it. Additionally, the study also identified other driving factors towards diagnosis of HTN being culture that could be through the diet and lifestyle led by people that share common characteristics. Both studies draw a conclusion that there is the need to bridge in the gap of education through enlightening the population on HTN and the risk factors associated with the condition. Through education, people are able to adjust their lifestyle to avoid the condition, improve their quality of life, and also reduce the systolic pressure.

Ethical Considerations

Ethical considerations denote the guiding principles that set the design and practices in research. Informed consent is one ethical consideration that should be met by each researcher. The informed consent help the participants to freely and voluntarily participate and consent to being part of the research (National Institutes of Health (NIH), 2015). The document also shows the participant the rules in the participation in the study and also gives them the chance to either be part of the research or no reject being part of it. Privacy is also an ethical consideration in research where participants’ data is not let out to the public but only for the researcher to use so as to analyze results (National Institutes of Health (NIH), 2015). The privacy involves the names of participants and any other information that can make the participant identifiable by the public.

Both qualitative studies did not expose the names or any information that could have led to participants being identified by the public. This shows the ethical consideration in privacy of data. Additionally, both studies had informed consents that were signed prior to the start of the study and even after signing the informed consent, some participants dropped out of the study.

 

 

References

Boitchi, A. B., Naher, S., Pervez, S., & Anam, Md. M. (2021). Patients’ understanding, management practices, and challenges regarding hypertension: A qualitative study among hypertensive women in a rural Bangladesh. Heliyon, 7(7), e07679. https://doi.org/10.1016/j.heliyon.2021.e07679

Busetto, L., Wick, W., & Gumbinger, C. (2020). How to use and assess qualitative research methods. Neurological Research and Practice, 2(1). https://doi.org/10.1186/s42466-020-00059-z

CDC. (2021, June 7). Defining Adult Overweight & Obesity. Centers for Disease Control and Prevention. https://www.cdc.gov/obesity/adult/defining.html

National Institutes of Health (NIH). (2015, June 3). Guiding Principles for Ethical Research. National Institutes of Health (NIH). https://www.nih.gov/health-information/nih-clinical-research-trials-you/guiding-principles-ethical-research

 

Shamsi, A., Dehghan Nayeri, N., & Esmaili, M. (2017). Life experiences of patients before having hypertension: a qualitative study. Electronic Physician, 9(3), 3925–3933. https://doi.org/10.19082/3925

World Health Organization: WHO. (2021, June 9). Obesity and overweight. Who.int; World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight#:~:text=In%202019%2C%20an%20estimated%2038.2,years%20were%20overweight%20or%20obese.&text=The%20prevalence%20of%20overweight%20and,just%20over%2018%25%20in%202016.

World Obesity Federation. (2016). Prevalence of Obesity | World Obesity Federation. World Obesity Federation. https://www.worldobesity.org/about/about-obesity/prevalence-of-obesity