Nursing Practice Essay: Qualitative Study of Health Staff & Patients Views

Question

This assignment as an academic report on nursing practice essay illustrating the qualitative study of health staff and patients views. Please include a discussion of each of the following ensuring you provide a theoretical explanation of each phase as well as illustrating the phase from the study to demonstrate your understanding.

• How the research problem was identified by the authors (phase one of the research process)
• The function of the literature review in your study (phase one)
• How the researchers gained their research sample (phase two)
• The ethical process used by the researchers in your research study including the concept of ‘informed consent’ (phase three of the research process)
• The method(s) used to collect data (phase three)
• The data analysis process (phase four)
• The answer to the research question is described and the results are interpreted (phase four)
• How research outcomes are disseminated to inform current nursing practice (phase five)
• Application of the ideas gained from the research as they translate into your practice as a developing nurse.

Answer

Introduction to the case scenario of nursing practice essay
Knowledge translation can be defined as the active and iterative process consisting of mixture, diffusion, exchange and appliance of facts to gain benefits in the global and local innovation of various health systems and healthcare services (Greenhalgh & Wieringa, 2011). This is dependent on two types of factors, namely, supply and demand. These supply factors include presence of evidence, opinion leaders and credible sources of knowledge, while demand factors are local knowledge providers, political support, implementing research evidence and strategic presence on decision-making. They indicate how effective knowledge can be disseminated and exchanged for improving the healthcare systems. However, often patients are unable to achieve benefits from advances in healthcare because of the failure to translate the clinical and health services research evidence (Grimshaw, et al., 2012). The nursing practice essay aims to analyse the research process of a qualitative study of health staff and patient views to understand how the evidence can be used for better nursing practices.

Discussion of Phases
Formulation of research problem is the foremost step in a research process because it lays the foundation of the entire research (Shoket, 2014). It is important to identify a research problem because it helps in finding the issue or concern of the particular setting that is being studied for motivating and guiding the needs of conducting the study. This has encouraged the authors of the particular qualitative study to at first identify a research problem (Pardede, 2018). They have first started with exploring certain relevant facts about the dressing issues of abdominal wounds by looking at the survey conducted by the Bluebelle feasibility study. Furthermore, they have identified the main aims or objectives that most wound dressing researches focus on for gaining insight about what have previously been found out by other researchers. Besides, they have further recognized various findings from such studies and identified gaps in those existing research articles. By doing so, the authors have been able to found out the lack of detailed information that exists about patients’ views on such dressed and undressed wounds (McMullan, et al., 2019). Furthermore, they also have pointed out the main issue of absence of adequate views of health professionals and patients’ perceptions about practical or clinical concerns associated with the post-surgical dressing use, no dressing use and novel dressing strategies. This resulted in the formulation of their research problem on exploring their perspectives in dressing use concerns on primary abdominal wounds and comparing the same (Pardede, 2018). This indicates the fact that the phenomenon of forming the research problem took place with the help of fundamental elements such as difficulties to be overcome, conditions to be improved upon, existing knowledge gaps in scholarly articles, theory requiring meaningful understanding and exploration of views to validate and confirm a theory.

Literature review for this nursing practice essay refers to the survey of existing scholarly articles for gaining a detailed insight and overview of the research topic (Machi & McEvoy, 2016). It involves collection of various relevant and significant publications associated with the particular topic for gaining a comprehensive idea about what has been found out by previous researchers. There are various functions for which the authors have carried out the literature review. The first function involves conveying to the readers about the knowledge and ideas previously established about the research topic and consequently, identifying their strengths and weaknesses (Torraco, 2016). This is evident from the research study where they have pointed out that abdominal surgical procedures are one of the most widespread operations performed by clinical and health personnel. The authors have further provided the different percentage of dressings provided in surgical wounds like simple adhesive dressings, adhesive applied over closed skin, advanced dressing and absence of dressing. The strengths were dressing researchers exploring the association existing between risk and cost of SSI, clinical and cost-related issues after dressings of surgical wounds and patients’ perspectives on some specific and specialized dressing types for open and chronic wounds (McMullan, et al., 2019). The weaknesses were lack of researchers on their perspectives regarding common wound dressings, exhaustive information about their views on dressed and undressed wounds and deep insight about clinical issues linked with post-surgical dressing. Furthermore, the authors have identified new lines of inquiry that needs to be done for exploring the perspectives of healthcare individuals and patients on the area of dressing and other clinical issues associated with the abdominal wound dressing. They have been successful in gaining facts such as what types of dressing the wounds are prevalent after surgical treatments and the risks associated with the same (Randolph, 2018). In addition, the authors have gained new perspectives by conducting the literature review and distinguishing the research to be done from the existing ones. Lastly, they have been able to seek recommendations for further research into the grounded theory through support from grounded theory.

It is essential to choose a suitable sampling method for selecting samples that are proper representatives of the entire population. This ensures that they yield significant and accurate results that would be analysed for gaining knowledge and arriving at conclusions about the research topic (Emmel, 2013). An appropriate sampling method must be chosen by the authors to avoid the most common sampling errors like sampling bias, sample frame errors and systematic errors. McMullan, et al. (2019) have undertaken purposive sampling method for selecting the sample respondents in their research study. This is a non-probabilistic method of sampling technique in which particular persons from a specific setting or event are selected deliberatively for gaining important information that is not possible to be obtained from other sources (Taherdoost, 2016). The authors of the article selected in this nursing practice essay have undertaken this sampling method for including a diverse range of patients as sample respondents and gain relevant data about the research topic. This is a low-cost method that has been taken under consideration for the readily available sample participants to explore about the dressing wounds and clinical issues after abdominal surgical treatments. Besides, these samples were selected with the help of purposive sampling because of conducting qualitative interviews with them (McMullan, et al., 2019). Thus, choosing samples based on their availability and enthusiasm to contribute in the interview and the appropriateness of representing the population of undergoing surgical treatments and dressing wounds were the reasons for such a method. Furthermore, they were chosen based on having glue as a dressing or no dressing for exploring their experiences of dressing strategies. However, it must also be noted here this type of non-probabilistic sampling consists of certain weaknesses (Taherdoost, 2016). Apart from the bias and errors, purposive sampling does not allow generalization or undertaking a subjective approach towards drawing conclusions on the research topic.

It has been observed by various scholars that researchers face moral challenges during all stages of the research study starting from the designing to reporting phase (East, et al., 2019). These include confidentiality, anonymity, informed consent, potential impact of researcher on participants and others. Thus, it is essential for all healthcare officials, clinicians and educators to remain well-informed about the different aspects of their roles while conducting the qualitative research studies. The authors have also made sure that roles have been clarified and practical guidelines and protocols followed for ensuring ethical research at all stages (Aluwihare-Samaranayake, 2012). The sample participants involved in the qualitative interviews for phase A and B were health professionals in upper or lower gastrointestinal and obstetric surgery consisting of various surgeons, nurses, midwives and research nurses and eligible patients. For ensuring confidentiality, the researchers have ensured that no personal information or professional secrecy would be harmed in the process. This duty of confidentiality was extended beyond the interview phase towards elaborating the outcomes from the study (Sanjari, et al., 2014). Furthermore, the authors have ensured to reduce the chances of any intrusion into the autonomy of the sample participants during the research study. They have been clarified about the aims for conducting the research and arranging qualitative semi-structured interviews for gaining views about their perspectives on dressing strategies. Besides, it has also been made knowledgeable the type of data that would be used for the research purpose. Lastly, the authors have guaranteed the presence of written informed consent of the sample participants before conducting each of the interviews. This is considered as one of the integral parts of ethical approach in research study (Sanjari, et al., 2014). This ensures that the researchers have made it clear to the patients and health professionals about how the data would be collected and used for the research purpose. Thus, it is stated herein nursing practice essay that the principle of informed consent has enabled the authors to be responsible for informing those participants about diverse aspects of the research in a comprehensible manner. These include clarifications associated with the nature of the study, participants’ potential roles, ways of publishing the results and using the, identity if the researcher and the financial body.

Data collection can be referred to as the procedure of congregating information on variable topics of interest in a systematic format for answering the research questions, test hypothesis and evaluate relevant outcomes of the research study (Olsen, 2011). It is essential to undertake appropriate data collection method based on the qualitative or quantitative data that is gathered for the research purpose for ensuring integrity. This not only enhanced the quality of the data but also helps in reducing potential errors. The authors have gathered qualitative data through primary sources for understanding about the patients and health professionals’ perceptions on wound dressing use. Semi-structured interviews through face-to-face conversations and telephone have been conducted with the sample participants on the hospital premises and participants’ homes (McMullan, et al., 2019). These interviews have been carried out at two different phases, where the phase A interview focused on understanding the perspectives of the participants while phase B emphasized on their actual experiences. Interviewing method of data collection in qualitative study has often been considered as one of the most effective ways for attaining and exploring views of the sample respondents on the particular research topic (Alshenqeeti, 2014). It provides them with the opportunity of comfortably expressing their views and experience on the issue, which consequently have enabled the authors to gain perspectives about the research topic. Besides, they have used the semi-structured interview method, which is viewed as more flexible version of the structured interview for collecting relevant data. Thus, this method has helped the researchers in gaining depth from the responses of the participants by probing and expanding them. In addition, it helps in covering key areas through in-depth probing while remaining within the parameters for achieving the aim of the research study (Englander, 2012). Thus, it can be said in this nursing practice essay that the authors have used an appropriate data collection method for the research study as it deals with qualitative and human specific perspectives and experiences.

Qualitative data consists of prejudiced, rich and comprehensible information in the form of words. Thus, analysing these data require reading a large amount of transcripts for identifying similarities or dissimilarities for finding patterns or developing categories (Grbich, 2012). Thus, data analysis in qualitative research can be referred to as the process of systematic looking for and arranging of the interview transcripts that the authors have collected from interviewing the sample participants and other non-textual materials for understanding about their views or perspectives. It has involved comprehending the huge amount of collected data by minimizing raw information through identification of significant patterns and deriving relevant meaning from them (Smith & Firth, 2011). McMullan, et al. (2019) has undertaken thematic analysis with the usage of NVivo10 software guided by the invariable comparison method for analysing the data collected from interviews with the sample participants. Two researchers were responsible for coding the interview transcripts through an initial coding framework and reading each of them several times for understanding the data. Use of this computer-aided qualitative data analysis software has gained popularity in the recent years because they enable qualitative inquiry beyond coding, sorting and retrieval of the data (Bergin, 2011). This software has provided with the facility of integrating coding with qualitative thinking, shaping and modelling, thus resulting in a systematic way of managing and interpreting the collected data. The authors have been able to do away with the laborious task of manual analysis of such large amounts of data collected from 106 health professionals and 88 patients. With the removal of this tremendous amount of manual tasks, they have been able to save more time and spend it on exploring trends, identifying themes and making conclusions on the perspectives about wound dressing strategies (Emmel, 2013). Thus, NVivo has made the data analysis process in the researcher more systematic and easier for the authors.

The research questions of the qualitative study were aimed at exploring and eliciting the views and perspectives of patients and health officials with regards to the medical and realistic issues associated with wound dressing use after abdominal and obstetric surgery. Besides, it also intended to find out how the practice of original dressing strategies undertaken in the hospital settings can be compared with the perspectives of the sample participants (McMullan, et al., 2019). In this regard, the researchers analysed the data gathered on issues such as concerns with wound infection and contamination, physical protection through simple dressings, emotional impact arising from bare wounds and patients’ aptitude to carry out daily errands. These issues were openly discussed with patients and health professionals in the pilot settings of Phase B interview. The researchers were able to understand that the concerns identified in the Phase A interview were not confirmed by patients or staff in many contexts (Hennink, et al., 2020). This was possible because of the fact that the data collection method through semi-structured interviews was conducted at two phases, which enabled the participants and researchers to undergo an open discussion for interpreting the findings. Furthermore, the results were also interpreted with the help of a randomised controlled trial which helped in gaining a deeper insight about the views of both staff and patients regarding test interventions and acceptability of dressings after surgery. Thus, analysis of the collected data through the computer software and discussion at the second phase on interview enabled the authors in gaining answers to the research questions (Grossoehme, 2014).

Dissemination of the research findings or outcomes obtained in this nursing practice essay can be referred to as the planned process involving deliberation of the target audiences and settings where such findings are expected to be received and communicating the same with those audiences (Edwards, 2015). The authors have thus found out the target audiences for whom those findings or results would be beneficial in the future and the ways of reaching them with such outcomes. They have identified six core themes from Phase A of the interview process from the perspectives of health professionals and patients (McMullan, et al., 2019). These themes included relevant information about the purposes and practices of wound dressings in GI and obstetric surgery. They include wound healing, wound contamination and infection, physical protection that can be obtained from simple dressings, wound care, potential psychological impact due to an exposed wound and the everyday tasks that patients carry out after surgery. These findings about perceptions were further compared with the actual experiences of patients in the Phase B interview who displayed a feeling of confidence, control and reassurance in the post-surgical dressing process. Thus, this information proves to be beneficial for both the hospitals and the health professionals who can use this for providing better future treatment to the patients (Davies, et al., 2010). Besides, the participants in the research study were overall positive about their experience regarding no dressing options and using glue as a dressing. While this might be important for undertaking dressing strategies in future surgical treatments, it also helps in pointing out any pertaining clinical or practical issues that patients face for future reference to nurses and doctors.

The authors have clearly identified the views and perceptions of patients and health professionals associated with wound dressings in primary post-surgical wounds. These views are deep-rooted in clinical practice, which is difficult to change. However, it has also been pointed out that these views might be challenged while experiencing novel dressing strategies or with the emergence of new developing strategies like wound infection or healing. These findings would be helpful for future nurses in the sense that they would be able to understand the pertaining beliefs that are existent in clinical practices. Furthermore, with the identification of which wound dressings are considered more effective, suitable and comfortable for the patients and safe by the health professionals, future nurses would be able to undertake training in such areas to gain expertise in such wound dressing. Besides, it would also provide them with the knowledge of adopting such dressing strategies that are perceived as the most beneficial in post-surgical treatments. Moreover, the research study has also pointed out various clinical and practical issues that exist in these dressing treatments of GI and obstetric surgery. This provides the opportunity to future nurses for not only dealing with dressing related concerns of the health professionals or patients, but also any other pertaining psychological issues that they might be facing in this area. In addition, the research findings provide a deep knowledge about different types of dressing wound strategies and healing procedures that are undertaken in hospitals and the related perceptions about their effectiveness from both the health professionals and the patients undergoing the treatment.

Conclusion
The nursing practice essay deals with the various phases of research that are undertaken in order to conduct a study effectively. It analysed the research on dressing issues in primary abdominal wounds that was carried out through a qualitative study involving health staff and patients. It clearly pointed out how a research study begins from formulating a string research problem and research aims, reviews existing literature, selects sample participants through effective method, conducts the interview, identify research findings and analyze them for gaining relevant information. The nursing practice essay examined how the authors undertook each step carefully for gaining detailed insight about the research topic. In addition, it also represented how abiding by ethical principles is essential while conducting a research and the possible benefits that target audiences get from these researchers in their professional lives.

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