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Qualitative Study Critique Chassie Harris RN, BSN November 25th, 2009

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Qualitative Study Critique Statement of Phenomenon of Interest The study addresses the perceptions and feelings of patients with pressure ulcers. Many studies have focused on the presence of pressure ulcers and developing treatment regimes. The researcher clearly identified the phenomenon of interest in the in introduction and abstract. The researcher used a descriptive, phenomenologicallybased approach to describe the experiences of patients with pressure ulcers. The philosophical underpinnings of the research study are identified in the methodology section. The researcher used semi-structured interviews that were based on the physical, psychological and social domains. The researcher also wanted to increase her own knowledge and provide better care for her patients (Burns & Groove). Purpose The purpose of the study was to explore and describe the patients experiences with pressure ulcers. The researcher indicates that there should be just as much emphasis on treatment regimes as on the patients psychological reaction. She identifies the unique relationship the nurse has with patients and their ability to help these patients holistically. Nurses play an important role in the management of pressure ulcers. The study provides an area of pressure ulcer research that has not yet been studied (Burns & Groove). Methodology The researcher used semi-structured interviews to collect data. This allowed the researcher to multisensorily be immersed in the data. The method was adequate to

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address the phenomenon of interest. The research was able to conduct one-on-one interviews. She was in true presence and was able to engage the patients (Burns & Groove). Sampling The researcher described the participants by using purposive sampling. The patients were selected from the researchers caseload. The researcher did not provide any direct care, for the patients, at the time of the interviews. Purposive sampling was chosen because patients needed to be able to answer questions about personal experiences with pressure ulcers. The sample included patients who had suffered pressure ulcers. Pressure ulcers were described as damage extending to the subcutaneous tissue and deep fascia. The study was limited by the small number of participants. There were only five patients included in the study. This researcher was unable to generalize the study findings (Burns & Groove). Data Collection and Data Analysis Data collection was focused on the patients experience with pressure ulcers. The researcher used open-ended questions that allowed the patients to explain how pressure ulcers affected their mood, social activities, and overall quality of life. The researcher described data collection strategies in the methodology section. The data collection was conducted over a two week period. The study was approved by local ethics committees. The researcher conducted the interviews and it was restricted to one hour. There was only one interview per patient and they were recorded. This allowed the researcher to immerse herself in the data and generate categories and themes. The

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study could be replicated using similar conditions, sampling, questions, and data analysis. The study did not identify the exact question asked to the patients. The study summarized issues that emerged from the data and gave quotes to validate the findings. It is hard to determine if the findings were biased because you are only given quotes the researcher felt was significant. The study has a lack of validity because of the small number of participants and results presentation. Women were also underrepresented in the study. The findings are not generalizable but they do identify an area of knowledge that is lacking (Burns & Groove). Credibility The participants recognize the experience as their own because they experienced the pressure ulcers first hand. The study used purposive sampling in order to find individuals that personally experienced pressure ulcers. This allowed the researcher to evaluate physical issues, problems associated with exudates, psychological issues, worry about healing, relationships, body image, and social issues. The phenomenon of interest is very important to the nursing body of knowledge; however the subject needs to be further studied to identify appropriate interventions (Burns & Groove). Auditability The researcher presented the information clearly; making it easy for the reader to follow. The introduction gives an explanation of pressure ulcers and their potential impact on an individuals health. The literature review provides current information of pressure ulcers and identifies areas that are lacking. The researcher then proceeds to

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discuss the study and its impact on the current nursing body of knowledge. The researcher identified methods of documentation and data analysis processes (Burns & Groove). Fittingness The findings are not statistically significant enough to change current practices and the researcher is unable to generalize them to any specific groups. There was a lack of available participants and women were underrepresented. The study did however, identify areas of study that are lacking in nursing practice. There is a need to study the proper interventions for the pressure ulcer and the person experiencing the occurrence (Burns & Groove). The interviews were conducted by the researcher and recorded for later evaluation. This allowed the researcher to concentrate on the patient and not on recording information. The strategy used for data analysis was appropriate because it allowed the researcher to immerse herself in the data(Burns & Groove) . Findings The findings were presented within the context of the study. Context is the body of concerns unique to individual and understood by the individual (Burns & Grove 2009). The researcher was able to identify some themes through data analysis. The data analysis process allows the researcher to categorize the data. This linking of data allows the researcher to keep the context central in the data analysis process. The researcher conceptualizations were true to the data. She acknowledged a number of study limitations and identifies the need for additional research(Burns & Groove) .

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Conclusions, Implications, and Recommendations The study allows the reader to draw conclusions, implications, and recommendations from the context of the study. The study provides identifies areas of information that are lacking from the nursing body of knowledge. The study identifies problems with current assessment processes. There are many studies on the treatment of pressure ulcers but there is a lack of knowledge that focuses on the experience of living with pressure ulcers. The reader could use this story as a springboard for future studies. The effect of pressure ulcers on the individual needs to be further studied. The findings are not generalizable due to the small sample size. The study would need to include more individuals and more women. The study would also need to identify interventions to help the nurse aide the patient though the experiences. The study identifies very significant information to the field of nursing. Patients are the center of a nurses purpose. They must treat the individual holistically. Many times patients are treated as the stage III with the purulent discharge. It is important that we realize the effect pressure ulcers have on patients and their families (Burns & Groove).

(Not part of the paper- Recently I had a hospice patient with an end-stage Kennedy ulcer. It had a very foul smell and was embarrassing for both the patient and his family. After weeks of this smell we finally found a solution, Flagyl. This may be common knowledge but I thought it was very interesting. We crushed the flagyl and sprinkled it on the ulcer and within minutes the smell started going away. It was wonderful for the patient and family)

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References Burns, N., & Grove, S. (2009) The practice of nursing research: Appraisal, synthesis, and generation of evidence. (6th ed.) St. Louis, Saunders.