Qualitative Critique: A qualitative study of primary healthcare professionals’ view of falls prevention
Tarafdar S, Pugh N, Doyle A et al. (2018) A qualitative study of primary healthcare professionals’ views of falls prevention. Primary Health Care. doi: 10.7748/phc.2018.1429
Research in nursing has the potential to influence both current and future nursing practices (Tingen.et al., 2009, p.168). In nursing practices, critical questions are often answered by reviewing related topics literature. However, it is essential to note that not all published studies are scientifically valid (Boswell and Cannon, 2018, p.404). It, therefore, important for nurses to critically evaluate scientific reports before their application into nursing practices. The validity and reliability of scientific research can thus be determined by assessing the quality of work conducted by the researcher. Glasofer (2014) defines quality as the degree with which a study minimizes biasness in outcome analysis and subject selection (Glasofer. 2014, P.18). Nursing research is, therefore, critical in the provision of optimal care in nursing. Before the application of nursing research is essential to make a crucial judgment on how sound the research is and to what extent this is evident throughout the research paper.
The research critique process is part of evidence-based practices. Many clinical decisions are, however, supported by habits, traditional methods, and evidence from different sources, which may or may not have a strong research basis (Vincent et al., 2015, p.48). Evidence-based appraisals may, therefore, be applied to help solve this challenge is a more beneficial and efficient manner. Such evaluations may help to assert the strengths of a health care practice as well as exploit potential problems and implications of such clinical practices. Evidence-based practice critical appraisal, therefore, enables nurses to systematically review the validity and relevance of research outcomes in the clinical setting to improve patient clinical outcomes (Boswell and Cannon, 2018, p.423). Evidence-based appraisals are also an essential determinant in patient safety and quality care. The 2009 oncology of nursing society also provides that the EBP process should consist of problem identification, finding the evidence, critiquing the evidence, summarizing the evidence, research application, and results in evaluation (Constance et al.,2009, p. 619).
Falls are among the leading cause of hospital admissions among the elderly (Department of Health and Social Care 2012). healthcare professionals should, therefore, be positioned to conduct fall assessments, management as well as reduce risk factors related to falls. This study research topic is particularly important in the field of nursing because improved fall prevention has the potential to lower costs associated with patient admissions, enhance the quality of care among the elderly through the application of a place-based approach. The place-based method has the potential to reduce elderly patient mortality and morbidity related to falls. The study also ascertains that fall prevention is a primary priority among health professionals, and this is particularly important at improving fall prevention contingency measures both at home and in clinical settings.
This essay aims to make a critical analysis of a research study conducted in 2018 on “A qualitative study of primary healthcare professionals’ view of falls prevention” (Tarafdar et al.,2018, p.1). This essay will make the use of a critical qualitative framework to critique the relevance of the research to clinical practice. The article will make use of the essential skills of the appraisal programme (CASP) framework to establish the research relevance. The essay will adopt the following chronological order to achieve critical analysis. An overall analysis of the research structure, author details, research paper title, and abstract analysis, study aims, literature review analysis, research methodology, whether or not ethical considerations were addressed to avoid biasness if the data collection methods used were suitable for addressing the research, did data analysis address validity and reliability issues, was there a clear report of the research findings, and the research implications (Ryan et al.,2007,p.739). Key terms will also be defined throughout the essay because there is the need to establish a sound understanding of terminologies used in this critical qualitative research essay to facilitate a clear understanding of this paper critical analysis
The report is concise and well written. The research has adopted proper sentence structures and makes use of simple vocabulary, which makes it easy for readers to read through the main topics and themes, as discussed by the authors.
Author details and credentials are also provided within the research paper. The authors also provide sufficient knowledge in the field to effectively conduct this study. The authors’ qualifications further aid in the proper choice of the data collection and analysis methods as well as in the provision of a sufficient literature review framework to support the study.
Title
The title, A qualitative study of primary healthcare professionals’ view of falls prevention” is a bit ambiguous. It fails to identify the age group relevant to this study’s benefits. Fall prevention could also be clinically examined in other clinical settings, such as bathroom fall prevention in epilepsy specialist care units. However, the research content provides more information about falls in older people. The title should, therefore, provide more information about this research content. The title also offers essential keywords for the research design, which is important in predicting the research content. In addition, the title reflects the tone of the study.
Abstract.
The abstract provides a summary of the significant research aspects within the study and provides the aim of the research study. There is also a clear description of the research content. Major themes were also explicitly listed in the abstract. These provides the basic framework for preventing falls among the elderly. However, the abstract fails to identify the qualitative data collection methods used. There is also a lack of research findings recommendations within the abstract construct. However, there is evidence of future recommendations within the research paper context to help improve patient care in both primary and secondary care to lower mortality and morbidity among the elderly. The abstract is also elaborative with a word count of 109, and this is within the acceptable 100-200-word count (Pollit and Beck, 2008, p. 72).
Significance of the study
The research identifies the research gap in the fall prevention of inpatient care. The study identifies that there is little research done on the perception of primary healthcare professionals in fall prevention. The objective of this study is clearly and directly structure towards solving the research problem statement through the aim of this study. The potential benefits of the research objective can be identified in helping healthcare professionals provide the most suitable person-centered and in addressing health inequalities using a place-based approach to lower mortality and morbidity among the elderly in the city of Birmingham in the UK.
Literature review
The study literature review focuses on the problem presented in the research problem statement. The literature review also provides consistent information about the research problem statement. The literature also demonstrates the use of enough recent benchmark publications. Publications provided help in reflecting the importance of fall prevention at a global level. In this paper, the researchers have reviewed literature in a manner that helps identify other research gaps for further studies. The literature review is well organized with an introduction about falls among the elderly and with a conclusive summary on the same. There is also a clear description of this study implication in the healthcare setting within the literature review. However, the literature review is a bit scant, and more information should have been provided. There is a need for more information regarding similar research done to help prevent fall prevention rather than just providing the menace behind falls among the elderly. The literature review also contains the current literature, and this further contributes to the validity of the study. (Tarafdar et al.,2018, p.1)
Methods
The study method is clearly outlined in this section. The qualitative approach used ensured that the data collected was objective to the study. Unlike quantitative research, the qualitative approach ensured less time would be allocated to data collection and data analysis. The sample size used in both face to face interviews and questionnaires is also well outlined. Eight participants participated in the face-to-face interviews while nine filled questionnaires. The sample size description is vital in ensuring data consistency and dependability. The study used a total of 17 participants. This sample size is too small to generalize internationally or to other regions within the UK (Tarafdar et al.,2018, p.1).
sampling
sampling may be referred to as the selection of a group from the entire population to act as a statistical representation of the entire population (Etikan and Bala, 2017, p.149). Purposive sampling was used to select the study participants for the study. Purposive sampling is a type of non-probability sampling used in qualitative research (Rahi, 2017, p.3). Purposive sampling often depends on the researcher’s judgment during the participant selection process. Study participants involved a group of healthcare professionals involved in patient referral in fall interventions. These ensured that study participants were viable to the study and that information obtained was relevant to preventing future falls among the elderly and in reducing health inequalities related to elderly patient falls. Initial participants used in snowball sampling are likely to exclude potential participants by forming the entire sample population. Snowball sampling also makes it hard to determine sampling errors. There are, however, no definitions of the sampling methods used. Information regarding the choice of sampling methods is also not provided. Some of the sampling methods used may be new to practicing nurses, and even though the methods used use standard terms, these terms adopt new meaning within the research context. However, the sampling methods used are suitable for this qualitative study, as they are both qualitative.
There is, however, no sufficient information on the sample size demographic characteristic. Information on sample demography is essential in understanding why the respondents have different responses. This is because the respondent’s professional experience and duration of employment in primary care influenced respondent perception towards the study topic. The small sample size, as well as response disparity, is among the critical limitations to this study as it lowers the validity of this research findings application in other clinical settings within the UK.
Perhaps elderly persons should have been included in the study. Their inclusion would provide a general sense of whether fall prevention is a priority to healthcare professionals. This is because healthcare providers are likely to give a biased answer on this because failing to reflect fall prevention as a priority would act as a compromise to their oath on quality care provision. The perception obtained from the elderly would serve as a proper benchmark to answers provided by the primary healthcare caregivers because they are the first line contact persons in fall-related clinical emergencies. Fall prevention awareness creation among both primary and secondary caregivers in the clinical setting is important, but perhaps including the elderly in this study would increase their awareness about this study findings and would have a favorable clinical outcome.
Ethical considerations
Participant recruitment adhered to ethical consideration guidelines. Email invitations were used to obtain participants’ consent. The participant recruitment process also made use of snowball sampling. This method involves study participants recruiting other study participants until the desired sample size is achieved (Etikan et al.,2016, p.55). One key ethical compromise to this method is biasness. This is because participants with high social connections provide participants with similar perceptions, and this may compromise the data collected. Snowball sampling may also compromise the ethical guidelines because participants are recruited by other participants who may not be discrete and therefore compromising their privacy. Purposive sampling also ensured that all participants were of legal ages to participate in the study as they were all medical practitioners. The study does not provide any relevant information as to whether or not relevant Uk ethical consideration bodies approved the study.
Data collection methods
The data collection methods are well outline within the research methodology design. The tools used are also valid and reliable for this study. Questionnaires and semi-structured interviews were the appropriate data collection methods used. The questions used in both data collection methods also addressed the research question hypothesis. Both adopted closed and open-ended questions. The open question structure enabled respondents to be expressive, while open questions were easy for respondents to answer. A general sample of questions used is also provided. The questions used are valid to the objective of this study. Questionnaires were sent to primary healthcare professionals by mail, and after completion, the respondents emailed back their responses. This ensured the confidentiality and privacy of respondents. The emails also encouraged participants to give a more honest answer without fear of victimization, unlike in the use of focused group interviews.
A Questionnaire is a data collection method that involves participants answering questions about a specific subject. The feasibility study conducted on the questionnaire helped ensure proper adjustments were made to the questionnaire. The feasibility study done on general practitioners helped in identifying that the questionnaire was lengthy, and this would discourage participants from participating. The length questionnaire was also likely to cause data errors because respondents were likely to develop fatigue while answering. A lot of time would also be consumed when responding to the items of the questionnaire. This would make respondents skim through the questions without critically evaluating the open questions in the questionnaire. A shorter version was then constructed., the questionnaire still addressed the original questionnaire core areas. The questionnaire used both closed and open questions. This was particularly important as both questions’ structures were advantageous to this study. The two methods were therefore used because of their ability to complement each other. Closed questions were easy to answer, and this encouraged participant participation and helped avoid fatigue when participants were answering the question. Fatigue is likely to compromise accuracy. The open question urged participants to be more expressive, and this allowed (Krosnick. 2018, p.446.).
The semi-structured interviews were also used in the study. These facilitated an in-depth discussion on the research topic between the respondent and the interviewer, and In addition, the face-to-face interview provided the interviewer with an opportunity to make clarifications and make follow up using discussions. The interviews were conducted by Suhail Amin, a general practitioner with sufficient knowledge on the research topic. The general practitioner’s knowledge allowed open discussions within the interview settings. This also helped established rapport. Study participants were also recorded during face-to-face interviews. This minimized biasness during data transcription. There is also a mentioning of who conducted the face-to-face interview. There is sufficient evidence to indicate the face to face interviews were appropriately conducted.
Data analysis
The data analysis method is explained in this unit. The author states that a qualitative approach was used to analyze the data. The data analysis method is most suited to this study because the data collection methods were also qualitative in nature. The author also states that empirical data is thematically categorized into two; there are six main themes identified from the thematic approach used. A step by step breakdown of this approach up to theme refining is also given during data analysis to ensure data reliability and validity. Two different authors independently review the data. The reviewers had little disparity over the theme’s coding, and as a result, the data collected were classified into strong and more meaningful themes. A qualitative analysis software could also be used to supplement the thematic approach used. The software analysis is likely to help improve result validity and reliability.
Findings
Finding from the research study fit the objective of this study. The themes identified will help reduce falls among older adults and, as a result improving the quality of care among the aged. The research findings are categorized into two themes, and each theme is discussed in detail. The nursing implications identified from the research project include; The need to create more awareness about localized falls services to reduce referral delays in social care services and healthcare settings. The need for social care and healthcare integration for effective fall or fracture prevention to achieve proper clinical outcomes. Respondents also referred to the need for risk stratification tools that are simple to implement, and finally, healthcare perspective on fall and fracture as primary care priority among healthcare professionals. The theme identified and the research findings are also outlined and described in an organized manner. The themes are categorized into two. Each main theme is then well described using the eight sub-themes identified. There are, however, no visual aids incorporated in the study to help supplement the findings in this research paper (Tarafdar et al.,2018, p.1).
Conclusion, implications, and recommendations
This study offers a helpful insight into improvements necessary for improving the quality of care offered to old persons. Old persons are at risk of falling or are already under clinical care by offering valuable information about primary health professional perception on fracture and fall preventions among the elderly in UK primary clinical care. After reading this research paper, it easy to identify the researchers’ credibility. The method used in data collection, data analysis, and the overall layout of this study indicates that the researchers are knowledgeable about research. The research finding is also valid and reliable as appropriate methods were adopted. The author also identifies limitations to this research paper, and this may form a base for future research, which may help improve old patient care within the UK. There is an increased need for awareness creation among primary healthcare caregivers of different fall interventions and the need to make these services locally available to improve older adults’ quality of care and to prevent mortality and morbidity. The small sample size used in the study limit this research findings in other clinical settings outside Birmingham. There is also a need to explain the sample demography used in the sample used as the sample. Demography influences research findings. There is also a need for a bigger sample size to provide more information about the research topic in other Uk regions other than in the city of Birmingham. There is also a need to integrate secondary and primary clinical care services, as this will prove useful in managing and preventing falls among the elderly. A straightforward referral pathway will also reduce time spent by caregivers during patient referrals to social care services and healthcare and, as a result improving the efficiency of fall management in clinical settings.
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Tarafdar S, Pugh N, Doyle A et al (2018) A qualitative study of primary healthcare professionals’ views of falls prevention. Primary Health Care. doi: 10.7748/phc.2018.1429
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