NRS 433 Week 2 Assignment: Quantitative Research Critique and Ethical Considerations
NRS 433 Week 2 Assignment: Quantitative Research Critique and Ethical Considerations
Quantitative Research Critique and Ethical Considerations
Diabetic ketoacidosis or DKA is a medical emergency that requires quick interventions if the patient is to survive. These patients are usually children since type I DM usually affects people from an early age. However, some children grow to be adults with the condition and so it is not uncommon to find an adult presenting with DKA. It is a condition that results from the metabolism of fats in a patient who is a type I diabetic. This metabolism of fats occurs because the body cannot have glucose to metabolize and produce energy in the form of adenosine triphosphate or ATP. The metabolism of fats produces ketones that are acidic and lower the pH of the blood to dangerous non-life sustaining levels (Hammer & McPhee, 2018). The PICO question for this project is: In type I patients with diabetic ketoacidosis (DKA) (P), what impact does hospital based education program for both patients and providers have (I) compared with no education (C) on reducing the incidences of diabetic ketoacidosis (O)? The purpose of this paper is to analyze and critique two articles on this subject. The two articles chosen are those by Iovane et al. (2018) and Vitale et al. (2018).
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How the Articles are Used to Answer the PICO Question
The two articles chosen were both retrieved from research databases during evidence search. To do this, search terms and phrases had to be formed from the PICO question so that these could guide the search. For this reason, these articles address the PICO question in very specific terms. They will be used to answer the PICO question because they are both about investigating ways to prevent DKA in children and adolescents. Since the PIC is seeking to find out if an educational intervention for both providers and patients (parents) can be effective in preventing DKA; these articles would be able to answer this question.
The Critique and Ethical Considerations
- How the Interventions and Comparison Groups in the Articles Compare to those Identified in the PICO Question
In Iovane et al. (2018), the researchers identify children under five years as the population of interest. This is in line with the population (P) identified in the PICO question. The researchers also go ahead to reveal the purpose of the study as identifying the clinical symptoms of DKA early in children under the age of five with type I DM so that these can be used to design preventive measures for DKA. This angle of prevention is in line with the intervention stated in the PICO question and specified as being educational in nature.
In Vitale et al. (2018), the researchers assembled a sample of n=42 of patients with type I DM who are above the age of 13 years and n=34 of patients with type I DM who are 13 years old and below. This is in conformity with the population of interest as stated in the (P) of the PICO question. In other words, the population being investigated has been properly identified just as in the PICO question. The purpose statement in this article also gives the intervention just as stated in the PICO question – an educational intervention to hep parents and patients recognize early signs of DKA.
- Method of Study
- The Methods and How They Are Different
Both of these studies are quantitative studies and this means that they are thorough and use nonparametric inferential statistical tools to draw valid and reliable conclusions. Iovane et al. (2018) used a sample of n=60 children between the ages of 1 and 10 years old. These were divided into two groups, group 1 of those five years and below and group 2 of those 6-10 years old. On the other hand, Vitale et al. (2018) assembled a total sample of n=76 respondents. Forty two of these were aged 13 years and above while 34 of them were aged 13 years and below. Iovane et al. (2018) obtained data from previous medical records to base their investigation on. On the other hand, Vitale et al. (2018) administered a questionnaire to the participants before and after the educational intervention. Both articles show that the researchers in both studies used strong inferential nonparametric statistical tests. For instance, Iovane et al. (2018) used the t-test and Chi-square test. Vitale et al. (2018) on their part used paired t tests, Wilcoxon signed-rank test and χ2 (Chi-square) test.
- A Benefit and a Limitation of Each Method
The benefit of the methodology used by Iovane et al. (2018) is that there is already a body of historical data about the sample that the researchers can use to determine the relationship between the dependent and independent variables. This is because they used available medical records. The limitation in this is that there would be inevitable errors and misrepresentation if the nurses and clinicians did not make accurate and correct documentation.
The benefit of the methodology used by Vitale et al. (2018) is that it will generate fresh knowledge and perspectives from the participants. This is because they used a multiple-choice question formula which is akin to a Likert scale questionnaire to get the views of the participants before and after giving them DM management guidelines. The limitation in this methodology is that some participants may just choose an answer so that they appear to be correct when they actually subscribe to a different (and erroneous) way of thinking about DKA and its management.
- Results of Study
- Summary of Key Findings
In the study by Iovane et al. (2018), they found that the occurrence of DKA events increased in children aged 5 years and below (incidence 21.8%). This turned out to be contrary to what they found on children over 5 years old. In these ones, they found that the incidence of DKA reduced significantly (3.75%; p=0.021). This difference in outcomes could be a true picture but it could also be due to errors in documentation as already alluded to above on methodology limitation.
In the study by Vitale et al. (2018), there was an overwhelming improvement in the DKA symptomatology of the participants after the educational intervention was administered and the answers to the MCQs analyzed and processed. This second study produces the results that very accurately address the PICO question as to the effectiveness of an educational intervention in improving the understanding of DKA in patients.
- Implications of the Two Studies to Nursing Practice
The two studies analyzed, compared, and critiqued so far (Iovane et al., 2018; Vitale et al., 2018) have significant and far-reaching implications for nursing practice. To begin with, contemporary nursing practice is now based on evidence-based practice or EBP. What this means is that every intervention that the nurses use on patients must have scholarly evidence supporting its efficacy and effectiveness (Melnyk & Fineout-Overholt, 2019). This scholarly evidence must in addition be recent, peer-reviewed, and published in a reputable journal. With that said, these two articles are a source of scholarly evidence for clinical practice that is based on EBP.
The two studies have shown that indeed an educational intervention given to patients and/ or their parents and by extension to providers is effective in the prevention of DKA. This is because it boosts understanding of the condition, demystifies it, and equips the patient, parent, and provider with the necessary knowledge that will be used during an attack. Going forward, nurses can now confidently use and apply an educational intervention to DKA patients and their parents (if children). This they can do knowing very well that this kind of intervention is supported by scholarly evidence as provided by Iovane et al. (2018) and Vitale et al. (2018).
- Outcomes
The outcomes of the two studies conform to expectations in that they both showed that the interventions studied have an impact on the incidence of DKA. The only discrepancy seen is with the study by Iovane et al. (2018), but this has been attributed to a possible methodological shortcoming or previous errors in documentation.
- Comparison
- The Anticipated Outcomes for the PICO
The anticipated outcomes for the PICO had been that the educational interventions administered would produce positive results with regard to a decrease in the incidence of DKA in the participants. Indeed this is what was largely achieved, especially with the study by Vitale et al. (2018).
- How the Outcomes of the Articles Compare with the Anticipated Outcomes
The outcomes of the articles compare with the anticipated outcomes in that the educational interventions in the studies proved to be efficacious and effective in reducing the incidence of DKA among the participants.
References
Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8th ed. McGraw-Hill Education.
Iovane, B., Cangelosi, A. M., Bonaccini, I., Di Mauro, D., Scarabello, C., Panigari, A., … & Vanelli, M. (2018). Diabetic ketoacidosis at the onset of Type 1 diabetes in young children: Is it time to launch a tailored campaign for DKA prevention in children< 5 years?. Acta Bio Medica: Atenei Parmensis, 89(1), 67. https://doi.org/10.23750/abm.v89i1.6936
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4th ed. Wolters Kluwer.
Vitale, R. J., Card, C. E., Lichtman, J. H., Weyman, K., Michaud, C., Sikes, K., … & Weinzimer, S. A. (2018). An Effective Diabetic Ketoacidosis Prevention Intervention in Children with Type 1 Diabetes. SAGE Open Nursing, 4, 2377960818804742. https://doi.org/10.1177/ 2377960818804742
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Write a critical appraisal that demonstrates comprehension of two quantitative research studies. Use the “Research Critique Guidelines – Part II” document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples, and reference content from the study in your responses.
Use the practice problem and two quantitative, 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 quantitative 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.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
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.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Attachments
Research Critique Guidelines – Part II Use this 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. Quantitative StudiesBackground1.Summary of studies. Include problem, significance to nursing, purpose, objective, and research question. How do these two articles support the nurse practice issue you chose?1.Discuss how these two articles will be used to answer your PICOT question.2.Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question. Method of Study:1.State the methods of the two articles you are comparing and describe how they are different.2.Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method. Results of Study1.Summarize the key findings of each study in one or two comprehensive paragraphs.2.What are the implications of the two studies you chose in nursing practice? Outcomes Comparison1.What are the anticipated outcomes for your PICOT question?2.How do the outcomes of your chosen articles compare to your anticipated outcomes