Critical Essay on Quantitative Research Literatures on Interventions to Reduce Fall Risk

Introduction

Today, research is occupying a crucial place in nursing. American Nurses Association has termed it as "the diagnosis and treatment of human responses to actual or potential health problems" (2017). Therefore, the right comprehension of literature research is a requirement for every person in the nursing area. Even though most nurses are able to attain certain skills in research, only a few are able to manage and apply research data or research findings into practice due to their inability to critique a research and evaluate its pros and cons. The paper, therefore, critically analyses two quantitative research literatures on interventions to reduce fall risk. The first research is on "Four months of wearing a balance orthotic improves measures of balance and mobility among a cohort of community-living older adults" (Noah, Gibson-Horn & Vincenzo, 2018). While the second research is "Balance and functional outcomes for older community-dwelling adults who practice Tai Chi and those who do not: a comparative study" (Bubela, Sacharko, Chan & Brady, 2017). Although there are lots of studies that have been carried out, the two research articles implicitly deal with ways of reducing fall risk.

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Quantitative Research Design of the Study

The research of Noah, Gibson-Horn, and Vincenzo (2018) uses the quantitative study design of quasi-experimental that is more adequate and less biased compared to other methods. In completing the study, 1-group pre/post-test is used to investigate the effects of 4 months of daily wear of balance orthotic on mobility, balance, and efficacy of fall in aged people. Using the quantitative study design makes the research to appear too analytical and objectively oriented. Even though objectivity is essential for such type of research, it is necessary to combine both objectivity and subjectivity in the study, i.e. combining both qualitative and quantitative study. Bernard (2017) exposes the inadequacy of the qualitative method by claiming that a qualitative method is likely to produce unpredictable results, unlike the quantitative method which makes it possible for researchers to forecast the final results. Additionally, the treatment tests of pre/post-test entailed the "Timed up and Go (TUG), Functional Gait Assessment (FGA), Falls Efficacy Scale (FES) and Short Physical Performance Battery (SPPB)" (Noah, Gibson-Horn & Vincenzo, 2018). Irrespective of not using a pilot study which is essential for illuminating some problems of the study, all these assessments were carried out to bring reliability to the findings of the research.

On the other hand, the research of Bubela, Sacharko, chan, and Brady (2017) uses the quantitative study design by utilizing the quasi-experimental pre- and posttest design which brings a comparative experimental group with a control group. To bring out certain dissimilarities between the group experienced in Tai Chi training program and those who were not experienced in the program, the research applies the multivariate and bivariate analyses. Independent and dependent variables are not used in differentiating the experienced and non-experienced irrespective of the researchers not defining the hypothesis of the analysis. All in all, the study techniques and methods used in the research are of great strength since there is a thorough description in regard to the collection of data and the design of the study.

Research Problems and Research Questions

The research conducted by Noah, Gibson-Horn, and Vincenzo (2018) evaluated the impacts of balance orthotic in improving measures of balance and mobility among older adults. The title gives a clue to the focus of the subject and in a clear scientific view, the abstract provides succinct information by pointing out the major aspects of the research. The research question is not indicated in the abstract section but in the introduction part and look at "Does BO that is strategically weighting with the BBTW assessment when worn for 2 hours twice per day for 4 months, bring any changes in balance, functional mobility, fall risk and falls efficacy to older adults in a cohort community?" (2018).

On the other hand, the research by Bubela, Sacharko, chan, and Brady (2017) also talks about the interventions for reducing fall risk. Even though the title covers the theme in an explicit way, the abstract does not as there is less detailed information concerning the topic. According to Moule, Aveyard, and Goodman (2016), an abstract is an obvious potency of the analysis serving as an example to other researchers investigating various nursing aspects. However, in the research, the abstract does not state the research question but gives the purpose of the study. Due to this, it complicates the general apprehension of the research making the reader develop a question like; "what are the comparison measures relating to fall risk between the participants that participated in a 16-week community-based Tai Chi program to those in a control group who did not participate in Tai Chi?" (2017). Research questions are significant in the study since they allow rightfully evaluation of adverse events and preventable adverse events allowing the reliability and effectiveness of the content (Bernard, 2017). Contrary, the two types of research have paid little attention to such aspects of the investigation.

Even though both types of research provide a valid explanation in the introduction of the essence of the problem, they do not provide an overview of the previous study or certain reports. Hence, decreasing the overall presentation and reducing the value of the data presented. Nonetheless, statements problems are evaluated in a way that is concise while narrowing down to areas to areas of clinical setting so as to get accurate results. Of factual is that the issue of fall risk is becoming a major concern to many nations in the world. In the research article by Noah, Gibson-Horn, and Vincenzo, they saw that there is an increased rate of falls and injuries every year among the exponentially growing age group pointing that "it decreased balance and mobility disability among the older adults that led to the loss of independence (2018). From this problem, it inspires the interest of the reader from the beginning on the issue of falls and injury of the older adults. In the research by Bubela, Sacharko, chan, and Brady observe that older adults undergo various problems including "documented reduction in trunk and limb mobility, diminished muscle strength and a tendency toward flexed posture and impaired upright balance" (2017). By looking at those problems, they try to see how they can address such using the Tai Chi program. In the introduction part of the research, they both lack the appropriate background and theoretical frameworks which considerably limit the studies. They don't include specific theories that can back up the presented data hence they are theory-free with no concepts that entail the basis of practical nursing. Unlike theory-testing research and theory-generating research, Noah, Gibson-Horn, and Vincenzo (2018) and Bubela, Sacharko, chan, and Brady (2017) articles, focuses on a practical problem-solving framework that purposely looks for solutions on the underlying problems instead of focusing on the theoretical implications.

In the research by Noah, Gibson-Horn, and Vincenzo (2018), the interest of the population were older adults above 65 years of age. Out of 33 participants, only 30 completed the 5-day study and agreed to continue in a 4-month study. However, only twenty-four participants aged 87 years completed the 4-month study. Before protesting for the activity, the participants were weighted and after 4-month study, they were re-weighed again based on the protocol of BBTW. Using flyers and letter from the retirement center, individuals were recruited from various regions with no specific place where the study took place but it was in the regions of America. The research of Bubela, Sacharko, chan, and Brady (2017), the participants were individuals of equal gender and old aged people above 55 years. Individuals from the Tai Chi training group were 16 participants and all of them participated in the activity while those from the controlled group were 14 members and only one who did not complete the test. The activity took place in the Chinese community where Tai Chi programs were common and volunteers were recruited from various regions of the community.

In regard to ethical considerations, both studies do not openly address ethics clearly. However, in the study of Noah, Gibson-Horn, and Vincenzo (2018), there is the mention of the approval of the investigation which was approved by the Institutional Review Board of the Arkansas University. In any research, Bernard (2017) asserts that ethical approval is significant especially those researches that deal with human beings as during the research the participants may experience certain problems that may require immediate handling. Even though the research by Bubela, Sacharko, chan, and Brady (2017) provide a descriptive nature of the present research, it does require ethical considerations due to its quasi-experimental design. Moule, Aveyard, and Goodman (2016) point out that research should consider confidentiality of the participants and their rights of defense as well as risk control. Therefore, it is significant for researchers to enhance their potential gains by decreasing the potential risks especially in researches involving a large number of participants. Researchers should in detail illustrate the condition of the subject and potential harm that are likely to occur especially in view that nursing is linked directly to the safety of the community. Even though in both studies defended the ethical rights of the participants by not exposing their personal details, there was no information on the way the data was being stored and protected before and during the analysis. Correspondingly, there was no reference made from informed consents in both studies which are a prerequisite for any research in nursing.

Findings and Limitations

Illustrating their findings, there is a parallel drawn by Noah, Gibson-Horn, and Vincenzo (2018) between the received results and the findings of the earlier studies. Most findings of the previous research are constant with the present ones including those of Moreland, et.al. 2003, Rubenstein, 2006 and Hilliard, et.al., 2008. However, some findings contradict the previous results as that of Smulders, et.al. 2010. Having such, the research becomes more valid to the overall results even when there is no justification at the beginning of the literature review. Generally, Noah, Gibson-Horn, and Vincenzo (2018) findings are related directly to the objectives of the study, steadily producing evidence that proves the initial suggestion of the authors. In particular, the research findings were that 24 subjects were the one able to complete the study. Paired t-tests showed that SPPB, GS, and FGA mean group scores increased significantly from pre to posttests. SPPB increased by 1.3 points, GS by 0.09m/s, FGA by 2.6 points and both mean values increased above cutoffs of fall risks. Though there was no change in TST, Wilcoxon signed rank tests showed that FTSST median group scores increased significantly from pre to posttests by 7.4 seconds and median TUG time by 3.5 seconds. Evaluating the independent variables, the authors showed that participants of older adults with limited mobility when they wear BO for 4 hours daily within four months, it lead to improvement in functional assessment linked to falling risk such as SPPB, GS FGA etc.

In Bubela, Sacharko, chan and Brady's (2017) findings, it showed that in nearly...