Ethnographic Study of End-of-Life Care Strategies for Advanced Dementia in Nursing Homes - Essay Sample

Introduction

The research paper chosen for critiquing in this assignment is "An ethnographic study of strategies to support discussions with family members on end-of-life care for people with advanced dementia in nursing homes" (Saini, et al. 2016). Additionally, this research paper has been chosen for critical appraisal because there is a significant increase in the number of people developing dementia today. Past research suggests that one new case of dementia emerges every three seconds somewhere in the world (Helvik, et. al 2015). Moreover, in nursing practice, dementia care has a great importance in promoting the overall mental health and wellness of the affected patients (Spears 2018).

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Rationale for Choosing the Paper

Critical appraisal of healthcare articles contributes to evidence-based practice and improves understanding for better implementation of nursing practices (Fain 2017). Thus, choosing this research paper for a critical appraisal will have a positive impact in improving care persons that have been clinically diagnosed with dementia. Additionally, critical analysis is also imperative because it provides a systematic way of objectively reviewing a research paper by highlighting its weaknesses as well as strengths and also evaluating the applicability of the research findings to practice (Kinchin 2014). According to Cutcliffe and Ward (2014), critiquing a research paper also helps in developing knowledge related to subject area of the work in focus. Also, according to Kinchin (2014) research, critical appraisal also enhances a researcher's understanding of a study's purpose, development of argument, intended audience and structure of the evidence.

Description of the Critique Tool Employed

For the current research critical appraisal, the Caldwell et al. (2005) critiquing tool will be used. Additionally, the tool was developed on basis that good research identifies important themes and concepts of a study under investigation. The tool has been considered to be the most effective for this appraisal because it has been certified by research to be an evidence based practice (EBP). In this case, EBPs have great significance in research as they aid in providing the most effective care for improved patient healthcare outcomes. Also, the EBPs promote positive attitude of inquiry in health professionals and also ensures that practice information and finite health resources are used in intervention implementation.

Lastly the use of EBPs help healthcare practitioners to execute a critical appraisal of research evidence, which is imperative in making astute decisions regarding implementation of best available clinical practice evidence (LoBiondo-Wood and Haber 2017). The article to be critiqued is related to discussions of end-of-life care between nursing home staff and families of dementia patients. The study has examined practices related to end-of-life discussion with families of advanced dementia patients living in nursing homes. It has also explored strategies to improve the practice of taking care of persons with dementia.

Critical Evaluation of the Research Paper

Parts of the Caldwell et al. (2005) Critical Analysis Tool to Be Used for the Analysis

The Caldwell et al., (2005) critiquing tool is being used for critically appraising the research paper. It consists of two arms; one used for analyzing quantitative research and the other for qualitative research. Additionally, the stated critique tool involves reflecting on relevance of content with title, credibility of authors, ethical issues being considered, rationale for research, abstract summarizing important components, clear communication of aim of research and justification for methodology. The given research article of Caldwell et.al. (2005) has discussed some effective points related to the development of the framework for critiquing the health research. There is a clear abstract, introduction and the proper explanation related to the working of the tool.

Research Article Critique

The focused study is an ethnographic that takes social life and culture into consideration and is based on multiple detailed observations. The development of the new framework is explained effectively. Additionally, different features of the research critique framework are divided on the basis of the quantitative and qualitative research. Moreover, an illustration makes it easier to understand and differentiate between the methods of research used in the project. Also, the evaluation of the framework is shown by use of a scale and the study has explained effectively about the critique framework that was used in the teaching sessions of the two groups of students. Moreover, the tool also points out the need of qualitative research to provide perspective of author, detailed description of methods used for gathering data, description of quality measures in analyzing data, results credibility as well as findings transferability.

The title summarizes the main content of the research paper. A good title has the ability to adequately describe purpose and content of research paper (Bavdekar, 2016). In this case the title clearly reflects the main concerns and aims of the study. It clearly states that the paper has conducted ethnographic study of strategies that support discussions with family members on end-of-life care for people that have dementia and live in nursing homes. Yet it can be said that the title is quite long, evaluating based on standard length of title. According to Caldwell critiquing tool it is important to determine credibility of authors. Author credibility is reflected by quality and credential which indicate whether source is reliable or not (Sorenson, 2016).

Credibility of the author helps in supporting arguments and ideas of research paper. The authors of the current research are credible they belong to well-known institutions such as University College London, University of Ulster, Centre of Mental Health and Department of Primary Care and Population Health. Caldwell's tool points out that if abstract summarizes key components then it is a strong research. The abstract should be around 300 words or less (Meltzoff and Cooper, 2018). The abstract of the current research paper mentions background, methods use in the study, findings and results if the study and conclusions that have been drawn. The abstract has described the overall purpose of the study, problem being investigated, basic design of study, trends found from findings and summary of conclusions and interpretations.

The research paper has outlined the rationale clearly. It is reason for why research has been conducted. The rationale of the research has answered the need for conducting the study. Rationale has justified the novelty of the study. The study has clearly stated the need for conducting EOL discussions with the family members of the dementia patients living in nursing homes. Study focused on this need as it found that discussion reduce unnecessary and aggressive medical interventions for dementia patients. The literature review of the research is quite comprehensive as it has mentioned only those researches which are most relevant to issue under study. Indication of good literature review is that it mentions research papers from past 5 years (Machi and McEvoy, 2016) however this research has referenced articles from past 10 years and more.

Caldwell's tool suggests that good research article must clearly state the aim which the research paper under analysis has been able to do. It has clearly stated aim under the heading of Rational and Aim. Ethical issues are important to identify in order to avoid ethical challenges (Walliman, 2017). The research paper has identified and addressed the ethical issues as it was found that ethical requirements prevented authors to come in direct contact with carers. Participation of the careers was made ethical through ethical approval granted by National Research Ethics Service Committee. The methodology used in the research paper is qualitative. This involved using interview method for collection of data. Authors of the study have justified the use of qualitative methodology by stating that it ensures quality findings and improve validity of findings.

Background of the research provides brief overview of topic that being researched (Neuman, et. al, 2014). This is done by including previous information as well s current information related to history of the topic. One of the main reasons for providing philosophical background is to provide a link between the concerns of the study and topic of the study (Ormston, et.al, 2014). According to Caldwell critiquing tool, a strong research provides philosophical background which gives researcher the idea of previously conducted research. The paper under analysis has provided philosophical background which has mentioned statistics related to dementia patients in United Kingdom. Background of the study provides the reader with an insight of the topic. The current paper includes benefits and barriers which arise in conducted end-of-life care discussions. Study design of the research is an essential decision made by the author of the study for setting methodology of the research study (Maes, et. al, 2015). It describes the way study will be conducted particularly explaining data analysis and sampling methods (Ness, 2015).

The current paper has explained study design clearly as it has mentioned that the study is ethnographic which will use qualitative data taken from reflective diary possessed by professional delivering Intervention as well as from interview transcripts obtained through family members and HCPs of dementia patients in nursing homes. Rationale for choice is evident as the authors have explained that interview method was best for obtaining descriptive, in-depth and credible knowledge.

Caldwell's describes good research as a research which identifies major concepts. For researchers it is highly important to identify key concepts of the study. Through these key concepts, authors areable to generate keywords which are required for searching databases of article (Hartas, 2015). The authors of the current research have identified the major concepts related to ethnography, nursing homes, End-of-life discussions, family careers and advanced dementia. These concepts are related to the study as the author aimed at finding strategies for supporting family members regarding end-of-life care of individuals living in nursing homes who had advanced dementia. Context of the study helps in making sense of outside information and defining unknown words (Ormston, et. al, 2014).

It provides the readers an opportunity to understand situation and existing knowledge for determining source of the information. The current study has outlined the context by clearly mentioned existing knowledge related to the topic. It is also significant for a good research to mention selection of participants and method for sampling (Edwards and Talbot, 2014). The current study is qualitative and has followed interview methods. Authors have undertaken semi-structured interviews that used open-ended questions. Participants of the research consisted of family carers and formal/staff carers. 7 family careers and 19 staff careers were assessed for data collection. The method of data collection is not auditable as information has been collected through interview method. The data gained is theoretical thus it cannot be audited. The paper has mentioned that in order to ensure accuracy interview transcripts were assessed against recordings. Manual data analysis was conducted, and data was co...