Research Ethics and Evaluating Quantitative Research

Introduction

End-of-life (EOL) care has become a primary concern among patients, relatives as well as healthcare practitioners today. Subsequently, the enactment of quality decisions pertaining the form of treatment that should be accorded to terminally ill patients as part of their EOL fiats has become a fundamental prerequisite in the nursing practice. Nevertheless, the ease of developing tolerable EOL decisions have been hampered by ethical as well as moral impasses, essentially on the choice of effective medical intervention to espouse. However, to remedy the problem, effective communication between patients, relatives, and healthcare providers have been validated to be an essential remedy that promotes the seamless development of EOL decisions. This research provides a summary of the EOL decision-making problem, an explanation of how the findings can be used in the nursing practice and ethical considerations associated with the execution of the study.

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Summary of the Study

The PICOT that provided the guideline for executing this research hypothesized that adoption of effective communication strategies by nursing practitioners, patients and relatives can aid in the development of logical and acceptable healthcare decisions. Additionally, the targeted population that was employed in the study included the nursing providers that are responsible for providing EOL care services to the patients with terminal clinical conditions. Also, the intervention used was the adoption of effective communication strategies between healthcare providers, patients, and relatives, to devise logical and acceptable decisions on chronic illnesses during the provisioning of the EOL care services. The comparative analysis was done by contrasting between the healthcare outcomes of chronically ill patients when good communication between nurses, patients, and relatives was facilitated and when poor or no communication at all was used.

Ultimately, the outcome yielded from the study showed that there was an improvement in healthcare outcomes among chronically ill patients when effective communication was employed in the development of logical and acceptable EOL care decisions. Moreover, the validity of the data collected during the study was supported by a range of literary publications. Moreover, the publications illustrated the link between improved healthcare outcomes among chronically ill patients and effective communication between patients, relatives and healthcare practitioners. Furthermore, a variety of literary publications were employed to substantiate the findings of the research study. Among them included a research study executed by Luce and White (2007) whom in their research publication asserted that good communication could avert conflict between nurses and patients on matters pertaining life-sustaining therapy. Additionally, according to the study, sometimes physicians exert pressure on relatives of chronically ill patients to either withhold or withdraw life-sustaining therapy treatment from patients.

Moreover, such pressure often arises from social, economic, prognostic and professional factors facing a patient. Eventually, if not mitigated, such occurrence can turn into a full-blown conflict that also significantly affects the healthcare status of the concerned chronically ill patients. Moreover, research developed by Oczkowski et al. (2016) stated that research, patients, and relatives agree that better communication and decision-making with physicians, should be offered a high priority in the EOL care provisioning process. Furthermore, this is in an effort to promote the attainment of quality end-of-life care by the patient. Also, Oczkowski et al. (2016)'s research asserted that using structured communication tools can elevate the frequency of discussions between physicians, patients, and relatives when making end-of-life decisions.

Furthermore, the essentiality of using proper communication support programs for patients as well as caregivers in the attainment of improved end-of-life care for patients have been supported by Walczak et al. (2014). Additionally, the research stated that discussing the prognosis of terminally ill patients between clinicians and relatives is of paramount importance when administering EOL care to chronically ill patients. Also, according to research by Sinuff et al. (2015), the goal of an end-of-life communication and decision-making process is to develop a shared understanding of a patient's treatment preferences. Additionally, Sinuff et al.'s (2015) research certified that proper communication between patients and clinicians during end-of-life situations could aid in the development of a plan that is consistent with the patient's clinical intervention preferences. Consequently, this would lead to the attainment of an improved standard of end-of-life care services offered to the terminally ill patients.

How the Findings Can Be Employed In the Nursing Practice

EOL care provisioning should be accorded utmost importance in the nursing practice because it offers the patients comfort during the last days of their life. Additionally, comfort is attained through the effectiveness of the nursing practitioners in providing essential pain management interventions to patients. However, each patient or his/her relatives may have their preference for the type of medical intervention that should be offered to them during EOL care. Subsequently, the effectiveness of the treatment offered during EOL care offered to patients can only be effective if proper communication between the patients, relatives and nursing practitioners is employed. As such, the findings of this research will be employed to educate the nursing practitioners pertaining the importance of good communication when implementing EOL care services to chronically ill patients.

Ethical Considerations Associated With the Conduct of the Study

Two ethical considerations must be considered when conducting the study. First, the researcher must respect the confidentiality and anonymity of all participants used in the study. In this case, any information gathered from the patients pertaining their EOL treatment preferences must be kept confidential even when reporting the findings of the research to the targeted audience. Second, the researcher must also ensure that the respondents of the research have offered their informed consent before pertaining them to participate in the research. Additionally, in this case, it would be advisable for the researcher to obtain signed consent from the participants indicating their willingness to participate in the research without any form of coercion.

Conclusion

In conclusion, EOL care has become a primary concern among patients, relatives as well as healthcare practitioners today. Consequently, the enactment of quality decisions pertaining the form of treatment that should be issued to chronically ill persons as part of their EOL preferences has become a primary necessity in the nursing practice. Nevertheless, extensive research has certified that the employment of effective communication between patients, relatives, and healthcare providers. Additionally, this is in promoting the seamless development of EOL decisions pertaining the form of treatment that should be issued to chronically ill patients. Ultimately, a researcher conducting similar research must respect the confidentiality and anonymity of the research participants. Furthermore, the researcher must ensure that he or she has informed consent from the respondents before executing the research. The two are fundamental ethical issues that must be honored to promote the ethicality of the research.

References

Luce, J. M., & White, D. B. (2007). The Pressure to Withhold or Withdraw Life-sustaining Therapy from Critically Ill Patients in the United States. American Journal of Respiratory and Critical Care Medicine, 175(11), 1104-1108. http://doi.org/10.1164/rccm.200609-1397CP

Oczkowski S. J., Chung H-O., Hanvey L., Mbuagbaw L., & You J. J. (2016). Communication Tools for End-of-Life Decision-Making in Ambulatory Care Settings: A Systematic Review and Meta-Analysis. PLoS ONE 11(4): e0150671. doi: 10.1371/journal.pone.0150671

Sinuff, T., Dodek, P., J.You, J., Barwich, D., Tayler, C., Downar, J., ... K. Heyland, D. (2015). Improving End-of-Life Communication and Decision Making: The Development of a Conceptual Framework and Quality Indicators. Journal of Pain and Symptom Management, 49(6), 1070-1080. doi:10.1016/j.jpainsymman.2014.12.007

Walczak. A., Butow P.N., Clayton J. M., Tattersall M. H., Davidson P. M., Young J., & Epstein R. M. (2014). Discussing prognosis and end-of-life care in the final year of life: a randomized controlled trial of a nurse-led communication support program for patients and caregivers. BMJ Open 2014; 4: e005745. doi: 10.1136/ BMJ open-2014-005745