Assignment task:
Please respond to this article below, and these are the instructions. Review the qualitative articles and Access the article through the permalink provided in the worksheet and include this content in your replies. Describe one area of the critical appraisal you found incomplete including a supporting rationale. Describe one area of the critical appraisal which provided new knowledge. Describe the new knowledge gained including how you will apply in future critical appraisals of research.
Competency: Compare research methodologies
Review the article that you selected and complete the following analysis. Be sure to include the permalink for the article you selected.
What is the identified research problem? Does the author include the significance and background of the problem?
The goal of this research was to identify nurse attitudes regarding family presence during resuscitation for cardiac arrest (FPDR). The stated significance of the problem is found in previous literature which has demonstrated that FPDR can promote family members' healing and supports patient-and-family-centered care.
(Bader, et al, 2023)
Did the author clearly articulate the research purpose? What was the purpose of the research?
The author states the objectives of the research as, "to examine the scientific evidence regarding critical and emergency care nurses' attitudes about perceptions of, and behaviors related to FPDR and to identify factors that influence its practice."
(Bader, et al, 2023, pg 2)
Identify the study methodology.
The study methodology is identified as an integrative review tallying the responses of nearly 5000 ICU and ED nurses. Further, it is stated that the review followed a method proposed by Whittemore and Knafl that includes five stages of rigor: highlighting the problem, searching the literature, evaluating data, analyzing data, and presentation of results. The study also utilized the Johns Hopkins level of evidence tool for assessing the quality of articles used. All articles included in the analysis were of 'good' or 'high' quality.
(Bader, et al, 2023; Whittmore & Knafl, 2005; Dang & Dearholt, 2018)
Did the article include a relevant review of the literature? Explain.
The article did review some of the literature in the introduction and discussion though I found it lacking in one key area. As someone who has run full arrest codes in the field in family or even in public, I am generally indifferent about FPDR. That said, I felt as though the amount of evidence provided to justify the push to expand FDPR was lacking. I only saw a couple of articles to justify its use, and I didn't see any real attempt by the authors to review and address its drawbacks. Overall, the paper just felt a bit biased to read.
(Bader, et al, 2023)
Describe the theoretical framework for the research study?
The theoretical framework of the study isn't explicitly addressed. Aside from the items described in the methodology addressed above, the authors describe their study as a 'thematic analysis'. Essentially, they took all of the results of different studies and grouped the results into more generalized categories. If I attempted to apply some nursing theory to this article, I can see elements of Orlando's Nursing Process ("Deliberative Nursing": allowing family in for its patient and family benefits over nurses' discomfort) as well as King's Goal Attainment theory ("Interpersonal Health": it is a health benefit for the family members) in this work.
(Bader, et al, 2023)
Identify the components of the qualitative research study.
According to the identified methodology outlined by Whittmore and Knafl the components of this study are:
Highlighting the problem: Nurses' attitudes toward FPDR
Searching the literature: Out of 131 articles found on the subject between two databases.
Evaluating the Data: Of the found articles, the authors concluded that 22 of the articles were suitable for the review and assessed the quality of these articles using the Johns Hopkins level of evidence tool.
Analyzing the data: The data was evaluated using a thematic analysis of nearly 5000 ICU and ED providers.
Presenting the results: They wrote and published the paper in a peer-reviewed journal.
(Bader, et al, 2023; Whittmore & Knafl, 2005; Dang & Dearholt, 2018)
Describe the results of the study along with identified strengths and limitations.
Include appropriate terms for rigor in qualitative research
The results of the study found that multiple factors affected nurses' perceptions of FPDR both positively and negatively. Positive attitudes toward FPDR were associated with beliefs in the importance of respecting the family members' health, healing, and possible contributions to the process of resuscitation, with many nurses explicitly stating their belief that FPDR is a fundamental right of the family. Negative attitudes toward FPDR were associated with concerns regarding the safety of staff and ability to handle the situation with possible staffing shortages, the lack of training and education on FDPR in the ACLS course, limited space in the treatment area, and the general absence of policy and/or protocol in the handling of FDPR as well as the associated possibility of legal action from both family or the patient concerning the harm of witnessing the trauma associated or the possible violation of the surviving patient's HIPPA rights.
The limitations listed included lack of inclusion or generalization to all provider levels or even other types of nurses, and the lack of addressing the issue from the family members' perspective.
(Bader, et al, 2023)
Discuss the findings including relevancy to clinical practice.
The findings of this study are important to the practice of anyone who finds themselves involved in a cardiac arrest in the hospital environment when family has the opportunity to be present. While the ability to witness the actions taken by the healthcare providers can give family members a greater sense of closure, it can also be traumatizing for them. It can be a difficult situation and requires the provider to be aware of the delicate nature of the situation even while being often overwhelmed with handling the situation, both personally and medically/professionally, themselves.
Permalink for the article selected.
Critical Care Nurses' Attitudes About Family Presence During Resuscitation: An Integrative Review - PubMed