RESEARCH CRITIQUE The purpose of this essay is to critically appraise a research that was carried out in a mental health hospital in Southern Norway titled “ Relatives of persons with recently discovered serious mental illness: in need of support to become resource persons in treatment and recovery” by (K. Norby, K. KJonsberg and J. K. Hummelvoll, 2009). I am going to look at the approach, methodology, the design, population sample, data collection method, ethical issues and how the data was analysed.
I am then going to identify the strengths and weaknesses of the research. To evaluate this research, I am going to use the framework for critiquing health research by (Cadwell. k, Henshaw. L, and Taylor. G, 2005). The title of the study is very informative and indicates the focus of the study. However it failed to mention staff members as they were also part of the population in the data collection process. Parahoo,(2006) states that reference should be made to the population from whom data are collected.
The study was conducted by three authors with respectable academic backgrounds and they are all registered Psychiatric nurses. Their professional fields are relevant to the study, K. Norby is head of research and development, K. K Jonsberg is a research assistant and J. K Hummelvoll is a professor in health and sports which makes them suitable to carry out this research project. They also hold further academic qualifications in different fields in health studies. I find the authors credible with the qualifications that they hold.
In this research, the abstract is straight to the point and contains most of the information a good abstract should have as stated by (Schneider et al, 2007) that the abstract should contain sufficient information about the stages of the research process for example aim of the study, method, sample and findings. However, it does not summarise the key components for example no recommendation or conclusion. The abstract also clearly states the research is of a qualitative nature.
It is stated that this research was undertaken because more knowledge was needed about relatives experiences and views concerning factors facilitating an active involvement from relatives. Previous studies (Hogary et al. 1986, Moltova 2006) proved that active involvement of patients reduces relapse. However other studies (Leff et al, Kottgen et al 1984) did not find any differences in relapse rates in treatment strategy that involves family. The present study is part of a large cooperative inquiry. The literature review undertaken was relevant to the study.
Polet and Beck (2006) state that a good literature review in a qualitative research should summarise the existing body of knowledge related to the problem or phenomenon of interest. Most of the materials used for the literature review were less than five years old. Parahoo, (2006) points out that literature review should be current, not more than five years old and up to date. Another strength of this article is that the literature review lays a solid basis for a new study. However the weakness of literature review is that not enough primary sources were used.
The aim for the study is clearly stated that they wanted to explore and describe what facilitates active involvement for relatives in the treatment and rehabilitation of their family members so therefore this research aims to get more information from relatives and health workers. To do this, the researchers set themselves a research question to set out what they wanted to achieve. Ethical issues were properly addressed. Consent was obtained and participation was voluntary and the project was approved by the relevant authorities.
The issue of confidentiality and anonymity are the main ethical issues researchers must consider when conducting an interview, Parahoo,(2006). In this research, these were properly addressed by the authors. Because anonymity is impossible when conducting interviews, there is a possibility that parents and relatives may not have been able to express themselves fully. It is clear that the researchers used the qualitative research strategy from the terms used such as “ explore” and the tool they used to collect their data which is focus group interview although they did not necessarily state it.
In this study, the researchers made it clear that they wanted to explore and describe what relatives and health workers consider as necessary conditions in the treatment and rehabilitation of their family members. I find that this strategy was appropriate for the study because qualitative researchers seek to understand personal experiences, interpretations and constructs from the perspective of research participants, Schneider et al,(2007). The researchers used an approach called Phenomenology which is a qualitative research approach hat focusses on individuals interpretation of their experiences and the way they express them, Parahoo,(2006). Although the researchers did not mention what approach they used, it is clear that they used phenomenology and I find this was appropriate because of its aim to explore the different ways in which people experience their worlds and their relations with others and their environment. (Parahoo, 2006) The study took place at four psychiatric hospital units. Information is clearly given on how the participants were selected. Participation was voluntary and purposive sampling was used.
Schneider et al (2007) states that purposive sampling occurs when the researcher selects people who have the required status or experience to provide the researcher with vital information they seek. The researchers wanted the representatives of those involved and health workers. The sample comprised of health workers, relatives and parents. Interviews were used as a method of data collection. The interviews were in the form of focus group interviews which are defined as an interaction between one or more researchers and more than one responded for the purpose of collecting research data, (Parahoo, 2006).
This was appropriate to the aim in the sense that it allowed the researchers to explore but it is clear that some relatives may not have been able to express themselves and not be able to discuss other sensible issues which is one of the disadvantages of focus group interviews according to Brockopp and Hastings,(2003). Individual interviews could have managed to raise more sensitive topics. Two of the researchers work at the trust where data was collected, this might have also caused some bias. To ensure that the method is auditable, all interviews were taped for analysis.
The method of data analysis used in this study is qualitative content analysis. This is credible because the researchers gave a clear explanation about how the data analysis process took place and the whole process was clearly described and theoretically justified. The analysis was confirmed through a process called systematic test condensation. This helps the reader get a sense of how the themes and concepts were identified and developed from the data. According to Polet and Beck (2006) qualitative data analysis should be able to yield an appropriate product for example thematic pattern.
The findings and reports were well written, well organised and sufficiently detailed. The description of the method, findings and all interpretations were logical. The use of a table, direct quotation to support themes and consent in presentation of the results was very clear and this made it easy to understand. The discussion was comprehensive, because this is a qualitative study the findings and discussion were represented as narrative. The researchers were able to discuss the findings in the context of what is already known.
One of the major merits of this study is that the results are transferable. This was achieved because the study is part of a large research and the issue of plausibility, credibility and integrity of the research process was rigorously addressed. Trustworthiness of the study was established, the analysis was given back in writing to each unit and the materials were discussed between staff and researchers and materials were also sent to the relatives giving them the opportunity to make comments on the contents and also to confirm if the content reflect their views and experience.
According to Koch (2006) the rigour or trustworthiness of a study may be established if the reader is able to audit the action and developments of the researcher. I feel that the findings from the study can be applied and the context of this study situation. This is so because I can relate the findings to my own experience. The conclusion was comprehensive and supported the findings. Some limitations were highlighted due to the fact that two of the researchers are employed at the hospital trust where data was collected which makes it difficult to assume an unbiased position.
Irrespective of this limitation of this study, a lot was gained from the research. The findings from the study point to the necessity of equality between relatives and staff. The study gave some recommendation by encouraging further research in how support for patient relatives can improve especially after discharge and further research is equally needed about possible connection between relatives and professionals in nurturing hope. This study has contributed in no small way to the existing knowledge about relatives of people with mental illnesses.