This assignment is a presentation and critically assessed reflection on the article “Self-care agency and perceived health among people using advanced medical technology at home” by Fex et al. and its relevance to clinical nursing practice. Ethical aspects concerning development and research work are taken into consideration. Strengths and weaknesses of the study are illuminated plus analysed. As a conclusion the contribution to nursing practice is evaluated.
Content.
2 Introduction
3 Presentation of the article
3.1 Relevance in the clinical nursing practice
4 Critical assessment of the article
4.1 Strength and weaknesses
4.2 Ethical aspects
5 Contributions to clinical nursing practice
6 References
2 Introduction
While working on a group assignment for Module 9 the article “Self-care agency and perceived health among people using advanced medical technology at home” by Fex et al. was used. This assignment is a presentation and critically assessed reflection on the article and its relevance to clinical nursing practice. Ethical aspects concerning development and research work are taken into consideration. Strengths and weaknesses of the study are illuminated plus analysed. As a conclusion the contribution to nursing practice is evaluated.
3 Presentation of the article
The article was published 2012 in Journal of Advanced Nursing (JAN). The original research is reported. They used “a descriptive, comparative, cross-sectional quantitative design” (2, 806). Numerical data was collected with mailed questionnaires during winter 2009/10. 180 of 323 mailed questionnaires were returned completed (2, 806-9). Swedish adults using advanced medical technology (AMT) and performing self-care at home have been addressed. These used AMTs are long-term oxygen therapy, ventilators, haemo- or peritoneal-dialysis (2, 806-8). With this study the researchers aimed to find and describe factors influencing “self-care agency and perceived health” (ibid.) of people using AMT at home. The questionnaires consist of 30 questions. Questions 1-9 refer to personal background factors the following 8 are regarding “health and daily life” (ibid.). 13 further questions ask about the participants’ daily life with AMT. 8 questions can be answered with yes/no and 13 were to be answered “on ordinal scales” (ibid.). To complete the questionnaire the Swedish version of the Appraisal of Self-care Agency scale (ASA-A) and the 13-item version of Antonovsky’s sence of coherence (SOC) scale were used (ibid.).
The study’s results show that health- and “technology-related variables in daily life” (ibid.) were rated highly satisfactory. There are highly positive contributing factors for self-care agency and perceived health as social contacts, being satisfied with life, being active along with knowledge about how to use AMT or not feeling helplessness. A negative factor was age. In addition people using long-term oxygen rated perceived health lower (2, 806, 13).
3.1 Relevance in the clinical nursing practice
The world population is ageing and as a result chronic and degenerative diseases will increase among older people (10, 1). According to the UN this ageing population furthermore brings consequences on a social, political as well as economic level (10, xii-1). Fex et al. summed up that more chronically ill people being in need of advanced medical technology will exist (2, 807) and elderly persons can independently live at home alone or with their spouse (10, xiii). Health-care reforms began to try to reduce the length of hospital stays and reduce costs. For this reason more and more chronically ill persons using AMT can be found living in their own home. Living at home furthermore enhances the quality of life compared to staying in the hospital for long terms or for known repetitive treatment (2, 807). Besides that a person’s “attitude towards life and technology” (ibid.) influences people’s wellbeing and can influence dealing with it.
4 Critical assessment of the article
To critically assess and evaluate the article the chapters “Data Analysis and Interpretation” of a textbook by Polit & Beck (7, 391-573) and “Evaluating Research Studies” by Parahoo (6, 375-81) are used as guidelines to analyze several strength and weaknesses. This chapter does not claim to include entire aspects because characters are limited for this assignment.
4.1 Strength and weaknesses
When starting to analyze some external attributes can be assessed. The title draws “readers’ attention to the precise area of study and (…) the population from whom the data were collected” (6, 377). The study taking place during winter 2009/10 was accepted in May `11 and published `12. This shows that it is still up-to-date. As the oldest used references is from 1980 the newest one from 2010 broad literature was used. The original research report was published in JAN, an academic, international and scientific journal. JAN is the most cited and read nursing journal in the (2, 815). To address more academics than practitioners it is written in a special style and language. Furthermore it is peer-reviewed which means that they were refereed by other authors who are like experts. This helps to keep a high level of quality and “gives credibility and value” (6, 113) to the published article and speaks for a high intellectual standard (ibid.). Another positive aspect is a short introduction about the researchers who all have PhD RM and a mail address as a possibility to correspondence. Overall the study is and its findings are explained step by step. The discussion shows limitations of the study. It is structured and comprehensible for the reader.
The abstract briefly summarizes the essential important informations without missing anything of importance. The following literature review gives an overview and ends with stating a hypothesis plus leading to the aim (ibid., 377-8).
“A descriptive, comparative, cross-sectional quantitative design was used” (2, 806). The method of data collection was questionnaires mailed to adults using ATM in their own home. It is disputable if a quantitative design was the best choice to answer a research question about perceived health and to measure Antonovsky’s SOC. Fex et al. (2009) published an article about a qualitative research about the patient experience before. “Self-care among persons using advanced medical technology at home” aimed to describe the lived experience of these people (1, 2809). The quantitative study can be seen as an expansion to measure the influencing factors. Are the authors’ objective enough or influenced by their previous findings on research? Furthermore they explain that they formulated questions 18-30 asking about “daily life with medical technology, based on knowledge from earlier studies” (2, 808) about the same subject the authors themselves conducted. They say that there have been no “conflicts of interest” (2, 813).
It is a strength that with using SOC and Orems theory keywords e.g. SOC and used theoretical concepts are explained in the beginning. “Self-care agency is a person’s complex, acquired capability to know about and meet continuing requirements for deliberate actions to regulate his/her function and development” (2, 807-8). As a weakness can be pointed out when they talk about “a convenience sample” (ibid., 808) they only refer to Polit & Beck. They do not explain that a convenience sampling is a “selection of the most readily available persons as participants in a study” (7, 550). But they mention inclusion and exclusion criteria (2, 808).
The authors miss to give a detailed description of the questionnaire to evaluate its validity and reliability. It is not added as an appendix and they give no information about “pilot-testing, validity and reliability tests, reminders or follow-ups to increase response rates” (6, 302; 3, 87-102).
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- Quote paper
- Annina Grimm (Author), 2014, Nursing. Evidence-based activities and research methodology, Munich, GRIN Verlag, https://www.hausarbeiten.de/document/287171
