This paper offers a critical appraisal of a nursing article. The critical appraisal is a systematic review of the article, which aimed at identifying the strengths and weaknesses of the author(s)’ presentation of findings as well as the validity of data and techniques used in collecting the data (Mitchell and Jolley, 2012). The title of the article critiqued in the paper is ‘Physical health monitoring in mental health settings: a study exploring mental health nurses’ views of their role’ using the qualitative critical appraisal technique’. The article was authored by Herbert Mwebe and published in the year 2016 at the Journal of Clinical Nursing.
The critical appraisal tool used in this case is qualitative appraisal tool. The qualitative appraisal tools are necessary in this case since the article took a qualitative research approach in the study. A qualitative tool of critical appraisal has 10 key questions which when fully answered will provide a comprehensive critique that presents weaknesses and strengths of the qualitative approach used by the author (Munn, Moola, Riitano, & Lisy, 2014). The questions range focus on the reliability of the tools used in the study and the validity of the research findings. The main objective of the research article was to study the views of nurses on the roles they play in screening and monitoring physical healthcare needs for patients with serious mental illness.
Summary of appraisal and critical analysis.
The appraisal summary is based on the answers provided to the ten key questions of the qualitative tool discussed above. The questions were closed (yes/no questions) hence it was easy to conclude on the strengths and weaknesses of the article based on the response provided in the critical analysis tool (Katrak, Bialocerkowski, Massy-Westropp, Kumar, & Grimmer, 2004). Out of the ten questions, the article got 8 Yes and 2 No. This indicates that the article has very many qualitative strengths and a few weaknesses. The strengths and weaknesses of an article can be assessed based on the three major issues of appraising a qualitative study which are (Vlayen, Aertgeerts, Hannes, Sermeus, & Ramaekers, 2005);
The strengths of the article under critical appraisal were in sections (a) and (c). With regards to the first section, the first made a clear statement of the objectives of the research. The researcher stated that the objective of his study was “To explore nurses’ views of their role in the screening and
monitoring of the physical care needs of people with serious mental illness in a
mental health service provider” (Mwebe 2017, p.1). The researcher then goes ahead to give a rationale for the study by stating the importance of the research and contribution it could make to the society. Secondly, a qualitative methodology approach is employed effectively by the researcher. The qualitative techniques were relevant for this research since the research design was qualitative in nature. The researcher also justified his research design, which is a very important aspect of any research (Jacobs, Jones, Gabella, Spring, & Brownson, 2012). The research design used in this research article was a qualitative exploratory approach. The researcher describes this design as one that “involves studying a small sample of participants by reconstructing their reality and understanding lived experiences through extensive and prolonged engagement to develop a pattern and relationship of meaning” (Mwebe 2017, p.4). Apart from the attributes discussed above, the researcher employed an appropriate recruitment strategy. The 20 participants were sampled on a voluntary basis and had to be nurses who are registered by the UK Nursing and Midwifery Council (NMC). The data, which was collected by the researcher through interviews, clearly helped in achieving the objectives of the research (Katrak, Bialocerkowski, Massy-Westropp, Kumar, & Grimmer, 2004). The research also took into consideration all the ethical issues related to conducting of a qualitative research. The researcher first sought the approval of his research from the relevant ethics committees that deal with issues of mental health. The main ethical issue that was adhered to by the researcher was assuring the participants of anonymity and confidentiality of the information shared.
The other key strength attributed to the article was the application of the research results. The researcher clearly stated the findings of his research. His research findings were explicit and the researcher adequately discussed the evidence both for and against his own arguments. The other key strength was the way the researcher related his findings with real societal issues. The researcher discusses a number of applications of his research to the society. The researcher proposed areas that he felt needed more research to be conducted in the future. Mckie (2013) observes that ethical research is very important in validating the research outcomes.
The main weakness of the research, as identified earlier, was the poor presentation of the research results. While the researcher did an awesome job to collect credible data, he did not carry out a sufficient analysis of the data. The analysis process was not analyzed in-depth and the researcher also failed to explain how the data presented were selected from the sample and eventually subjected to the analysis process which is a key weakness when it comes to research (Reynolds,2008). The article also fails to adequately outline the issues that may have affected the credibility of the data such as biases arising from external factors. Polit and Beck (2008, p. 127) observe that the most important aspect of any research is one in which the researcher tries to eliminate bias as much as possible.
The strengths and weaknesses of the research article that have been identified above are necessary in making informed evaluation of the findings and recommendations of the research article. The research article presented its findings and a number of recommendations which are important in guiding effective nursing practice. From the research, the researcher found that there is a “clear commitment and overall support for physical health monitoring” (Mwebe 2017, p.5) among the mental patients. The findings were analyzed based on four themes which are; (a) current practice in physical health monitoring of the mentally ill patients; (b) the perceived obstacles to effective physical health care and monitoring; (c) education and training needs with respect to the issue; (d) the strategies that can be adopted to address the issue.
The first three themes point out to challenges that face nurses when carrying out monitoring of physical health of mental patients. The fourth theme is in form of recommendations that can be adopted to address the research issue. These recommendations, most of which were suggested by the participants, are based on the results of the interview. One recommendation is allocating more resources to nurses and health facilities that will enable nurses to effectively offer adequate services and physical health monitoring of the patients (Mwebe 2017, p.8). The other recommendation is to increase and/or improve education and training of nurses with regards to the issue of physical health monitoring of the mental patients. A number of evidence-based techniques were also suggested, such as the Modified Early Warning Scores (MEWS) which had proven to be effective in other interventions.
The recommendations above have some key strengths and also a few weaknesses. The key strength of the recommendations is their applicability. Most of the recommendations are easily implementable and are realistic (Parahoo, 2000, p.93). It is possible for more education and training to be conducted within hospitals and even within nursing colleges, with respect to this issue of physical health monitoring of mental patients. Such training can also be integrated to the curriculum and similar guidelines drafted through the Nursing and Midwifery Council. The only weakness of the recommendations is that most of them are long-term in terms of implementation. The researcher since to have forgotten to provide short-term measures that can be adopted in the short-term to serve as immediate interventions to the issue.
The critical appraisal carried out above is significant to my nursing practice and will have a positive implication on my decision making ability in person centered care. The article appraised in this case has highlighted a number of relevant issues that are relevant to person centered care. The recommendations presented by the author are very practical and can go a long way in serving as effective intervention to the research subject. I would act on the evidences and recommendations presented by the author. As discussed earlier, these recommendations would require cooperation from different stakeholders that include nurses and government institutions. Personally, as a nurse, I would play my role in nursing that the evidences and the recommendations presented by the author are implemented.
In conclusion, this paper has provided a critical appraisal of the nursing research article by Herbert Mwebe. The qualitative critical appraisal tool used, effectively captured the strengths and weaknesses of the article. Some of the key strengths that were identified included the clear validity of the research process as well as the effective presentation of the results. The critical appraisal exercise carried out in this paper has been a great learning process for me. At the end of the exercise, I feel I have acquired immense understanding of research process and how to critically assess the validity of the research process as well as that of the results, especially with regards to evidence based nursing practice. After the exercise I was able to identify the strengths and weaknesses of evidence-based practice. The key strength of the practice is the fact that it is based on in-depth research and precedence which serve to give the most realistic and viable solutions to existing problems (Reynolds, 2008). The key weakness of evidence-based practice is that it is vulnerable to inadequacies in research. Some researchers can present findings which have numerous shortcomings which if not critically appraised may have detrimental effect on the outcome of such adoption.
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Mwebe, H., 2017. Physical health monitoring in mental health settings: a study exploring mental health nurses’ views of their role. Journal of clinical nursing, 26(19-20), pp.3067-3078.
Munn, Z., Moola, S., Riitano, D., & Lisy, K. (2014). The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. International journal of health policy and management, 3(3), 123.
Parahoo, K., 2000. Barriers to, and facilitators of, research utilization among nurses in Northern Ireland. Journal of advanced nursing, 31(1), pp.89-98.
Polit, D.F. and Beck, C.T., 2008. Nursing research: Generating and assessing evidence for nursing practice. Lippincott Williams & Wilkins.
Reynolds, S., 2008. Evidence-based practice: a critical appraisal. John Wiley & Sons.
Vlayen, J., Aertgeerts, B., Hannes, K., Sermeus, W., & Ramaekers, D. (2005). A systematic review of appraisal tools for clinical practice guidelines: multiple similarities and one common deficit. International Journal for Quality in Health Care, 17(3), 235-242.
APPENIX: QUALITATIVE CRITICAL APPRAISAL TOOL