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This critical appraisal is an appraisal of a literature review “Understanding lived experiences of Aboriginal people with type 2 diabetes living in remote Kimberley communities: diabetes, it don’t come and go, it stays”. Critical appraisal of a published article is a thorough evaluation of the article to check its scientific validity as well as its generalizability to the given population and the reader's work environment (Umesh, Karippacheril, & Magazine, 2016). The article aims to explore the lived experiences of Aboriginal people that have type 2 diabetes that are managed by the Kimberley remote Aboriginal Community Controlled Health Services with the use of phenomenological analysis for the development of certain strategies for improving diabetes management (Straw et al, 2019). The article is been evaluated with the help of the Joanna Briggs Institute (JBI) tool to provide an appropriate way to check every aspect of the study on the given Review article.
The methodology used in this paper involves qualitative analysis and was operated within the community-based participatory research approach. There are certain strengths and weaknesses of the methodology used in the article and are being critically appraised in this critical appraisal.
There is congruity between the stated philosophical perspective and the research methodology as the article is clearly focused around the phenomenon of diabetes diagnosis, its management, and education. The authors have included studies by involving only qualitative methodology in the article using the phenomenological approach by conducting semi-structured interviews. The approach used was successful in eliciting the participant-led narrative, exploring the experiences of living with diabetes, and including its impact on their life, this shows the congruity between the research methodology and the research objectives.
The representation and analysis of data collected from the interviews were recorded in the Microsoft Word documents. The records were first reviewed as a whole and later on were combined into the Microsoft Word’s textual database and this is reflecting the congruity between the research methodology and data representation and its analysis.
Maximum variation sampling was considered during the interview for obtaining the information regarding the significance of various circumstances (Palinkas et al. 2015). In addition to this, The article has also provided research protocol and has taught the skills for the management of diabetes among Aboriginal and Torres Strait Islander people with type 2 diabetes that live in the remote Kimberley community shows well congruity between the interpretation of results and research methodology.
The article has limited interpretations. Personal experience of people from different community and their knowledge may influence the observations and conclusions.
In the given article, the strengths of the methodology are more than the weaknesses that show the approach used for the methodology is appropriate. Also, the methodology seeks to interpret the actions as well as experiences of the participants that are addressing the research goal clearly.
The results clearly showed the overall clinical features of assessed patients with Type 2 Diabetes. It concluded that one-quarter of patients had been spotted with Type 2 Diabetes, and a lot of them could not meet the glycaemic control target.
The article states that the study follows a phenomenological approach to explore the experiences of Aboriginal people dealing with type 2 diabetes that are managed by the Kimberley remote Aboriginal Community Controlled Health Services and the results are used for informing the practitioners regarding the accommodating individual differences in experiences (Straw et al, 2019). This shows congruity between the methodology and the approach that has been used for the interpretation.
Well, informative headings and sub-headings have been used in the result section of the article. The usage of headings and sub-headings in an article divides the different sections and findings of the result (Gastel & Day, 2016). The views and the voices of the participants who participated in the interview were adequately represented with the help of the tables.
The findings of the article flow logically from the research aim/question and is answering to the research question. The tables are listing the descriptive information of each study.
The result section is ensuring that the outcomes and recommendations stated in the article are appropriate for the results attained in the study.
There are three fundamental concepts of generalizability, validity, and reliability of qualitative research, out of which generalizability has not been considered in the article. Generalisability can be defined as the extent up to which the results of a study could be valid, applicable, reliable to other settings also. It can also be termed as external validity (Leung, 2015). This entails internal validation and judgment regarding whether the results of a study will be applicable to a particular group or others also. Though the article is a community based that too in a confined region. Generally, if the qualitative research studies focus on a specific issue within a certain population of a particular confined locality in a particular context, then, generalizability is usually not an anticipated attribute. With mounting tendency of knowledge synthesis from the qualitative research via meta-narrative, meta-synthesis, or meta-ethnography; the assessment of generalizability becomes more applicable. However, the findings in one study could be generalized to some other study under similar theoretical as well as proximal model, where generalizability of one research study to the another one is moderated by similarities between the people, time, place, and other social contexts (Leung, 2015).
The article uses a multi-faceted team approach for exploring the experiences of the remote Aboriginal community with Type 2 Diabetes. The authors have developed a model for the improvement of culturally suitable communication for diversified patients, Aboriginal health workers, clinicians, and researchers and this shows that all the findings and the issues were discussed thoroughly and were relevant to the topic.
The article has also provided an appropriate framework of recommendations that is potential in improving the experience of Aboriginal and Torres Strait Islander people with type 2 diabetes who lives in the remote Kimberley community shows well congruity between the interpretation of results and research methodology.
Participants were able to discuss the effect of diabetes on their lives and their recommendations for improved services in the interviews that were conducted.
There are some statements that locate the researcher culturally as it has been mentioned some of the practitioners were from the Aboriginal community and some were from the non-Aboriginal community.
The authors have not concentrated on the limitations of the study and its possible impact on the outcomes. According to Ross & Zaidi (2019), limitations are important for understanding the research findings in the framework, checking the validity and relevancy of the work, and identifying the integrity level to the results of published research. Recognition of limitations needs an elucidation of the meaning, persuade of errors, and validation of problems on the published findings.
Presenting the study limitations is certainly a crucial part of any scholarly process. Without limitations, the readers would fully grapple the possible segregated areas or other biases that may have an impact on the results provided (Greener, 2018). However, providing limitations also come under ethical consideration of the scientific inquiry. It makes sure the lucidity of both the research as well as the researchers along with providing the transferability of the methods used. It also supports proper analysis and validation of the findings (Resnik & Shamoo, 2017).
Ethics are the standards that set what is right and what is wrong. Informed consent, do no harm, voluntary participation, maintaining confidentiality, and assessment of only relevant components are the 5 major ethical considerations that must be considered during any research (Arifin, 2018). On account of ethical considerations, the article may have considered the ethics inclusively but, the authors have nowhere mentioned about ethical considerations exclusively such as taking consent of the individuals that have participated in the interview, or during the audio recording of them along with this authors also have not mentioned if they have maintained the confidentiality of them or not. There are possibilities that they might have taken care of these ethics but, in research, it is very important to mention all of these things clearly. However, the authors have given credit to the other authors whose articles have been used for information by citing them and mentioning in the references. They promote the aims of the research, such as expanding knowledge. Ethical considerations support the values that are required for working collaboratively with mutual respect and fairness and important social and moral values. It also states that the researchers are accountable for their own actions (Wu, 2019). This is why it is important to mention even though, researchers consider ethical laws during the whole but, mentioning in the literature review is important along with increasing the transparency as well as the standards of ethical reporting.
This particular research is valuable and appropriate. The title and the content given are relevant to each other. The purpose of the study is well justified, along with the methodological approach used. The methods used in the study are appropriate to identify, deduce, and evaluate the relevant studies. Although, a mixed-methods approach could also be used to highlight some more important findings related to the study. The findings are clear and relevant to the title. However, the findings do not generate generalisability for other researchers, healthcare providers, and policymakers whenever they will be in a dilemma for decision-making processes. The two major things where the article is lacking is providing study limitation and mentioning about ethical consideration because both of the aspects play a significant role in researches. Otherwise, the whole article is well-formatted and informative.
Arifin, S. R. M. (2018). Ethical consideration in qualitative study. International Journal of Care Science, 1(2).
Gastel, B. & Day, R. A. (2016). How to write and publish a Scientific paper. Calfornia: ABC Clio publication.
Greener, S. (2018). Research limitations: the need for honesty and common sense. Interactive Learning Environment. 26(5), 567–568. doi: 10.1080/10494820.2018.1486785.
Leung L. (2015). Validity, reliability, and generalizability in qualitative research. Journal of Family Medicine and Primary Care, 4(3), 324-327.
Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015). Purposeful sampling for qualitative datacollectionandanalysisin mixed method implementation research. Administration and Policy in Mental Health 42, 533–544. doi:10.1007/s10488-013-0528-y
Resnik, D. B., & Shamoo, A. E. (2017). Reproducibility and Research Integrity. Accountability in Research, 24(2), 116–123. https://doi.org/10.1080/08989621.2016.1257387
Ross, P. T., & Bibler Zaidi, N. L. (2019). Limited by our limitations. Perspectives on Medical Mducation, 8(4), 261–264. https://doi.org/10.1007/s40037-019-00530-x
Shorten, A. & Smith, J. (2017). Mixed methods research: Expanding the evidence base. Evidence-Based Nursing, 20(3), 74-75.
Straw, S., Spry, E., Yanawana, L., Matsumoto, V., Cox, D., Cox, E., Singleton, S., Houston, N., Scott, L., & Marley, J. V. (2019). Understanding lived experiences of Aboriginal people with type 2 diabetes living in remote Kimberley communities: Diabetes, it don't come and go, it stays! Australian Journal of Primary Health, 25(5), 486–494. https://doi.org/10.1071/PY19021
Umesh, G., Karippacheril, J. G., & Magazine, R. (2016). Critical appraisal of published literature. Indian Journal of Anaesthesia, 60(9), 670–673. https://doi.org/10.4103/0019-5049.190624
Wu, Y., Howarth, M., Zhou, C., Hu, M., & Cong, W. (2019). Reporting of ethical approval and informed consent in clinical research published in leading nursing journals: a retrospective observational study. BMC Medical Ethics 20(94). https://doi.org/10.1186/s12910-019-0431-5
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