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Ethical Consideration in Qualitative Study

Introduction to Rural Hospital Nursing

Critical analysis of a study is understood as a detailed examination of particular research in order to evaluate the effectiveness of the study. This assessment is a critical analysis of a study. For this assessment total, four articles were given out of which one has to be selected for the critical analysis. The selected article for this assessment is the study presented by Newhouse et al., (2011) entitled “Rural hospital nursing: Results of a national survey of nurse executives”. This study was conducted to explain the characteristics of nursing in both small and larger rural hospital along with determining whether there are certain contextual differences that exist in the market, hospital, and nursing characteristics or not. This assessment will critically analyse the identified strengths and weaknesses of the study in relation to the research design, sampling technique, data collection, statistical analysis, results and discussion of the study. At last, a summary of the study’s implications for nursing practice would be given to understand the significance of the study and how it could be helpful if implicated in the nursing practice. 

Critical Analysis of The Strengths and Weaknesses of Research Design

The study design used is a qualitative study. The study was done by conducting surveys among nurse executives in different small and larger rural hospitals. The authors have utilised an exploratory and descriptive research design. The exploratory research aims to focus on providing insights into the problem. While the descriptive research approach focuses on describing the characteristics (Rendle et al., 2019). Similarly, the authors have done. Along with this, a phenomenological method has also been used in which the perceptions of the nurse executives have been taken by conducting the survey. According to the study presented by Neubauer, Witkop & Varpio, (2019) a phenomenological method is considered as a powerful approach for investigating that focuses on the analysis of individual experiences of the participants. 

Strengths

By critically evaluating the research design used in the study it can be said that there is a clear congruity between the selected research methodology for the study and the stated philosophical perspective. This could be considered as the strength of the research design. This is so because the study is clearly focusing on the nurse executives’ experiences as well as on the contextual differences that exist in between the smaller and larger rural hospitals.

The article has given various interpretations and personal experiences and perceptions have been acknowledged.

Weakness

Certain grammatical and spelling errors that were found in the study. In a study presented by Krenier et al., (2001) it has been said that spelling errors in a study directly affect the perceptions of the writers and goes below the standards of academic writing. 

Critical Analysis of The Strengths and Weaknesses of The Sampling Technique

Strength

The participants in the survey were selected to participate in this qualitative research that was based on their experiences and perceptions regarding the nursing characteristics as well as the hospital characteristic in the rural region. Initially, 688 nurse executives in the rural hospitals from 47 states were invited for the completion of the telephone or written survey (whichever preferred by them). The invitation letter was received by first 54 nurse executives with a follow-up call that was made 2 weeks later to that of the schedule telephonic interview. Rest of the nurse executives were invited in order to complete the written survey that was conducted by the use of a modified Dillman method. Finally, in total 280 nurse executives completed the survey. The number of participants could be the strength of the sampling technique because a large number of participants able to achieve the maximum variation (Vasileiou et al., 2018). As per the study conducted by Palinkas et al. (2015), the maximum variation sampling during the survey is considered to gather important information with respect to the significance of multiple circumstances.

Weakness

Despite drawing the sample of the study nationally, there are chances that the sampling bias could limit the results’ generalizability.

Critical Analysis of The Strengths and Weaknesses of Data Collection and Statistical Analysis

Strengths

The gathered data from the survey was entered and all analyses were conducted by the usage of SPSS 15 (SPSS Inc, Chicago, Illinois). Continuous analyses of the data were done with the help of independent t-tests. Later on, the categorical data were analysed with the help of 22 tests. Along with them, A Mann-Whitney U test was also being used in the odd cases where the assumptions for the t-test did not meet. However, PG .05 was being considered the most significant. 

Yes, this type of method for data collection is appropriate and valuable. The data was collected by conducting surveys with nurse executives. Nursing characteristics and hospitalization characteristics were discussed along with the nursing challenges. Written and telephonic means of the survey was utilized as per the preferences of the participants. 

The levels of measurement of the variables of this study are also considered as the strength. The variables of the study here are the nursing characteristics and the hospitalization characteristics wherein the level of measurement could be understood by as the relationship between the characteristics of the variable and the numeric values of those variables (Cooper & Johnson, 2016). According to Cooper & Johnson, (2016), five major levels of measurement are there that are nominal, ordinal, binary, interval, and ratio. These five levels of the measurement create the continuum. This is because the numeric values of the identified variables take on a rising number of the useful numerical properties as soon as the one starts proceeding from the nominal level to that of the ratio level. 

Another strength of the data collection and the statistical analysis and actually the who article is the ethical consideration. According to Arifin, (2018) ethics are considered to be the standards that set the regulations for what is appropriate and what is not. Doing no harm to anyone, informed consent, intended participation, maintaining the confidentiality of the participants, taking ethical approval, and assessing only relatable components are considered to be the major ethical considerations. And it is said these ethical considerations must be considered during the conduct of any research (Wu, 2019). While analyzing and reviewing the article by keeping ethical considerations in mind, it can be said that the authors have very well considered the ethics in their study because they have clearly mentioned regarding the ethics that have been considered throughout the study exclusively. In the study, it is also mentioned that the authors have been taken approval from both the ethical as well as the organizations from where the nurse executives belonged. Authors have clearly stated that ethical approval was obtained from the Johns Hopkins Medicine institutional review board. All participants that have been the part of the survey were been given informed consent and all the related information was also provided in order to acknowledge the ethics and avoid chaos at the time of the survey. The confidentiality of the participants was also kept. Along with all these, the authors have properly cited and reference whatever he has used from the content of the other authors which means they have given credits to the other authors whose study has been used as the source of information. 

Weakness

The article has a very limited number of interpretations. The personal experiences of the nurse executives from the small and large rural hospital might clash and tend to influence the observations and conclusions.

In the selected study, the strengths of the data collection and statistical analysis are more than that of the weaknesses of the approach used for the data collection and statistical analysis. So, it could be said that the data collection method and statistical analysis was done for the study was appropriate. 

Critical Analysis of The Strengths and Weaknesses of Results

Strengths

The results have clearly shown all the aspects of the small and larger hospital settings in the rural area that shows the congruity between the research statement and the results obtained. 

The study followed a phenomenological approach for exploring the perceptions of the nurse executives and the results were used for informing the hospital nurse executives, researchers, and policymakers regarding the obliging individual differences in the perceptions so that it could be implemented as a strategy to develop the nurse executives professionally. 

According to Gastel & Day, (2016) using headings and sub-headings in the result section of the research articles makes the reader understand different findings and aspects as per the theme. Along with this, it divides the findings of the result in different sections which makes it easy to correlate with the study. In the result section of the selected study, appropriate headings have been used and the perceptions of the participants who participated in the survey were represented in the form of tables. 

The findings of the study were the perceptions of the executives regarding the different setting of the rural region were evaluated and compiled in the form of the table and a logical flow of findings was observed.

Weakness

In qualitative research, there have been three basic concepts that must be kept in mind during the study. These concepts are generalizability, validity, and reliability (Leung, 2015). However, the study has shown validity and reliability but lacked in generalisability. Generalisability of a study could be understood as the extent of how valid, reliable, and applicable the study is to the other settings also (Leung, 2015). In the limitation section of the study, the authors have themselves mentioned that Despite drawing the sample of the study nationally, there are chances that the sampling bias could limit the results’ generalizability.

Critical Analysis of The Strengths and Weaknesses of Discussion of The Study

Strengths

The major strength of the discussion of the study is that it has been divided into appropriate sections with appropriate headings that are useful for understanding and getting a deep insight into the findings with the supporting pieces of evidence. 

The authors have included limitations of their own study which is a very important aspect in research. According to the study presented by Greener, (2018) providing study limitations is considered as an imperative part of any scholarly process. And, without incorporating study limitations, there are chances that the readers would grapple with the biases that could potentially impact the results and conclusion of the study (Greener, 2018).

Weaknesses

No potential weaknesses were found in the discussion provided by the authors in the study as all the aspects that are generally needed to be in the discussion are presented here.

Summary of The Study’s Implications

The findings and the results of this study can be implicated to the rural hospital settings and the implications are for the nurse executives, researchers, and policymakers. It was found that there is a need for the nurse executives that were from the small rural hospital settings to understand how they can make themselves and their staff developed professionally. This may entail the utilization of clinical ladders. In order to engage the nurses and the other staff members in the initiatives of the local, state, and national level networking with some other small hospitals is necessary along with partnering with them to develop such programs to get them engaged. The results that were obtained can be used for informing the interventions that have been modified as per the rural setting. Bothe, Small and larger rural hospitals need various distinct strategies that will help in promoting the adoption of the best nursing practices in rural settings. 

References for Rural Hospital Nursing

Arifin, S. R. M. (2018). Ethical consideration in qualitative study. International Journal of Care Science, 1(2).

Cooper, I. D., & Johnson, T. P. (2016). How to use survey results. Journal of the Medical Library Association : JMLA104(2), 174–177. https://doi.org/10.3163/1536-5050.104.2.016

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.

Kreiner, D. S., Schnakenberg, S. D., Green, A. G., Costello, M. J., & McClin, A. F. (2002). Effects of spelling errors on the perception of writers. The Journal of General Psychology, 129(1), 5–17. https://doi.org/10.1080/00221300209602029

Leung L. (2015). Validity, reliability, and generalizability in qualitative research. Journal of Family Medicine and Primary Care, 4(3), 324-327.

Neubauer, B. E., Witkop, C. T., & Varpio, L. (2019). How phenomenology can help us learn from the experiences of others. Perspectives on Medical Education, 8(2), 90–97. https://doi.org/10.1007/s40037-019-0509-2

Newhouse, R. P., Morlock, L., Pronovost, P., & Sproat, S. B. (2011). Rural hospital nursing: results of a national survey of nurse executives. The Journal of Nursing Administration, 41(3), 129–137. https://doi.org/10.1097/NNA.0b013e31820c7212

Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health 42, 533–544. doi:10.1007/s10488-013-0528-y

Rendle, K. A., Abramson, C. M., Garrett, S. B., Halley, M. C., & Dohan, D. (2019). Beyond exploratory: a tailored framework for designing and assessing qualitative health research. BMJ Open, 9(8), e030123. https://doi.org/10.1136/bmjopen-2019-030123

Vasileiou, K., Barnett, J., Thorpe, S., & Young, T. (2018). Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period. BMC Medical Research Methodology18(1), 148. https://doi.org/10.1186/s12874-018-0594-7

 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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