Research Critique: What Do Patients With Advanced Incurable Cancer Want From the Management of Their Pain?

Introduction

Critical appraisal is essential because it assists readers to have understanding research and to examine the weaknesses and strengths of studies. Critiquing a provides an in-depth assessment of the applicability and significance of the study based on the future and current nursing practice. Therefore, this critique will focus on analyzing a qualitative research study of "What do patients with advanced incurable cancer want from the management of their pain? The research was carried out by Jane Gibbins, Bhatia Rebbecca, Karen Forbes, and Colette Reid. Jane Gibbins is a doctor of philosophy and a registered nurse. She is also a professor at the University of Bristol, and she lectures in the school of molecular and cellular medicine. Bhatia Rebecca is a registered nurse and has a Ph.D. in palliative medicine. Bhatia lectures at the University of Bristol in the school of clinical science. Karen Forbes is also a registered nurse and is a doctor of philosophy. Karen lectures at the University of Bristol in the department of palliative medicine. Lastly, Colette Reid is a registered nurse, and she has a Ph.D. in palliative medicine, and she is a professor at the University of Bristol in the department of palliative medicine. All four authors are qualified and accredited to carry out research. The paper has an abstract and it helpful to the reader because it offers a summary of the study by showing the background, aim, design, setting/participants, results, and conclusion of the research.

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Problem and Purposes

A research problem is a field of focus within the nursing practice requiring more information that contributes to the quality and safe healthcare. The study has clearly stated the research problem and has shown its significance in the nursing practice. The research problem is on the need for seeking for the most effective mechanism of managing pain among patients having incurable cancer to reduce their suffering (Gibbins, Bhatia, Forbes, & Reid, 2013). The research problem is of significance in nursing practice because in clinical settings measuring the efficiency of pain management is one of the challenges facing healthcare providers. In spite of the many scales and mechanisms put in place, they all have shortcomings on arriving at the most appropriate pain management intervention. As a result, having the necessary knowledge needed for controlling and managing pain among patients with advanced incurable cancer will enhance the provision of quality and safe healthcare by nurses.

The problem is also significant as patients with advanced incurable cancer experience chronic pain, a situation calling for effectiveness in the assessment, management, and the use of appropriate components in the control and management of pain. The study purpose is also evident because of the reported incidences of unsuccessful pain management and control in patients with advanced incurable cancer. The paper has some limitations conserving the study problem and purpose as it lacks objectives and goals (Grove, 2011). The study also has no stated research questions. Though the survey does not have research objectives, goals, and questions, it has descriptive vividness relative to the purpose and problem.

Review of Literature

The literature review aims at understanding want other researchers have found out concerning the research topic through the assessment of both the scientific and theoretical information. Literature reviews help in assessing current sources about the research topic, and it leads to the identification of gaps in the area of study (Grove, 2011). The most relevant research concentrates on seeking information to fill the gaps to offer more knowledge in the chosen field of study. Though the literature review is of importance in research, the study lacks this essential section. The authors did not include the literature review in the paper, a situation that does not provide the theoretical and scientific basis if the study.

Although there is no inclusion of the literature review section, the authors have put a list of references at the end of the paper as evidence for the in-text citations used in different parts of the article. The sources used are not current; this can lead to failure in having the present or recent scenarios regarding what is required in the management of pain in patients having advanced and incurable cancer. The conceptual/theoretical framework for the study is not clearly stated. Since, the study lacks a section that the assessment of the secondary source, there is no identification of gaps in knowledge. Even if the authors failed to maximize the use of secondary sources, the paper has used primary data (Grove, 2011). There is sufficient use of face-to-face interviewing in the collection of primary data. As a result, the literature review for the study was not adequate as the researchers did not sufficiently carry out an assessment of secondary data by reviewing existing journals and books concerning the research topic.

Research Design

The research design has the role of acting as the outline or plan followed when carrying out a study. The research design used by Gibbins et al. (2013) has a well-described research design. The study used the qualitative approach to collect data from respondents that focused on getting views on their experiences and expectations of what is needed in the management of pain among patients having advances and incurable cancer. The patients used in the study were known to specialists care teams either in the hospice or hospital setting who approached the respondents regarding the survey. The researchers explain and justify the research design to provide its suitability in the study. The study also lacks underlying assumptions for the selected research design. Therefore, the reader is supposed to note assumptions in the study.

Besides, the researchers controlled the process of data collection by a topic guide to investigating various views surrounding pain experience, control, and management. Researchers also revisited the question in the course of having a face-to-face interview session with participants which is an indication of trust between the interviewers and the respondents. The study was not exclusively qualitative as there was the use of quantitative data in collecting information on pain scores. The inclusion of quantitative data was to complement the qualitative study (Grove, 2011). The design used in the study was relevant, and it also provided an in-depth and intensive assessment of want is required when managing pain among patient having advanced and incurable cancer.

Methodological Congruence

The researchers used the purposive kind of sampling which refers to a non-probability sampling technique of choosing sample based on particular features of a population as well as the study objective. The choice of the sampling technique was appropriate for the study because this research intended to assess the views and experiences of patients having advanced incurable cancer. Therefore, the respondents to participate in the assessment required selection depending on the kind of the illness (cancer) and the severity of the condition (advanced and incurable). The study showed the identification of the philosophical approach by describing the process of having suitable participants in the study. The respondents used were known to specialists palliative care teams who included patients with different kinds of cancers at an advanced and incurable stage. The study setting was from the hospital, home, as well as hospice.

The study has the inclusion of detail information in explaining the methodology used during data collection. The process used to arrive at the participants, the study setting description, and the number of participants used is well-detailed by the researchers. There was a congruence of the philosophical approach as well as the assumptions underlying the research and process of collecting data as seen in the procedural illustration of arriving at the study sample, settings, as well as the number of participants interviewed. Individuals who carried out the study were members of the palliative care team, and they were qualified. The sample size was not adequate as the study only approached 17 patients of which 15 agreed to participate in the assessment.

Ethical Aspect

The study considered ethical concerns regarding data collection involving subjects. First of all, there was respect for the participants' rights. The researchers did not include vulnerable participants in the study, but instead, there was respect of the respondents' right to choosing to participate in the study or not. The study used informed consent to give participations a right to decide on their own whether to take part in the assessment or not. The confidentiality of the respondents was also respected where a single researcher interviewed each participant either at home, in an outpatient setting, or a private section of the ward. Ethics was also considered through the approval and monitoring of the data collection process by an approved committee. Researchers obtained approval from the research ethics committee from the National Research Ethics Service of South West, Central Bristol.

Findings/Credibility

Researchers presented the study findings using interpretive and analytical preciseness. Investigators have shown the trustworthiness of the study by describing the number of participants that accepted to participate in the assessment with the explanation of why some respondents did not participate in the study. The information provided shows that of the total number of respondents that agreed to take part in the study, three of them were too unwell to give the required information. The study findings were also in line with the demographic information of participants to provide specifications for drawing the study results. The enhancement of the data credibility was gained by assessing the trends, a situation that led to the emergence of four themes. The identified themes are maintaining the role, independence, and self followed modifying expectation and the functions of healthcare providers, and lastly, the meaning of pain within the context of advanced and incurable cancer.

The data analysis used in the study was the constant comparison technique which refers to the data analysis method that intends to develop a grounded theory. The use of constant comparison method involves the process of phenomenon identification, understanding the experiences, deciding concerning the initial data collection, establishing a theoretical sampling, and lastly, developing the rationale of comparing groups as per their theoretical relevance. Following the procedure of data analysis applied, the philosophical approach was congruent. There was also the categorization of data based on obtained codes, and it contributed to the relevant aspect of the study. The researchers themselves did coding, and it involved three individuals who independently went through the transcripts to come up with codes. Individuals that coded the data met at intervals to refine and compare their data. There was also the development of connections between coded to help in the identification of categories as well as the derivation of themes. The study used adequate respondent quotes, a situation that aids the reader to understand the phenomenon under investigation.