Relatives’ Experiences on Sedation of Ventilated Patients in ICU
Rigor in qualitative research is associated with “openness, scrupulous adherence to a philosophical perspective, thoroughness in collecting data, and consideration of all the data in the subjective theory development phase” (Burns and Grove, 2005, p. 55). There are six different approaches to a rigorous qualitative 10-hour research such as grounded theory research, phenomenological research, philosophical inquiry, historical research, critical social theory and ethnographic research.
Each approach influences the process of data interpretation; as such, the researcher must be able to appropriately identify which approach would be accurate for his or her study. On the research study conducted by Dreyer and Nortvedt (2007) entitled, “Sedation of Ventilated Patients in Intensive Care Units: Relatives’ Experiences,” the researchers utilized a phenomenological research approach wherein they tried to describe the experiences of relatives while their loved ones in intensive care unit or ICU are being treated with sedation.
Here, the researchers recognized the value of the relatives’ experiences on the process of nursing ventilated patients as relatives have inter-connection with their loved ones which enable them to identify the feelings of patients while being sedated. The researchers perceived that relatives’ experiences could contribute to the healthcare system, particularly in the field of nursing, on properly treating ventilated
Although the topic in this research study is not valuable in the nursing discipline especially when it comes to understanding the patient’s condition, upon analyzing the research’s content, one would notice that it lacks in quality because the process and methodology that the researchers utilized are very limited. Critique and Analysis
Using the Rigor of the Research Process in evaluating Dreyer and Nortvedt’s research on Sedation of Ventilated Patients in Intensive Care Units: Relatives’ Experiences, the phenomenon of interest is focused on relatives’ experiences while their ventilated loved ones are being treated by physicians and nurses using sedation. The purpose of the study is to qualitatively explore the experiences of being relatives of ventilated and sedated patients in ICU.
Furthermore, the researchers hypothesized that relatives’ experiences would be of great help upon providing new knowledge about patient well-being and proper treatment using pain relief and sedation. This is a strong point on this study as considering relatives’ experiences and perception on the treatment of their loved ones is relatively useful especially on the ongoing process of nursing and curing the critically ill patient.
The researchers were able to effectively convey the research’s phenomenon of interest, problem, purpose and hypothesis such that even audiences outside the healthcare system would be able to comprehend the path of research. The research problem covers all gender as women and men’s experiences being relatives of ventilated patients vary on their emotional and psychological capacity and capability of understanding their loved ones’ undertakings.
In addition, the researchers were able to conduct a feasible study, wherein the subjects are available and research facilities, equipment and money are also accessible, which matched to the authors’ fields of expertise who are both Registered Nurse and professors in the Health Discipline. However, the literature review for this study is lacking since the researchers found limited data that could help in explaining the area being studied.
Most of the literature reviews used was about family participation in ICU while studies on the impact of relatives on assessment of sedation were not yet available during the time when the study was conducted. With limited literature, the researchers were only able to utilize such on explaining the effects of sedation and on depicting relatives’ experiences of having loved ones in ICU.
Having limited data and without the use of theory, which also caused the absence of theoretical, conceptual and operational framework of the study that could explain the phenomena of the area being studied, this reduces the quality of a research which often pushes researchers to encourage further research on the field of their study. With regard to ethical consideration, the researchers were able to abide with the ethic code of research.
No medical records of unconscious patients were accessed and the information provided by participants during the interview was treated with confidentiality. Only data which are of great importance on the research study were utilized and analyzed. More to this, the researchers provided accurate information about the study on every participant and the subjects were not coerced to be involved in the conduct of study. This also made a strong point on the study as the researchers did not attempt to manipulate the possible result of their study.
Having volunteer participants increases the quality of a research such that researchers did not select respondents according to their expected outcome of the study. Concerning the research design, researchers of this study used phenomenological approach as the research is about relatives’ experiences on “life world of critical illness” (Dreyer & Nortvedt, 2008, p. 550). The researchers perceived the importance of relatives’ experiences in nursing critical ill patients; thus with the use of phenomenological approach, such experiences were properly dealt with.
In addition, the researchers utilized hermeneutical interpretation principles in analyzing their collected data. Textual analysis is often used in conducting qualitative study, as words from participants comprise the value of the study. In analyzing the research design, it is appropriate to say that the researchers were able to pick the accurate methodology that would help them treat and analyze the data in order to come up with quality result.
However, when it comes to population and sample used in this study, the use of eight participants reduces the quality of result as limited number of participants could not represent large number of a whole. Moreover, only relatives whose ventilated patients were being treated for more than four days were considered. To generate more quality data, the researchers should have used a larger sample of participants and considered only those relatives whose loved ones were sedated for more than a week or a month as waiting for the result of treatment for these patients were more sensitive and critical.
In addition, the researchers only employed participants from major hospital in Norway and those whose age was within the 40 to 50 years age bracket; thus, the diversity of the result was not largely recognized. To gather the needed data, the researchers conducted in-depth interviews where questions are composed of open-ended questions such as “Can you tell me about your experience with this acute situation” (Dreyer & Nortvedt, 2008, p. 551).
Although in-depth interview could produce great quality results, the researchers should also consider conducting focus group discussion inviting ventilated patients’ relatives who have undergone the same field of experiences. Follow up focus group interview could also further strengthen the result as being a relative of presently ventilated patients is more critical as compared to those relatives who have experienced that situation a week or a month ago.
With regard to data analysis and research outcome, the researchers were able to use appropriate tools – hermeneutical interpretation principles and phenomenological approach – which helped them in properly dealing with the collected data. The data from relatives were immediately transcribed and interpreted, thus the research experience is still fresh owing to proper time consideration. Moreover, each valuable data is either compared to or supported by other research findings thus giving the audience an idea that the study was not limited on personally interpreting the result.
The data analysis was classified under four areas namely: “(1) unfamiliarity and strangeness – loss balance; (2) seeking information and awareness of relatives’ relationship with nurses and patient; (3) growing need or being an active participant in caring for the patient; and (4) changing focus – awareness of their own situation as relative” (Dreyer and Nortvedt, 2008, p. 551). Classifying the collected data is important in order to properly identify which information is very important and which data are of less significance.
Moreover, such activity guarantees quality as only valuable data are included on interpretation and analysis. With some significant words from relative participants presented on this part of the study, the researchers were able to accurately treat the data and were able to effectively convey what the relatives actually feel on that critical situation or condition. Meanwhile, the researchers were able to accomplish the study according to its possible value in the field of nursing research and application.
The results of the study are useful such that the researchers were able to explore how the relatives feel when their loved ones are being ventilated or sedated. Considering the connection of relatives on the critically ill patient, they could be of good help on the process of understanding the well-being of the patients. In addition, relatives could aid and guide nurses on properly dealing with sensitive and critical patients which in turn would minimize ethical dilemma and other medical problem resulting to health and life loss.
In general, the research study conducted by Dreyer and Nortvedt (2008) was significant in the nursing discipline as it opened a new path in understanding the well-being of critically ill patients. However, using the Rigor of the Research Process in evaluating the study, it was identified that there are some aspects or parts of the research that needs to be improved in order to produce a more qualitative result. The strength of using rigor principles in research lies on the possibility of further improving or developing the conduct and result of the study and, in nursing, refining knowledge about the discipline.
It enabled the critique to identify the strength and weakness of the study in order to have future researchers to be properly guided. On the other hand, the weakness of using rigor principle in research is that researches would always be questionable as to its efficiency, application and attempt to interpret phenomena or other researchable discipline. The aim for perfection using rigor principle would, most of the time, weaken studies conducted to explain phenomena or to improve the discipline or the field of study.