IntroductionIntroduction please prof read Qualitative and quantitative research are the two main schools of research, and although they are often

IntroductionIntroduction please prof read

           Qualitative and quantitative research are the two main schools of research, and although they are often used in tandem, the benefits and disadvantages of each are hotly debated. Particularly in the social sciences, the merits of both qualitative and quantitative research are fought over, with intense views held on both sides of the argument. It is generally agreed upon, however, that there are some phases of research where one or the other is clearly more useful than the other. Research on DVT prevention has provided a multitude of qualitative and quantitative studies. Both studies are useful in the advancement of healthcare regarding DVT prevention. In this paper I will review two studies, one qualitative and one quantitative, and compare the data gained from each study and how it can be applied to the concept of DVT prevention.

Contrast Between Quantitative and Qualitative Studies Regarding DVT Prevention

There exists a fundamental distinction between two types of data: qualitative and quantitative. The way we typically define them, we call data 'quantitative' if it is in numerical form and 'qualitative' if it is not (Batrawi et al., 2017). Qualitative research is multimethod in focus, involving an interpretive, naturalistic approach to its subject matter. This means that qualitative researchers study things in their natural settings, attempting to make sense of, or interpret, phenomena in terms of the meanings people bring to them (Damman et al., 2018). This is evident in the qualitative article I choose by Seaman, Nelson & Noble (2014). In that study, researchers conducted their interviews in the participants house. By using the natural setting of the participant, the subjects felt more comfortable to discuss their feelings on the research topic. The researchers were concerned with understanding data from the participants point of view.

Quantitative research gathers data in a numerical form which can be put into categories, or in rank order, or measured in units of measurement (Stoel, Ballou & Heitger, 2017). This type of data can be used to construct graphs and tables of raw data. The data from the quantitative article I choose by Sousa et al (2001) contrasted with the qualitative approach. In this article, the researchers were more interested in facts regarding their experiment, the use of sirolimus-coated BX Velocity stents. There was no need for reviewing how the participants felt during this experiment. The only data that was relevant was if the stents used produced the desired effect.

Advantages when using a qualitative approach is that the data obtained can provide depth and detail. There are many time restrictions that are placed on research methods. The goal of a time restriction is to create a measurable outcome so that metrics can be in place. Qualitative research focuses less on the metrics of the data that is being collected and more on the subtleties of what can be found in that information (Batrawi et al., 2017). This allows for the data to have an enhanced level of detail to it, which can provide more opportunities to glean insights form it during examination. This was evident in the article by Seaman, Nelson & Noble (2014). The findings of this study add further information to what is already known about VTE in the palliative care setting. It suggests that CAT produces a significant symptomatic and psychological burden. Also, it confirms that, despite several clear downsides to long-term LMWH therapy, patients are willing to persevere with the treatment and will even work to overcome barriers to continue with the injections (Seaman, Nelson & Noble, 2014). Finally, the study highlights the need to further explore the role of NOACs, not only for the treatment of VTE in palliative care, but for all cancer patients. Qualitative research was very useful in this study to show how human emotions and experiences can affect the data recorded.

Advantages of quantitative research allows the researcher to measure and analyze data. The relationship between an independent and dependent variable is studied in detail. In the article by Sousa et al (2001), this is evident in the data recorded. Twenty-six patients had stable angina and 4 patients had unstable angina. All stents were implanted successfully, and all patients were discharged without complications 24 hours after treatment. No patient approached >50% vessel narrowing by QCA or IVUS, and only 3 patients had >15% intimal hyperplasia by IVUS (Sousa et al., 2001). In both the edge segments and in the stented segment, lumen loss detected by IVUS was minimal. All patients completed 4 months of angiographic and 8 months of clinical follow-up. There were no repeat revascularizations, stent thromboses, or major clinical events (cerebrovascular accident, myocardial infarction, or death). Quantitative research allowed the researchers to more objective about their findings. With the data obtained in this study, the researchers were able to test their hypotheses in the experiment by using statistics to measure the data.

Sometimes qualitative research is looked down upon as not being real science. Qualitative research is valued for its relevance but is considered lacking in scientific accuracy. To encourage high scientific quality and relevance in medical research, researchers need to enhance knowledge about qualitative methods, and their scientific guidelines. This is especially relevant when complex and comprehensive phenomena are to be studied. Quantitative research methods can provide results that are reliable due to their high controls and strict adherence to the scientific method (Park & Park, 2016). However, they can be criticized for their lack of in depth description and explanations. Qualitative research, in contrast to quantitative research, are viewed as being low in reliability and are often discredited because they are regarded as less scientific (Park & Park, 2016). In conclusion, although qualitative data seems to lack scientific qualities, researchers must not take these methods at face value and underestimate how scientific qualitative research can be.

In summary, there are a lot of similarities among quantitative and qualitative research methods. Regardless of which method is used, it is still necessary to create an appropriate research question, understand the theory behind what will be observed, create a research design, collect and analyze data, and create a report of the results. However, there are several key differences between quantitative and qualitative research methods. These methods differ in the types of questions that they pose. They also differ in their analytical objectives and the amount of flexibility allowed in the research design. Differences in the data collection instruments that are used, and the type of data that are ultimately produced must be accounted for. Quantitative methods can be viewed as generally inflexible since categories are typically closed-ended or fixed, while qualitative methods are more flexible, with a large amount of spontaneity and adaptation occurring during interaction with other people, especially in the form of open-ended questions. To decide which research approach should be used, several things should be considered, including the problem of interest, the resources available, the skills and training of the researcher, and the audience for the research. Since there are considerable differences in the assumptions that underlie these two research approaches, as well as the collection and analysis of data, these considerations are important elements all researchers must account for.

References

Batrawi, M., Sayed, H. E., Hussein, H., Mawella, S. A., Madbouly, N., & Fawzi, S. (2017). Qualitative versus quantitative study of distress in a sample of young age breast cancer survivors. The Egyptian Journal Of Psychiatry, (3).

 Damman, O. C., Vonk, S. I., Van den Haak, M. J., van Hooijdonk, C. M., & Timmermans, D. R. (2018). The effects of infographics and several quantitative versus qualitative formats for cardiovascular disease risk, including heart age, on people's risk understanding. Patient Education And Counseling, doi:10.1016/j.pec.2018.03.015

Park, J., & Park, M. (2016). Qualitative versus Quantitative Research Methods: Discovery or Justification?. Journal Of Marketing Thought, 3(1), 1-7. doi:10.15577/jmt.2016.03.01.1

Seaman, S., Nelson, A., & Noble, S. (2014). Cancer-associated thrombosis, low-molecular-weight heparin, and the patient experience: a qualitative study. Patient Preference and Adherence, 8, 453-461. http://doi.org/10.2147/PPA.S58595

Sousa, J., Costa, M., Abizaid, A., Abizaid, A., Feres, F., Pinto, I., & ... Serruys, P. (2001). Lack of neointimal proliferation after implantation of sirolimus-coated stents in human coronary arteries: a quantitative coronary angiography and three-dimensional intravascular ultrasound study. Circulation, 2001(2), 192-195.

Stoel, M. D., Ballou, B., & Heitger, D. L. (2017). The Impact of Quantitative versus Qualitative Risk Reporting on Risk Professionals' Strategic and Operational Risk Judgments. Accounting Horizons, 31(4), 53-69. doi:10.2308/acch-51777

Critique Template for a Qualitative Study

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or Mixed Methods Studies (due by Day 7 of Week 7)

Date: 4/17/19

Your name:Opheli,okebata

Article reference (in APA style):  Seaman, S., Nelson, A., & Noble, S. (2014). Cancer-associated thrombosis, low-molecular-weight heparin, and the patient experience: a qualitative study. Patient Preference and Adherence, 8, 453-461. http://doi.org/10.2147/PPA.S58595    

URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3986276/ 

What is a critique? Simply stated, a critique is a critical analysis undertaken for some purpose. Nurses critique research for three main reasons: to improve their practice, to broaden their understanding, and to provide a base for the conduct of a study.

When the purpose is to improve practice, nurses must give special consideration to questions such as these:

• Are the research findings appropriate to my practice setting and situation? 
• What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness?
• How might a proposed change in practice trigger changes in other aspects of practice?

To help you synthesize your learning throughout this course and prepare you to utilize research in your practice, you will be critiquing a qualitative, quantitative, or mixed-methods research study of your choice.

If the article is unavailable in a full-text version through the Walden University Library, you must e-mail the article as a PDF or Word attachment to your Instructor.

QUALITATIVE RESEARCH CRITIQUE

1.     Research Issue and Purpose

What is the research question or issue of the referenced study? What is its purpose? (Sometimes ONLY the purpose is stated clearly and the question must be inferred from the introductory discussion of the purpose.)

The purpose of this study is to explore the acceptability of long-term low-molecular -weight heparin (LMWH) for the treatment of cancer-associated thrombosis (CAT) in the contexts of living with cancer and quality of life.

2.     Researcher Pre-understandings

Does the article include a discussion of the researcher's pre-understandings? What does the article disclose about the researcher's professional and personal perspectives on the research problem?

Previous research suggested that LMWH is an acceptable intervention in the treatment of CAT, yet clinical practice and therapeutic opportunities have changed in the decade since the study was conducted. Furthermore, in the previous study there was acknowledged selection bias in participant recruitment. There is increasing clinical use of the novel oral anticoagulants, although their efficacy and safety is yet to be demonstrated within the cancer population. The experience of patients receiving anticoagulation for CAT will inform future practices with respect to quality of life and adherence to anticoagulation therapy.

3.     Literature Review

What is the quality of the literature review? Is the literature review current, relevant? Is there evidence that the author critiqued the literature or merely reported it without critique? Is there an integrated summary of the current knowledge base regarding the research problem, or does the literature review contain opinion or anecdotal articles without any synthesis or summary of the whole? (Sometimes the literature review is incorporated into the introductory section without being explicitly identified.)

Literary review showed that clinical guidelines recommend that first-line treatment of CAT requires 3-6 months anticoagulation with weight-adjusted low-molecular-weight heparin (LMWH). The evidence supporting this is compelling, with met-analysis form four randomized controlled trials identifying a 50% relative risk reduction in recurrent venous thromboembolism (VTE) without increased bleeding rates. Because 47%-65% of those enrolled had metastatic disease, these recommendations are also considered appropriate in the advanced-cancer setting. The guidelines also recommended that in patients with active cancer who thus have an ongoing risk for recurrent CAT, consideration should be given to indefinite anticoagulation.

4.     Theoretical or Conceptual Framework

Is a theoretical or conceptual framework identified? If so, what is it? Is it a nursing framework or one drawn from another discipline? (Sometimes there is no explicitly identified theoretical or conceptual framework; in addition, many "nursing" research studies draw on a "borrowed" framework, e.g., stress, medical pathology, etc.)

This study used conceptual framework that can be applied to all healthcare providers. By using LMWH in cancer patients, a decrease in CAT can be achieved. There is overwhelming data from a multitude of studies that have confirmed this assumption.

5.     Participants

Who were the participants? Is the setting or study group adequately described? Is the setting appropriate for the research question? What type of sampling strategy was used? Was it appropriate? Was the sample size adequate? Did the researcher stipulate that information redundancy was achieved?

A screening of 40 sequential CAT outpatients identified 14 suitable patients. All 14 patients who were approached agreed to participation in the study. Patients were 52-84 years of age (median 66 years). All patients had commenced LMWH at diagnosis of CAT, except for one patient who had received warfarin for 3 months and was then diagnosed with cancer and changed to LMWH. I feel this was an appropriate sample of participants due to the studies goal of showing the benefits of using LMWH in cancer patients with CAT.

6.     Protection of Human Research Participants

What steps were taken to protect human research subjects?

Ethical approval had been obtained through the National Health Service of South Wales Research Ethics Committee. As part of the ethical review, it was recommended that specific questions be introduced to explore patient attitudes to alternative anticoagulants such as the NOACs and whether they would prefer these to the LMWH.

7.     Research Design

What was the design of the study? If the design was modeled from previous research or pilot studies, please describe.

The researchers used a qualitative study of cancer patients who had been receiving LMWH for at least 3 months for CAT. Audiotaped semi-structured interviews were conducted and transcribed. Thematic analysis was undertaken until theoretical saturation.

8.     Data Collection/Generation Methods

What methods were used for data collection/generation? Was triangulation used? 

Semi-structured interviews were carried out over a 6-month period from February-July 2013. The researcher was nan experienced palliative care physician, trained in conducting qualitative research. Interviews were conducted at patient's homes and guided by a prompt list to ensure that the same issues were discussed at each interview. Open-ended questions were used, as well as prompts to probe further into issues that arose as significant or meaningful to the participant. Interviews took approximately 30 minutes each.

9.     Credibility

Were the generated data credible? Explain your reasons.

I feel that the data collected in this study was credible. By reaching theoretical saturation, the researchers could conclude their data results could be replicated if used on another group of participants.

10.  Data Analysis

What methods were used for data analysis? What evidence was provided that the researcher's analysis was accurate and replicable?

Researchers in the study analyzed data using thematic content analysis. Initial coding was undertaken independently by the researchers. Theoretical saturation was achieved at eight interviews. However, to optimize the breadth of primary cancer diagnoses and ages of participants, it was agreed that a further six participants should be interviewed. This was done to increase the reliability of findings.

11.  Findings

What were the findings?

The findings of the study suggest that LMWH is still an acceptable intervention in this population and that most patients are willing to continue with the treatment beyond 6 months.

12.  Discussion of Findings

Was the discussion of findings related to the framework? Were those the expected findings? Were they consistent with previous studies? Were serendipitous (i.e., accidental) findings described?

The findings of this study add further information to what is already known about VTE in the palliative care setting. It suggests that CAT produces a significant symptomatic and psychological burden. Also, it confirms that, despite several clear downsides to long-term LMWH therapy, patients are willing to persevere with the treatment and will even work to overcome barriers to continue with the injections. Finally, the study highlights the need to further explore the role of NOACs, not only for the treatment of VTE in palliative care, but for cancer patients as a whole. 

13.  Limitations

Did the researcher report limitations of the study? (Limitations are acknowledgments of internal characteristics of the study that may help explain insignificant and other unexpected findings, and more importantly, indicate those groups to whom the findings CANNOT be generalized or applied. It is a fact that all studies must be limited in some way; not all of the issues involved in a problem situation can be studied all at once.)

Limitations of the study were acknowledged by the researchers. The study was undertaken within a single institution through a dedicated CAT clinic. It is possible that results generated through a specialist setting may not represent those from a more generalist environment. Although there was strong consistency between participant responses, the sample size was too small to draw conclusions worthy of changing practice.

14.  Implications

Are the conclusions and implications drawn by the author warranted by the study findings? (Sometimes researchers will seem to ignore findings that don't confirm their expectations as they interpret the meaning of their study findings.)

The implications of conclusions reached in this study showed that it is possible that managing CAT within a specialist environment affords the patient greater access to information and understanding of the rationale for using LMWH. Increased understanding may consequently improve compliance and tolerance of the intervention.

15.  Recommendations

Does the author offer legitimate recommendations for further research? Is the description of the study sufficiently clear and complete to allow replication of the study? (Sometimes researchers' recommendations seem to come from "left field" rather than following obviously from the discussion of findings. If a research problem is truly significant, the results need to be confirmed with additional research; in addition, if a reader wishes to design a study using a different sample or correcting flaws in the original study, a complete description is necessary.)

Although confirmation of the acceptability of LMWH is not a new finding per se, this study offers additional insight into patient experiences and attitudes. This study suggests that patients experiencing distressing symptoms from VTE considered LMWH a "necessary evil" in treating a potentially life-threatening condition. Recommendations for further research is needed to confirm that patients will comply with LMWH therapy as indefinite anticoagulation therapy if required.

16.  Research Utilization in Your Practice

How might this research inform your practice? Are the research findings appropriate to your practice setting and situation? What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness? How might the utilization of this research trigger changes in other aspects of practice?

The findings of this study can be used in my current practice. As a critical care nurse, I regularly have patients with cancer receiving DVT prevention or treatment. The use of LMWH or NOACs in the therapy of these patients is a part of standard practice. Finding the safest and most reliable medication to use in this patient population is a constant struggle. With studies like this one, we can continue to grow out knowledge regarding the use of these medication and provide the best evidence based practice for therapy for patients with CAT.

Critique Template for a Quantitative Study

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or Mixed Methods Studies (due by Day 7 of Week 7)

Date: 4/14/18

Your name: Phillip Comalander

Article reference (in APA style): Sousa, J., Costa, M., Abizaid, A., Abizaid, A., Feres, F., Pinto, I., & ... Serruys, P. (2001). Lack of neointimal proliferation after implantation of sirolimus-coated stents in human coronary arteries: a quantitative coronary angiography and three-dimensional intravascular ultrasound study. Circulation, 2001(2), 192-195.

URL: http://circ.ahajournals.org/content/103/2/192.full

What is a critique? Simply stated, a critique is a critical analysis undertaken for some purpose. Nurses critique research for three main reasons: to improve their practice, to broaden their understanding, and to provide a base for the conduct of a study.

When the purpose is to improve practice, nurses must give special consideration to questions such as these:

• Are the research findings appropriate to my practice setting and situation? 
• What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness?
• How might a proposed change in practice trigger changes in other aspects of practice?

To help you synthesize your learning throughout this course and prepare you to utilize research in your practice, you will be critiquing a qualitative, quantitative, or mixed methods research study of your choice.

If the article is unavailable in a full-text version through the Walden University Library, you must e-mail the article as a PDF or Word attachment to your Instructor.

QUANTITATIVE RESEARCH CRITIQUE

1.     Research Problem and Purpose

What are the problem and purpose of the referenced study? (Sometimes ONLY the purpose is stated clearly and the problem must be inferred from the introductory discussion of the purpose.)

To determine the safety and efficacy of sirolimus-coated BX Veloscity stents

2.     Hypotheses and Research Questions

What are the hypotheses (or research questions/objectives) of the study? (Sometimes the hypotheses or study questions are listed in the Results section, rather than preceding the report of the methodology used. Occasionally, there will be no mention of hypotheses, but anytime there are inferential statistics used, the reader can recognize what the hypotheses are from looking at the results of statistical analysis.)

That sirolimus-coated BX Velocity stents can reduce the neointimal proliferation after implantation.

3.     Literature Review

What is the quality of the literature review? Is the literature review current? Relevant? Is there evidence that the author critiqued the literature or merely reported it without critique? Is there an integrated summary of the current knowledge base regarding the research problem, or does the literature review contain opinion or anecdotal articles without any synthesis or summary of the whole? (Sometimes the literature review is incorporated into the introductory section without being explicitly identified.)

There was no literature review of the study done for the study. This was the first human experience with the implantation of sirolimus-coated BX Velocity stents was performed. Differences in stent design limit scientific comparison with other reports. The quality of the study would be on the weaker side due to this being the first of its kind. There will need to be additional studies done to have a valid comparison.

4.     Theoretical or Conceptual Framework

Is a theoretical or conceptual framework identified? If so, what is it? Is it a nursing framework or one drawn from another discipline? (Sometimes there is no explicitly identified theoretical or conceptual framework; in addition, many "nursing" research studies draw on a "borrowed" framework, e.g., stress, medical pathology, etc.)

Although not specifically listed, the theoretical framework was designed with physicians and pharmaceutical companies in mind. This study would be of benefit for cardiovascular physicians who perform stenting as a new product to use. Pharmaceutical companies can use this data to adjust current stent design and improve product function.

5.     Population

What population was sampled? How was the population sampled? Describe the method and criteria. How many subjects were in the sample?

Thirty patients with angina pectoris were electively treated with 2 different formulations of sirolimus-coated stents.

6.     Protection of Human Research Participants

What steps were taken to protect human research subjects?

Researchers made sure that all stents were placed correctly, and patients were discharged without complications.

7.     Research Design

What was the design of the study? If the design was modeled from previous research or pilot studies, please describe.

The researchers blended sirolimus in a mixture of nonerodable polymers that have been used clinically in bone cements, ocular devices, and a drug-releasing intrauterine device. Fifteen patients received a fast release formulation, and fifteen received a slow release formulation.

8.     Instruments and Strategies for Measurement

What instruments and/or other measurement strategies were used in data collection? Was information provided regarding the reliability and validity of the measurement instruments? If so, describe it.

Quantitative coronary angiography and IVUS imaging were performed immediately after the procedure and at 4-month follow-up in all patients after bolus infusion of intracoronary nitrates. Quantitative angiographic and volumetric IVUS analyses were performed by independent core laboratories.

9.      Data Collection

What procedures were used for data collection?

Comparisons between postintervention and follow-up measurements were performed with a 2-tailed paired t test. Comparisons between groups were performed using an unpaired Student's t test. 

10.  Data Analysis

What methods of data analysis were used? Were they appropriate to the design and hypotheses?

Quantitative methods were used. This was a valid method for this study in that numerical data was important to prove the hypotheses for the study correct.

11.  Interpretation of Results

What results were obtained from data analysis? Is sufficient information given to interpret the results of data analysis?

Twenty-six patients had stable angina and 4 patients had unstable angina. All stents were implanted successfully, and all patients were discharged without complications 24 hours after treatment. No patient approached >50% vessel narrowing by QCA or IVUS, and only 3 patients had >15% intimal hyperplasia by IVUS. In both the edge segments and in the stented segment, lumen loss detected by IVUS was minimal. All patients completed 4 months of angiographic and 8 months of clinical follow-up. There were no repeat revascularizations, stent thromboses, or major clinical events (cerebrovascular accident, myocardial infarction, or death).

12.  Discussion of Findings

Was the discussion of findings related to the framework? Were those the expected findings? Were they consistent with previous studies? Were serendipitous (i.e., accidental) findings described?

This was the first human experience with the implantation of sirolimus-coated BX Velocity stents. The absence of adverse events for up to 8 months of follow-up suggests that the implantation of this stent, which is coated with a potent cell-cycle inhibitor, is feasible and safe.

13.  Limitations

Did the researcher report limitations of the study? (Limitations are acknowledgments of internal characteristics of the study that may help explain insignificant and other unexpected findings, and more importantly, indicate those groups to whom the findings CANNOT be generalized or applied. It is a fact that all studies must be limited in some way; not all of the issues involved in a problem situation can be studied all at once.)

The study was comprised of only 30 patients with 4 months of QCA and 3D IVUS data and 8 months of clinical data. With such a small sample group, additional studies will be needed.

14.  Implications

Are the conclusions and implications drawn by the author warranted by the study findings? (Sometimes researchers will seem to ignore findings that don't confirm their hypotheses as they interpret the meaning of their study findings.)

The implication for the use of sirolimus-coated BX Velocity stents were confirmed by the results of this study. The data showed very positive results in the use of these stents to prevent neointimal proliferation after stenting.

15.  Recommendations

Does the author offer legitimate recommendations for further research? Is the description of the study sufficiently clear and complete to allow replication of the study? (Sometimes researchers' recommendations seem to come from "left field" rather than following obviously from the discussion of findings. If a research problem is truly significant, the results need to be confirmed with additional research; in addition, if a reader wishes to design a study using a different sample or correcting flaws in the original study, a complete description is necessary.)

The findings of this study show that sirolimus-coated stents can be a safe and effective device for preventing neointimal formation at 4 months after stent implantation. These findings warrant further confirmation by large, placebo-controlled, multicenter trials.

16.  Research Utilization in Your Practice

How might this research inform your practice? Are the research findings appropriate to your practice setting and situation? What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness? How might the utilization of this research trigger changes in other aspects of practice?

As a critical care nurse who takes care of post-stented patients, this information can be useful for physicians at my facility when determining the best stent to use for patients. With proper stent implantation, adverse effects may be minimalized, and patients will recover faster with less of a chance for occlusion of the stent.

           Qualitative and quantitative research are the two main schools of research, and although they are often used in tandem, the benefits and disadvantages of each are hotly debated. Particularly in the social sciences, the merits of both qualitative and quantitative research are fought over, with intense views held on both sides of the argument. It is generally agreed upon, however, that there are some phases of research where one or the other is clearly more useful than the other. Research on DVT prevention has provided a multitude of qualitative and quantitative studies. Both studies are useful in the advancement of healthcare regarding DVT prevention. In this paper I will review two studies, one qualitative and one quantitative, and compare the data gained from each study and how it can be applied to the concept of DVT prevention.

Contrast Between Quantitative and Qualitative Studies Regarding DVT Prevention

There exists a fundamental distinction between two types of data: qualitative and quantitative. The way we typically define them, we call data 'quantitative' if it is in numerical form and 'qualitative' if it is not (Batrawi et al., 2017). Qualitative research is multimethod in focus, involving an interpretive, naturalistic approach to its subject matter. This means that qualitative researchers study things in their natural settings, attempting to make sense of, or interpret, phenomena in terms of the meanings people bring to them (Damman et al., 2018). This is evident in the qualitative article I choose by Seaman, Nelson & Noble (2014). In that study, researchers conducted their interviews in the participants house. By using the natural setting of the participant, the subjects felt more comfortable to discuss their feelings on the research topic. The researchers were concerned with understanding data from the participants point of view.

Quantitative research gathers data in a numerical form which can be put into categories, or in rank order, or measured in units of measurement (Stoel, Ballou & Heitger, 2017). This type of data can be used to construct graphs and tables of raw data. The data from the quantitative article I choose by Sousa et al (2001) contrasted with the qualitative approach. In this article, the researchers were more interested in facts regarding their experiment, the use of sirolimus-coated BX Velocity stents. There was no need for reviewing how the participants felt during this experiment. The only data that was relevant was if the stents used produced the desired effect.

Advantages when using a qualitative approach is that the data obtained can provide depth and detail. There are many time restrictions that are placed on research methods. The goal of a time restriction is to create a measurable outcome so that metrics can be in place. Qualitative research focuses less on the metrics of the data that is being collected and more on the subtleties of what can be found in that information (Batrawi et al., 2017). This allows for the data to have an enhanced level of detail to it, which can provide more opportunities to glean insights form it during examination. This was evident in the article by Seaman, Nelson & Noble (2014). The findings of this study add further information to what is already known about VTE in the palliative care setting. It suggests that CAT produces a significant symptomatic and psychological burden. Also, it confirms that, despite several clear downsides to long-term LMWH therapy, patients are willing to persevere with the treatment and will even work to overcome barriers to continue with the injections (Seaman, Nelson & Noble, 2014). Finally, the study highlights the need to further explore the role of NOACs, not only for the treatment of VTE in palliative care, but for all cancer patients. Qualitative research was very useful in this study to show how human emotions and experiences can affect the data recorded.

Advantages of quantitative research allows the researcher to measure and analyze data. The relationship between an independent and dependent variable is studied in detail. In the article by Sousa et al (2001), this is evident in the data recorded. Twenty-six patients had stable angina and 4 patients had unstable angina. All stents were implanted successfully, and all patients were discharged without complications 24 hours after treatment. No patient approached >50% vessel narrowing by QCA or IVUS, and only 3 patients had >15% intimal hyperplasia by IVUS (Sousa et al., 2001). In both the edge segments and in the stented segment, lumen loss detected by IVUS was minimal. All patients completed 4 months of angiographic and 8 months of clinical follow-up. There were no repeat revascularizations, stent thromboses, or major clinical events (cerebrovascular accident, myocardial infarction, or death). Quantitative research allowed the researchers to more objective about their findings. With the data obtained in this study, the researchers were able to test their hypotheses in the experiment by using statistics to measure the data.

Sometimes qualitative research is looked down upon as not being real science. Qualitative research is valued for its relevance but is considered lacking in scientific accuracy. To encourage high scientific quality and relevance in medical research, researchers need to enhance knowledge about qualitative methods, and their scientific guidelines. This is especially relevant when complex and comprehensive phenomena are to be studied. Quantitative research methods can provide results that are reliable due to their high controls and strict adherence to the scientific method (Park & Park, 2016). However, they can be criticized for their lack of in depth description and explanations. Qualitative research, in contrast to quantitative research, are viewed as being low in reliability and are often discredited because they are regarded as less scientific (Park & Park, 2016). In conclusion, although qualitative data seems to lack scientific qualities, researchers must not take these methods at face value and underestimate how scientific qualitative research can be.

In summary, there are a lot of similarities among quantitative and qualitative research methods. Regardless of which method is used, it is still necessary to create an appropriate research question, understand the theory behind what will be observed, create a research design, collect and analyze data, and create a report of the results. However, there are several key differences between quantitative and qualitative research methods. These methods differ in the types of questions that they pose. They also differ in their analytical objectives and the amount of flexibility allowed in the research design. Differences in the data collection instruments that are used, and the type of data that are ultimately produced must be accounted for. Quantitative methods can be viewed as generally inflexible since categories are typically closed-ended or fixed, while qualitative methods are more flexible, with a large amount of spontaneity and adaptation occurring during interaction with other people, especially in the form of open-ended questions. To decide which research approach should be used, several things should be considered, including the problem of interest, the resources available, the skills and training of the researcher, and the audience for the research. Since there are considerable differences in the assumptions that underlie these two research approaches, as well as the collection and analysis of data, these considerations are important elements all researchers must account for.

References

Batrawi, M., Sayed, H. E., Hussein, H., Mawella, S. A., Madbouly, N., & Fawzi, S. (2017). Qualitative versus quantitative study of distress in a sample of young age breast cancer survivors. The Egyptian Journal Of Psychiatry, (3).

 Damman, O. C., Vonk, S. I., Van den Haak, M. J., van Hooijdonk, C. M., & Timmermans, D. R. (2018). The effects of infographics and several quantitative versus qualitative formats for cardiovascular disease risk, including heart age, on people's risk understanding. Patient Education And Counseling, doi:10.1016/j.pec.2018.03.015

Park, J., & Park, M. (2016). Qualitative versus Quantitative Research Methods: Discovery or Justification?. Journal Of Marketing Thought, 3(1), 1-7. doi:10.15577/jmt.2016.03.01.1

Seaman, S., Nelson, A., & Noble, S. (2014). Cancer-associated thrombosis, low-molecular-weight heparin, and the patient experience: a qualitative study. Patient Preference and Adherence, 8, 453-461. http://doi.org/10.2147/PPA.S58595

Sousa, J., Costa, M., Abizaid, A., Abizaid, A., Feres, F., Pinto, I., & ... Serruys, P. (2001). Lack of neointimal proliferation after implantation of sirolimus-coated stents in human coronary arteries: a quantitative coronary angiography and three-dimensional intravascular ultrasound study. Circulation, 2001(2), 192-195.

Stoel, M. D., Ballou, B., & Heitger, D. L. (2017). The Impact of Quantitative versus Qualitative Risk Reporting on Risk Professionals' Strategic and Operational Risk Judgments. Accounting Horizons, 31(4), 53-69. doi:10.2308/acch-51777

Critique Template for a Qualitative Study

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or Mixed Methods Studies (due by Day 7 of Week 7)

Date: 4/17/19

Your name:Opheli,okebata

Article reference (in APA style):  Seaman, S., Nelson, A., & Noble, S. (2014). Cancer-associated thrombosis, low-molecular-weight heparin, and the patient experience: a qualitative study. Patient Preference and Adherence, 8, 453-461. http://doi.org/10.2147/PPA.S58595    

URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3986276/ 

What is a critique? Simply stated, a critique is a critical analysis undertaken for some purpose. Nurses critique research for three main reasons: to improve their practice, to broaden their understanding, and to provide a base for the conduct of a study.

When the purpose is to improve practice, nurses must give special consideration to questions such as these:

• Are the research findings appropriate to my practice setting and situation? 
• What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness?
• How might a proposed change in practice trigger changes in other aspects of practice?

To help you synthesize your learning throughout this course and prepare you to utilize research in your practice, you will be critiquing a qualitative, quantitative, or mixed-methods research study of your choice.

If the article is unavailable in a full-text version through the Walden University Library, you must e-mail the article as a PDF or Word attachment to your Instructor.

QUALITATIVE RESEARCH CRITIQUE

1.     Research Issue and Purpose

What is the research question or issue of the referenced study? What is its purpose? (Sometimes ONLY the purpose is stated clearly and the question must be inferred from the introductory discussion of the purpose.)

The purpose of this study is to explore the acceptability of long-term low-molecular -weight heparin (LMWH) for the treatment of cancer-associated thrombosis (CAT) in the contexts of living with cancer and quality of life.

2.     Researcher Pre-understandings

Does the article include a discussion of the researcher's pre-understandings? What does the article disclose about the researcher's professional and personal perspectives on the research problem?

Previous research suggested that LMWH is an acceptable intervention in the treatment of CAT, yet clinical practice and therapeutic opportunities have changed in the decade since the study was conducted. Furthermore, in the previous study there was acknowledged selection bias in participant recruitment. There is increasing clinical use of the novel oral anticoagulants, although their efficacy and safety is yet to be demonstrated within the cancer population. The experience of patients receiving anticoagulation for CAT will inform future practices with respect to quality of life and adherence to anticoagulation therapy.

3.     Literature Review

What is the quality of the literature review? Is the literature review current, relevant? Is there evidence that the author critiqued the literature or merely reported it without critique? Is there an integrated summary of the current knowledge base regarding the research problem, or does the literature review contain opinion or anecdotal articles without any synthesis or summary of the whole? (Sometimes the literature review is incorporated into the introductory section without being explicitly identified.)

Literary review showed that clinical guidelines recommend that first-line treatment of CAT requires 3-6 months anticoagulation with weight-adjusted low-molecular-weight heparin (LMWH). The evidence supporting this is compelling, with met-analysis form four randomized controlled trials identifying a 50% relative risk reduction in recurrent venous thromboembolism (VTE) without increased bleeding rates. Because 47%-65% of those enrolled had metastatic disease, these recommendations are also considered appropriate in the advanced-cancer setting. The guidelines also recommended that in patients with active cancer who thus have an ongoing risk for recurrent CAT, consideration should be given to indefinite anticoagulation.

4.     Theoretical or Conceptual Framework

Is a theoretical or conceptual framework identified? If so, what is it? Is it a nursing framework or one drawn from another discipline? (Sometimes there is no explicitly identified theoretical or conceptual framework; in addition, many "nursing" research studies draw on a "borrowed" framework, e.g., stress, medical pathology, etc.)

This study used conceptual framework that can be applied to all healthcare providers. By using LMWH in cancer patients, a decrease in CAT can be achieved. There is overwhelming data from a multitude of studies that have confirmed this assumption.

5.     Participants

Who were the participants? Is the setting or study group adequately described? Is the setting appropriate for the research question? What type of sampling strategy was used? Was it appropriate? Was the sample size adequate? Did the researcher stipulate that information redundancy was achieved?

A screening of 40 sequential CAT outpatients identified 14 suitable patients. All 14 patients who were approached agreed to participation in the study. Patients were 52-84 years of age (median 66 years). All patients had commenced LMWH at diagnosis of CAT, except for one patient who had received warfarin for 3 months and was then diagnosed with cancer and changed to LMWH. I feel this was an appropriate sample of participants due to the studies goal of showing the benefits of using LMWH in cancer patients with CAT.

6.     Protection of Human Research Participants

What steps were taken to protect human research subjects?

Ethical approval had been obtained through the National Health Service of South Wales Research Ethics Committee. As part of the ethical review, it was recommended that specific questions be introduced to explore patient attitudes to alternative anticoagulants such as the NOACs and whether they would prefer these to the LMWH.

7.     Research Design

What was the design of the study? If the design was modeled from previous research or pilot studies, please describe.

The researchers used a qualitative study of cancer patients who had been receiving LMWH for at least 3 months for CAT. Audiotaped semi-structured interviews were conducted and transcribed. Thematic analysis was undertaken until theoretical saturation.

8.     Data Collection/Generation Methods

What methods were used for data collection/generation? Was triangulation used? 

Semi-structured interviews were carried out over a 6-month period from February-July 2013. The researcher was nan experienced palliative care physician, trained in conducting qualitative research. Interviews were conducted at patient's homes and guided by a prompt list to ensure that the same issues were discussed at each interview. Open-ended questions were used, as well as prompts to probe further into issues that arose as significant or meaningful to the participant. Interviews took approximately 30 minutes each.

9.     Credibility

Were the generated data credible? Explain your reasons.

I feel that the data collected in this study was credible. By reaching theoretical saturation, the researchers could conclude their data results could be replicated if used on another group of participants.

10.  Data Analysis

What methods were used for data analysis? What evidence was provided that the researcher's analysis was accurate and replicable?

Researchers in the study analyzed data using thematic content analysis. Initial coding was undertaken independently by the researchers. Theoretical saturation was achieved at eight interviews. However, to optimize the breadth of primary cancer diagnoses and ages of participants, it was agreed that a further six participants should be interviewed. This was done to increase the reliability of findings.

11.  Findings

What were the findings?

The findings of the study suggest that LMWH is still an acceptable intervention in this population and that most patients are willing to continue with the treatment beyond 6 months.

12.  Discussion of Findings

Was the discussion of findings related to the framework? Were those the expected findings? Were they consistent with previous studies? Were serendipitous (i.e., accidental) findings described?

The findings of this study add further information to what is already known about VTE in the palliative care setting. It suggests that CAT produces a significant symptomatic and psychological burden. Also, it confirms that, despite several clear downsides to long-term LMWH therapy, patients are willing to persevere with the treatment and will even work to overcome barriers to continue with the injections. Finally, the study highlights the need to further explore the role of NOACs, not only for the treatment of VTE in palliative care, but for cancer patients as a whole. 

13.  Limitations

Did the researcher report limitations of the study? (Limitations are acknowledgments of internal characteristics of the study that may help explain insignificant and other unexpected findings, and more importantly, indicate those groups to whom the findings CANNOT be generalized or applied. It is a fact that all studies must be limited in some way; not all of the issues involved in a problem situation can be studied all at once.)

Limitations of the study were acknowledged by the researchers. The study was undertaken within a single institution through a dedicated CAT clinic. It is possible that results generated through a specialist setting may not represent those from a more generalist environment. Although there was strong consistency between participant responses, the sample size was too small to draw conclusions worthy of changing practice.

14.  Implications

Are the conclusions and implications drawn by the author warranted by the study findings? (Sometimes researchers will seem to ignore findings that don't confirm their expectations as they interpret the meaning of their study findings.)

The implications of conclusions reached in this study showed that it is possible that managing CAT within a specialist environment affords the patient greater access to information and understanding of the rationale for using LMWH. Increased understanding may consequently improve compliance and tolerance of the intervention.

15.  Recommendations

Does the author offer legitimate recommendations for further research? Is the description of the study sufficiently clear and complete to allow replication of the study? (Sometimes researchers' recommendations seem to come from "left field" rather than following obviously from the discussion of findings. If a research problem is truly significant, the results need to be confirmed with additional research; in addition, if a reader wishes to design a study using a different sample or correcting flaws in the original study, a complete description is necessary.)

Although confirmation of the acceptability of LMWH is not a new finding per se, this study offers additional insight into patient experiences and attitudes. This study suggests that patients experiencing distressing symptoms from VTE considered LMWH a "necessary evil" in treating a potentially life-threatening condition. Recommendations for further research is needed to confirm that patients will comply with LMWH therapy as indefinite anticoagulation therapy if required.

16.  Research Utilization in Your Practice

How might this research inform your practice? Are the research findings appropriate to your practice setting and situation? What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness? How might the utilization of this research trigger changes in other aspects of practice?

The findings of this study can be used in my current practice. As a critical care nurse, I regularly have patients with cancer receiving DVT prevention or treatment. The use of LMWH or NOACs in the therapy of these patients is a part of standard practice. Finding the safest and most reliable medication to use in this patient population is a constant struggle. With studies like this one, we can continue to grow out knowledge regarding the use of these medication and provide the best evidence based practice for therapy for patients with CAT.

Critique Template for a Quantitative Study

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or Mixed Methods Studies (due by Day 7 of Week 7)

Date: 4/14/18

Your name: Phillip Comalander

Article reference (in APA style): Sousa, J., Costa, M., Abizaid, A., Abizaid, A., Feres, F., Pinto, I., & ... Serruys, P. (2001). Lack of neointimal proliferation after implantation of sirolimus-coated stents in human coronary arteries: a quantitative coronary angiography and three-dimensional intravascular ultrasound study. Circulation, 2001(2), 192-195.

URL: http://circ.ahajournals.org/content/103/2/192.full

What is a critique? Simply stated, a critique is a critical analysis undertaken for some purpose. Nurses critique research for three main reasons: to improve their practice, to broaden their understanding, and to provide a base for the conduct of a study.

When the purpose is to improve practice, nurses must give special consideration to questions such as these:

• Are the research findings appropriate to my practice setting and situation? 
• What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness?
• How might a proposed change in practice trigger changes in other aspects of practice?

To help you synthesize your learning throughout this course and prepare you to utilize research in your practice, you will be critiquing a qualitative, quantitative, or mixed methods research study of your choice.

If the article is unavailable in a full-text version through the Walden University Library, you must e-mail the article as a PDF or Word attachment to your Instructor.

QUANTITATIVE RESEARCH CRITIQUE

1.     Research Problem and Purpose

What are the problem and purpose of the referenced study? (Sometimes ONLY the purpose is stated clearly and the problem must be inferred from the introductory discussion of the purpose.)

To determine the safety and efficacy of sirolimus-coated BX Veloscity stents

2.     Hypotheses and Research Questions

What are the hypotheses (or research questions/objectives) of the study? (Sometimes the hypotheses or study questions are listed in the Results section, rather than preceding the report of the methodology used. Occasionally, there will be no mention of hypotheses, but anytime there are inferential statistics used, the reader can recognize what the hypotheses are from looking at the results of statistical analysis.)

That sirolimus-coated BX Velocity stents can reduce the neointimal proliferation after implantation.

3.     Literature Review

What is the quality of the literature review? Is the literature review current? Relevant? Is there evidence that the author critiqued the literature or merely reported it without critique? Is there an integrated summary of the current knowledge base regarding the research problem, or does the literature review contain opinion or anecdotal articles without any synthesis or summary of the whole? (Sometimes the literature review is incorporated into the introductory section without being