Assignment: Factors that Influence Obesity Related Behaviors Responses

Assignment: Factors that Influence Obesity Related Behaviors Responses ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assignment: Factors that Influence Obesity Related Behaviors Responses I’m working on a Nursing question and need support to help me understand better. Reply back to these 2 critique papers( 2 different groups). The PDF and papers are attached. Assignment: Factors that Influence Obesity Related Behaviors Responses Then, post your responses to at least two (2) peers’ critiques with a substantive, referenced response. Need to go deeper into the point you are making on peer critiques. APA FORMAT. Group 9: Title of our study: Barriers and facilitators to preventing pressure ulcers in nursing home residents: A qualitative analysis informed by the Theoretical Domains Framework Lavallee et al., 2018). Group 8: The article that we used for our qualitative critique is Interventions for Prevention of Childhood Obesity in Primary Care: A Qualitative Study. attachment_1 attachment_2 attachment_3 attachment_4 Critique of Qualitative Nursing Research By: Breanna Vaira, Daniela Gonzalez & Dashyrah Wilson Adapted from Beth L. Rodgers, Ph.D., RN, University of Wisconsin-Milwaukee, School of Nursing © 1997, with the permission of Dr. Beth Rodgers. The article we chose to critique for our Qualitative Analysis is titled: “Barriers and facilitators to preventing pressure ulcers in nursing home residents. A qualitative analysis informed by the Theoretical Domains Framework” (Lavallee et al., 2018). Question 1: Identifying the Phenomenon Part A: Is the phenomenon focused on human experience within a natural setting? Answer: Pressure ulcers are injuries to the skin and underlying tissue which can cause pain and immobility (Lavallee et al., 2018). The people who are more at risk for are those who are immobile, seriously ill, elderly, and those who have poor nutrition which people in nursing homes are at greater risk. The phenomenon is focused on human experience within a natural setting because the study focuses on the individual’s direct experiences. The study didn’t manipulate any of the individual’s interviews. The researchers interviewed 25 individuals for this study. All of these people work in a healthcare facility. They interviewed 20 people who work in a nursing home; 2 managers, 7 health care assistants and 11 qualified nurses. They interviewed 5 from National Health Service community services: 4 tissue viability nurses and 1 manager. Therefore, we can accurately say that yes, this phenomenon is in fact focused on human experience within a natural setting as it possibly can be. Assignment: Factors that Influence Obesity Related Behaviors Responses Part B: Is the phenomenon relevant to nursing and/or health? Answer: The phenomenon is relevant to nursing. The phenomenon lies on how to understand the prevention of pressure ulcers in nursing homes and explore the healthcare providers knowledge, physical skills, interpersonal skills and social influences towards pressure ulcers. With all of the information we were presented within this article, as you can see, everything that is discussed can be related to nursing and/or health in one way or another. Question 2: Structuring the Research Question Part A: Does the question specify a distinct process to be studied? Does the question identify the context (the participants and setting) of the process that will be studied? Answer: The questions do not specify a distinct process to be studied. The questions are direct and specific for the data they are trying to obtain but do not specify one distinct process to be studied. The questions do identify the context of the process that will be studied. The questions were formulated to enable an exploration of each of the domains in the relation to pressure ulcer prevention practices in nursing home settings. Part B: What specific qualitative method is used? Answer: The qualitative method used in this study was semi-structured interviews. Semi-structured interviews are in-depth interviews where the participants have to answer open ended questions (Jasmshed, 2014). The interviews typically last between 30 minutes to an hour. In this study, all participants were interviewed face to face and the interviews lasted approximately 50 mins in length with the participants. In our opinion, open interviews are an excellent way to gather information we need in detail. If we ask the participants open ended questions it gives us more than just a yes or no answer. Instead, it will give us an infinite number of possible responses and let us give the respondents time to enter their own comments and thoughts as well. Assignment: Factors that Influence Obesity Related Behaviors Responses Part C: Does the specific qualitative method chosen fit with the research question? Answer: The qualitative method fits the research questions because the researchers are trying to obtain data from the employees. They want information about what employees from the nursing homes know and what they do to prevent ulcers, and a great way is to ask open-ended questions to get all the information possible. Semi-structured interviews help the researcher to obtain personal experiences data, which in this study that is what they are looking for. They want to know the experiences that employees have with treating patients to prevent ulcers or the care they do for patients with ulcers. Question 3: Researcher’(s)’ Perspective Part A: Do(es) the researcher(s) provide a theoretical framework or structure of ideas that reflects the researcher’(s)’ beliefs? Answer: The interview guide was developed using the Theoretical Domains Framework. This was used to explore the barriers and facilitators to pressure ulcer prevention in nursing home residents. Researchers analyzed the data by using the framework analysis and domains were identified as salient based on their frequency and the potential strength of their impact. Assignment: Factors that Influence Obesity Related Behaviors Responses Part B: Do(es) the researcher(s) report any personal biases? (Remember, researcher “biases” are different from study “limitations”.) Answer: The researcher does not report any personal biases in this study. Part C: Are biases present that the researcher(s) do(es)not report? Answer: We do not feel that there are any biases present that the researcher does not report. Part D: Do the biases, reported or not reported by the researcher(s), affect the quality of the study? Answer: We do not feel that there are any biases that affect the quality of the study. We know that all of the researchers have experience in wound care research and qualitative research. Since all the researchers have experience in providing care and conducting wound care research, they always assured that the analysis was a true reflection of the data when conducting the interviewing process. Question 4: Sample Selection Part A: Is the sample size appropriate to answer the research question? Is it clear that the selected sample is living the phenomenon of interest? Answer: Purposive sampling was used to recruit registered nurses and healthcare assistants. A total of 25 participants from three nursing home sites which provide a range of care services including nursing, dementia, residential, respite, palliative and convalescent care for 70–125 residents each in the North West of England. Sample size was based on data saturation which was assessed using the criteria proposed by Francis et al. (2010), whereby data collection can cease when no additional codes emerge within three consecutive interviews following the analysis of at least ten interviews. With this given information, we can conclude that the sample size was adequate, however it may be more valid if a larger sample size would have been used. Assignment: Factors that Influence Obesity Related Behaviors Responses Question 5: Data Gathering Part A: Are data sources and methods for gathering data specified? Answer: The topic guide was developed based on the Theoretical Domains Framework which contains 14 domains related to practitioner behaviors as shown in table one. Each question was formulated to enable an exploration of each of the 14 domains in relation to pressure ulcer prevention practices in nursing home setting. The topic guide was piloted with two participants and no further changes were necessary, researcher collected demographic information relating to participants’ experiences of working with patients who are at risk of developing pressure ulcers. Face-to-face interviews were conducted at the participant’s place of work. Each interview was conducted by the same researcher to ensure consistency and was about 50 minutes depending on the work commitments of the participants. The interviews were audio-recorded, transcribed verbatim and proof-read. Names and organizations were removed from all of the transcripts to protect their privacy. With this given information, we can accurately say that yes, this article clearly states the data sources and methods that were used in gathering the data that was specified in our article. Part B: Is there evidence that participant consent was an integral part of the data gathering process? Answer: Those who were interested in participating were asked to contact the researcher to schedule an appointment for the researcher to visit the nursing home. Interviewed participants were all asked to complete a consent form if they agreed to take part. Therefore, you can see that very clearly the participants of this experiment did show consent in the data gathering process and there is specific evidence that proves this as you can see. Assignment: Factors that Influence Obesity Related Behaviors Responses Question 6: Data Analysis Part A: Can the dimensions of data analysis be identified and logically followed? Answer: We can say yes, the dimensions of data analysis can be identified and logically followed. This can be shown through the fact that when they were using the framework method outlined, the data was read and coded inductively and then deductively using the Theoretical Domains Framework, where specific themes and codes were categorized according to the related domain. Part B: Do(es) the researcher(s) paint a clear picture of the participants’ reality? Answer: We can clearly say that yes, the researchers were able to paint a clear picture of the participants’ reality. This can be proven because if you read the article, the questions used in Appendix A topic guide uses Knowledge, Behavioral regulation, Memory, attention, and decision processes to prompt for further exploration of the nurses and health care team perception of pressure ulcers and how to prevent them. This article clearly states the reality of what the participants experienced during the study. Part C: Is there evidence that the researcher’(s)’ interpretation captured the participants’ meaning? Answer: We concluded that yes, there is evidence that the researchers’ interpretation captured the participants’ meaning during this study. While using the Theoretical Domain framework to find the barriers between hospital acquired pressure ulcers and how multidisciplinary teams can stop the formation, researchers placed an example of participants’ feedback to each point during the sample capturing their own meaning. Assignment: Factors that Influence Obesity Related Behaviors Responses Part D: Have other professionals confirmed the researcher’(s)’ interpretation? Answer: There is some evidence, but little information in this article to support this statement. Meaning, the author who helped write the article as well as performed the interview previously worked in the healthcare field as an assistant or a nurse and had experienced conducting wound care and qualitative research. This is beneficial to the study; however, no further information was given on confirmation, so it is hard to conclude how much input other professionals have given or have on the researchers’ interpretation. Question 7: Describing the findings Part A : Are examples provided to guide the reader from the raw data to the researcher’(s)’ interpretation? Answer: While analyzing the article, we discovered that only during the introduction were examples used and was only used to distinguish between avoidable and unavoidable pressure ulcers and regarded the majority as avoidable when the correct preventative measures are used. There are currently several national and international clinical guidelines for the prevention of pressure ulcers. These guidelines draw on both research findings and expert opinion and recommend a range of activities and interventions to promote pressure ulcer prevention including risk assessment, skin assessment, repositioning, good hydration and nutrition, pressure redistributing devices and barrier creams. This example is important to include as raw data to give a baseline of how the research is about to be conducted. With this being said, you can see that there were some examples that were used to guide the reader from the raw data to the researcher’s interpretation. These examples are very beneficial to provide support for this study; however, this was only the case in the beginning of the study during the introduction phase. It would be beneficial if the article included additional examples throughout the entire study as well. Overall, the examples that were included were in fact very sufficient in our opinion. Part B : Do(es) the researcher(s) link the findings to existing theory or literature, or is a new theory generated? Answer: If we look at whether this can be linked to an existing theory or literature or if a new theory is generated, we must think about what we already know about pressure ulcer formation and prevention. Most people understand ways to prevent pressure ulcers such as frequent repositioning, using barrier cream, etc. Not much new information was obtained in our opinion relating to a new theory of how pressure ulcers are either formed or barriers to prevent them. The information that was obtained such as barriers (knowledge, physical skills, social influences, and environmental context) and facilitators (interpersonal skills, environmental context and resources, social influences, beliefs about capabilities, beliefs about consequences, and social identity) is not new in regard to pressure ulcer formation or prevention. With that being said, we can accurately say that the researcher did not link the findings to a new theory, but instead just re-instated facts and was able to prove them through the findings of this study. Question 8: Discussion/Interpretation of findings Part A: Does the discussion “fit” with the data? Is it logical based on the data and results presented? Answer: During the discussion section of this qualitative study, several things can be concluded. Overall, this study mainly focused on exploring the pressure ulcer prevention within the nursing home setting. It also focuses on discussing the findings. In this case; barriers and facilitators to evidence informed pressure ulcer prevention, which were identified throughout the entirety of the study. When we ask ourselves if the discussion “fits” with the data. We can say yes. The information provided in the discussion section is very logical based on the results and data that was presented. If we wanted to go into more detail, first off, we will discuss the barriers. As an example, the four most common barriers we can discuss include knowledge, physical skills, social influences and environmental context and resources. Overall, the staff showed a high level of interest in improving knowledge and skills in pressure ulcer formation, however the knowledge they already had appeared to me limited. Views differed dramatically throughout the staff which is a problem. We also learned how the nursing home itself can be a barrier due to understaffing. This is likely to impact the quality of care for the patients. This is just one example. There are multiple factors discussed that relate to barriers. In addition, facilitators are also a factor that “fits” with the data and results presented. One example is teamwork and effective communication that are reported as facilitators for pressure ulcer prevention. With the information we are being presented in the discussion, we can say that yes, the discussion does fit with the data and results that we are presented in this study. Part B: Do(es) the researcher(s) discuss the findings in regard to previous research? Do(es) the researcher(s) discuss the findings in regard to a theoretical framework or structure of ideas? Answer: When we look at this study and its findings, the researchers do touch briefly on previous research related to this specific topic. They state how existing literature and studies report that staff attitudes towards pressure ulcer prevention is equivocal. They also touch on the fact that some studies report that staff have a lack of interest in pressure ulcer prevention and low motivation. This is important because it relates back to our barriers and facilitators we mentioned earlier in the study. This is not a new thing; however, it is still being talked about and re-studied due to lack of knowledge and compliance. Our researchers then mention how the findings in this study suggest that our positive attitudes in today’s age suggest that we may have a “fear of adverse consequences” (Lavallee et al., 2018). This is very interesting because in previous research this has not been identified as a possible facilitator as much as it has now. Overall, the researchers in this study do mention previous research and are able to accurately compare those results to the findings in this study. Our researchers also discuss the findings in regard to a theoretical framework. The Theoretical Domains Framework states how a person’s behavior can be affected by their beliefs about the consequences of a particular action (Lavallee et al., 2018). This is important because in this particular study all of the participants reported how they felt that within society pressure ulcers are a consequence of a lower quality of care. They then went on to explain their beliefs about what may happen if a patient developed a pressure ulcer under their care (Lavallee et al., 2018). Therefore, now all of the participants now have a positive attitude toward pressure ulcer prevention. With this information we are given we can accurately say that the researchers did in fact discuss our results in relation to a theoretical framework as well. Part C: Do(es) the researcher(s) identify limitations of the study? What are these limitations? Do they affect the quality of the study? If so, how? Answer: The researchers in this study do identify limitations of this study. Many participants reported a lack of pressure ulcers in their patients during this study. This means that many nursing home staff that were participating may not have come from nursing homes that are representative in terms of health or quality care of their residents. All the staff that were recruited for this study came from different areas in North West England and different staffing grades were also recruited. There was also a small number of participating nursing homes which was a limitation to the research due to the small sample size. Also, the barriers may have been previously reported already as we mentioned earlier. Overall, we feel that a big limitation is the lack of motivation from the nursing home managers in regard to the research they were trying to conduct. All of these limitations affect the quality of the study given that there is limited participation, and lack of motivation. Since the findings may be interrelated to previous research this is also a limitation that affected the overall quality of the study. Part D: Are there limitations that the researcher(s) do(es) not identify? What are these limitations? Do they affect the quality of the study? If so, how? Answer: There are usually always possible limitations that the researchers do not identify in our opinion. For example, there may be certain limitations due to time constraints, cultural bias’, and lack of knowledge about pressure ulcers that may impeded and affect the quality of the study. This was overall a pretty simple study to identify limitations for and the researcher did do an excellent job identifying them. Overall, the limitations in this study were very well laid out. Part E: Do(es) the researcher(s) discuss implications for practice? Are these appropriate? Answer: When we think about implications for practice, we are thinking simply about what our findings may mean for individuals that work in the healthcare field. In other words, how we are going to apply our findings to a clinical scenario. In this study, the researcher mentions several things that may be applied to real life scenarios as a result. After we look at the barriers and facilitators of pressure ulcer prevention and formation, the researcher has set a couple of goals that may be now applied: Nursing home staff will become motivated to share the information and newly acquired skills with their colleagues, Nursing home managers will allow time for sharing of practice and transference of skills, and providing regular training sessions. With this, these are appropriate goals for nursing home staff that will hopefully as a result eliminate some potential barriers to provide our patients with overall better quality of care. Assignment: Factors that Influence Obesity Related Behaviors Responses Question 9: Application to Nursing Practice Part A: How similar are the conditions of the study (setting, sample, interventions, etc.) to other practice settings you have been exposed to? Answer: When we compare the conditions of the study to other practice settings we have been exposed to; we will first look at the setting. For this study they gathered 25 participants to interview from three nursing home sites that performed a range of care services. Overall, this aspect was similar to what we have been exposed to. As nursing students, we also go from place to place gaining knowledge on all ranges of care. With these all being healthcare professionals, we can directly relate to them as well. The sample size in this study was similar to a study design we would conduct in a school setting with this being such a small sample. This would be a comfortable study for us to conduct ourselves as the sample is not overwhelming. This however is not a benefit to the overall validity of the study though. A larger sample size would validate the study more thoroughly if this study were to be conducted again. Overall, with them conducting face to face interviews to healthcare professionals, this study is very similar to the conditions and other practice settings we have been exposed to such as communicating with registered nurses during clinicals. Part B: How feasible, in your opinion, would it be to make a change in practice based on this research? Answer: In our opinion, the results from this research study would be relatively easy for us to make a change in practice. Since the prevention of pressure ulcers is beginning to become an even bigger issue throughout the healthcare field, nursing homes and hospitals most likely would be very inclined to participate in additional training for example to educate the staff to prevent such a simple thing. Due to the fact that most of this is due to lack of knowledge in our opinion, it would be easy for nursing home staff to initiate an intervention to support pressure ulcer prevention. Particularly, they would need to focus on increasing knowledge, improving skills, and providing a supportive and educative work environment to change their techniques. With how much money this could end up saving nursing homes, appropriate interventions would be easy to initiate in most cases if facilities realize the benefits that could result. Part C: Are the benefits likely to offset the costs and risks of a change in practice for the patient/ the nurse/ the organization? Assignment: Factors that Influence Obesity Related Behaviors Responses Answer: Yes, the benefits in this situation are likely to offset the costs and risks of a change in practice for the patient, nurse and organization. Many people fail to realize how much a facility gets charged if they are deemed at fault for the development of a pressure ulcer in a patient. A lot of times if the pressure ulcer becomes serious enough the patient will need to be hospitalized for pain control or infection. According to the American Journal of Surgery, “The average hospital treatment cost associated with stage IV pressure ulcers and related complications was $129,248 for hospital-acquired ulcers during one admission, and $124,327 for community-acquired ulcers over an average of 4 admissions” (Brem et al., 2010). Many people do not realize that cost is charged to the nursing home that caused the pressure ulcer if it is proven. Halting the progression of early stage pressure ulcers has the potential to eradicate enormous pain and suffering, save thousands of lives, and reduce healthcare expenditures by millions of dollars (Brem et al., 2010). With that being said, we do agree that the benefits of initiating a change of practice are likely to offset the costs of pressure ulcer formation. This will not only be cheaper but will drastically improve patient care in the long run. Question 10: Budding Consumer of Research Impression: Briefly discuss your impression of this research, including comments related to: Part A: The usefulness of this research in a specific or a general setting Answer: Using qualitative research is useful in providing an in-depth understanding of the ways that people act or manage day to day situations. This type of research study helps us to understand more about “why” and “how” something is happening. The benefits of this is that it focuses on words rather than numbers, basically it provides us with a more detailed way to answer research questions. In this specific case, using qualitative research to understand the concept of pressure ulcer prevention in nursing homes will help us to provide specific ways to prevent them and also to discover ways to facilitate staff. By doing this research, we were able to better understand the barriers and realize what we need to do as healthcare professionals to better deliver patient care. Part B: The ease of understanding of the research process Answer: Learning to understand the research process is an excellent skill to have. In this case, learning to recognize and trust the research will allow us to ask ourselves specific questions, analyze a research question, evaluate it and apply it to real life situations. In this case specifically, we gathered health care professionals, interviewed them, got the results, interpreted the results and then was able to apply it in real life to address problems that need to be solved; the prevention of pressure ulcers. With the research we gathered we now find it easy to realize what we need to do to fix such a simple problem. Assignment: Factors that Influence Obesity Related Behaviors Responses Part C: The ease of understanding of the research article Answer: It is very important to be able to understand and interpret a research article. When you look at an article such as pressure ulcer prevention, we first look at the abstract. This gives us a quick summary of the paper or highlights the main points. Then we go on to the introduction. This will give us background information about the paper’s topic. If we want to know more about what pressure ulcers are, we would go to this section. Next is the methods section. This gives us details about how the study was conducted and is the most detailed section. The results section contains all of the data from the experiments. The discussion section gives the author an opportunity to give us their opinions. They may also draw conclusions or compare their opinions with other authors. Overall, it is so important to understand your research article you are reading. Knowing where to get the information for you are looking for will make it that much easier to complete what you are looking for. Part D: Any other comments you thought of as you read and critiqued the article Answer: One thing I would very interesting while reading my article is that it included a section titled “what is already known about the topic?” This was right in the beginning under the abstract. It was interesting because it provided us with information to get us thinking about the topic of pressure ulcers however it gives us information that is already known worldwide, something that we are not necessarily asking yourself in this research question, but it is still very important to note. Something else I found interesting is that it included a section to mention where the funding for this study was obtained. I have not seen that in many articles before and it was nice to know who funded the research for this study. In this case it was the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC). Assignment: Factors that Influence Obesity Related Behaviors Responses References Brem, H., Maggi, J., Nierman, D., Rolnitzky, L., Bell, D., Rennert, R., Golinko, M., Yan, A., Lyder, C., & Vladeck, B. (2010). High cost of stage IV pressure ulcers. American journal of surgery , 200 (4), 473–477. Francis JJ, Johnston M, Robertson C, Glidewell L, Entwistle V, Eccles MP, Grimshaw JM (2010) What is an adequate sample size? Operationalizing data saturation for theory-based interview studies. Psychology and Health. 2010 Dec;25(10):1229-45. doi: 10.1080/08870440903194015. PMID: 20204937. Jamshed S. (2014). Qualitative research method-interviewing and observation. Journal of basic and clinical pharmacy, 5(4), 87–88. Lavallée, J. F., Gray, T. A., Dumville, J., & Cullum, N. (2018). Barriers and facilitators to preventing pressure ulcers in nursing home residents: A qualitative analysis informed by the Theoretical Domains Framework. International journal of nursing studies , 82 , 79–89. 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