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Discussion

Discuss About The FoundationsEvidence Based Oxford University.

Stroke patients should be rehabilitated and it should be patient centred. Implementation of effective rehabilitation of stroke patients can be evaluated by exploring experience of caregivers. Experience of caregivers to stroke patients can be explored through studies aimed at exploring experiences of caregivers. Critical appraisal of the research article can be helpful in assessing validity and robustness of the research study. In this essay, experience of caregivers in the rehabilitation of stroke patients will be critically compared, analysed and assessed. This essay will critically appraise quality of the research article in terms of authors, purpose of the study, study design, study methodology and results. This essay will also assess rigour and validity of research.

Every author mentioned in this research study were with appropriate expertise and experience for conducting research study related to stroke rehabilitation. All these authors were affiliated to research organisation. This organisation was having all the facilities and resources for conducting research study. Every author contributed significantly in carrying out research; moreover, these authors were not having any conflict of interest. Authors conducted this research in 2015 and these findings are still relevant.

Clinical question was set from the clinical scenario. Efforts were made in the research article to answer research question set during the clinical scenario. Research question set during the clinical scenario was in alignment with the aim of the research study. Both clinical question from clinical scenario and aim of the research study mentioned about the exploration of the caregiver’s experience in the rehabilitation and activities of daily living of patients followed by stroke. There were few studies available for Perceptions of caregivers in rehabilitation. Hence, this study was planned for exploring perceptions of caregivers in rehabilitation of stroke patients.

Mixed research design should comprise of combined qualitative and quantitative research designs. Mixed research design need to be implemented when combined research design can produce more robust and valid result as compared to either qualitative or quantitative research design. Analysis of the data was also included in this study along with qualitative and quantitative research. Experiments and surveys comes under quantitative research design and focus groups and interviews comes under qualitative research. In this research study, different samples and different studies were compared in quantitative methods and insight or awareness of caregivers about stroke rehabilitation were assessed in qualitative methods (Richardson-Tench, Taylor, Kermode et al., 2015).

Conclusion

Quantitative research design comprised of comparison and it was achieved through descriptive research design. Descriptive study can be carried out by observational study and in this study, variables are being not controlled. Descriptive research design can be carried out through both longitudinal and cross-sectional design (Hoffmann, Bennett, and Del Mar, 2017). In the present study, same study samples were being interviewed over the period of time. It indicates, longitudinal study was being used in this study. Longitudinal study was more suitable study design for this study because perceptions of same caregivers need to be analysed over the time. Hence, variation in the perception of same caregiver was being analysed over the period of time. It reflects, in comparison to the cross-sectional study design, longitudinal study design was more suitable for this research study  (Schneider, Whitehead, LoBiondo-Wood et al., 2016).

Mixed method of research are more efficient methods of research because strengths and weaknesses of qualitative and quantitative research can be effectively balanced. Outcome of research can be demonstrated more effectively and in elaborative manner in mixed method of research (Punch, 2013). Mixed method of research can also be helpful in establishing relationship among varied outcomes of the research. Mixed method of research requires more time and plan; hence, these methods are more complex as compared to either of the methods. This study comprised of qualitative study in the initial phase and quantitative study in the later phase. It reflects, sequential exploratory method was used in this study (Greenhalgh, Wherton, Papoutsi et al.,  2017).  

In this article, secondary analysis of data obtained from prospective observational study was done. Random sampling was used in this research study, in which each participant can have equal opportunity for participation in the study. Samples selected in this study were based on the preselected criteria; hence, this sampling method was purposive sampling method. These samples were suitable to meet the aim of the study. Inclusion and exclusion criteria should be mentioned in the research study because these can be helpful in explaining sample universe, describing sample characteristics, reducing sample variability and optimising decision making in sampling. However, in this study inclusion criteria were mentioned and exclusion criteria were not mentioned (Bernard, 2012).

Research assistant was trained prior to data collection. These research assistants were trained in field of the study like occupational therapist or a physiotherapist. Collected data can be considered as the valid and robust data because this data was collected by trained personals. Interview process was implemented in the data collection process (Creswell, 2013).

Interview process was implemented for collecting baseline data and for collecting data from the caregivers. Both structured and semi structured interviews were implemented in this study. In structured interviews questionnaires and in semi structured interviews open ended questions were being used. Qualitative research can be effectively carried out through both structured and semi structured interviews. Structured interviews and semi structured interviews comprised of closed ended and open-ended questions respectively. In closed ended questions fixed data can be obtained and in open ended questions obtained data can vary based on participants (Liamputtong, 2016). Interview based data collection is effective method in qualitative research because accurate data can be collected; moreover, emotions and behaviour of the participants can be recognized. However, interview-based data collection is associated with drawbacks like high cost and time-constraint because research assistant should visit for each participant’s home for data collection (Punch, 2013).

ANOVA was used for the statistical analysis and it was the most appropriate method for data analysis because in this study difference among and between groups need to be assessed. Different research questions can be effectively addressed through ANOVA (Creswell, 2013).

Both tabular format and descriptive format was used for presenting results of this study. It helped in better understanding of the results. It was difficult to generalize these results because these results were obtained from the participants of one hospital. Validity and rigour of the outcome of the study can be improved by coding of data of every participant. Biasness of the outcome was reduced effectively by performing coding by three independent authors. Transparency of the outcome was effectively improved by coding of the data and by eliminating biasness (Melnyk and Fineout-Overholt, 2015). Presented data was considered as clear and concise data because data for different category participants were presented differently. Both numerical and statistical format was used for the presentation of the data. Results were presented and described by using proper headings and subheadings. It helped in effective interpretation and analysis of obtained data. In this research article, strategies to improve rigour of the study was mentioned. It helped in improving trustworthiness of the results (Bernard, 2012; Polit and Beck, 2017). Presented results were in accordance with the aim of the study and were in alignment with the study design.

Conclusion:

Outcome of this study indicates complete picture of perception of caregivers in rehabilitation of stroke patients can be obtained by implementing mixed method research approach. Perceptions and experiences of the caregivers were compared on group basis and not on the individual basis. Hence, data collected from the caregivers related to their experiences was generalised data and not the specific data. Outcome of this study was mainly based on the self-reporting; hence this outcome was prone to biasness. Outcome of these research was not compared to the outside studies; hence, it is difficult to consider this study as the evidence-based study. Practical and theoretical importance of the research can be effectively established through critical appraisal of the research article. Critical appraisal of the research can be helpful in validating evidence of the research. Further amendments in the research can be implemented by understanding strengths and weakness of the research. Critical appraisal can be helpful in identifying strengths and weakness of the research. 

References:

Bernard, H. R. (2012). Social research methods: Qualitative and quantitative approaches. Sage.

Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.

Greenhalgh, T., Wherton, J., Papoutsi, C., et al. (2017). Beyond Adoption: A New Framework for Theorizing and Evaluating Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies.  Journal of Medical Internet Research, 19(11), e367. doi: 10.2196/jmir.8775.

Hoffmann, T., Bennett, S., and Del Mar, C. (2017). Evidence-Based Practice Across the Health Professions. Elsevier Health Sciences.

Liamputtong, P. (2016). Research Methods in Health: Foundations for Evidence-Based.  Oxford University Press.

Melnyk, B. M., and Fineout-Overholt, E. (2015). Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice. Lippincott Williams & Wilkins.

Polit, D. F., and Beck, C. T. (2017). Nursing Research: Generating and Assessing Evidence for Nursing Practice. Lippincott Williams & Wilkins.

Punch, K. F. (2013). Introduction to social research: Quantitative and qualitative approaches. Sage.

Richardson-Tench, M., Taylor, B. J., Kermode, S., and Roberts, K. L. (2015). Inquiry in Health Care. Cengage Learning.

Schneider, Z., Whitehead, D., LoBiondo-Wood, G., et al.  (2016). Nursing and Midwifery Research: Methods and Critical Appraisal for Evidence Based Practice. Elsevier Health Sciences.

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