A Quantitative Study in Primary Health Care, Article Critique Example

Quantitative Article Critique

In strong attempt to educate the Nursing community on the importance of preparedness, identification and taking authoritative action against Intimate Partner Violence (IPV), the authors of this article pilot tested and later completed a full study within a specific geographic region. Unfortunately, the method by which the research was conducted lacks global or national authority and consensus across the entire Nursing community. The strengths of this article could have been the background research and commentary on prior studies conducted within the realm of IPV and other abusive behaviors within a medical facility.  However, even the background knowledge lacks statistical support to suggest research of this type is warranted. The authors more or less utilize their limited study as a basis to call for overall communal actions; whereas, the research simply proves that additional studies should be performed to truly ascertain the effectiveness and knowledge of nurses when experiencing cases of possible or definite abuse and IPV.

Background

While the authors of this study provide a very large supply of references and sources to support the importance of this topic, there are no statistical results provided to indicate that there is a true decline or inability to identify and address IPV cases within the Nursing community.  The authors definitely succeed in convincing the audience that IPV is an important issue and that there are no socioeconomic factors that prevent or promote its prevalence (Sundborg et al., 2012).  The background successfully illustrates the widespread existence of IPV and abusive behaviors towards women; however, it does not provide background research or statistics to support the supposition that the Nursing community is neither prepared nor able to take effective actions in cases where IPV is or may be a causal factor for physical or emotional harm.  The authors seek to prove this thesis, but reference previously cited research as if similar research had already been conducted to support the claims.

Methods

The research utilizes a simple questionnaire method to acquire and collect data from a small sector of Nursing practitioners within a specific geographic area.  Through collaboration with outside experts, the authors of this study were able to utilize their own field expertise with outside support to create a questionnaire featuring 29 data-driven questions.  As previously mentioned, one of the key drawbacks to the final research is that it is geographically limited.  The researchers neither comment nor recognize this limitation within the study and only go so far as to mention that the study is based in Stockholm County.

Random selection within the geography did exist in the method by which PHCCs were chosen.  A method of random card drawing was conducted to restrict the 174 centers down to a reasonable group of 40.  While random selection could have been conducted for individual respondents, the researchers chose to utilize it for entire centers and groups of Nursing practitioners.  This was an interesting alternative yet still achieves the randomization that a study of this caliber requires.  The details of the methods and the population included in the study are very descriptive.  The authors successfully outline the methods by which the study was created and released to the population so as to ensure duplication may be achieved.  While the geography and total population surveyed each has its inherent limitations, the research can certainly be quantified and analyzed to draw conclusions upon the data.

Results

Questionnaires were distributed to 277 nurses working within Stockholm County at the 39 PHCC within the region.  There was a positive response rate of 69.3%.  Those that did not complete the survey primary positively opted out of responding by returning a blank form and many provided a reason for not participating, while a small portion of those surveyed did not respond at all.  Likewise, the demographic population is exactly what the researchers were aiming for in conjunction with commentary outlined within the Background section.  All but one of the respondents were female; the average age was 49 and the average length of service within the field was 21 years (Sundborg et al., 2012).

The research results provide an overwhelming support of the suppositions made within the Background section, supporting the necessity of conducting such a study.  Only 15% of nurses had discussions about how to intervene in cases where women were exposed to IPV; 10% has used existing guidelines and 25% had information packets at their disposal (Sundborg et al., 2012).  Similar results existed that showcased a lack of resources, lack of education, and lack of intervention efforts being conducted within the PHCC.  However, a glaring component of the study that brings its relevance to question is that 90% of nurses indicated they either have never experienced IPV cases or the frequency of cases is less than once per month.  Unfortunately, the breakdown does not draw greater time differences between the frequency of cases, but this data leads to question whether IPV is in fact a growing issue and as highly prevalent as the authors suggested in the Background.

Discussion

The authors successfully connect the results of their study to the information communicated within the Background. Where possible, the attempt was made to combine study results with overarching industry practices and necessities to suggest that each continues to support ongoing training and resources to promote IPV intervention strategies and practices.  The study clearly illustrates the importance of guidelines to assist nurse practitioners with an outline of actions that should be taken when IPV has been identified.  However, as background and current study results indicate, 95% nurses either are not aware of or positively affirm that guidelines are limited or completely non-existent within the PHCC (Sundborg et al., 2012).  A lack of guidelines is a serious concern regardless of the prevalence.  When an IPV case has been identified nursing practitioners need to have the knowledge and tools readily available to effective take action and support the female patients in a time of need.

A second key finding was that attitudes within the PHCC and the Nursing community in general inhibit the acceptance that IPV exists and the comfort level that practitioners have with handling these cases.  Many responses suggest that nurses would be more confortable with a specialist to rely on when IPV has been identified.  Part of the issue is that nurses feel uncomfortable when forced to inquire if abuse or IPV is prevalent within a home or personal relationship.  In essence, nurses would rather treat the symptoms than to treat the patients’ personal causal factors that exist outside of the health community.  Unfortunately, the discussion by the researchers only continues to emphasize the need for guidelines and education for nurses.  This suggests that education and institutional resources can address the attitudes limiting effective identification and handling of IPV cases.  The authors do not acknowledge that there is a personal component to attitude and simply being knowledgeable and informed may not be enough to help nurses overcome their inhibitions.  Guidelines and institutional resources are certainly a strong step in overall preparedness, but this key finding requires additional psychosocial research to change how nurses think and react to uncomfortable situations that are very personal in nature for the patient.

Lastly, the authors contain a very limited suggestion of study limitations.  They do not reference geographic limitations. However, their key focus is on those individuals that declined to respond to the questionnaire and emphasize that many had no reason for not responding. In essence, the study limitations the authors did identify were not limitations of the study and more a restatement of that the number of respondents was sufficient to meet the goals and ethical considerations stated in the study.

Conclusion

The conclusions outlined within this section are definitely in line with the results of the study.  The results clearly suggest that changes need to be implemented at both the organizational and individual level to provide an overall higher quality of care for patients that are victims of IPV.  The culmination of background research and current study results both support this statement.

Throughout the entire body of work, the researchers did not provide outside statistical support for their comments nor did they acknowledge true study limitations.  The geographic limitations of the study only suggest issues exist in Stockholm County, Sweden and the results of this study cannot be used to suggest an overarching issue within the Nursing community nor in PHCC’s outside of this geographic area.  The authors do not comment on this limitation nor state the reason for the limitation whether it is time, money or other research constraints.  This research does support the overall thesis and argues for ongoing analysis of organizational and individual programs to better address the poor quality of care within IPV cases.  While the study supports the thesis, the authors do not provide any recommendations or actions that either organizations or individuals can taken within the medical community to better identify, treat and address IPV.  Ongoing research should be completed and consensus must be drawn as to the total impact of IPV and preparedness across the Nursing community as a whole.

References

Sundborg, E. M., Saleh-Stattin, N., Wändell, P., & Törnkvist, L. (2012). Nurses’ preparedness to care for women exposed to Intimate Partner Violence: a quantitative study in primary health care. BMC nursing, 11(1), 1.