Patients’ experience of identifying and managing exacerbations in COPD: a qualitative study

This study focuses on the management of exacerbations in patients with chronic obstructive pulmonary disease (COPD). The study used the grounded theory approach to analyse the respondents and collect data for the study. The collected data fitted the aim of the study since it was gathered in the natural settings of the environment.

Running head: ARTICLE ANLYSIS
Williams, V., Hardinge, M., Ryan, S., & Farmer, A. (2014). Patients’ experience of
identifying and managing exacerbations in COPD: a qualitative study. Primary Care
Respiratory Society, 1-6.
Student’s Name
University

ARTICLE ANLYSIS
1. Background of the study
a. What is the health issue that provides the focus of this study?
Management of exacerbations in patients with chronic obstructive pulmonary disease
b. Generally, what have been the results of previous studies of this issue?
Williams, Hardinge, Ryan, & Farmer (2014) suggests that there have been limited iterature
on management of exacerbation sinc s most studies that have been preseented have been
inconclusive in the study of the topic.
c. What is the significance of this study?
Since most studies that have focussed on management of exacerbations by chronic
obstructive pulmonary disease patients have been ineffective and their findings can be used in
suggesting pathways for managing the disease, then this study is significant in understanding
ways that can be used to manage exacerbations and reduce hospital admissions. By
determining the level of knowledge of patients and individual interventions that they take to
mitigate the situation. The study offers a better future for managing exacerbations and
reducing hospital admission.
2. Overview of research design
a. What was the aim of the research?
To understand ways that patients with chronic obstructive pulmonary disease use to manage
exacerbations.
b. What research design was used?
The study used the grounded theory approach to analyse the respondents and collect data for
the study.
c. Describe the main characteristics of the research design identified.
The major characteristic of grounded theory is the study of participants in their natural
environment to gather the data as it exists on the ground. By focusing on the respondents in

ARTICLE ANLYSIS
their natural settings, the research is able to understand the issues that revolve around the
research problem more (Potrata, 2010). Another characteristics is the ability of the method to
lead to enriched data that reflects the settings in which the events take place unlike in the case
of controlled experiments.
d. How did the research design chosen meet the aim(s) of the study?
The ability of the researcher succeed in any study is the use of an appropriate research design
that meets the needs of the topic (El-Hussein, Hirst, Salyers, & Osuji, 2014). The grounded
theory approach allows the researcher to explore the natural environment of respondents to
gather authentic data that can be applied within the field of study (Gullick & West, 2012).
Since the method does not allow modification of the setting through use of experimental
controls, it treats all the subjects to the same condition of study thus increasing uniformity
and reliability of data. Since patient interaction with the environment is not interfered, it leads
to more reliable information for the study.
3. Sampling
a. What were the characteristics of the participants in this study?
The participants of the study were patients with chronic obstructive pulmonary disease across
the demographics of age, gender, education, income and status. The participants were patient
who initially been admitted to Oxford hospital or had the experience of managing
exacerbations on their own.
b. What were the inclusion and exclusion criteria of the sample?
The criteria for inclusion into the study sample was any patient who had once suffered
chronic obstructive pulmonary disease exacerbations either by being admitted to the hospital
or managing it at home. The sample did not limit the demographic characteristics of those
who qualified.
c. Why is it important to identify these criteria before recruitment starts?

ARTICLE ANLYSIS
The importance of inclusion exclusion criteria is to ensure that the researcher gets the right
segment of the population that needs to be studied (Weathington, Cunningham, & Pittenger,
2015). Since this is not a generalised study, the researcher needs a criteria for sorting out
patient from a list of all possible participants.
d. What sampling technique was used in this study?
The researchers used purposive sampling to narrow down the sample to only patients with
chronic obstructive pulmonary disease to be used in the study. This makes it easy to gather
uniform information and at the same time omitting irrelevant samples from the study.
e. How was this sample appropriate for meeting the research aim?
Purposive sampling is appropriate for grounded studies because it allows the researcher to
work with the respondents that meet the requirements of the study (Donald & White, 2014).
This allows the researcher easier work when analysing the results since they do not have to be
sorted for irrelevance and ambiguity.
4. Data collection
a. How were the data collected?
The data was collected using interview schedules which were recorded and transcribed for
easy entering into the analysis software.
b. What, specifically, did the researchers do?
To access patient records, the researcher started by seeking permission from ethics committee
that allows access of patient records. Then the researcher sought permission from the hospital
administration to get hold of all patient records with information on chronic obstructive
pulmonary disease exacerbations (Williams, Hardinge, Ryan, & Farmer, 2014). The
researcher then reached to the selected patients to seek their consent through requesting them
to sign a consent form for those willing to take part in the study. The researcher then did the

ARTICLE ANLYSIS
interviews with each of the selected patients in their homes to determine the ways that they
use to manage exacerbations.
c. How did data collection fit the aims of this study?
The collected data fitted the aim of the study since it was gathered in the natural settings of
the environment. This makes the data more reliable from the fact that the researcher recorded
the audio interviews for authenticity before they were transcribed rather than using the
research notes of the researcher.
d. What might have been some advantages and disadvantages of this method of
data collection?
Interviews have been regarded as the best approaches for grounded theory since they allow
the researcher to explore issues related to the research topic in detail. The questions of the
research interview are organised in themes that the researcher uses to ask questions. Every
theme questions must be excluded or reach saturation before the researcher moves to the next
level (Ranney, Garro, Sasson, & Morrow, 2016). Further, the researcher enjoys the freedom
of exploring the issues from any angle and asking further questions based on the analysis of
the environment and the response given by the patient. This increases the validity of the data
for the research since the researcher can seek clarity from the respondent (Creswell, 2012).
The disadvantage with this data collection method is it can be costly since it requires
interviewing respondents one by one. The research can thus take longer than expected before
reaching out to all the respondents.
e. From your understanding of the weekly readings, what if any, are some
alternative methods of data collection that these researchers could have
chosen?
Ethnographic studies and observation can also be used to collect data for the topic. However,
the methods may require more time in the field as compared to patients.

ARTICLE ANLYSIS
5. Data analysis/results
a. How was the data analysed?
The data was transcribed and keyed into the NVIVO 10 software for analysis.
b. Why is it important to select applicable methods of data analysis in
qualitative research?
The climax of any research study is presentation of analysis and presentation of findings to
the reader. An applicable analysis method makes it easier for the researcher to establish
correlation and links between different variables of the study to answer the hypothetical
question of the study. This means that the analysis method has to meet the nature of the study
if qualitative or quantitative and make it easy for the researcher to present results (El-
Hussein, Hirst, Salyers, & Osuji, 2014). An applicable method of analysis also leads to
justifiable results that are easy for the reader to understand from a layman’s language. The
findings of any research are random results that have no meaning until they are analysed and
presented in a scientific format.
c. What did the researchers say about the rigour of their analysis?
The researcher did not present any rigour of analysis since there are no reported limitations.
d. What were the study findings?
The study found that the respondents had different terms that they used to call exacerbations.
Most patients did not understand the researcher until the term was further elaborated for
them. However, they had knowledge of the signs of chronic obstructive pulmonary disease
related exacerbations and could not by reading the signs and symptoms when the
exacerbation was about to strike. This led the patients to seek clinical interventions in
advance through taking of drugs or purchasing the same drugs over the counter (Williams,
Hardinge, Ryan, & Farmer, 2014). Further, the found that the ability of the patient to manage
the exacerbations increased as they went out of managing one exacerbation to another. This

ARTICLE ANLYSIS
means that hospital admissions can be reduced through teaching patients ways that can be
used to manage these exacerbations thus reducing serious complications that require hospital
admission.
e. Into which other settings can these findings be transferred
The findings of the study can be applied into clinical setting by developing strategies to build
patient capacity on management of exacerbations at home. Practitioners need to train
admitted patients ways of detecting the exacerbations so that they can manage them early
before they become sever.

ARTICLE ANLYSIS
References
Creswell, J. (2012). Research design: Qualitative, quantitative and mixed methods
approaches. Thousand Oaks:: Sage Publications.
Donald, H. M., & White, T. L. (2014). Research Methods . Cengage Learning.
El-Hussein, M., Hirst, S., Salyers, V., & Osuji, J. (2014). (2014). Using Grounded Theory as
a Method of Inquiry: Advantages and Disadvantages. The Qualitative Report, 19(27).
Gullick, J., & West, S. (2012). Uncovering the common ground in qualitative inquiry:
combining quality improvement and phenomenology in clinical nursing research.
International Journal of Health Care and Quality Assurance, 25(6), 532-548.
Potrata, B. (2010). Rethinking the ethical boundaries of a grounded theory approach.
Research Ethics Review, 6(4), 154-158.
Ranney, M. L., Garro, M. M., Sasson, C., & Morrow, K. (2016). Interview-Based Qualitative
Research in Emergency Care Part II: Data Collection, Analysis and Results
Reporting. , 22(9),. Academic Emergency Medicine, 22(9), 1103-1112.
Weathington, B., Cunningham, C., & Pittenger, D. (2015). Research Methods for the
Behavioral and Social Sciences. . :: . Hoboken: John Wiley & Sons.
Williams, V., Hardinge, M., Ryan, S., & Farmer, A. (2014). Patients’ experience of
identifying and managing exacerbations in COPD: a qualitative study. Primary Care
Respiratory Society, 1-6.