Critical appraisal of Research Article

Critical appraisal of Research article

Paper 1- Qualitative research article- Making decisions for people with dementia who lack
capacity: qualitative study of family carers in UK.
The term critical appraisal refers to systematically analyzing a study which has been published in
a journal. For the purpose of systematically analyzing a study it is needed to analyze it with the
help of using a checklist of main questions. Thus it is with the help of the process of critical
appraisal wherein the research evidence of a research is systematically examined wherein the
underlying intension is to evaluate its results, validity and relevance prior utilizing the
information for the purpose of decision making.
1. What is the significance and relevance of the topic area?
The topic area associated with the research which focuses on the issue of decision making for
people with dementia is of great relevance to health science. It is due to the fact that dementia as
a health condition is a progressive condition having no particular medication for complete cure
or treatment of the condition. The complexity further increases due to the fact that in the
treatment of dementia of dementia there are various decisions which are needed to be taken that
includes ethical and practical issues (Livingston et al., 2010). Dementia being a progressive
condition, in the later stage of the condition takes away the decision making ability of the care
users, which makes it essential for the care providers to take decision on behalf of the care users.
It is due to the above discussed aspects and facts associated with the condition which if dealt
effectively in the particular research being backed scientifically, would result in making the topic
area associated with the research significant and relevant to health science.
2. Can the study be considered to be original?
The originality of the study depends on the fact if there is any new dimension associated with the
topic area of the research which has been highlighted on the part of the researcher. On the basis
of this criteria if the chosen file is analyzed it may be observed that the study added to the topic
area certain new aspect (Warner, 2013). The study dealt with the aspect of difficulties in decision
making on the part of the individuals lacking the capacity of decision making which is frequently
aggravated due to active resistance. The study further came up with the fact that the presence of
legal authority is not adequate. In this regards it is essential on the part of the families to devise
strategies for the purpose of overcoming barriers and gain agreement, which is a new dimension
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being highlighted by the study. In the process of decision making on the part of the carers they
are needed to be provided with certain support wherein the chosen study would turn out to be
effective. Considering these facts it may be stated that the study was original in nature.
3. Can the research hypothesis be considered to be clear?
The clear specification of research hypothesis in the chosen paper is questionable which is due
to the fact that it has not been specified in a clear and specific manner. However, the paper does
mentions about the fact in the unanswered questions and future research part, that on the part of
the researcher it was hypothesized prior collecting the data that they will be able to establish
ethno-cultural difference associated with help seeking (Khan, 2011). However, in reality it was
observed that such difference were minimal.
4. What was the study design?
The design of the study was that of qualitative study with the underlying intension of specifying
decision areas with the help of focus groups and issue of decision making in individual
interviews (Neuman, 2013).
5. Can the research design be considered to be an appropriate way of evaluating the research
hypothesis?
The research design can be considered to be the appropriate way of evaluating the considered
research hypothesis. It is due to the fact that the sample was large enough and had the variety
needed to be present within the chosen sample for the purpose of determining the different issues
associated with decision making in case dementia patients lacking the needed capacity (Lewis,
2015). It is due to the fact that the sample was effective in providing the opinion of care users,
carers as well as family members. In addition to that the aspects associated with non-dementia
health decisions were also taken into consideration which acted as a contributing factor in
making effective comparison and come up with desired outcome associated with the research
(Livingston et al., 2010). It is the present of diversity or variety within the sample group which
was large enough to provide the researcher with an idea and establish the interlink between
dementia patients who are not having the ability of decision making and issues of decision
making in case of these patients.
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6. Can the recruitment strategy be considered to be appropriate in regards to the aims of the
research?
In regards to the recruitment strategy, on the part of the researcher it may be observed that clear
specification associated with the specification of the participants i.e. the number of participants
and the setting which has been chosen has been clearly specified (Robinson, 2014).. In addition
to that, on the part of the researcher clear specification regarding the inclusion criteria can be
observed. In this regard on the part of the researcher it has been stated that on the part of the
researcher that carers who has participated in the decision making process for care users with
dementia has been included in the study. In addition to that, the researcher focused on inclusion
of individuals belonging from diverse socio-economic characteristics along with individuals who
are providing care services to individuals suffering from dementia and they are at different stages
of the condition (Livingston et al., 2010). This has helped the researcher to incorporate in the
study a varied range of experiences. Bereaved carers, newly referred and care users using care
services for considerable time can also be seen to have been included in the study. On the basis
of the above made discussion it may be stated that the recruitment strategy for the study has been
in alignment with the research aim. It is due to the fact that the underlying essence of the
research aim was to provide with maximization of variation associated with the experiences
related to difficult in decision making among dementia patients which can be seen to have
ascertained with the help of findings of the wide group. This puts forward the fact that the
recruitment strategy for the study has been effective in nature.
7. Can the ways of data collection be seen to be effective in addressing research issue?
In regards to justification of the method of data collection it is noticeable that the setting for data
collection was Community settings in London. This has been helpful for the researcher in
gathering wide range of experiences in regards to issues related to decision making among care
users with dementia (Livingston et al., 2010). In addition to that it may be observed that the
researcher has clearly specified regarding the focus group which consisted of five sections-
spouses, individuals living in the care home, individuals with young onset dementia along with
those individuals seen in primary care setting. There are also specification regarding the ways in
which the interview was conducted which was performed with the help of semi-structured
schedules which included a wide range of choices including facilitators, choices, barriers in
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regards to the decision making process. In regards to recording the data the discussion and
interview was digitally recorded which was transcribed it vertibatim wherein the identity was
removed. Thus on the basis of the above discussed aspects it may be stated that data collection
method was effective in this research as it was impactful in collecting a wide range of aspects
associated with barriers in decision making among dementia care users.
8. Has the researcher taken into consideration relationship between researcher and participants?
No such focus on the part of the researcher on relationship between participants and researcher
may be observed which can be effectively established with the help of the fact that the issue of
bias has not been focused upon on the part of the researcher.
9. Has the study taken into consideration ethical issues?
On the part of the researcher it can be observed that ethical approval has been taken into
consideration wherein relevant research ethics can be seen to approve the study (Livingston et
al., 2010). It can be clearly noticed with the help of the fact that signed informed consent has
been given by the participating family carers. In this process the data was shared and no
additional data was available which further reinforces the fact.
10. If the conclusion of the study is supported by relevant data?
The concluding note associated with this research lacks any particular backup or support
provided by relevant data. It is in the portion of the research- unanswered questions and future
research wherein the concluding note of the research has been presented. It is in this portion of
the study in which the researcher has mentioned regarding the fact that there is lack of alignment
between the hypothesis and the research findings (Livingston et al., 2010). In this part of the
study it has been stated on the part of the researcher that the researcher has succeeded in
establishing an alignment between family conflicts and its impact on issues associated with
decision making. However, on the part of the researcher no specification or backup with data
was given to the mentioned statement.
11. Was the data analysis sufficiently robust?
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The data analysis process used in the study has been clearly specified on the part of the
researcher wherein it has been stated that qualitative research software programme- Atlas. Ti 5.2
has been used on the part of the researcher for the purpose of management, coding and analysis
of data (Livingston et al., 2010). The researcher has also specified regarding the fact that
thematic content analysis has been used on the part of the researcher. On the basis of this fact it
may be stated that the data analysis was sufficiently robust.
Paper 2- Quantitative research article- The decide study: dementia carers making
informed decisions feasibility rct.
1. What is the significance and relevance of the topic area?
Dementia as a health condition being progressive in nature, in its later stage takes away the
ability of decision making on the part of the care users. In this alignment of discussion, like any
healthcare services in case of dementia patients it also becomes essential to practice informed
decisions in the process of providing the care users with care services (Prince et al., 2013).
However, due to the condition being progressive in nature participating in informed decisions
becomes a complex task. Considering the above discussed aspects, the topic area of the research
is significant and relevant in nature it is due to the fact that it deals with the issue of dementia
carers making informed decisions making it significant for health sciences.
2. Can the study be considered to be original?
The originality of a study is largely dependent on the fact if the study provides with new area or
dimension associated with the research topic. Basing on the above made discussion if the chosen
paper is analyzed it may be observed that the aspect of DECIDE manual has been implemented
in the study for the purpose of minimizing the decisional conflict on the part of family carers
associated with decision making process for dementia patient’s residential place in the future
(Lord, 2016). This was a new aspect of research associated with topic area of dementia and
decision making as compared to the earlier researches conducted in this arena. This establishes
the fact that the study is original in nature.
3. Can the research hypothesis be considered to be clear?
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The hypothesis of the chosen study may be considered to be clear, specific and precise in nature
as it clearly specifies regarding its hypothesis which was to primarily evaluate the hypothesis that
the family carers who were receiving DECIDE manual intervention will find it useful and
relevant. This clearly established the clarity of the research hypothesis (Lord, 2016).
4. What was the study design?
The study design which has been used in the study focuses on mixed method approach wherein
exploratory design has been used on the part of the researcher (Lord, 2016). In this context
feasibility trial has been implemented.
5. Can the research design be considered to be an appropriate way of evaluating the research
hypothesis?
Exploratory research design is usually implemented and apt in cases of research wherein the
topic area has not been explored or lacks in depth study. The main intension in these studies is to
establish priorities (Creswell & Creswell, 2017).. Considering the above made discussion if the
present chosen paper is analyzed it may be observed that the aspect of implementation of
DECISION manual in regards to decision making process for dementia patients has been dealt
with in this paper which is a new area of research in regards to decision making for dementia
patients. On the basis of this fact it may be stated that the research design in the particular study
is appropriate for the purpose of evaluating the hypothesis.
6. Can the recruitment strategy be considered to be appropriate in regards to the aims of the
research?
On the part of the researcher clear specification regarding the recruitment process has been
specified. The researcher clearly mentioned about the process and the way in which the
recruitment process was conducted (Mapstone et al., 2007).. In this regards on the part of the
researcher it has been stated that the recruitment occurred within the period of February- July of
2014. The researcher had recruited family carers along with individuals with dementia or clinical
diagnosis of Mild Cognitive Impairment. The paper also specifies regarding the inclusion and
exclusion criteria.. In this regards the family carers who were mainly informal carer and
possessed the sufficient skills for English language were included and carers under the age of 18,
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in case of carers with clinical concerns and lack of ability of providing with informed consent
went were excluded. Thus the above discussed aspects clearly reflect the appropriateness of the
recruitment strategy for analyzing the aims of the research.
7. Can the ways of data collection be seen to be effective in addressing research issue?
In regards to the affectivity of the data collection in the process of addressing the research issue
it may be observed that the researcher aimed at recruiting 40 carers, 20 into each arms from
Islington, Camden and Haringey memory clinical setting. Other than that clear specification
regarding the associated focus groups and the ways of data collection has been specified. In this
context piloting, follow-up telephonic interview and face-to-face follow-up interview and semi
structure interview has been used (Lord, 2016). In regards to recording the interview, all the
information were digitally audio recorded and transcribed verbatim. It helped in ensuring that the
recorded information is true. In regards to data saturation, on the part of the researcher it has
been stated that on judging data saturation, recruitment was ceased. On the basis of the above
specified facts it may be stated data collection was effective in addressing research issue.
8. Has the researcher taken into consideration relationship between researcher and participants?
On the part of the researcher clear focus on the relationship between participants and researcher
may be observed which can be noticed from the fact that issues associated with selection bias,
observer bias, instrument bias, attribution bias, statistical bias have been focused upon on the
part of the researcher (Lord, 2016).
9. Has the study taken into consideration ethical issues?
On the part of the researcher it may be observed that ethical approval had been obtained from
National Research Ethics Service Committee London, Bloomsbury. From Enfield and Haringey
Mental Health Trust, Camden and Islington NHS Foundation trust and Barnet the researcher has
obtained NHS Research and Development approvals (Lord, 2016). This clearly establishes the
fact that ethical issues have been taken into consideration on the part of the researcher.
10. If the conclusion of the study is supported by relevant data?
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In the present study it may be observed that the researcher has not supported the conclusion with
relevant data. In the conclusion, on the part of the researcher it has only been specified regarding
the outcome of the study wherein, on the part of the researcher it has been stated that with the
help of implementation of DECISION model the carers were benefited in the deicion making
process.
11. Was the data analysis sufficiently robust?
On the part of the researcher clear specification regarding data analysis has been stated. In this
context it may be observed that analysis plan was based on Braun and Clarke’s thematic
analysis: familiarization with coding, data, reviewing, searching for and naming themes and
writing up (Lord, 2016). Basing on the above discussed fact it may be stated that the data
analysis of the study was robust.
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References
Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed
methods approaches. Sage publications.
Khan, J. A. (2011). Research methodology. APH Publishing Corporation.
Lewis, S. (2015). Qualitative inquiry and research design: Choosing among five approaches.
Health promotion practice, 16(4), 473-475.
Livingston, G., Leavey, G., Manela, M., Livingston, D., Rait, G., & Sampson, E. et al. (2010).
Making decisions for people with dementia who lack capacity: qualitative study of family
carers in UK. BMJ, 341(aug18 1), c4184-c4184. doi: 10.1136/bmj.c4184
Lord, K. (2016). The decide study: dementia carers making informed decisions feasibility rct.
Alzheimer's & Dementia, 12(7), P301. doi: 10.1016/j.jalz.2016.06.544
Mapstone, J., Elbourne, D., & Roberts, I. (2007). Strategies to improve recruitment to research
studies. Cochrane database of systematic reviews (Online), (2), MR000013.
Neuman, W. L. (2013). Social research methods: Qualitative and quantitative approaches.
Pearson education.
Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W., & Ferri, C. P. (2013). The global
prevalence of dementia: a systematic review and metaanalysis. Alzheimer's & dementia:
the journal of the Alzheimer's Association, 9(1), 63-75.
Robinson, O. C. (2014). Sampling in interview-based qualitative research: A theoretical and
practical guide. Qualitative Research in Psychology, 11(1), 25-41.
Warner, M. (2013). Originality: challenges in Chinese HRM research. Journal of Chinese
Human Resource Management, 4(2), 117-120.
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Appendix
Paper 1- Qualitative research article- Making decisions for people with dementia who lack
capacity: qualitative study of family carers in UK.
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Paper 2- Quantitative research article- The decide study: dementia carers making
informed decisions feasibility rct.
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