The Effect of Group Discussion-Based Education on Self-Management of Adults With Type

Research critique
Jordan university of science and technology
Subject: research critique
Prepared by: Omar hashem Jebreel
ID: 143290
Supervised by: PhD. Mohammad aldalaykeh
Section: (6)
0

Critique
Critique: The effect of group discussion-based education on self-management of
adults with type 2 diabetes mellitus compared with usual care: a randomized
control trial
Title:
Title is good, includes key variables (DV, IV) and the study population
Abstract:
the abstract clearly and concisely summarizes the main features of the
report, including (methods, results, conclusions), but problem is not
identified clearly.
Introduction:
 Statement of the problem
• problem statement is clearly defined and easily to locate.
• the problem statement builds a cogent, persuasive argument (for the new
study, including that researcher got motivated by the increased number of
patients with diabetes and the lack of self-management program for them)
• the problem has significance for nursing that mentioned (motivated the
1 | P a g e

Critique
researcher to conduct an interventional study with an emphasis on the
nurses’ role), (Studies have shown that nurses play a key role in improving
the self management11 and QOL of patients.12 In addition, they are
frequently responsible for the major components of self-management
training programs12 including delivering individual and group training as
well as offering group counseling, providing essential information via the
internet and phone, and holding any follow-up sessions (e.g., such as home
meetings))
• there is a good match between the research problem and the
paradigm and methods used.
•The quantitative approach was appropriately used in this stud
 Hypotheses or research questions:
•research questions and hypotheses were implicitly stated.
2 | P a g e

Critique
their absence was not justified. But they were easy to create from purpose
statement
•research questions and hypotheses were not appropriately worded, but
Both key variables and the study population were mentioned too in purpose
statement
• the literature review was consistent to the research question and hypothesis
, the conceptual framework was not identified.
 Literature review
•the literature review up to date within the past 8 years and based mainly on
primary sources.
• the review provides a state-of-the-art synthesis of evidence on the problem
with resources stated all information that emphasized on the problem
• the literature review provides a sound basis for the new study based on a
gap found in previous researches which motivated the researcher to conduct
a new study
 Conceptual/ theoretical framework:
3 | P a g e

Critique
• key concepts were inadequately conceptually defined such as diabetes
type 2
• no conceptual or theoretical framework was mentioned in this study And
the reason of absence was not justified.
Method
 protection of human rights
•human rights were protected, appropriate procedures used to protect the
rights of study participants especially the confidentiality and respect of
person, the study was approved under the code IR.umsu.rec.1392.164 in the
ethics council of Urmia University of Medical Sciences
• the study was designed to minimize risks and maximize benefits to
participants, benefits were mentioned.
 Research design
• one of the most rigorous possible design was used (unblinded-randomized
control trial) that meets the study purpose. It would be better if the
researcher used the double-blinded method.
4 | P a g e

Critique
• appropriate comparisons made to enhance interpretability of the findings,
that included assessment done pre- and post-discussion groups application,
comparison done for both control and interventional group.
• the number of data collection points was appropriate, sample size
calculation was based on Shirazi et al, considering β = 0.20, α = 0.05, S1 =
1.83, S2 = 1.71, μ1 = 5.97, and μ2 = 7.12, in addition, possible dropout was
taken into consideration, sample size was slightly more than the
recommended size.
• the design minimizes biases by using random assignment into two group.
Allocation was random using an even and odd method and an allocation
ratio of 1:1. Random allocation was performed by a person uninvolved in
sampling and data collection.
• threats to the internal, construct, and external validity of the study
were mainly minimized but it would be better if the researcher used double
blinded method to minimize bias or result bias which occurred after
sampling and some participant withdrawer. In addition, history, maturation
5 | P a g e

Critique
and mortality were not minimized; age group 30-70, data collection done
among three months.
Attrition was minimized, no sample dropout occurred.
 population and sample
•the Population was clearly described
•the sample was described in sufficient detail.
• sampling design used in this study enhances the sample’s representativeness,
by using multisite, larger sample homogeneous participant whom is Iranian,
with types 2 dm and with age group from 30-70 whom are the most
vulnerable to get dm type 2
• sampling biases was minimized; it was performed by a person uninvolved
in sampling and data collection Also, it’s done randomly using an even and
odd method (probability sampling)
• the sample size was adequate, power analysis used to estimate sample size
needs it was (0.2)
6 | P a g e

Critique
 Data collection and measurement method
• the operational and conceptual definitions were congruent.
• the key variables were operationalized using the best methods which was
the group discussion and with adequate justification.
• the instruments that used was adequately described; it was a good choice;
It is specially developed to measure the self-management dm patients It
gives the study purpose, all variables was being studied, and the study
Population
• the report provides an evidence that the data collection methods yielded
data that were reliable and valid, especially In Iran, also mentioned the
method used to measure reliability and validity and all were accepted.
 Procedures
•there was an intervention included (group discussion session), it is
adequately described including settings, numbers of hours needed, how
7 | P a g e

Critique
many sessions were needed and content was based on the gap that appeared
after completed the initial assessment questionnaire.
• it was rigorously developed and implemented.
All participants allocated to the intervention group receive the intervention
without any dropout.
•the evidence of intervention fidelity was not totally mentioned
• data collected in a manner that minimized bias was not achieved data
collector was the researcher he also was the group leader
•data collectors were not mentioned, but the study was unblinded it is mainly
the researcher was the collector but still not mentioned.
Results
 Data analysis
• Analyses were undertaken to address all research questions also the
demographic data.
8 | P a g e

Critique
• appropriate statistical methods were used and mentioned with the level of
measurement of each variable, number of groups being compared, and
assumptions of the tests.
• powerful analytic method was used which help to control for confounding
variables)
Such as: (demographic data)
• Type I and Type II errors were minimized one the level of significance
mentioned and a larger sample was picked up, also type I error minimized
by using the significant values equal 0.05
• an intention-to-treat analysis was performed.
• no problems of missing values were mentioned.
 Findings
• information about statistical significance was presented
•information about effect size and precision of estimates (confidence
intervals) was presented
9 | P a g e

Critique
• the findings were adequately summarized, with good use of tables.
• findings are reported in a manner that facilitates a meta-analysis, and with
sufficient information needed for EBP was reported statistically in the
findings part and discussed later in the discussion part
Discussion
 Interpretation of the findings
• only the major findings interpreted and discussed within the context
of the findings of prior research.
• causal inferences were mentioned in the discussion part, that included
some
measurements were not assessed such as weight and hba1c as the result of
no consideration was taken about the duration of the study, only 3 months;
this study did not assess the long-term effect of this intervention.
• interpretations well-founded and consistent with the study’s limitations
were discussed.
10 | P a g e

Critique
• the report did not address the issue of the generalizability of the findings in
a specific way.
 Implications and recommendations
•the researchers discussed the implications of the study and
recommendations for clinical practice or further research were mentioned,
those implications were reasonable and complete.
Global Issues
 Presentation
• the report well-written, organized, and sufficiently detailed for critical
analysis.
• a CONSORT flow chart was provided to show the flow of participants in
the study, which make it easy the reader to discover how the trial was
conducted, reporting enrolment, allocation, follow-up and analysis of
patients involved in the RCT.
11 | P a g e

Critique
• the report was written in a manner that makes the findings
accessible to practicing nurses also emphasized on the role on nursing in the
manner of patient education.
 Researcher credibility
• of course, the researchers’ clinical, substantive, or methodologic
qualifications and experience enhance confidence in the findings and their
interpretation, it gives the reader the sense of trust of study result.
 Summary assessment
• Despite any limitations, the study findings appeared to be valid as many
studies showed, I have confidence in the truth value of the results.
• the study contributes meaningful evidence that can be used in nursing
practice or that is useful to the nursing discipline, in patient-family education
part, the group discussion method is really helpful as many studies showed,
and the result of this study confirmed this point of view.
12 | P a g e

Critique
References
Polit, D. F., & Beck, C. T. (2008). CHAPTER 5 Literature Reviews: Finding and
Critiquing Evidence. In Nursing research: Generating and assessing evidence for nursing
practice (pp. 112-114). Philadelphia, PA: Wolters Kluwer.
13 | P a g e