Critical Appraisal Essay: Evaluating AAA Research on Elderly Patients

This critical appraisal essay evaluates a qualitative research paper titled 'Animal-Assisted Activity: Experiences of Institutionalized Japanese Older Adults.' The essay examines the study's title, abstract, background, theoretical framework, methodology, ethical considerations, and data analysis. It assesses the appropriateness of the study design, sampling methods, and the use of qualitative research methods, including interviews and thematic analysis. The essay highlights the study's findings on the positive impact of animal-assisted activity on elderly participants and discusses the implications for clinical nursing practice. The appraisal also identifies limitations such as the small sample size and potential biases, while acknowledging the study's contributions to understanding the benefits of animal-assisted activity. The author provides references from various sources to support the critical evaluation of the research paper.

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Running head: CRITICAL APPRAISAL ESSAY
Critical Appraisal Essay
Name of student:
Name of university:
Author note:

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CRITICAL APPRAISAL ESSAY
Research is a significant part of nursing practice as it forms the basis for professional
development of nurses in the contemporary era. Through research, professionals are expected
to identify rich literary sources and analyse the implications of the study findings in their
profession. For practising evidence-based nursing, nurses must apply the scientific research
to the scenarios of individual patients as an element of their clinical decision making process.
Critical appraisal of a research article, either qualitative or quantitative, refers to the
systematic process of identifying the strengths and limitations of the article for assessing the
validity and usefulness of the study findings. The most significant elements of a critical
appraisal are the assessment of the appropriateness of the study design and accurate analysis
of the key methodological features of this design in alignment with the research question
(Stavor, Zedreck-Gonzalez and Hoffmann 2017). The present paper is a critical appraisal of a
qualitative research paper titled ‘Animal-Assisted Activity: Experiences of Institutionalized
Japanese Older Adults’ (Kawamura, Niiyama and Niiyama 2009). The appraisal of the article
would be done on the basis of a guideline provided that would analyse the key aspects of the
research rigorously.
According to Flick (2015) the title of an research article must clearly articulate the
research being done and include the fundamental methodology used, if possible. The abstract
of the article must elucidate the aim of the research and the prime results. In the present case,
the title of the article written by Kawamura, Niiyama and Niiyama (2009) clearly explains the
study conducted without being extensive. From the title one can make out that the research
topic was animal-assisted therapy and that experiences of the respondents were considered as
the data collection method. Further, though the title does not explain the result, it is able to
inform the readers about the research aim without being uninteresting. The aim of the study
was to determine the perceptions and experiences of a group of institutionalised elderly
Japanese women in relation to animal-assisted activity (AAA). Further, it aimed at

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highlighting how the perceptions of the respondents might be aligned with clinical nursing
practice in the AAA context. The abstract of the article is well written and represents the
study aim, study methodology, key findings in a comprehensive manner.
In the section explaining the background of the research, the researchers have
identified the importance of the research claim and the need for the research. Using
background literature is important to allow the readers understand the concepts behind the
research and the credibility of the claim (Fain 2017). The researchers stated that previous
research had established the positive impact of communication with animals on quality of life
of older adults. These effects mostly relate to increase in verbal interaction and social
behaviour and decrease in loneliness and agitation. These studies had put forward the
respective author’s own narrative evaluation and objective evaluation. There had been a
scarcity of studies evaluating the effectiveness of animal-assisted activity (AAA) as
perceived by older adults. The present research had the objective of studying the effect of
AAA on lives of older adults in Japan.
As opined by Houser (2016) theoretical framework in research is responsible for
introducing and describing the theory that explains the reason behind the existence of the
research problem. The same is the structure holding a theory of a research study. In the
present article, the researchers defined the concept of animal-assisted activity and the
differences with animal-assisted therapy (AAT). Due to overlapping in nature of the
intervention, references of AAT were also included. The section also put up a major
discussion about older adults and their mental health, and the relationship with animals.
The participants for the study were 8 elderly Japanese women aged between 67 and
94 years who resided in a private nursing home in northern Japan. The patients had suffered
dementia but were capable of giving consent for participation. Further one participant was

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diagnosed with depression. However, the study does not mention the sampling method used,
and it is also unclear about how the respondents were selected from the wider population.
This would have a significant impact on the study results as only a proper sampling can
ensure study reliability. Chances of sampling bias cannot be thus eliminated in this case (Fain
2015). Further, there remains a chance of gender bias in the study as all the participants were
women. Lastly, the small sample size conferred a certain disadvantage to the study, such as
increased variability, which means small sample size leads to less accurate results.
The researcher used qualitative method for the study that deems appropriate for the
research purpose as the study aimed at highlighting experiences, emotions and attitudes of the
participants in relation to AAA. Qualitative research gives a deep look into the essence of
social phenomena and gives readers the opportunity to understand the nature of relationships
(Flick 2015). The present research did not use statistics, and instead recorded the responses of
study participants around the topic.
In the article, the researchers did not disclose the name of the nursing home in which
data collection was done. In addition, the researchers did not mention the exact place where
the data was collected. This could have an influence on the study results since it could make
an impact on the influence on the emotions of the participants and their comfort level
(Parahoo 2014). There is, however, a section of the article that described the data collecting
method. The researcher has however not provided any comment on their rationale for using
the methods. Providing a rationale is beneficial to ensure validity in the research process and
results (LoBiondo-Wood and Haber 2017). The interview was done with the study
participants face-to-face. Undertaking a semi-structured interview, face-to-face with the
participants, allows the researcher to observe nonverbal cues of the participants (Fain 2017).
Open-ended questions were used for the assignment and as opined by Flick (2015) there are
multiple advantages of the same. The respondents can provide answers in details, and

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unanticipated findings are easier to be discovered. However, the most important disadvantage
of the method is that responses might be irrelevant under certain circumstances. The article
does not mention the number of interviewers taking part and the use of a moderator. The
method of data recording, however, has been mentioned by the researcher as an audio
recording.
Ethical considerations are to be fulfilled in case of primary research, and approval is
to be taken from the ethics committee prior to commencing on the study (LoBiondo-Wood
and Haber 2017). For ensuring the protection of rights of the participants, it was thought
advisable to get approval from the researcher’s university’s Human Subjects Review
Committee. Informed consent was taken from the participants which are the main ethical
principle in research. The study participants and their family members were informed about
the aim of the research and the research methodology by providing written information.
Confidentiality and anonymity of the participants were ensured. Further, the respondents
were explained that they could withdraw from the study anytime.
The data transcripts were analysed with the help of Colaizzi’s phenomenological
methodology. Phenomenology is a research method and a philosophical movement that
examines the phenomena under question as consciously experienced (Houser 2016). The
researchers mentioned the step wise manner in which the data was analysed. The analysis
technique was congruent with the research question since themes were identified that
explored the interactive relationship between the participants and the animals. There is also
evidence that the researchers interpretation captured the meaning of the participant. Six
themes related to the interactive relationship emerged, and these were Positive feelings about
the dogs; Confidence in oneself; Recalling fond memories about dogs; A break from the
daily routine; Interacting with other residents through dogs; Enhanced communication with

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volunteers. The researchers did not mention how the criteria for judging the scientific rigour
for the study was maintained.
The main findings of the study were clearly outlined by the researchers. From the
themes emerging from the study, it was evident that the participants developed a bond with
the dogs that acted in the AAA as the intervention. There was a positive influence on the
participants by AAA. There was also a change in the daily lives of the participants as
reported by the researchers. Volunteers from the outside made the residents feel better, and
opportunities were provided to enhance social interactions.
The researchers pointed out the relevance of the research to clinical practice. Nurses
can consider AAA as an activity that provides an environment for the participants to maintain
the social ability. Through AAA, nurses can meet the individualised needs of the patients
while delivering care. Nurses in nursing homes are to manage the wide range of health needs
and improve the patient’s outlook towards life. With the help of AAA, the close connection
between nurses and patients can also be enhanced. The researchers further point out the
limitations of the study as small sample size, study setting of only one nursing home, and
dementia of the patients. It has been mentioned in the article that there is a need for future
research aligned with the present research. A study is required that is more comprehensive
and is capable of gathering corroborating data. The researchers hoped that the study would
act as the first step for such future research that can throw light on the implementation of
AAA for institutionalised older adults (Kawamura, Niiyama and Niiyama 2009).
At no stage was the role of the researchers in the study and researcher bias mentioned
in the article. Researchers are thought to be biased when they do not have an objective
approach to research. Minimal bias from the researchers is expected in a study (Parahoo
2014).

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At the end of this paper, it can be stated that the article was critiqued since it had the
potential to provide rich information on the selected topic of animal-assisted activity.
Appraising the article allowed for scrutinising the reliability of the study findings. The study
under scrutiny has provided useful and meaningful results as it had proper study design. Thee
background to the research and the aim are impeccable. The results have also been articulated
in a clear manner, supported by a comprehensive discussion. The main downfall of the article
is that minimal justifications of the choices made have been included in the paper.Since the
researcher pointed out limitations in the study and the need for future research, nursing
professionals might not consider bringing change in their practice on the basis of this article
solely.

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References
Fain, J.A., 2017. Reading, understanding, and applying nursing research. FA Davis.
Flick, U., 2015. An introduction to qualitative research. Sage.
Houser, J., 2016. Nursing research: Reading, using and creating evidence. Jones & Bartlett
Learning.
Kawamura, N., Niiyama, M. and Niiyama, H., 2009. Animal-assisted activity: experiences of
institutionalized Japanese older adults. Journal of psychosocial nursing and mental health
services, 47(1), pp.41-47.
LoBiondo-Wood, G. and Haber, J., 2017. Nursing Research-E-Book: Methods and Critical
Appraisal for Evidence-Based Practice. Elsevier Health Sciences.
Parahoo, K., 2014. Nursing research: principles, process and issues. Palgrave Macmillan.
Stavor, D.C., Zedreck-Gonzalez, J. and Hoffmann, R.L., 2017. Improving the use of
evidence-based practice and research utilization through the identification of barriers to
implementation in a critical access hospital. Journal of Nursing Administration, 47(1), pp.56-
61.