Analysis of a Qualitative Study on Crystal Methamphetamine in Nursing

This report provides a critical analysis of a qualitative study by Cleary et al. (2017) which explores the experiences of healthcare professionals caring for patients presenting to the emergency department after using crystal methamphetamine (ICE). The analysis covers the study's topic, research questions, and its relevance to nursing practice, particularly within the Australian healthcare context where ICE-related emergency admissions are increasing. It examines the study's methodology, including the sampling technique, study settings, and data collection methods like semi-structured interviews. The report critiques the methodology, discussing its strengths and limitations, and considers alternative approaches. The results section summarizes the key findings, such as the importance of resources and collaborative working, and the need for thoughtful strategies for comprehensive care. The report also highlights the study's conclusions and implications for future nursing practice, emphasizing the importance of considering the social and emotional aspects of patients' lives and adopting a collaborative approach to patient management. The student concludes with a reflection on how the study's findings will inform their future practice, particularly in handling patients with ICE intoxication.

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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Introduction of the paper
The following oration attempts to provide critical analysis of a qualitative study
conducted by Cleary, Jackson, Woods, Kornhaber, Sayers and Usher (2017). The parameters
over which the critical analysis will be done include topic selection, sampling technique,
methodology used and the implications of the final results.
Topic
The topic of the selected paper is Experiences of Health Professionals Caring for
People Presenting to the Emergency Department After Taking Crystal Methamphetamine
Research Questions
The main research question that is addressed in the paper: "what are the experience of
the healthcare professionals who are caring for the people in the emergency department after
taking crystal methamphetamine (ICE)”. In Australia, the use of ICN related emergency
department admissions are higher, and the rate is 7.6% and is associated with psychiatric
symptom like acute psychosis, anxiety disorder and depression. Thus people intoxicated with
ICN are more likely to be aggressive, having violent outburst and in extreme cases, might
have schizophrenia. Thus ICN user represents damage both to themselves and care givers.
Thus the experience of handling patients with ICU intoxication will be different from that
handling a patient admitted with stomach and chest pain or other injury. This research papers
aims to identify the difference in the experience of the healthcare professionals in managing
or handling such patients in the emergency department (ED).
Rational of research in nursing practice
Several research undertaken over the mental health nursing have highlighted that a
different approach or effective communication skills (verbal and non-verbal communication

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skills) must be undertaken in order to establish the therapeutic relationships with the patients
suffering from psychosis, bipolar disorder or depression. The patients who are suffering from
ICN are found to be aggressive as stated earlier. Thus a different approach of handling such
patients must be undertaken. However, there are so specific, person centred approach is
reported in order to handle the patient with ICN intoxication. Establishment of evidence-
based practice for handling ICN users must be based on the experience of the healthcare
professionals who have handled ICN users. The establishment of the evidence-based practice
for ICN user handling will help to improve the overall quality of care of the ICN and will also
make to easier for the emergency care nurses to handle those patients. This is important under
the Australian healthcare context as the number of reported cases of the emergency hospital
admission of the ICN users is increasing as reported by the Commonwealth of Australia.
Thus, establishment of the evidence-based practice will help in improving the service quality
of the ICN patients. The development of the evidence-based practice will help to establish a
standardised training program for the healthcare professionals to handle ICN users.
Location of the study
The study was conducted over the healthcare professionals. The main inclusion
criteria include: experience of handling ICN users under the emergency settings. The
healthcare professionals practicing in urban and rural areas of the New South Wales and
Queensland were recruited as the main target population for the study.
Study settings
The setting is appropriate with the scope of the research. Research aims in
highlighting the experience of the healthcare professionals in handling the ICN patients under
the emergency setting. Thus the main focus group of the study is healthcare professionals
who work in the ED and have experience of handling ICN patients. Healthcare professionals

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working in both urban and rural healthcare settings are selected. Thus the study will help to
establish a comprehensive training manual for both the rural and urban healthcare nurses.
Generalization of the results
The setting is not generalized for wider population. Selection of the sample from the
New South Wales (NSW) and from the Queensland ED limited the overall scope of
generalization of the research result. According to the data reported by the Australian
Institute of Health and Welfare (AIHW) in the year 2017, the majority of the indigenous
population of Australia resides in NSW and Queensland. The verbal and non-verbal
communication approaches for the indigenous population are different from that of the non-
indigenous population. Thus highlighting of the experiences of the healthcare professionals in
NSW and Queensland will help to establish the evidence-based practice guidelines for the
indigenous population. Selecting nurses from the metropolitan cities like Sydney will help in
establishing more generalized approach for handling the ICN users. According to the report
published by the Parliament of Australia (2019) nearly 24,000 people used ICN and majority
of them are 14 years or older. Thus focus must be given towards generalised evidence-based
practice for the ICN patient management irrespective of the indigenous and non-indigenous
origin.
Sampling
Sample appropriate
The selection of the sample is appropriate for the question because it selected nursing
professionals from the both urban and the rural healthcare settings. The exact sample size of
the study is not reported in the methodology section. The study highlighted that selection of
the sample population was done from the Australian College of Mental Health nurses and
through other professional networks until data saturation was obtained. This helped to reduce

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the chances of recruiting the redundant population. However, the paper failed to highlight
whether it used random sampling or non-random sampling for the selection of the target
population. This leads to the generation of the sampling bias. Moreover overall experience of
the nurses was not considered during the sample selection. Nurses having fewer experiences
of handling the ICN patients might not be helpful for the generation of evidence- based
practice guidelines.
Sample size
There was no definite methodology reported to elaborate the procedure of sampling.
Moreover, no specific sample size was stated by the authors thus it can be said that the
sampling procedure is not appropriate and lags significant information.
Methodology
Methodology critique
The scope of the research focused on extracting the experience of the healthcare
professionals on handling the ICN patients. In order to address the research scope, the authors
used semi-structured interview with open ended questionnaire. The interview was conducted
either face-to-face or through telephone. According to the nursing research book written by
Parahoo (2014), the open-ended questions help in extracting the lived experience of the
interviewee. Moreover, the use of the open ended questions help in understanding the
underlying emotions of the interviewee or the underlying thought process and thereby helping
to generate evidence-based practice guidelines. Demographic data, workplace settings were
also considered during the conduction of the interview. This further increased the overall
strength of the study.

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Methodology defined
Methodology is clearly illustrated in the methods section of the research. The
methodology section clearly mentions duration of the interview, mode of interview
(telephonic or verbal), data collection instrument (digital recorder) and data extraction
approach (generation of transcript) used in research. It can be said that discussing the
parameters of the methodology helps in increasing the reliability and validity of the
methodology under the different research settings. Methodology also defined the significant
statements or the excerpts of the interview that was used for the generation of the themes.
However, the study failed to state the list of questionnaire used for the conduction of the
interview.
Limitations of methodology
The research failed to provide desired information about the interviewer and the
person employed to convert the audio file into written transcript format. The methodology
section also fails to report whether or not the generated transcript were verified by the
respective interviewee before they are being used in the research for the generation of
themes. However, the approach of the methodology used for conducting semi-structure
interview format was useful for the research.
Could other methodologies be considered?
No as it is be best approach to understand the experience of the healthcare
professional. DeJonckheere and Vaughn 2019 also reported in favor of the semi-structured
interview for qualitative data analysis in case of generating evidence-based practice.

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Results
Results of the study
Thematic analysis showed that complexcity and intensity of the resources are
important for delivering emergency care of the ICN users. The results also highlighted the
need of thoughtful strategies in order to increase the capacity and capability of the healthcare
professionals for comprehensive care.
Future research recommendation
Many participants have raised the importance of collaborative working in order to
manage the social aspect of the health. Thus further research must be undertaken in order to
justify the validity and importance of collaborative working of the healthcare professionals to
manage patients suffering from the ICN intoxication.
Conclusion and Implications to future practice
The study concluded that complex mental health conditions, challenging situations,
lack of trauma along with support are the barriers behind the comprehensive service delivery
for the ICN. The results also showed that disturbing childhood or physical, sexual or mental
abuse in childhood or untreated emotional pain inflicts the vulnerability of using ICN. Thus
going forward the social life of the people suffering from the ICN intoxication must be taken
under consideration apart from the physical, mental and behavioural health management.
Thus going forward I will take help from the social activist and the mental health
professionals while dealing with the ICN patients. Understanding the emotional and social
aspects that are provoking intoxication will help in generating person-centred care. Overall, I
will make use of the collaborative approach for managing the health of the ICN intoxication.

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References (optional)
Cleary, M., Jackson, D., Woods, C., Kornhaber, R., Sayers, J. & Usher, K., (2017).
Experiences of health professionals caring for people presenting to the emergency
department after taking crystal methamphetamine (“ICE”). Issues in mental health
nursing, 38(1), pp.33-41.
DeJonckheere, M. & Vaughn, L.M., (2019). Semistructured interviewing in primary care
research: a balance of relationship and rigour. Family Medicine and Community
Health, 7(2), p.e000057.