Evaluation of Honey Treatment for Wounds: A Nursing Research Report

This report critically evaluates a nursing research paper exploring older patients' experiences and perceptions of wound treatment using medical-grade honey. The study, employing a qualitative approach with semi-structured interviews and interpretative phenomenological analysis, investigated the lived experiences of patients and their views on honey as a treatment. The report highlights the study's methodology, including participant selection and data collection methods, and analyzes the findings, which revealed both positive outcomes, such as improved wound healing and a sense of comfort, and negative experiences, like stinging sensations and allergic reactions. The report discusses the implications of these findings for clinical practice, emphasizing the need for further research and the importance of considering individual patient experiences when implementing honey-based wound care. The report concludes by acknowledging the non-generalizable nature of qualitative research while suggesting that further studies with different honey dressings could provide a broader comparison of patient perspectives.

Research Methods for
Nursing

Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY..................................................................................................................................1
Critical evaluation of study paper................................................................................................1
Research findings analysis and implications for clinical practice...............................................3
CONCLUSION................................................................................................................................5
REFERENCES................................................................................................................................6

INTRODUCTION
Honey is used by several civilizations to treat wounds since 4000 years. However, after the
discovery of antibiotics, it lost its popularity. But, the healthcare professionals or practitioners
now providing this ancient remedy other look because of the need for economical and effective
products that limit antibiotic resistance and fight infection (Alligood, 2017). This project is based
on an article “Older patients’ experiences and perceptions of having their wounds treated with
medical-grade honey”. It covers critical evaluation of the research paper utilizing Caldwell
critiquing tool.
MAIN BODY
Critical evaluation of study paper
In this project, is critical appraisal performed on the article named as “The experiences of
older patients and perceptions about treatment of wounds with medical grade honey”. This article
was written by Abdul M Seckam and Jenny Mercer, (2018). The purpose of this study is to
critique the article by using Caldwell et al (2005) critiquing tool in order to make sure an
objective and valid approach to the process of critical evaluation. The title of the article
administers clear insights about the content of article. This is a qualitative research based article
in which the population of interest is older patients and the main purpose of article was to
capture as well as explore the perceptions and experiences of older patients of utilizing medical
grade honey in order to treat their wounds. In the abstract section of the paper, the extract of
entire study is summarised and the key elements which are including in the article like aim,
design, outcomes and implications of study (Boswell, and Cannon, 2018). In the article, the
literature review is unclear and not provide detailed information regarding the study area. The
qualitative study in the article is not generalizable, but performance same studies with different
honey dressings as well as other antimicrobial dressings will complement this investigation and
enabling for or general comparisons among the perspectives and experiences of patient. Apart
from this, the large sample size may also enable for exploration of other emerging themes.
This investigation revealed about the complexity of utilising medicated honey for treating
wounds and also outlines the perceptions and experiences of patients. According to the author, it
was projected that the occurrence of individuals with at least single chronic or acute wound is 3.7
out of thousand people, which resulting in up to 3.1 million pounds’ treatment cost per 100000
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individuals in the population. In United Kingdom, wound care is one of the public health
concern. Because of inappropriate and excessive use, antibiotics are becoming ineffective on
wounds or against wound pathogens (Curtis, Comiskey, and Dempsey, 2016). Thus, the interest
has been changed in rediscovery and execution of primeval remedies like honey. This article
emphasizes on the lived know-hows of utilising medical grade honey as well as perceptions
about honey as folkloric medicine. The article provides high quality sign about honey that it
rectifies partial thickness burns speedily in comparison to conventional dressing. The author also
provides adequate quality evidence that it is effective as compared to antibacterial followed by
gauze in order to heal the wounds which are infected after surgical operations (Fawcett and
Ellenbecker, 2015). Honey contains enzymes, carbohydrates, organic acids, amino acids and
vitamins. The medical grade honey has been standardized by filtration, gamma irradiation and
lab controlled situations in order to ensure that it is free from containments. In care of wound,
ancient remedies have been utilized and are being rediscovered now; in specifically, the
utilization of honey. After attaining the age of 65, vulnerability to wounds becomes common
because of diminishing immunity and thinning of epidermis (Bogdanov, Jurendic, Sieber, and
Gallmann, 2008).
In this article, the authors clearly described the rational of the study based on contemporary
semi structured interview from the participants. The author highlighted in the article about a 12-
week study which was conducted on 40 leg ulcer patients who treated with medicated honey.
There is no detailed literature review provided in the article. The author explicitly discusses the
aim of study by conducting a semi-structured interview in order to gain information about lived
experiences of older patients as well as their perceptions about treatment of wounds with medical
grade honey (Frykberg, and Banks, 2015). In conducting the semi-structured interview, the
authors were recruited 6 participants from Lindsey Leg Club. They were conducted semi
structured interview and precise transcriptions were evaluated by utilizing interpretative
phenomenological analysis. In this particular study, two themes were identified by the authors
including experiences of utilising medicated honey and the another is perception of honey as a
medicine with natural folkloric (Seckam, 2019).
The authors discussed some examples in the article and revealed that qualitative researches
have usually deliberated experiences of patient with chronic wound, instead of their experience
regarding treatment. The study mainly focuses on revealing the experiences of people of having
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their wound cured by medicated honey (Gibson and Green, 2013). The authors made use of
phenomenological methodology for conducting that particular study on the topic " experiences
and perceptions of older patients of having their wounds cured with medicated honey". The
general methodological approach in the article is qualitative in nature, which is consistent with
the objective of study. The qualitative research often depends on strong philosophical
investigation background so as to justify the means utilise to gather data or information as well
as to analyse and interpret the outcomes properly within chosen paradigm. However, in
presenting the paper, the authors had discussed less about philosophical stance, which is a
notable limitation. The interpretative phenomenological analysis performed in the study offers an
idiographic analysis, administrating detail explanations of particular meanings that participants
give to their experiences (Gimenes and et. al., 2015).
For accommodate the analysis, small sample size was taken by the author. A double
hermeneutic was acknowledged by interpretative phenomenological analysis where by the
respondents engages in the process which is interpretative when relaying their accounts (Ubbink,
and et. al., 2015). The participants of research and the data collection methods utilised in the
study were discussed appropriately by the researcher. The design of research is based on semi
structured interviews which the authors not particularly justified as an approach. Yet, a semi
structured interview is an appropriate method that enable others for detailed narrative to be
acquired from each individual along with coverage of main topics (Greenlee, and et. al., 2017).
The details about semi structured interview process was not provided in the article, but the
responses of respondents regarding the experiences of utilising medicated honey for the
treatment of wounds are discussed appropriately.
That participants in the study was selected by the authors from Lindsey leg club and their
inclusion in the study was based on completion of key criteria. In the article, the inclusion &
exclusion criteria were discussed. The inclusion criteria of the research were any of the member
of leg club whose wound in the leg had been treated by medicated honey and whose wounds may
have not treated with medicated honey (Grove, and Gray, 2018). The exclusion criteria discussed
in the study were any members who were not able to provide informed consent or the individuals
for whom interacting in English was very much difficult. The participants selected for getting
respond on the topic area are from the age group of 64 to 86 years. Prior to the interview,
informed consent was taken from the respondents by the authors. The author made use of
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participant info sheet and once the participants agreed to participate in investigation, the author is
scheduled convenient time. Before taking each interview, written informed consent was taken by
the authors respondents (Henly, 2015). The conclusion provided in the study paper is not much
comprehensive so the outcomes of study are not clearly presented in the paper.
Research findings analysis and implications for clinical practice
The author asked open ended questions regarding the history of contributors of utilization of
honey on wounds as well as their experiences and reflections regarding treatment. The semi
structured interviews conducted by the author extended from 24 - 45 minutes and were audio
recorded and recorded by first author. At the time of conducting interview the author was
maintained the privacy of participants by protecting their information (Ingham-Broomfield,
2015). By utilizing the guidelines related to interpretative phenomenological analysis, the
transcripts were analysed in the study. From the analysis and findings of the study, it has been
found that according to the respondents, honey is effective in healing the wound. The utilization
of honey dressings assisted in the healing process for patients. Though, not all interviewees had
optimistic experiences. some of the interviewees had a hostile reaction of using honey dressing
and he said that the cure as dreadful. For one of the respondent, a stinging sensation seemed due
to honey dressing. The painful effects of using honey dressing appeared which cause distress
along with the pain suffered (Lazim, and Baharudin, 2017).
By conducting the interview, it has been found that no single antimicrobial dressing is
appropriate for all the type of wounds. Apart from this, 2 other interviewees also reported
allergic reactions as well as related stinging sensation because of honey dressing. These patients
discontinued the treatment of honey. Although, the considered honey to be the marvellous thing
to heal all kinds of things. Initially, it seemed counter intuitive, though, when the records of other
participants were analysed, it became clear to the author that several of them have same
narratives. By analysis it has been found that the way honey was practised by the patients in care
of wound could not be dissociated from the beliefs of people regarding honey in health care
(LoBiondo-Wood, and Haber, 2017). By the semi structured interview, it has been found by the
author that most of the participants considered honey as a usual medicine. The responses of the
interviewees reveal that many people trust on the approach based on nature. According to them,
honey consists of natural medical properties which helps in healing the wounds. Honey consists
of several antiseptic properties due to which it is very effective in treating the wounds. In modern
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day medicine, the knowledge and experience of older person and village experience ladies
provides a sense of credibility for the use of honey (Maruhashi, 2020).
The analysis and findings section of the paper is based on analytical approach and are
presented as series of themes in which authors administers summary of findings from
participants by supporting these with quotations from transcript of interview. For presenting the
qualitative data which are thematic in nature, analytical approach is used commonly and thus
justified (Rathur, and Boulton, 2007). The utilization of quotations enables other persons to
relate the assertions of investigators back to original transcripts, and thereby maximize the
credibility of process of research. The discussion section of the article renders an overview of
main findings of the study and attempts to place those outcomes within wider context of care of
patient. By the overall study presented in the paper, it has been found that the research offers
great insights into the experience of patient of utilizing medicated honey in order to treat the
wounds. It appeared to render a sense of relief and cure which reassured the wound healing
journey of participants. It can be analyzed from the article that being natural honey improve the
sense of comfort (Westra, and et. al., 2017). On contrary to that, some people reported adverse
reaction of honey in terms of stringing sensations. However, some of the participants were
perceived these sensation as an expectation of process of wound healing.
CONCLUSION
As per the above discussed report it can be concluded that qualitative research method is not
generalizable, however performing several similar investigations with different honey and
antimicrobial dressings will complement the investigation and allow more general comparison
among perspectives and experiences of patient. It has been found in the study that, honey is a
natural antimicrobial agent that consists of various medicinal properties that helps in healing the
wounds. The perceptions of patients about the use of honey provided it credibility in modern day
medicine.
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REFERENCES
Books and Journals
Alligood, M.R., 2017. Nursing theorists and their work-e-book. Elsevier Health Sciences.
Bogdanov, S., Jurendic, T., Sieber, R. and Gallmann, P., 2008. Honey for nutrition and health: a
review. Journal of the American College of Nutrition, 27(6), pp.677-689.
Boswell, C. and Cannon, S., 2018. Introduction to nursing research. Jones & Bartlett Learning.
Curtis, E.A., Comiskey, C. and Dempsey, O., 2016. Importance and use of correlational
research. Nurse researcher, 23(6).
Fawcett, J. and Ellenbecker, C.H., 2015. A proposed conceptual model of nursing and population
health. Nursing outlook, 63(3), pp.288-298.
Frykberg, R.G. and Banks, J., 2015. Challenges in the treatment of chronic wounds. Advances in
wound care, 4(9), pp.560-582.
Gibson, S. and Green, J., 2013. Review of patients' experiences with fungating wounds and
associated quality of life. Journal of wound care, 22(5), pp.265-275.
Gimenes, F.R.E., Marck, P.B., Atila, E.G. and Cassiani, S.H.D.B., 2015. Engaging nurses to
strengthen medication safety: fostering and capturing change with restorative
photographic research methods. International journal of nursing practice, 21(6), pp.741-
748.
Greenlee, H., and et. al., 2017. Clinical practice guidelines on the evidence‐based use of
integrative therapies during and after breast cancer treatment. CA: a cancer journal for
clinicians, 67(3), pp.194-232.
Grove, S.K. and Gray, J.R., 2018. Understanding Nursing Research E-Book: Building an
Evidence-Based Practice. Elsevier Health Sciences.
Heinrich, M., Ankli, A., Frei, B., Weimann, C. and Sticher, O., 1998. Medicinal plants in
Mexico: Healers' consensus and cultural importance. Social science & medicine, 47(11),
pp.1859-1871.
Henly, S.J. ed., 2015. Routledge international handbook of advanced quantitative methods in
nursing research. Routledge.
Ingham-Broomfield, R., 2015. A nurses' guide to qualitative research. Australian Journal of
Advanced Nursing, The, 32(3), p.34.
Lazim, N.M. and Baharudin, A., 2017. Honey—A Natural Remedy for Pain Relief.
In Nutritional Modulators of Pain in the Aging Population (pp. 123-134). Academic
Press.
LoBiondo-Wood, G. and Haber, J., 2017. Nursing research-e-book: methods and critical
appraisal for evidence-based practice. Elsevier Health Sciences.
Maruhashi, E., 2020. Honey in Wound Healing. Therapeutic Dressings and Wound Healing
Applications, pp.235-254.
Rathur, H.M. and Boulton, A.J., 2007. The neuropathic diabetic foot. Nature Clinical Practice
Endocrinology & Metabolism, 3(1), pp.14-25.
Seckam, A., 2019. Reflection: patients’ experiences of being treated in a Leg Club setting.
Ubbink, D.T., and et. al., 2015. Evidence-based care of acute wounds: a perspective. Advances
in wound care, 4(5), pp.286-294.
Westra, B.L., and et. al., 2017. Big data science: a literature review of nursing research
exemplars. Nursing Outlook, 65(5), pp.549-561.
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