Evidence Based Nursing Research: Preventing Influenza in Older Adults

This report provides an analysis of two qualitative studies focused on preventing influenza in individuals aged 60 and over. The first study explores nurses' perceptions of factors influencing influenza vaccination rates among the elderly, using semi-structured interviews to identify barriers and facilitators. The second study is a systematic review examining behavioral factors affecting influenza vaccination, drawing from the Theory of Reasoned Action and the health belief model. For each study, the report discusses the study findings, research type, trustworthiness (credibility, confirmability, dependability, and transferability), and applicability to a potential observational study on nurses mediating vaccination in elderly people. The report concludes that the first study may have limited applicability due to its reliance on past experiences, while the second study's transferability is diminished by the variability in cultural contexts across different studies.

Running head: Evidence Based Nursing Research
Evidence Based Nursing Research
Name of the Student
Name of the University
Author note

1EVIDENCE BASED NURSING RESEARCH
Introduction
The paper deals with the subject of preventing influenza in person aged 60 years and
over. Two qualitative papers are chosen for this purpose and for each paper the study findings,
type of research, author’s establishment of trustworthiness, and applicability of the findings to
the present population is discussed.
First qualitative paper- by Ellen (2017)
In this paper, the author explored the factors perceived by the nurses necessary to hinder
and help the influenza rates among the elderly patients. The study is justified as the influenza
rate is considerably higher in elderly and related mortality. Vaccination for preventing influenza
is considered an effective tool. As per the study findings the prevalent barriers identified by the
nurses are technical considerations, feeling of good health, and side effects of vaccine.
According to the nurses perception the facilitators of influenza vaccine in elderly are ease of
access and encouragement from the health care providers, social media networks, direct
recommendations from the care providers and leading by example.
The author uses semi structured interview for collecting the qualitative data. This method
balances the flexibility of a focused structured ethnography survey and the flexibility of an open
ended interview (Reeves et al., 2015). The interview was focused on the nurses’ view of
facilitators, barriers, and health care providers in vaccinating elderly influenza patients.
The author of the qualitative study has ensured the credibility of the research by sharing
the academic credentials. The author holds P.hD and highlights workplace. It explains the author
has in-depth knowledge and expertise to conduct research in health sector. Moreover, the results

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seem to be believable from the perspective of the nurses, who are the participants of the research
and are justified for data collection as they are caregivers. However, the credibility would have
been high if the nursing population was represented as a whole. The transferability may not be
said to have ensured in this study as the nurses relied on the past experiences and the interviews
were not conducted in the real time. In order to transfer the results to different context, the effect
of the health care team on vaccine rates should be examined directly in real time (Ellen, 2017).
The author has ensured the conformability of the research by checking and rechecking the data.
Two researchers were used for coding each interview and highlighted the taxonomy used.
However, judging the potential bias or distortion would have increased conformability (Kallio et
al., 2016). If the same participants are chosen once again then the there is chance of getting
similar data but new set of nurse group would not replicate the previous data. Representing the
nurse pupation as a whole would and using audit trial can make the results more dependable
(Fernandez et al., 2018).
This study may not be applicable for my study population as I want to conduct
observational study to note experiences of nurses in real time in mediating vaccination in elderly
people.
Second qualitative paper by- Kan & Zhang (2018)
The author explores the behavioural related factors affecting the influenza vaccination
among elderly. For this purpose the author conducts a systematic review and uses framework
derived from the Theory of Reasoned Action and the health belief model. As per the findings the
mediating variables influencing the vaccination behaviour are threat perception, beliefs related to

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side effects, past behavior, recommendations from the health professionals and perceived barrier
such as side effects, financial burden, and transportation cost.
The credibility of the article seems to have decreased as the author did not involve papers
that are in non-English language. Important evidence may have excluded. As most of the data
reviewed is of qualitative nature the causal relationship cannot be drawn (Kan & Zhang, 2018).
No eligibility assessment was conducted before excluding the inaccessible full texts or the poor
quality studies. However, reliability is ensured as the quality assessment of the selected study
was conducted using STROBE and CASP checklist and presented as table. Conformability is
inured owing to the relevancy of relevant studies and less excluded studies. Dependability is
minimized as the papers selected have participants from different parts of world and the culture
reflected may vary. Results from systematic review cannot be directly transferred to experiences
of health care services in other regions of world (Bowling, 2014). Hence, transferability in
systematic review is diminished. Overall trustworthy analysis is difficult in systematic review as
different studies as different aims (Holm & Severinsson, 2013).
The study I believe may not be applicable to my research on elderly patients for
preventing influenza as despite publish of large number of systematic reviews there is lack of
consideration of information related to applicability of results (Ahmad et al., 2010).

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References
Ahmad, N., Boutron, I., Dechartres, A., Durieux, P., & Ravaud, P. (2010). Applicability and
generalisability of the results of systematic reviews to public health practice and policy: a
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Bowling, A. (2014). Research methods in health: investigating health and health services.
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Ellen, M. (2017). Factors that influence influenza vaccination rates among the elderly: nurses’
perspectives. Journal of nursing management.
Fernandez, R., Sheppard-Law, S., Curtis, S., Bancroft, J., & Smith, W. (2018). Exploring the
experiences of neophyte nurse mentors: A qualitative study. Nurse education in
practice, 29, 76-81.
Holm, A. L., & Severinsson, E. (2013). A qualitative systematic review of older persons’
perceptions of health, ill health, and their community health care needs. Nursing research
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Kallio, H., Pietilä, A. M., Johnson, M., & Kangasniemi, M. (2016). Systematic methodological
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Kan, T., & Zhang, J. (2018). Factors influencing seasonal influenza vaccination behaviour
among elderly people: a systematic review. Public Health, 156, 67-78.

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Reeves, S., McMillan, S. E., Kachan, N., Paradis, E., Leslie, M., & Kitto, S. (2015).
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