Critical Appraisal of Research: Nursing Practice and Opioid Abuse

This assignment involves a critical appraisal of two research articles, one qualitative and one quantitative, focusing on nursing practice. The qualitative article explores undergraduate nursing students' experiences with patients with opioid use disorder, assessing the background, literature review, data analysis, sampling technique, and ethical considerations. The appraisal identifies strengths such as identifying key themes and limitations like abrupt transitions. The quantitative article examines motivational interviewing training for prescription opioid abuse among older adults, evaluating the background, literature review, data analysis, design, sampling, and ethical aspects. Strengths include the use of a three-pronged educational strategy, while limitations involve gender disparity. Both appraisals contribute to understanding the importance of experience, empathy, and non-judgmental approaches in nursing practice, particularly in the context of opioid abuse. Desklib provides similar past papers and solved assignments for students.

Running Head: NURSING
NURSING
Name of the Student
Name of the University
Authors Note

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PART A – Qualitative article critical appraisal
Article: Lewis, L. F., & Jarvis, L. (2019). Undergraduate nursing students' experiences and
attitudes towards working with patients with opioid use disorder in the clinical setting: A
qualitative content analysis. Nurse education today, 73, 17-22.
RESPONSE TO QUESTION 1
The background of the study provides a through fact oriented analysis and evidence to
the various barriers and challenges that a young and inexperienced nursing student comes
across while caring for patient who has psychosocial disorders of opioid abuse. The various
problems with the attitude of the nurse have been considered to having the negative
implications with respect to the caring experiences of the patients with opioid use disorder
(Lewis & Jarvis, 2019). Although, the right evidences has been used to explain the impact of
psychosocial disorder such as opioid use disorder in the population of United States, very less
has been described about the nursing student’s negative experiences or the problems with
perceptions which should have been used more extensively in this background section
(Arthur, 2019). The background of the research study transitions very abruptly to the purpose
of the study.
The research of the study has used the scholarly electronic databases such as
CINAHL, PUBMED has been used to search the scholarly articles that have been used
properly and comprehensively in the literature review section to understand the gaps in the
scholarly literature. The articles used in the review of literature was peer reviewed, was in
English language and was in the range of last seven years were used in the research which
makes the literature review section valid, reliable and purposeful as well. However, more
articles from the last five years could have been used in order to understand the more critical
problems with respect to the nursing student’s negative attitudes and experiences with the

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patients who have opioid use disorder as well. The conclusion of the literature review
mention misinformation, social stigmas causing the improper care is and the actual review
areas discusses about the nursing students low esteem for the addicted patients and negative
biases that are mostly responsible for the various psychosocial issues and conflicts that arises
between the nursing students and the patients. The researcher covers a lot of information but
the researcher does not clearly mentions the gap here.
Krippendorff's method has been used for analysis of the content and it is critical to
note the method used here, is highly appropriate in identifying the vital and the critical
themes that were revealed by the researchers to understand the exact issues. The researcher of
the study contributes to the knowledge extensively in this section by finding out the crucial
themes which were first the presence of ethical dilemmas in the nursing students led to
various complications in the opioid use disorder patient care. The researcher soon after
identifying the exact issue reveals the solution to same and identifies a facilitator to the
conflict resolution in the nursing students. Growing experience of the students with time was
identified as a facilitator and gaining practical pragmatic experience was identified as another
critical theme that added to the elaboration of the research analysis and finding. Lastly, the
data analysis method also finds out another critical theme as the very difference between bias
and stigma as an important learning in the nursing students. Hence, the data analysis using
the right clustering technique to find these themes was purposeful, critical and important as
well.
In the sampling technique, a purposeful sampling technique was used that added to
the quality of the research and saved time and expenditure as well. The eleven graduate
nursing students were selected from the university and then by the use of semi structured
interview as a qualitative method of data collection, the data was collected. It is exactly
appropriate that the views, perceptions, insights, judgements and decision making skills and

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experiences are explored by the participants properly through their own reflections and an
open ended questioning technique that is used in the semi structured interviews are just the
right and the accurate ways to allow the exact and the hidden thoughts of the nursing students
to be revealed freely without any blocks (Surmaitis et al., 2018).
RESPONSE TO QUESTION 2
The evidence presented in each of the four areas of the journal article are peer
reviewed, scholarly and the evidences coherently supports the research outcomes in a very
detailed and positive manner as well. The insights that were drawn in the four areas provides
a substantial base for the future scientific research in the same area.
RESPONSE TO QUESTION 3
The ethical considerations in regards to protection of the human subjects have been
addressed imperatively by the researchers of the study. A nursing student, who was aptly
trained, conducted the interviews of the participants only and this prevented any response
bias or chances of coercion. This also addressed the cultural consideration. Moreover, it was
made very clear that the grades of the students would not be impacted if they participated in
this study and hence, the ethical considerations of beneficence, non-maleficence, autonomy
were maintained. An informed content was taken from each participant.
RESPONSE TO QUESTION 4
The one strength of the research was that it identified all the right and the correct
themes that provided the right implications for the higher and future researches and
contributed to the knowledge base. The limitation was that the background and the transitions
were too abrupt and digressive at times.
RESPONSE TO QUESTION 5

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The evidences in the research add to the knowledge pertaining to importance of
growing nursing experience, use of empathy, addressing the patient with esteem and without
any biases, the difference between the biases and the social stigmas and the importance of
having a non-judgemental approach towards the patient with opioid use informs the nursing
practice.
PART B – Quantitative article critical appraisal
Article name: Chang, Y. P., Cassalia, J., Warunek, M., & Scherer, Y. (2019). Motivational
interviewing training with standardized patient simulation for prescription opioid abuse
among older adults. Perspectives in psychiatric care, 55(4), 681-689.
RESPONSE TO QUESTION 1
The background section used in this quantitative research study contains a lot of
information about the increasing opioid drug abuse among the elderly people in United States
of America and the researcher of the study puts a significant logical flow starting from the
factors affecting the use of opioids in the chronic pain management of elderly to the non-
medical use of opioids by the elderly that leads to abuse and the impact of motivational
interviewing techniques by the doctorate nursing students for the enhancement of behavioural
outcomes of the opioid abuse patient through intrinsic motivation (Chang et al., 2019). The
background also discusses about the cardiovascular and neuropsychological risks that affects
the psychosocial addictions of the elderly people in a more adverse manner and the researcher
puts all the imperative information to set the pace of the study.
As for literature review, all the articles that has been used are scholarly, peer reviewed
and also the fact that current articles has been used to support them contributes to validity and
reliability of the research.

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In the data analysis section, the descriptive statistics were used to find out the exact
combinations of age, gender and experiences required to interview the substance abuse
patient with a greater use and to a more accurate effect in relation to the positive outcomes
and an elaborate analysis was performed by the research to add more purpose and more
meanings to the findings.
In the design and sampling section, the one‐group design (pretest‐posttest) was used.
That fact that convenience sampling was used added the pace and cost effectiveness to the
research and more focus could be given to the training of the students while preparing them
for participation in the research (Carr, 2017). As for sampling, thirty one enrolled students
from the bachelor level to the doctorate level nursing education were selected as participants
who undertook the vital Motivational Interviewing related education including a role playing
exercise, standardized patient stimulation and a didactic lecture as well added to the quality,
effectiveness and fluency of the study (Rosenthal et al., 2018). The data was collected
through a demographic survey that included various vital factors such as age, expertise and
the specialization of the nurse, sex, the years of expertise and work experience regarding the
opioid abuse patients and these attributed to the holistic and complete multi-level
perspectives that the study was about to explore and quantify (Martino et al., 2019).
RESPONSE TO QUESTION 2
The evidences used in the four parts of the research article were valid, reliable and
trustworthy and were found be congruent with the outcomes of the research. The evidence
did provide the right implications to continue with the further research.
RESPONSE TO QUESTION 3

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The ethical considerations pertaining to the protection of the human subjects were
maintained as because the motivational interviewing education along with standardized
patient simulation, didactic lecture and the role play exercise improved the skills, knowledge
and the perception of the students (beneficence) and an informed content was taken from the
participants (autonomy). To order to guide and secure the subjects, an expert panel of
educators and mental health and family health professionals were involved in the
standardized patient simulation settings. As for cultural consideration, the study exclusively
demonstrates equity amongst the nurses of different genders, of different expertise and
professions and of different experiences by helping them benefit equally from the
motivational education program.
RESPONSE TO QUESTION 4
The strength of the study was that it used a three educational strategy to educate the
doctorate of nursing professionals that helped all of them in gain the necessary interviewing
skills in the clinical management of opioid abuse patients. The limitation was that there was
huge disparity in the gender ratio that can be seen as a bias.
RESPONSE TO QUESTION 5
The clinical skills pertaining to the role playing, correct ways of motivating,
maintaining the right body language and troubleshooting in an appropriate motivational
interviewing of opioid abuse patients - was understood and this pertinently informed the
nursing practice.

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References
Arthur, J. A., Reddy, A., Smith, U., Hui, D., Park, M., Liu, D., ... & Bruera, E. (2019).
Practices and perceptions regarding intravenous opioid infusion and cancer pain
management. Cancer, 125(21), 3882-3889.
Carr, D. D. (2017). Motivational interviewing supports patient centered-care and
communication. Journal of the New York State Nurses Association, 45(1), 39-43.
Chang, Y. P., Cassalia, J., Warunek, M., & Scherer, Y. (2019). Motivational interviewing
training with standardized patient simulation for prescription opioid abuse among
older adults. Perspectives in psychiatric care, 55(4), 681-689.
Lewis, L. F., & Jarvis, L. (2019). Undergraduate nursing students' experiences and attitudes
towards working with patients with opioid use disorder in the clinical setting: A
qualitative content analysis. Nurse education today, 73, 17-22.
Martino, S., Zimbrean, P., Forray, A., Kaufman, J. S., Desan, P. H., Olmstead, T. A., ... &
Yonkers, K. A. (2019). Implementing Motivational Interviewing for Substance
Misuse on Medical Inpatient Units: a Randomized Controlled Trial. Journal of
general internal medicine, 34(11), 2520-2529.
Rosenthal, L. D., Barnes, C., Aagaard, L., Cook, P., & Weber, M. (2018). Initiating SBIRT,
alcohol, and opioid training for nurses employed on an inpatient medical-surgical
unit: a quality improvement project. Medsurg Nursing, 27(4), 227-230.
Surmaitis, R. M., Amaducci, A., Henry, K., Jong, M., Kiernan, E. A., Kincaid, H., ... & Katz,
K. D. (2018). Perception and practice among emergency medicine health care
providers regarding discharging patients after opioid administration. Clinical
therapeutics, 40(2), 214-223.

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