Research Critiques and PICOT Statement Final Draft

03/15/2020

Qualitative Research Critique

With smoking being recognized as the greatest cause of preventable deaths globally, various studies have been conducted to evaluate the effectiveness of possible interventions. One of the most common interventions is nicotine substitution treatment, which basically entails the replacement of the nicotine from tobacco as a way of reducing the urge to smoke and, at the same time controlling withdrawal symptoms. There are different qualitative researches that evaluate the effectiveness of nicotine substitution treatment (NST). In answering the PICOT question, it is essential to assess this existing literature. It will help in understanding if and why nicotine substitution treatment is a more effective approach as compared to other approaches such as counseling in reducing smoking among cigarette smokers aged 17 years above. This comprehension is crucial for evidence-based practice in managing smoking among the population. The purpose of this paper will be to critique two qualitative research artciles related to…

PICOT Question: In cigarette smokers whose ages are more than 17 years (P), does nicotine substitution treatment (I), as opposed to utilizing other smoking discontinuation treatments (C) influence smoking end results (O) over a time of a quarter of a year (T)?

Background of Study

Two examples of qualitative studies that can be applied in answering the PICOT question are Nicotine Replacement Therapy: An Overview by Wadgave and Nagesh (2016), and A systematic review and meta-evaluation of adolescent smoking cessation intervention that utilized nicotine replacement therapy (NRT) by King, Pomeranz, and Merten (2018). In the first study, the researchers summarize the literature on different forms of the current nicotine substitution therapy methods to come up with an overview of possible interventions to treat the smoking disorder. In the second study, the researchers review different completed intervention studies, so as to determine the quality of smoking cessation using NRT and determine how the intervention can be improved. The interventions studied in these two pieces of research are similar to the intervention in the PICOT statement. Therefore, these two studies will not only help in answering whether nicotine substitution therapy influence smoking end results, but also suggests opportunities on how the NST therapy can be improved for effective treating of the identified population. Comment by ESC: Neither of these articles are qualitative design; one is a systematic review and the other a scholarly paper Comment by ESC: Incomplete presentation of background Background of study, including problem, significance to nursing, purpose, objective, and research questions, is thorough with substantial relevant details and extensive explanation.

Method of Study Comment by ESC: Incomplete; review grading rubric for the criteria for this section of the paper

The two studies used a slightly different approach to coming up with their deductions. Wadgave and Nagesh (2016) perform a literature review into drawing their conclusions. The authors drew articles from electronic database PubMed, on various updates in the field of NRT, ranging from January 1990 to May 2015. These articles included systematic review, comparative studies, narrative reviews, reports, and guidelines of international health agencies, and clinical trials. The advantage of this method is that it is simple, while its disadvantage is the generalization of the population. Comment by ESC: Not qualitative design Comment by ESC: Identify the type of qualitative design of each study: 1) phenomenology 2) ethnography 3) grounded theory 4) case study

On the other hand, the researchers of the second article conducted a systematic review and meta-analysis to analyze the methodological quality of interventions using NRT for stopping smoking (King, Pomeranz & Merten, 2016). Under the systematic review, the researcher applied the matrix method. Unlike in the first study, in addition to PubMed, the researchers in the second study used EBSCOhost, ERIC, and ProQuest hence increasing the range of included researches (King, Pomeranz & Merten, 2016). Also, unlike in the first study where the key search phrase was nicotine replacement therapy, the other research used a more specific key phrase, defining the population of interest as youths or adolescents. This specificity relates to the population in the PICOT statement. A major challenge of this method is time unconscious. Comment by ESC: Not qualitative

Results of Studies Comment by ESC: Qualitative results will be noted as common themes Qualitative Results – Themes For qualitative research, the findings are reporting by presenting the common themes of the analyzed transcribed data. Make sure to provide this info in the Week 5 paper, see attachment for additional feedback about themes http://designresearchtechniques.com/casestudies/thematic-analysis/

Currently, among the most common nicotine replacement methods are transdermal patch, gum, nasal spray, oral inhaler, and tablet. They basically help to relieve the craving of nicotine (Wadgave & Nagesh, 2016). While their effectiveness varies, they are more effectual than other interventions such as behavioral intervention. As a way of even making them more effective, there are various approaches undertaken to improve their delivery. These approaches include e-cigarette or electronic nicotine delivery systems (ENDS), high does nicotine patches, and rapid release gum (Wadgave & Nagesh, 2016). This NRT based therapy can be improved through nicotine preloading, true pulmonary inhaler, and nicotine vaccine (Wadgave & Nagesh, 2016). A major setback for this approach is due to misinformation as well as inadequate information among the patients hence poor compliance. Using this knowledge, nurses can use it to provide evidence-based practices in the management and therapy of smokers. While nicotine substitution is a very effective approach, nurses should consider the specific methods as well as the delivery.

Similarly, the second study identified NRT as a very effective approach to reducing smoking among adolescents and youths. The researchers also found that this method was more appropriate for the population. While adolescents show different smoking habits from adults, addiction is possible even to the less consistent smokers (King, Pomeranz & Merten, 2016). Therefore, a modifiable version would be much applicable to youths for use. The authors also noted inadequate interventions, including adolescents. This implied that NRT alone is not sufficient for cessation. An intervention environment is vital for increased efficiency of nicotine replacement therapy among youths (King, Pomeranz & Merten, 2016). As nurses seek to help improve the population to make health decisions, they can use this approach to help reduce smoking among young adults aged above 17years. However, to make this approach more effective, it is essential to include the patients (smokers seeking to quit) decisions in their treatment. As a way of advocacy, there is also a need for more research in the field so as to get a better understanding of the efficacy of nicotine replacement treatment in adolescents.

Ethical Considerations Comment by ESC: Ethical Principles Principles of research ethics PRINCIPLE ONE: Minimizing the risk of harm. PRINCIPLE TWO: Obtaining informed consent. PRINCIPLE THREE: Protecting anonymity and confidentiality. PRINCIPLE FOUR: Avoiding deceptive practices. PRINCIPLE FIVE: Providing the right to withdraw.

While conducting research, it is essential to consider ethical issues. Two examples of ethical considerations when conducting the study are the skills of the authors as well as researcher role conflict. During a study, the researcher should exhibit high competence in the field. The research should carefully choose the method of data collection, ensuring high validity and reliability, while at the same time considering all other ethical issues. In instances where there is inadequate information, the researcher must clearly state. Under the second example of the ethical problems, researcher role conflict calls for nurse researchers' interests not to prevail the interests of social science. This will not only help in addressing other ethical dilemmas but also ensure that the quality of research provided does not compromise the quality of the practices. Comment by ESC: In-text citation needed In your paper, you often referred to as Article 1 and 2 but had two of each this is confusing. Better to refer to by author or in text citation so it is clear to which source you are referring to.

In these two studies, the authors successfully addressed these two ethical concerns. The researchers did choose not only effective methods in their respective studies but also included their professional qualification information. Additionally, where there was inadequate data, the researchers clearly indicated. While the first study did not declare the authors' conflict of interest, the second study clearly stated that the authors did not have any conflict of interest. Comment by ESC: Citations needed to support this section

Conclusion – not provided

References

King, J., Pomeranz, J., & Merten, J. (2016). A systematic review and meta-evaluation of adolescent smoking cessation interventions that utilized nicotine replacement therapy. Addictive Behaviors, 52, 39-45. doi: 10.1016/j.addbeh.2015.08.007 Comment by ESC: Not a qualitative article; plus systematic not acceptable as noted from the Wk 1 instructions

Wadgave, U., & Nagesh, L. (2016). Nicotine Replacement Therapy: An Overview. International journal of health sciences, 10(3), 425–435. Comment by ESC: Nota qualitative research article; scholarly paper