Ethical Considerations

8

PART 1 QUALITATIVE RESEARCH CRITIQUE

Part 1 Qualitative Research Critique and Ethical Considerations

Sample Paper

Running head: ASSIGNMENT TITLE HERE

1

Running head: PART 1 QUALITATIVE RESEARCH CRITIQUE

Part 1 Qualitative Research Critique and Ethical Considerations

This is a critique of two qualitative research articles that looks into patients that struggle with mental illness in the minority group and how providers can better serve this population. These articles will look at the how within a minority ethnic group deals with this diagnosis, how it pertains to the nursing practice, what methods are used in the studies, the results from the studies and ethical considerations for this population sector. Many providers find it hard to connect with patients that suffer from mental illness as they cannot understand the rationale behind not taking ones’ medications and the struggles patients deal with on a day to day basis. Health care providers need to have more research to providing answers on how one can help this subset population to have high quality of life and fulfilling lives. There seems to be a disconnect between patients and providers to help one another come to a conclusion as to how to make medication compliance or provide services that are beneficial for both parties. In these studies, researchers are trying to gain insight as to why these barriers exist and how to move towards optimal health.

Background of Study

The first article by Ewart et al (2017), in review look at how Chinese culture manages mental illness, what the problem areas that psychiatrics’ has navigating mental illness within a private practice and public setting health setting. The problem in this study is lack of coverage for mental health within the Chinese healthcare system. This is significant to nursing and health care professionals as the medical world is still down playing the importance of mental illness. People diagnosed with mental illness have shorter lives and poorer physical health, compared to the general population, these health inequities are usually viewed at an individual and clinical level, yet there is little research on the views of mental health consumers on clinical factors in broader contexts (Ewart et al., 2017). The purpose of this study was to look into barriers that patients may face when seeking help for their mental illness. The objective in this study was to gain access to practicing psychiatrics’ and see what their perceived perspective of this situation is for them in the navigation process. The research question in this study what are the major barriers that psychiatrics faces when treating, prescribing medications and insurance issues for their patients.

The second article by Gault et al. (2019), looks at how to develop a better training and education programs for providers serving the minority group helping this population sector become more medication compliant. The research problem for this study BAME (Black, Asian and Minority Ethnics) backgrounds highlight differing cultural beliefs about medication and problems with acknowledging mental health conditions within their communities (Gault, Pelle, & Chambers, 2019). The significance this has related to nursing is ensuring that we as nurses understand how different cultures view mental illness, so that we can provide the best care possible. The purpose of the study is to bring cultural awareness when educating patients with their mental health diagnosis to enhance medication compliance. The objective for this study is “to achieve consensus on content and delivery of an educational intervention for mental health‐care professionals (Gault, Pelle, & Chambers, 2019). The research question for this study is how do you develop better programs tailored towards BAME and their cultural considerations. Excellent discussion of the background information.

Nursing Practice Considerations

Both of these articles look at cultural consideration in the realm of mental health. These articles tie into the PICOT question that was asked in the first assignment as they are looking to identify factors that can enhance or restrict access to care or medication adherence. It is important within the nursing community to understand culture and how situations or things are handled to ensure cultural competence. The interventions used in these are articles are as follows: “extra health‐care training on cultural competence” for the BAME group (Gault, Pelle, & Chambers, 2019), all-inclusive care with actively engaging the patient, looking at barriers that face mentally ill patients, medication compliance and addressing the stigma that surrounds mental illness. Looking at the inventions outline in the first assignment for the PICOT question is well lack luster. In this assignment there was no clear direction but more of statement. When looking at the research studies being compared these are far more concise with the information being presented.

Method of Study

In the study for the BAME group they used a “2‐stage qualitative coding via the software tool NVivo version 11 to analyse transcribed data and to produce the main explanatory categories” (Gault, Pelle, & Chambers, 2019). They used semi-structured interviews to collect the data from 15 participants. For the other research with Chinese culture they used focus group interviews to explore in‐depth opinions of the psychiatrists on the study topic (Sun, Lam, Lam, & Lo, 2017). These studies are very different in the approach that they are looking at the research data, one article looks at how minorities respond to teachings with medication compliance and other looks at research from the perspective of the providers not the patients. The benefits for these methods are very concise in choosing who was to participate in this study. In choosing such a small selective group of people to research and ask questions you are able to find themes and alignments within the study. A limitation for both of these articles is that it does not include a population as a whole, it only chooses those that support the theory in which is being study. be sure to include some information on the population.

Results of Study

The results of these studies provide an insight into a field that has little research to help back the stance in which one researcher takes. In studies like these researchers are able to identify barriers to treatment and prepare solutions to the barriers. The key finding for the BAME group is that this study provides information for ethnic groups that are furnished with education based within their own culture about medications these patients are far more medication complaint. Once this theme was identified as the main source researcher noted “the need to educate students rather than trained professionals was emphasized, suggesting that educational content should be packaged in a contemporary manner (a virtual reality experience) and findings indicated education should focus upon understanding the impact of taking prescribed antipsychotic medication on both SUs and carers” (Gault, Pelle, & Chambers, 2019).

Another valid issue identified in the other study is that “no insurance coverage of mental health problems, patients’ poor compliance of medication, and stigma of seeing psychiatrists were rated as the top barriers” (Sun, Lam, Lam, & Lo, 2017). Psychiatrists also noted that if they did not attach a medical diagnosis to the patients chart in hopes that insurance will cover the cost of the visit and or medications. Another huge finding in this study result is that there just are not enough mental health providers in either arena whether it be public or private sector to handle the patient load in China.

In both studies the nursing implications are far worse than one would have thought. These studies highlight the lack of understanding for patient that are dealing with mental illness and the neglect received from insurance companies to see this as a valid health related issues. It is through continuous education, enforcing positive change behavior towards seeking help for mental illness, and acknowledging the shortage of health care professionals that work in this field. Truly understanding the disease, its function and how to educate your patients with medication compliance is when the full potential is reached not only with health care provider but also for the patient and their families. When all of this is tied together we can see the trend that facilitates health disparities when it is associated with mental illness. These studies have highlighted a section where health care is falling flat in providing care especially for the mentally ill. This information can be used to look at ways to improve the model and provide better care and address insurance inadequacies for this population.

Ethical Considerations

In order to ensure confidentiality researchers must make sure that all participants’ privacy was protected and all participants have a letters of consent that they were willing to partake the research. Researchers also gave letters to participants outlining what the study was exactly about with a letter of consent attached with a small deadline to return the paperwork. Ethical considerations for these specific studies where more so concentrated on treatment but more so on how to provide better care for patients with mental illness. Researchers also provided a sense of neutrality with these studies to avoid potential conflicts of interest thus boosting no ethical issues within the studies.

Conclusion

These studies have highlighted that there is still much to learn when it comes to delivering proper mental health care especially with the barriers that most patients face. A shortage of health care providers, medication compliance and the obstacles that hinder ones’ care. The more research shines a light onto this subject matter the more that we as health care professionals can move forward with better patient outcomes. In these studies, it has shown the gaps that left in mental health care whether it be for the patients or for the providers trying to deliver the care. Researchers have highlighted that more education needs to be given for patients to ensure better medication compliance and to aid the providers in having more education with medication that will reinforce the importance of taking medication. Also identified is a lack of funding from insurance companies wanting to pay out for these services. Providing patients with more resources such a peer groups and one on one therapy will help to elicit better medication compliance moving forward in the future. Could you imagine an insurance company denying a claim related to heart surgery because the patient did not understand the importance of taking the heart medication? Providing more research evidence that mental illness is a true health condition is the only way to help our patients get the proper insurance coverage that need to live long fulfilling lives. If patients are not worried about how they are going to pay for their services or medications, they are able to concentrate on making themselves better.

References

Ewart, S. B., Happell, B., Bocking, J., Platania-Phung, C., Stanton, R., & Scholz, B. (2017). Social and material aspects of life and their impact on the physical health of people diagnosed with mental illness. Health Expectations, 20(5), 984–991. https://doi.org/10.1111/hex.12539

Gault, I., Pelle, J., & Chambers, M. (2019). Co‐production for service improvement: Developing a training programme for mental health professionals to enhance medication adherence in Black, Asian and Minority Ethnic Service Users. Health Expectations, 22(4), 813–823. https://doi.org/10.1111/hex.12936

Sun, K. S., Lam, T. P., Lam, K. F., & Lo, T. L. (2017). Barriers and facilitators for psychiatrists in managing mental health patients in Hong Kong-Impact of Chinese culture and health system. Asia-Pacific Psychiatry, 10(1), e12279. https://doi.org/10.1111/appy.12279