Summative Assignment: Critique of Research Article

The purpose of this paper is to critique a research article. The research

article that is going to be critiqued is the “Impact of Coping Strategies on

Nurses’ Well-Being and Practice”. The problem presented in the report

is occupational stress and burnout that the nurses are confronted with

causing emotional changes associates with stress, suffering, emotional

exhaustion, and poor psychological well-being (Lee, Tzeng, & Chiang,

2018). The investigators has placed the study problem within the

context of existing knowledge. The knowledge placed in the article

reflects the problem from other studies that has been done. There has

been numerous research done on the well-being of nurses related to

their environment. The study does solve a problem relevant to nursing.

The study provides important implications for nursing interventions that

will promote nursing psychological well-being, which can improve

nursing practicing, improving patient safety, and bettering nursing care

outcome (Lee, Tzeng, & Chiang, 2018). The purpose of the study is to

examine the direct and indirect impacts of coping strategies on

psychological well-being, quality of the practice environment, and

patient safety among clinical nurses (Lee, Tzeng, & Chiang, 2018). Literature Review

The concepts explored in the literature review includes how stress can affect the nurse,

the correlation between better work environments and the quality of care or mental health,

positive correlation between quality of practice and patient satisfaction, the correlation between

mental health and quality of care, and the good and bad coping strategies displayed by the nurse

(Lee, Tzeng, & Chiang, 2018). Stress is causing nurses is often resulting in mental illness and

emotional exhaustion. Previous study has shown that nurses that work in better work

environments were associated with better quality of car and increase patient satisfaction, and

they were less likely to give their hospitals poor or failing grades on patient safety (Lee, Tzeng,

& Chiang, 2018). Working better environments include sufficient resources and staffing. Study

has also shown that the nurses’ environment and feelings of being burned out predicted job

outcomes and the quality of nursing care and that emotional exhaustion was a significant

predictor of quality of care provided to the patient (Lee, Tzeng, & Chiang, 2018). Psychosocial

well-being has found to be influenced by stress, and the choice of stress coping mechanism.

There has been bad and good coping strategies that will help with the nurses psychosocial well-

being. Good ways to help cope are problem focused and reflect cognitive and behavioral efforts

Commented [SD1]: In this section be sure you demonstrate the need for the study: nurses’ psychological wellbeing is necessary to prevent burnout and turnover What is the main problem that led the researchers to want to conduct this investigation? E.g. nursing is considered a high stress occupation that left unchecked or unattended to can result in (those things you mention) Was the purpose of the study clearly stated or was it implied and then offer what that was Is the design of this research study appropriate and how so, will it provide empirical evidence (if it’s a quantitative) or insights from the experiences of nurses (if its qualitative)

Commented [SD2]: Nurses’

Commented [SD3]: Too many sentences begin with the word “The” giving the appearance and sound of a question answer format

Commented [SD4]: In the Literature Review section were the studies mentioned relevant to the problem and then summarize that; was there a good range of and scope of ideas, opinions and points of view relevant to the problem? For example, several studies mentioned by the Authors reflect the negative correlation of nurse stress and work environments, quality of patient care, and nurse mental health Was the review, in your opinion, well organized, provide for a brief critical appraisal of each study in the lit review and did this section of the article conclude with a summary of the literature with implications for the study the researcher has decided to undertake (include brief support for your opinion with the info you have to the left)

Commented [SD5]: And to whom—patient or nurse?

to master or resolve life stressors and a bad way to cope would be avoidance which has been

related to mood disturbances. (Lee, Tzeng, & Chiang, 2018). The references range in date but

most of them are pretty current to the article and are well documented. The resources used in this

article is used to support the impact that stress and work environment has on nursing

psychological well-being and how it is interfering with their quality of work.

Theoretical Framework

The framework has been made clear in the research article and is related to the research

article. As stated in the article the conceptual framework is based on positive psychology,

according to which individual traits such as resilience, psychological well-being, and a positive

work environment can lead to the expression of positive emotions, improved nursing

performance, and promotion of perceived positive safety attitudes (Lee, Tzeng, & Chiang, 2018).

The research article draws on theory from other disciplines. Nursing theories usually define the

nursing scope of practice but in this article the theory is based on other disciplines. Nursing

theory is present in the article but it is also based on patient satisfaction, quality of care, the work

environment, coping strategies, and the mental health of the nurses.

Variables/Hypotheses/Questions/Assumptions

The dependent variable is the respondents. The independent variable are the survey

questions, the incentives, and the environment that the surveys are done in. The operational

definitions of the variables are given. The operational definitions for the dependent variable

include age, gender, marital status, education level, years of nursing experience, number of

children, and work unit. Another operational definition are the questionnaires used to get the

nurses feedback on topic. There is not a research question or hypothesis stated. The aim of the

study is to examine ways nurses can cope.

Methodology

In this study the quantitative design is used. The quantitative designs is used to examine

relationship among variables are categorized experimental or nonexperimental (Schmidt &

Brown, 2019). Experimental designs are used for the purposes of examining causality while

nonexperimental designs can be used for the purposes of describing a phenomenon in detail,

explaining relationships and differences among variables, and predicting relationships and

differences among variables (Schmidt & Brown, 2019). The type is a cross-sectional design

which is a nonexperimental design used to gather data from a group of subjects at only one point

in time (Schmidt & Brown, 2019). Deductive reasoning is used here. Surveys are commonly

used to test a hypothesis, which makes it deductive reasoning. The original sample size is 1,500

registered clinical nurse with 3 or months or more working experience. The sample method used

was a power analysis performed using a sample size calculator for structural equation indicating

that at least 296 participants would be required to assure statistical power of > .80, with α < .05

and a small effect size (Lee, Tzeng, & Chiang, 2018). After review and approval by the

hospital’s ethics committee, 500 nurse were randomly sampled and contacted between July and

October 2015. The nurses were from a medical center with 1,350 beds in Taipei City, Taiwan. Of

500 nurses, 474 filled out the questionnaire which is the sample method. The nurses were to

Commented [SD6]: This is where you want to link the theory concepts to the study variables (if this is a quantitative study). At the least you need to explain the theory, nursing or not. If a nursing theory was not used, what is an appropriate one that could have been used? Why? Are there any definitions of concepts or how variables will be measured? If so, include in this section; would Sister cellist Roy’s adaptation Model be a fit and why?

Commented [SD7]: This area definitely needs to be strengthened. If this is a qualitative research study, there will be no starting hypothesis or variables. If it a quantitative study there will be. Remember back to your PICOT question. Are not the nurses your population? Operational definitions are definitions that explicitly state how the variable will be measured or operationalized— what you have here are merely the demographics of the nurses and the questionnaire is the instrument to collect and measure data Conceptual definitions (that would be included in the above section) are the definitions of the concepts contained in the theory being used The Independent variable (by looking at the title which we often do) the nurses’ coping strategies and the dependent variable is the nurses’ well-being Above you mention hypothesis and variables—I did look up and see this is a quantitative study so there should be –they are not always clearly stated and that can be something you state at the end as a limitation of this study At a minimum the research question is implied: Does nurses’’ coping strategies impact their well-being?

Commented [SD8]:

Commented [SD9]: Is this research approach (cross sectional design) appropriate and why Deductive reasoning is that which moves from the general to the particular—researchers use a theory to help them reason out a hunch (hypothesis). For example, if the researcher believes that coping strategies affect nurse well- being then the researcher could deduce poor coping strategies would result in lack of well-being Surveys are the research instruments used to collect the data—is the questionnaire an appropriate instrument for this type of study and why? Is the instrument described in terms of content, structure, validity and reliability so that the researcher can have confidence in the data collected for analysis, testing and interpretation ...

complete their survey in their free time after work. The sample included mostly single women

ranging from 20 to 59 years of age. They all had an education of at least a bachelor’s degree and

one third of them reported less than 2 years of nursing experience and most of them worked on a

medical surgical ward. The investigator choose a probability sampling which involves random

selection and calculating the odds. Every element in the accessible population has an equal

chance of being selected for inclusion in the study (Schmidt & Brown, 2019). The type of

validity used is the statistical conclusion validity in which the degree that the results of the

statistical analysis reflects the true relationship between the independent and dependent variables

(Schmidt & Brown, 2019). Reliability??. Ethical consideration were addressed. All participants

signed a consent form and to maintain anonymity, the participants were asked to drop the

consent form and questionnaire respectively into two separate boxes located at the front door of

the department of nursing (Lee, Tzeng, & Chiang, 2018). The study was reviewed and approved

by the Institutional Review Board of Tri-Service General Hospital (Lee, Tzeng, & Chiang,

2018).

Data Analysis

The tool used to analysis the data is the structural equation modeling which investigates

latent variables with multiple indicators and provides unbiased estimates of mediation and

suppression effects (Lee, Tzeng, & Chiang, 2018). It is an inclusive statistical approach for

testing the correlations in the path model and the measurement model simultaneously and this

model may provide more accurate estimates than a hierarchical regression approach of the

mediating effects when latent variables are modeled (Lee, Tzeng, & Chiang, 2018). The results

were presented through models used to find correlations between coping strategies,

environmental factors, and psychological well-being. These models included the psychological

well-being scale, the practice environment scale of the nursing work index, the safety attitude

questionnaire, and the brief COPE inventory. One of the findings from the research showed that

psychological well-being is directly associated with quality of nurses’ practice environments and

safety attitudes (Lee, Tzeng, & Chiang, 2018).

Summary and Conclusions

Strengths of the study is that the researcher were able to get responses form the nursing

workers themselves. This allowed it to be versatile because different nurses from all age groups

and experience were able to fill out these forms honestly because they were anonymous. The

study was also cost effective in that only surveys needed to be sent out. Researchers didn’t have

to spend money on more equipment to do the study. The limitations of the study were that the

research on psychological well-being was only cross sectional and not longitudinal so the study

didn’t examine the possible interaction between the nursing practice environment and patient

safety (Lee, Tzeng, & Chiang, 2018). Another limitation is that the participants were mainly

young women which limited the generalization of the findings. The data was also derived

entirely from self-reports measures which made the results subject to limitations associated with

the research methodology (Lee, Tzeng, & Chiang, 2018). In terms of finding researchers cannot

generalize to other populations because of the limitations. Most of these result come from young

women so the input of the men wouldn’t be included. Researchers could generalize the findings

Commented [SD10]: Is the presentation of data clear? Was the method of data analysis selected appropriate? Explain Are the tables, charts and graphs pertinent to help understand the study results and do they enhance what was reported in content of the study (they shouldn’t duplicate one another Are the results based on the data presented? Is the evidence sufficient to draw conclusions: that is, that environment and coping strategies can either positively or negatively impact nurse well being—here you can see why it is important to be able to identify the IV and DV Were the results interpreted in the context of the problem/purpose, hypothesis, and theoretical framework/lit reviewed. The hypothesis is the research question turned into a statement (back in week 1) so…nurses’ environment and coping strategies have an influence on nurse well-being is your research hypothesis; the null hypothesis would be that there is no influence (positive or negative—no effect)

Commented [SD11]: Are the conclusions and generalizations clearly stated and what are they (briefly) Are the limitations of the findings clearly delineated? Do they include what we observed—not a clear hypothesis statement or research question The generalizations the researchers make (if any) are they within the scope of the findings Does the study contribute to nursing knowledge? Think about how important these findings are to preventing nurse burnout, compassion fatigue and turnover… how the findings could be incorporated into a nurse orientation/residency/mentor program especially in new nurses transferring to professional practice or how about the high stress areas of nursing—should we be teaching positive coping strategies

that the psychological well-being does have a correlation with the quality of the environment, but

also most of this is subjective so to generalize it would dismiss others perspective. Also these

findings are based on one medical center, if the study was based on different medical center in

different states then maybe most of the findings would be able to be generalized. The findings

show that the nurses’ psychological well-being is important for nurses who face challenges of

balancing their jobs stress, and patient care outcome without letting their emotional exhaustion

lead to burnout and loss of job retention. The study findings suggest that approach oriented

coping strategies has positive effects on psychological well-being and patient safety whereas,

avoidant coping strategies have the opposite effects (Lee, Tzeng, & Chiang, 2018). These

findings are significant for nursing especially nursing educational interventions because it

promotes nurses’ psychological well-being which can result in better nursing practices, better

nursing practice environment, improved patient safety, and better nursing care outcomes.