Purpose of the Study
Williams, Eilers, Heermann and Smith (2012) conducted a study to determine:
“The lived experiences of parents and guardians as they prepared for and provided post-discharge care to a child who received an isolated intestine or a liver/intestinal transplant and to assess the impact of transplants on parents’ stress levels.”
From the abstract and the introduction, one can clearly understand the objective of the study and thus follow through to the rest of the sections. The authors have also provided sufficient background to the study purpose by describing the prevalence rates for the targeted pediatric conditions, giving details about expectations and impacts of caring for such children on the patients. According to the authors, the study purpose is worth pursuing given that many parents and guardians still seek healthcare for the children who have to undergo isolated intestine or liver transplants, outside their home towns. Because of the financial and social pressures that the parents undergo as a result of the transformation, they are vulnerable to increasing stress levels and some even end up with post-traumatic stress disorder.
In the study, the authors have not clearly distinguished the literature review section from the other sections of the paper. However, an exploration of extant literatures has been conducted in the section labeled as the background of the problem. The background begins from an exploration of the symptom under consideration, which is parental stress where children have to undergo isolated intestinal or liver transplant. Through the background section, the authors conduct an extensive literature review. Most of the past literatures used in the section are credible, valid and potentially accurate as they were obtained from peer reviewed journals, have the support of other pieces of literatures and provide sufficient qualitative and quantitative information based on the study theme. Based on the focus maintained by the authors in literature selection for the study, it can be concluded that the authors provided strong evidential support for the study problem.
The study methods have been clearly described by the authors, giving the impression that one can easily repeat the study. To ensure that the rights and welfare of the research subjects in the study were respected in accordance with the federal regulations, the authors had the study design approved by the institutional review board. Additionally, no one was forced to participate in the surveys. Rather, an invitation letter was mailed to all the potential participants along with a consent form where they were to sign and confirm that they were made aware of the research and would willingly participate. The authors have provided this information and confirmed that all those who participated had given their informed consent prior to the call for the actual interviews.
There are various approaches attributed to qualitative research. Approaches such as interviews, surveys, focus groups and observations are classified as qualitative research methods, in which data collection processes are conducted with the direct input of participants who have experienced the phenomenon under study (Houser, 2015). The qualitative approach therefore, is recommended in scenarios where the study is exploratory, comparative, argumentative, or on any other basis that requires the input of participants either actively or passively. In the current research, Williams et al. used a qualitative approach based on an interview technique. The approach has been extensively described in the paper including sampling methodologies, the research tool, ethical considerations in subject treatment and the results of the interviews. Through the descriptions given, the exercise conducted is quite clear and thus repeatable.
Population and Sample
The initial letters for informed consent were mailed to 39 individuals. The authors received responses from only 7 of the 39. Eventually, interviews were conducted in only five subjects. The subjects were all parents and/ or guardians of children who had undergone different types of organ transplant. The major focus was on parents whose children had undergone liver and small bowel transplants. In most cases, the actual number of interviews required in qualitative research to reach data saturation is difficult to quantify. Accordingly, Fusch and Ness (2015) posited that the researcher only takes what he is able to get from the interview invitations. As such, it can be concluded that Williams et al. also utilized all the participants they were able to access.
Data Collection and Measurement
Data collection in qualitative research requires the consideration of various research characteristics and the objective of the research. The type of targeted research also influences the choice of data collection methods. Houser (2015) describes various data collection methods in qualitative research including observation techniques, interviews, surveys and focus groups. Each of these methods is suitable for a particular population sample and has its strengths and weaknesses. For instance, interviews are used where the participants have a particular experience, are likely to give a specific perspective to the study report and/ or have played a specific role in the phenomenon under study (Houser, 2015). In the study by Williams et al., the characteristics of participants are described namely, that they have had children who underwent small bowel and/ or intestinal transplants. The targeted patients had unique experiences in taking care of those children and were able to give a specific perspective of caring for such patients in terms of stress levels. The description of the interview technique as given by the authors therefore fits that given by Houser (2015).
Results: Data Analysis and Rigor
There are two different approaches to analyzing qualitative data. These approaches include inductive and deductive analyses. The deductive analysis process entails grouping of data based on themes raised from the research objectives. On the other hand, the inductive approach is based on the use of the use of an emergent framework for data grouping. In the study by Williams et al., research objectives were not classified into themes. Instead, an emergent framework based on the background to the problem and the interview responses was used. The authors therefore utilized an inductive approach to research data analysis. In so doing, the correct procedures were used.
The concept of data trustworthiness was not addressed by the authors in the study. However, they mentioned that the only limitation that could be observed in the study is that it was focused on a limited sample population, which made it difficult to determine the applicability of the data to a larger population. Trustworthiness can be attained by using accurate, valid and reliable sources of reference for both primary and secondary data. The data collection process was also confined to the use of interviews; hence the authors could not increase the participant populations through other data collection strategies. Moreover, the authors neither discuss nor utilize triangulation, which is the process of collecting data on the same subject through different approaches.
The authors discussed the findings extensively. While the qualitative data presented was easy to understand, providing a summary table could have helped to understand the findings even further. The only table presented by the authors was the participant summary table.
Discussion: Implications and Recommendations
The study discussion goes into details about the implications of the findings to the care of pediatric patients with conditions requiring intestinal or liver transplants. Through the description provided by the authors, the study has a strong implication on care practice, particularly for the said patients. Nurses and other clinical practitioners ought to understand the impacts of pediatric medical procedures on the patients’ caregivers, and this study provides an excellent starting point. The study is also a pointer towards the focus of future research in pediatric healthcare.
Fusch, P.A. & Ness, L.R. (2015). Are we there yet? Data saturation in qualitative research. The Qualitative Report, 20(9). Retrieved from nsuworks.nova.edu/cgi/viewcontent.cgi?article=2281&context=tqr
Houser, R.A. (2015). Counseling and educational research: Evaluation and application 3rd Ed. Sage Publications.
Williams, L., Eilers, J., Heermann, J. & Smith, K. (2012). The lived experience of parents and guardians providing care for child transplant patients. Progress in Transplantation, 22(4): 393- 402.